RESUMEN
The main aim of this study was to determine how constructive thinking (CT), executive functioning (EF), and antisocial behavior (ASB) are related to drug use involvement in 282 adolescent females, 14-18 years of age, with a substance use disorder (SUD) and in controls. CT was measured using the Constructive Thinking Inventory (S. Epstein & P. Meier, 1989), EF was measured using a battery of neuropsychological tests, and ASB was measured using the Youth Self-Report Inventory (T. Achenbach, 1991) and a psychiatric interview. Females with an SUD demonstrated lower CT and EF scores and higher ASB scores compared with the controls. Low CT and low EF were significantly related to increased drug use involvement even when controlling for age, socioeconomic status, and vocabulary level. ASB partially mediated the relation between CT and drug use involvement, and it fully mediated the relation between EF and drug use involvement. Moreover, ASB moderated the relation between EF and drug use involvement.
Asunto(s)
Desempeño Psicomotor/fisiología , Conducta Social , Trastornos Relacionados con Sustancias/psicología , Pensamiento/fisiología , Adolescente , Educación , Etnicidad , Femenino , Humanos , Delincuencia Juvenil/psicología , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Violencia/psicologíaRESUMEN
Two child self-report scales were developed to measure parental neglect (emotional distance and parental involvement) in a sample of 344 boys between 10 and 12 years of age. Psychometric analyses of the parental emotional distance and involvement scales demonstrated their unidimensionality; construct, concurrent, and predictive validity; and reliability. Cross-sectional analyses indicated that neglect was more severe among boys who had a parent with a DSM-III-R lifetime substance use disorder (SUD) compared to youth whose parents had no Axis I psychiatric disorder. In addition, children reported more severe neglect by the mother than the father. Longitudinal analyses of a subsample (n = 99) revealed that child neglect at ages 10-12 predicted significant variance on a composite measure of substance use involvement and severity of substance use as well as increased the risk for SUD at age 19.
Asunto(s)
Maltrato a los Niños/psicología , Relaciones Padre-Hijo , Apego a Objetos , Trastornos de la Personalidad/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Padres/psicología , Determinación de la Personalidad , Desarrollo de la Personalidad , Trastornos de la Personalidad/epidemiología , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , Reproducibilidad de los Resultados , Factores de Riesgo , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/epidemiología , Factores de Tiempo , Estados Unidos/epidemiologíaRESUMEN
This review provides a synthesis of the literature on the complex sequence of maturational, psychosocial, and neuroadaptive processes that lead to substance use disorders (SUD) in adolescence. A brief overview introduces the concepts of liability to SUD and epigenesis. A theory is presented explaining how affective, cognitive, and behavioral dysregulation in late childhood is exacerbated during early and middle adolescence by family and peer factors, as well as puberty, leading to substance use. Continued exacerbation of the three components of dysregulation by drug and non-drug stressors during late adolescence is posited to result in neuroadaptations that increase the likelihood of developing SUD, particularly in high-risk individuals. Implications for etiologic research as well as clinical and preventive interventions are discussed.
Asunto(s)
Trastornos Relacionados con Sustancias/psicología , Adaptación Psicológica/fisiología , Adolescente , Conducta del Adolescente/psicología , Encéfalo/fisiopatología , Trastornos del Conocimiento/complicaciones , Humanos , Trastornos Mentales/complicaciones , Trastornos del Humor/complicaciones , Reproducibilidad de los Resultados , Estrés Psicológico/psicología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/fisiopatologíaRESUMEN
OBJECTIVE: To determine whether neuropsychological deficits in female adolescents are more closely related to a diagnosis of a substance use disorder (SUD) or a conduct disorder (CD). METHOD: Subjects were 470 female adolescents between the ages of 14 and 18 years. They were categorized into one of four groups: (1) SUD-only (n = 63), (2) CD-only (n = 58), (3) SUD+CD (n = 239) and (4) normal controls (n = 110). The groups were compared on multiple neuropsychological measures covering four cognitive domains: general intelligence, executive functioning, language competence and academic achievement. RESULTS: The findings were consistent across all measures. Multivariate analyses of variance revealed significant group differences for all four neuropsychological domains. Univariate tests indicated that the two CD groups equally exhibited the poorest performance of all four groups on nearly all measures of intelligence, executive functioning, language competence and academic achievement. The SUD-only group performed better than the two CD groups but not as well as the control group. Socioeconomic status and chronological age were statistically controlled for in all analyses. CONCLUSIONS: These data suggest that the neuropsychological deficits found in our sample of female adolescents with SUD are more closely related to CD, or antisociality in general, than to SUD. Future studies assessing the neuropsychological functioning of persons with SUD should make efforts to measure comorbid antisociality.
Asunto(s)
Alcoholismo/diagnóstico , Daño Encefálico Crónico/diagnóstico , Trastornos de la Conducta Infantil/diagnóstico , Drogas Ilícitas , Pruebas Neuropsicológicas , Trastornos Relacionados con Sustancias/diagnóstico , Adolescente , Alcoholismo/psicología , Trastorno de Personalidad Antisocial/diagnóstico , Trastorno de Personalidad Antisocial/psicología , Daño Encefálico Crónico/psicología , Trastornos de la Conducta Infantil/psicología , Comorbilidad , Femenino , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
OBJECTIVE: To test the hypothesis that low socioeconomic status (SES), a disturbed parent-daughter relationship, early sexual development, and antisocial behavior are risk factors in adolescent females affiliating with adult male sexual partners. To determine whether the relation between these risk factors and affiliating with adult male sexual partners is stronger in females with greater, rather than fewer, substance use disorders (SUD). METHOD: Subjects were 180 adolescent females with SUD and 87 normal controls (14-18 years of age). RESULTS: The SUD group had a lower SES and more negative parent-daughter interactions, and exhibited greater antisocial tendencies. Also, the SUD group showed a more frequent affiliation with adult male sexual partners. Chronological age, age of menarche (sexual development), antisocial behavior, and quality of the parent-daughter relationship were significantly associated with affiliation with adult male sexual partners. Moreover, the number of SUD diagnoses enhanced the relation between the quality of the parent-daughter relationship and antisocial behavior with affiliation with adult male sexual partners. CONCLUSIONS: From a prevention perspective, interventions directed at enhancing child rearing practices, communication skills, and involvement in children's needs and activities might result in improved parent-child attachments that may attentuate young women's propensities to become involved in antisocial behavior and affiliate with adult sexual partners. Also, the risk imposed by an early sexual maturation may be offset by enhancing the female adolescent's social skills to select non-deviant and supportive male partners.
Asunto(s)
Conducta del Adolescente , Conducta Sexual , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Femenino , Humanos , Relaciones Interpersonales , Masculino , Relaciones Padres-Hijo , Responsabilidad Parental , Factores de Riesgo , Parejas Sexuales , Conducta Social , Clase Social , Trastornos Relacionados con Sustancias/etiologíaRESUMEN
The etiology of early age onset substance use disorder (SUD), an Axis I psychiatric illness, is examined from the perspective of the multifactorial model of complex disorders. Beginning at conception, genetic and environment interactions produce a sequence of biobehavioral phenotypes during development which bias the ontogenetic pathway toward SUD. One pathway to SUD is theorized to emanate from a deviation in somatic and neurological maturation, which, in the context of adverse environments, predisposes to affective and behavioral dysregulation as the cardinal SUD liability-contributing phenotype. Dysregulation progresses via epigenesis from difficult temperament in infancy to conduct problems in childhood to substance use by early adolescence and to severe SUD by young adulthood.
Asunto(s)
Trastornos Relacionados con Sustancias/etiología , Adolescente , Conducta del Adolescente/psicología , Adulto , Afecto/fisiología , Factores de Edad , Envejecimiento/fisiología , Encéfalo/crecimiento & desarrollo , Niño , Trastornos de la Conducta Infantil/psicología , Preescolar , Humanos , Trastornos Mentales/psicología , Teoría Psicológica , Medio Social , Estrés Psicológico/psicología , Temperamento/fisiologíaRESUMEN
The authors assessed whether low executive cognitive functioning (ECF) and a difficult temperament are related to aggressive and nonaggressive forms of antisocial behavior (ASB) in 249, 14-18-year-old, conduct-disordered females and controls. ECF was measured using neuropsychological tests; temperament was measured using the Dimensions of Temperament Survey-revised; and ASB was assessed using psychiatric symptom counts for conduct disorder. The conduct-disordered females exhibited lower ECF capacity and a greater difficult temperament compared with the controls. The combined influence of low ECF and difficult temperament was significantly related to both forms of ASB. In comparison with low ECF, difficult temperament was more strongly related to nonaggressive ASB, whereas in comparison with difficult temperament, low ECF was more strongly related to aggressive ASB. Last, ECF mediated the relation between difficult temperament and aggressive ASB.
Asunto(s)
Trastorno de Personalidad Antisocial/complicaciones , Trastornos del Conocimiento/complicaciones , Trastorno de la Conducta/etiología , Adolescente , Factores de Edad , Agresión/clasificación , Femenino , Humanos , Pruebas Neuropsicológicas , Corteza Prefrontal/fisiopatología , Análisis de Regresión , Temperamento/clasificaciónRESUMEN
OBJECTIVE: This study had four objectives: (1) to determine whether female adolescents with a psychoactive substance use disorder are more impaired than controls on a battery of neuropsychological tests of Executive Cognitive Functioning (ECF); (2) to determine whether these individuals exhibit higher levels of disruptive, delinquent and aggressive behavior compared with controls; (3) to determine whether ECF is related to disruptive, delinquent and aggressive behavior in this population; and (4) to determine whether these relations are moderated by drug use. METHOD: Multiple indicators of ECF, and disruptive, delinquent and aggressive behavior, as well as drug use, were used to test these relations in a sample of 188 female adolescents who qualified for a DSM-III-R diagnosis of a psychoactive substance use disorder (PSUD) and 95 normal controls between the ages of 14-18 years (N = 283). RESULTS: Hierarchical multiple regression equations determined that ECF was related to disruptive, delinquent and aggressive behavior even when chronological age, SES and drug use were accounted for. The final regression models suggested that drug use was more strongly related to disruptive and delinquent behavior, whereas ECF was more strongly related to aggression. Drug use did not moderate any relation between ECF and the dependent measures. CONCLUSIONS: One implication of these results is that violence prevention and treatment outcomes may be ameliorated by incorporating cognitive habilitation of ECF as an integral component of multimodel interventions.
Asunto(s)
Agresión , Déficit de la Atención y Trastornos de Conducta Disruptiva/complicaciones , Trastornos del Conocimiento/complicaciones , Delincuencia Juvenil , Trastornos Relacionados con Sustancias/complicaciones , Adolescente , Atención/fisiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/fisiopatología , Estudios de Casos y Controles , Trastornos del Conocimiento/fisiopatología , Análisis Factorial , Femenino , Humanos , Conducta Impulsiva/complicaciones , Conducta Impulsiva/fisiopatología , Delincuencia Juvenil/psicología , Pruebas Neuropsicológicas , Corteza Prefrontal/fisiopatología , Trastornos Relacionados con Sustancias/fisiopatología , Volición/fisiologíaRESUMEN
This study had three aims: (1) to determine the relations between behavioral dysregulation, negative affectivity, and familial impairment with violence and suicidality (i.e., severity of ideation and attempts) in a sample of adolescent females with a psychoactive substance use disorder and controls; (2) to determine whether these relations are mediated by internalizing (depression/anxiety) and externalizing (nonviolent antisocial behavior) symptomatology; and (3) to determine whether severity of alcohol/drug use involvement moderates the relations between the mediating variables with violence and suicidality. Multiple behavioral, psychiatric interview, and self-report measures were used to index behavioral dysregulation, negative affectivity, familial impairment, internalizing and externalizing symptomatology, and violence and suicidality in one hundred sixty-one 14- to 18-year-old adolescent females with a psychoactive substance use disorder and in 80 controls. Structural equation modeling was used to determine the proposed relations. Results indicated that behavioral dysregulation, negative affectivity, and familial impairment were related to violence, whereas only familial impairment was related to suicidality. Internalizing symptomatology mediated the relation between familial impairment and suicidality, and was related to violence, whereas externalizing symptomatology mediated the relations between behavioral dysregulation, negative affectivity, and familial impairment with violence. Severity of alcohol/drug use involvement did not moderate the relations between internalizing or externalizing symptomatology with suicidality or violence. Nevertheless, the relation between internalizing symptomatology and suicidality was stronger in females with a greater degree of alcohol/drug use involvement, compared with those with a milder degree of involvement. Therefore, from a prevention standpoint, behavioral dysregulation, negative affectivity, familial impairment, as well as internalizing and externalizing symptoms, may serve as clinical "points of intervention" for altering the development of violence and suicidality in high risk and substance abusing youth.
Asunto(s)
Trastornos Relacionados con Alcohol/epidemiología , Psicotrópicos , Trastornos Relacionados con Sustancias/epidemiología , Intento de Suicidio/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Trastorno de Personalidad Antisocial/epidemiología , Trastorno de Personalidad Antisocial/psicología , Causalidad , Hijo de Padres Discapacitados/psicología , Comorbilidad , Femenino , Humanos , Control Interno-Externo , Rhode Island/epidemiología , Factores de Riesgo , Trastornos Relacionados con Sustancias/psicología , Intento de Suicidio/psicología , Violencia/psicologíaRESUMEN
OBJECTIVE: Although several mental disorders have been shown to be common in adolescents with substance use disorders, prior studies have not specifically focused on alcohol dependence and have not had sufficient sample sizes to examine gender effects. This study contrasts mental disorder diagnoses and symptoms between a sample of adolescents with alcohol dependence and a community control sample of adolescents and incorporates gender analyses. METHOD: Adolescents (aged 14 years 0 months to 18 years 0 months) with alcohol dependence (females: n = 55; males: n = 78) and community-dwelling control adolescents without substance use disorders (females: n = 44; males: n = 42) were assessed by means of a semistructured interview for DSM-III-R. RESULTS: While cannabis and hallucinogen use disorders were common in the alcohol dependence group, females and males had similar rates. Conduct disorder (CD), oppositional defiant disorder, attention-deficit hyperactivity disorder, major depression (MD), and posttraumatic stress disorder (PTSD) had significantly higher rates in the alcohol dependence than in the community control group. Depression and PTSD symptoms were more strongly associated with alcohol dependence in females than in males. A configural frequency analysis showed that CD and MD tended to occur together in both female and male adolescents with alcohol dependence. CONCLUSIONS: While alcohol-dependent females and males similarly exhibited more comorbid disorders than control adolescents, gender affects the relationship of alcohol dependence to MD and PTSD. Rather than reflecting distinct types, the comorbid disorders of CD and MD jointly characterize many adolescents with alcohol dependence.
Asunto(s)
Alcoholismo/epidemiología , Adolescente , Edad de Inicio , Análisis de Varianza , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Trastornos de la Conducta Infantil/epidemiología , Análisis por Conglomerados , Comorbilidad , Estudios Transversales , Trastorno Depresivo/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Pennsylvania/epidemiología , Prevalencia , Factores Sexuales , Trastornos por Estrés Postraumático/epidemiología , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
OBJECTIVE: While preadolescent children of parents with substance use disorders (SUDs) are known to have more behavior problems, depression, and anxiety than expected, psychiatric disorders in these children and their relationships with parental disorders have not been systematically investigated. This study compares the psychiatric disorders of preadolescent boys of fathers with and without SUDs and examines the relationships between offspring and parental psychopathology. METHOD: Fathers (i.e., probands) of boys 10 through 12 years old were recruited to represent families of boys with paternal SUD (high risk or HR: n = 113) and boys without paternal SUD (low average risk or LAR: n = 170). These boys (i.e., index cases) and their biological parents participated in structured diagnostic interviews, and diagnoses were determined by the best-estimate method. RESULTS: Disruptive behavior disorders and anxiety disorders were more prevalent in HR than in LAR index cases. Logistic regression analyses examining the relationships between parental and index case psychopathology indicated that parental childhood psychiatric disorders were more strongly predictive of index case psychiatric disorders than parental adulthood psychiatric disorders, including SUDs. CONCLUSIONS: Inasmuch as HR boys had increased rates of disruptive behavior disorders and anxiety disorders, these disorders may be important targets for early intervention to prevent the development of SUD, as well as the morbidity associated with these disorders. Prevention efforts and studies of the transmission of liability for psychiatric disorders in children should carefully consider parental childhood characteristics.
Asunto(s)
Trastornos de la Conducta Infantil/epidemiología , Hijo de Padres Discapacitados/psicología , Salud de la Familia , Padre/psicología , Trastornos Neuróticos/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Intervalos de Confianza , Humanos , Modelos Lineales , Masculino , Oportunidad Relativa , Pennsylvania/epidemiologíaRESUMEN
Adolescent patients qualifying for a DSM-II-R diagnosis of alcohol use disorder were studied to determine whether a multidimensional schema could classify subjects into subgroups. The Drug Use Screening Inventory was administered to 151 subjects. To test the concurrent validity of the subtypes, subjects also received a structured diagnostic psychiatric evaluation along with measures of personality, academic achievement, and drinking behavior. Two clusters were identified for each gender. Differences between clusters were reflected primarily on indicators of severity of disorder. Young women were more inclined toward affective disturbances, whereas conduct disorder was the most frequent disorder in young men. This study underscores the heterogeneity of the adolescent population qualifying for a diagnosis of alcohol use disorder. The differential pattern of alcohol involvement and comorbid psychopathology within clusters and between genders demonstrates the need for interventions tailored to specific clinical presentation.
Asunto(s)
Alcoholismo/psicología , Trastornos Mentales/clasificación , Adolescente , Alcoholismo/epidemiología , Niño , Trastornos de la Conducta Infantil/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos del Humor/epidemiología , Psicología del Adolescente , Distribución por SexoRESUMEN
The purpose of this study was to elucidate the etiological pathways towards substance use and risky sexual behavior in female adolescent substance abusers. The study had three aims: (1) to determine the relations between behavioral dysregulation, negative affectivity, and childhood victimization with substance use and risky sexual behavior, (2) to determine whether these relations are mediated by internalizing symptomatology, antisocial behavior, and affiliating with an adult boyfriend; and (3) to determine whether age of menarche moderates the relation between the mediating variables and substance use and risky sexual behavior. Multiple behavioral, psychiatric interview, and self-report measures were used to index behavioral dysregulation, negative affectivity, childhood victimization, internalizing symptomatology, antisocial behavior, affiliation with adult boyfriends, substance use, and risky sexual behavior in 125 substance abusing female adolescents and 78 controls between the ages of 14-18 years. Structural equation modeling was used to determine the etiological pathways. Results indicated that behavioral dysregulation, negative affectivity, and childhood victimization were related to substance use and risky sexual behavior. Age of menarche was significantly correlated with affiliation with an older boyfriend and risky sexual behavior. Antisocial behavior mediated the associations between behavioral dysregulation, negative affectivity and childhood victimization with substance use and risky sexual behavior. Affiliation with an adult boyfriend was directly associated with substance use involvement and accounted for the relationship between chronological age and risky sexual behavior. Finally, late menarche enhanced the association between internalizing symptomatology and substance use involvement. The results highlight the importance of behavioral dysregulation, negative affectivity, and childhood victimization in predicting substance use and risky sexual behavior, as well as the finding that antisocial behavior and affiliation with an adult boyfriend may be etiologically important in predicting these outcomes. Therefore, from a prevention and treatment standpoint, behavioral and affective dysregulation, childhood victimization as well as antisocial behavior may serve as clinical 'gateways' for altering the developmental trajectory toward substance use and risky sexual behavior in high risk and substance abusing youth. For example, reducing dysregulation through behavior modification procedures that have been developed for conduct disordered children would appear to be a heuristic avenue of investigation emanating from the results obtained in this study.
Asunto(s)
Drogas Ilícitas , Psicotrópicos , Conducta Sexual , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Adulto , Trastorno de Personalidad Antisocial/diagnóstico , Trastorno de Personalidad Antisocial/epidemiología , Trastorno de Personalidad Antisocial/psicología , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Comorbilidad , Depresión/diagnóstico , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Control Interno-Externo , Masculino , Determinación de la Personalidad , Factores de Riesgo , Parejas Sexuales/psicología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
We conducted this study with a sample of sons of fathers having a Psychoactive Substance Use Disorder (PSUD+, n = 55) and sons of fathers who did not qualify for a PSUD (PSUD-, n = 97). Parental discipline practice from the child's perspective was investigated in relation to the child's difficult temperament to determine their association with sons' externalizing and internalizing behavior problems reported by mothers. PSUD+ status, difficult temperament in the boys, and their ratings of parental discipline practices accounted for a significant proportion of variance with respect to their externalizing behavior (11%), but only PSUD+ status had a main effect on internalizing behavior. However, the main finding of this study was that the interaction of parental discipline and difficult temperament in the child moderated both externalizing and internalizing behavior problems, accounting for an additional 5% of an explained variance. Thus, this study illustrates the importance of the conjoint influence of children's temperament characteristics and parental discipline practices on the children's adjustment. These results support the findings from previous studies showing that a difficult temperament disposition places the child at risk for maltreatment by parents and for development of a disruptive behavior disorder. Both outcomes have been found in many investigations to presage alcohol and drug abuse in adolescence. The findings also underscore the importance of both individual and contextual variables for understanding the development of psychopathology. In this regard, the results show the need for prevention and treatment to encompass strategies directed at disaggregating the basis of maladaptive family interaction patterns.
Asunto(s)
Trastornos de la Conducta Infantil/psicología , Padre , Responsabilidad Parental , Trastornos Relacionados con Sustancias/psicología , Temperamento , Adulto , Niño , Femenino , Humanos , Masculino , Trastornos Mentales/complicaciones , Trastornos Mentales/psicología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/prevención & controlRESUMEN
Female adolescents who qualified for a DSM-III-R diagnosis of psychoactive substance use disorder (n = 106) were compared to normal controls (n = 74) on a battery of cognitive, intellectual and achievement tests. It was found that the substance abuse group performed deficiently on tests requiring language skills, sustained attention and perceptual efficiency and scored lower than controls on standardized tests of intelligence and academic achievement. No relationship between magnitude of cognitive deficit and severity of substance abuse was observed. The implications of these findings are discussed with respect to the etiology and maintenance of drug use.
Asunto(s)
Trastornos del Conocimiento/inducido químicamente , Drogas Ilícitas/efectos adversos , Pruebas Neuropsicológicas , Psicotrópicos/efectos adversos , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/psicología , Adolescente , Alcoholismo/psicología , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/psicología , Escolaridad , Etanol/efectos adversos , Femenino , HumanosRESUMEN
In structured clinical interviews of 43 adolescents hospitalized for alcohol abuse or dependence, 17 subjects met criteria for an anxiety disorder, with social phobia (N = 9) and posttraumatic stress disorder (N = 7) most common. Of these 17 subjects, only four were identified in hospital records as having an anxiety disorder. In a comparison of 30 hospitalized adolescents with a matched control group of 30 adolescents from the community, the hospitalized adolescents had a higher rate of anxiety disorders, psychoactive substance use disorders, disruptive behavior disorders, and mood disorders.
Asunto(s)
Alcoholismo/rehabilitación , Trastornos de Ansiedad/diagnóstico , Admisión del Paciente , Adolescente , Alcoholismo/diagnóstico , Alcoholismo/psicología , Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/rehabilitación , Terapia Combinada , Comorbilidad , Femenino , Humanos , Masculino , Readmisión del Paciente/estadística & datos numéricos , Determinación de la Personalidad , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/psicología , Trastornos Fóbicos/rehabilitación , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/psicología , Australia del Sur/epidemiología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/rehabilitación , Revisión de Utilización de RecursosRESUMEN
An association between childhood aggression and risk for subsequent development of a substance abuse disorder is now well-accepted. In order to better understand the relationship between the presence of paternal substance abuse and aggression among their offspring, 10-12 year old sons of fathers with (n = 34) and without (n = 39) a history of a substance abuse disorder were contrasted on demographics, aggressivity, biological indices of reproductive maturation, and the presence of psychiatric diagnoses. In addition, personality factors, the potential for physical abuse, and psychiatric diagnoses were also ascertained among their fathers. Sons of substance-abusing fathers were found to be significantly more aggressive than sons of nonsubstance abusers. However, they also differed from comparison boys on the basis of SES and school grade attained, as well as the proportion with specific psychiatric disorders. Substance-abusing fathers differed from nonsubstance-abusing men in terms of personality factors and the presence of specific psychiatric disorders, including antisocial personality. They also showed significantly higher child abuse potential scores. A multiple regression analysis of factors contributing to aggression in the boys revealed that a paternal personality factor characterized by stress reactivity, alienation, and aggression was the most robust contributor to aggression among the boys. The boys' diagnoses of attention deficit disorder, oppositional defiant disorder, and lower household socioeconomic status were also significant predictors of aggressivity. Contrary to expectations, paternal, psychiatric diagnoses, substance abuse status, and potential for physical abuse were noncontributory. The results suggest potential mechanisms by which both aggression and risk for substance abuse may be transmitted from father to son.
Asunto(s)
Agresión , Padre/psicología , Trastornos Mentales/psicología , Conducta Paterna , Pubertad/fisiología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/psicología , Niño , Estradiol/sangre , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Masculino , Trastornos Mentales/complicaciones , Trastornos Relacionados con Sustancias/complicaciones , Testosterona/sangreRESUMEN
The distribution and the statistical accuracy of scores on the Drug Use Screening Inventory (DUSI) and the discriminative power of the DUSI for identifying individuals who qualify for a DSM-III-R diagnosis of Psychoactive Substance Use Disorder (PSUD) were examined in 846 adolescents. The subjects with PSUD had higher mean scores, and the distribution of their scores approximated a normal distribution in each of the 10 domains measured by the DUSI. All of the DUSI domains yielded more precise trait estimates for the subjects who had more severe PSUD. Within the normal sample, using a score of 30 on the overall problem density index as the cutoff score, the DUSI correctly classified 95% of the normal sample and 81% of the PSUD cases.
Asunto(s)
Tamizaje Masivo , Inventario de Personalidad/estadística & datos numéricos , Psicotrópicos , Trastornos Relacionados con Sustancias/epidemiología , Adolescente , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Alcoholismo/psicología , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psicometría , Valores de Referencia , Sensibilidad y Especificidad , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Female adolescents who qualified for a DSM-III-R diagnosis of Psychoactive Substance Use Disorder were not distinguishable from depressed and conduct disorder subjects on measures of coping but were differentiable from normal controls. Age of onset of substance use, interval between age of first use and age of diagnosis of abuse, and severity of substance use involvement did not correlate with coping capacity. These findings indicate that deficient coping is not specifically related to drug abuse but rather, where present, is concomitant to comorbid psychopathology among females who have a substance abuse disorder.
Asunto(s)
Adaptación Psicológica , Identidad de Género , Psicotrópicos , Trastornos Relacionados con Sustancias/psicología , Adolescente , Alcoholismo/psicología , Alcoholismo/rehabilitación , Niño , Trastornos de la Conducta Infantil/psicología , Comorbilidad , Trastorno Depresivo/psicología , Femenino , Humanos , Determinación de la Personalidad , Trastornos Relacionados con Sustancias/rehabilitaciónRESUMEN
PURPOSE: Few studies have examined the impact of alcohol abuse on the health status of adolescents. The purpose of this investigation was to determine whether adolescents with a diagnosis of alcohol abuse differed from controls on the frequency of self-reported health problems, clinical signs and symptoms detected upon clinical examination, and liver injury test results. METHODS: Cases were ascertained from in-patient drug and alcohol treatment centers. Age- and sex-matched controls were recruited from community sources. The Health Problems Checklist (HPC) was used to measure self-reported problems; the clinical examination was performed by a physician or a physician's assistant. RESULTS: Alcohol-abusing adolescents reported significantly more physical symptoms than did controls as measured by the HPC. The results of the clinical examination revealed a low prevalence of overt abnormalities in both groups, however, alcohol-abusing adolescents reported a higher frequency of appetite changes, weight loss, eczema, headaches and episodes of loss of consciousness than did controls. As expected, alcohol-abusing adolescents had significantly higher levels of ALT, AST and GGTP as compared to controls. CONCLUSIONS: The findings of this study are generalizable only to in-patient adolescent alcohol abusers. In this study, alcohol abuse was also associated frequently with psychiatric disorders, drug abuse, cigarette smoking, and low parental education. Future studies using larger sample sizes should address the importance of social environmental and behavioral variables in moderating the relationship between alcohol abuse and decreased health status in adolescents.