Tackling Problem Drug Use

SUMMARY

Successful 'recovery' from long-term problem drug use has depended largely upon understanding and tackling the physiological and psychological nature of drug dependence; however, drawing upon research and practice in Liverpool, England, the author questions whether this discourse is sufficient given the changing nature, context and attitudes towards drug consumption in the twenty-first century. This article emphasises the importance of incorporating structural and social factors. Drawing upon qualitative data from three separate studies, the author illustrates how stigmatisation, marginalisation, and social exclusion are significant debilitating components that have tended to be overlooked. This paper contributes new insights into the damaging impact of political rhetoric and structural discrimination that has placed many long-term drug users vulnerable to relapse. In response to these findings the author offers a new conceptual framework for practice that incorporates and promotes an understanding of the social nature and context of long-term drug dependence.     

Characteristics of responding-, nonresponding- and refusing-parents in an adolescent lifestyle choice study.

The acquisition of a random sample is one of the many methodological problems that arise when conducting research with adolescent populations. Frequently, due to ethical considerations associated with collecting data from adolescents, active parental consent procedures are required. The current study examined characteristics of parents who consented, refused consent, or did not respond to an active consent request for their children to participate in a large-scale study of adolescent lifestyle behaviors. Results indicated nonresponding-parents were more likely to be employed than consenting-parents. Further, differences were found for a number of attitudinal variables and about the importance of adolescent research. There were significant differences between refusing-parents, and consenting- and nonresponding-parents who were similar in their attitudes toward adolescent research. The findings suggest that nonresponding-parents are characteristically more similar to consenting-parents than to refusing-parents, which supports the use of passive consent procedures as a reasonable alternative to requiring active parental consent in adolescent research.     

Harsh Parenting,Deviant Peers,Adolescent Risky Behavior: Understanding the Meditational Effect of Attitudes and Intentions

Although research supports the influence of parents and peers on adolescent risky behavior, less is known about mechanisms proposed to explain this relation. This study examined the influence of adolescent attitudes and intentions about such behaviors. Prospective, longitudinal data came from rural youth who participated throughout adolescence (n = 451). Observed harsh parenting and relationship with deviant peers was assessed in early adolescence, attitudes and intentions were measured during middle adolescence, and risky behavior was assessed in late adolescence. Results indicated that parenting and deviant peers was related to engagement in tobacco use, alcohol use, and risky sexual behaviors. Moreover, attitudes and intentions mediated this relationship even after parent use and adolescent early involvement in these behaviors were taken into account.     

Oral Cancer Risk Behaviors Among Indiana College Students: A Formative Research Study

Objectives: In fall 2004, the authors used a survey to assess the knowledge, attitudes, motivations, and behaviors of college students relative to oral cancer prevention to inform development of targeted prevention programming. Participants: A convenience sample of 1,003 undergraduate students at one public university in Indiana participated. Methods: Discriminant function analysis was employed to analyze participants' motivations; perceived risks; individuals who influence participants' alcohol, tobacco, and marijuana use; and factors that facilitate and discourage use. The study sample was divided into users and nonusers to differentiate between groups and predictor (discriminating) variables. Multiple regression analysis was used to determine the extent to which participants' knowledge, attitudes, peer perceptions, sex, age, and ethnicity contributed to participants' combined alcohol, tobacco, and marijuana use behaviors. Results: With 2 exceptions, discriminant function analysis (p < .01) correctly categorized user status (ie, nonusers vs combined users of alcohol and cigarettes; nonusers vs combined users of alcohol, cigarettes, and marijuana) by the predictor variables. Multiple regression analysis to determine whether independent variables predicted combined drug use generated significant (p < .01) results across all combined use behaviors. Conclusions: Multiple oral cancer prevention program options along with additional formative research efforts were suggested by study results.     

The effects of perceived parental behaviors, attitudes, and substance-use on adolescent attitudes toward and intent to use psychoactive substances

The effects of parental behaviors, attitudes, and drug-use as perceived by adolescents on the latter's attitudes toward and intent to use psychoactive substances were studied. Perceived parental rejection, acceptance, and attitudes significantly differentiated between adolescents who reported favorable attitudes toward and high intent to use substances and those who expressed less favorable attitudes. On most parameters, the father's influence was significant, whereas the effect of the mother did not reach significance. Positive and significant relationships were also found between perceived parental rejection, acceptance, and attitudes and adolescent attitudes and intent to use psychoactive substances. No relationships were found between controlling parental behavior and adolescent attitudes and intent to use psychoactive substances. The role of the parents, as well as implications of the findings for prevention are discussed.     

Dimensions of Adolescent Employment

Work during adolescence, including part-time work during the school year, has been viewed as vocational behavior with mixed effects on other behaviors and attitudes. Using two different samples (West Point cadets and high school seniors who qualified for ROTC membership), we examined possible positive and negative correlates of adolescent work as a function of work dimensions, and both concurrent and subsequent performance criteria. Results indicated that concurrent costs and benefits of adolescent employment may depend on dimensions of work as well as adolescent characteristics. Similarly, adolescent employment was found to be generally related to subsequent work motivation and nonacademic performance.     

Predicting continued use of marijuana among adolescents: the relative influence of drug-specific and social context factors.

Most research on the determinants of adolescent drug use has focused on predictors of either initiation or current use. Little attention has been given to the determinants of continued use of drugs after initiation, even though some researchers have found that the consequences of continued use are more serious than those associated with experimental or occasional use. In this study, a longitudinal sample of 456 secondary and high school students who had already tried marijuana was used to examine the determinants of continued use of marijuana. Nearly 38 percent of those who had tried marijuana continued using, according to the definition operationalized in this study. Potential predictor measures were grouped in a drug-specific domain and a social context domain, and their effects on continued use, controlling for background characteristics, were examined in logistic regression models. Results showed that only the drug-specific domain had a statistically significant effect on the likelihood of continued use. Students who felt that the adverse physical and psychological effects of marijuana were not very important reasons for discontinuing use and those who had gotten stoned during their experimental stage of use were the most likely to continue use after initiation. The results suggest that the perceived physical and psychological effects of the drug are more important determinants of continued use than are social factors or benefits related to use. Any relationships between social factors and continued use are mediated by the perceived effects and risks of the drug.     

Adolescent females who have sexually offended: comparisons with delinquent adolescent female offenders and adolescent males who sexually offend

Very little is known about adolescent females who commit sexual offenses. In this two-part exploratory study, a sample of 11 adolescent females with sexual offense histories is described. In Study I, the sample is compared to an age-matched sample of 11 adolescent females with non-sexual victim-involved offense histories. The sexually offending group had significantly fewer antisocial behavior problems, such as alcohol or drug use problems, problems with fighting, or problems at school. They began their offense behaviors at younger ages than their non-sex offending delinquent peers. Few differences emerged with respect to attitudes about offense behaviors, such as level of denial. In Study II, the same sample of females with sex offense histories was compared with a group of age-matched adolescent males with sex offense histories. The two sex-offending groups were found to be remarkably similar. There were few differences with respect to psychosocial and criminal histories, antisocial behavior, and variables related to clinical presentation and treatment (e.g., level of denial about offense). Likewise, the two groups are remarkably similar with respect to specific sex offense behaviors. The females, however, appear to have experienced more severe and pervasive abuse compared to the males.     

The Social Construction of Romantic Relationships in Adolescence: Examining the Role of Peer Networks,Gender, and Race*

Romantic activity is a social psychological phenomenon. Gender, race, and peer networks are key contexts for understanding the social construction of this behavior as gender‐ and race‐based norms structure feelings and behaviors that define “appropriate” romantic activity and peer networks serve as incubators of this activity. With a nationally representative sample of adolescents (N= 8510) drawn from the National Longitudinal Study of Adolescent Health, this study explored the linkages among peer networks, conceptions of idealized romantic relationships and actual romantic relationships, and the ways in which gender and race moderate these associations. Several characteristics of peer networks predicted adolescent attitudes about romantic behaviors as well as actual romantic behavior. Moreover, the linkages among peer networks, romantic attitudes, and romantic behaviors varied by race.     

Ethnic identity, neighborhood risk, and adolescent drug and sex attitudes and refusal efficacy: the urban African American girls' experience

This study examined the impact of ethnic identity and neighborhood risk on drug and sex attitudes and refusal efficacy among early adolescent urban African American females (n = 175). The model also predicted a moderating relationship of ethnic identity on neighborhood risk for drug and sex attitudes and refusal efficacy. Data were collected as part of a larger drug education program and analyzed via hierarchical multiple regression. The analyses controlled for household structure and menarche. Results indicated a direct relationship of higher ethnic identity and higher sexual refusal efficacy, higher disapproval of drug use, and lowered intentions to use drugs. Neighborhood risk was directly related to lower disapproval of drug use. There was a small moderating effect of ethnic identity on neighborhood risk for intention to use drugs. Findings provide support for prevention programs for African American youth that seek to reduce risk behaviors by increasing ethnic identity, particularly in low resource communities.     

Cybersex and the E‐teen: What Marriage and Family Therapists Should Know

Adolescents who use the Internet regularly (the “e‐teen”) present a new set of challenges for marriage and family therapists. This article introduces marriage and family therapists to (a) the basic technological concepts and unique psychological characteristics of the Internet important in understanding and addressing adolescent online sexual behavior, (b) the appropriate developmental expectations for teens online, including risk‐taking behaviors and critical decision‐making skills, and (c) suggested strategies for assessment, prevention, and intervention when dealing with problematic online sexual behavior in adolescents. Marriage and family therapists cannot ignore the role the Internet plays in adolescent sexual development and its implication for the family. This article will serve as a primer for the marriage and family therapist when presented with adolescents who engage in online sexual behaviors.     

Reducing HIV/AIDS high-risk behavior among injection drug users: peers vs. education

This study examines the effects of peer groups and education on risk behavior for HIV among injection drug users (IDUs). The sample consisted of 682 participants in the Eastern Connecticut Health Outreach project, which compares traditional and peer-driven outreach interventions for IDUs. Participants are educated about safer injecting, subsequently administered a risk-reduction knowledge test, and given an extensive interview. Logistic regression shows that education alone is not a significant factor in reducing risky behavior in IDUs among the behaviors studied. A significant interaction was found between peer support for safer use and personal saliency of peer attitudes for both syringe and water sharing. Neither peer attitudes nor education affected cooker sharing. These results suggest that while education may be an important component in any intervention, it is not alone sufficient to reduce risky behavior. Our findings suggest that peer-directed interventions may be useful in reducing some forms of risk behavior among IDUs.     

Stigma Consciousness Concerns Related to Drug Use and Sexuality in a Sample of Street-Based Male Sex Workers

Abstract

Measurement of, and response to, three different stigmas and their exposure (homosexual behavior, sex work, and drug use) were studied a group of 90 key-informant recruited male sex workers in Houston, Texas who were over 18 and had exchanged sex for money in the previous 7 days. Respondents reported on self-identified sexual orientation and were interviewed, including providing responses on a measure of perceived stigma relating to sexual behavior and drug use. Two thirds were white, almost all had used drugs (many in the past week), and half had ever injected. A fifth identified as heterosexual, with the remainder split between gay and bisexually-identified men. There was a high level of homelessness and contact with the criminal justice system for drug and property offences. Consciousness about drug-related stigma was moderately associated with concerns about drug-related exposure and sensitivity to rejection as a drug user, but not to exposure as homosexual or as a sex worker. Drug-using status is related to greater concern about exposure as a sex worker. Data suggest that stigma is domain-specific and that there are different patterns of response to different stigmata in the same individual. Measurement of stigmata and concern about exposure and rejection need to be specific to stigmatized behaviors, and not generalized to other stigmatized behaviors since the data suggest that they are minimally related.     

Attributions and coping in sexually abused adolescents referred for group treatment

This study aims to assess the predictive value of two sets of variables, self-attributions, and coping behaviors, on sexually abused (SA) teenagers' functioning, while controlling for abuse-related and family variables. A total of 103 female adolescents completed self-report measures to assess their psychological functioning in terms of anxiety, depression, PTSD, sexual concerns, dissociation, anger, their self-injurious behaviors, antisocial behaviors, and drug use. After controlling for SA and family characteristics, final regression models indicate that attributions and coping behaviors explained between 22% and 39% of additional unique variance for seven out of the nine measures of adolescent functioning. Attributions and coping behaviors did not significantly explain additional variance for scores of antisocial behaviors and drug use. Personal attributions of blame for negative events were the strongest predictors of adolescents' functioning. Implications for future research and interventions are highlighted.     

Acute psychotic symptoms linked to adolescent marijuana use

Many adolescent marijuana users report acute symptoms — paranoia, anxiety or hallucinations — associated with their use of the drug, researchers from Boston Children's Hospital and Harvard Medical School have found. Rates of these symptoms were higher among regular users, those who met criteria for cannabis use disorder (CUD) and those who were also depressed.     

Social Psychological Processes that Facilitate Sexual Assault within the Fraternity Party Subculture

Rape on the college campus has gained increasing amounts of attention in higher education, mainstream news, and public policy. The prevalence rates of rape are especially high among students who frequent campus parties, such as those hosted by fraternities. Researchers have described this increased risk by focusing on individual attitudes and behaviors of fraternity members or on the organizational norms and practices within the fraternity party subculture. To incorporate these studies into a single theoretical framework, this essay uses a social psychological approach to connect individual‐level attitudes, (sub)culture, and behavior. I describe and apply identity theory and affect control theory, two structural symbolic interactionist theories, to explain why certain men are drawn to high‐risk fraternities and how membership reinforces hostility toward and abuse of women. In doing so, I suggest several avenues for future research that would increase social psychological understanding of the heightened prevalence of sexual victimization within the fraternity party subculture.     

Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study

The effects of parental attitudes, practices, and television mediation on adolescent sexual behaviors were investigated in a study of adolescent sexuality and media (N = 887). Confirmatory factor analyses supported an eight‐factor parenting model with television mediation factors as constructs distinct from general parenting practices. Logistic regressions indicated that adolescents reporting greater parental disapproval and limits on viewing at Wave 1 were less likely to initiate oral sex between Waves 1 and 2. Adolescents who reported more sexual communication with parents were more likely to initiate oral sex. Results for vaginal intercourse were similar to those for oral sex. Coviewing was a significant negative predictor of initiation of sexual behavior. Parental attitudes and television mediation can delay potentially risky adolescent sexual behaviors.     

A comparison of drug involvement between runaways and school youths

Problems related to homeless/runaway youths have received increased attention in recent years. Homeless/runaway youths manifest many problems in addition to being absent from home and without supervision of a parent or guardian. The purpose of the study was to determine drug use and abuse patterns of homeless/runaway youths and to compare those patterns, along with attitudes toward selected illicit behaviors, with similar data collected from adolescents in school. Data were collected from persons (n = 253) in homeless/runaway shelters in the southeast United States. Comparisons made with data from other studies of runaways and of youths in school indicate that drug use and abuse is two-three times more prevalent for runaways than with the school youths. Runaways' attitudes toward selected illicit behaviors are more tolerant than those of school youths. Intervention programs for runaway/homeless youths should reflect an understanding of the complexity of the psycho-social and behavioral history of the clients which is much different than that of those who are in school.     

Pornography Actresses: An Assessment of the Damaged Goods Hypothesis

The damaged goods hypothesis posits that female performers in the adult entertainment industry have higher rates of childhood sexual abuse (CSA), psychological problems, and drug use compared to the typical woman. The present study compared the self-reports of 177 porn actresses to a sample of women matched on age, ethnicity, and marital status. Comparisons were conducted on sexual behaviors and attitudes, self-esteem, quality of life, and drug use. Porn actresses were more likely to identify as bisexual, first had sex at an earlier age, had more sexual partners, were more concerned about contracting a sexually transmitted disease (STD), and enjoyed sex more than the matched sample, although there were no differences in incidence of CSA. In terms of psychological characteristics, porn actresses had higher levels of self-esteem, positive feelings, social support, sexual satisfaction, and spirituality compared to the matched group. Last, female performers were more likely to have ever used 10 different types of drugs compared to the comparison group. A discriminant function analysis was able to correctly classify 83% of the participants concerning whether they were a porn actress or member of the matched sample. These findings did not provide support for the damaged goods hypothesis.