Mandi L. Burnette

Developmental Pathways to Adolescent Cannabis Abuse and Dependence: Child Maltreatment, Emerging Personality, and Internalizing Versus Externalizing Psychopathology

Child maltreatment is strongly associated with adolescent psychopathology and substance abuse and dependence. However, developmental processes unfolding from childhood into adolescence that delineate this trajectory are not well understood. The current study used path analysis in a structural equation modeling framework to examine multiple mediator models, including ego control, ego resiliency, and internalizing and externalizing symptoms to investigate this developmental process. Participants were 415 children, assessed across 3 waves of data, (i.e., at ages 7 to 9, 10 to 12, and 13 to 15). The sample included maltreated (n = 259) and nonmaltreated (n = 156) children; groups were comparable in sociodemographic characteristics. Findings support an transactional-ecological model by revealing a developmental sequence in which severity of early childhood maltreatment potentiates less adaptive childhood personality functioning, followed by externalizing problems in preadolescence, and ultimately adolescent cannabis abuse and dependence symptoms. A developmental pathway from child maltreatment to adolescent cannabis abuse and dependence symptoms via personality and preadolescent internalizing problems was not supported. Understanding developmental pathways by which maltreatment experiences increase risk for substance abuse and dependence symptoms in youth has far-reaching implications for the treatment and prevention of substance use disorders.

Childhood Maltreatment Histories, Alcohol and Other Drug Use Symptoms, and Sexual Risk Behavior in a Treatment Sample of Adolescents

OBJECTIVES We tested a structural model of relations among self-reported childhood maltreatment, alcohol and other drug abuse and dependence symptoms, and sexual risk behavior in a sample of adolescents receiving outpatient treatment of substance use problems. METHODS Structured interviews were administered to an ethnically diverse sample of 394 adolescents (114 girls, 280 boys; mean = 16.30 years; SD = 1.15 years; 44.9% Hispanic, 20.6% African American, 25.4% White non-Hispanic, and 9.1% other) in 2 outpatient treatment settings. RESULTS Path analyses yielded findings consistent with a mediation model. Alcohol abuse and dependence symptoms mediated (1) relations between emotional neglect scores and sex with co-occurring alcohol use and (2) relations between sexual abuse scores and sex with co-occurring alcohol use. Drug abuse and dependence symptoms mediated relations between (1) neglect scores and (2) sexual intercourse with co-occurring alcohol or drug use, as well as unprotected sexual intercourse. CONCLUSIONS Efforts to treat alcohol or drug use problems among adolescents or to prevent transmission of HIV or other sexually transmitted infections among youths with substance use problems may require tailoring treatment or prevention protocols to address client histories of maltreatment.

Pathways from harsh parenting to adolescent antisocial behavior: a multidomain test of gender moderation.

We tested for gender moderation within a multidomain model of antisocial behavior (ASB) among community youth, drawn from the Project on Human Development in Chicago Neighborhoods study. Youths (N = 1,639) were 9 to 12 years old at baseline and were followed for two additional waves, spaced approximately 2.5 years apart. We hypothesized that harsh and physically coercive parenting, a familial level risk factor, would impact individual level risk factors for ASB, such as childhood temperament ratings of emotionality and inhibitory control, and preadolescent externalizing and internalizing symptoms, as well as involvement with antisocial peers. We further hypothesized that this process and its impact on ASB would be moderated by gender. We used both multiple indicator multiple causes and multiple group analyses to test for gender moderation and a structural equation modeling multiple mediation framework to evaluate the strength of indirect effects. We tested the role of family, individual, and peer level influences on ASB, after accounting for the role of known contextual factors, including poverty, race, and neighborhood. Our overall model fit the data well for males and females, indicating harsh parenting, disinhibition, emotionality, and peers exert a strong influence on risk for ASB. Gender moderated the pathway from harsh parenting to externalizing behavior, such that this was a significant pathway for girls, but not boys. We discussed the importance of these findings with regard to intervention planning for youth at risk for ASB and future gender-informed models of ASB.

The association between violence and lifetime suicidal thoughts and behaviors in individuals treated for substance use disorders.

OBJECTIVE The present study examined the association between lifetime violent behavior and suicidal thoughts and attempts in a national sample of patients seeking substance use disorder (SUD) treatment. METHOD A large national sample of adults entering substance use disorder treatment (N=6,233) was examined. After describing the correlates of prior suicidal thoughts and attempt(s) in this sample, we examined the association between self-report of lifetime violence and suicidal ideation, a single prior attempt and multiple prior attempts in patients seeking SUD treatment. RESULTS In bivariate analyses, individuals with prior violence were more likely to report suicidal ideation, single and multiple suicide attempts than those without prior violence. These associations remained significant after controlling for demographic factors, symptoms of depression, and childhood victimization. In examinations of specific types of violence, more extreme forms of violence (i.e., murder, rape) were most strongly associated with risk of multiple suicide attempts. CONCLUSIONS Prior violence is consistently associated with greater risk for suicidal thoughts and behaviors in patients seeking SUD treatment. Treatment providers should be aware that those patients with some of the greatest violence in their past are also those at elevated risk for harm to themselves.

Multilevel approaches toward understanding antisocial behavior: current research and future directions.

Antisocial behavior is multifaceted and has a rich history ofresearch. Nearly two decades have passed since RichtersandCicchetti (1993a)co-editedaSpecialIssueinthisJournalentitled, “Toward a Developmental Perspective on ConductDisorder.” At that time, researchers in the field examinedquestionssuchastheutilityoftaxonomiesindefiningantiso-cial behavior (Hinshaw, Lahey, & Hart, 1993; Richters C Pennington & Bennetto,1993), gender differences in antisocial behavior (Zahn-Wax-ler, 1993; Zoccolillo, 1993) and the role of attachment andfamilies in the etiology of antisocial behavior (Greenberg,Speltz, & Deklyn, 1993; Waters, Posada, Crowell, & Keng-Ling, 1993). The issue ended by presenting some fresh ap-proaches to the treatment of antisocial behavior in youth(Dodge, 1993; Kazdin, 1993). At the time of publication,these manuscripts contributed a great deal to the literatureon antisocial behavior, propelling the field forward intonew and exciting directions.MuchhaschangedsincethepublicationofthatSpecialIs-sue. Advances in quantitative theory and practice have madeit increasingly possible to account for heterogeneity withinthose who exhibit antisocial behavior using person-centeredanalyses and growth curve analyses (Nagin, 1999, 2005).We now have a greater understanding of the varied develop-mental pathways by which youth come to exhibit antisocialbehavior (Campbell et al., 2010; Mulvey et al., 2010). How-ever,thisliteratureisrelativelynew,andmoreworkisneededin order to understand the variability in the development ofantisocial behavior.Researchershavealsobeguntoincorporatemultiplelevelsof analysis in their approach to studying antisocial behavior,particularly the intersection of biological and environmentalinfluences on antisocial behavior (Cicchetti, 2008). Wenow understand that genetic vulnerabilities for violencemay be moderated by extreme environmental events, suchas childhood maltreatment (Caspi et al., 2002; Jaffe et al.,2004; Kim-Cohen et al., 2006; Mead, Beauchaine, & Shan-non, 2010). The literature has moved toward understandinghow distinct physiological patterns, such as low resting heartrate, may help us to further understand differences in risk forantisocial behavior (Baker et al., 2009). In this issue, authorsbuild upon the existing research to apply a multilevel ap-proach toward understanding antisocial behavior acrossmany developmental periods, using a number of differentphenotypic expressions of antisocial behavior (e.g., aggres-sion, substance use).As the field has become more multidimensional, modelsof how antisocial behavior develops have also becomemore comprehensive and innovative. Cascade approacheshave highlighted the dynamic role of early experience in in-fluencing later outcomes (Cicchetti & Tucker, 1994; Masten& Cicchetti, 2010). Such approaches have been combinedwith existing models to investigate how early risk factorsmay impact functioning across multiple domains and levelsof analysis to influence antisocial behavior. Studies have ex-aminedhowearlyexperiencesshapebraindevelopment,neu-rotransmitter functioning, temperament, and neuroendocrinefunctioning, which may in turn influence antisocial behavior(Cicchetti, 2002; Gunnar & Vazquez, 2006; Mead et al.,2010). The role of gender, attachment, and parent–child rela-tionships can now be examined within broader contextualmodels of antisocial behavior. The articles in this issue shareaninnovativespiritandtestnoveltheoriesamongpopulationsat varying levels of risk from young childhood to samples ofincarcerated offenders.

Gender and the Development of Oppositional Defiant Disorder Contributions of Physical Abuse and Early Family Environment

Research is needed to understand the role of gender in the stability, course and etiology of antisocial behavior. Family environment, given its proximal association with children’s behavior, holds great promise in understanding risk for antisocial behavior. The present study examined the role of parental acceptance and emotional responsivity as assessed using the HOME, caregiver report of intimate partner violence (IPV), and levels of physical abuse as assessed using the Conflict Tactics Scales, on subsequent symptoms of Oppositional Defiant Disorder (ODD), a childhood disorder characterized by antisocial behavior. Data were drawn from Waves 1-3, cohorts 3 and 6 of the Project for Human Development in Chicago Neighborhoods. Results suggest only minor gender differences in levels of ODD symptoms, with equal rates of stability from Wave 2 to 3 in symptom levels. For boys and girls, IPV was associated with an increased risk of ODD symptoms, and higher acceptance was associated with reduced risk of ODD symptoms. However, gender differences emerged in the impact of physical abuse and emotional responsiveness, in that the former was a significant predictor for girls only, and the latter was significant for boys only. Potential implications for these findings, including the role of gender socialization are discussed.

Comparing the Youth Psychopathic Traits Inventory (YPI) and the Psychopathy Checklist–Youth Version (PCL-YV) Among Offending Girls

Using a multimeasure longitudinal research design, we measured psychopathy with the Youth Psychopathic Traits Inventory (YPI) and the Psychopathy Checklist–Youth Version (PCL-YV) among 122 offending girls. We examined the psychometric properties of the YPI, investigated the association between the YPI and the PCL-YV, and assessed their concurrent and longitudinal association with externalizing problems on the Youth/Adult Self-Report and violent and delinquent behaviors on the Self-Report of Offending. Alphas for the YPI were adequate and there were small to moderate correlations between the YPI and PCL-YV, suggesting that each assesses distinctive personality features. The YPI and the PCL-YV were approximately equivalent in their association with concurrent and longitudinal outcomes with two exceptions, where the YPI demonstrated a stronger association with antisocial behavior. Concurrently, there was a divergent relationship between the psychopathy factor scores and antisocial outcomes. Within 2 years, the psychopathy affective factor, which constrained the YPI and PCL-YV to be equivalent, was associated with externalizing behaviors and the YPI affective factor was associated with violent offending. Approximately 4½ years later, neither measure was significantly related to antisocial behavior after accounting for past behavior. Reasons for continuity and discontinuity in risk identification are discussed.

It's Not You, It's Me: An Examination of Clinician‐ and Client‐Level Influences on Countertransference Toward Borderline Personality Disorder

Individuals with borderline personality disorder (BPD) appear more likely than individuals with other mental disorders to evoke negative countertransference reactions. The current study examined countertransference toward BPD across client- (e.g., client age and gender) and clinician-level (e.g., age, discipline, clinical experience, training) factors. Participants (N = 560) completed an anonymous online survey in which they read case information describing a client with BPD and answered questions to assess their reactions toward the client. The study used a 2 × 2 between-subjects design in which client age and gender were experimentally manipulated. Despite receiving the same vignette, clinicians were more accurate in diagnosing the female client with BPD than the male client, and clinician reactions differed as a function of client age and clinician experience. Specifically, clinicians viewed adolescent clients with BPD as less ill, less trustworthy, and more dangerous than adults with BPD; more clinical experience among clinicians was associated with more positive reactions to clients. Findings help to better understand countertransference reactions and the ways they may impact diagnostic choices and treatment decisions. The implications of these findings for facilitating better clinician-client matching, reducing clinician burnout, and improving treatment experiences for individuals with BPD are discussed.

Developmental Trajectories of Substance Use among Sexual Minority Girls: Associations with Sexual Victimization and Sexual Health Risk

PURPOSE To examine mechanisms underlying the development of sexual health risk behaviors in sexual minority girls (SMGs) and its association with sexual victimization. METHODS Data were drawn from the Project on Human Development in Chicago Neighborhoods cohorts, aged 15 and 18 years (N = 391; 54 SMGs). RESULTS Sexual minority girls reported more sexual victimization and steeper positive trajectories of substance misuse over time than heterosexual girls. Growth in alcohol use during adolescence mediated the link between SMG status and past year number of partners, whereas growth in marijuana use mediated the link between SMG status and self-reported sexually transmitted diseases (STDs). Adding unwanted sexual experiences to the models resulted in a reduction of significance in the direct or indirect effects from SMG status on the sexual health outcomes. Unwanted sexual experiences emerged as a robust predictor directly and indirectly related to past-year number of partners via growth in alcohol use. Unwanted sexual experiences also directly predicted STD history. CONCLUSIONS The increased risk of SMGs for alcohol and marijuana during adolescence, higher rates of sexual partners, and STD diagnosis may also be linked to their significant risk for sexual victimization. Findings highlight the importance of preventive interventions targeting victimization of SMGs.

Gender and the Development of Oppositional Defiant Disorder

Research is needed to understand the role of gender in the stability, course and etiology of antisocial behavior. Family environment, given its proximal association with children’s behavior, holds great promise in understanding risk for antisocial behavior. The present study examined the role of parental acceptance and emotional responsivity as assessed using the HOME, caregiver report of intimate partner violence (IPV), and levels of physical abuse as assessed using the Conflict Tactics Scales, on subsequent symptoms of Oppositional Defiant Disorder (ODD), a childhood disorder characterized by antisocial behavior. Data were drawn from Waves 1-3, cohorts 3 and 6 of the Project for Human Development in Chicago Neighborhoods. Results suggest only minor gender differences in levels of ODD symptoms, with equal rates of stability from Wave 2 to 3 in symptom levels. For boys and girls, IPV was associated with an increased risk of ODD symptoms, and higher acceptance was associated with reduced risk of ODD symptoms. However, gender differences emerged in the impact of physical abuse and emotional responsiveness, in that the former was a significant predictor for girls only, and the latter was significant for boys only. Potential implications for these findings, including the role of gender socialization are discussed.