Substance use initiation (SUI) among adolescents is a critical public health concern. Research indicates SUI in middle adolescence increases the risk of substance use in adulthood and later dependence, which can result in deleterious consequences for youth, family relationships, and community (Substance Abuse and Mental Health Services Administration, [SAMSHA], 2014). This study investigated the role of involvement with deviant peers, school connectedness, and parenting quality on SUI (e.g., alcohol, cigarettes, and marijuana) in middle adolescence using secondary data from a 5-year longitudinal study (N = 387). First, exploratory factor analyses and confirmatory factor analyses with a separate independent sample were conducted to develop a measure of parenting quality. Second, moderated mediation was tested using PROCESS (Hayes, 2013) with each parenting quality factor as a moderator of two mediation pathways (involvement with deviant peers and school connectedness) on three SUI outcomes. Results from the exploratory factor and confirmatory factor analyses were consistent and provided evidence for a three-factor solution for parenting quality: Parental Knowledge and Affective Relationships, Parental Control, and Parental Communication and Involvement. Results from the moderated mediation analyses did not support parenting quality factors as moderators for either mediation model. Involvement with deviant peers (Wave 3) mediated the relation between school connectedness (Wave 2) and each of the three substances (Wave 5) across all levels of parenting quality (e.g., bias-corrected bootstrap confidence intervals = -.50 – -.18 at low, -.47 – -.19 at average, and -.50 – -.16 at high levels of Parental Knowledge and Affective Relationships for alcohol use initiation). More specifically, low school connectedness predicted higher involvement with deviant peers, which, in turn, predicted a higher likelihood of SUI. School connectedness was not a significant mediator in the relationship between involvement with deviant peers and SUI. Although parenting quality factors did not moderate either of the mediation pathways, development of a comprehensive and psychometrically valid measure may aid in identifying specific parenting problem areas necessary for preventive intervention planning. Additionally, supporting adolescents who lack strong connections within the school may help prevent involvement with deviant peers and SUI.

acase@tulane.edu

Purpose. The purpose of this study was to evaluate whether severe victimization experiences, and psychological and social resources were shared risk factors for internalizing only, externalizing only, and co-occurring internalizing and externalizing disorders among victimized substance-using adolescents. Method. Data for this cross-sectional study were obtained from a multisite research project. Adolescents, ages 11-18, participated in a comprehensive screening program for substance abuse at 106 Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT)-funded grantee sites throughout the United States. Results. Longer duration/frequent victimization, more than one type of victimization, recent victimization, low self-efficacy beliefs and available sources of emotional support were related to co-occurring internalizing and externalizing disorders. Victimization by a trusted person, however, was only related to internalizing disorders. Conclusion. The findings show that some indicators of severe victimization experiences, psychological and social resources are shared risk factors for internalizing, for externalizing, and for co-occurring internalizing and externalizing problems, thus providing support for the common factors model of co-morbidity. These findings suggest that practitioners in substance abuse treatment must thoroughly assess for severe victimization experiences among adolescents presenting with co-occurring mental health issues. Treatment planning and interventions may focus on helping adolescents cope effectively with their victimization experiences and addressing their MH needs. Particular emphasis may be placed on enhancing self-efficacy and social skills, so that adolescents may benefit from their available sources of support.

Intimate partner violence (IPV) against women is a major public health issue worldwide. The purpose of this dissertation is to characterize violence perpetrated by an intimate partner against a "high-risk" group of pregnant women who sought elective abortion services at a family planning clinic. Analyses were based on the Iowa Women's Health Experience Survey (IWHES), a cross-sectional study of 519 abortion patients who completed an anonymous, self-administered questionnaire over a period of seven months. IWHES eligibility criteria were 'Seeking pregnancy termination'; 'Age ≥ 18 years'; 'Iowa resident' and 'Fluent in English or Spanish'. The survey instrument covered physical, sexual and psychological types of violence, health correlates of violence as well as demographic, socioeconomic and lifestyle characteristics of participating women and their current intimate partners. Aim I examined the prevalence of physical, sexual and/or psychological abuse by employment characteristics of elective abortion patients and their current intimate partners. Aim II examined associations of substance use, depression and social support with physical, sexual and/or psychological abuse perpetrated by current intimate partners against women seeking pregnancy termination. To achieve the analytic goals of Aims I and II, the study sample was restricted to women who had a current partner and valid IPV data. The overall prevalence of physical, sexual and/or psychological abuse perpetrated by a current partner was 12.3%, with some overlap between the different IPV sub-types. In general, the prevalence of IPV did not differ significantly by employment status or by broadly defined occupational groups of women and their partners. However, a trend was noted whereby a woman's employment and a partner's unemployment were associated with greater likelihood of IPV. Specifically, the prevalence of IPV was highest among couples where the woman was employed and the partner was unemployed. Consistently positive associations were noted between the partner's (but not the woman's) substance use indicators (alcohol intake, binge drinking, recreational drug use) and IPV. Higher levels of depressive symptoms and less perceived availability of social support were noted among women who had experienced IPV versus those who had not experienced IPV. The association between depressive symptoms and IPV was stronger for women who reported having children in their homes compared to those did not report having children in their homes. Implications for policy and future research are discussed.

Substance use disorders (SUD) and mental health disorders are often thought of as completely separate problems even though these disorders commonly co-occur. Among adolescents who seek treatment for substance use problems, co-occurring mental health problems (MHP) are common. This is concerning because co-occurring disorders among adults have been associated with more severe MHPs, relapsing to substance use sooner, being less likely to maintain abstinence, and other problems. Despite the awareness that co-occurring disorders are problematic for adolescents, few studies have been conducted to understand these problems with an adolescent sample. The purpose of this study was to understand if factors commonly related to co-occurring disorders among adults were the same for adolescents and to examine two measurement models for the dependent variable, substance use. This secondary analysis of data first examined characteristics that are related to MHPs among a sample of adolescents (N=801) who use substances. Factors in three domains were examined: demographics, substance use, social factors. The results indicated that among these adolescents, MHPs were common. Two key factors related to having a MHP were gender and the severity of the SUD. Females and adolescents with more severe SUDs, like dependence, were more likely to have MHPs. Furthermore, severity of the SUD partially mediated the relationship between several of the other factors and MHPs. The type of substance an adolescent reported using was also important. In addition, adolescents who had more peers and more family members who participated in deviant activities had more severe substance use problems and were more likely to have a MHP. In addition to examining the factors related to mental health problems among a substance using population, this study modeled the dependent variable in two different ways which had not been done before and allowed for variance in the measure to be accounted for in the model. MHPs were measured both continuously and categorically. The results of the comparison indicated that there were not major differences between the two models. Implications for social work practice, policy and research are discussed.

No description available.

The status of athletic department ATOD policies has received limited attention. Few studies have examined the extent to which athletic trainers are currently involved in developing and revising their drug education and prevention policies. This study compared the perceptions of head athletic trainers from NCAA member Divisions I, II and III toward the status of their current ATOD policies and what they would ideally like to see in their athletic departments. Policy issues were related to each of the following four domains, 1) policy implementation; 2) educational programs; 3) ATOD policy enforcement; 4) athletic trainer participation in developing and evaluating ATOD policies. A web-based questionnaire was designed to collect data. Responses were collected from (353) head athletic trainers at three NCAA member institutions. Conveying ATOD policies to visiting student athletes related to the use of drugs banned by the NCAA during recruitment visits was the highest priority among HATS in three NCAA divisions. Athletic trainers from all divisions wanted to see ATOD education programs scheduled closer to athletic events when the potential for drug use could increase. Drug enforcement policies related to the consequences of testing positive for using a banned drug after a second or a third time by athletes was a high priority for Division I and III HATS. Division II trainers reported that mandatory drug testing was also a high priority. More Division I NCAA member institutions had evaluated their ATOD policies during the past year compared to Division I and III members. Participation in developing and revising athletic department and team ATOD policies was an important priority for head athletic trainers. HATS who were more involved in developing ATOD policies mentioned that they gained a better understanding of drug abuse and drug testing issues when they were part of their athletic departments' policy making process. / Graduation date: 2004

The subject of drug and alcohol abuse on college campuses across the country is the concern of many college administrators. There exists a relatively high consumption pattern of drug and alcohol abuse among college students when compared to the general population. This pattern of alcohol abuse has remained stable despite the presence of substance abuse programs on campuses that are specifically targeted toward the student population. There exists little research on how these programs operate and how they address the problem of substance abuse on campuses. Most of the research that exists is of survey design. This study examined through a descriptive case study, the substance abuse programs in three public universities in Oregon. The study used descriptive case study to describe what components comprised the programs as well as how the programs functioned under the various organizational structures. Three organizational structures were identified. The first university's organizational structure was under the health center, both administratively and physically. The second university studied had part of the program under the counseling center and other components under the athletic department and the health center. The third university had what was termed as a de-centralized structure, with the treatment component under the health center, the prevention component under an academic department, and the peer education component under the health center. The various organizational structures were also examined for their influence on the respective program. The 1989 Drug-Free Schools and Campuses Act Amendment, required institutions of higher education receiving federal funds to have programs. The impact of the Act on both the program and the organizational structure of the program was also examined. The study demonstrated an impact of the legislation on the programs in the form of funding that made possible new services. The study also suggested an influence of the organizational structure on the programs in the form of the funding of new program components that changed the organizational structure. Implications for programming as well as research as a result of this study's findings are presented. Recommendations for program models are also presented. / Graduation date: 1994

Approximately 2.2 million children and adolescents are arrested each year, and these youthful offenders often display serious psychosocial dysfunction across a wide spectrum of areas: family dysfunction, mental health distress, problems with drug use, risky sexual behaviors, and a history of traumatic experiences. Of particular interest, the rate of female adolescent arrest and incarceration has been on the rise over the past several decades, yet female juvenile offenders are understudied compared with their male peers. It is important to identify risk factors that predispose certain female adolescents to criminal behavior to inform future interventions. Given the associations of mental health problems, substance use, trauma, and family dysfunction with crime in adolescent girls, further study is warranted to more clearly understand the links between these psychosocial factors and criminality in adolescents, especially girls. The impacts of mental health disorders, family functioning, risky sexual behavior, trauma, and substance use on juvenile justice involved youths are of great public health and social importance because of the potential to intervene and to prevent criminal behavior in at-risk teens. However, the relationships between these risk factors and the severity of juvenile offending in girls have not been studied adequately. By analyzing data from interviews and follow-up criminal records for almost 500 arrested and detained adolescent girls, we first investigated the associations between concurrent substance use and psychosocial dysfunction in this population. Secondly, we examined which psychosocial domains (i.e., mental health disorders, substance use/abuse, trauma, sexual behavior, and family functioning) were most predictive of recidivism and violent recidivism during adolescence for this group of offending girls. Finally, we studied which psychosocial variables best predicted time to next arrest, thereby determining if psychosocial functioning can also predict the amount of time before a given adolescent reoffends. Our findings indicated that substance use and sexual risk behaviors are the most important psychosocial predictors of poor outcomes in adolescent female juvenile offenders.

Central to many theories of deviance and delinquency (differential association, social learning, and social bond) are peer and familial influences on deviant behavior. A conceptual framework that incorporated both peer and familial influence to address the role of cross-sex peers on female deviance was built based on a review of the literature. Using substance use as an indicator of deviance, the effects of having three forms of male associates (male friends, romantic partners, and sexual partners) on female substance use were examined. Focus was on the effects of different types of male peer relationships, how those effects differed from the effects of female peer relationships, and how parental control might be greater for girls with only female peers. The conceptual model incorporated three measures of parental control—parentally granted autonomy, parental presence at home, and time spent in shared activities with parents—that were used to test the effects of male associates on female substance use. Analyzing data from the National Longitudinal Study of Adolescent Health (Add Health), one combined measure for male associates was regressed on female substance use while controlling for parental control measures to determine if the effects of male associates on female substance use were mediated by parental control. Results indicated that while each type of male associate increased the likelihood of female substance use, effects were stronger for romantic and sexual partners than for male friends. Female friends also increased the likelihood of substance use. While the effects of male friends did not significantly differ from the effects of female friends, the effects of romantic and sexual partners did. The effects of male associates were significant even with the inclusion of parental control measures. Though both relationships with male associates and parents significantly affected female substance use, results did not provide support for the conceptual model. With results providing greater support for theories of peer influence than parental influence, future research should continue to examine peer relationship influences on deviance, how these influences vary by type of association, and how gender effects peer influence processes.