Child maltreatment types and adolescent substance use: The role of deviant peer affiliation

This is the first study to examine the mediating effects of deviant peer affiliation on the association between different types of child maltreatment and adolescent substance use that includes alcohol, tobacco, and marijuana. Peer deviance is a well‐established correlate of adolescent substance use, but most studies exploring the relationship between child maltreatment and adolescent substance use have failed to include peer deviance. Structural equation modelling was conducted to examine the direct effects of each type of child maltreatment (i.e., physical, sexual, and emotional abuse, and neglect) on adolescent substance use, as well as indirect effects via deviant peer affiliation, using Longitudinal Studies of Child Abuse and Neglect. The results indicated that deviant peer affiliation fully mediated the individuals who had been emotionally abused showed increased deviant peer affiliation, which in turn was associated with higher levels of adolescent substance use. None of the four types of child maltreatment was directly associated with adolescent substance use. The study's findings underscore the importance of early assessment and intervention for the peer relationships of youth who have been emotionally abused.     

American Juvenile Justice: Recent Trends and Issues in Youth Offending

Trends in juvenile offending in the United States since the 1970s are reviewed. Serious youth violence, co-occurring mental health and substance abuse problems among offenders, female delinquency, and other issues currently confronting the American juvenile justice system are examined. Policy considerations associated with recent trends in juvenile offending among American youth are identified.     

Childhood maltreatment among Norwegian drug abusers in treatment

This article reports on the investigation of the correlation between the European Addiction Severity Index (EuropASI) and the Childhood Trauma Questionnaire (CTQ) among 102 Norwegian drug abusers admitted to treatment. The aim of the study is to explore how different types and levels of childhood trauma and social and psychiatric factors, medical situation and experienced family history are interrelated. The study addresses three main questions: 1) What is the prevalence of different kinds of childhood trauma among drug abusers in treatment? 2) Does type or level of maltreatment in childhood predict specific substance abuse problems as adults and/or specific social, psychiatric and medical problems as adults? 3) Do substance abuse problems and mental health problems in the primary family predict different types and levels of childhood maltreatment? Twenty‐five per cent of the total sample was included in the high‐level trauma group and 54% in the intermediate‐level group. Females had significantly higher scores than males in all types of childhood trauma. The strongest correlations were found between childhood trauma and lifetime psychiatric problems and psychiatric status during the last 30 days before admission for treatment. More research, and especially prospective studies, is needed to clarify the importance of parents' substance abuse and psychiatric problems in childhood/adolescent compared with trauma in the client's childhood and the client's current psychiatric status.     

Patterns of offending behaviour over time for different groups of children in relation to time spent in and out of care

Children who spend time in care are more likely to have an official record of offending behaviour than the general population. However, there is a lack of longitudinal research on the timing, severity, and volume of offending in relation to time spent in and out of care. Furthermore, differences in patterns of offending by identifiable groups in care are rarely a focus of research. This study is both longitudinal and identifies 8 groups within the care population with different volumes of recorded offending: ranging from a mean of 41.75 (prolific) to 1.60 (low). Substance misuse, gender, and reasons for referral to care were associated with different patterns of offending in and out of care. The study is primarily based on a subsample of 64 children who had offended whilst in care. The subsample represents 38.5% of a cohort of children who had been in care or were taken into care over a particular period (2008–2011) in one local authority. The placements and recorded offences of the 64 children were tracked for a further 2 years (2011–2013). The study highlights future areas of research and the need for more tailored responses to different groups within the care system.     

Examining Protective Factors for Dysthymia Among Individuals Attending Substance Abuse Treatment

ABSTRACT

Dysthymia affects millions of people and has been associated with impaired psychosocial and occupational functioning and poor clinical treatment outcomes. Yet few studies have examined protective factors that can be utilized to help individuals with dysthymia in clinical settings, particularly among individuals with comorbid substance use disorders. The purpose of this study was to examine the potential protective quality of adult attachment dimensions, spirituality, and meaning in life among clients with and without dysthymia in treatment for addiction. Data were obtained from 305 self-report questionnaires administered to clients attending a residential substance abuse treatment center. Approximately 25% of the sample met criteria for dysthymia. Results from logistic regression analyses indicated that purpose and meaning in life and attachment anxiety were the most important protective factors against having dysthymia. These results suggest that mental health professionals may need to integrate these protective factors into the treatment of individuals with dysthymia and substance use disorders, which may enhance treatment outcomes and maximize treatment effectiveness. Future studies should continue to explore protective factors that can assist individuals who experience these comorbid conditions and consider replicating this study using an ethnically diverse sample and other clinical settings to determine the generalizability of the findings.     

Coping Styles in Persons Recovering from Substance Abuse

This qualitative study was conducted among persons recoveringfrom substance abuse. The data were collected in three rehabilitationfacilities in Trinidad in 2002–03. The aim was to examinethe types of coping strategies which subjects used and learnedin response to stressful and problematic life situations, startingwith experiences related to childhood and socialization. Thecoping styles reported were overwhelming in the category ofemotion-focused coping, developed in the main to regulate stressin uncontrollable situations in childhood and to cope with theloss of significant others. Only a minority used, or were ableto use, problem-focused or social support coping strategiesto meet stressful events. It is suggested that the observedbias in the development of the individuals’ coping ‘armamentarium’might have had, in the long run, negative implications for individuals’capacity to meet ongoing challenges of life. This has criticalimplications for how we fashion preventive approaches to theproblem of substance abuse.     

Physical and Sexual Abuse,Battering, and Substance Abuse

Abstract

Women born before 1945 are the older women of today. Many of these women were subjected to childhood physical and sexual abuse and spouse battering at a time where there were no laws to protect them and few people discussed such subjects. Some of these women became substance abusers or lived with substance abusers. While there are retrospective studies on the experiences of adult women who suffered abuse in the family, little is known about the experiences of women over the age of 60 years.

Similarly, there is information on substance abuse among young and middle-aged women, but very little information on or about older womens' experiences with substance abuse. In this study, we review the literature on abuse and substance abuse. We present three clinical cases of older women who have experienced various forms of abuse and who in turn abuse substances. The cases are analyzed. Assessment, treatment, and evaluation methods for social workers are discussed.     

Baby Boomer’s Substance Abuse and Researcher Indifference

The current older adult population is more likely to need and seek treatment for alcohol and drug abuse than previous cohorts of older adults, which necessitates the need for age-appropriate substance use treatment. Building on previous research that examined the lack of attention on substance use among older adults, this study examines articles addressing substance use disorders among older adults in leading gerontological and substance abuse journals and federal funding between 2011 and 2017. Publications were identified from ten leading gerontological and ten leading substance abuse journals using Medical Subject Heading (MeSH) terms. During this time-period, there were 68 and 44 articles published in gerontology and substance abuse journals respectively related to substance use disorders in older adults. Most (59.8%) addressed alcohol abuse and 7% involved intervention studies. In the 7-year period, there were 13 federal grants. A paucity of published or funded work exists in this area despite growing misuse and treatment seeking among older adults with substance use disorders. Effectively addressing substance abuse in older adults will require a coordinated effort between researchers and practitioners to establish and implement best practices for practitioners to rely on when working with substance abusing older adults.     

Iwi community justice panels reduce harm from re-offending

ABSTRACT

The effect of iwi community justice panels is assessed using data from seven years of implementation. Panel participants of 1013 are compared to a control group drawn from 73,000 offenders charged with similar offences and propensity-matched by age, gender, ethnicity, offending history and location. The dependent measure is re-harm from offending calculated using the NZ Crime Harm Index. Panel participants did not reduce their rate of offending compared to matched controls. However, there is a significant reduction in harm from post-panel offending, on average by 26.9 ± 21.05 equivalised prison days. The relative reduction is 22.25% of the harm committed by matched controls. Iwi panels are an effective alternative justice resolution. Panel participants are found to re-offend with minor offences and thus any focus on rates of offending would miss the complexity of the restorative justice process that reduces the harm of re-offending.     

Treatment progress of foster care adolescents with severe behavioural problems: Factors conditioning their performance in the residential treatment centres

Behavioural problems are a recurring issue in the child welfare system population. Normative residential centres do not have the characteristics to address the specific needs of these adolescents, so they are usually treated at therapeutic residential centres. In Catalonia (Spain), these cases are treated in intensive educational residential centres (CREIs), a variant of therapeutic residential care (TRC) facilities. This exploratory study seeks to understand the treatment progress of adolescents with severe behavioural problems who were placed in the CREIs, a variant of TRC facilities. Data from 206 cases, the totality of population under treatment in the CREIs, were collected using a questionnaire administered to the treating team. A cross‐sectional design was used, applying quantitative methods to analyse the incidence and interrelation of a series of variables related to the progress of adolescents in the CREIs. Significant differences among profiles by sex, place of origin, criminal offences, substance abuse and mental health disorders were found. Furthermore, adolescents who performed a positive treatment progress according to the professional staff arrived at the CREI at an earlier age and had longer stays than the group with an unremarkable progress. Logistic regression indicated that duration of stay in the centre and runaways predict the adolescents' treatment progress. This treatment is working well with the milder cases; however, it does not tend to be successful for adolescents with greater difficulties. It is recommended that interventions focus on factors that engage the adolescents in their own rehabilitation process, include substance abuse programmes and consider the gender perspective.     

Supervisor ideology and organizational response: HIV/AIDS prevention in outpatient substance abuse treatment units

Distinct practice ideologies or ideologies of care are deemed to influence greatly the selection of intervention methods and the mix of services adopted by the providers. Examined here is the relation between clinical supervisor ideology and variation among human service organizations in their provision of HIV/AIDS prevention services. Data were drawn from a 1990 national, representative sample of outpatient substance abuse treatment (OSAT) units. The study affirms that ideology is central to both means and ends in HSOs, helping to define the organization's mission and goals, and establishing guidelines for practice and procedures. Future research on the relationship between ideology and HIV/AIDS education can benefit from efforts to develop alternative strategies for measuring ideologies of care among both managers and staff in substance abuse settings.     

The Associations Between Socioeconomic Status,Caregivers' Depressive Symptoms,Children's Health‐Promoting Behavior,and Children's Physical Health: A Mediation Model

The aim of this study was to examine the mediating effects of children's health‐promoting behaviors on the association between socioeconomic status, caregivers' depressive symptoms, and children's physical health outcomes. We used the first wave of “Seoul Education and Health Welfare Panel.” Data were collected from 820 fourth‐grade elementary and first‐year middle school students and their caregivers using self‐administered surveys. Structural equation modeling was employed to analyze the mediating effects of health‐promoting behaviors. Bias‐corrected bootstrap confidence intervals were used to test the mediating effect. The results showed that both low socioeconomic status and caregivers' depressive symptoms were negatively associated with a child's health‐promoting behaviors. Children's health‐promoting behaviors were positively associated with physical health. However, children's physical health was not significantly associated with socioeconomic status but was marginally associated with caregivers' depressive symptoms. We found that children's health‐promoting behaviors significantly mediated associations between both socioeconomic status and children's physical health and between caregivers' depressive symptoms and children's physical health. Based on the findings, we suggest the development and implementation of school‐based, health‐enhancement programs as a means to improve the general health of all children and to reduce health inequalities.     

A Review of Car Crime in England and Wales

Summary With 21 per cent of offences recorded by the police in the 12months ending March 1999, and representing 1,077,700 theftsof and from vehicles, motor vehicle crime is the single mostcommon offence in England and Wales. Young males under 21 yearshave been found to be responsible for three-quarters of carthefts. Studies in the United Kingdom suggest the characteristicsof these offenders include those associated with socio-economicdeprivation and poor self-esteem; whilst for many, involvementin car crime is a means of seeking excitement. The requirement to identify the needs of car offenders, andthe establishment of intent and purpose within offending behaviourprogrammes, saw an increase in the number of probation-basedmotor projects from 1990. Access to the car, and opportunitiesto drive in controlled environments were present in some ofthe newer projects, although many had abandoned this principle.Whilst little empirical evidence exists to support their claims,a number of projects have boasted success in their efforts toreduce the risks of further car crime amongst offenders whohave completed programmes at motor projects as part of theirsentences. Eight motor projects that challenge offending behaviourare reviewed and the latest Home Office evaluation discussed.     

Predicting Retention in Three Substance Abuse Treatment Modalities Among Anglo,African American,and Mexican American Juvenile Offenders

Abstract

Many of the same factors that predict delinquent behavior also predict adolescent drug use. This study examined factors that predict, and interventions that maximize, substance abuse treatment retention in three modalities among high-risk Anglo, Mexican American, and African American juvenile offenders. The study sample includes youth (N = 211) who were discharged from probation supervision and who received substance abuse services through a CSAT-funded federal demonstration project. The key predictors examined included the stage-of-change (i.e., precontemplation, contemplation, preparation) in which a juvenile fell, various dimensions captured by the Comprehensive Addiction Severity Index for Adolescents, and other intervention status (probation, case management, and mental health treatment). The research questions were addressed using statistical models known as survival analysis that treated time from entry into substance abuse treatment to exit from substance abuse treatment as the outcomes. Among key findings were that females were 73% more likely to leave day treatment relative to males; for each additional family problem ever experienced, Mexican American adolescents were 15% more likely to leave residential treatment compared with African American adolescents; and African American and Mexican American adolescents in the contemplation stage-of-change were 50% less likely to leave day treatment compared with Anglo adolescents. Applications for practice and research with this population are discussed.     

An exploratory study of substance abuse among Latino older adults

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

Rising to the Challenge of Treating OEF/OIF Veterans with Co‐occurring PTSD and Substance Abuse

This article reviews data on the relatively high incidence of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans reporting mental health and substance abuse problems, and some perceived barriers that may account for low rates of their engaging in treatment. Treatment outcomes for veterans with co‐occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) are generally poorer than for those with PTSD or substance abuse alone. Several evidence‐based individual therapy approaches offered by VA Medical Centers are described along with how they conceptualize the relationship of substance abuse to PTSD. Problems with sequential treatment for persons with PTSD and substance abuse in specialized programs are discussed, including notably the practice of requiring veterans to be completely drug and alcohol free for a month or longer prior to entering PTSD treatment. Several integrated treatment programs are described along with a brief summary of evidence supporting their effectiveness. Some recent policy changes from the Department of Veterans Affairs that bode well for the future of PTSD/SUD treatment are described. Differences between younger and older veterans were cited along with their implications for treatment. Recommendations regarding how to better engage and retain OEF/OIF veterans with PTSD/SUD in treatment are presented together with examples of their implementation. The author concludes that to rise to the challenge of treating this difficult population it is necessary to adapt treatment to meet their needs rather than requiring them to adapt to therapies that may not be a good fit.     

Perceptions of Students about Younger and Older Men and Women who May Be Homeless

ABSTRACT

Future human service providers will interact with homeless persons in health, mental health, and social service practice contexts. This study investigated the perceptions of students enrolled in social work courses who are pursuing degrees in human service programs toward older and younger female and male homeless individuals. Respondents (N = 207) were given one of four vignettes in which a character was identified as an older male, a younger male, an older female, or a younger female who was frequently seen near an interstate highway, talking to him/herself and appearing unkempt, thin, and frail. Most respondents perceived the vignette character as mentally ill, neglectful of health, likely to have HIV, tuberculosis, hepatitis A and/or hepatitis B and/or hepatitis C, likely to experience suicidal thoughts/ideation, and to have head lice/scabies/body lice. Older men were more likely to be perceived as military veterans with a history of mental illness and substance abuse. Older women were least likely to be perceived as having a history of substance abuse or using a handout to purchase ethanol. Older women were perceived to be homeless because they could not afford other living accommodations. A general linear model revealed significant differences in 7 of 41 items that respondents answered based on the gender and age of the vignette characters. These perceptual differences between male and female homeless persons will require additional investigation.     

An Exploratory Study of Substance Abuse Among Latino Older Adults

ABSTRACT

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

Child sexual abuse: a marker or magnifying glass for family dysfunction?

A report of child sexual abuse leads to a multi-agency investigation that often reveals other maltreatment and dysfunctional behaviors within the family. Due to recent developments in this field, the emphasis of the investigation has shifted to the child’s history rather than information from the parent or accused, or the presence of injuries. In the last 10 years Children’s Advocacy Centers have become a central component to the investigation of child sexual abuse and provide a means for long-term follow-up of referred families. The idiosyncrasies of this investigative and advocacy system have provided an in-depth view of the families of sexually abused children.Four family types emerge: safe and secure, safe and insecure, unsafe and enmeshed, and unsafe and insecure. The characteristics of child sexual abuse, the response to the child’s disclosure of abuse, and the prognosis for the child victim vary among the different family types. An innovative long-term program of wrap-around services for sexually abused children and their families provides counseling, peer activities, family mentoring, and child mentoring while tracking the symptoms and behaviors of the child victims. The identification of a child victim of sexual abuse can be a tragic crisis and an opportunity for intensive and timely intervention.     

Linking illicit substance misuse during pregnancy and child abuse: what is the quality of the evidence?

In most Australian states, legislation makes provision for professionals to report their concerns about the future welfare of an unborn child to appropriate authorities. The legislation establishes guidance for the implementation of family supports to minimize future child protection involvement. Given the legislation and the potential benefits, empirical research linking substance misuse during pregnancy and child protection involvement is relatively limited. We review 21 original studies linking substance misuse during pregnancy with child protection outcomes and the potential generalizability of results to the Australian context. The majority of studies reviewed were conducted in the USA and were mostly retrospective. Other differences between studies include sample sizes, comparison groups, study setting, participants’ ethnicity and pattern of drug use. In the postnatal literature, it is well established that child abuse is associated with a complex array of factors including partner, as well as broader family factors and yet, the studies reviewed focus upon maternal substance abuse without including the wider context. Given the available evidence‐based literature, it is difficult to come to definitive conclusions that can assist clinicians involved in frontline decision‐making for early intervention. Well‐designed research, accessible by antenatal health‐care professionals, is needed to adopt an evidence‐based approach to risk assessment in the prenatal context.