Journal of substance abuse最新文献

Purpose. We investigated the psychometric properties (factor structure, internal consistency reliability, concurrent validity) of the Short Form Inventory of Drinking Situations (IDS-42) in women substance abusers.

Methods. A sample of 297 substance-abusing women was recruited from the community. The women completed the IDS-42 and the three-factor Drinking Motives Questionnaire (DMQ).

Results. Confirmatory factor analyses of IDS-42 items suggested a hierarchical structure for the scale. Eight factors (corresponding to Marlatt and Gordon's eight heavy drinking situations) provided the best model fit at the lower-order level, and three factors (i.e., Negatively Reinforcing vs. Positively Reinforcing vs. Temptation Situations) provided the best model fit at the higher-order level. Lower- and higher-order IDS-42 subscales were shown to possess adequate-to-high levels of internal consistency. The eight lower-order IDS-42 factors demonstrated excellent concurrent validity with conceptually similar DMQ subscale scores. Across the entire sample of female substance abusers, a higher frequency of heavy drinking was reported in Positively Reinforcing Situations and Unpleasant Emotions Situations, as compared to other heavy drinking situations.

Implications. Results support the IDS-42's good psychometric properties and demonstrate its utility as a tool in identifying situation-specific antecedents to heavy drinking among women substance abusers.

Purpose: Past research has revealed a strong correspondence between alcohol use and family dysfunction (e.g., Straus and Gelles in 1986 and 1990). Unfortunately, much of this research has relied on reports from only one family member. Methods: Here, we present the results from a recent, nationwide study of alcohol-consumption patterns, alcohol-related partnership problems, and intimate partner violence (IPV) based on reports from both romantic partners of 1,615 married and cohabiting couples. Results: Using the “drinking partnerships” construct developed by Roberts and Leonard in 1997, we found that despite considerable concordance between couple members' drinking behaviors, discrepant drinking patterns were strongly predictive of relational distress and the incidence of physical violence. Implications: These findings suggest that the interaction between couple members' alcohol-related behaviors has crucial implication for the health and well-being of the entire family.

Purpose: Public traffic safety campaigns in Germany have focussed on the changing risk perception of young drivers. While there is some consensus that perceptions of risk affect driving, less is understood about the relationship and interaction of alcohol consumption and risk perception on the decision to drive. We examined the influence of light alcohol consumption on risk perception and decision to drive, and the interaction of alcohol consumption and cognitive feedback on the handicapping effect of alcohol on risk perception and decision to drive.

Method: In a double-blind block-randomized experimental study of 104 young drivers between 19 and 24 years of age, with two experimentally manipulated independent factors of alcohol consumption (three levels: 0% BAC, 0.015% BAC, 0.03% BAC) and feedback (positive or negative), we assessed three dependent variables: perception of traffic accident risk, subjective judgement about driving-relevant cognitive performance, decision to drive a car. Analyses of variance and covariance were used to analyze differences between levels of experimental factors.

Results: We found that persons with 0.015 BAC performed better than persons in both other alcohol conditions on the standardized risk perception task. Perceived handicap of driving was significantly more pronounced for negative feedback compared to positive feedback with no influence of the level of alcohol consumption. No significant influence on decision to drive was found of either level of alcohol consumption, feedback or sex.

Implications: Decision to drive in young drivers could not be influenced by feedback or light consumption. Public health approaches have to find better determining factors.

Purpose. Earlier research estimated the incremental costs and outcomes of a modified therapeutic community (modified TC) for mentally ill chemical abusers (MICAs) relative to a treatment-as-usual (TAU) control group. The present study extended the cost analysis by disaggregating the modified TC group into clients who completed the program (completers) and clients who dropped out (separaters).

Methods. Bivariate and multivariate analyses were conducted to estimate differences in treatment and other service costs among completers, separaters, and TAU. Subjects were sequentially assigned to the modified TC (n=171) or TAU (n=47), and the analysis period covered 12 months post-baseline. Using a standardized instrument to collect resource use and cost data, the estimated weekly cost per client in the modified TC was US$554, with completers showing a larger average cost of treatment (US$27,595) than separaters (US$9,986).

Results. The average TAU subject had a much higher cost for other (non-modified TC) services (US$29,795) relative to separaters (US$22,048) or completers (US$1,986). These findings suggest that, from baseline to the 12-month follow-up, the total cost of modified TC treatment and other services for completers may be slightly lower than the total cost for separaters or TAU subjects. Since the modified TC group had better outcomes than the TAU group, and the completers had better outcomes than the separaters, the modified TC program could be an effective mechanism to reduce the costs of service utilization as well as improve clinical outcomes.

Implications. This detailed investigation into service utilization and cost provides policy-makers and program directors with valuable information regarding potentially cost-effective interventions and further underscores the importance of retention in treatment for this vulnerable population.

Purpose: This report addresses whether smoking increases as a function of working in a smoking environment. Methods: Casino employees were targeted to complete a survey designed to assess smoking behavior. The survey contained standardized questions consistent with other major surveys on tobacco use to ensure comparability with state and national trends. Data collection occurred between September and November 1997. Results: Out of 755 surveys distributed, 587 completed surveys were returned, resulting in a response rate of 77 percent. A test of proportions showed that the proportion of smokers had not changed significantly as a result of working in a smoking environment although the amount of smoking decreased significantly (one-sample t-test). The change in the amount of smoking was assessed using difference scores. Males and females did not differ in the rate in which their smoking changed. A significant correlation between age and the change score suggested that younger smokers were more likely to increase their intake whereas the older smoking employees were more likely to decrease their consumption by the time of the survey. Implications: The finding that individuals who work in a smoking environment decreased their smoking behavior merits further investigation in the area of smoking aversion.

Purpose: A short form for situational temptations to drink scale was developed from an original 21-item inventory by Migneault. Methods: The form measured four hypothesized subscales of temptations on a sample of 348 college drinkers (66% female). Peer pressure, social anxiety, negative affect, and positive/social situations subscales were replicated and reduced. Results: Strong empirical support was found for a hierarchical model, indicating that the four subscales can be summed to provide a global measure of situational temptations. Confirmatory factor results, internal and external validity, and high correlations with the original measures indicate that the short form was as psychometrically valid as the original measure. Implications: Measures of external validity demonstrated the applicability of this measure to heavy drinking prevention programs.

Purpose: Continued illicit drug use by opioid-dependent patients maintained on methadone is a serious problem, undermining the goal of methadone maintenance treatment and increasing the risk for HIV. The current study employed structural equation modeling (SEM) to examine cognitive, affective, and behavioral predictors of treatment response during the first 12 weeks of methadone maintenance treatment. Methods: 302 opioid-dependent individuals (72% male; 28% female) entering a methadone maintenance program (MMP) were provided with a comprehensive intake assessment. Heroin and cocaine use were assessed using twice weekly urine toxicology screens. The model accounted for 37 percent of the variance in abstinence from illicit opiates and 38 percent of the variance in abstinence from cocaine. Results: Continued heroin use while maintained on methadone was predicted by pre-treatment severity of addiction and by strength of self-identity as an “addict.” Cocaine use was predicted by pre-treatment severity of addiction, low self-efficacy, lack of negative affect, and strength of self-schema. The strongest predictor of abstinence from both heroin and cocaine was attendance at the adjunctive manual-guided psychosocial group interventions. Implications: Implications for treatment are discussed.

Purpose. While workplace sexual harassment has received a great deal of attention in both the popular media and scientific literature, less attention has been directed to the differential occurrence of sexual harassment among lesbians, gay men, and heterosexual men and women, and the relationships between these experiences and alcohol-related outcomes. Additionally, the distribution of alcohol-related outcomes of non-sexual forms of workplace harassment among these groups have not been adequately explored.

Method. Using data from a university-based study of workplace harassment and alcohol use (N=2492), we focus on exposure to workplace harassment and alcohol-related outcomes for lesbians, gay men, and bisexuals compared to heterosexual men and women.

Results. Lesbian/bisexual women did not differ significantly from heterosexual women in their experiences of workplace harassment. However, stronger linkages between harassment and increased alcohol consumption and problems were found for lesbian and bisexual women than for heterosexual women. Gay/bisexual men, on the other hand, experienced significantly more sexual harassment than heterosexual men, but did not report a corresponding increase in alcohol use and abuse.

Implications. Implications for future research on sexual identity, alcohol use, and workplace harassment are discussed.

Shedler and Block offered the provocative proposal that individuals who experiment with drugs are psychologically healthier than either those who abstain completely or those who are frequent users. Not all studies have come to such conclusions, however. In an effort to specify under what conditions Shedler and Block's conclusions might hold, the present study examined three groups of drug users (abstainers, experimenters, frequent users) classified according to three different criteria: (a) marijuana use at age 20; (b) alcohol use during 10th grade; and (c) alcohol use at age 20. The three groups were compared at age 20 in terms of personality, deviant behavior, and psychopathology. The results revealed that abstainers were never more psychologically impaired, and were occasionally healthier, than experimenters. Frequent users of marijuana were consistently more impaired than both the abstainers and experimenters, in terms of both internalizing and externalizing disorders. Classification according to marijuana use appeared to be more related to psychopathology than did classification according to alcohol use.

This study was designed to identify different risk models associated with non-use, first use, and prior substance use among a group of early adolescents. A total of 582 students completed a self-report questionnaire at the beginning and end of sixth grade. Nine predictor variables were used in discriminant function analysis to classify adolescents into three groups. Five variables distinguished non-users (never used by the end of sixth grade) and new users (first used during sixth grade) from prior users (first used before sixth grade). Prior users were found to have weaker decision making skills, more susceptibility to peer pressure, more negative perceptions of school, less confidence in their skills, and an increased likelihood of being male. A second function indicated that new users were similar to prior users in that they had less positive peer relations, were more likely to come from single parent families, and had less knowledge about alcohol and drugs than did non-users. The similarities and differences between new and prior users have implications for future research and prevention programming.