Associations between gambling,substance misuse and recidivism among Canadian offenders: a multifaceted exploration of poor impulse control traits and behaviours

Moderate correlations among gambling, substance use and crime suggest these three behaviours may each be indicators of a single underlying problem trait, such as poor impulse control. We tested whether self-reported traits prospectively predicted future criminal recidivism, when accounting for incarcerated adult offenders' past criminal behaviour, substance use and gambling behaviour. We took a multi-construct approach to measuring components of impulse control, utilizing three questionnaires that assess sensation seeking, poor premeditation, and reward sensitivity. Male participants incarcerated in two federal institutions were invited to complete self-report booklets; participation was self-selected and fully voluntary. Results indicated moderate correlations between measures of trait impulse control, self-reported drug use, and official criminal history (N = 140). Gambling problems prospectively predicted post-release criminal recidivism (n = 83), even when accounting for past criminal behaviour, impulse control traits and substance misuse. Although they represent a small percentage of this sample, results suggest offenders with high gambling problems represent a particularly at-risk group for future crime, who were more than four times likely to reoffend compared to offenders without problem gambling. These results suggest there may be mutual impact of problem behaviours on life outcomes above the contribution of poor impulse control.     

Effects of Substance Abuse Central Intake on Treatment and Justice Costs

ABSTRACT

The cost-benefits of a central intake intervention for substance abuse treatment referrals were demonstrated using a transaction cost analysis on two cohorts of participants during the three-year initiative. Costs for clients receiving central intake services were compared with those just prior to the intervention's implementation. In order to study the relationship between substance abuse treatment costs and avoided criminal justice costs, data from three administrative data sets were used. Results indicate that clients receiving the central intake intervention had approximately a 58 percent decrease in costs compared to clients not receiving the intervention. The initiative produced opportunity cost savings to treatment, court, and correctional systems, with completion being crucial to opportunity cost savings.     

Sociodemographic and maternal behaviors in younger and older pregnant adolescents

Sociodemographic and maternal behaviors were examined in a group of 295 (59%) younger adolescents 10–17 years of age, and compared to a group of older adolescents over 18 (n=203, 41%). Younger adolescents were more likely to be single, of minority group status, family dependent, and poor users of contraceptives. Older adolescents had higher rates of substance abuse, treated psychiatric problems, and abortion histories. Both groups reported parental drinking problems, parental divorce, and poverty. Health indicators did not show differences between groups, although older adolescents had higher than national average low birth weight babies. The age of first pregnancy was markedly lower for the younger than older teen. These findings support the need for prevention strategies in treatment programs.     

Comparing the Lifestyles of Victims,Offenders, and Victim-Offenders: A Routine Activity Theory Assessment of Similarities and Differences for Criminal Incident Participants

Abstract

Drawing on routine activity theory, this paper examines a sample of college students involved in criminal assault to assess whether victims, offenders, and those who are both victims and offenders show similarities on demographic, social activity, neighborhood, exposure, illegal activities, and alcohol and drug use variables. This research tests previous claims that criminal victims and offenders have numerous shared characteristics and behaviors. For all three groups a wide range of sophisticated measures of lifestyle are used to predict the likelihood of involvement in criminal incidents of assault. Victimization risks are primarily explained by indicators of individuals' exposure to offenders. Likelihood of offending is most usefully explained by demographics and participation in other illegal behaviors. Being both a victim and offender of assault is explained by a more complex set of indicators, encompassing a wide range of factors. Based on these results it appears that, for the crime of assault, victims, offenders, and victim-offenders are three distinct groups, identifiable by varying lifestyle measures. Results provide moderate support for routine activity theory and strongly support the need for refined measures of lifestyle when assessing criminal incident involvement.     

Life Course Heterogeneity in the Transition from Adolescence to Adulthood Among Adolescent Mothers

Longitudinal data were used to examine pathways taken by 227 adolescent mothers during the transition from adolescence into adulthood. Latent profile analysis identified three sub‐groups of adolescent mothers from 6 months to 6 years postpartum: a problem‐prone profile (15%), a psychologically vulnerable profile (42%), and a normative profile (43%). Group membership was related to long‐term adult outcomes (adult status markers, health‐risk and deviant behaviors, substance use, mental health, and intimate relationships) when respondents were nearing age 30. The psychologically vulnerable group reported greater health and mental health problems, relational problems, and substance use than the normative profile group. Only the problem‐prone profile group, taken together, reported serious problems in all domains of adult outcomes examined including financial, relational, behavioral, and health and mental health problems. Results confirm the existence of different pathways through adolescent parenthood that are associated with adult functioning 12 years postpartum.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Long-term changes in parenting and child behavior after the Home-Start family support program

Background

The intervention Home-Start is a wide spread program in a number of countries, among which the Netherlands. In Home-Start, trained volunteers visit families with young children in need of support once or twice a week to help them to deal with problems in family life and parenting. Little is known, however, about the effects of Home-Start. This study describes short-term and long term changes in families that participated in Home-Start.

Methods

Three groups of families with young children (at the start mean age 1 1/2 years) were followed over a period of four years. One of the groups of families participated in the Home-Start family support program in the first 6.6 months of this period. The two other groups were (1) a randomly selected community sample and (2) a group of families with elevated parenting stress and a need for support. Data were collected at the beginning of the study, (after median 1.4 months), directly after the intervention (median 6.6 months) and at two follow-up occasions (respectively, median 12.5 and 49.2 months after the first measurement). At the last measurement, data were available for 33, 45 and 34 families respectively.

Results

Multilevel analysis showed more positive changes in parental wellbeing, competence and behavior (more consistent behavior and less rejection) during the intervention period in the Home-Start group than in the two other groups. At the three year follow up, the Home-Start group showed, compared to the other groups, more improvements in parenting (more responsiveness), but also diminished child externalizing and internalizing behavior problems (less oppositional defiant behavior, affective problems and anxiety problems).

Conclusions

Home-Start seems a promising family support intervention that deserves to be studied more extensively.     

A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Preliminary results and methodological issues

This article is an initial report from a review of alcohol and drug treatment studies with follow-ups of 2 years or more. The goals of the review are to examine the stability of substance use outcomes and the factors that moderate or mediate these outcomes. Results from 12 studies that generated multiple research reports are presented, and methodological problems encountered in the review are discussed. Substance use outcomes at the group level were generally stable, although moderate within-subject variation in substance use status over time was observed. Of factors assessed at baseline, psychiatric severity was a significant predictor of outcome in the highest percentage of reports, although the nature of the relationship varied. Stronger motivation and coping at baseline also consistently predicted better drinking outcomes. Better progress while in treatment, and the performance of pro-recovery behaviors and low problem severity in associated areas following treatment, consistently predicted better substance use outcomes.     

One-year outcomes from the CASAWORKS for Families intervention for substance-abusing women on welfare

AIM: To evaluate the effectiveness of a multiservice intervention designed to move substance-abusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. DESIGN: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women conducted in 11 selected sites across the country. There were significant improvements shown in substance use and family and social functioning by the 6-month point, and additional improvements in employment by the 12-month point. By 12 months, more than 46% were abstinent from alcohol and other drugs, and 30% were employed at least part-time. There were only modest improvements shown in the medical and psychiatric status of these women. These preliminary findings suggest that site-level interagency coordination and program-level case management were associated with improvements in the targeted areas as predicted by the model. Future work will require a more closely specified, manual-guided form of the intervention plus the inclusion of control groups and cost measures to fully evaluate the cost benefits from the final form of the intervention.     

Post Adoption Service Need and Use as Predictors of Adoption Dissolution: Findings From the 2012 National Adoptive Families Study

Data from the 2012 National Adoptive Families Study (NAFS) were used to examine the relationships between adoptive parents' need for and utilization of post-adoption services and adoption dissolution. NAFS was an online survey administered to adoptive parents (N = 437) who had adopted a child from the United States foster care system. The study found that needing and accessing post-adoption services predicted 26% of the variance in dissolution. Substance abuse treatment, educational advocacy, and parent support groups were the only significant predictors of adoption dissolution. Both needing and accessing substance abuse treatment increased the likelihood of adoption dissolution. Needing educational advocacy increased the likelihood of dissolution, but actually accessing it decreased the likelihood of dissolution. Accessing parent support groups similarly decreased the likelihood of dissolution. Policy and practice implications of the findings are discussed.     

Predictors of Burden of Family Caregivers of Women with Substance Use Disorders or Co-Occurring Substance and Mental Disorders

ABSTRACT

This study examined the impact of having a female family member with a substance use or co-occurring disorders on family caregivers. Predictors of subjective burden (worry, stigma, and displeasure) and objective burden (family disruption) on caregivers and on types of burden were explored. Subjects were 82 women receiving substance abuse treatment and their family member providing most social support. Behavioral problems of the recipient and lack of social support for caregivers predicted higher levels of family member burden, with different types of social support predicting different types of burden. Having a dual disorder did not predict family member burden. Implications of findings for treatment are discussed.     

Client and program factors associated with dropout from court mandated drug treatment

To examine why court mandated offenders dropout of drug treatment and to compare their characteristics, treatment experiences, perceptions, and outcomes with treatment completers, we analyzed self-reported and administrative data on 542 dropouts (59%) and 384 completers (41%) assessed for Proposition 36 treatment by thirty sites in five California counties during 2004. At intake, dropouts had lengthier criminal histories, lower treatment motivation, more severe employment and psychiatric problems, and more were using drugs, especially heroin. Relatively fewer dropouts received residential treatment and their retention was much shorter. A similar proportion of dropouts received services as completers and the mean number of services received per day by dropouts was generally more, especially to address psychiatric problems, during the first three months of treatment. The most commonly offender-reported reasons for dropout included low treatment motivation (46.2%) and the difficulty of the Proposition 36 program (20.0%). Consequences for dropout included incarceration (25.3%) and permission to try treatment again (24.0%). Several factors predicting drug treatment dropout were identified. Both groups demonstrated improved functioning at one-year follow-up, but fewer dropouts had a successful outcome (34.5% vs. 59.1%) and their recidivism rate was significantly higher (62.9% vs. 28.9%) even after controlling for baseline differences. Understanding factors associated with drug treatment dropout can aid efforts to improve completion rates, outcomes, and overall effectiveness of California's Proposition 36 program. Findings may also aid a broader audience of researchers and policy analysts who are charged with designing and evaluating criminal-justice diversion programs for treating drug-addicted offenders.     

Stress,strain, coping and social support for affected family members attending the National Problem Gambling Clinic,London

Aims were: to compare burden experienced by affected family members (AFMs) attending a problem gambling treatment clinic in London, England with that of AFMs affected by substance problems; to examine socio-demographic correlates of AFM burden; to evaluate change following an intervention designed for AFMs; and to test the assumption of the stress-strain-coping-support (SSCS) model that change in AFM coping is important. AFMs (N = 215) completed a gambling version of the short questionnaire for family members affected by addiction (SQFM-AA) which assesses stressful impact, symptoms of ill health, ways of coping, social support and overall burden. All received a 5-Step Method workbook, based on the SSCS model. The SQFM-AA was repeated three to six months later (n = 96). T-test analyses showed that baseline burden and related variables were comparable to those of family members affected by substance problems, were greater for wives and those living in the same household as the gambling relative, and were significantly reduced at follow-up. Regression modelling indicated the importance, for AFMs’ health, of reduced levels of engaged-emotional coping. Family members affected by gambling, some subgroups especially, experience high levels of burden. They can benefit from a model-based intervention, and coping change may be an important process.     

Alcohol and substance use disorders as predictors of child to adult sexual revictimization in a sample of community women

Alcohol- and substance-related diagnoses were examined as factors in child to adult sexual revictimization. Three hundred community women completed interviews and self-report instruments to obtain information regarding victimization and to diagnose substance use disorders (alcohol and substance abuse/dependence). Childhood sexual abuse (CSA) survivors were more likely than nonvictims to meet criteria for both substance use disorders and to report rape (e.g., unwanted intercourse due to threat or use of force, or due to the inability to consent due to the respondent's alcohol or drug use) and coerced intercourse (e.g., unwanted intercourse due to verbal coercion or misuse of authority by the perpetrator) by acquaintances, strangers, and husbands. In general, both CSA and substance use disorders were predictive of adult sexual victimization, but there were no significant interactions between these factors. Overall, substance use disorders were related to rape for all women; this relationship was not unique to CSA survivors. Alcohol- and substance-related diagnoses predicted rape by all three types of perpetrators, but CSA was predictive of rape only by acquaintances and strangers and not husbands. In contrast, CSA predicted coerced intercourse by all three perpetrators, while alcohol- and substance-related diagnoses predicted coerced intercourse by acquaintances and strangers, but not husbands. Results highlight the need to continue the study of revictimization of CSA survivors, including examination of both rape and sexually coercive experiences by different types of perpetrators. Findings support continued research of substance use disorders as risk factors for sexual victimization among all women.     

The best and worst of 2018, and hopes and fears for 2019

With public understanding growing every day about the need to address substance use disorders (SUDs) with the full array of health responses our nation deploys for other major illnesses, we hope to see great progress in the coming year. Progress should include dramatic expansion of all quality prevention, treatment services and medications, and recovery supports, with financial investment increased sufficiently to meet the need; full coverage of all SUD treatment services and medications by every state's Medicaid program and by Medicare; much stronger enforcement of federal and state requirements for parity in commercial insurance and Medicaid, including prohibitions on prior authorization, fail‐first, overly burdensome utilization review and inadequate reimbursement for care; availability of all effective and quality SUD treatment and medications at every level of the criminal justice system and throughout the child welfare system; and elimination of discriminatory barriers facing people still suffering or in recovery from SUD, including those with criminal histories, as they seek employment, housing, government benefits, the right to vote and other necessities of life.     

Game-Based Cognitive-Behavioral Therapy (GB-CBT) Group Program for Children Who Have Experienced Sexual Abuse: A Three-Month Follow-Up Investigation

This study examined the efficacy of a game-based cognitive-behavioral group therapy program for addressing problems typically found among elementary school-aged victims of child sexual abuse immediately after treatment and at three months following treatment. It was hypothesized that positive gains would be observed among the following domains: (a) internalizing symptoms (e.g., anxiety, depression, and trauma); (b) externalizing behaviors (e.g., oppositional behavior, disobedience, and conduct disordered behavior); and (c) sexually inappropriate behaviors. Improved knowledge of abuse and personal safety skills was also predicted. Results indicated that game-based cognitive-behavioral group therapy resulted in improvements in internalizing symptoms, externalizing behavioral problems, total behavioral problems, and personal safety skills both immediately after treatment and at three-month follow-up.     

Networks,Neighborhoods, and Depression: Negative Interactions by Social Support Members as a Mediator of Neighborhood Characteristics and Depressive Symptoms in a Sample of Recovering Substance Abusing Women

Abstract

Although social networks and substance abuse have been extensively studied, less is known about the role social networks play in the context of neighborhood disorder and depression. Sixty-five women were recruited from CASAWORKS for Families, a national demonstration project for substance abusing women. Average participant age was 31; half of the sample was European American, 40% African American, and 10% was other ethnicities. The average length of time in the program was about three months. We found that negative interactions partially mediated the relationship between neighborhood disorder and depression. Specifically, higher levels of neighborhood disorder predicted increased negative social exchange that in turn predicted higher levels of depressive symptoms. However, mediation analysis indicated that the strength of the relationship between neighborhood disorder and depression was attenuated when negative interactions were considered. These results support the importance of community endeavors that seek to improve basic living conditions in disadvantaged communities.