Elisha R. Galaif

Suicidality, depression, and alcohol use among adolescents: a review of empirical findings

Suicide is a serious health problem as it is currently the third leading cause of death for teenagers between the ages of 15 and 24 years. Depression, which is also a serious problem for adolescents, is the most significant biological and psychological risk factor for teen suicide. Alcohol use remains extremely widespread among todays teenagers and is related to both suicidality and depression. Suicidality refers to the occurrence of suicidal thoughts or suicidal behavior. The consensus in empirical research is that mental disorders and substance abuse are the most important risk factors in both attempted and completed adolescent suicide. Therefore, it is incumbent upon researchers to identify the factors that can lead to their prevention among todays youth. This review compiles the existing literature on suicidality, depression, and alcohol use among adolescents spanning over the past 15 years. Both Problem Behavior Theory and Stress-coping Theory can explain the relationships among suicidality, depression and alcohol use. The prevention of suicidality is critical, especially during the early school years, when it is associated with depression and alcohol use. Suicidality, depression and alcohol use are three phenomenon that noticeably increase in adolescence marking this time period as an ideal opportunity for prevention efforts to commence. Future empirical work is needed that will further assess the impact of adolescent depression and alcohol use on suicidality. In sum, this review of empirical research highlights critical results and limitations, as well as indicates a need for continued efforts in preventing suicidality, depression, and alcohol use among adolescents.

Continuation High Schools: Youth at Risk for Drug Abuse

Students at alternative high schools may be at substantial risk for drug abuse. The present article provides a general overview of the drug use-related context of continuation high schools in southern California. A total of 144 students and ninety-six staff were interviewed from twenty continuation high schools. The interview data revealed that continuation school students show high levels of substance use. However, only 20 percent of the students report that they received any drug abuse prevention programming. Also, students at continuation high schools aspired to a productive life after high school including continued education. Thus, these youth may still be amenable to preventive educational interventions which deter them from drug use and help them to fulfill their future goals.

The correlates of substance abuse and dependence among adolescents at high risk for drug abuse

Correlates of substance abuse disorders in teenagers may suggest new treatment modalities. The present article examines correlates of self-reported substance abuse and dependence among a sample of 1936 youth at high risk for drug abuse, from 21 southern California continuation high schools. Among 32 demographic, drug use, drug use intention, coping, or health attitude-related variables, gender, cigarette smoking, anger coping, depression, and addiction concern were most consistently associated with self-reported substance abuse or substance dependence. These results suggest that affect management may help facilitate the prevention or control of adolescent drug abuse.

Drug problems and psychological distress among a community sample of adults: Predictors, consequences, or confound?

Although the comorbidity of drug abuse and psychological distress is well established in adult-treatment samples, the directionality of this association is in question. There is less evidence that this relationship exists among community samples of adults. The prospective relationships between psychological distress and drug problems (e.g., alcohol, marijuana, and cocaine) were examined in a community sample of 470 adults. Results addressed three theories—self-medication/self-derogation, impaired functioning, and general deviance—to explain the relationship between drug use and psychological distress. Although the latent constructs of Polydrug Problems was largely unaffected by Psychological Distress and generally had no effect on Psychological Distress, several specific effects emerged. Providing support for the impaired-functioning theory, adults who abused drugs early on experienced later impaired functioning, anxiety, suicidal ideation, psychoticism, hostility, and decreased purpose in life four years later. Providing support for both the self-medication and self-derogation theories, those who experienced aspects of psychological distress (e.g., dysphoria, suicidal ideation) reported drug problems four years later. Moderate cross-sectional support was also found for the general deviance theory in that Social Conformity reduced or eliminated the associations between Polydrug Problems and the measures of psychological distress. Implications of these findings are discussed.

Predictors of polydrug use among four ethnic groups: A 12-year longitudinal study☆

We examined adolescent risk and protective constructs associated with adult polydrug use among four ethnic groups. Both mean and relational differences among the constructs were examined by ethnic group. Teenage polydrug use was a significant predictor of adult polydrug use for Caucasians, African-Americans, and Latinos. Although this relationship was not evident for Asians, teenage alcohol use increased adult cigarette use, and early religiosity increased adult alcohol use. Early parental support/bonding predicted less adult Polydrug Use for Caucasians. For Latinos, general social conformity and low liberalism decreased cigarette use as an adult. In general, the implications of the results are that prevention strategies should emphasize the reduction of teenage drug use to decrease adult polydrug use among Caucasians, Latinos, and African-Americans. Future research should examine other possible risk and protective conditions related to adult polydrug use among diverse populations.

Psychosocial predictors of current drug use, drug problems, and physical drug dependence in homeless women

We examined risk and protective factors associated with three qualitatively different drug use constructs describing a continuum of drug use among a sample of 1,179 homeless women. Relationships among positive and negative sources of social support, positive and negative coping strategies, depression, and the drug constructs of current drug use, drug problems, and physical drug dependence were assessed using structural equation models with latent variables. Current drug use was predicted by more negative social support (from drug-using family/friends), depression, and less positive coping. Drug Problems were predicted by more negative coping, depression, and less positive coping. Physical Drug Dependence was predicted by more negative social support and depression, and less positive social support. Results highlighted the importance of investigating both the positive and negative dimensions of psychosocial functioning, while suggesting that empowering homeless women and offering tangible resources for coping with the stress of being homeless may be beneficial to them.

For whom does Alcoholics Anonymous work

A brief summary of the literature to evaluate for whom Alcoholics Anonymous (A.A.) is or is not likely to be effective is provided. A description of A.A. is presented. Next, support and criticisms of A.A., details of who A.A. seems to help and does not seem to help, and alternatives to A.A. are discussed. Finally, recommendations regarding matching clients to supportive treatments are made.

Depression, Suicidal Ideation, and Substance Use Among Continuation High School Students

This study examines the structural relationships among depression, suicidal ideation, “gateway” substance use (including cigarettes, alcohol, and marijuana), and “hard” substance use (including cocaine, stimulants, and inhalants) in a sample of continuation high school students at high risk for drug abuse. When the model was examined separately by ethnic group (Latino and Caucasian) and gender, significant differences among the factor correlations emerged. Compared to Latinos and females, Caucasians and males, respectively, demonstrated a greater number of significant relationships among the factors. For Latinos and females, only the depression and suicidal ideation factors were significantly correlated with each other, as were the gateway and hard substance use factors. For Caucasians and males, four of the six factors were significantly intercorrelated. One implication is that mood enhancement may be a particularly important reason for hard substance use among Caucasian and male adolescents.

Implementation and process evaluation of a school-based drug abuse prevention program: Project Towards No Drug Abuse.

The present study provides an implementation, process, and immediate outcomes evaluation of the classroom component of Project Towards No Drug Abuse (TND). This project involves development and evaluation of a school-based drug abuse prevention curriculum for continuation high school youth, who are at relatively high risk for drug abuse. Three randomized conditions were evaluated: a standard care, classroom only, and classroom plus school-as-community. The latter condition was an enhanced school-based condition which involved outside-of-classroom meetings and activities. Implementation was high in both program conditions even though this was a higher risk context. Process evaluation data were favorable and did not vary between the two program conditions. Immediate outcomes data (knowledge) was higher in the two program conditions than in the standard care condition. Regarding the classroom program, addition of extra-classroom activities does not appear to alter the quality of delivery of the program.

The drug-crime nexus in a community sample of adults

The authors tested several theories using prospective data to explain the associations between drug abuse and crime in a community sample of 470 adults. Polydrug problems in early adulthood predicted both criminal behavior and polydrug problems in adulthood. Consequences of drug problems as a young adult included arrests and convictions for drug-related offenses, property damage, and driving under the influence of other drugs. Predictors of later polydrug problems included thefts, driving under the influence of alcohol and other drugs, arrests and convictions for drug-related offenses, and a lack of support for drug problems. Theoretical implications of these findings are discussed.