Sarah W. Feldstein

Substance use and risk-taking among adolescents

Background: Among adolescents, substance abuse often occurs in conjunction with risk-taking behaviors. Aims: This review explores the nature and etiology of concomitant risk-taking behaviors, addressing behavioral, genetic, temperamental, and family factors that accompany adolescent substance use. Method: A literature review was conducted to determine the breadth of factors that contribute to adolescent substance abuse and correlated risk-taking behaviors, and to identify relevant evidence-based treatments. Results: The literature review revealed that among adolescents, substance abuse occurs as part of a cluster of problems and risk-taking behaviors. Predisposing factors include temperament, genetics, neurobehavioral disinhibition, social competencies, parenting, abuse/neglect, and peer behaviors. Various interventions, including individual therapies, parent training, and family therapies comprise the empirically-supported treatments for these co-occurring behaviors. Conclusions: The literature indicates that adolescents being seen for substance-related problems should be evaluated for engagement in other risk-taking behaviors, and school, peer, and social functioning. In addition, the data support that family, versus individual, interventions should be the norm for substance-abusing adolescents. Declaration of interest: The authors neither received financial support, nor are involved in financial relationships that pose a conflict of interest for this work.

Motivational Interviewing with Underage College Drinkers: A Preliminary Look at the Role of Empathy and Alliance

This study evaluated the impact of a motivational interview (MI) on alcohol use in underage college drinkers, and examined the specific role of empathy and alliance in MI. Fifty-five underage heavy drinkers were randomized to a one-session MI or no-treatment control. Empathy and alliance were evaluated through the MITI, participant, and therapist ratings. At two-month follow-up, multivariate tests reveal no significant interaction effects. Means comparisons indicated that both groups showed reductions in alcohol-related problems, however, only the MI sample evidenced significant reductions in binge drinking. In addition, despite the reductions of both groups, effect sizes indicated that the MI group outperformed the control in terms of binge-drinking and alcohol-related problems. Contrary to predictions, empathy and alliance showed no relationships with outcomes.

Glatt's Curve Revisited: A Pilot Study Investigating the Progression of Recovery in Alcoholics Anonymous

ABSTRACT Glatts 1958 curve is used in AA to illustrate the nature of alcohol dependence and recovery, and spiritual gains are considered an important point in the recovery progression. Sixteen AA members, who had experienced transformational changes, were interviewed regarding the progression of recovery surrounding their transformation. Their progressions were compared with Glatts hypothetical curve. For most, the transformation was located in the middle of the recovery progression and was positively correlated with Glatts progression. For this sample, the working of the 4th step of AA appeared to be an important catalyst for transformational change. In addition, the experience of transformation often resulted in a rebirth of ideals and a new set of enduring moral values.