Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Mixed Messages: Inconsistent Parental Mediation Indirectly Predicts Teens’ Online Relational Aggression

Although the predictors of off-line relational aggression have been examined in prior work, less is known about the factors that contribute to online relational aggression perpetration and victimization. This study examined parental restrictive and active mediation of teenagers’ social media use as potential predictors of these outcomes. We were particularly interested in understanding whether parental agreement about media rules and the consistency with which mediation was implemented had implications for teens’ social media use, conflict with parents, and experience with online relational aggression. We conducted an online survey of 814 adolescents from the United States (14- to17-year-olds), asking about perceived agreement between parents about media rules, parental mediation styles, the teens’ social media use, and their experiences with online relational aggression. Results showed that parental rule agreement negatively predicted inconsistent parental mediation. Inconsistent parental mediation predicted more adolescent social media use and more parent-teen conflict over media rules, which in turn, predicted both online victimization and perpetration.     

Characteristics Associated with Housing Loss Among Youth in a Rapid Rehousing Program

Child and Adolescent Social Work Journal - Housing First programs, such as rapid rehousing, are a well-established approach to addressing homelessness among adults, yet there remains a lack of...     

Modeling time series data with semi-reflective boundaries

Time series data are increasingly common in many areas of the health sciences, and in some instances, may have natural boundaries serving as performance guidelines or as thresholds associated with adverse outcomes. Such boundaries may be labeled as semi-reflective, in that the time series values have an increased chance of returning towards middle levels as the boundaries are approached, but boundaries can still be breached. In this paper we review a model that was previously proposed for such data and we investigate its statistical properties. Specifically, this model consists of a third-order auto-regressive projection component, parameterized as a constrained linear combination of linear, flat, and quadratic trends, and an error term that uses a logistic regression model for its sign. We describe and compare a previously-proposed estimation method with a modified version thereof, using computer simulations, as well as data examples from heart monitoring and from a driving simulator. We find that the two methods tend to give different results, with the modified technique having lower bias and more accurate confidence intervals than the previously-proposed method.     

Bidirectional Linkages Between Emotion Recognition and Problem Behaviors in Elementary School Children

Cross-sectional studies support negative associations between children’s skills in recognizing emotional expressions and their problem behaviors. Few studies have examined these associations over time, however, precluding our understanding of the direction of effects. Emotion recognition difficulties may contribute to the development of problem behaviors; additionally, problem behaviors may constrain the development of emotion recognition skill. The present study tested the bidirectional linkages between children’s emotion recognition and teacher-reported problem behaviors in 1st and 3rd grade. Specifically, emotion recognition, hyperactivity, internalizing behaviors, and externalizing behaviors were assessed in 117 children in 1st grade and in 3rd grade. Results from fully cross-lagged path models revealed divergent developmental patterns: Controlling for concurrent levels of problem behaviors and first-grade receptive language skills, lower emotion recognition in 1st grade significantly predicted greater internalizing behaviors, but not hyperactivity or externalizing behaviors, in 3rd grade. Moreover, greater hyperactivity in 1st grade marginally predicted lower emotion recognition in 3rd grade, but internalizing and externalizing behaviors were not predictive of emotion recognition over time. Together, these findings extend previous research to identify specific developmental pathways, whereby emotion recognition difficulties contribute to the development of internalizing behaviors, and early hyperactivity may contribute to the development of emotion recognition difficulties, thus highlighting the importance of examining these processes and their mutual development over time.     

Evaluation of the Food and Agriculture Sector Criticality Assessment Tool (FASCAT) and the Collected Data

To protect and secure food resources for the United States, it is crucial to have a method to compare food systems’ criticality. In 2007, the U.S. government funded development of the Food and Agriculture Sector Criticality Assessment Tool (FASCAT) to determine which food and agriculture systems were most critical to the nation. FASCAT was developed in a collaborative process involving government officials and food industry subject matter experts (SMEs). After development, data were collected using FASCAT to quantify threats, vulnerabilities, consequences, and the impacts on the United States from failure of evaluated food and agriculture systems. To examine FASCAT's utility, linear regression models were used to determine: (1) which groups of questions posed in FASCAT were better predictors of cumulative criticality scores; (2) whether the items included in FASCAT's criticality method or the smaller subset of FASCAT items included in DHS's risk analysis method predicted similar criticality scores. Akaike's information criterion was used to determine which regression models best described criticality, and a mixed linear model was used to shrink estimates of criticality for individual food and agriculture systems. The results indicated that: (1) some of the questions used in FASCAT strongly predicted food or agriculture system criticality; (2) the FASCAT criticality formula was a stronger predictor of criticality compared to the DHS risk formula; (3) the cumulative criticality formula predicted criticality more strongly than weighted criticality formula; and (4) the mixed linear regression model did not change the rank‐order of food and agriculture system criticality to a large degree.     

Personal Network Correlates and Predictors of Homelessness for Injection Drug Users in Baltimore, Maryland

Injection drug users are at high risk for homelessness and human immunodeficiency virus (HIV) infection. This study sought to examine incidence rates and the social and economic antecedents of homelessness of impoverished inner-city injection drug users. Of the 569 participants, from a nontreatment sample who participated HIV prevention study, interviewed at baseline, 324 (57%) were reinterviewed 5.2 months later. At baseline 48% of the participants reported that they had been homeless in the past 10 years. Of the 324, 18% reported that at both interviews they had been homeless within the prior 6 months, 12% reported homelessness at baseline but not at follow-up, and 8% reported homelessness at follow-up but not at baseline. At baseline personal social support network characteristic of size of material aid and size of sex network was found to be associated with self-reports of homelessness. Baseline reports of presence of mother in personal network, size of material aid network, and network density were found to be associated with reports of homelessness at follow-up. These result suggest the need for alternative approaches to addressing issues of homelessness injection drug users.     

(Dis)respecting versus (Dis)liking: Status and Interdependence Predict Ambivalent Stereotypes of Competence and Warmth

As Allport (1954) implied, the content of stereotypes may be systematic, and specifically, ambivalent. We hypothesize two clusters of outgroups, one perceived as incompetent but warm (resulting in paternalistic prejudice) and one perceived as competent but not warm (resulting in envious prejudice). Perceived group status predicts perceived competence, and perceived competition predicts perceived (lack of) warmth. Two preliminary surveys support these hypotheses for 17 outgroups. In-depth analyses of prejudice toward particular outgroups support ambivalent prejudice: Paternalistic prejudice toward traditional women, as well as envious prejudice toward career women, results in ambivalent sexism (Glick & Fiske, 1996). Envious prejudice toward Asians results in perceived competence but perceived lack of social skills. Ambivalent content reflects systematic principles.     

Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption

This paper examines effects of tacit and codified knowledge on performance improvement as organizations gain experience with a new technology. We draw from knowledge management and learning curve research to predict improvement rate heterogeneity across organizations. We first note that the same technology can present opportunities for improvement along more than one dimension, such as efficiency and breadth of use. We compare improvement for two dimensions: one in which the acquisition of codified knowledge leads to improvement and another in which improvement requires tacit knowledge. We hypothesize that improvement rates across organizations will be more heterogeneous for dimensions of performance that rely on tacit knowledge than for those that rely on codified knowledge (H1), and that group membership stability predicts improvement rates for dimensions relying on tacit knowledge (H2). We further hypothesize that when performance relies on codified knowledge, later adopters should improve more quickly than earlier adopters (H3). All three hypotheses are supported in a study of 15 hospitals learning to use a new surgical technology. Implications for theory and practice are discussed.     

Designing a non-inferiority study in kidney transplantation: a case study

In organ transplantation, placebo-controlled clinical trials are not possible for ethical reasons, and hence non-inferiority trials are used to evaluate new drugs. Patients with a transplanted kidney typically receive three to four immunosuppressant drugs to prevent organ rejection. In the described case of a non-inferiority trial for one of these immunosuppressants, the dose is changed, and another is replaced by an investigational drug. This test regimen is compared with the active control regimen. Justification for the non-inferiority margin is challenging as the putative placebo has never been studied in a clinical trial. We propose the use of a random-effect meta-regression, where each immunosuppressant component of the regimen enters as a covariate. This allows us to make inference on the difference between the putative placebo and the active control. From this, various methods can then be used to derive the non-inferiority margin. A hybrid of the 95/95 and synthesis approach is suggested. Data from 51 trials with a total of 17,002 patients were used in the meta-regression. Our approach was motivated by a recent large confirmatory trial in kidney transplantation. The results and the methodological documents of this evaluation were submitted to the Food and Drug Administration. The Food and Drug Administration accepted our proposed non-inferiority margin and our rationale.