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5 results

  • Adolescent predictors of psychiatric disorders in adulthood: The role of emotional distress and problem drinking in emerging adulthood

  • Tricia K. Neppl, Olivia N. Diggs, Ashlyn K. Neppl, Natalie L. Denburg
  • Journal:
    Development and Psychopathology / Volume 36 / Issue 2 / May 2024
    Published online by Cambridge University Press:
    27 February 2023, pp. 799-809
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  • The current study evaluated risk factors in adolescence on problem drinking and emotional distress in late adolescence and emerging adulthood, and meeting criteria for diagnosed disorders in adulthood. The study included 501 parents and their adolescent who participated from middle adolescence to adulthood. Risk factors in middle adolescence (age 18) included parent alcohol use, adolescent alcohol use, and parent and adolescent emotional distress. In late adolescence (age 18), binge drinking and emotional distress were assessed, and in emerging adulthood (age 25), alcohol problems and emotional distress were examined. Meeting criteria for substance use, behavioral, affective, or anxiety disorders were examined between the ages of 26 and 31. Results showed parent alcohol use predicted substance use disorder through late adolescent binge drinking and emerging adulthood alcohol problems. Behavioral disorders were indirectly predicted by adolescent and emerging adult emotional distress. Affective disorders were indirectly predicted by parent emotional distress through adolescent emotional distress. Finally, anxiety disorders were predicted by parent alcohol use via adolescent drinking; parent emotional distress via adolescent emotional distress, and through adolescent alcohol use and emotional distress. Results provided support for the intergenerational transmission of problem drinking and emotional distress on meeting criteria for diagnosed psychiatric disorders in adulthood.

  • A prospective longitudinal model predicting early adult alcohol problems: evidence for a robust externalizing pathway

  • A. C. Edwards, C. O. Gardner, M. Hickman, K. S. Kendler
  • Journal:
    Psychological Medicine / Volume 46 / Issue 5 / April 2016
    Published online by Cambridge University Press:
    16 December 2015, pp. 957-968
  • Background

    Risk factors for alcohol problems (AP) include biological and environmental factors that are relevant across development. The pathways through which these factors are related, and how they lead to AP, are optimally considered in the context of a comprehensive developmental model.

    Method

    Using data from a prospectively assessed, population-based UK cohort, we constructed a structural equation model that integrated risk factors reflecting individual, family and peer/community-level constructs across childhood, adolescence and young adulthood. These variables were used to predict AP at the age of 20 years.

    Results

    The final model explained over 30% of the variance in liability to age 20 years AP. Most prominent in the model was an externalizing pathway to AP, with conduct problems, sensation seeking, AP at age 17.5 years and illicit substance use acting as robust predictors. In conjunction with these individual-level risk factors, familial AP, peer relationships and low parental monitoring also predicted AP. Internalizing problems were less consistently associated with AP. Some risk factors previously identified were not associated with AP in the context of this comprehensive model.

    Conclusions

    The etiology of young adult AP is complex, influenced by risk factors that manifest across development. The most prominent pathway to AP is via externalizing and related behaviors. These findings underscore the importance of jointly assessing both biologically influenced and environmental risk factors for AP in a developmental context.

  • Older homeless people: increasing numbers and changing needs

  • Maureen Crane, Louise Joly
  • Journal:
    Reviews in Clinical Gerontology / Volume 24 / Issue 4 / November 2014
    Published online by Cambridge University Press:
    31 October 2014, pp. 255-268
    Print publication:
    November 2014

  • Evidence from England, Australia, Canada, Japan and the USA indicates that the single homeless population is ageing, and that increasing numbers of older people are homeless. This paper reviews evidence of changes in the age structure of the single homeless population, and the factors that are likely to have had an influence on the growth of the older homeless population. In many Western cities, the housing situation of older people is changing and there is a growing reliance on the private rented sector. Unemployment is also having an impact on older people who are under the official retirement age. An increasing number of older people are experiencing problems linked to alcohol, drugs, gambling and criminality, and these are all behaviours that can contribute to homelessness. Despite high levels of morbidity and disability among older homeless people, they are a relatively neglected group and receive little attention from policy makers and mainstream aged care services.

  • 9 - Guided Self-Change: A Brief Motivational Intervention for Cannabis Abuse

  • from Part II - Interventions with Cannabis-Dependent Adults
  • Edited by Roger Roffman, University of Washington, Robert S. Stephens, Virginia College of Technology
  • Foreword by G. Alan Marlatt, University of Washington
  • Book:
    Cannabis Dependence
    Published online:
    29 October 2009
    Print publication:
    23 February 2006, pp 204-224

  • Summary

    This chapter describes the guided self-change (GSC) treatment as applied to cannabis users. The brief motivational nature of this intervention may be particularly appropriate for cannabis users who approach treatment with less severe problems and ambivalence about reducing use, and who may be reluctant to accept a goal of complete abstinence from marijuana use. Important influence on the development of the GSC treatment was the purported efficacy of brief treatments for alcohol problems, especially less severe problems. In order to evaluate the efficacy of the GSC approach with cannabis users, the chapter uses data from a randomized controlled trial comparing an individual and group format of GSC treatment. The fact that the majority of cannabis abusers in the GSC trial chose a reduced use goal suggests that a harm reduction approach might be a good way to involve cannabis abusers in treatment.

  • 2 - Practice and Promise: The Azrin Studies

  • Edited by Robert J. Meyers, University of New Mexico, William R. Miller, University of New Mexico
  • Book:
    A Community Reinforcement Approach to Addiction Treatment
    Published online:
    05 August 2012
    Print publication:
    16 August 2001, pp 8-27

  • Summary

    In the early 1970s, George Hunt and his advisor, Nathan Azrin, developed a theory for describing the etiology and maintenance of alcohol problems and a therapy approach for addressing how to treat them. Azrin and his colleagues designed a series of subsequent studies, testing the relative effectiveness of specific treatment components in order to refine the approach. Community Reinforcement Approach (CRA) was first tested on alcohol-dependent individuals in an inpatient setting, then tailored for use with outpatient populations who might have required residential treatment. As Azrin noted when conducting the 1976 study, disulfiram compliance difficulties were a significant barrier in alcohol treatment programs. The major contribution of the study that followed was a test of the relative importance of the disulfiram compliance procedures and the behavioral CRA components introduced in the previous trial. The effectiveness of the CRA procedures has now been demonstrated with a broader range of participant groups.