The effectiveness of drug abuse treatment for clients coerced into care remains controversial. Some studies find clients with legal pressure do better than those without legal pressure, while others report the exact opposite. Opposing views are often fueled by the wide-ranging models that guide delivery of addiction treatment. The present study examined how participants with and without legal pressure to attend treatment responded to a motivational (MET) vs. traditional (TAU) form of addiction treatment. Additionally, the predictive value of the Readiness to Change (RTC) score, from the URICA, was assessed across days of substance use and treatment retention. Legal status was shown to have a significant effect on days of primary substance use per week and treatment retention, regardless of intervention condition. The RTC score was shown not to be predictive of days of primary substance use or treatment retention. Research and clinical implications and future directions are discussed.

To date, low rates of patient compliance have made it impractical to study whether regular exercise can contribute to positive outcomes in women with substance use disorders (SUD). One robust strategy for promoting and maintaining behavior change is contingency management (CM). CM has been used successfully to reinforce drug abstinence, treatment attendance, and other pro-social behaviors. CM delivers incentives (prizes) contingent upon target behaviors, though can be expensive. To reduce costs, CM is often delivered with an escalating variable-ratio schedule, first tested by Petry and colleagues (2005). As a Stage Ib behavioral therapies development project (Rounsaville et al., 2001), the primary aim of the present study was to test the use of behavioral incentives (BI) to promote regular physical activity in a residential SUD treatment setting with cocaine-dependent women. The target was physical activity, which was objectively defined at two levels: 30 minutes of treadmill walking at any pace and treadmill walking at moderate intensity. Specifically, a pilot RCT compared rates of physical activity over a six-week study period in a sample of N = 17 women with Cocaine Dependence. N = 10 were randomized to BI group and n = 7 were placed in the control (C) group. All participants completed baseline assessment, attended a 45-minute health and fitness education class, and were scheduled in exercise sessions three days/week. Those randomized to BI, however, were eligible three days/week, to receive incentives for meeting the target behavior(s). Follow-up assessment occurred at 3-weeks and 6-weeks post-randomization (midpoint and end of intervention), and 4-weeks post-discharge from the residential program. The primary outcome variables (percentage of sessions completed and total time spent in scheduled sessions) were used for effect size estimations, which were then used to perform power analyses so that sample size calculations could be estimated for the design of a Stage II RCT. A significant Group effect demonstrated that the BI group spent a significantly greater number of total minutes in scheduled exercise sessions than the C group. This dissertation provided benchmark data on the utility of BI for promoting physical activity for women with cocaine dependence. These promising findings support the use of BI procedures to promote exercise compliance, which will ultimately allow scientists to better develop SUD programs that directly utilize the mental and physical health benefits of physical activity.

Adolescent dating violence is commonly experienced by adolescents and is associated with a variety of negative outcomes. Stress and coping and social learning theories suggest that dating violence victimization may predict increased substance use and dating violence perpetration. However, few studies have assessed these relations over time, and existing studies have not assessed physical and psychological dating violence victimization separately nor focused on early adolescent populations. The current study addressed these gaps by examining longitudinal relations between physical and psychological dating violence victimization and substance use and physical and psychological dating violence perpetration among early adolescents. The extent to which gender and class norms for dating violence moderated these relations was also examined. Participants included two cohorts of sixth grade students who reported being involved in a dating relationship at Waves 1 and 2 (N = 2,022; 43% female; 52% African American, 21% Latino/a, 20% European American, and 7% other). Analyses utilized a multilevel approach whereby students were represented at Level 1 and classes (scores for students in the same cohort and school; n = 74) at Level 2. Models tested direct effects from Wave 1 psychological and physical victimization to Wave 2 outcomes and the extent to which gender moderated this effect. Models including psychological and physical perpetration also tested cross-level interactions between Level 1 dating violence victimization and Level 2 class norms for dating violence. Key findings indicated that gender moderated relations between physical and psychological victimization and psychological perpetration. High levels of psychological victimization predicted greater change in psychological perpetration for girls as compared to boys and high levels of physical victimization predicted greater change in psychological perpetration for boys as compared to girls. Additionally, physical and psychological victimization significantly predicted changes in substance use. High levels of physical victimization predicted greater change in substance use, whereas high levels of psychological victimization predicted less change in substance use. These findings highlight the need to address dating violence early in middle school, so as to prevent negative outcomes associated with victimization by a dating partner.

This study focuses on the social networks of probationers, who comprise the largest segment of the criminal justice population in the United States, but about whom there are few studies of network processes. It provides information on how elements of a probationer’s social network change over time and can affect drug use. This study employs longitudinal analysis of the social networks for 251 substance abusers on probation to examine how these networks are influenced by an intervention designed to increase pro-social behaviors and how network changes impact drug use. Baseline drug use of the probationers was examined according to the number of substances used in the last 6 months. Blacks were less likely to be polydrug users (aOR: 0.34, 95% CI: 0.14 to 0.84), while those using cocaine or heroin as their primary drug of choice were more likely to be polydrug users (aOR: 3.02, 95% CI: 1.32 to 6.94). Age at first illicit drug use was also significant, with those initiating drug use younger than 18 more likely to be polydrug users (aOR: 2.12, 95% CI: 1.01 to 4.46).The majority of probationers had drug user networks with the same number of persons in them over the 12-month follow-up period (82.5%), and perceived social support that also did not change (76.1%). Men were less likely to change their drug user networks over time and older persons were less likely to have decreasing social support over time. Those with low drug use that have increasing (aOR= 5.08, 95% CI: 1.09 to 23.75) and decreasing (aOR= 6.45, 95% CI: 1.35 to 30.85) drug user networks over time were more likely to be in the lowest drug using group compared to those with stable larger drug user networks. Older persons were less likely to be in the drug use trajectory (aOR=0.96, 95% CI: 0.92 to 0.99), whereas those with high criminal risk were more likely to be in a stable drug use class compared to an increasing drug use class (aOR=2.52, 95% CI: 1.03 to 2.64). The findings of this study indicate that changing the drug using networks of probationers may be difficult, given that most are stable over time and effective interventions to decrease substance use may need to target individual and structural factors, rather than social support and network composition. The finding that smaller networks that do change over time were associated with lower rates of drug use indicates that programs could also focus on mechanisms that determine how and why probationers choose drug using network members. Reducing drug using peers for corrections-involved populations may be difficult, but can lead to lower drug use rates which can also reduce recidivism.

A multidimensional model of associations between domestic violence exposure and risk of violence and prosocial behavior was tested in a sample of Colombian adolescents, with attention to impulsivity and substance use problems as mediators of these associations. A representative sample of 1,152 school youths and a convenience group of 148 juvenile offenders aged 11-19 years was recruited from Medellin, the second largest city in this South American country. Assessment was carried out in classrooms in the school sample and in correctional institutions for juvenile offenders. Structural Equation Modeling (SEM) was utilized to test the conceptually derived models. Similarly, multisample analyses and nested model comparisons were used to explore mediator effects. Results showed strong associations between domestic violence exposure and putative mediators and outcomes, especially among offenders. Though impulsivity and substance use problems mediated the relation between family violence (i.e., exposure to interparental violence) and adolescent maltreatment (i.e., harsh parenting) and violent and prosocial behavior in both groups, impulsivity exerted a greater effect on adjustment among juvenile offenders than their counterparts. Juveniles who reported less ability to inhibit their impulsive responses engaged in more problems related to illicit substance use, violent acts (e.g., carrying weapons at school and in the streets), and less prosocial activities with their peers. Nonetheless, the best model fit indexes were obtained when paths from impulsivity to substance use problems and violent behavior were added to model comparisons. Results are discussed within the framework of Information-Processing theory for understanding pathways to violent and prosocial behavior.

Substance use is a significant problem among middle school students in the United States. Research indicates that the early use of substances increases the likelihood of negative outcomes including long-term use and abuse. Both parenting and peer variables exert strong influences on children's decisions to use or abstain from substances. As children age, peers begin to exert a stronger influence, but parenting practices can significantly reduce peers' harmful influences. In this study, three waves of data (collected at the end of 6th grade, and the beginning and end of 7th grade) from a large multi-site study were used to examine the role of peer deviance as a mediator of the influence of parental monitoring on substance use among an ethnically diverse sample of over 2,500 middle school students. Structural equation modeling was used to examine the longitudinal interrelations among parental monitoring, peer deviance, and substance use among middle school students, and to investigate potential group differences by gender and family structure. The hypotheses that peer deviance and substance use would influence one another over time were upheld. The two variables were interrelated such that peer deviance produced increases in substance use over time, but so too did substance use produce peer deviance over time. The prospective relation between substance use and peer deviance was stronger than the converse relation, suggesting that substance using peers seek one another out. Parental monitoring was associated with decreases in substance use over time, but its influence was small. Parental monitoring was more strongly associated with decreases in peer deviance. However, parental monitoring's effect on substance use was not mediated by peer deviance over these 3 waves in that parental monitoring at Wave 1 did not predict substance use 1 year later. Contrary to hypothesis, substance use was not associated with changes in parental monitoring over time, although peer deviance was associated with less monitoring. In general, parental monitoring was more closely linked to peer deviance than it was to substance use. This study found no convincing evidence to suggest group differences in the overall pattern of findings according to gender or family structure.

The effects of family functioning and tangible support from family members are examined in an opiate addicted population. The study specifically assessed drug use, self-efficacy, and quality of life as treatment outcomes of interest. There have been mixed findings in the literature in regards to how families influence rehabilitation from substance use. Specially, previous research has shown that families can further patients’ recovery, while other findings have shown that families can impede patients’ recovery from substance use. The aim of this study was to analyze potentially contributing factors related to the family system, to gain a stronger understanding of how families influence recovery for patients receiving treatment for their opiate addiction. The study included 110 participants who were patients from a medically assisted recovery facility. The participants took survey measures regarding beliefs about their self-efficacy, quality of life, family functioning, and tangible support received from family members. The participant’s drug use information was verified through facility databases of current urine screens and prescription use. Survey results did not substantiate the hypotheses that tangible support influences treatment outcomes. However, hypotheses that family functioning would positively influence self-efficacy and quality of life were supported. The belief that family functioning would have a negative relationship with the participant’s drug usage was not corroborated by the data, as there was no relationship found between these variables. Finally, there was no moderating relationship observed between family functioning, tangible support, and treatment outcomes. This was contrary to expectations that a moderating relationship would be present. Implications of how the study’s findings can inform research and clinical interventions in an opiate addicted population are discussed.

Research on college student use of caffeine combined with alcohol (CAC) and public health concern over such use has been hampered by the absence of psychometrically sound measures of caffeine and CAC use. The present study examined agreement between survey (CAS) and interview (TLFB) methods for collecting data on caffeine, alcohol and CAC use. Participants were N=50 college students randomized to complete CAS followed by TLFB or the reverse. Qualitative follow-up interviews with N=15 participants were used to identify factors contributing to CAS-TLFB discrepancies. Responses varied by method of administration, with largest discrepancy magnitudes found for CAC, followed by caffeine, then alcohol use. Rates of reporting use by only one method were highest for CAC (65.5%). Lack of knowledge about caffeine was common, with over half (56%) having at least one caffeine misreport. Largest discrepancies were found for CAC use, an area of public health concern, particularly among college students.

Mobbning är ett stort globalt problem som har förekommit länge bland ungdomar. Syftet med denna föreliggande studie är att undersöka hur psykisk hälsa, tobak, alkohol och droganvändning samt föräldrabarnkommunikation relaterar till mobbning. Studien avser att kontrollera bakgrundsvariabler såsom kön, etnicitet och trivsel i området man bor i. Följande frågeställningar formulerades: (a) Finns det något samband mellan psykisk hälsa, tobak, alkohol och droganvändning, föräldrabarnkommunikation och mobbning? (b) Hur relaterar psykisk hälsa, tobak, alkohol och droganvändning, föräldrabarnkommunikation till mobbning samtidigt som kön, etnicitet och trivsel i området man bor i kontrolleras? För att studera detta område har vi använt oss av kvantitativ ansats med material från LoRDIA (Longitudinal Research on Development In Adolescence) studie 2015. I studien ingick det 1324 elever från två små och två medelstora städer i Jönköpings och Västra Götalands län i Sverige. Resultatet indikerar att det finns ett statistiskt signifikant samband mellan mobbning, psykisk hälsa, tobak alkohol och droganvändning, samt föräldrabarnkommunikation. Det mest intressanta resultatet i studien visar att det finns en signifikant skillnad mellan pojkar och flickors mobbningsbeteende och vad som predicerar det. Pojkar är mer involverade i mobbning än flickor och deras mobbningsbeteende prediceras av tobak, alkohol, och droganvändning och föräldrabarnkommunikation samt upplevd trivsel i bostadsområdet medan flickors mobbning relaterar till psykisk hälsa, föräldrabarnkommunikation, etnicitet och upplevd trivsel i området. / Bullying is a major global problem that is prevalent among young people. The aim of the present study is to investigate mental health and tobacco, alcohol and drug use and child disclosure related to bullying. The study intended to verify background variables such as gender, ethnicity and enjoyment of the area one lives in. The following questions were formulated: (a) Is there any connection between mental health, tobacco, alcohol and drug use, child disclosure and bullying? (b) How does bullying relate to mental health, tobacco, alcohol and drug use and child disclosure while controlling for gender, ethnicity and enjoyment of the area? To study this area, we used a quantitative approach with material from the LoRDIA (Longitudinal Research on Development In Adolescence) study in 2015. The study included 1324 students from two small and two medium-sized cities in Jönköping’s and Västra Götaland’s county in southern Sweden. The result indicate that there is a statistically significant relationship between bullying, mental health, tobacco, alcohol and drug use, as well as child disclosure. The most interesting result of the study shows that there is a significant difference between boys and girls bullying behavior: Boys are more involved in bullying than girls, and their bullying behavior is predicted by tobacco, alcohol, and drug use and child disclosure and perceived enjoyment of the area they live in, while girls bullying related to mental health, child disclosure, ethnicity and enjoyment of the area they live in.

>Magister Scientiae - MSc / Introduction: Sustained attention is known to be dysfunctional in psychotic disorders. Sustained attention is the ability to remain focused on a specific time-locked stimulus within a task. We aimed to determine whether there are specific group differences between CON and three psychotic disorders: SCZ, MPD and BPD, then to determine differences between these psychotic disorders. This included differences in behavioural performance and prominent electrophysiological event-related potential (ERP) wave components during cueing and target processing of a visual sustained attention task. Further we aimed to characterize ERP waveform component relationships across and within these groups for demographics, substance use, behavioural performance, and clinical variables, the last limited to the psychotic groups. Lastly, we investigated the effects of prescribed medications on ERP wave components within the psychotic groups. Methodology: 103 participants (29 schizophrenia (SCZ), 28 bipolar disorder with a history of psychosis (BPD), 21 methamphetamine-induced psychotic disorder (MPD), and 30 controls (CON)) underwent electroencephalography (EEG) record while completing a visual continuous performance task. Participants were presented with 60 trials with three consecutive S’s, the presentation of the third S required a behavioural response. Prominent ERP waveform components were extracted from cues and target stimulus. Group differences were determined by ANOVA with Bonferroni post-hoc correction or multivariate Kruskal-Wallis test dependent on data distribution. Relationships between ERP wave components were determined appropriate with Spearman’s Rank order correlation analyses.