The life course perspective on drug use: a conceptual framework for understanding drug use trajectories

This article discusses the life course perspective on drug use, including conceptual and analytic issues involved in developing the life course framework to explain how drug use trajectories develop during an individual's lifetime and how this knowledge can guide new research and approaches to management of drug dependence. Central concepts include trajectories marked by transitions and social capital and turning points influencing changes. The life course perspective offers an organizing framework for classifying varying drug use trajectories, identifying critical events and factors contributing to the persistence or change in drug use, analytically ordering events that occur during the life span, and determining contributory relationships.     

Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples

This study aimed to explore the correlation between job burnout and self-stigma of seeking help among nonmedical mental health care providers (psychologists, social workers, and counselors) in two countries – Lithuania and the US. The study included 234 professionals (111 social workers and 123 psychologists) from Lithuania and 93 professionals (33 counselors, 23 social workers, and 37 psychologists) from the US on a voluntary basis (93% females, mean age – 39.81?years). They completed a self-reported questionnaire with the Self-Stigma of Seeking Help Scale (SSOSH) and the Maslach Burnout Inventory-General Survey (MBI-GS). The results revealed a statistically significant positive correlation between self-stigmatization and burnout in the Lithuanian sample, but only weak positive correlation between depersonalization and self-stigma of seeking help in the US sample. The relationship between the self-stigma of seeking help and burnout was stronger in the Lithuanian sample of professionals when compared to their colleagues in the US.     

Un/gendering Social Selves: How Nonbinary People Navigate and Experience a Binarily Gendered World

Based on in‐depth interviews, we explore how people who do not identify exclusively or consistently as either women or men (i.e., nonbinary people) navigate a culture that bifurcates people into women or men. Using an interactionist approach, we first analyze how interviewees employ discourse (e.g., names, identity labels, and pronouns) and the body (e.g., expressions, decoration, and transformation) to present themselves as nonbinary, which we conceptualize as ungendering social selves. Second, we examine the emotional benefits (e.g., authenticity, pride, liberation) and burdens (e.g., fear, rejection, exhaustion) of ungendering. Third, we uncover the emotional, social, and structural conditions under which our nonbinary‐identified participants sometimes present themselves as binarily gendered, which we conceptualize as gendering social selves. We conclude with discussing empirical and theoretical contributions.     

Dyadic Supervision Evaluation: An Actor–Partner Relational Model

This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.     

Adolescent Conflict Appraisals Moderate the Link Between Marital Conflict and Physiological Stress Reactivity

The goal of this study was to advance understanding of how adolescent conflict appraisals contribute uniquely, and in combination with interparental conflict behavior, to individual differences in adolescent physiological reactivity. Saliva samples were collected from 153 adolescents (52% female; ages 10–17 years) before and after the Trier Social Stress Test. Saliva was assayed for cortisol and alpha‐amylase. Results revealed interactive effects between marital conflict and conflict appraisals. For youth who appraised parental conflict negatively (particularly as threatening), negative marital conflict predicted dampened reactivity; for youth who appraised parental conflict less negatively, negative marital conflict predicted heightened reactivity. These findings support the notion that the family context and youth appraisals of family relationships are linked with individual differences in biological sensitivity to context.     

Business Cycles,Medicaid Generosity,and Birth Outcomes

Birth outcomes influence many aspects of later life health and wellbeing, making healthcare access during pregnancy a policy priority. Low-income mothers often depend on Medicaid, for which eligibility is determined by their income relative to state eligibility thresholds. The prevalence of adverse birth outcomes is known to exhibit cyclical variation, due in part to changes in the composition of women giving birth in response to changing economic conditions. However, cyclical variation in adverse birth outcomes also varies with respect to Medicaid eligibility thresholds. Our analysis uses birth-records data for 2000 through 2013, aggregated into 173,936 county-by-quarter observations and linked to county-level unemployment rates and state-level parental Medicaid thresholds. Using fixed-effects negative binomial models, we examine the role of Medicaid generosity in influencing birth outcomes across business cycles. We test for interactions between Medicaid and unemployment, hypothesizing that the negative effects of recessions are worse where Medicaid thresholds are more restrictive. We find that higher Medicaid generosity dampens the negative effects of recessions on birth outcomes. The extent to which Medicaid interacts with unemployment also varies according to the age and race composition of mothers; in particular, Black mothers are both most affected by unemployment and most responsive to Medicaid generosity. Given current concerns about racial gaps in both infant and maternal mortality, our findings suggest that Medicaid may be an important feature of a strategy to close gaps in the prevalence of adverse birth outcomes across racial groups, especially during bust years.     

Assessing state substance abuse prevention infrastructure through the lens of CSAP's Strategic Prevention Framework

Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of system attributes and which attributes are most conducive to overall effectiveness. As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes. In this paper we describe the development of this instrument and summarize findings from its baseline administration. As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well. The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority. The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure.