RESUMEN
OBJECTIVE: Youth use of cigars has increased in the USA. Understanding brand preference among youth could help explain the attraction to cigars, and develop prevention strategies. This study reports on youth characteristics associated with preferences for cigar brands. DESIGN: Data are presented on 5006 students in grades 7-12 (ages 12-18 years) in classrooms administered the cigar use reasons evaluation (CURE), a questionnaire assessing alternative tobacco use (cigars, bidis, and kreteks). SETTING: Twelve middle and high schools across Massachusetts. MAIN OUTCOME MEASURES: Preferred brands of cigars. RESULTS: Cigar smoking was reported by 16.4% of the sample. The brands preferred by over 5% of cigar users were Phillies (overall prevalence: 31.0%, 95% confidence interval (CI) 27.9% to 34.3%), Black & Mild (12.3%, 95% CI 9.8% to 15.4%), Garcia y Vega (11.4%, 95% CI 9.3% to 13.8%), Swisher Sweets (9.6%, 95% CI 7.6% to 12.2%), Backwoods (6.1%, 95% CI 4.6% to 8.1%), and non-listed brands (16.4%, 95% CI 14.0% to 19.0%). Male cigar smokers were significantly more likely than females to prefer five brands: Backwoods, Dutch Masters, Garcia y Vega, Phillies, and Swisher Sweets, while females were more likely to prefer Black & Mild and non-listed brands. Brand preferences were also distinguished by self, friends' and siblings' tobacco use, race/ethnicity, parents' education and cigar use, GPA (grade point average), college plans, and community type. Urban students were more likely to prefer Black & Mild; students whose parents smoke cigars preferred non-listed brands. CONCLUSIONS: Youth prefer certain brands, most notably Phillies. Particular brands are preferred by particular youth subgroups, raising the possibility of selective marketing toward these groups.
Asunto(s)
Comportamiento del Consumidor , Fumar/psicología , Adolescente , Niño , Conducta de Elección , Femenino , Humanos , Masculino , Massachusetts/epidemiología , Análisis Multivariante , Fumar/epidemiologíaRESUMEN
The authors used longitudinal data to develop a risk factor index (RFI) for the prediction of smoking behavior in youth. Students were followed yearly from 6th through 12th grades in a prospective longitudinal study. Ten risk factors were identified and combined into an RFI. Data were analyzed with a generalized estimating equations approach. The RFI predicted both concurrent smoking and use of cigarettes in the succeeding year. It further predicted whether a youth would smoke at any point during his or her school career. Prediction was better for boys than for girls. Furthermore, the RFI better predicted heavy smoking than any use of cigarettes. The RFI could be useful in selecting youth for intensive prevention and early intervention efforts. Results also suggest the importance of further examination of gender differences in smoking behavior.
Asunto(s)
Modelos Teóricos , Prevención del Hábito de Fumar , Adolescente , Análisis de Varianza , Niño , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Massachusetts , Oportunidad Relativa , Estudios Prospectivos , Análisis de Regresión , Factores de Riesgo , Factores Sexuales , Fumar/psicologíaRESUMEN
BACKGROUND: This paper examines whether the Massachusetts Tobacco Control Program is affecting the rates of smoking and smokeless tobacco use among Massachusetts' youth. METHODS: School survey data from the Massachusetts Prevalence Study were analyzed to estimate differences between 1993 and 1996 rates of youth cigarette and smokeless tobacco use, attitudes toward smoking, and awareness of cigarette ads and promotions of antismoking messages. RESULTS: Lifetime and Current Smoking rates declined significantly among middle school males, contrasting with stable national trends. Among girls in this age group, Lifetime and Current Smoking did not change significantly. Hispanic middle school students exhibited a significant decline in Lifetime Use. There were no significant changes in Lifetime or Current Smoking rates among high school students. Lifetime use of smokeless tobacco declined among middle school students while Current Use declined among both middle and high school students. Students reported declines in awareness of cigarette ads or promotions and increases in awareness of antismoking messages. CONCLUSIONS: These results provide evidence for cautious optimism regarding the impact of tobacco control, but indicate that these efforts should begin earlier and that additional research is needed to understand and address the problems of tobacco use by girls.
Asunto(s)
Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/tendencias , Adolescente , Publicidad/tendencias , Actitud , Concienciación , Femenino , Humanos , Masculino , Massachusetts/epidemiología , Prevalencia , Prevención del Hábito de Fumar , Encuestas y CuestionariosRESUMEN
BACKGROUND: Many studies have noted a strong association between poor social support and premature mortality. A limitation of such studies has been their failure to control adequately for confounders that damage both social supports and physical health. METHODS: A 50-year prospective multivariate study of 223 men was used to examine the possible causal relationships between social supports and health. Alcohol abuse, prior physical health and mental illness prior to age 50 were controlled. Relative social supports were quantified over the period from age 50 to 70. RESULTS: Adequacy of social supports from age 50 to 70 was powerfully correlated with physical health at age 70 (P < 0.001). However, such social supports were also powerfully predicted by alcohol abuse (P < 0.001), smoking (P < 0.001) and indicators of major depressive disorder (P < 0.01) assessed at age 50. When prior smoking, depression and alcohol abuse were controlled, then the association of physical health with social supports was very much attenuated. Some facets of social support like religion and confidantes were unassociated with health even at a univariate level. Surprisingly, in this sample friends seemed more important for sustained physical health than closeness to spouse and to children. CONCLUSIONS: While social supports undoubtedly play a significant role in maintaining physical well-being in late life, much of the association between poor social supports and mortality may be mediated by alcoholism, smoking and pre-morbid psychopathology.
Asunto(s)
Envejecimiento/psicología , Estado de Salud , Apoyo Social , Actividades Cotidianas , Factores de Edad , Anciano , Alcoholismo/epidemiología , Trastorno Depresivo/epidemiología , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Mortalidad , Análisis Multivariante , Estudios Prospectivos , Factores de Riesgo , Fumar/epidemiologíaRESUMEN
Over the past twenty years many MMPI studies of substance abuse have investigated the complex relationship between personality profile and drug of choice. This work has repeatedly established that alcoholics, heroin, cocaine and polydrug addicts share 4-2/2-4 (Psychopathy and Depression) or 4-8/8-4 (Psychopathy and Thought Disorder) MMPI profiles, but that the substance abuse populations differ in the plane of severity in that general profile. The alcoholics occupy the least disturbed sector, the polydrug abusers the most disturbed level and the heroin and cocaine addicts positions of moderate disturbance. The vast majority of studies, however, cite only group means to buttress their conclusions. Our work probed more deeply into the data using Discriminant Function Analysis. With this methodology we discovered important differences between the groups, previously hidden, which may carry differential treatment implications.
Asunto(s)
Cocaína , Etanol , Heroína , MMPI , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/etiología , Trastornos Relacionados con Sustancias/complicaciones , Adulto , Análisis de Varianza , Análisis Discriminante , Femenino , Humanos , MasculinoRESUMEN
The patterns of use of defense mechanisms by 306 inner-city men were rated from interviews at age 47 and these ratings were analyzed by cluster analysis. Five clusters resulted. The correlates of cluster membership were examined using data from the 50-year longitudinal study of these men. One cluster exhibited the greatest use of mature defenses; the men in this cluster functioned best on all psychosocial and health variables. Two clusters of men used primarily neurotic defenses; these men functioned at an intermediate level on all outcomes. The men in two clusters primarily used immature defenses. The men in one of these clusters used primarily action defenses, whereas the men in the other cluster were the greatest users of projection and fantasy. In general, the men in both these clusters functioned worse than those in the other three. However, the users of action defenses exhibited greater sociopathy, alcohol problems, and marital instability. The findings provide general support for the DSM-IV hierarchy for nonpsychotic defenses, with mature defenses at the top, neurotic defenses in the middle, and action defenses toward the bottom. In particular, the study supports the DSM-IV distinction of action defenses from other immature defenses.
Asunto(s)
Mecanismos de Defensa , Hombres/psicología , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adaptación Psicológica , Adolescente , Adulto , Alcoholismo/diagnóstico , Alcoholismo/epidemiología , Alcoholismo/psicología , Trastorno de Personalidad Antisocial/diagnóstico , Trastorno de Personalidad Antisocial/epidemiología , Trastorno de Personalidad Antisocial/psicología , Análisis por Conglomerados , Fantasía , Estado de Salud , Humanos , Estudios Longitudinales , Masculino , Estado Civil , Persona de Mediana Edad , Proyección , Reproducibilidad de los Resultados , Fumar/epidemiología , Ajuste Social , Clase Social , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Terminología como AsuntoRESUMEN
This study reports on the time-limited (18-month long) group therapy of 49 outpatients, most of whom were diagnosed with DSM-III-R, Axis II personality disorders (American Psychiatric Association, 1987). Although many patients did not complete the full course of treatment, those who did experienced many areas of change. Completers reported substantial changes in self-esteem, symptomatology, and diagnosability on Axis II. This type of group treatment appears to be a promising mode of intervention for those with personality disorders.
Asunto(s)
Trastornos de la Personalidad/terapia , Psicoterapia de Grupo/métodos , Adulto , Femenino , Humanos , Masculino , Modelos Psicológicos , Análisis Multivariante , Pacientes Desistentes del Tratamiento , Trastornos de la Personalidad/psicología , Factores de TiempoRESUMEN
Development of a new scale to measure patient behavior in group psychotherapy, the Individual Group Member Interpersonal Process Scale (IGIPS), is described. This scale captures clinically important aspects of how patients act in group, including how they respond to the other group members. The IGIPS was applied to videotapes of the first four sessions of seven 15-session outpatient therapy groups (52 patients) in the Mental Health Department of a health maintenance organization. The scale was found to have five factors (Activity, Interpersonal Sensitivity, Comfort with Self, Self-Focus, and Psychological Mindedness). Patient behavior that was moderate on two IGIPS dimensions was connected with better outcome than was that of patients with more extreme behavior in either direction.
Asunto(s)
Relaciones Interpersonales , Pruebas Psicológicas , Psicoterapia de Grupo/métodos , Adulto , Femenino , Humanos , Masculino , Resultado del TratamientoRESUMEN
In an attempt to compare different methods for assessing personality disorder, this study compared the Millon Clinical Multiaxial Inventory-II (MCMI-II; Millon, 1987), a self-report questionnaire, and the Personality Disorder Examination (PDE; Loranger, 1988), a semistructured clinical interview. Subjects (N = 97) were mental health outpatients of a health maintenance organization in New England. The instruments were compared in terms of the presence of personality disorder, the number of diagnoses assigned to a patient, and agreement in specific diagnoses and in cluster assignment. Agreement between the two instruments was low; the two instruments exhibited greater agreement in predicting the absence of diagnoses than their presence. Agreement was best for the borderline and avoidant diagnoses. Correlations between scales exhibited somewhat better agreement than was evident for diagnoses. Analyses at the cluster level resulted in moderate correlations between the instruments. Very high intracluster correlations were found for the MCMI-II, but not for the PDE.
Asunto(s)
Trastornos de la Personalidad/diagnóstico , Inventario de Personalidad/estadística & datos numéricos , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Adulto , Análisis por Conglomerados , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Trastornos de la Personalidad/clasificación , Psicometría , Reproducibilidad de los ResultadosRESUMEN
The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these groups; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.
Asunto(s)
Adaptación Psicológica , Psicoterapia Breve/métodos , Psicoterapia de Grupo/métodos , Conducta Verbal , Adulto , Femenino , Estudios de Seguimiento , Procesos de Grupo , Humanos , MasculinoRESUMEN
Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.