Edith E. Simpson

Treating adult marijuana dependence: a test of the relapse prevention model.

Men (n = 161) and women (n = 51) seeking treatment for marijuana use were randomly assigned to either a relapse prevention (RP; G.A. Marlatt & J.R. Gordon, 1985) or a social support (SSP) group discussion intervention. Data collected for 12 months posttreatment revealed substantial reductions in frequency of marijuana use and associated problems. There were no significant differences between the cognitive-behavioral RP intervention and the SSP group discussion conditions on measures of days of marijuana use, related problems, or abstinence rates. Men in the RP condition were more likely than men in the SSP condition to report reduced use without problems at 3-month follow-up. Posttreatment increases in problems associated with alcohol did not appear to relate to reduced marijuana use. Results are discussed in terms of the need for further research with marijuana-dependent adults and the efficacy of RP.

Adult Marijuana Users Seeking Treatment.

In an effort to study the efficacy of attracting and intervening with adult marijuana users, 290 men and 92 women were screened for participation in a treatment-outcome study focused on marijuana cessation. The well-educated, self-referred sample reported using marijuana on 79 of the past 90 days before testing. Indices of the severity of marijuana abuse and general psychopathology were in the clinical range for a majority of Ss. Ss who did not report evidence of alcohol or other drug abuse (n = 144) reported less severe consequences of marijuana use and experienced less general psychological distress than Ss who also reported lifetime (n = 165) or current abuse (n = 73) of other substances in addition to marijuana. The findings indicate the need for clinical research targeting adults who are dependent on marijuana.

Crime, Social Structure and Criminal Punishment: White and Nonwhite Rates of Imprisonment

Durkheimian, Marxist, and Weberian theories provide contrasting views of the influences of the social structure of areas and communities on law and the legal process. In light of these theories, we examine how various aspects of community social structure differentially affect criminal punishments administered to whites and nonwhites. Using county-level data from the state of Washington, we regress white and nonwhite rates of imprisonment on measures of crime and arrest rates, county social structure, and court workload. This analysis indicates that nonwhites—but not whites—are particularly likely to be sentenced to prison in urbanized counties and in counties with relatively large minority populations. We conclude by presenting material from interviews with justice officials which sheds light on the perceptual and political processes that link structural conditions to patterns of criminal punishment.

Predictors of attrition from an outpatient marijuana-dependence counseling program

We sought to characterize attrition-related characteristics of three subgroups of adults (i.e. early dropouts, late dropouts, treatment completers) who had participated in a marijuana-dependence treatment outcome study involving two alternative forms of outpatient group counseling. Early dropouts were younger, earned less income, were more likely to rent rather than own their domiciles, were less able to pay bills, and had a higher level of psychological distress than was the case with treatment completers. Late dropouts and completers were quite similar on a number of measures (e.g., age, income, home ownership, ability to pay bills, psychological stress level, confidence in being abstinent in the future), yet the lower rates of abstinence in the late dropouts largely resembled the treatment outcomes of early dropouts. The findings suggest that attrition prevention in the early phase of counseling ought to focus on motivational ambivalence as well as assisting the client in dealing with schedule conflicts or financial impediments to continued involvement. In the later stage of counseling, attrition reduction is more likely to be accomplished through efforts to better understand and address the clients dissatisfaction with treatment components delivered at that stage.

Testing the abstinence violation effect construct with marijuana cessation

It has been proposed that internal, stable, and global attributions for the cause of a lapse following a period of abstinence and concomitant feelings of guilt and loss of control increased the probability of a return to regular substance use. The Abstinence Violation Effect (AVE) hypotheses were tested in a sample of 75 adult marijuana users who reported a lapse into marijuana use following completion of either a relapse prevention (RP) or social support group treatment aimed at abstinence. Results showed that more internal, stable, and global attributions for the cause of the lapse and perceived loss of control were related significantly to concurrently reported relapse. Further, internal and global attributions predicted marijuana use during the subsequent 6 months. Results are discussed in terms of support for the AVE construct, treatment implications, and the failure of the RP treatment to modify reactions to a lapse.

Children's beliefs about smoking

Childrens beliefs about smoking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that, relative to those in earlier grades, children in higher grades held more positive beliefs about the positive outcomes of smoking and the long-term negative consequences of smoking, but there was no association between grade level and beliefs about the immediate negative consequences of smoking. Children in higher grades also perceived more favorable norms toward smoking. There were few gender or race/ethnicity differences at these ages in childrens beliefs about smoking. These outcome and normative beliefs were related to smoking behavior. Of the nine beliefs about the effects of smoking, all but two were significantly related to smoking behavior.

Children's Beliefs About Drinking

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children not only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in childrens beliefs and perceived norms about drinking.

Bonding in a High-Risk and a General Sample of Children:Comparison of Measures of Attachment and Their Relationship to Smoking and Drinking

Bonding in parent, peer, and school domains were compared in a general sample of children and a sample of children of methadone-treated parents. Bivariate comparisons revealed that children of methadone-treated parents had lower SES, and were significantly more likely to smoke cigarettes but not more likely to drink alcohol. Several measures of attachment were significantly different between the two samples across parent, peer, and school domains. Multivariate analyses indicated that the children of methadone-treated parents were more likely to smoke, even after accounting for the effects of demographic and attachment variables. For drinking, sample membership was not found to be significant. Attachment to school decreased the odds of both smoking and drinking in both samples. Peer attachment had no effect on the odds of smoking initiation; however,loyalty to best friend did predict increased odds of drinking initiation.