Myriam Forster

A Framework for the Specificity of Addictions

Research over the last two decades suggests that a wide range of substance and behavioral addictions may serve similar functions. Yet, co-occurrence of addictions has only been reported among a minority of addicts. “Addiction specificity” pertains to a phenomenon in which one pattern of addictive behaviors may be acquired whereas another is not. This paper presents the PACE model as a framework which might help explain addiction specificity. Pragmatics, attraction, communication, and expectation (PACE) variables are described, which may help give some direction to future research needs in this arena.

Predictors of alcohol-related negative consequences in adolescents: A systematic review of the literature and implications for future research.

OBJECTIVE To conduct a systematic review of the literature examining risk and protective factors of alcohol related negative consequences (ARNCs) among adolescents. METHODS We conducted a systematic search of original empirical articles published between January 1, 1990 and June 1, 2015. The qualitative synthesis was performed using the Theory of Triadic Influence as a framework. RESULTS Fifty-two studies were reviewed. Intrapersonal (e.g., personality traits, drinking motives and expectancies, depression), interpersonal (e.g., parental and peer alcohol use, violence exposure) and attitudinal factors (e.g., media exposure to alcohol, religiosity) influence ARNCs. Emerging evidence of new trends contributing to ARNCs include ready mixed alcohol drinks and childhood trauma and abuse. CONCLUSIONS Risk factors from all domains of influence were observed. More research is needed on protective factors and how alcohol use interacts with preventive factors in predicting ARNCs. The conceptualization of negative consequences varies significantly between studies and may impact the external validity of previous research.

The Role of Bicultural Stress and Perceived Context of Reception in the Expression of Aggression and Rule Breaking Behaviors Among Recent-Immigrant Hispanic Youth

Adolescent aggression and delinquency impede healthy adjustment in early adulthood and may have particularly serious long-term consequences for minority youth. Therefore, prevention research should examine these behaviors within a sociocultural framework among newer immigrant samples to determine whether, and how, adaptation to life in the US affects these behaviors. This study investigated the role of two sociocultural variables–bicultural stress and negative context of reception–on changes in aggression and rule breaking behaviors over two time points among recently immigrated Hispanic adolescents residing in Los Angeles (N = 136) and Miami-Dade (N = 142) counties. Linear stepwise regression models were used to assess the associations between predictors and behavioral outcomes. Bicultural stress and negative context of reception both had independent associations, above and beyond parental involvement and delinquent peer associations, with changes in aggressive and rule-breaking behavior during the first year of high school. These findings suggest that social, cultural, and interpersonal processes all influence deviant behaviors in recent-immigrant Hispanic populations. We discuss the implications of these finding for prevention and intervention research and practice. We also recommend that future research continue to examine the role of these factors over the course of adolescence and consider sociocultural influences when designing behavioral interventions for Hispanic immigrant populations

Bullying victimization as a mediator of associations between cultural/familial variables, substance use, and depressive symptoms among Hispanic youth.

Objectives. This article examines the antecedents and consequences of bullying victimization among a sample of Hispanic high school students. Although cultural and familial variables have been examined as potential risk or protective factors for substance use and depression, previous studies have not examined the role of peer victimization in these processes. We evaluated a conceptual model in which cultural and familial factors influenced the risk of victimization, which in turn influenced the risk of substance use and depression. Design. Data were collected as part of a longitudinal survey study of 9th and 10th grade Hispanic/Latino students in Southern California (n = 1167). The student bodies were at least 70% Hispanic/Latino with a range of socioeconomic characteristics represented. We used linear and logistic regression models to test hypothesized relationships between cultural and familial factors and depression and substance use. We used a mediational model to assess whether bullying victimization mediated these associations. Results.Acculturative stress and family cohesion were significantly associated with bullying victimization. Family cohesion was associate d with depression and substance use. Social support was associated with alcohol use. Acculturative stress was associated with higher depression. The associations between acculturative stress and depression, family cohesion and depression, and family cohesion and cigarette use were mediated by bullying victimization. Conclusion. These findings provide valuable information to the growing, but still limited, literature about the cultural barriers and strengths that are intrinsic to the transition from adolescence to emerging adulthood among Hispanic youth. Our findings are consistent with a mediational model in which cultural/familial factors influence the risk of peer victimization, which in turn influences depressive symptoms and smoking, suggesting the potential positive benefits of school-based programs that facilitate the development of coping skills for students experiencing cultural and familial stressors.

Characteristics of emerging adulthood and e-cigarette use: Findings from a pilot study.

INTRODUCTION Emerging adults (ages 18 to 25) are more likely to use e-cigarettes compared to other age groups, but little is known about their risk and protective factors. A next step to understanding e-cigarette use among emerging adults may involve examining how transition-to-adulthood themes are associated with e-cigarette use. It may also be important to know which specific transitions, and how the accumulated number of role transitions experienced in emerging adulthood, are associated with e-cigarette use. METHODS Emerging adults completed surveys indicating their identification with transition-to-adulthood themes, role transitions in the past year, and e-cigarette use. Logistic regression models examined the associations between transition-to-adulthood themes and e-cigarette use. Separate logistic regression models explored the association between individual role transitions, as well as the accumulated number of role transitions experienced, and e-cigarette use, controlling for age, gender, and ethnicity. RESULTS Among the participants (n = 555), 21% were male, the average age was 22, 45% reported lifetime, and 12% reported past-month, e-cigarette use. Participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report e-cigarette use. Several role transitions were found to be associated with e-cigarette use such as loss of a job, dating someone new, and experiencing a breakup. The relationship between the accumulated number of role transitions and e-cigarette use was curvilinear. CONCLUSION Findings from this pilot study can be a point of departure for future studies looking to understand the risk and protective factors of e-cigarettes among emerging adults.

Associations between Gun Violence Exposure, Gang Associations, and Youth Aggression: Implications for Prevention and Intervention Programs

Using cross-sectional data collected from three middle schools in Southeast Los Angeles, we assessed the association of neighborhood violence exposure, gang associations, and social self-control with past week aggression in a sample of minority youth (). Results from Poisson and logistic regression models showed that direct exposure to gun violence, having friends in gangs, and low social self control were all positively associated with past week aggression. Among girls, having gang affiliated family members was positively associated with aggression, whereas among boys having friends in gangs was associated with past week aggression. Subjective expectations of engagement in future interpersonal violence were associated with being male, having friends in gangs, and fear of neighborhood gun violence. We recommend that youth violence prevention and intervention programs address the impact of family, peers, and gun violence on student coping and identify students with low social self-control who could benefit from social and emotional skills training.

Problematic Substance Use Among Hispanic Adolescents and Young Adults: Implications for Prevention Efforts

Using data collected between 2005 and 2012 from a longitudinal study of acculturation patterns and substance use among Hispanic youth in Southern California (N = 2722), we fit multivariate logistic regression models to estimate the association of type and frequency of drug use, friend and parent drug use, cultural orientation (measured by the ARSMA-II), and psychological distress (CES-D score) in 10th grade with problematic substance use (measured with the RAPI) in (i) 11th grade and (ii) young adulthood. We conclude that future intervention efforts with Hispanic adolescents and young adults should target polysubstance and problem users and emphasize inter-individual, structural, and cultural processes as they relate to problematic substance use.

The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students

INTRODUCTION Research suggests that college students are an especially vulnerable subset of the population for substance use and misuse. However, despite evidence of the high prevalence of adverse childhood experiences (ACE) among students and the link between family-based ACE and substance use among older adults, this relationship remains understudied in college populations. Moreover, whether ACE represents a shared risk across substance use behaviors and ethnic groups is unknown. METHODS Data are student responses (n=2953) on the 2015 American College Health Associations National College Health Assessment II (ACHA-NCHA II) administered at one of the largest, most diverse public universities in California. Multivariable logistic and negative binomial regression models tested the association between individual and accumulated ACE and past 30-day alcohol, tobacco, marijuana, and illicit drug use, past 12-month prescription medication misuse and polysubstance use. RESULTS Between 50% and 75% of students involved in substance use were ACE exposed. There was a significant dose-response relationship between ACE and substance use and polysubstance use. Although accumulated ACE increased risk for substance use, there was considerable ethnic variability in these associations. CONCLUSIONS The graded effects of ACE for substance use underscore the link between family-based stressors and these behaviors in emergent adult college students. Our findings make a compelling case for investing in health initiatives that prioritize ACE screening and access to trauma-informed care in campus communities. Continued research with college populations is needed to replicate findings and clarify the role of ethnicity and culture in trauma response and help seeking behaviors.

Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents

OBJECTIVE Few studies have investigated associations between adverse childhood experiences (ACE) and nonmedical use of prescription medication (NMUPM) in population-based samples of adolescents, and even fewer have examined whether promotive factors might buffer these effects. The present study assesses the direct effects of ACE and positive student-teacher relationships on NUMPD and whether positive student-teacher relationships moderate this association. DESIGN Data were from the 2013 Minnesota Student Survey (MSS), an in-school survey administered every three years to students throughout Minnesota. The analytic sample (n=104,332) was comprised of 8th, 9th, and 11th graders. RESULTS Approximately 3% of students acknowledged past year NMUPM, the majority of whom reported at least one ACE. The most frequently used prescription drug was Ritalin/ADHD medications (1.71%) followed by opiate-based painkillers (1.67%), tranquilizers (0.92%), and stimulants (0.75%). Students who reported any use tended to use more than one medication. For every additional ACE, there was a 56%, 51%, 47%, and 52% increase in the odds of past year stimulant use, ADHD medication, pain reliever, and tranquilizer use, respectively. The estimated rate of the number of prescription drugs used increased by 62% for every additional ACE. Positive student- teacher relationships buffered the association between ACE and NMUPD, especially at higher levels of ACEs. CONCLUSION Our findings have important implications for prevention work. Training educators to recognize trauma symptomology and cultivating strong student-teacher relationships are important considerations for future school-based substance use prevention initiatives.

Adverse Childhood Experiences and School-Based Victimization and Perpetration:

Retrospective studies using adult self-report data have demonstrated that adverse childhood experiences (ACEs) increase risk of violence perpetration and victimization. However, research examining the associations between adolescent reports of ACE and school violence involvement is sparse. The present study examines the relationship between adolescent reported ACE and multiple types of on-campus violence (bringing a weapon to campus, being threatened with a weapon, bullying, fighting, vandalism) for boys and girls as well as the risk of membership in victim, perpetrator, and victim–perpetrator groups. The analytic sample was comprised of ninth graders who participated in the 2013 Minnesota Student Survey (n ~ 37,000). Multinomial logistic regression models calculated the risk of membership for victim only, perpetrator only, and victim–perpetrator subgroups, relative to no violence involvement, for students with ACE as compared with those with no ACE. Separate logistic regression models assessed the association between cumulative ACE and school-based violence, adjusting for age, ethnicity, family structure, poverty status, internalizing symptoms, and school district size. Nearly 30% of students were exposed to at least one ACE. Students with ACE represent 19% of no violence, 38% of victim only, 40% of perpetrator only, and 63% of victim–perpetrator groups. There was a strong, graded relationship between ACE and the probability of school-based victimization: physical bullying for boys but not girls, being threatened with a weapon, and theft or property destruction (ps < .001) and perpetration: bullying and bringing a weapon to campus (ps < .001), with boys especially vulnerable to the negative effects of cumulative ACE. We recommend that schools systematically screen for ACE, particularly among younger adolescents involved in victimization and perpetration, and develop the infrastructure to increase access to trauma-informed intervention services. Future research priorities and implications are discussed.