Nita W. Glickman

Prediction to Successful Treatment Outcome by Client Characteristics and Retention in Treatment in Adolescent Drug Treatment Programs: A Large-Scale Cross Validation Study

NIDA–CODAP file data on adolescent clients admitted to thirty selected outpatient programs were available for calendar years 1979 (N = 2509) and 1980 (N = 3094). Two outcome criterion variables were utilized: 1) CODAPs “Reasons for Discharge” classification, and 2) a formula for “Reduction of Drug Use.” School grade, controlled for age, was the only client predictor variable found to account for more than 1 percent of the variance in the “Reasons for Discharge” outcome variable. Marijuana as the primary drug of abuse was the only client variable to account for more than 1 percent (4.4 percent) of the variance in the Reduction in Drug Use. The primary marijuana users showed less reduction in amount of drug use, and were less often considered to have completed the course of treatment. Time in treatment accounted for 1.6 percent in 1979 and 1.3 percent in 1980 of the variance in the “Reduction in Drug Use” criterion.

Effects of psychiatric symptomatology on treatment outcome for adolescent male drug abusers.

There is evidence that adult substance abusers tend to have high rates of psychiatric symptomatology and diagnosable psychiatric disorders and that those with more severe psychiatric problems show lower levels of improvement. This paper examines whether these same two findings also hold for adolescent substance abusers. The outcome of treatment, in a day treatment center in a private vocational high school setting, for 130 court-referred substance-abusing delinquent boys aged 14 to 18 years was studied in relation to their psychic symptomatology at admission, as measured by the Brief Symptom Inventory and the Emotional Reaction Inventory. The unexpected finding, although not conclusive, shows that there is a slight tendency among these young clients for those who report more psychiatric symptoms to improve more, rather than less, with treatment. For example, a greater score on the borderline psychotic subscale of the Emotional Reaction Scale predicted to more improvement as measured by reduction in drug use. A response set explanation was postulated for this finding: those clients who were more self-evaluative and more open and self-revealing about their disturbing inner thoughts and feelings might have been more trusting, more ready, and better motivated for counseling. The following are some possible explanations for the fact that the findings are different from those of some studies reported for adult substance abusers: (a) adolescent drug abusers have, or are aware of having, or report, less psychiatric symptomatology, than adult abusers or addicts; (b) our study sample included only court-referred delinquents; and (c) there are differences in research methodology, specifically in the types of instruments and measures used. In any event, further research with adolescent drug abusers on the relationships between psychiatric status at admission and treatment outcome is indicated.

Does drug and alcohol use lead to failure to graduate from high school

In a study of 526 students in two Philadelphia public high schools, the majority (135 of 265) who had been using drugs were found subsequently to have dropped out (failed to graduate) from high school, compared to only approximately one out of four (42 of 158) of the non-drug using students. In a multiple regression analysis, which controlled for twenty demographic, personal and family variables which had previously been found to have significant correlation with dropping out versus graduation from high school, the severity of the students earlier drug use was still found to predict to failure to graduate, to a significant degree (F = 6.03). While drug use may not be the main cause of dropping out of high school, but only a concomitant effect of earlier, more basic state of disaffection from school, it is nevertheless clear that drug use by adolescents interferes with academic progress in high school.

Psychopathology as an Antecedent to, and as a "Consequence" of, Substance Use, in Adolescence.

In this longitudinal study of 232 student-subjects in two public high schools, it was found, by a cross-lagged correlation method, that earlier psychopathology predicted to a statistically significant degree to substance use seventeen months later, and that earlier substance use also predicted to a statistically significant degree to later psychopathology. Thus it appears likely that there is an additive or cumulative interaction effect in which having psychiatric symptoms (psychopathology) contributes to the tendency to use drugs, and using drugs adds to the tendency to have psychiatric symptoms. Among the nine types of psychic symptoms measured, obsessive-compulsive symptoms, hostility, paranoid ideation and depression were found to be somewhat more predictive of later increase in substance use than the other types of psychic symptoms; and phobic anxiety was not predictive at all.

Levels and psychosocial correlates of adolescent drug use.

Trends and patterns of adolescent drug use were examined through consideration of over 125 psychosocial correlates with drug use and nonuse. A sample of 480 urban high-school students was given personal interviews and a survey questionnaire that included several psychological scales and test batteries. A severity of drug use index was also employed in order to clarify the role of various causal factors at differential levels of drug-use severity. Study results seemed to confirm suggestions in the literature that drug use has become a normal, predictable form of behavior that accompanies adolescent development. Psychopathological factors were found to be important in cases of severe drug-using behavior. The role of current, larger social structural factors in adolescent drug use is discussed, along with the programming and policy implications that stem from the multileveled structure of drug use.