Drugs & Self-Esteem (Drugs 101 Book 9)

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Concepts, Prevention, and Cessation

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Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers. Psychology of Addictive Behaviors , 14 , — Nijmegen high and low responders to novelty: A new tool in the search after the neurobiology of drug abuse liability.

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Intrinsic and extrinsic motivation for smoking cessation. Journal of Consulting and Clinical Psychology , 58 , — In Ott , R. Health risk behaviors of adolescent and young adult siblings. Health Psychology , 16 , — Expectancy challenge and drinking reduction: Experimental evidence for a mediational process. Journal of Consulting and Clinical Psychology , 61 , — Process and structure in the alcohol expectancy network. Experimental and Clinical Psychopharmacology , 6 , 1— Confessions of an English opium eater.

An example of integral prevention.

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American Behavioral Scientist , 39 , — Migration and HIV risk behaviors: American Journal of Public Health , 93 , — A study of normative and informational social influences upon individual judgment. Journal of Abnormal and Social Psychology , 51 , — Their automatic and controlled components.

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What does cue-reactivity have to offer clinical research? Addiction , 95 Suppl. Conditioned learning in alcohol dependence: Implications for cue exposure treatment. British Journal of Addiction , 85 , — A controlled trial of cue exposure treatment in alcohol dependents. Journal of Consulting and Clinical Psychology , 62 , — What is moderate drinking?: An emerging new paradigm for drug education. Journal of Drug Education , 24 , — The use of brief interventions adapted from motivational interviewing across behavioral domains: Addiction , 96 , — Empirical modeling of an alcohol expectancy memory network in elementary school children as a function of grade.

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What it is and is not. Drug and Alcohol Review , 14 , — Amygdala and nucleus accumbens in responses to receipt and omission of gains in adults and adolescents. NeuroImage , 25 , — Psychology of Addictive Behaviors , 11 , — Dual process accounts of reasoning. Trends in Cognitive Sciences , 7 , — A historical perspective on effective prevention.

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Substance Use and Misuse , 39 , — For whom does Alcoholics Anonymous work? International Journal of the Addictions , 30 , — Depression, suicidal ideation, and substance use among continuation high school students. Journal of Youth and Adolescence , 27 , — Contextual determinants of drug use risk behavior: Journal of Urban Health , 80 , 50— Retrieved June 20, , from http: The importance of this early use is that it places the child on a deleterious trajectory for future drug use.

If a child smoked tobacco or drank alcohol, they were 65 times more likely to use marijuana than a child who never smoked or drank. Children who used marijuana were times as likely to use cocaine compared with their peers who never used marijuana. Addiction develops from a complex interplay between the individual, the agent drugs and alcohol , and the environment. The initiation of first drug use is determined by interactions between social, cognitive, cultural, attitudinal, personality, and developmental factors. The earliest influences to smoke, drink alcohol, or use drugs may come from the family.

Factors that are related to drug use during adolescence include poor self-image, low religiosity, poor school performance, parental rejection, family dysfunction, abuse, under- or over-controlling by parents, and divorce. Risk factors for the development of externalizing disorders are found in the preschool years. These disorders may initially present with relatively mild behavior problems and progress to severe symptoms such as stealing, aggression, and substance abuse.

Temperament difficulties may exacerbate childhood troublesome behaviors and result in an insecure attachment with the child's primary caregiver. Difficult temperament, characterized by moodiness, negativity, poor compliance, and provocativeness, may lead to the child being criticized and ostracized by parents. The resultant parent-child interactions may lead to the coercive model of parenting that is often present in families who have children with substance abuse and delinquency.

Hyperactivity in childhood imparts a higher risk of later development of adult alcoholism and substance abuse. Childhood aggression has been reported to place a child at risk for adolescent substance abuse. Peer influence plays a pivotal role in the initiation of tobacco and drug usage. Peer cross-pressure, 48 that is, the opposing influences on individuals exerted by the choices they make or by their socioeconomic standing or social group membership, may play a role in initiation of drug use.

The study by Robin and Johnson 49 on peer cross-pressure found adolescents believed their peers' general attitude was against drug use. With the exception of alcohol, there was a direct relationship between peer cross-pressure and subsequent drug use; the lower the acceptance of drug use, the less frequent the drug use.

The higher the perceived risk, the lower the drug use. Adolescents whose drug use is influenced by peer pressure, in the absence of psychological dysfunction, are more likely to stop using drugs. Biological children of alcohol-dependent parents who have been adopted continue to have an increased risk 2- to 9-fold of developing alcoholism. The transmission of type II alcoholism, from father to son, demonstrated a high heritability despite environmental factors. It was hypothesized that this receptor gene, located on the qq23 region of chromosome 11, may confer increased probability for the development of alcoholism.

Other studies suggest that the dopamine D 2 receptor locus may serve as a gene that modifies expression of severe psychiatric disorders, rather than being a marker for alcoholism.

Illicit drug use by men has twice the reported prevalence rate of women's drug use. The trajectory for these patterns of drug use may be found in childhood, where drug use is generally higher in boys than in girls. In their long-term study, Block et al 30 found that there were remediable psychosocial and behavioral risk factors in 3- and 4-year-olds that predicted drug use during adolescence.

Notably, risk factors differed by sex. In short, for girls, the absence of resiliency ie, skills that allow a person to cope with adverse situations and the lack of self-control during early childhood predict both marijuana and hard drug use in adolescence. In boys, lack of self-control is strikingly important. Involvement with harder drugs seemed to represent an extension of the behavioral characteristics that predisposed to marijuana use in boys, while in girls additional psychopathological characteristics were usually present when harder drug use was evidenced.

In another study, Luthar et al 66 reported that women who abused drugs had a higher incidence of internalizing problems, eg, depression, anxiety, and withdrawn behaviors, during childhood and had more severe psychiatric symptoms as adults. Conduct disorders were found more frequently in men who were in treatment for drug abuse. Childhood abuse has been implicated as a significant risk factor for later substance abuse.

Girls seem to be more influenced by environmental factors in the home. Unkempt, crowded, noisy, disorderly conditions where there is little emphasis on conventions and religion are very potent predictors of later drug use in girls. Eighth-graders who took care of themselves after school had a significantly higher risk of using alcohol, tobacco, and marijuana. Children who were quick to anger, perceived themselves to be stressed, were resentful of parents' absence, or from families with conflicts had high drug use rates.

These findings were confirmed by later studies including that of Chilcoat and Anthony 70 who studied youths and found children in the lowest quartile of parent monitoring initiated drug use at earlier ages. The percentage of children aged 12 to 17 years who have seen people selling drugs is higher in the African American community than in communities with a majority of white or Hispanic children More African American children aged 12 to 17 years are exposed to people who are high or drunk Despite this exposure, African American adolescents have a lower reported rate of drug use than their white peers.

Youths living in the most disadvantaged areas were more than 5 times as likely to be offered cocaine as compared with those in more advantaged areas. Protective factors are characteristics within the individual, the family, and the environment that advance one's ability to resist adverse outcomes.

Protective factors for the pediatric population include growing up in a nurturing home with open communication with parents and positive parental support. Protective factors instill the individual with resiliency. Resiliency is the property of an individual to overcome a negative set of life circumstances. Adolescent resiliency is associated with high intelligence, low novelty-seeking behaviors, and avoidance of friendships with delinquent peers. The Challenge Model 81 , 82 uses the principles of resiliency to focus on individuals' capacity to respond and manage their lives.

A chaotic family environment does not necessarily cause a child to be forever damaged. Where the risk-protective equation implies the tallying of factors, the Challenge Model asserts that individuals can achieve beyond the negative factors in their lives; in essence, resiliency. The Challenge Model delineates 7 principles that facilitate an individual's adaptive and healthy development. These include insight, independence, relationships, initiative, humor, creativity, and morality. As conceptualized in the work of Newcomb and Felix-Ortiz, 83 consideration and attention to both protective factors and risk factors are fundamental in developing effective prevention strategies.

Prevention efforts prior to were based on an information-deficit approach. The assumption was that children lacked adequate knowledge regarding the effects of drug use. Thus, prevention efforts involved the dissemination of information. During the s through s, prevention efforts focused on social and interpersonal influence models. The theory underlying this approach postulated that youth experimented with drugs and alcohol because they had not fully developed their own internal value system to resist external pressures.

The prevention programs of the s offer a comprehensive systems approach. They are research-based, age-appropriate, culturally relevant interactive resistance models. These prevention programs promote protective factors while reducing risk factors using school-based curricula that include social resistance skills training and normative education.

Active learning techniques are the primary teaching modality, as opposed to passive didactics. Small-group, role-playing, and interactive learning techniques are imperative in these programs. Prevention curricula have been developed for children from preschool ages to young adulthood. Young children are increasingly likely to feel pressure to drink alcohol and use drugs. The adolescence period represents the greatest risk for substance abuse. Programs in prevention have developed a new nomenclature to denote the target audience and focus of the program. Programs are designated as universal , selective, or indicated.

Universal interventions are designed to address a general population, such as a community or school. Selective curricula target an at-risk population, such as those curricula that are designed for children whose parents have drug or alcohol dependence. Indicated programs target individuals who already demonstrate the problem behavior or have other high-risk behaviors related to initiating the target behavior. Research on the effectiveness of prevention curricula have generally focused on universal programs that target children in junior high and high school. One researched intervention that targets the elementary school child is the Seattle Social Development Project.

Based on the theory that the greater the number of childhood risk factors the greater the likelihood of child delinquency and drug use, the Seattle Social Development Project employed a model of intervention focusing on both family- and school-based interventions in grades 1 through 4 to enhance protective factors against delinquency and substance abuse. The study by Hawkins et al 98 supports the presence of reduced incidents of drug use, antisocial and disruptive behaviors, and improved school performance following the implementation of the Seattle Social Development Project.

Despite DARE's popularity in US schools, studies have found little difference in drug use patterns among students who have participated in the curriculum compared with cohorts who have not received the DARE program. Life Skills Training was found to be effective in lowering tobacco, alcohol, and marijuana use in a 6-year long-term randomized field trial involving New York State students in 56 high schools. Life Skills Training uses resistance skill training in a broader framework of self-improvement and interpersonal social skills development.

Recent studies supported the effectiveness of the program in minority inner-city populations.

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