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.     

Off-label medication use

Prescribing medications for off-label uses is not illegal. Off-label prescribing includes using medications for unapproved indications; using a drug outside of the recommended dosage range or duration of use; using a drug in certain unapproved patient populations, such as those defined by age, sex, or particular clinical parameters; or intentionally using a medication in a patient who has a known contraindication. Medications would be considered appropriate for off-label use based on their known clinical pharmacology, evidence from clinical studies, and sometimes from the personal experience of the prescriber. The decision to use a drug off label should be based on a careful assessment of the patient's treatment history and the drug's potential risks and benefits. Patients should be given adequate informed consent about how the drug is being used off label and why, along with appropriate information about known risks and side effects.     

Patterns of intimate partner violence in young adult couples: nonviolent, unilaterally violent, and mutually violent couples

This study examined nonviolent (NV), unilaterally violent (UV), and mutually violent (MV) patterns of perpetrated intimate partner violence in relation to dyadic relationship quality and partner injury. The respondents were 1,294 young adult, Add Health partners (AHP) and their non-Add Health partners (NAHP), in dating, engaged, or in marital relationships, who were participants in Wave III of the National Longitudinal Study of Adolescent Health (Add Health). Using both partner reports of perpetration to classify intimate partner violence (IPV) patterns resulted in 25% of couples with a MV pattern, and 75% of couples with a UV pattern; among those couples (41%) reporting any perpetrated IPV. Results also showed poorer relationship quality and higher partner sensation-seeking scores among MV and UV couples when contrasted with NV couples. Those couples with MV patterns were more likely to contain partner injury than those with UV patterns.     

Links between childhood physical abuse and intimate partner aggression: the mediating role of anger expression

Research linking childhood physical abuse (CPA) and adult intimate partner aggression (IPA) has focused on individuals without sufficient attention to couple processes. In this study, 109 couples reported on histories of CPA, IPA, and anger expression. Actor-partner interdependence model (APIM) was used to examine links between CPA and revictimization and perpetration of IPA, with anger suppression as a potential mediator. Women's CPA histories were associated with more physical aggression towards and more revictimization by partners. Men's CPA histories were only associated at the trend level with their revictimization. Anger suppression fully mediated the link between women's CPA and both revictimization and perpetration of IPA. Findings suggest that women with CPA histories are more prone to suppress anger, which leaves them at greater risk for revictimization and perpetration of IPA.     

Mentoring Siblings of Gang Members: A Template for Reaching Families of Gang Members?

Mentoring has become a popular model of intervention to reduce the risk of offending, and has been proposed as an effective tool to tackle the risk of gang membership. This paper reviews the existing literature on mentoring and reports on a qualitative evaluation of a mentoring programme targeted at young people ‘at risk’ of gang membership in an English city. The study highlights important issues around these interventions. Although we found it a useful way to engage otherwise hard‐to‐reach families, important limitations remain: their potential labelling impact and their limited impact in isolation from other more ambitious measures.     

Expressing Gambling-Related Cognitive Biases in Motor Behaviour: Rolling Dice to Win Prizes

Cognitive perspectives on gambling propose that biased thinking plays a significant role in sustaining gambling participation and, in vulnerable individuals, gambling problems. One prominent set of cognitive biases include illusions of control involving beliefs that it is possible to influence random gaming events. Sociologists have reported that (some) gamblers believe that it is possible to throw dice in different ways to achieve gaming outcomes (e.g., ‘dice-setting’ in craps). However, experimental demonstrations of these phenomena are lacking. Here, we asked regular gamblers to roll a computer-simulated, but fair, 6 sided die for monetary prizes. Gamblers allowed the die to roll for longer when attempting to win higher value bets, and when attempting to hit high winning numbers. This behaviour was exaggerated in gamblers motivated to keep gambling following the experience of almost-winning in gambling games. These results suggest that gambling cognitive biases find expression in the motor behaviour of rolling dice for monetary prizes, possibly reflecting embodied substrates.     

Characteristics and Outcomes of College-Age Adults Enrolled in Private Residential Treatment: Implications for Practice

Substance use among college-age adults is of interest due to high levels of use and low levels of treatment access and engagement relative to other adults. Data collected from 1,972 clients in residential services were analyzed to investigate differences in use patterns, treatment outcomes, and other life area problems. Participants completed an Addiction Severity Index (ASI) and the University of Rhode Island Change Assessment (URICA) at baseline, and an ASI and Treatment Services Review at 1-month and 6-month postdischarge interviews. Almost a quarter (24.1%) of participants were college age (18–25 years old). They were more likely to be White and male, and less likely to complete treatment although they had a longer average length of stay. College-age adults improved on all outcome measures, and posttreatment service use shows significant difference between college-age and older participants. Implications for practice are discussed.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Movement-in-depth, cognitive impairment, and crash risk

In this study, 243 cognitively intact and cognitively impaired older participants' movement-in-depth (looming) abilities were assessed using a portable device that we had previously developed in our laboratory. Results indicated normative relationships between looming ability and age, looming ability and driving violation records, and age and driving violation records. Findings also confirmed the validity and reliability of the measurements taken with the device. In conclusion, this device may be useful for identifying drivers at risk for rear-end collisions, developing effective training interventions, and creating fair and valid driver licensing tests.     

Review of walking hazards for railroad workers

This is a review of walking tasks in the railroad environment, and the injuries that result from slips, trips, falls, or other acute or even non-traumatic exposures. The lack of federal regulations for railroad walkways has led several states to develop and enforce their own regulations. Support from the research literature for such regulations has come from biomechanical studies of the effects of walking on railroad ballast, which will be reviewed.