Arthur P. Sullivan

Development of Self Esteem as a Function of Familial Reception.

Low self esteem and familial environment have been separately linked to substance use and abuse. It is argued here that these are causatively linked, that parental relationship with the child provides the experiences from which self esteem is learned. Cognitive errors are made in the process, and faulty experimentation results in these errors being confirmed, rather than refuted, by peers. The self esteem, or evaluation of the self, once learned, is very resistant to change. When low, it becomes a source of background pain in a persons life. Substance abuse is a frequently observed, maladaptive attempt to cope with this experience of pain.

Chronic Imperceptible Pain as a Cause of Addiction.

It is argued that acute, chronic pain, whether arising from environmental or psychological contexts, is a necessary condition of addiction; conditioning and neurochemical changes are assigned a catalyzing role. Imperceptible pain which the patient can neither appreciate nor articulate because of gradual onset and lack of contrast is discussed, and it is argued that this pain, although imperceptible can be acute, and sufficient to fuel addiction. Inadequate self esteem is thought to be a common source of imperceptible pain, and therefore a cause of addiction.

Changes in Self-Concept during Therapeutic Community Treatment: A Comparison of Male and Female Drug Abusers

Self-concepts of men and women in treatment in a therapeutic community were tested using the Tennessee Self-Concept Scale (TSCS). Testing occurred at four points, the first between three and six months after entering treatment, and again at approximately four month intervals. The 127 males and 42 females were part of the Daytop Miniversity project, in which the effect of enrollment as matriculated college students on self-concept was one area which was tested. Changes in the selfconcepts of men and women as measured by five empirically derived factors, plus the scales of the TSCS, are traced. Particularly striking are the negative selfconcepts of females preparing to leave treatment in the areas of acceptance by family, self, and peers. An awareness of these problem areas may suggest different treatment strategies for women as they near the end of treatment.

Measuring and Interpreting School-Based Prevention Outcomes: The New York City Model.

Theoretical standpoint, procedures and instruments used to evaluate school-based substance abuse prevention in the New York City public schools are detailed. Outcome measures are discussed, and the argument is made that the process by which the outcome behavioral change was achieved must be explored before the outcomes are certified as beneficial and appropriate for an educational environment. The changes in the meanings the student attaches to objects and events in his environment and the way in which he construes his environment and self which are antecedent to behavioral change are explored by obtaining written responses from the student, but more fully by repeated observation of the prevention process for the duration of the prevention activities. If the changes in meaning and construct are likely to enhance the students life, the outcome behaviors are judged adequate. A further argument is made that prediction of future behaviors can be made from the meaning and construct data, and these favorable or unfavorable predictions caused by changes attributable to prevention activities can serve as a basis for evaluation of the prevention work, even in the absence of presently observable behavioral outcomes.

The Theoretical Model: Diagnostic Assessment and Placement in Prevention Treatment Mode by School Personnel.

The process by which children in the New York City Public Schools are identified and provided one of the several types of substance abuse prevention education or intervention services is presented as a formal model. The aligning of the students with services is compared to a psychological diagnostic-prescriptive process, and it is concluded that the school personnel, using observations available to them, make essentially the same decisions trained mental health professionals would. The types of student problems matched to each prevention service is shown in terms of comparable match between DSM III diagnostic categories and suitable treatment procedures. The exact nature of the decision model, the differential diagnoses, the different prevention dynamics, and the match of student-to-service are displayed schematically.