Claire E. Blevins

The impact of motives-related feedback on drinking to cope among college students

Motives for alcohol use are associated with distinct antecedents and consequences. Drinking alcohol to cope with negative affect is consistently associated with the most problematic patterns of use. Interventions targeting drinking to cope are needed. This randomized controlled treatment trial is an initial attempt to evaluate the impact of a brief coping motive-specific personalized feedback intervention on motives and problematic outcomes associated with drinking. The study randomized 170 participants to receive either a brief Standard Feedback Condition (SFC; n=83) or a Motives Feedback Condition (MFC; n=87) that added education and feedback on drinking to cope as well as alternative coping strategies. Significant reductions in drinking to cope with anxiety and with depression were greater in the MFC at the 2-month follow-up. Significant reductions in drinking and negative consequences were observed but did not differ significantly by condition. Indirect tests showed that the MFC, relative to SFC, was associated with outcomes of drinking and negative consequences through change in drinking to cope with depression. Moderation analyses revealed that there were no differential outcomes according to baseline level of coping. This study is a promising new direction in motives research, providing support for brief personalized feedback interventions incorporating motives-related feedback.

Motives for marijuana use among heavy-using high school students: An analysis of structure and utility of the Comprehensive Marijuana Motives Questionnaire.

Motives for marijuana use are important predictors of problematic outcomes associated with marijuana use. Most measures, to date, were developed by adapting alcohol motives measures. However, the Comprehensive Marijuana Motives Questionnaire (CMMQ) was created using a bottom-up approach to evaluate twelve distinct motives for use. The CMMQ was developed and validated in a normative college population. As such, no known study has evaluated the factor structure and utility of the CMMQ in a heavy-using, high school student population. The current study utilized a sample of 252 heavy marijuana-using high school students recruited for a combination motivational enhancement/cognitive behavioral intervention. Results from baseline measures indicated that the factor structure of the CMMQ was maintained in this population. Results from multiple regression analyses revealed distinct relationships with measures of negative consequences of use, including indices of marijuana use, marijuana-related problems, self-efficacy, and internalizing and externalizing symptoms. In particular, the Coping motive was associated with several negative outcomes, which is consistent with previous marijuana and alcohol motives literature. Results suggest that the CMMQ may be useful in assessing marijuana motives among heavy marijuana-using adolescents.

Situational determinants of use and treatment outcomes in marijuana dependent adults.

Research and theory strongly support the importance of situational determinants of substance use as targets for intervention, but few studies have systematically examined situational use characteristics in marijuana dependent adults. The present study describes situational use of marijuana in a population of 87 marijuana dependent adults and reports relationships with outcomes of treatment. Use in negative affective situations was independently associated with psychological distress, maladaptive coping strategies, lower self-efficacy, and poorer outcomes post-treatment. The findings were consistent with research on using drugs to cope with negative affect providing evidence of convergence between two different methods of assessing high risk situations for substance use. The results support continued emphasis on coping with negative affect as a target in treatments for marijuana dependence.

Motivational pathways from antecedents of alcohol use to consequences: a structural model of using alcohol to cope with negative affect

ABSTRACT Background: Drinking among college-aged individuals can be problematic. The motivational model of use, which examines various cognitive factors, personal characteristics, and environmental factors, can provide a greater understanding of what contributes toward the decision to drink in these young adults. Objectives: The current study evaluates proposed paths from risk factors for alcohol use, motives for drinking, and subsequent outcomes of alcohol use, drawing from seminal research on the motivational model and drinking motives. Methods: This model was tested in a sample of 303 undergraduate drinkers (77.9% female, mean age = 19.8 years), and evaluated the potential impact of gender and pattern of use. Results: Results indicate that expectancies, maladaptive coping, and negative affect personality styles are associated with coping motives for drinking, and that coping motives are significantly related to problems associated with use. These results are similar for males and females, and among heavy and lighter drinkers. Conclusion: Findings support the role of the coping motive in problematic outcomes associated with drinking and suggest that expectancies, negative affect personality styles, maladaptive coping, and drinking motives are potential targets of prevention and intervention.

Deterring domestic violence: Do criminal sanctions reduce repeat offenses?

This study presents an empirical analysis of domestic violence case resolution in North Carolina for the years 2004 to 2010. The key hypothesis is that penalties at the level set for domestic violence crimes reduce recidivism (re-arrest on domestic violence charges or conviction in 2 years following an index arrest). We use state court data for all domestic violence-related arrests. Decisions to commit an act of domestic violence are based on a Bayesian process of updating subjective beliefs. Individuals have prior beliefs about penalties for domestic violence based on actual practice in their areas. An individual’s experience with an index arrest leads to belief updating. To address endogeneity of case outcomes, we use an instrumental variables strategy based on decisions of prosecutors and judges assigned to each index arrest in our sample. Contrary to our hypothesis, we find that penalities, at least as set at the current levels, do not deter future arrests and convictions.

Change in motives among frequent cannabis-using adolescents: Predicting treatment outcomes

BACKGROUND Heavy cannabis use has been associated with negative outcomes, particularly among individuals who begin use in adolescence. Motives for cannabis use can predict frequency of use and negative use-related problems. The purpose of the current study was to assess change in motives following a motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) intervention for adolescent users and assess whether change in motives was associated with change in use and self-reported problems negative consequences. METHODS Participants (n=252) were non-treatment seeking high school student cannabis users. All participants received two sessions of MET and had check-ins scheduled at 4, 7, and 10 months. Participants were randomized to either a motivational check-in condition or an assessment-only check-in. Participants in both conditions had the option of attending additional CBT sessions. Cannabis use frequency, negative consequences, and motives were assessed at baseline and at 6, 9, 12, and 15 month follow-ups. RESULTS There were significant reductions in motives for use following the intervention and reductions in a subset of motives significantly and uniquely predicted change in problematic outcomes beyond current cannabis use frequency. Change in motives was significantly higher among those who utilized the optional CBT sessions. CONCLUSIONS This study demonstrates that motives can change over the course of treatment and that this change in motives is associated with reductions in use and problematic outcomes. Targeting specific motives in future interventions may improve treatment outcomes.

Motives for Prescription Stimulant Misuse in a College Sample: Characteristics of Users, Perception of Risk, and Consequences of Use

ABSTRACT Background: Prescription stimulant misuse is increasingly prevalent in college populations, with some misuse estimates over 40%. Stimulant use is associated with a variety of health and psychological problems. Motives for use may provide insight into problematic trajectories. Objectives: The purpose of the current study was to evaluate characteristics of users and motives for prescription stimulant misuse in a large southeastern university. Method: College students reported on prescription stimulant use, motives for use, consequences associated with use, perceptions of risk, and social norms. We specifically elicited participation from prescription stimulant misusers. Of the 199 participants, 86 reported misusing prescription stimulants in the past 60 days. We assessed motives for use, rates of substance use, risk perception, normative beliefs, and consequences associated with use. We evaluated differences between misusers and non-misusers, differentiate motives subscales, and identify relationships between motives subscales, rates of use, and consequences. Results: Misusers used more alcohol and other drugs, held different normative beliefs regarding stimulants, and had lower risk perceptions than non-misusers. We evaluated seven motives subscales among misusers: coping, social, enhancement, expansion, conformity, academic performance, and weight loss. Enhancement, social, weight loss, and expansion scales were correlated with negative consequences, while social motives were correlated with use. Results from regression analyses revealed positive associations between weight and expansion with negative consequences, and a negative association between conformity and consequences. Conclusions/Importance:Motives for prescription stimulant use and user characteristics may provide insight into prevention and treatment. Continued work is needed to refine item content and replicate findings.

A preliminary evaluation of synthetic cannabinoid use among adolescent cannabis users: Characteristics and treatment outcomes

Little is known regarding the use of synthetic cannabinoids (SC), particularly use among adolescent substance users who may be at higher risk. The present exploratory study seeks to describe SC use and subjective effects among cannabis-using adolescents as well as compare the characteristics of cannabis users who do and do not use SC. Exploratory analyses evaluated cannabis treatment outcomes among SC users and non-users. Participants enrolled in a randomized, controlled intervention for cannabis-using high school students aged 14-19 (N=252) completed questionnaires regarding their use of SC and other substances. Those who used SC in the past 60days reported subjective effects of SC, consequences, and SC use disorder symptoms. Baseline characteristics, alcohol and other drug use, and treatment outcomes of SC users were compared to participants who never tried SC. Within this sample 29% had tried SC, and 6% used SC recently. Although most reported use at a relatively low rate, 43% of recent SC users reported SC use-disorder symptoms. Positive and negative subjective effects of SC were endorsed, with positive subjective effects reported more often. SC use was associated with more cannabis use, but not more alcohol or other (non-SC and non-cannabis) drug use. SC users did not differ from non-users on cannabis treatment outcomes. This exploratory study described SC use, and compared characteristics and treatment outcomes among SC users and non-users. Negative subjective effects of SC were reported as occurring less often, but SC use was associated with use disorder psychopathology. SC use was associated with more problematic cannabis use at baseline, but was not associated with use of other substances or differences in treatment outcome.

Do Specialty Courts Achieve Better Outcomes for Children in Foster Care than General Courts

Objective: This study assessed the effects of unified family and drug treatment courts (DTCs) on the resolution of cases involving foster care children and the resulting effects on school performance. Method: The first analytic step was to assess the impacts of presence of unified and DTCs in North Carolina counties on time children spent in foster care and the type of placement at exit from foster care. In the second step, the same data on foster care placements were merged with school records for youth in Grades 3–8 in public schools. The effect of children’s time in foster care and placement outcomes on school performance as measured by math and reading tests, grade retention, and attendance was assessed using child fixed-effects regression. Results: Children in counties with unified family courts experienced shorter foster care spells and higher rates of reunification with parents or primary caregivers. Shorter foster care spells translated into improved school performance measured by end-of-grade reading and math test scores. Adult DTCs were associated with lower probability of reunification with parents/primary caregivers. Conclusion: The shortened time in foster care implies an efficiency gain attributable to unified family courts, which translate into savings for the court system through the use of fewer resources. Children also benefit through shortened stays in temporary placements, which are related to some improved educational outcomes.

An examination of the impact of maladaptive coping on the association between stressor type and alcohol use in college

ABSTRACT Objective: Examine the impact of maladaptive coping style on the association between source of stress (academic, interpersonal, intrapersonal, environmental) and alcohol use (consumption, heavy episodic drinking, driving under the influence) among college students. Participants: 1,027 college students completed an online survey in April 2014. Methods: To test the mediating effects of maladaptive coping on the association between academic stress and alcohol use variables, indirect effects were examined using the PROCESS analytical framework for SPSS. Results: Maladaptive coping and academic stress were associated with alcohol use outcomes. Moreover, maladaptive coping mediated the relationship between academic stress and two of three alcohol use outcomes (consumption, heavy episodic drinking). Conclusions: Among college students, the association between academic stress and alcohol use may be driven by maladaptive coping. College students may benefit from interventions that seek to improve coping skills, potentially alleviating the burden of academic stress and decreasing problematic alcohol use.