Peter W. Vik

Correlates of success following treatment for adolescent substance abuse

Abstract To date, little research is available examining the course and features of recovery from substance abuse following adolescent treatment. The current study evaluated the functioning of 142 teens for 2 years following treatment for substance abuse. Adolescent drug and alcohol outcome was examined in relation to functioning on five major life domains: academic involvement, interpersonal problems, emotional well-being, family relations, and social and occupational activities. Results of this investigation demonstrate that psychosocial functioning is associated with adolescent posttreatment drug and alcohol use. Teens who were abstinent and those with less substance use involvement generally displayed better functioning. The relationship between teen alcohol and drug use and improvement in functioning varied across psychosocial domains. Clinical implications of these findings are discussed along with advances in teen substance abuse research and treatment.

Severity of psychosocial stress and outcome of alcoholism treatment

We examined the relation between stressful life events and drinking outcome among 129 male alcoholics who had completed an alcohol treatment program. Life events were assessed for the year prior to treatment and for the 3 months after treatment and were rated on the Psychiatric Epidemiology Research Interview and the Contextual Rating System. Approximately 40% of the pretreatment stressors were found to be directly or indirectly related to alcohol use. When stressors related to drinking were excluded from consideration, we found that men who returned to drinking after treatment experienced more severe or highly threatening stress before their relapse than men who remained abstinent during the follow-up period. These data suggest that although less severe stress may not increase risk for relapse, acute severe stressors and highly threatening chronic difficulties may be associated with elevated relapse risk.

College student heavy drinking in social contexts versus alone

Heavy drinking is common among college students and typically occurs in social contexts. Heavy drinking when alone, however, is less common. The present study hypothesized that students who drink heavily when alone (HD-Alone) would differ from college students who only drink heavily in social contexts (Social HD). Forty-nine HD-Alone students (at least one heavy-drinking episode when alone), 213 Social HDs, and 63 non-heavy drinkers (Non-HDs) were compared on alcohol-related consequences, drinking milestones, alcohol-outcome expectancies, and symptoms of depression. HD-Alone students reported more negative drinking consequences, earlier onset of regular drinking, more alcohol expectancies, less self-efficacy and motivation to reduce drinking, and higher depression scores than Social HDs and Non-HDs. Findings imply individual differences among heavy-drinking college students according to their drinking context.

Cognitive impairment in substance abuse

Conventional wisdom, and even well-reasoned theoretical mechanisms, suggests that the chronic use of psychoactive substances would impair cognitive functioning of individuals. This article summarizes the research literature with regard to specific drugs of abuse. Undoubtedly, acute intoxication and immediate and protracted withdrawal produce transient alterations of cognitions that can persist for weeks to months. Some subtle residual effects remain for up to 1 year for certain drugs. Evidence of irreversible effects is less clear. Even subtle lingering effects can impact treatment efforts, yet they often go undetected or unaddressed.

Help seeking for alcohol problems in a college population

Despite the availability of effective treatments for problem drinkers, only a minority seek professional assistance. The authors investigated the influences on help seeking for alcohol-related difficulties in two separate studies. In Study 1, 59 men and 74 women completed questionnaires regarding their alcohol use, related problems, readiness to change, and help-seeking interest. The authors also developed a measure of stigma related to alcohol help seeking. Problem recognition, anxiety symptoms, and stigma predicted a global rating of help-seeking. Students (22 men and 60 women) participated in Study 2, which incorporated a multi-item measure of help-seeking intentions as well as attitude and personality measures. Positive attitudes, less perceived stigma, and greater self-efficacy increased help seeking. The findings highlight the importance of both approach and avoidance factors that affect help-seeking decisions, and the authors suggest directions for further research.

Female Adjustment to Incarceration as Influenced by Sexual Assault History

The number of female prisoners is increasing, and many of these women report a history of sexual assault. The purpose of this study was to explore the effect of sexual assault on adjustment to incarceration. Females with a history of childhood and adult sexual assault were expected to show greater initial reaction and slower adjustment to incarceration than women with no history of sexual assault or a history of adult assault exclusively. Female minimum-security inmates (N = 92) at a state prison participated in interviews and completed questionnaires on initial incarceration and 2 weeks later. Results indicated that type of sexual assault history influences adjustment to prison for female inmates initially and after 2 weeks of incarceration.

Detecting college binge drinkers using an extended time frame

Collegiate binge-drinking is estimated at 44% nationwide, yet epidemiological studies typically limit estimates of binge drinking to episodes during the prior 2 weeks. This study hypothesized that a group of students will have binged on alcohol during the past 3 months but not within the past 2 weeks, and therefore would not be detected using the standard 2-week time frame. Forty males and 72 females who reported drinking alcohol within the past 3 months were included in this study. Fifty-four of the student drinkers (48.2%) were classified as binge drinkers using the prior 2-weeks time criterion, whereas 88 (78.6%) were identified as bingers using the prior 3 months as the criterion. Over one third (38.6%) of the students who binged during the past 3 months would not have been identified as bingers using a 2-week detection period. Furthermore, age, church attendance, alcohol-related consequences, and age of first intoxication were the same regardless of whether bingers had binged in the past 2 weeks or the past 3 months. In contrast, recent binge drinkers reported more frequent alcohol consumption than the 3-month bingers.

Hypothesized simple factor structure for the Alcohol Expectancy Questionnaire: confirmatory factor analysis.

This study proposed and tested a theoretical factor structure for the Alcohol Expectancy Questionnaire (AEQ; S. A. Brown, M. S. Goldman, A. Inn, & L. R. Anderson, 1980). Factors were hypothesized to (a) reflect either positive or negative reinforcement, and (b) target either personal feelings or social contexts, resulting in 4 hypothesized factors (Social Enhancement, Social Coping, Personal Enhancement, Personal Coping). Participants were 180 male and 226 female undergraduates who completed the AEQ and additional self-report measures. Confirmatory factor analysis revealed that the hypothesized model fit the data. Post hoc adjustments further improved the model. Finally, a higher order factor model fit the data best. Factors correlated in hypothesized ways with other measures: (a) Only Personal Coping expectancies correlated with negative affect; (b) self-efficacy to resist drinking for emotional relief correlated highest with Personal Coping; and (c) self-efficacy to resist social pressure to drink correlated highest with Social Enhancement. Correlations with B. C. Leigh and A. W. Stacys (1993) Drinking Expectancy Questionnaire indicated congruent and divergent validity.

Application of the PTSD-alcohol expectancy questionnaire (P-AEQ) to sexually assaulted college women

Risk of alcohol use problems is an important clinical concern for women who have been sexually assaulted and experience PTSD symptoms. This study explored this risk by testing a factor structure of an alcohol expectancy questionnaire that assesses beliefs about alcohols effects on posttraumatic stress symptoms (P-AEQ). Symptom-specific expectancy scores were then tested as predictors of alcohol consumption. Subjects were 96 female undergraduate women who reported being forced to have sex, 68 who experienced pressure to have sex, and 149 who denied any forced or pressured sex. Alternative factor models were tested using Confirmatory Factor Analysis. A four-factor model reflecting posttraumatic stress symptom domains (Intrusions, Avoidance, Arousal, and Numbing) was found. The numbing factor was correlated with drinking among assaulted women; however, no support was found for symptom-specific expectancies to moderate between assault and drinking. Findings supported a role for posttrauma symptom-specific alcohol expectancies as a potential link between sexual assault and alcohol consumption.

Methamphetamine use among incarcerated women

Problem Women face greater vulnerability to using stimulant drugs, their rate of incarceration for methamphetamine use is increasing, and womens issues have been historically neglected in substance abuse research. This study examined demographic, social and psychological characteristics of incarcerated methamphetamine‐using women that could influence service needs and utilization during incarceration. Method Incarcerated women completed individual interviews and questionnaires regarding drug use and other psychosocial variables. Psychosocial factors were examined according to lifetime drug use history. Comparison groups were: (1) nonstimulant drug users (n=16); (2) noninjection methamphetamine users (n=24); and (3) injection methamphetamine users (n=31). Psychosocial factors were also examined according to recent methamphetamine use. Recent use comparison groups were: (1) no recent drug use (n=18); (2) nonstimulant drug use (n=17); (3) noninjected methamphetamine (n=22); and (4) injected methamphetamine (n=20). Findings Nearly one‐third of these incarcerated drug‐using women had never before received substance abuse treatment. Drug abuse, sexual assault and concomitant psychiatric symptoms were high across the entire sample, but greatest for methamphetamine users. Conclusion Results revealed the complex psychosocial needs and risks that confront incarcerated methamphetamine‐using women and pose serious threats to eventual drug recovery.