Origins and Pathways to Drug Abuse

Research Findings from February, 2001 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the origins and pathways to drug abuse. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Minors Purchase Snuff at Corporate- and Independently-Owned Convenience Stores

Two underage males attempted to purchase moist snuff at each of 90 convenience stores. Two corporate owned chains with the largest number of convenience stores were selected (n = 45), along with a random sample of 45 independently owned convenience stores that held current tobacco licenses. Overall, underage buyers were sold snuff on one out of four purchase attempts. Sales occurred significantly more often in independent stores (35.6%) than in corporate stores (13.3%). An important variable associated with sales was whether the store clerk requested identification. Hanson, K., Hatsukami, D., Boyle, R. and Brown, S. Addict Behav, 25(2), pp. 289-293, 2000.

Childhood Trauma as a Correlate of Lifetime Opiate Use in Psychiatric Patients

Tardiff's group (Heffernan et al. 2000) at Cornell University Medical Center found that the opiate abusers were 2.7 times more likely to have a history of childhood sexual and/or physical abuse than non-opiate users. The investigators examined the relationship between childhood abuse and opiate abuse in particular among 763 men and women consecutively admitted for psychiatric hospitalization between 1991 and 1992. Patients (age 18-59) were interviewed about demographic information, alcohol and drug use, and history of interpersonal violence. About 18% of the patients reported heavy opiate use. Childhood abuse was reported by 41.6% of the sample (17.2% physical abuse only, 9.3% sexual abuse only, and 14.8% both). Opiate use was higher among those reporting physical abuse alone (24%) or both physical and sexual abuse (27%) than among those reporting sexual abuse alone (8.8%) indicating that impact of physical abuse may create greater risk for opiate use. Heffernan, K., Coitre, M., Tardiff, K., Marzuk, P.M., Portera, L. and Leon, A.C. Addictive Behaviors, 25(5), pp. 797-803, 2000.

Links Between School Misbehavior, Academic Achievement, and Cigarette Use

The directionality of the association between substance abuse behaviors and negative school behaviors is unclear. In a study using the Monitoring the Future follow-up panel data, investigators at the University of Michigan examined relations among academic achievement, school bonding, school misbehavior, and cigarette use from 8th to 12th grade in two national panel samples of youth (n=3056). A series of competing conceptual models developed a priori was tested using structural equation modeling (SEM). The findings suggest that during middle adolescence the predominant direction of influence is from school experiences to cigarette use. School misbehavior and low academic achievement contribute to increased cigarette use over time both directly and indirectly. Two-group SEM analyses involving two cohorts -- gender and ethnicity -- showed robust findings. In addition, comparisons between high school dropouts and non-dropouts and between 8th grade cigarette use initiators and nonusers revealed few differences in direction or magnitude of effects. Results suggest that prevention programs that attempt to reduce school misbehavior and academic failure, as well as to help students who misbehave and have difficulty in school constructively avoid negative school- and health-related outcomes, are likely to be effective in reducing adolescent cigarette use. Bryant, A.L., Schulenberg, J., Bachman, J.G., O'Malley, P.M., and Johnston, L.D. Understanding the Links Among School Misbehavior, Academic Achievement, and Cigarette Use: A National Panel Study of Adolescents. Prevention Science, 1(2), pp 71-87, 2000.

Executive Cognitive Functioning Mediates the Relation Between Language Competence and Antisocial Behavior in Conduct-Disordered Adolescent Females

Researchers affiliated with the Center for Education and Drug Abuse Research (CEDAR) at the University of Pittsburgh conducted a study to determine (1) whether adolescent females with a conduct disorder (CD) demonstrate inferior language skills and lower executive cognitive functioning (ECF) compared with controls and (2) whether the relations between language abilities and different forms of antisocial behavior (ASB) are mediated by ECF. Language skills were measured using the Test of Language Competence-Expanded, ECF was measured using multiple neuropsychological tests, and ASB was assessed using various self-report and psychiatric interview indices reflecting mild delinquency to severe violence. Subjects were 223 adolescent females with a CD and 97 normal controls ranging between 14 and 18 years of age (N = 320). The CD group demonstrated significantly poorer language skills and lower ECF compared with the controls. Moreover, even when controlling for chronological age and socioeconomic status, ECF still fully mediated the relations between language competence and each measure of ASB. The results are discussed in relation to a neurobehavioral model of ASB. Giancola, P.R. and Mezzich, A.C. Executive Cognitive Functioning Mediates The Relation Between Language Competence and Antisocial Behavior in Conduct- Disordered Adolescent Females. Aggressive Behavior, 26(5), pp. 359-375, 2000.

Inhalant Use Among High School Students in Illinois

Researchers at the University of Illinois at Chicago analyzed data from two years (1993 and 1995) of a statewide survey of high school students on drug use. Changes in the rates of inhalant use, and associations between inhalant use and sociodemographic variables, were examined across the two survey years. Measures of inhalant use included lifetime use, past year use, and past month use. Analyses showed no significant difference in the rates of inhalant use across years. Associations with sex, ethnicity, and age were partly consistent with previous research findings. Both lifetime and recent inhalant use were more prevalent among males than females. Blacks were less likely to use inhalants (lifetime and recent) than other racial/ethnic groups in both survey years. Native Americans showed elevated rates of recent inhalant use in 1993 but not in 1995. While patterns in age-specific rates in the 1993 survey were consistent with expectations, those in the 1995 survey were not: recent inhalant use was constant across age groups in the 1995 sample. Also contrary to expectations, inhalant use was not more prevalent in low-income or high- poverty areas. The associations of inhalant use with family intactness and academic performance varied by race/ethnicity. Family intactness was a significant protective factor only for whites and Hispanics. Poor grades were not a significant predictor of lifetime inhalant use for blacks, and the protective effect of high grades was found only for whites. Poor grades were highly predictive of lifetime inhalant use for Asians. Mackesy-Amiti, M.E. and Fendrich, M. Trends in Inhalant Use Among High School Students in Illinois: 1993-1995. American Journal of Drug and Alcohol Abuse, 26(4), pp. 569-590, 2000.

Decreased Drug Reporting in a Cross-Sectional Student Drug Use Survey

Longitudinal cohort studies have suggested that reinterviews about drug use often lead to decreased reports of lifetime substance use (recanting). Respondents may edit their answers on reinterview because of perceptions regarding question threat. Since reinterviews usually occur after long periods of time, the influence of inadequate recall (memory), cannot be ruled out. In order to evaluate the relative importance of editing and memory on recanting, researchers examined a cross-sectional survey administered in 1993 to a probability sample of Illinois students who were in the 7th through 12th grade. Two sets of self-administered survey questions assessed drug use in this survey: the I-SAY drug-use questionnaire, and a supplemental questionnaire asked at the end of the survey. Rates of "new use " (i.e., cases where use of a drug was not reported in the I-SAY questionnaire but was reported on the supplement) with rates of recanting (use for a drug reported on the I-SAY but no use for the drug reported on the supplement). Findings indicate that recanting was generally more pronounced than was new use, especially for cocaine, heroin, marijuana, and inhalants. Those classified as light or inconsistent users on the I-SAY were significantly more likely to recant their drug use reports. Fendrich, M. and Mackesy-Amiti, M.E. Decreased Drug Reporting in a Cross-sectional Student Drug Use Survey. Journal of Substance Abuse, 11(2), pp. 161-172, 2000.

Risk and Protective Factors Influencing Adolescent Problem Behavior

Investigators at Oregon Research Institute examined the dynamic relations between adolescent- problem behaviors (alcohol, marijuana, deviance, academic failure) over time and predictors of these behaviors using data from the National Youth Survey, which included 1,044 adolescents (53.5% male; mean age at year 1 = 13.20). Dependent measures were adolescent alcohol use, marijuana use, deviance, and academic failure; assessments were conducted annually over 4 years. Independent measures included age, gender; marital status, income, family time, family support, time with friends, friend deviance, knowledge of friends, activities, and neighborhood problems. An associative latent growth modeling (LGM) analysis showed significant increases and relations between the four behaviors in both initial status and development. Second-order multivariate LGM analyses indicated that the four behaviors could be modeled by a higher-order problem behavior construct. Significant effects on the common problem behavior intercept or slope included time with friends, deviant friends, age, marital status, family time, and support. Additional effects were found to be specific to the initial status and slopes of individual problem behaviors. Overall, results indicate the importance of assessing the relations between adolescent problem behaviors as they change over time and identifying risk and protective factors that have both common and individual influences on these behaviors. Duncan, S.C., Duncan, T.E., and Strycker, L.A. Risk and Protective Factors Influencing Adolescent Problem Behavior: A Multivariate Latent Growth Curve analysis. Annals of Behavioral Medicine, 22(2), pp. 103-109, 2000.

School Dropout and Injecting Drug Use in a National Sample of White Non-Hispanic American Adults

Researchers at Johns Hopkins conducted a study to extend their previous finding of an association between school dropout and injecting drug use (IDU) among African Americans by testing the association in a sample of White non-Hispanic Americans. A nationally representative sample of White non-Hispanic Americans age eighteen years and older was drawn from public use data files of the 1995-1996 National Household Surveys on Drug Abuse (NHSDA). Adults with a self-report history of IDU were identified, and were matched to non-IDU adults in the same neighborhoods of residence. Conditional logistic regression was used to estimate the association between dropping out of high school and the occurrence of IDU. White non-Hispanic American high school dropouts were more likely than high school graduates to have injected a drug at least once. The findings of this research on non-Hispanic Whites are generally consistent with earlier evidence on the association between educational status and a history of IDU among African-American adults. School dropout prevention programs may merit attention in an overall strategy of preventing injecting drug use and HIV/AIDS. Obot, I.S. and Anthony, J.C. School Dropout and Injecting Drug Use in a National Sample of White Non-Hispanic American Adults. Journal of Drug Education, 30(2), pp. 145-155, 2000.

Implications of Genetic Epidemiology for the Prevention of Substance Use Disorders

Despite advances in characterizing human genotypes, the complex process through which genes exert their influence limits the application of molecular genetics to human diseases. Substance use disorders are necessarily complicated by gene-environment interaction because exposure to an exogenous substance is required for their development. The methods of genetic epidemiology are specifically designed to identify sources of complexity that impede etiologic findings and prevention efforts. Researchers at Yale report a study illustrating the application of family study methods to identify risk factors for substance abuse and their implications for prevention. The Yale Family Study is a controlled family study of the comorbidity of substance and psychiatric disorders. The sample consists of 223 probands with substance use and/or an anxiety disorders and community controls, 1218 adult first degree relatives and spouses, and 203 offspring (ages 7-17) followed for 8 years. Results indicated familial aggregation of substance disorders in adults and children, independence of familial aggregation of alcoholism and drug dependence, and specificity of familial clustering of some drugs of abuse. Familial factors are more strongly associated with substance dependence than abuse, with an attributable risk of 55%. Premorbid psychiatric disorders -social phobia and bipolar affective disorder in adults, and depression, anxiety, conduct, and oppositional defiant disorders in children - were strongly associated with the subsequent development of substance dependence (attributable risks ranging from 44 to 86%). A family history of substance abuse and premorbid psychopathology are strongly associated with the development of substance use disorders. As specific genetic vulnerability markers for substance use disorders become identified, application of the tools of genetic epidemiology may be employed to identify specific environmental risk factors that may serve as targets for prevention. Merikangas, K.R. and Avenevoli, S. Implications of Genetic Epidemiology for the Prevention of Substance Use Disorders. Addictive Behaviors, 25(6), pp. 807-820, 2000.

Childhood Sexual Abuse Predicts Adult Psychiatric and Substance Use Disorders in Women

Dr. Kenneth Kendler and colleagues at the Medical College of Virginia used a genetically-informed design and population-based sample of 1411 female adult twins to explore the association between childhood sexual abuse and adult psychiatric disorders, including alcohol and substance abuse, assessed retrospectively. They found that women who reported childhood sexual abuse are at substantially increased risk to develop a range of psychopathologic outcomes, particularly alcohol and substance use disorders, primarily due to more severe sexual abuse. Of note, this relationship held when parental psychopathology was controlled in the analyses, suggesting that the relationship between childhood sexual abuse and adult outcomes is indeed causal. Although the association between sexual abuse and psychopathology has been reported previously, this study is remarkable for applying methodology that can help distinguish between association and causation by including family factors and using a co-twin report method in a population-based sample. Kendler, K.S., Bulik, C.M., Silberg, J., Hettema, J.M., Myers, J., and Prescott, C.A. Childhood Sexual Abuse And Adult Psychiatric And Substance Use Disorders In Women: An Epidemiological And Cotwin Control Analysis. Archives of General Psychiatry, 57, pp. 953-959, 2000.

Heritability of Tobacco Consumption Varies by Gender and Time Cohort

This article reports the largest and most comprehensive analysis to date of twin data yielding heritability estimates for tobacco use. The probands were obtained from a Swedish registry of twins born since 1886. By comparing monozygotic (MZ) and dizygotic (DZ) twin pairs, heritabilities for males was 56% with considerably lower contributions to the variance for use of tobacco; 24% and 20% for familial-environment and individual-specific environment risk factors, respectively. The pattern for females was not the same and subsequent analyses were needed to understand the differences. What seemed to matter for females was the era of their birth: those born in the first and second third of the cohort had much less heritability than those born in the last third (since 1940). In fact, those females born most recently had essentially the same heritability as males. The authors' conclude that "a reduction in the social restrictions on smoking in women in Sweden as the twentieth century progressed permitted genetic factors influencing the risk for regular tobacco use to increasingly express themselves."

Risk Factors for Early Tobacco Experimentation

This prospective study examines the relations between the mother's prenatal and current smoking and the offspring's smoking experimentation. A low SES birth cohort of 589 10-year-olds, who have been followed since their gestation, completed a self-report questionnaire about their substance use. Half were female, and 52% were African-American. Detailed data on exposure to tobacco and other substances in the prenatal and postnatal periods were collected from the mothers. During pregnancy, 52.6% of the mothers were smokers; 59.7% were smokers when their children were 10. Six per cent of the children (37/589) reported ever-smoking cigarettes, 3% had had one full alcoholic drink, and none had started to use other drugs. Maternal smoking during pregnancy was significantly associated with an increased risk of the child's tobacco experimentation. Offspring exposed to more than _ pack per day during gestation had a 5.5-fold increased risk for early experimentation. Structural equation modeling showed that prenatal tobacco exposure had a direct and significant effect on the child's smoking and that maternal current smoking was not significant. Prenatal tobacco exposure also predicted child anxiety/depression and externalizing behaviors, and these outcomes affected child smoking through the mediating effect of peer tobacco use. Cornelius, M.D., Leech, S.L., Goldschmidt, L., and Day, N.L., Prenatal Tobacco Exposure: Is It A Risk Factor For Early Tobacco Experimentation? Nicotine & Tobacco Research, 2, 45-52, 2000.

Monthly Bursts in Adolescent Drug Use

The goal of this study was to determine the extent to which monthly bursts in substance use (i.e., tobacco, marijuana, alcohol) were related to family and peer relations. Using a structured protocol, monthly interviews were conducted with 181 young adolescents, ages 11-14 yrs old, and their parents. Scores derived from monthly telephone reports described variation in parent involvement, exposure to deviant peers, peer conflicts, and level of family stress. Consistent with an ecological framework of development, environmental factors varied by gender and family membership. Across gender in both 1- and 2-parent families, exposure to peer problem behavior co-varied with increased substance use in the same month. Other monthly predictors varied by gender. Findings suggest that intervention programs for high-risk youth targeting adolescent problem behavior need to focus on managing the peer environment. Dishion, T.J. and Medici Skaggs, N. An Ecological Analysis of Monthly "Bursts" in Early Adolescent Substance Use. Applied Developmental Science, 4(2), pp. 89-97, 2000.

Youth Violence

This study replicates earlier research findings on developmental risk factors for youth violence and explores the effects of violent behavior on factors shown to increase risk for other problem behaviors. Risk factors from the individual, family, school, peer, and community domains are examined. Prospective longitudinal data on 808 young people participating in the Seattle Social Development Project were used. Potential risk factors for violence at age 18 measured at ages 10, 14, and 16 years. Results show that at each age examined, risk factors strongly related to later violence were distributed among the 5 domains. Ten of 15 risk factors measured at age 10 were significantly predictive of violence at age 18. Twenty of 25 constructs measured at age 14 and 19 of 21 constructs measured at age 16 were significantly predictive of later violence. The hyperactivity, low academic performance, peer delinquency, and availability of drugs, were measured at all 4 ages and all 4 predicted later violence. Subjects exposed to multiple risks were more likely than others to engage in later violence. The overall accuracy in predicting those who would go on to commit violent acts was limited. Herrenkohl, T.I., Maguin, E., Hill, K.G., Hawkins, J.D., Abbott, R.D. and Catalano, R.F. Developmental Risk Factors for Youth Violence. Journal of Adolescent Health, 26(3), pp. 176-186, 2000.

Aggression and Drug Use Related in Inner-City Youth

In a study of 517 inner-city eighth graders, investigators found that self-reported aggressive and unsafe behaviors were associated with initiation of drug use (use of tobacco, alcohol, and marijuana). Sex differences were found for aggressive behavior, victimization, and unsafe behavior. Epstein, J.A., Botvin, G.J., Diaz, T., Williams, C., and Griffin, K. Aggression, Victimization and Problem Behavior Among Inner-City Minority Adolescents. J. of Child and Adolescent Substance Abuse, 9(3), pp. 51-66, 2000.

Reducing Adolescent Aggressive Behavior

Data from a randomized trial including 22 public schools assigned either to the Iowa Strengthening Families Program or a control condition were examined for long-term effects of this seven-session intervention for parents and their sixth-grade children on aggressive and hostile behaviors of adolescents. Analyses supported sample representativeness of this general population study and failed to show differential attrition effects 4 years after baseline. The multi-informant, multi-method measures included independent observer ratings of adolescent aggressive and hostile behaviors in adolescent-parent interactions, family-member report of aggressive and hostile behaviors in those interactions, and adolescent self-report of aggressive and destructive conduct across settings. Data were collected during the 6th (pre- and post-intervention), 7th, 8th, and 10th grades. All measures showed a generally positive trend in intervention compared to the control group over time. During 10th grade, significant intervention-control differences were found for adolescent self-report of aggressive and destructive conduct with relative reduction rates ranging from 31.7% to 77.0%. Significant differences were shown for observer-rated aggressive and hostile behaviors in adolescent-parent interactions; differences in family member reports of those behaviors were not significant. Supplemental analyses interaction behavior measures, specific to parent gender, indicated significant experimental group differences in interactions with mothers for both measures, but not with fathers. Spoth, R.L., Redmond, C., and Shin, C. Reducing Adolescents' Aggressive and Hostile Behaviors - Randomized Trial Effects of a Brief Family Intervention Four Years Past Baseline. Archives of Pediatrics and Adolescent Medicine, 154 (12), pp. 1248-1257, 2000.

Psychosocial and Behavioral Factors Predict Heavy Drinking

A longitudinal study found that heavy drinking in 12th grade was predicted by multiple factors measured in the 7th grade, including experimentation with alcohol or cigarettes, having had a majority of friends who drink and having had poor behavioral self-control. Several effects were limited to either boys or girls. For example, positive alcohol expectancies in 7th grade predicted greater heavy drinking later in boys, while friends' smoking predicted later heavy drinking in girls. Griffin, K.W., Botvin, G.J., Epstein, J.A., Doyle, M.M. and Diaz, T. Psychosocial and Behavioral Factors in Early Adolescence as Predictors of Heavy Drinking Among High School Seniors. J. of Studies on Alcohol 61(4), pp. 603-606, 2000.

Results Linking Parenting Practices and Problem Behavior Replicated With Urban Minority Youth

A study of 228 6th grade urban minority youth found that boys from single-parent families engaged in the highest rates of problem behavior. The relationship between parenting practices and outcomes was moderated by family structure and gender. More parental monitoring was associated with less delinquency overall, as well as less drinking in boys only. Eating family dinners together was associated with less aggression overall, as well as less delinquency in youth from single-parent families and in girls. Unsupervised time at home alone was associated with more smoking for girls only. Griffin, K.W., Botvin, G.J., Scheier, L.M., Diaz, T. and Miller, N.L. Parenting Practices as Predictors of Substance Use, Delinquency, and Aggression Among Urban Minority Youth: Moderating Effects of Family Structure and Gender. Psychology of Addictive Behaviors, 14(2), pp. 174-184, 2000.

Competence Skills Protect Inner-City Adolescents from Alcohol Use

In a three-wave longitudinal study of inner city students in middle or junior high school at baseline, investigators found that decision making and self-efficacy predicted higher refusal assertiveness relative to alcohol use. Refusal assertiveness in turn predicted less drinking at the 2-year follow-up. Earlier drinking also predicted 2-year follow-up drinking. Epstein, J.A., Griffin, K.W. and Botvin, G.J. Role of General and Specific Competence Skills in Protecting Inner-City Adolescents from Alcohol Use. J. of Studies on Alcohol, 61(3), pp. 379-386, 2000.

The Relation of Perceived Neighborhood Danger and Childhood Aggression

Data from a school-based sample of 732 inner city predominantly African American 5th graders were analyzed to determine whether two mediational mechanisms, parenting practices and children's beliefs about aggression, accounted for the relationship between perceived neighborhood danger and childhood aggression. Results suggested that perceived neighborhood danger was associated with strong positive beliefs about aggression, which in turn was associated with high levels of aggression. The hypothesized mediating role of parenting practices (restrictive discipline, parental monitoring, and parental involvement) on the relation between perceived neighborhood danger and child aggression was not supported. The current findings suggest that children's positive beliefs about aggression mediated the relationship between restrictive discipline and aggression. Colder, C.R., Mott, J., Levy, S., and Flay, B. The Relation of Perceived Neighborhood Danger to Childhood Aggression: A Test of Mediating Mechanisms. American Journal of Community Psychology, 28(1), pp. 83-103, 2000.

Children's Beliefs About Long-Term Health Effects of Alcohol and Cocaine Use

The objective of this study was to assess age differences in children's beliefs about the long-term health effects of alcohol and cocaine, to use such beliefs to predict attitudes toward and intentions to use these substances, and to establish whether accurate beliefs are more predictive of attitudes and intentions than inaccurate ones. Children ages 6 to 12 (N=217) responded to an open-ended question about the effects of long-term alcohol and cocaine use and to 12 structured questions about drug effects. Differentiation of alcohol, cocaine, and tobacco effects was limited but increased with age. Beliefs about health effects had no impact on alcohol attitudes and intentions, but intentions to drink were stronger among older and white children. Anti-cocaine attitudes and intentions were associated with being older and non-White and with having accurate knowledge of cocaine's true health effects-but also with believing falsely that cocaine has tobacco-like effects and that drugs in general have catastrophic effects. With age, children differentiated more sharply between substances. Sigelman, C., Leach, D., Mack, K., Bridges, L., Rinehart, C., Dwyer, K., Elizabeth, D. and Sorongon, A. Children's Beliefs About Long-Term Health Effects of Alcohol and Cocaine Use. Journal of Pediatric Psychology, 25(8), pp. 557-566, 2000.

Childhood Sexual Abuse Among Female Addicts and Subsequent Parenting

The relationship between childhood sexual abuse (CSA), family of origin and the status of 248 female narcotic addicts currently raising adolescent children was examined. Seventy-eight of these women reported a history of CSA. The CSA group and the non- CSA group were compared on variables related to parental substance abuse, parenting behavior, and other family dynamics (retrospectively for families of origin and contemporaneously for current families). Findings suggest that the abuse of alcohol by the mothers of some of the CSA subjects was a contributing factor in creating an environment or set of circumstances in which the abuse took place. The two groups also differed on variables such as involvement, attachment, responsibility, discipline, and punitive actions. CSA was also related to addiction careers, parental substance use, adult psychological symptoms, and home atmosphere. Blatchley, R.J., Hanlon, T.E., Nurco, D.N., and O'Grady, K. Childhood Sexual Abuse Among Female Addicts and Changes in Parenting Across Two Generations. Fishbein, D.H. (Ed), et al. The Science, Treatment and Prevention of Antisocial Behaviors: Application to the Criminal Justice System, Kingston, NJ, US: Civic Research Institute, pp. 27-25, 2000.

Group Self-Identification and Prediction of Drug Use and Violence in High-Risk Youth

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after controlling for baseline assessment of the drug use or violence measure. This is the first study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors. Sussman, S., Dent, C.W., and McCullar, W.J. Group Self-Identification as a Prospective Predictor of Drug Use and Violence in High-Risk Youth. Psychology of Addictive Behaviors, 14(2), pp. 192-196, 2000.

Prediction of Drug Use from Stress-Related Variables

Six stress-related variables, gender, age, and ethnicity were investigated as concurrent and prospective predictors of three types of drug use (cigarettes, alcohol, and illicit drug use) among 875 "high risk" adolescents. The stress-related variables were socioeconomic status, "missing" one's parent(s), family conflict, victimization, perceived stress, and stress-drug beliefs. In general, findings indicated that those who were lower in socioeconomic status, held beliefs favorable toward drug use and who had been victimized in the last year were more likely to be cigarette, alcohol, or illicit drug users. Those who had used drugs at baseline and had been victimized in the last year were relatively more likely to use drugs the next year. Significant predictors in the multivariable models accounted for between 56 and 85% of those subjects who were above the median on later drug use. Victimization is a relatively important source of stress in the prediction of future drug use. Thus, drug-use interventions need to provide supportive services to those who have been victims of violent attacks on their person or property. Sussman S., and Dent C.W. One-Year Prospective Prediction of Drug Use from Stress-Related Variables. Substance Use & Misuse, 35(5), pp. 717-735, 2000.

Trauma, Drugs and Violence Among Juvenile Offenders

Trauma typically occurs when one experiences a situation where life has been threatened or lost. If the trauma is not resolved, negative residual effects may result in alcohol and drug use, involvement in violent activities as well as the development of mental health problems such as posttraumatic stress disorder (PTSD). Findings from a study examining the link between trauma, drug use and violence among youth are presented. Results from interviews with 414 juveniles remanded to the Office of Children and Family Services (formerly New York State Division For Youth) for assault, sexual assault, robbery or homicide, document the trauma experienced by these youth, as well as how it correlated with their drug usage and participation in violent, illegal activities. Discussion of these findings, their implications for understanding and intervening, and recommendations for future research are highlighted. Crimmins, S.M., Cleary, S.D., Brownstein, H.H., Spunt, B.J., Warley, R.M. Trauma, Drugs and Violence among Juvenile Offenders. J Psychoactive Drugs, 32, pp. 43-54, 2000.

Trauma, Drugs and Violence Among Juvenile Offenders

Trauma typically occurs when one experiences a situation where life has been threatened or lost. If the trauma is not resolved, negative residual effects may result in alcohol and drug use, involvement in violent activities as well as the development of mental health problems such as posttraumatic stress disorder (PTSD). Findings from a study examining the link between trauma, drug use and violence among youth are presented. Results from interviews with 414 juveniles remanded to the Office of Children and Family Services (formerly New York State Division For Youth) for assault, sexual assault, robbery or homicide, document the trauma experienced by these youth, as well as how it correlated with their drug usage and participation in violent, illegal activities. Discussion of these findings, their implications for understanding and intervening, and recommendations for future research are highlighted. Crimmins, S.M., Cleary, S.D., Brownstein, H.H., Spunt, B.J., Warley, R.M. Trauma, Drugs and Violence among Juvenile Offenders. J Psychoactive Drugs, 32, pp. 43-54, 2000.

Differences in Young Adult Psychopathology Among Drug Abstainers, Experimenters, and Frequent Users

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. Milich, R., Lynam, D., Zimmerman, R., Logan, T.K., Martin, C., Leukefeld, C., Portis, C., Miller, J. and Clayton, R. Differences in Young Adult Psychopathology among Drug Abstainers, Experimenters, and Frequent Users. J Subst Abuse, 11, pp. 69-88, 2000.

Development of Marijuana Use From Childhood to Young Adulthood

The present study was designed to examine the relationship between unconventionality and marijuana use over time. The sample for this paper consisted of 532 male and female participants interviewed during early adolescence, late adolescence, their early twenties, and their late twenties. Latent growth modeling was used. The findings indicated that (1) the influence of initial unconventionality (T2) on initial marijuana use (T2) was stronger for males, (2) unconventionality at T2 was not significantly related to overall rate of growth in marijuana use, and (3) change in unconventionality was related to overall growth rate of marijuana use. The implications of the findings for prevention and treatment are discussed. Brook, J.S., Whiteman, M., Finch, S.J., Morojele, N.K. and Cohen, P. Individual Latent Growth Curves in the Development of Marijuana Use from Childhood to Young Adulthood. J Behav Med 23(5), pp. 451-464, 2000.

Associations Between Bipolar Disorder and Other Psychiatric Disorders

This study investigated cross-sectional and longitudinal associations between bipolar disorder and other psychiatric disorders during adolescence and early adulthood. Psychiatric interviews were administered to a representative community sample of 717 youths and their mothers in 1983 (mean age of youths=14 years) and again in 1985-1986, and 1991-1993. Findings show a wide range of psychiatric disorders co-occurred with bipolar disorder during adolescence and early adulthood. Adolescent anxiety disorders were uniquely associated with increased risk for early adulthood bipolar disorder after adolescent bipolar disorder was accounted for. Manic symptoms during adolescence were associated with increased risk for anxiety and depressive disorders during early adulthood after adolescent anxiety and depressive disorders were accounted for. Researchers concluded that adolescents with anxiety disorders might be at increased risk for bipolar disorder or clinically significant manic symptoms during early adulthood. Adolescents with manic symptoms may be at increased risk for anxiety and depressive disorders during early adulthood. Johnson, J.G., Cohen, P., and Brook, J.S. Associations between Bipolar Disorder and Other Psychiatric Disorders during Adolescence and Early Adulthood: A Community-Based Longitudinal Investigation. Am J Psychiatry 157(10), pp. 1679-1681, 2000.

Personality Disorders Associated With Violence and Criminal Behavior

This community-based, longitudinal prospective study investigated whether personality disorders during adolescence are associated with elevated risk for violent behavior during adolescence and early adulthood. A community-based sample of 717 youths from upstate New York and their mothers were interviewed in 1983, 1985-1986, and 1991-1993. Axis I and II disorders were assessed in 1983 and 1985-1986. Antisocial personality disorder was not assessed because most participants were less than 18 years of age in 1983 and 1985-1986. Violent behavior was assessed in 1985-1986 and 1991-1993. Results show that adolescents with a greater number of DSM-IV cluster A or cluster B personality disorder symptoms were more likely than other adolescents in the community to commit violent acts during adolescence and early adulthood, including arson, assault, breaking and entering, initiating physical fights, robbery, and threats to injure others. These associations remained significant after controlling for the youths' age and sex, for parental psychopathology and socioeconomic status, and for co-occurring psychiatric disorders during adolescence. Paranoid, narcissistic, and passive-aggressive personality disorder symptoms during adolescence were independently associated with risk for violent acts and criminal behavior during adolescence and early adulthood after the covariates were controlled. Cluster A and cluster B personality disorders and paranoid, narcissistic, and passive-aggressive personality disorder symptoms during adolescence may increase risk for violent behavior that persists into early adulthood. Johnson, J.G., Cohen, P., Smailes, E., Kasen, S., Oldham, J.M., Skodol, A.E. and Brook, J.S. Adolescent Personality Disorders Associated with Violence and Criminal Behavior during Adolescence and Early Adulthood. Am J Psychiatry, 157(9), pp. 1406-1412, 2000.