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1.  Impact of Brief Intervention Services on Drug Using Truant Youth Arrest Charges over Time 
School truancy is a serious concern in the U.S., with far-reaching negative consequences. Truancy has been positively associated with substance use and delinquent behavior; however, research is limited. Consequently, the Truancy Brief Intervention Project was established to treat and prevent substance use and other risky behaviors among truants. This article examines whether the Brief Intervention program is more effective in preventing future delinquency over a 12-month follow-up period, than the standard truancy program. Results indicate the Brief Intervention was marginally significant in effecting future delinquency among truants, compared to the standard truancy program. Future implications of this study are discussed.
PMCID: PMC4222076  PMID: 25382960
Truancy; delinquency; substance use; Brief Intervention
2.  Relationship between School Administrators’ Reports of Parental Involvement in School and Students’ Substance Use: A National Study 
This study examines the relationship between student substance use and school-level parental involvement as reported by administrators. Questionnaires were administered to school administrators and 111,652 students in 1,011 U.S. schools. Hierarchical logistic regression analyses conducted on 1998–2003 data from students and administrators indicate significantly lower prevalence of alcohol use among 8th graders in schools where administrators reported high parental involvement. Overall, administrators’ reports of high parental involvement were unrelated to prevalence of substance use among 10th graders, and were associated with higher prevalence of alcohol use among 12th-graders. Implications and limitations are discussed, along with suggestions for future research.
PMCID: PMC4586172  PMID: 26430355
3.  Relapse Contexts for Substance Abusing Adolescents with Comorbid Psychopathology 
The relationship of diagnosis, developmentally relevant factors (e.g., life stress, peer substance use) and mental health symptoms to contexts of a return to substance use were examined for 103 substance abusing adolescents with Axis I psychopathology (ages 12–17) following inpatient treatment. Proximal psychiatric symptoms and developmentally relevant factors, but not psychiatric diagnosis at treatment entry, predicted contexts in which youth returned to alcohol and drug use in the 6 months following treatment. The findings suggest that comorbid youth are similar to same-aged peers without comorbid psychopathology and adults with comorbid psychopathology in regard to contexts associated with a return to substance involvement.
PMCID: PMC4539968  PMID: 26294850
Substance use disorder; comorbidity; adolescents; relapse
4.  Brief Intervention for Truant Youth Sexual Risk Behavior and Marijuana Use 
Substance use and sexual risk behaviors are common among adolescents. Although attention has focused primarily on alcohol use, less is known about the relationship between marijuana use and sexual risk behavior among high-risk youth. Since truant youth often experience problems in school, troubled family situations, and other psychosocial problems, they represent an important group of high-risk youth to study. Previous research suggests that truant youth are at considerable risk of continuing their troubled behavior in school and entering the juvenile justice system. It is also likely that truant youth are involved in marijuana use and sexual risk behavior at a higher rate, than the general youth population. Involving them in effective intervention services could reduce these risk behaviors. The current study presents interim findings from a NIDA-funded experimental, brief intervention (BI) study involving truant youths and their parents/guardians. Longitudinal data were analyzed to study: (1) the relationships between the youths’ marijuana use and engaging in sexual risk behavior over time, and (2) the effects of a substance use BI on their marijuana use and sexual risk behavior. Analyses examined a growth model for parallel processes in marijuana use and sexual risk behavior, and an assessment of the effect of the intervention on linear and quadratic trends, and on subgroups of youth differing in their sexual risk behavior and marijuana use. Implications of the results for future research and service delivery are considered.
PMCID: PMC4228961  PMID: 25400493
5.  The Relationship Between Peer, Parent, and Grandparent Norms and Intentions to Use Substances for Urban American Indian Youth 
Peer, parent, and grandparent norms may be a protective factor for American Indian (AI) youth intentions to use substances, but little research has explored these influences on urban AI youth. Using OLS regression, a secondary data analysis examined the relationship between peer, parent and grandparent substance use norms, and intentions to use substances (N = 148). Findings indicated that grandparent and peer norms were the strongest predictors of intentions to use substances. Implications of these results include the need for concerted, culturally focused efforts that address AI youth substance use by targeting AI peer and family networks.
PMCID: PMC4507275  PMID: 26203212
American Indian adolescents; substance use; parental drug norms; peer drug norms
6.  The Social Contexts of Drug Offers and Their Relationship to Drug Use of Rural Hawaiian Youth 
This paper examines the differences in drug offers and recent drug use between Hawaiian and non-Hawaiian youth residing in rural communities, and the relationship between drug offers and drug use of Hawaiian youth in these communities. Two hundred forty nine youth (194 Hawaiian youth) from 7 different middle or intermediate schools completed a survey focused on the social context of drug offers. Hawaiian youth in the study received significantly more offers from peers and family, and had significantly higher rates of recent alcohol and marijuana use, compared with non-Hawaiian youth. Logistic regression analysis indicated that the social context differentially influenced drug use of Hawaiian youth, with family drug offers and context influencing overall drug use and the use of the widest variety of substances. Implications for prevention practices are discussed.
PMCID: PMC4029507  PMID: 24860249
Culture; Drug offers; Drug use; Hawaiian; Youth
7.  Community Influence on Youth’s Use of Inhalants and Other Legal Products to Get High in Rural Alaska 
This study examines the use of inhalants and other harmful legal products (HLPs) to get high among pre-adolescents in frontier Alaska communities. Community factors that may influence use of HLPs are highlighted. This study uses secondary data from two NIH studies in 19 Alaska communities. A hierarchal generalized linear modeling technique was used to model community level effects on HLP use. The results show that lifetime use was reported by 18% of the pre-adolescents. Pre-adolescents in “dry” communities (with laws restricting alcohol use) had much higher lifetime and past 30-day HLP use. The results suggest that additional study of the relationship between use of HLPs and local laws governing availability is warranted.
PMCID: PMC4189822  PMID: 25309112
8.  Take One for the Team? Influence of Team and Individual Sport Participation on High School Athlete Substance Use Patterns 
The current web-based survey investigated the association between team or individual sport participation (or both) and self-reported alcohol and tobacco use among high school athletes (N=1, 275) transitioning to college. Peak Blood Alcohol Concentration, weekly drinking, and alcohol-related problems were significantly lower among athletes in individual sports compared to other groups. Athletes competing in both team and individual sports reported greater lifetime tobacco use and combined alcohol/tobacco use compared to individual or team sports alone. Preventive strategies targeting HS athletes in general and those participating in team sports in particular may be useful in minimizing future alcohol use and related problems.
PMCID: PMC4228378  PMID: 25400492
9.  Brief Intervention for Truant Youth Sexual Risk Behavior and Alcohol Use: A Parallel Process Growth Model Analysis 
Truant youths represent a challenging, yet very promising group of at-risk youth to study. In addition to problems in school, they frequently experience troubled family situations, emotional/ psychological problems, involvement in substance use, and delinquency. Given the problems often experienced by truant youth, it is likely they are engaging in alcohol use and sexual risk behavior at a higher rate, than the general youth population. Identification of these youths’ problems and early placement into effective intervention services would benefit them, their families, and society. The current study presents interim findings from an ongoing, NIDA-funded experimental, Brief Intervention (BI) study involving truant youths and their parent/guardians. Baseline, 3-month, 6-month, and 12-month follow up data were analyzed to determine whether alcohol use and sexual risk behaviors were longitudinally related, examine the effects of the intervention on longitudinal alcohol use and sexual risk behaviors, identify latent subgroups of youths in the data for alcohol use and sexual risk behaviors, and determine whether the intervention influenced these subgroups. Results indicated alcohol use and sexual risk were longitudinally related. Subgroups of youth were also identified based on alcohol use and sexual risk behavior levels and trends. Further, limited treatment effects were observed for alcohol use. Implications of the results for future research and service delivery are considered.
PMCID: PMC4165484  PMID: 25242878
Truancy; alcohol use; sexual risk; growth model; latent class analysis
10.  Can Parents Provide Brief Intervention Services to Their Drug-Abusing Teenager? 
The importance of parents as “interventionists” is supported by reviews of the treatment literature (e.g., Smit, Verdurmen, Monshouwer, & Smit, 2008; Winters, Botzet, Fahnhorst, & Koskey, 2009) as well as the emerging science that home-based initiatives by parents can contribute to desired health changes in adolescents (Fearnow, Chassin, Presson, & Sherman, 1998; Jackson & Dickinson, 2006). Parental influences on an adolescent can include reducing initiation, as well as altering its maintenance if it has started. This paper describes a project aimed helping parents to deal with a teenager who has already started to use alcohol or other drugs. Home Base is a home-based, parent-led program aimed at reversing the trajectory of drug use in an already drug-using adolescent. The program’s content is organized around motivational enhancement and cognitive behavioral techniques. The ongoing study will also be discussed.
PMCID: PMC4391737  PMID: 25866459
intervention; parenting; adolescent drug abuse
11.  Cannabis Withdrawal Among Detained Adolescents: Exploring the Impact of Nicotine and Race 
Rates of marijuana use among detained youths are exceptionally high. Research suggests a cannabis withdrawal syndrome is valid and clinically significant; however, these studies have mostly been conducted in highly controlled laboratory settings with treatment-seeking, White adults. The present study analyzed archival data to explore the magnitude of cannabis withdrawal symptoms within a diverse sample of detained adolescents while controlling for tobacco use and investigating the impact of race on symptom reports. Adolescents recruited from a juvenile correctional facility (N=93) completed a background questionnaire and the Marijuana Withdrawal Checklist. Analyses revealed a significant main effect for level of tobacco use on severity of irritability, and for level of marijuana use on severity of craving to smoke marijuana and strange/wild dreams. Furthermore, a significant main effect for race was found with Black adolescents reporting lower withdrawal discomfort scores and experiencing less severe depressed mood, difficulty sleeping, nervousness/anxiety, and strange/wild dreams. Although exploratory, these findings may have significant clinical implications for providers in juvenile detention facilities, allowing the execution of proper medical and/or behavioral interventions to assist adolescents presenting with problematic cannabis and/or tobacco withdrawal.
PMCID: PMC4331066  PMID: 25705103
Adolescents; Cannabis; Nicotine; Withdrawal; Race
12.  Development and Initial Evaluation of a Web-Based Program to Increase Parental Awareness and Monitoring of Underage Alcohol Use: A Brief Report 
The development of a web-based parent-focused intervention to improve parental awareness and monitoring of adolescent alcohol use was preliminarily evaluated. Upon completion of baseline assessment, sixty-seven parents were randomly assigned to the experimental web-based parent-focused intervention or an assessment only control condition. Participants who completed the experimental program, relative to control participants, significantly improved knowledge of problems related to underage drinking (p < .01) while improvements in overall monitoring of their children approached significance (p = .08). Improvements in monitoring by experimental participants, relative to controls, were pronounced in phone monitoring (p < .01) and indirect monitoring (p = .05). Participants in this study improved their communication about alcohol from pre- to post-intervention regardless of intervention. There were no statistical between group differences found regarding underage drinking attitudes. This pilot evaluation demonstrates that this program warrants further examination in controlled trials with greater power. Study implications are discussed in light of results.
PMCID: PMC4355948  PMID: 25774082
alcohol; adolescent; web-based program; monitoring
13.  Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs 
Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance abuse, recovery schools appear to successfully function as continuing care providers reinforcing and sustaining therapeutic benefits gained from treatment. Small size and therapeutic programming allow for a potentially broader continuum of services than currently exists in most of the schools. Recovery schools thus provide a useful design for continuing care warranting further study and policy support.
PMCID: PMC3938279  PMID: 24591808
14.  The Association Between Attention-Deficit Hyperactivity Disorder and Nicotine Use Among Adolescents and Young Adults 
Previous research indicates that youth with ADHD are more susceptible to nicotine use compared to those without ADHD and one explanation for this association is the self-medication theory. The present study examines nicotine use in a prospective sample derived from a community sampling procedure rather than a clinical setting. Nicotine use was measured through young adulthood (mean ages: 18, 20 and 22) and three groups were compared based on childhood status: ADHD-only, ADHD-extemalizers and control groups. Results indicated that at all three data points, individuals with childhood ADHD plus an externalizing disorder reported higher nicotine use on all variables compared to the ADHD group absent of an externalizing disorder and the comparison group of non-ADHD youth. The group differences were significant even after controlling for possible confounding variables (age, gender, and current treatment with psychostimulant medication). Study results are discussed in light of the self-medication hypothesis and of the importance of including nicotine prevention programs for adolescents and young adults with ADHD and externalizing problems.
PMCID: PMC4306279  PMID: 25632218
ADHD; Externalizing disorder; Nicotine; Self-medication hypothesis
15.  [No title available] 
PMCID: PMC4290751  PMID: 25589826
16.  Do Sources of Cigarettes Among Adolescents Vary by Age Over Time? 
Trends in sources of cigarettes among adolescents were assessed using data from a teen cohort (2000-2006). Five sources—bought from store, got from other teen, stole from others, bought from others, and got from an adult—were measured over time by age. The most common source among all ages was other teens. Fewer teens bought cigarettes from stores, with a downward trend for all ages. Among all ages there was an upward trend in stealing with younger teens more likely to steal cigarettes. In addition to targeting cigarette sales, interventions are needed to target other youth cigarette sources.
PMCID: PMC3927921  PMID: 24563604
cigarettes; smoking; source; access; adolescents
17.  A Behaviorally-Anchored Rating System to Monitor Treatment Integrity for Community Clinicians Using the Adolescent Community Reinforcement Approach 
This study evaluated a process for training raters to reliably rate clinicians delivering the Adolescent Community Reinforcement Approach (A-CRA) in a national dissemination project. The unique A-CRA coding system uses specific behavioral anchors throughout its 73 procedure components. Five randomly-selected raters each rated “passing” and “not passing” examples of the 19 A-CRA procedures. Ninety-four percent of the final ICCs were at least ‘good’ (≥.60) and 66.7% were ‘excellent’ (≥.75), and 95% of the ratings exceeded the 60% or better agreement threshold between raters and the gold standard. Raters can be trained to provide reliable A-CRA feedback for large-scale dissemination projects.
PMCID: PMC4000045  PMID: 24778544
Evidence-based treatment; A-CRA; community reinforcement; rater training; coder training; treatment adherence
18.  Alcohol Use and Related Behaviors among Late Adolescent Urban Youth: Peer and Parent Influences 
Peer and parent influences on alcohol use and related risky behaviors were examined in a sample of late adolescent (M = 17.3 years; SD = 1.11 years) urban youth. Participants (N = 400) completed an online measure assessing peer influences of alcohol use and alcohol offers, and parent influences of rules against alcohol use and perceived levels of emotional family support, relative to youths’ alcohol use, binge drinking, alcohol-related consequences, and intentions to drink. Hierarchical regression analyses revealed that increased peer alcohol use and alcohol offers were associated with youths’ increased drinking, binge drinking, alcohol-related consequences, and intentions to drink. Controlling for peer influences, parental rules against alcohol use were associated with decreased drinking, binge drinking, and intentions to drink; increased levels of family support was associated with decreased alcohol-related consequences and intentions to drink. These findings suggest that parental influences, albeit small relative to peer influences, are associated with fewer instances of monthly alcohol use and related risky behaviors among late adolescent urban youth.
PMCID: PMC4167796  PMID: 25246757
youth; alcohol; peers; parents; influences
19.  Reducing Alcohol Risk in Adjudicated Male College Students: Further Validation of a Group Motivational Enhancement Intervention 
This study examined the effectiveness of a single-session group motivational enhancement alcohol intervention on adjudicated male college students. Over two sequential academic years, 230 students sanctioned by the university for alcohol-related infractions attended a 60- to 75-minute group intervention. The intervention consisted of a timeline followback, social norms education, decisional balance for behavioral change, blood alcohol content (BAC) information, expectancy challenge, and generation of behavioral goals. Participants were followed weekly for three months and showed reductions in drinking (29%) and alcohol-related consequences (32%) at three-month follow-up. The intervention was successful in reducing drinking for both first-year students and upperclassmen, with reductions appearing to be a function of the intervention and not the citation itself. Furthermore, a post hoc control condition revealed that those participants randomly assigned to the intervention group condition reduced drinking (19%) and alcohol-related consequences (44%) more than participants in the control condition over one month. These results provide continued evidence of the effectiveness of group motivational enhancement interventions with adjudicated male college students.
PMCID: PMC4267112  PMID: 25525319
adjudicated college students; alcohol consequences; group intervention; motivational interviewing
20.  Sexual Experience and Risky Alcohol Consumption among Incoming First-Year College Females 
This study examines the relationship between sexual experience and various drinking measures in 550 incoming first-year college females. During this transition period, sexually experienced participants reported stronger alcohol expectancies and endorsed higher drinking motives, and drank more frequently and in greater quantities than sexually inexperienced participants. Sexual status was also a significant predictor of alcohol-related nonsexual consequences, over and above amount consumed. Furthermore, controlling for drinking, sexual status moderated the relationship between coping motives and consequences. Among women who endorsed strong coping motives for drinking, sexual experience was linked to greater nonsexual alcohol-related consequences. Implications for prevention and intervention are discussed.
PMCID: PMC4226333  PMID: 25392606
alcohol; alcohol-related consequences; college females; college transitions; drinking motives; sexual experience
21.  MTFC for High Risk Adolescent Girls: A Comparison of Outcomes in England and the United States 
The current study examined 12-month outcomes for girls enrolled in an implementation trial of Multidimensional Treatment Foster Care (MTFC) in England. In addition to examining changes from pre-treatment to post-treatment, we also compared results for girls enrolled in the England implementation trial to girls enrolled in two randomized controlled trials (RCTs) of MTFC in the United States (US). The England MTFC sample included 58 girls in foster care between the ages of 12 and 16 years. The US MTFC intervention samples included 81 girls between the ages of 13 and 17 years who were referred to out-of-home care due to chronic delinquency. Results indicated improvement in offending, violent behavior, risky sexual behavior, self-harm, and school activities for girls enrolled in the England implementation trial. The effect sizes of these results were similar to those obtained in the US RCTs, with the exception of substance use which showed significant decreases for girls enrolled in the US RCTs, but not for girls enrolled in the England implementation trial. These results, in combination with other cross-cultural findings, support the notion that MTFC might be relevant across US and European cultures.
PMCID: PMC3758489  PMID: 24003300
MTFC; implementation; cross-cultural; girls; delinquency
22.  Adolescent Onset of Maternal Substance Abuse: Descriptive Findings from a Feasibility Trial 
Although maternal substance abuse in child welfare populations is a well-documented occurrence, little is known about the onset of these behaviors or the substance abuse histories of these mothers. Descriptive data from a small feasibility trial of mothers referred for substance abuse and child neglect suggest adolescent onset of hard substance use. Age of onset was associated with family history of use. The majority of mothers reported polysubstance abuse starting at an early age and quickly escalating patterns of behavior including IV drug use. Implications for prevention efforts for children of families identified with substance abuse problems are discussed.
PMCID: PMC3726274  PMID: 23908582
child welfare; methamphetamine; early onset
23.  Intervention Effects on Health-Risking Sexual Behavior Among Girls in Foster Care: The Role of Placement Disruption and Tobacco and Marijuana Use 
The present study examined the effects of the Middle School Success intervention (MSS), a program to promote healthy adjustment in foster girls, on their health-risking sexual behavior, using a randomized controlled trial (RCT) design. As hypothesized, girls in the intervention condition (n = 48) showed significantly lower levels of health-risking sexual behavior than did girls in the control condition (n = 52) at 36 months postbaseline. Further path analysis indicated that this intervention effect was fully mediated through its effects on girls’ tobacco and marijuana use. Findings highlight the importance of providing preventive intervention services to foster girls during early adolescence.
PMCID: PMC3772734  PMID: 24043921
foster care; girls; tobacco and marijuana use; health-risking sexual behavior; adolescent; intervention
24.  Trauma, Delinquency, and Substance Use: Co-occurring Problems for Adolescent Girls in the Juvenile Justice System 
Girls in the juvenile justice system are known to have high rates of co-occurring childhood abuse, trauma, and substance abuse. Girls with this constellation of problems are at high risk for serious adverse outcomes, including problems with drug dependence and abuse. The relationship between childhood sexual abuse, childhood physical abuse, other types of childhood trauma, and rates of substance use during adolescence were examined for girls in the juvenile justice system. As expected, childhood sexual abuse was significantly related to girls’ substance use during adolescence. In contrast to prior research, no link was found between physical abuse, lifetime trauma, and substance use. Limitations and future directions are discussed.
PMCID: PMC3771528  PMID: 24039384
Females; delinquency; substance use; treatment
25.  Amygdala Activation and Emotional Processing in Adolescents at Risk for Substance Use Disorders 
Studies are needed that examine neurobiological characteristics in high risk individuals prior to substance use disorder (SUD) development. In this pilot study, 4 adolescent subjects at high risk (having at least 1 parent with a SUD) for SUD were compared with 4 adolescent reference subjects on a corticolimbic reactivity paradigm, where they were presented with affect-laden faces or geometric shapes. FMRI was used to measure cortical activation in response to these stimuli. High risk subjects, compared to low risk, exhibited greater left amygdala activation (t=3.60, df=6, p=0.01), suggesting they may exhibit hyper-responsivity of the amygdala in response to emotional stimuli.
PMCID: PMC3988200  PMID: 24748761

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