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Different dimensions of anxiety differentially predict binge drinking among juvenile offenders

Description
Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for…

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.
ContributorsNichter, Brandon (Author) / Chassin, Laurie (Thesis advisor) / Barrera, Manuel (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2014
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The role of relationship status changes in college students' heavy episodic drinking

Description
The beginning of college is a period in which increased alcohol use often coincides with greater involvement in romantic relationships. Existing literature yields inconsistent findings regarding the influence of different relationship statuses on drinking behavior, perhaps because these studies have not accounted for recent changes in the way college students…

The beginning of college is a period in which increased alcohol use often coincides with greater involvement in romantic relationships. Existing literature yields inconsistent findings regarding the influence of different relationship statuses on drinking behavior, perhaps because these studies have not accounted for recent changes in the way college students engage in dating/sexual relationships. In the current college environment, many students who define themselves as non-daters are nonetheless sexually active, a phenomenon referred to as the 'hook up' culture. The present study sought to address this issue by examining the effects of both relationship status and sexual activity on heavy episodic drinking (HED) among 1,467 college students over the course of their first three semesters. Results indicated that the effects of relationship status depended on whether or not an individual was sexually active. Non-dating but sexually active students reported rates of heavy drinking comparable to students who defined themselves as casual daters, but non-dating students who were not sexually active reported drinking behavior similar to those involved in committed relationships. Further, transitions between low and high risk relationship/sexual activity statuses were associated with corresponding changes in HED. Transitioning into a high risk status was associated with greater levels of heavy episodic drinking, whereas transitioning into a low risk status was associated with decreases in this behavior. Together, results indicate that engaging in nonexclusive dating or sexual relationships may play an important role in the development of problematic patterns of alcohol use during the early college years. These findings have potentially important implications both for future research and for prevention and intervention efforts targeting high risk college drinkers.
ContributorsZalewski, Suzanne (Author) / Corbin, Willaim (Thesis advisor) / Doane, Leah (Committee member) / Chassin, Laurie (Committee member) / Arizona State University (Publisher)
Created2012
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The influence of parent cultural values on Mexican heritage adolescent intentions to use drugs

Description
This study examined the influence of the traditional values held by Mexican heritage parents on the intention of their adolescent children to use drugs. Specifically, the study tested a mediation model in which the traditional cultural values of parents were hypothesized to influence adolescent drug use intentions indirectly by influencing…

This study examined the influence of the traditional values held by Mexican heritage parents on the intention of their adolescent children to use drugs. Specifically, the study tested a mediation model in which the traditional cultural values of parents were hypothesized to influence adolescent drug use intentions indirectly by influencing ethnic identify and adolescent perceptions of parental injunctive norms against drug use. Parents reported on traditional cultural values and expectations for their child. Adolescents reported perceived reaction from parents if they used drugs (parental injunctive norms), ethnic identity, and their intention to use drugs in the future. Two direct effects were observed: parental values on expectations and parental injunctive norms on adolescent drug use intentions. Two paths were also moderated by the sex of the adolescent. The path from parent values to parent expectations was significantly stronger for adolescent girls than boys; the path from ethnic identity affirmation to drug intentions was protective for boys but not for girls. The negative relationship between perceived parental reaction and adolescent drug use intentions suggests that anti-drug norms communicated by parents had a protective influence and can deter youth from using drugs. The results of the current study did not support the hypothesized mediational model, but did provide additional support for the importance of parental influence on adolescents' plans and ideas about using alcohol, cigarettes, and marijuana. More research is necessary to examine the influence of culture and the mechanisms by which cultural values impact Mexican heritage adolescents' intentions to use drugs and subsequent use.
ContributorsGarvey, Meghan (Author) / Gonzales, Nancy A. (Thesis advisor) / Marsiglia, Flavio F. (Committee member) / Mackinnon, David P. (Committee member) / Arizona State University (Publisher)
Created2012
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Cultural Factors and the HPA Axis Stress Response Among Latino Students Transitioning to College

Description
A record number of Latino students are enrolling in higher education in the U.S., but as a group Latinos are the least likely to complete a bachelor’s degree. Cultural factors theoretically contribute to Latino students’ success, including orientation toward ethnic heritage and mainstream cultures (i.e., dual cultural adaptation), feeling comfortable…

A record number of Latino students are enrolling in higher education in the U.S., but as a group Latinos are the least likely to complete a bachelor’s degree. Cultural factors theoretically contribute to Latino students’ success, including orientation toward ethnic heritage and mainstream cultures (i.e., dual cultural adaptation), feeling comfortable navigating two cultural contexts (i.e., biculturalism), and the degree of fit between students’ cultural backgrounds and the cultural landscapes of educational institutions (i.e., cultural congruity). In a two-part study, these cultural factors were examined in relation to the hypothalamic-pituitary-adrenal (HPA) axis stress response (indexed by salivary cortisol), a physiological mechanism that may underlie how psychosocial stress influences academic achievement and health. First, Latino students’ cortisol responses to stress were estimated in their daily lives prior to college using ecological momentary assessment (N = 206; 64.6% female; Mage = 18.10). Results from three-level growth models indicated that cortisol levels were lower following greater perceived stress than usual for students endorsing greater Latino cultural values (e.g., familism), compared to students endorsing average or below-average levels of these values. Second, cortisol and subjective responses to a standard public speaking stress task were examined in a subsample of these same students in their first semester of college (N = 84; 63.1% female). In an experimental design, viewing a brief video prior to the stress task conveying the university’s commitment to cultural diversity and inclusion (compared to a generic campus tour) reduced cortisol reactivity and negative affect for students with greater Latino cultural values, and also reduced post-task cortisol levels for students with greater mainstream U.S. cultural values (e.g., competition). These findings join the growing science of culture and biology interplay, while also informing initiatives to support first-year Latino students and the universities that serve them.
ContributorsSladek, Michael R. (Author) / Doane, Leah D (Thesis advisor) / Gonzales, Nancy A. (Committee member) / Grimm, Kevin J. (Committee member) / Luecken, Linda J. (Committee member) / Arizona State University (Publisher)
Created2018
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Investigating adverse effects of adolescent group interventions

Description
This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to…

This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to reduce or prevent. The current study used data from a longitudinal, randomized controlled trial of the Bridges to High School / Puentes a La Secundaria Program, a multicomponent prevention program designed to reduce risk during the middle school transition, which has demonstrated positive effects across an array of outcomes. Data were collected at the beginning of 7th grade, with follow-up data collected at the end of the 7th, 8th, 9th, and 12th grade from a sample of Mexican American adolescents and their mothers. Analyses evaluated long-term effects on externalizing outcomes, trajectories of externalizing behaviors across adolescence, and potential mediators of observed effects. Results showed that the adverse effect that was originally observed based on adolescent self-report of externalizing symptoms at 1-year posttest among youth with high pretest externalizing symptoms was not maintained over time and was not reflected in changes in adolescents' trajectories of externalizing behaviors. Moreover, neither of the peer mediators that theory suggests would explain adverse effects were found to mediate the relationship between intervention status and externalizing symptoms at 1-year posttest. Finally, only beneficial effects were found on externalizing symptoms based on mother report. Together, these findings suggest that the Bridges intervention did not adversely affect adolescent problem behaviors and that future studies should use caution when interpreting unexpected adverse effects.
ContributorsWong, Jessie Jong-Chee (Author) / Gonzales, Nancy A. (Thesis advisor) / West, Stephen G. (Thesis advisor) / Chassin, Laurie (Committee member) / Dishion, Thomas (Committee member) / Arizona State University (Publisher)
Created2015
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Depressive Symptoms and Drinking to Cope in Relation to Alcohol Use Outcomes Among European American and African American College Students

Description
Prior research suggests that African American adults are more likely than White adults to experience negative alcohol use outcomes such as alcohol use disorder (AUD) despite reporting lower rates of alcohol consumption. Research also shows that African Americans experience higher rates of depression, which can increase risk for alcohol consumption…

Prior research suggests that African American adults are more likely than White adults to experience negative alcohol use outcomes such as alcohol use disorder (AUD) despite reporting lower rates of alcohol consumption. Research also shows that African Americans experience higher rates of depression, which can increase risk for alcohol consumption and AUD through drinking to cope. The current study examined the role of depressive symptoms and drinking to cope in alcohol consumption and AUD symptoms among White and Black/African American college students. Participants completed an online survey during the fall (T1) and spring semester (T2) of their first year of college (N = 2,168, 62.8% female, 75.8% White). Path analyses were conducted to examine whether depressive symptoms and drinking to cope mediated the association between race/ethnicity and alcohol consumption and AUD symptoms, as well as whether race/ethnicity moderated the associations between depressive symptoms, drinking to cope, and alcohol use outcomes. Results indicated that White participants had higher levels of depressive symptoms and alcohol consumption than African American participants. Drinking to cope at T1 was also associated with more depressive symptoms at T1, higher levels of alcohol consumption at T2, and higher levels of AUD symptoms at T2. Also, there was an indirect effect of depressive symptoms on AUD symptoms via drinking to cope. Results from multigroup path analyses suggested that depressive symptoms were more strongly associated with drinking to cope for White students than African American students. There were no significant racial/ethnic differences in the associations between depressive symptoms or drinking to cope and alcohol use outcomes. Future research should examine the roles of race, depression, and drinking to cope in alcohol use outcomes for college students.
ContributorsTaylor, Nicole (Author) / Su, Jinni (Thesis director) / Corbin, William (Committee member) / Chassin, Laurie (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
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Screening, Brief Intervention and Referral to Treatment (SBIRT): Implementation in the Adolescent Inpatient Psychiatric Setting

Description

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT)…

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders
ContributorsMaixner, Roberta (Author) / Guthery, Ann (Thesis advisor) / Mensik, Jennifer (Thesis advisor) / Uriri-Glover, Johannah (Thesis advisor)
Created2019-05-02