Adolescent substance use and family-based risk and protective factors: a literature review

Adolescent substance use has become a serious concern nationwide. Although there are many ways of viewing adolescent substance use, family influence has been established as one of the strongest sources of risk and protection. A review of the literature indicated relevant theories for understanding adolescent substance use and specific family-based variables influencing adolescent substance use. In general, there seems to be a relationship between adolescent substance use and family-based risk and protective factors. Relevant theories identified in the literature review include family systems theory, social cognitive theory, social control theory, and strain theory. Specific family-based risk and protective factors include family relationships such as with siblings and parents and family characteristics such as ethnicity and religious backgrounds. Future implications for research and prevention/intervention in relation to family-based risk and protective factors are discussed.     

Evaluating skill acquisition in motivational interviewing: the development of an instrument to measure practice skills

Social work education has long emphasized the need to provide competence-based education. However, little work has been done to identify, validate and evaluate competencies in specific fields such as addictions. The purpose of this study was to isolate a set of substance abuse intervention competencies using Motivational Interviewing that could be used to teach and evaluate students. The research proceeded in three stages. First, a modified Delphi approach involving social work practitioners was used to discern a set of positive and dysfunctional skills related to Motivational Interviewing. The primary researcher taught a graduate social work class aimed at teaching students theory and skills related to this model. Students demonstrated these skills with simulated clients through videotaped interviews. Finally, three observers rated the student interviews using this developed instrument. While inter-observer agreement was lower than anticipated, this study does provide early support for the development of competencies related to specific theoretical frameworks.     

Residential substance abuse treatment for pregnant and postpartum women and their children: treatment and policy implications

In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.     

Emotional Climate in a European Problem Area: East Berlin and West Berlin Three Years After Reunification

In autumn of 1992, three years after the unification of Germany, during a period of violent attacks against foreigners, 120 students from East Berlin and West Berlin and 20 foreign students living in West Berlin answered the Emotional Climate Questionnaire developed by de Rivera and Fernandez-Dols. Foreign respondents expressed a positive attitude toward their government/state and believed in prosocial behavior to a greater extent than respondents from East Berlin and West Berlin. Whereas East Berlin students disagreed only somewhat with statements in favor of selfishness and egoism, West Berlin students strongly disagreed with them. We attribute the differences that were found in the answers of the foreign students to their national values. In addition, we regard the differences between the emotional climates of East Berlin and West Berlin as reflecting a climate of instability among East Berliners. We interpreted selfishness as a kind of polarized behavior indicating a climate of instability. A factor analysis revealed 5 factors of an emotional climate: Nation's Future, Just World, Reactive Egoism, Scepticism, and Basic Egoism. The concept of emotional climate is discussed on the basis of the current data.     

Obsessive-Compulsive Features in Pathological Lottery and Scratch-Ticket Gamblers

The results of this study support the notion that pathological gamblers drawn from the community would score higher on all three scores from the YBOCS than light gamblers. Consistent with hypotheses, pathological gamblers (lottery and scratch ticket) reported more obsessions, compulsions, and avoidance behavior than the light gamblers, and also reported having more urges to engage in injurious behaviors to themselves and others. These findings provide evidence that pathological gambling falls in a spectrum or family of disorders which have obsessive-compulsive disorder at its core. These findings support McElroy, Hudson, Philips, et al.'s (1993) suggestions of similarities between OCD and Impulse Control Disorders, and extend Blaszczynski (1999) findings of overlap between pathological gamblers and OCD in a treatment population. Heavy gamblers also reported significantly more hoarding symptoms and compulsive buying than light gamblers. More research in this area may show further evidence of a spectrum of disorders with obsessive compulsive disorder at its core, and show further links between impulse control disorders (such as pathological gambling) and OCD.     

The epidemiology of physical attack and rape among crack-using women

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.     

A randomized trial of emotion-focused therapy for couples in a training clinic

Forty married couples participated in a randomized trial comparing 8 weekly sessions of emotion-focused therapy (EFT) for couples to a group of couples who were placed on an 8-week waiting list. A composite marital satisfaction score was created from scores on the Dyadic Adjustment Scale, Positive Feelings Questionnaire, and Personal Assessment of Intimacy in Relationships scale. Controlling for pretest scores, participants in the treatment group had significantly higher levels of marital satisfaction after 8 weeks than wait-list participants. Supplementary analyses identified variables associated with gains in therapy and with dropping out of the study.     

Research on Domestic Violence in the 1990s: Making Distinctions

This review of the family literature on domestic violence suggests that two broad themes of the 1990s provide the most promising directions for the future. The first is the importance of distinctions among types or contexts of violence. Some distinctions are central to the theoretical and practical understanding of the nature of partner violence, others provide important contexts for developing more sensitive and comprehensive theories, and others may simply force us to question our tendency to generalize carelessly from one context to another. Second, issues of control, although most visible in the feminist literature that focuses on men using violence to control “their” women, also arise in other contexts, calling for more general analyses of the interplay of violence, power, and control in relationships. In addition to these two general themes, our review covers literature on coping with violence, the effects on victims and their children, and the social effects of partner violence.

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Development of a Screening Approach to Interpret Human Biomonitoring Data on Volatile Organic Compounds: Reverse Dosimetry on Biomonitoring Data for Trichloroethylene

A screening approach is developed for volatile organic compounds (VOCs) to estimate exposures that correspond to levels measured in fluids and/or tissues in human biomonitoring studies. The approach makes use of a generic physiologically-based pharmacokinetic (PBPK) model coupled with exposure pattern characterization, Monte Carlo analysis, and quantitative structure property relationships (QSPRs). QSPRs are used for VOCs with minimal data to develop chemical-specific parameters needed for the PBPK model. The PBPK model is capable of simulating VOC kinetics following multiple routes of exposure, such as oral exposure via water ingestion and inhalation exposure during shower events. Using published human biomonitoring data of trichloroethylene (TCE), the generic model is evaluated to determine how well it estimates TCE concentrations in blood based on the known drinking water concentrations. In addition, Monte Carlo analysis is conducted to characterize the impact of the following factors: (1) uncertainties in the QSPR-estimated chemical-specific parameters; (2) variability in physiological parameters; and (3) variability in exposure patterns. The results indicate that uncertainty in chemical-specific parameters makes only a minor contribution to the overall variability and uncertainty in the predicted TCE concentrations in blood. The model is used in a reverse dosimetry approach to derive estimates of TCE concentrations in drinking water based on given measurements of TCE in blood, for comparison to the U.S. EPA's Maximum Contaminant Level in drinking water. This example demonstrates how a reverse dosimetry approach can be used to facilitate interpretation of human biomonitoring data in a health risk context by deriving external exposures that are consistent with a biomonitoring data set, thereby permitting comparison with health-based exposure guidelines.