Stimulant Medication Use,Misuse, and Abuse in an Undergraduate and Graduate Student Sample

In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin. Men and women reported similar use patterns. Most respondents who abused or misused stimulant medication swallowed pills; 40% used intranasally. Reasons for abusing or misusing stimulant medication included improving attention, partying, reducing hyperactivity, and improving grades. Consistent with previous studies, results suggest that abuse of stimulant medication is a concern on college campuses. The results point to various reasons for and methods of abusing and misusing stimulant medication that may direct future research, prevention, and intervention.     

Illicit use of prescribed stimulant medication among college students

The authors investigated illicit use of stimulant medications at a midwestern university. They used a questionnaire to (a) examine the extent to which university students illicitly used stimulant medications prescribed for attention-deficit hyperactivity disorder; (b) determine why college students abused such drugs; and (c) identify the factors that predicted illicit use of prescribed stimulant medication. Findings revealed that 17% of 179 surveyed men and 11% of 202 women reported illicit use of prescribed stimulant medication. Forty-four percent of surveyed students stated that they knew students who used stimulant medication illicitly for both academic and recreational reasons. Students reported they experienced time pressures associated with college life and that stimulants were said to increase alertness and energy. Regression analysis revealed that the factor that predicted men's use was knowing where to get easily acquired stimulant medication, whereas the main predictor for women was whether another student had offered the prescribed stimulants.     

Association between physical partner violence, posttraumatic stress, childhood trauma, and suicide attempts in a community sample of women

Our objective was to estimate the prevalence of intimate partner violence (IPV) and to explore its association with childhood maltreatment, substance misuse, posttraumatic stress, and suicidal behavior in a representative community sample of women. IPV was operationalized as a "physical attack or beating by a spouse, boyfriend, or live-in partner." We surveyed 637 women in Memphis, Tennessee, by telephone survey. Sixteen percent reported ever experiencing IPV by a male partner, and 75% endorsed multiple assaultive acts. Of abused women, 5.9% met current PTSD diagnostic criteria, and an additional 11.8% were assessed with subthreshold symptoms. Abused women were more likely than other women to be divorced, to have less than 13 years education, to endorse high levels of childhood victimization, to have abused drugs and alcohol, and to have attempted suicide. Twenty-three percent of IPV+ (abused) women reported a suicide attempt at some time in their lives compared with 3% of IPV- (nonabused) women (p < .0001). Further, multiple logistic regression analysis showed that childhood sexual and emotional abuse and low educational attainment were the only significant predictors of IPV. These results suggest that in women who endorse IPV, careful inquiry of past abuse, trauma-related symptoms, suicidal behavior, and drug use may be important, so that interventions can be both timely and appropriate.     

Attention-deficit/hyperactivity disorder–specific stimulant misuse,mood, anxiety,and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.     

Painkilling drugs in collegiate athletics: knowledge, attitudes, and use of student athletes

This study was designed to examine the attitudes of student athletes toward the use of painkilling drugs. A total of 563 student athletes at two Division One NCAA universities were surveyed in this study. Twenty-nine percent of the student athletes (n = 165) reported that they felt there is nothing wrong with using painkilling drugs on the day of competition (when injured) to cope with pain. These student athletes reported that they would use painkilling drugs to mask injury in order to continue to participate in their sport. Student athletes' perceptions of societal norms and expectations related to competition, and the degree of control student athletes perceive that they have when deciding to use painkillers, may be important determinants governing the extent to which they may be at risk for abusing these substances. Research on planned behavior and reasoned action against suggests that salient beliefs affect intentions and subsequent behaviors, either through attitudes or subjective norms, or the degree of (perceived) control that an individual feels he/she has over the behavior [1, 2]. This theoretical model was used as a guiding framework for analyzing the attitudes of college athletes toward painkilling drugs. Recommendations are included in this article for coaches, educators, team physicians, team trainers, and administrators who are concerned about controlling the use and abuse of painkilling drugs by student athletes.     

Attendance problems and disciplinary procedures in Nebraska schools

STUDY PURPOSE: School principals were surveyed in rural and urban Nebraska schools to compare policies and procedures on school attendance, and to contrast the use of disciplinary procedures for attendance, violence and substance abuse. METHODS: A survey was sent to a 50 percent random sample of Nebraska schools. Respondent school addresses in metropolitan statistical areas (MSA) areas were categorized as urban, and non-MSA respondents were classified as rural area schools. RESULTS: Of the 680 surveys mailed, 464 (68.2 percent) completed surveys were returned. Overall, 86.2 percent of respondents were from rural schools and 13.8 percent from urban schools. A list of disciplinary problems and procedures was reported for a first-time offense by rural and urban schools. Both an "occasional attendance problem" and a "chronic attendance problem" were most frequently addressed through parent contact in both urban and rural areas. For "fighting with another student," rural schools most commonly reported discipline by teacher, followed by discipline by principal and parent contact. In urban schools, discipline by principal was most common. For "using drugs other than alcohol or tobacco at school" in both areas, disciplinary procedures included parent contact and short-term suspension. A list of disciplinary problems and procedures was also reported for a second-time offense and third-time offense. For "fighting with another student," the most commonly reported procedure was discipline by principal and parent contact for a second-time offense, followed by short-term suspension and long-term suspension for a third-time offense. For "using drugs other than alcohol or tobacco at school," for a second time offense was long-term suspension and semester expulsion for a third-time offense. Principals were also asked in an open-response format, what program or procedures were currently in place to prevent violence in their school. Common responses were "conflict resolution training," followed by "the Boys Town social skills and behaviors model" and "a zero tolerance policy." CONCLUSIONS: School principals generally reported similar disciplinary actions for most disciplinary problems. For recurrent offenses and for serious problems, principals generally used tougher disciplinary procedures. Some of the discrepancies in disciplinary actions, however, suggest the need for consistent enforcement and communication of policies for both urban and rural schools.     

Alcohol misuse among college athletes: self-medication for psychiatric symptoms?

A collegiate athlete population was surveyed for alcohol abuse as well as self-reported depression, anxiety, and other psychiatric symptoms. This study revealed that in a group of 262 athletes there were 21 percent who reported high alcohol use and problems associated with its use. Significant correlations were found between reported alcohol abuse and self-reported symptoms of depression and general psychiatric symptoms. Subjects with positive depression and psychiatric symptom ratings in the "severe" range had a significantly higher rate of alcohol abuse than subjects who had low depression and low or mild symptom ratings. Conversely, subjects reporting higher rates of alcohol misuse had more psychiatric symptoms. These findings suggest a possible causal link between psychopathology and serious alcohol abuse among college athletes. They also point to the need for routine depression and anxiety screening in college students who are typically beginning a significant exposure to alcohol.     

Helping Respondents Get It Right the First Time: The Influence of Words, Symbols, and Graphics in Web Surveys

We utilize and apply visual design theory to experimentallytest ways to improve the likelihood that web respondents reportdate answers in a particular format desired by the researcher,thus reducing possible deleterious effects of error messagesor requests for corrections. These experiments were embeddedin a series of web surveys of random samples of university students.We seek to examine the sequential and cumulative effects ofvisually manipulating the size and proximity of the answer spaces,the use of symbols instead of words, the verbal language ofthe question stem, and the graphical location of the symbolicinstruction. Our results show that the successive series ofvisual language manipulations improve respondents’ useof the desired format (two digits for the month and four digitsfor the year) from 45 percent to 96 percent. These results suggestthat writing effective questions for web surveys may dependas much or more on the presentation of the answer categories/spacesas the question wording itself.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

Psychotropic Drug Use Among College Students: Patterns of Use,Misuse, and Medical Monitoring

Abstract

Objective: To assess whether college students who use psychotropic drugs are (1) aware of potential side effects, (2) appropriately monitored by prescribing physicians, and (3) taking medications as prescribed. Participants: Fifty-five college students, currently taking psychotropic medications, were recruited between Summer 2008 and Fall 2009. Methods: Participants were given interviews assessing (1) interactions with prescribing physicians, (2) patterns of psychotropic drug use, and (3) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance use disorders. Results: Twenty-five percent of participants did not remember being assessed for suicidal ideation. A large number of participants took their medications in different quantities or frequencies than prescribed and 35% of participants met DSM criteria for substance dependence. Conclusions: Many students are misusing psychotropic medications and this misuse is not being communicated with prescribing physicians.     

Construct Validity and Error Components of Survey Measures: A Structural Modeling Approach

Measurement errors can have profound effects on statisticalrelationships, and better information on the quality of measuresseems needed. This study uses a new technology—structuralmodeling of data from special supplements to regular surveys—togenerate estimates of construct validity, method effects (amajor source of correlated error), and residual error (mainlyrandom error) for a broad set of measures obtained from fivenational surveys and an organizational survey (total respondents= 7,706). Analysis of these estimates suggested that a typicalsurvey item, when administered by a respected survey organizationto a general population sample, can be expected to yield 50–83percent valid variance, 0–7 percent method effects variance,and 14–48 percent residual variance. Multivariate analysisshowed that over two-thirds of the variation in measurementquality could be explained by 13 survey design characteristics;characteristics of respondents explained a small additionalportion. Results provide: (a) information on design conditionsassociated with better (or worse) measurement quality, (b) empiricallybased suggestions for improving measurement quality in futuresurveys, and (c) a set of coefficients for predicting the qualityof measures not studied here.     

Interviewing young children with anatomical dolls

Although children under six constitute a large number of sexual abuse victims, their immature intellectual and emotional development can severely hinder efforts to validate reported or suspected abuse. Interviewing with anatomical dolls offers a potential avenue of communication if interviewers are trained to use the dolls with care and an understanding of both their value and misuse. This article provides a full set of guidelines.     

The extent and nature of alcohol-related problems in public senior housing

To examine both the extent and nature of alcohol-related problems in senior housing and how management responds to these problems, 100 local housing authorities (LHAs) in Connecticut with responsibility for senior housing were surveyed. The response rate was 90%. Results indicated variability among LHAs regarding their experiences with alcohol misuse among residents. It was evident in the numbers of residents abusing alcohol, the procedures for addressing problems when they occur, and LHAs' assessment of the extent and seriousness of problems. Few LHAs had either staff training regarding alcohol abuse or policies to address alcohol-related problems. Conclusions concerning whether alcohol-related problems were widespread in public senior housing were related to the size of the LHA. Housing specialists, public policymakers, and educators should assist management personnel in developing policies and procedures regarding misuse of alcohol. In addition, resources should be directed to educate housing authority staff about detection of the problem and strategies for intervention.     

Recovery coaches and the stability of reunification for substance abusing families in child welfare

Substance abuse is a long-standing challenge for child welfare systems. Parental substance abuse disrupts family stability, family cohesion, and jeopardizes the well-being of children. In the current study we test an intervention to improve child welfare outcomes for substance abusing families, specifically the probability of families achieving a stable (at least 12 months) reunification. The intervention was an integrated case management model where recovery coaches were appointed to substance abusing parents associated with an open foster care placement. A diverse group of families (n = 1623) were randomly assigned to either a control group (services as usual) or an experimental group (services as usual plus a recovery coach). Multinomial logistic regression indicated that substance abusing parents associated with a recovery coach were significantly more likely to achieve a stable reunification as compared with similar families in the control group.     

Childhood sexual abuse patterns, psychosocial correlates, and treatment outcomes among adults in drug abuse treatment

This study reports on the effects of having a history of childhood sexual abuse (CSA) on treatment outcomes among substance abusing men and women (N = 2,434) in a national, multisite study of drug treatment outcomes. A history of CSA was reported by 27.2% of the women and 9.2% of the men. Controlling for gender, compared to patients without CSA, patients reporting CSA were younger at entry into the current drug treatment, were more likely to be White, were more likely to have a comorbid mental disorder, be alcohol or cocaine dependent, had higher levels of criminal activities, had a higher level of problem recognition, and had a more negative peer influence. Controlling for these correlates, a history of abuse was related to a lower likelihood of posttreatment abstinence.