Drug Abuse Prevention

Research Findings from May, 2002 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate youth drug abuse prevention. 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.

Influence of a Substance-Abuse-Prevention Curriculum on Violence-Related Behavior

The objective of this work was to test the impact of a school-based substance-abuse prevention program, Project Towards No Drug Abuse (TND), on risk for violence. Logistic regression analyses tested whether victimization, perpetration, or weapon carrying differed for intervention students relative to control students within a sample of 850 continuation high school students followed over 12 months. Data indicate a higher risk for victimization (OR=1.57) among male control students. No intervention effect was observed for female students or for perpetration among males. The findings provide limited support for a generalization of TND's preventive effect. Simon, T.R., Sussman, S., Dahlberg, L.L., and Dent, C.W. Influence of a Substance-Abuse-Prevention Curriculum on Violence-Related Behavior. American Journal of Health Behavior, 26(2), pp. 103-110, 2002. Relative Effectiveness of Anti-drug PSAs

Whether an anti-drug media campaign can produce behavior change in the target (i.e., youth) population is a critical question. Such change depends on knowing the extent to which that behavior is influenced by attitudes, norms and beliefs, and whether these can be altered by televised public service announcements (PSAs). This study explores the relative perceived effectiveness of 30 anti-drug PSAs and assesses the extent to which judgments of effectiveness are related to judgments of realism, amount learned, and positive and negative emotional responses. A sample of students in grades 5 through 12 were randomized to 5 experimental (E) conditions to view sets of 6 anti-drug PSAs or a control group that viewed a non-drug-related TV program. Three of the E groups saw ads focused primarily on the negative consequences of using various drugs; the other two E groups saw ads focused on refusal skills. The researchers report wide variation in the perceived effectiveness of the 30 PSAs: 16 were rated as significantly more effective and 6 significantly less effective than the control program. Ratings of effectiveness were highly associated with realism (r = .87), amount learned (r=. 88), and negative emotion (r=. 87). However, the more positive the adolescents' emotional response to the PSA, the less they regarded it as effective (r=-.35; p=. 06). These findings highlight the variation in the effectiveness of ads. While most ads made adolescents less inclined to use drugs, several had little effect and others had negative effects. Moreover, those youth who do not view drug use as risky behavior were least likely to view the ads as effective. These findings suggest that evaluative research is necessary to prevent broadcast of PSAs that could have a negative impact. PSAs should point out the negative consequences of drug use rather than telling adolescents to just say no. Fishbein, M., Hall-Jamieson, K., Zimmer, E., von Haeften I., and Nabi, R. Avoiding the Boomerang: Testing the Relative Effectiveness of Anti-drug Public Service Announcements before a National Campaign. Am. J. Public Health. 99(2) pp. 238-245, 2002.

Estimates of Intra-group Dependence for Drug Use and Skill Measures in School Drug Prevention Trials

Group-randomized drug abuse prevention trials customarily designate schools as the unit of assignment to experimental condition; however, students within schools remain the unit of observation. Students nested within schools may show some resemblance based on common (peer) selection or school climate factors (i.e. disciplinary practices, group norms, or rules). Appropriate analyses of any treatment effects must be statistically correct for the magnitude of clustering within these intact social units (i.e., intra-class correlation coefficient [ICC]). There is little reported evidence, however, of variation in ICCs that might occur with studies of racially or geographically diverse populations. The purpose of this study was to generate estimates of intra-group dependence for drug use and psychosocial measures (hypothesized mediators) from three separate drug abuse prevention trials. Clustering for the drug use measures averaged .02 across studies and age groups (range=. 002 to .053) and was equivalently small for the psychosocial measures (averaging .03 across studies and age-groups; range=. 001 to .149). With few exceptions and across different samples, clustering decreased in magnitude over time. Clustering was largest for peer smoking and drinking norms among white, suburban youth and smallest for alcohol expectancies among urban black youth. Scheier, L.M., Griffin, K.W., Doyle, M.M., and Botvin, G.J. Estimates of Intra-group Dependence for Drug Use and Skill Measures in School-Based Drug Abuse Prevention Trials: An Empirical Study of Three Independent Samples. Health Education & Behavior, 29(1), pp. 85-103, 2002.

Prevention - Effects on Developmental Progression in Drug Use

This study examines the plausibility of the gateway hypothesis to account for drug involvement in a sample of middle school students participating in a drug abuse prevention trial. Analyses focused on a single prevention approach to exemplify intervention effects on drug progression. Improvement in social competence reduced multiple drug use in 1- and 2-year follow-ups. Specific program effects disrupted drug progression by decreasing alcohol and cigarette use over 1 year and reducing cigarette use over a 2-year period. Controlling for previous drug use, alcohol was integrally involved in the progression to multiple drug use. Subgroup analyses based on distinctions of pretest use/nonuse of alcohol and cigarettes provided partial support for the gateway hypothesis. However, evidence also supported alternate pathways including cigarette use as a starting point for later alcohol and multiple drug use. Findings underscore the utility of targeting more than one gateway substance to prevent escalation of drug involvement and reinforce the importance of social competence enhancement as an effective deterrent to early-stage drug use. Scheier, L.M., Botvin, G.J., and Griffin, K.W. Preventive Intervention Effects on Developmental Progression in Drug Use: Structural Equation Modeling Analyses Using Longitudinal Data. Prevention Science, 2(2), pp. 91-112, 2001.

Reliability and Validity of a Brief Measure of Sensation Seeking

Sensation seeking is a powerful predictor of a wide array of problem behaviors. High sensation seekers (HSS) are more likely than low sensation seekers (LSS) to engage in risky behaviors and, subsequently are less likely to label them as risky. The widely used measure of sensation seeking, Form V of the Sensation Seeking Scale (SSS-V), however, has several shortcomings including length, forced-choice format and outdated colloquial language. This article reports on 2 studies that tested a brief alternative measure based on the SSS-V, the Brief Sensation Seeking Scale (BSSS) and its reliability and validity as a self-report of sensation seeking. Study 1 was administered in mass-testing sessions and found to have suitable item characteristics and internal consistency of responses to items across age (13-17 years), sex and ethnic categories. Study 2 participants completed the BSSS individually using a computer, and also responded to questions about their perceptions of and experiences with drugs and additional risk and protective factors. Their BSSS scores correlated inversely with negative attitudes toward drug use and positively with actual drug use and the BSSS's sensation seeking measure was a strong predictor of intention to use marijuana in the future. Thus, this new brief measure reliably and predictably measures sensation seeking and related factors. Hoyle, R.H., Stephenson, M.T., Palmgreen, P., Lorch, E.P., and Donohew, R.L. Reliability and Validity of a Brief Measure of Sensation Seeking. Personality and Individual Differences, 32, pp. 401-414, 2002.

The First 3 Years of a Prevention Trial With Children at High Risk For Adolescent Conduct Problems

Fast Track is a conduct-problem prevention intervention derived from longitudinal research on how serious and chronic adolescent problem behaviors develop. Over 9,000 kindergarten children at 4 sites in 3 cohorts were screened, 891 were identified as high risk, and randomly assigned to intervention or control groups. Beginning in Grade 1, high-risk children and their parents were asked to participate in a combination of social skills and anger-control training, academic tutoring parent training, and home visiting. A multiyear universal classroom program was delivered to the core schools attended by these high-risk children. By the end of third grade, 37% of the intervention group was determined to be free of serious conduct-problem dysfunction, in contrast with 27% of the control group. Teacher ratings of conduct problems and official records of use of special education resources gave modest effect-size evidence that the intervention was preventing conduct problem behavior at school. Parent ratings provided additional support for prevention of conduct problems at home. Parenting behavior and children's social cognitive skills that had previously emerged as proximal outcomes at the end of the 1st year of intervention continued to show positive effects of the intervention at the end of third grade. Bierman, K.L., Coie, J.D., Dodge, K.A., et al. Evaluation of the First 3 Years of The Fast Track Prevention Trial With Children At High Risk For Adolescent Conduct Problems. Journal of Abnormal Child Psychology, 30 (1), pp. 19-35, 2002.

Predictor Variables Associated with Positive Fast Track Outcomes at Grade 3

Progress has been made in understanding the outcome effects of preventive interventions and treatments designed to reduce children's conduct problems. However, limited research has explored the factors that may affect the degree to which an intervention is likely to benefit particular individuals. This study examines selected child, family, and community baseline characteristics that may predict proximal outcomes from the Fast Track intervention. The primary goal of this study was to examine predictors of outcomes after 3 years of intervention participation, at the end of 3rd grade. Three types of proximal outcomes were examined: parent-rated aggression, teacher-rated oppositional-aggressive behavior, and special education involvement. The relation between 11 risk factors and these 3 outcomes was examined, with separate regression analyses for the intervention and control groups. Moderate evidence of prediction of outcome effects was found, although none of the baseline variables were found to predict all 3 outcomes, and different patterns of prediction emerged for home versus school outcomes. Bierman, K.L., Coie, J.D., Dodge, K.A., et al. Predictor Variables Associated with Positive Fast Track Outcomes at the End of Third Grade. Journal of Abnormal Child Psychology, 30(1), pp. 37-52, 2002.

Family Process Assessment for an African-American Sample

Data from 492 parents and 226 children in the EARLY ALLIANCE (EA) prevention trial were used to explore an asessment of family processes for a sample of African American kindergarten children, their parents, and teachers. Modified versions of the Family Assessment Measure, the Family Adaptability and Cohesion Evaluation Scales, the Family Beliefs Inventory, and the Deviant Beliefs measure were examined for internal consistency. Exploratory and confirmatory factor analyses provided empirical support for a Cohesion factor (cohesion and communication), a Structure factor (support and organization), a Beliefs factor (on family purpose and child development), and a Deviant Beliefs factor. Regression analyses examined the relationship of these measures of family processes to child social and academic competence, problem behavior, and early reading achievement. Family Structure (support and organization), Family and Beliefs were consistently related to parent- and teacher-reported competence and behavioral outcomes. Smith, E.P., Prinz, R.J., Dumas, J.E., and Laughlin, J. Latent Models of Family Processes In African American Families: Relationships to Child Competence, Achievement, and Problem Behavior. J. Marriage & Family, 63(4), pp. 967-980, 2001.

Recruitment and Retention Procedures for Violence Prevention

Participant recruitment and retention problems and strategies of the EARLY ALLIANCE (EA) violence prevention intervention are presented. EA combines home visitation and school-based prevention, and targets entire families in the prevention of child conduct disorder, substance abuse, and school failure. Techniques used to enhance participant recruitment included signing families to a package of programs, presenting EA as a preventive program. Caregivers were directly approached at the beginning of 1st grade, a time when they are particularly motivated to help children. Retention techniques include maintaining flexible schedules, keeping appointments, adhering to procedures, providing support in times of need, and adequately compensating families for their time and inconvenience. Prinz, R.J., Smith, E.P., Dumas, J.E., Laughlin, J.E., White, D.W., and Barron, R. Recruitment and Retention of Participants in Prevention Trials Involving Family-Based Interventions. Am. J. Prev. Med., 20(Suppl1), pp. 31-37, 2001.

Behavior Management to Improve School-Wide Positive Behavior

The Effective Behavior Support program, a consultative approach to assisting middle schools in implementing empiricallybased school-wide behavior management practices, involved working with school staff to clarify rules, teach appropriate social behavior, increase positive reinforcement for positive behavior, consistently provide mild consequences for rule violation, and monitor data on student behavior. The intervention was evaluated through records of rewards given, discipline referrals, and frequent surveys of students. Where possible, data from the target school were evaluated against data from comparison schools. Results show effects at the target school on increased positive reinforcement for appropriate social behavior and decreased aggressive behavior among students. Discipline referrals were significantly decreased for 7th graders and for harassment among males. Students' perceptions of school safety improved at the target school but not at comparison schools. Students' reports of being physically or verbally attacked the previous day were reduced at the target school as well, but these changes were also seen at the comparison school. Metzler, C.W., Biglan, A., Rusby, J.C., and Sprague, J.R. Evaluation of a Comprehensive Behavior Management Program To Improve School-Wide Positive Behavior Support. Education & Treatment of Children, 24 (4), pp. 448-479, 2001.

Moderators of the Relation between Substance Use Level and Problems: Test of a Self-Regulation Model in Middle Adolescence

The authors tested predictions, derived from a self-regulation model, about variables moderating the relationship between level of substance use (tobacco, alcohol, and marijuana) and problems associated with use. Data were from two independent studies of adolescents, with mean ages of 15.4 and 15.5 years (Ns=1,699 and 1,225). Factor analysis indicated correlated dimensions of control problems and conduct problems. Protective moderation was found for variables indexing good self-control; risk-enhancing moderation was found for variables indexing poor self-control. These effects were generally independent of deviance-prone attitudes and externalizing symptomatology. Multiple-group structural modeling indicated moderation occurred for paths from life stress and coping motives and for paths from level to control and conduct problems. Moderation effects were also found for parental variables, peer variables, and academic competence. Wills, T.A., Sandy, J.M., and Yaeger, A.M. Journal of Abnormal Psychology, 111(1), pp. 3-21, 2002.

Emotional Distress Both Contributes To And Is Influenced By Cigarette Smoking

Empirical evidence regarding the causal nature of the relationship between emotional distress and tobacco use in male and female adolescents provides support for both the distress-to-use and the use-to-distress hypotheses. Using a cross-lagged model with 3 waves of data from 2,961 adolescents followed into young adulthood, the authors tested the hypothesis that this relationship changes over time. As hypothesized, emotional distress in Grade 10 was associated with increased smoking in Grade 12 for both boys and girls. Smoking in Grade 12 was, in turn, associated with increased emotional distress in young adulthood. The addition of 3 factors (rebelliousness, deviance, and family problems) to the model did not alter the results. Results suggest that the relationship between tobacco use and emotional distress is a dynamic one in which distress initially leads to use but then becomes exacerbated by it over time, Orlando, M., Ellickson, P.L., and Jinnett, K., Journal of Consulting & Clinical Psychology, 69(6), pp. 959-970, 2001.