ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.     

Some theoretical models and constructs generic to substance abuse prevention programs for adolescents: possible relevance and limitations for problem gambling

For the past several years the author and his colleagues have explored the area of how social psychological constructs and theoretical models can be applied to the prevention of health threatening behaviors in adolescents. In examining the need for the development of gambling prevention programs for adolescents, it might be of value to consider the application of such constructs and theoretical models as a foundation to the development of prevention programs in this emerging problem behavior among adolescents. In order to provide perspective to the reader, the present paper reviews the history of various psychosocial models and constructs generic to programs directed at prevention of substance abuse in adolescents. A brief history of some of these models, possibly most applicable to gambling prevention programs, are presented. Social inoculation, reasoned action, planned behavior, and problem behavior theory, are among those discussed. Some deficits of these models, are also articulated. How such models may have relevance to developing programs for prevention of problem gambling in adolescents is also discussed. However, the inherent differences between gambling and more directly health threatening behaviors such as substance abuse must, of course, be seriously considered in utilizing such models. Most current gambling prevention programs have seldom been guided by theoretical models. Developers of gambling prevention programs should consider theoretical foundations, particularly since such foundations not only provide a guide for programs, but may become critical tools in evaluating their effectiveness.     

The role of natural recovery in alcoholism and pathological gambling

While most pathological gamblers, like most alcohol abusers, recover on their own, it seems likely that they are at greater risk for relapse than those who have been through successful treatment. Accordingly, a substantial increase in treatment resources for pathological gamblers, along with greater efforts to establish the effectiveness of these treatments, ought to receive national priority. If the data on alcohol-abusing self-changers are generalizable to self-changing pathological gamblers, the prognosis for gamblers who stop gambling all together is better than for those who aspire to controlled or nonproblem gambling. While pathological gamblers with comorbid substance abuse are more difficult to treat than those without it, the impact of comorbid substance abuse on the decision by pathological gamblers to change has not yet been explored, although it should be. Similarly, the impact of other Axis I pathology on pathological gambling self-change, especially depression and anxiety, should be thoroughly explored. The most pressing problem in this field appears to be definitional. As a consequence, until consensus is reached on a reliable, valid, and useful classification scheme for pathological gambling, both research and clinical efforts will continue to suffer.     

Maternal substance abuse and disrupted parenting: Distinguishing mothers who keep their children from those who do not

Women with substance abuse disorders typically have psychosocial characteristics that put them at risk for disrupted parenting. Prior research indicates that comprehensive, accessible services tailored to the mothers' needs can contribute to family stability. This study further explores the complicated interplay of how maternal risk and protective characteristics and service elements are associated with reunification. The study contributes to existing literature by following mothers for three years; examining service needs as identified by the mother herself; using a summary proportion score to reflect the totality of services received to matched service needs identified; and using logistic regression to examine interactions of services received with critical maternal characteristics. The sample is comprised of 458 substance-abusing mothers enrolled during pregnancy or postpartum in the Washington State Parent-Child Assistance Program (PCAP), an evidence-based case management intervention. Participants' custody status was well distributed among four categories based on continuity of parenting. Findings indicate that at program exit 60% of the mothers were caring for their index child. These mothers had more treatment and mental health service needs met, had more time abstinent from alcohol and drugs, secure housing, higher income, and support for staying clean and sober. Among women with multiple psychiatric diagnoses, the odds of regaining custody were increased when they completed substance abuse treatment and also had a supportive partner. Mothers who lost and did not regain custody had more serious psychiatric problems and had fewer service needs met. We discuss implications of our findings for child welfare policy and practices.     

Communal invalidation of young adults with co-occurring substance abuse and mental health issues

This study explores how young adults with co-occurring substance abuse and mental health issues experience the challenges of belonging to their local communities. The data were generated through qualitative in-depth interviews with seven young adult service users, six of whom were interviewed twice. The qualitative data analysis resulted in three overarching themes: the need to accept one’s own life and the structures surrounding it; being caught between conflicting social worlds; and moral fumbling in choices and actions. Using an empirical study, we suggest that a process of ‘communal invalidation’ operates through which young adults in the community are socially defined as inadequate. This invalidation serves as a formidable barrier to their recovery.     

Estimating the costs of substance abuse: implications to the estimation of the costs and benefits of gambling

This presentation describes a recently developed set of guidelines for estimating the economic costs of substance abuse, summarizes the findings from a Canadian study that utilized these guidelines, and discusses the implications to the potential development of guidelines for estimating the costs and benefits of gambling. The guidelines for estimating the costs of substance abuse present a general framework of costs to be included and discuss methodological issues such as the definition of abuse; determination of causality; comparison of the demographic and human capital approaches; the treatment of private costs; the treatment of nonworkforce mortality and morbidity; the treatment of research, education, law enforcement costs, the estimation of avoidable costs and budgetary impact of substance abuse, and the significance of intangible costs. Utilizing these guidelines, a study was undertaken to estimate the economic costs of alcohol, tobacco, and illicit drugs to Canadian society in 1992. Based on this experience, it is argued that cost/benefit research should be conducted by multidisciplinary teams, that the real value of such work lies more in the detailed findings than in the bottom line results, and that focus should be placed on developing an ongoing process for developing consensus on how to conduct studies of the costs and benefits of gambling, rather than attempting to find a precise methodology that everyone agrees upon.     

“Me,the street,and a backpack”: employment,income, and physical capital in rural recovery

ABSTRACT

Recovery capital is a framework for understanding individuals’ resources for recovery from substance misuse. In a qualitative analysis of rural individuals in recovery (N = 49), the role of physical capital emerged prominently across ten focus groups. Participants highlighted the effects of employment status, income, and other forms of physical capital directly, as well as indirect effects through changes in human capital. Negative cultural capital components, in the form of stigma and employment discrimination, were described as barriers to physical capital acquisition and successful recovery. Based on these findings, we discuss rural recovery challenges and propose a model of recovery capital interactions.     

Preliminary evaluation of contingent meals and telephone use to improve evidence-supported family therapy session attendance in mothers referred by Child Protective Services for substance abuse

Persons referred by Child Protective Services (CPS) for substance abuse evidence high rates of nonattendance to therapy sessions, taxing systems of care and exacerbating outcomes. This study examined the influence of two telephone-based incentive programs on therapy session attendance in mothers who were referred by CPS for substance abuse. After baseline therapy session attendance was established in an evidence-based clinic that incorporated a telephone engagement intervention (Phase I), participants were provided free cellular telephones with limited minutes and permitted to order free meals delivered by the therapist during upcoming sessions (Phase II). The third phase was similar to Phase II, but participants were provided unlimited minutes. Results indicated that participants’ attendance was significantly improved when meals and cellular telephone minutes were contingent on attendance. Although the percentage of sessions attended by participants during Phase III was higher than Phase II, unlimited minutes and meals did not significantly enhance attendance relative to limited minutes and meals. Session attendance for significant others of these participants was significantly higher during Phase III as compared with Phase I. Session attendance of significant others was statistically similar between Phase I and II and between Phase II and Phase III. Study implications and recommendations for future research and practice are discussed in light of the findings.     

Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field

The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations—Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences among those involved in the substance-use disorder and recovery profession using an embedded design and grounded theory approach. Findings suggest that generational differences do exist across the three generations in regard to ideologies, value of formal and informal knowledge, training, and education. Results from the current study provide a further understanding of how we may bridge perceived contentious ideologies and knowledge gaps between generations to better develop current and future professionals within the field.     

Internet gambling in relation to Internet addiction,substance use,online sexual engagement and suicidality in a Greek sample

Research has found gambling to be related to a variety of other addictive behaviours. The study objective was to evaluate the association of Internet gambling with Internet addiction, online sexual engagement, suicidality and substance use, in a sample of Greek adults. The study sample consisted of 789 military personnel. During their annual medical examination the study participants anonymously completed a series of self-reported questionnaires in relation to socio-demographic data, Internet gambling practices, online sexual engagement, Internet addiction, suicidality and psychoactive substance use. We found that Internet addiction significantly predicted engagement with online gambling, followed by substance use in general, and, in particular, the use of cocaine or heroin. Finally, two other predictive indicators were self-reported suicide attempts and engagement with online sex. Online gambling is associated with various behaviours related to impulsivity such as Internet addiction, online sexual engagement, suicidality and substance use. Future research will increase our knowledge on the contribution of new technologies and the Internet in Internet gambling dimensions, as well as on the associations with other high-risk behaviours such as substance use, pornography and suicidality.     

Exploring the relationship between poverty,childhood adversity and child abuse from the perspective of adulthood

A recent Australian study of people experiencing poverty, involving in‐depth interviews with 20 participants, suggests that a complex process leading to poverty in adult life can stem from abusive and adverse experiences in childhood. It is considered that these experiences of abuse and adversity may begin a process of ‘negative chain effects’ (Rutter, 2000) resulting in a pathway into poverty caused by ‘accumulated adversity’ (Seth‐Purdie, 2000). The development and maintenance of human capital, defined as the sum of a person's physical, psychological and economic capabilities, are strongly influenced by the extent of adversity experienced over a person's life course, particularly experiences of adversity in early childhood (Seth‐Purdie, 2000). In this paper, the experiences of childhood abuse and adversity reported by the interviewees will be outlined and discussed in the light of theory and research related to development during childhood and adolescence. Copyright © 2007 John Wiley & Sons, Ltd.     

A review of the relationship between poverty and child abuse and neglect: Insights from scoping reviews,systematic reviews and meta-analyses

An up-to-date and accurate picture of the evidence on the impact of poverty is a necessary element of the debate about the future direction of children's social care services internationally. The purpose of this paper is to update evidence about the relationship between poverty and child abuse and neglect (CAN) published since a previous report in 2016 (Bywaters et al., 2016). A systematic search was conducted, identifying seven reviews. Poverty was found to be consistently and strongly associated with maltreatment, be that in terms of familial or community-level poverty, or in terms of economic security. Findings demonstrated that both the type and the quantity of economic insecurities impacted child maltreatment. Certain economic insecurities – income losses, cumulative material hardship and housing hardship – reliably predicted future child maltreatment. Likewise, as families experienced more material hardship, the risk for maltreatment intensified. In some studies, the relationship between poverty and maltreatment differed by abuse type. Future reviews need to investigate individual papers and their findings across different CAN measures, definitions, samples, abuse types and conceptualisations of poverty to provide a comprehensive understanding of the current research base and the directions which need to be taken to further understand and prevent CAN.     

Preparing social workers for practice with LGBT populations affected by substance use: perceptions from students,alumni, and service providers

Trends in the field of service among those with alcohol and other drug addictions highlight the urgent need for schools of social work to effectively train students to serve clients with substance use disorders, and have cultural humility to effectively serve disproportionately affected LGBT consumers. Online surveys and interviews examined perceptions of graduate social work students and alumni in a certified alcohol and drug counselor program, along with several service providers within an urban setting in the US. Results indicated that students and alumni did not feel adequately prepared through coursework to practice with LGBT populations affected by substance use, while feeling more clinically competent to practice with LGB individuals, than with transgender consumers. Similar findings related to unique differences associated with perceptions of faculty support, along with field preparedness to practice with LGB individuals when compared to transgender individuals. Service providers noted an overall commitment and to serve LGBT consumers as well as positive perceptions of students and alumni to do the same. Implications examine the role of faculty in addressing challenges related to preparation of social work students to practice with LGBT consumers affected by substance use disorders, along with suggestions for curricular changes, and ongoing field trainings.