Motivating Action and Maintaining Change: The Time‐Varying Role of Homework Following a Brief Couples' Intervention

Studies regarding the effectiveness of homework assignments in cognitive‐behavioral treatments have demonstrated mixed results. This study investigated predictors of compliance with homework recommendations and the time‐varying relationship of recommendation completion with treatment response in a brief couples' intervention (N = 108). More satisfied couples and couples with more motivation to change completed more recommendations, whereas couples with children completed fewer. The association between recommendation completion and treatment response varied with the passage of time, with the strongest effect observed 6 months after the intervention, but no discernible differences at 1 year postintervention. Couples that completed more recommendations experienced more rapid treatment gains, but even those couples doing substantially fewer recommendations ultimately realized equivalent treatment effects, although they progressed more slowly. Implications are discussed.     

TO “VAPE” OR SMOKE? EXPERIMENTAL EVIDENCE ON ADULT SMOKERS

A growing share of the U.S. population uses e‐cigarettes but the optimal regulation of these controversial products remains an open question. We conduct a discrete choice experiment to investigate how adult tobacco cigarette smokers' demand for e‐cigarettes and tobacco cigarettes varies by four attributes: (1) whether e‐cigarettes are considered healthier than tobacco cigarettes, (2) the effectiveness of e‐cigarettes as a cessation device, (3) bans on use in public places, and (4) price. We find that adult smokers' demand for e‐cigarettes is motivated more by health concerns than by the desire to avoid smoking bans or higher prices. (JEL C35, I12, I18)     

Childhood Obesity: An Overview

This article reviews recent research evidence, largely from systematic reviews, on a number of aspects of childhood obesity: its definition and prevalence; consequences; causes and prevention. The basis of the body mass index (BMI) as a means of defining obesity in children and adolescents is discussed: a high BMI for age constitutes obesity. In recent years the prevalence of obesity has increased dramatically across most of the world, and in the UK obesity prevalence is high and continuing to increase. Despite a widespread perception that obesity in childhood or adolescence is a cosmetic issue, the research evidence shows that it does matter to physical and psychological health and that there are adverse health risks for both the obese child and the adult who was obese as a child. Few interventions aimed at preventing or treating childhood obesity have been successful. There is an urgent need for more research on better strategies that will enable children and adolescents to make long‐term changes to their dietary and physical activity behaviour in order to prevent obesity.     

Children's Vocational Development: A Research Rationale

Vocational development research and interventions have focused primarily on adolescents and young adults. The lack of attention to career development antecedents in children has led to a serious neglect of this period of life when the foundation is laid for career choices and outcomes in later life. A harmful by‐product is the frequent preclusion of gender‐atypical occupational pathways by boys and especially by girls. To address this situation, the authors recommend identifying a core set of constructs that describe children's vocational development and developing sound instruments to measure them, leading to a longitudinal study ranging from childhood to early adulthood.     

Briefly Noted

Vaping and nicotine replacement therapy (NRT) were equally effective at decreasing craving and withdrawal symptoms for smokers discharged from smoke‐free residential treatment for substance use disorder, a pilot study has found. The study, a randomized controlled trial to be published in Nicotine & Tobacco Research on behalf of the Society for Research on Nicotine and Tobacco in Australia, also found that retention was greater for the vaping group (96% at 12 weeks) than the NRT group (68%). For the study, 100 patients received telephone Quitline support and a 12‐week supply of either NRT or a vaping device. At 12 weeks, 14% of the vaping group and 18% of the NRT group report not smoking at all in the last seven days. The researchers concluded that their criteria for retention might have been too strict, and that “some leeway and looking at eventual success over the period people continue to engage with the aids would give a better picture of their long‐term potential.” There is a big movement to legalize vaping in Australia. A key point, however, is that patients readily engaged with smoking cessation after treatment when given the chance. “QuitNic: A pilot randomised controlled trial comparing nicotine vaping products with nicotine replacement therapy for smoking cessation following residential detoxification” by Billie Bonevski and colleagues is available open access, go to https://academic.oup.com/ntr/advance‐article/doi/10.1093/ntr/ntaa143/5889985 .     

Psychosocial interventions used to treat children with ADHD: safety and efficacy

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.     

A SNP,Gene, and Polygenic Risk Score Approach of Oxytocin‐Vasopressin Genes in Adolescents’ Loneliness

Not much is known regarding underlying biological pathways to adolescents’ loneliness. Insight in underlying molecular mechanisms could inform intervention efforts aimed at reducing loneliness. Using latent growth curve modeling, baseline levels and development of loneliness were studied in two longitudinal adolescent samples. Genes (OXTR, OXT, AVPR1A, AVPR1B) were examined using SNP‐based, gene‐based, and polygenic risk score (PRS) approaches. In both samples, SNP‐ and gene‐based tests showed involvement of the OXTR gene in development of loneliness, though, significance levels did not survive correction for multiple testing. The PRS approach provided no evidence for relations with loneliness. We recommend alternative phenotyping methods, including environmental factors, to consider epigenetic studies, and to examine possible endophenotypes in relation to adolescents’ loneliness.     

The experience of smoking in recovery settings: an ecological momentary assessment pilot study

ABSTRACT

Smoking continues to be the leading cause of preventable death in the United States, and people with substance use disorders (SUD) smoke at higher rates compared to their non-using counterparts. Individuals with SUDs may have different emotional experiences and expectancies than those without. The current study explored the relationship between smoking and emotional experiences among residents in recovery homes, a population that little is known about regarding their tobacco addiction. Using ecological momentary assessment (EMA), significant emotional differences were found between nicotine users and nonusers. Implications of these findings could help in the development of interventions directed toward reducing smoking cessation.     

Family-based interventions for child and adolescent disorders

Emotional and behavioral symptoms and disorders are prevalent in children and adolescents. There has been a burgeoning literature supporting evidence-based treatments for these disorders. Increasingly, family-based interventions have been gaining prominence and demonstrating effectiveness for myriad childhood and adolescent disorders. This article presents the current evidence in support of family-based interventions for mood, anxiety, attention-deficit hyperactivity, disruptive behavior, pervasive developmental particularly autism spectrum, and eating disorders. This review details recent data from randomized controlled trials (RCTs) and promising interventions not yet examined using a randomized controlled methodology. It highlights the evidence base supporting various specific family-based interventions, some of which are disorder dependent. A practitioner perspective is then offered with regard to recommendations for future practice and training. The article closes with a summary and directions for future research.     

Youth tobacco sales-to-minors and possession-use-purchase laws: a public health controversy

Tobacco use among youth remains one of our nation's most significant public health problems, and yet available evidence from prevention and cessation person-centered approaches has been mixed. Given these disappointing outcomes, some have recommended more public health approaches, and these include tobacco sales-to-minors and possession-use-purchase laws. While community members and police officials have endorsed these types of public health initiatives, many within the public health community have been either guarded or even oppositional to such approaches. The primary reasons for this controversy are reviewed in this article. Outcome studies indicate that sales-to-minors laws can be an effective step toward the reduction of youth access to commercial sources of tobacco. However, even with these laws in place, many youth indicate that they continue to have easy access to tobacco, often by means of social sources. Advocates of these approaches have argued that more comprehensive public health interventions are needed, such as programs that combine youth access and possession-use-purchase laws. This article reviews the ongoing debate behind these types of public health efforts, and examines the evidence of such programs to reduce youth tobacco use.     

Exploring the Association Between Dispositional Cancer Worry,Perceived Risk,and Physical Activity Among College Women

Abstract

Objective: In this study, the authors explored the association between dispositional cancer worry (DCW), risk perceptions (RP), and physical activity (PA) among college females. Participants: Four hundred fifty-one females from a midwestern university completed an online survey in September/October 2012. Methods: DCW severity, DCW frequency, RP, and PA were measured along with qualitative data about PA as cancer prevention. Results: Sixty-nine percent of participants did not meet PA recommendations. DCW severity was a significant predictor of meeting PA recommendations (odds ratio = 1.2, 95% confidence interval [1.00, 1.38]; p = .05). Qualitative data revealed a lack of knowledge about breast cancer risk and PA as cancer prevention. Conclusions: College women do not engage in enough PA nor feel at risk for developing breast cancer. A lack of knowledge exists about the cancer prevention benefit of PA. Results indicate a need for PA interventions that both educate breast cancer risk and motivate health protective behaviors.     

On a Roll: The Process of Initiation and Cessation of Problem Gambling Among Adolescents

As gambling becomes more accessible and acceptable in society, problems associated with gambling and gaming have begun to affect ever increasing numbers of adolescents. Although restricted from most forms of gambling by law, many adolescents are finding a path into problem gambling. Some are becoming compulsive gamblers early in their gambling career, facing a future filled with consequences and problems. Understanding the pathway or process by which these adolescents become engaged in gambling behavior and how they can extricate themselves from this addictive behavior can enhance the efficiency and effectiveness of our interventions. This article offers a perspective on the initiation and cessation of compulsive gambling using the basic elements of the process of intentional behavior change outlined in the Stages of Change from the Transtheoretical Model. The process of initiation of a problematic behavior is similar to the process of modification or cessation of a problematic behavior in terms of these stages of change. With adolescents it is important to distinguish between the process of initiation, which has implications for prevention of gambling problems, and the process of cessation, which often necessitates the assistance of treatment. Creating interventions that parallel the process of change offers the potential for personalizing and potentiating efforts to reduce the prevalence and consequences associated with compulsive or pathological and problem gambling. Application of this model to gambling behavior offers a heuristic that is intriguing and requires substantiation through rigorous research.     

A quit smoking group. Pilot study

1. While the rate of smoking is extremely high among persons with mental illness, there have been efforts to assist this population to quit. A 10-week smoking cessation program was provided for 10 highly nicotine dependent persons with persistent mental illness. 2. No significant differences were found in psychiatric symptoms or drug side effects prior to and after smoking cessation efforts. Four months later, for the 7 subjects who completed the program, 14% were abstinent, 43% maintained reduced tobacco intake, and 43% had resumed previous smoking patterns. 3. Specific barriers to quitting include a lack of nonsmoking coping skills, long-term identity as a smoker, ready access to tobacco products, nicotine addiction, and limited nonsmoking social support.     

The other side: Pro‐cannabis physicians dispute SG advisory

Last week (see ADAW, Sept. 9), we wrote about the advisory from U.S. Surgeon General Jerome Adams, M.D., recommending against marijuana use by pregnant women or adolescents ( https://www.hhs.gov/surgeongeneral/reports‐and‐publications/addiction‐and‐substance‐misuse/advisory‐on‐marijuana‐use‐and‐developing‐brain/index.html ).     

Veteran-nonveteran differences in alcohol and drug misuse by tobacco use status in Alabama SBIRT

ABSTRACT

Alcohol and substance use can challenge military veterans who live in rural communities. In 2016, the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program was implemented in west Alabama. The primary aim of this study was to determine whether current tobacco use modified the relationship between veteran status and substance misuse. Self-reported wellness data was collected regarding substance, alcohol, or tobacco consumption. Risk levels for alcohol and drug use were measured using the United States Alcohol Use Disorders Identification Test (US-AUDIT) and the Drug Abuse Screening Test (DAST)-10. Substance and tobacco use were significantly and positively correlated. Veterans had a higher US-AUDIT and DAST score than nonveterans, and tobacco appeared to be an exacerbating factor. Effective evidence-based interventions are needed in rural settings. Technology based programs and motivational interviewing with trained clinicians may serve as beneficial and cost-effective interventions for tobacco use prevention and cessation efforts.     

Religiosity and Effortful Control as Predictors of Indonesian Adolescents’ Tobacco and Alcohol Use: Moderation and Mediation

Moderation and mediation models of religiosity and effortful control as predictors of tobacco and alcohol use were tested in this 2‐year longitudinal study of 563 16‐year‐old Muslim Indonesian adolescents. Adolescents reported their effortful control, religiosity, and tobacco and alcohol use and peers provided reports of adolescents’ effortful control. Although both moderation and mediation effects emerged when predicting Year 2 substance use, predictions of change from Year 1 to Year 2 substance use yielded effects of moderation for peer‐ but not self‐reported effortful control for boys; no mediation effects emerged. These findings provide evidence of interconnections between effortful control and religiosity as predictors of substance use and suggest the need for further longitudinal studies that compare moderation and mediation models.     

The effectiveness of family interventions for physical disorders

This article reviews the evidence for the effectiveness of family interventions in the prevention and treatment of physical disorders. Pathways by which families influence physical health and a typology of family interventions are described. Family intervention studies, particularly randomized clinical trials, are reviewed in four clinical areas: family caregiving of elders, childhood chronic illness, spouse involvement in chronic adult illnesses, and health promotion/disease prevention. Implications for family clinicians and recommendations for future research are presented.     

Racial and ethnic differences in patterns of adolescent tobacco users: A latent class analysis

BackgroundLittle is known about how tobacco use varies among youth of different racial and ethnic groups and how these patterns are related to levels of nicotine dependence.ObjectivesThis study investigated the tobacco use patterns of White, African American, and Hispanic high school students. We further explored whether tobacco use patterns were associated with levels of nicotine dependence and gender.MethodsData were analyzed from the 2014 National Youth Tobacco Survey (NYTS) of high school students who endorsed at least one form of tobacco use in their lifetime (n = 4691). Three separate latent class analysis (LCA) models were estimated using seven different types of tobacco products as indicators. Also, the level of nicotine dependence was compared with one class to another class in three racial/ethnicity groups.ResultsFour classes of White youth were identified: (1) “Non-user” (67%), (2) “Polytobacco” (6%), (3) “Chewing Tobacco” (8%), and (4) “(E-)Cigarettes” (19%) classes. The “Polytobacco” class had the highest nicotine dependence followed by “Chewing Tobacco,” “(E-)cigarettes,” and “Non-user.” Among African American youth, two tobacco patterns were identified: “Non-user” (91%) and “Cigarette/Cigar” (9%). The “Cigarette/Cigar” class had greater nicotine dependence than the “Non-user” class. Among Hispanic youth, three subgroups were identified: “Non-user” (78%), “(E-)Cigarette/Cigar” (14%), and “Hookah” (18%). “(E)Cigarette/cigar” had the highest nicotine dependence in Hispanic youth followed by the “Hookah” and “Non-users” classes.ConclusionWe found distinct classes of youth tobacco use by race/ethnicity. Although poly-tobacco use was common, White, African American, and Latino youth used different tobacco types, suggesting that racially and ethnically targeted prevention strategies may be indicated.     

The Development of Math–Race Stereotypes: “They Say Chinese People Are the Best at Math”

Sixty elementary‐school children (9–10 years old) and 82 adolescents (12–13 years old) completed explicit and implicit measures of racial stereotypes about math. 60 Asian, 42 Latino, 21 White, 15 Black, and four multiracial students participated (42% boys). On the explicit measure, children as early as fifth grade reported being aware of the stereotype that Asians = math, but only adolescents personally endorsed this stereotype. On the implicit measure, there was significant evidence for racial stereotypes about math among adolescents. Across both ages, individual students’ explicit awareness of the stereotype was significantly correlated with their implicit stereotypes. Early adolescence is a key developmental window for discussing stereotypes before they become endorsed as personal beliefs.