%0 Journal Article %J Psychol Addict Behav %D 2015 %T Computer-assisted behavioral therapy and contingency management for cannabis use disorder. %A Budney, Alan J %A Stanger, Catherine %A Tilford, J Mick %A Scherer, Emily B %A Brown, Pamela C %A Li, Zhongze %A Li, Zhigang %A Walker, Denise D %K Adult %K Cognitive Therapy %K Female %K Humans %K Male %K Marijuana Abuse %K Middle Aged %K Motivation %K Motivational Interviewing %K Psychotherapy, Brief %K Substance-Related Disorders %K Therapy, Computer-Assisted %K Treatment Outcome %K Young Adult %X

Computer-assisted behavioral treatments hold promise for enhancing access to and reducing costs of treatments for substance use disorders. This study assessed the efficacy of a computer-assisted version of an efficacious, multicomponent treatment for cannabis use disorders (CUD), that is, motivational enhancement therapy, cognitive-behavioral therapy, and abstinence-based contingency-management (MET/CBT/CM). An initial cost comparison was also performed. Seventy-five adult participants, 59% Black, seeking treatment for CUD received either, MET only (BRIEF), therapist-delivered MET/CBT/CM (THERAPIST), or computer-delivered MET/CBT/CM (COMPUTER). During treatment, the THERAPIST and COMPUTER conditions engendered longer durations of continuous cannabis abstinence than BRIEF (p < .05), but did not differ from each other. Abstinence rates and reduction in days of use over time were maintained in COMPUTER at least as well as in THERAPIST. COMPUTER averaged approximately $130 (p < .05) less per case than THERAPIST in therapist costs, which offset most of the costs of CM. Results add to promising findings that illustrate potential for computer-assisted delivery methods to enhance access to evidence-based care, reduce costs, and possibly improve outcomes. The observed maintenance effects and the cost findings require replication in larger clinical trials.

%B Psychol Addict Behav %V 29 %P 501-11 %8 2015 Sep %G eng %N 3 %R 10.1037/adb0000078 %0 Journal Article %J Prev Sci %D 2015 %T Long-term effects of staying connected with your teen® on drug use frequency at age 20. %A Haggerty, Kevin P %A Skinner, Martie L %A Catalano, Richard F %A Abbott, Robert D %A Crutchfield, Robert D %K Adolescent %K African Americans %K European Continental Ancestry Group %K Female %K Health Promotion %K Humans %K Interviews as Topic %K Male %K Parent-Child Relations %K Substance-Related Disorders %K Surveys and Questionnaires %K Young Adult %X

Drug prevention interventions frequently target early adolescents in order to stop or delay initiation of substance use. However, the prevalence and frequency of drug use escalate and then peak during emerging adulthood, making it important to determine whether drug use prevention efforts in adolescence have lasting effects into adulthood. Additionally, given differences in drug use frequency between ethnic groups, intervention effects by race should be examined when possible. This study evaluates the efficacy of a family-focused prevention program, Staying Connected with Your Teen®, delivered to parents and teens in the 8th grade, on family stressors during 9th and 10th grades, 10th-grade drug use (as potential mediators), and drug use frequency at age 20. Families (N = 331; Black = 163, White = 168) were randomly assigned to three conditions: parent-adolescent group-administered (PA), self-administered with telephone support (SA), and no-treatment control (Haggerty et al. Prevention Science, 8: 249-260, 2007). The impact of the intervention was assessed using latent variable structural equation models. Age 20 drug use frequency was significantly higher among Whites than Blacks as expected. The PA intervention had direct effects on reducing drug use frequency for both Blacks and Whites. The SA intervention had an impact on family stressors during adolescence for Whites, but not for Blacks. Results suggest that both formats for delivery were modestly efficacious for Whites, but only direct delivery was modestly efficacious for Blacks. Given the substantial savings in cost of the self-administered program over the group-administered format, improving the efficacy of self-administered programming for Blacks is recommended.

%B Prev Sci %V 16 %P 538-49 %8 2015 May %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25428694?dopt=Abstract %R 10.1007/s11121-014-0525-8 %0 Journal Article %J Addiction %D 2014 %T Adolescent predictors and environmental correlates of young adult alcohol use problems. %A Toumbourou, John W %A Evans-Whipp, Tracy J %A Smith, Rachel %A Hemphill, Sheryl A %A Herrenkohl, Todd I %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Alcohol Drinking %K Alcohol-Related Disorders %K Cohort Studies %K Female %K Humans %K Longitudinal Studies %K Male %K Risk Factors %K Social Environment %K Street Drugs %K Substance-Related Disorders %K Victoria %K Workplace %K Young Adult %X

AIMS: To examine the rates of young adult alcohol and drug use and alcohol problems, adolescent predictors of young adult alcohol problems and correlations with young adult social, work and recreational environments.

DESIGN: Adolescents were followed longitudinally into young adulthood. Predictors were measured in grade 9 (average age 15), and environmental correlates and outcomes in young adulthood (average age 21).

SETTING: Students recruited in Victoria, Australia in 2002, were resurveyed in 2010/11.

PARTICIPANTS: Analytical n=2309, 80% retention.

MEASUREMENTS: Adolescent self-report predictors included past-month alcohol use. Young adults completed the Alcohol Use Disorders Identification Test (AUDIT) together with reports of environmental influences.

FINDINGS: Comparisons to United States national school graduate samples revealed higher rates of alcohol, tobacco and illicit drug use (other than cannabis) in Victoria. For example, rates of past month use at age 21-22 were: alcohol 69.3% US versus 84.9%, 95% confidence interval (CI) 81.3-88.6% Victoria; illicit drugs (other than cannabis) 8.8 versus 12.7%, CI 9.7-15.7%. AUDIT alcohol problems (scored 8+) were identified for 41.2%, CI 38.8-43.6% of young adults in Victoria. The likelihood of young adult alcohol problems was higher for frequent adolescent alcohol users and those exposed to environments characterized by high alcohol use and problems in young adulthood.

CONCLUSIONS: High rates of alcohol problems are evident in more than two in five Australian young adults, and these problems appear to be influenced both by earlier patterns of adolescent alcohol use and by young adult social, work and recreational environments.

%B Addiction %V 109 %P 417-24 %8 2014 Mar %G eng %N 3 %R 10.1111/add.12401 %0 Journal Article %J Addict Behav %D 2014 %T Alcohol intoxication and condom use self-efficacy effects on women's condom use intentions. %A Davis, Kelly Cue %A Masters, N Tatiana %A Eakins, Danielle %A Danube, Cinnamon L %A George, William H %A Norris, Jeanette %A Heiman, Julia R %K Adult %K Alcoholic Intoxication %K Central Nervous System Depressants %K Condoms %K Decision Making %K Ethanol %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Intention %K Safe Sex %K Self Efficacy %K Women %K Young Adult %X

Although research has consistently demonstrated that condom use self-efficacy significantly predicts condom use, there has been little investigation of whether acute alcohol intoxication moderates this relationship. Because alcohol intoxication is often associated with increased sexual risk taking, further examination of such moderating effects is warranted. Using a community sample of young heterosexual women (n=436) with a history of heavy episodic drinking, this alcohol administration experiment examined the effects of intoxication and condom use self-efficacy on women's condom negotiation and future condom use intentions. After a questionnaire session, alcohol condition (control, .10% target peak BAL) was experimentally manipulated between subjects. Participants then read and responded to a hypothetical risky sexual decision-making scenario. SEM analyses revealed that alcohol intoxication directly decreased women's intentions to use condoms in the future. Women with greater condom use self-efficacy had stronger intentions to engage in condom negotiation; however, this effect was moderated by intoxication. Specifically, the association between condom use self-efficacy and condom negotiation intentions was stronger for intoxicated women than for sober women. These novel findings regarding the synergistic effects of alcohol intoxication and condom use self-efficacy support continued prevention efforts aimed at strengthening women's condom use self-efficacy, which may reduce even those sexual risk decisions made during states of intoxication.

%B Addict Behav %V 39 %P 153-8 %8 2014 Jan %G eng %N 1 %R 10.1016/j.addbeh.2013.09.019 %0 Journal Article %J Soc Work Health Care %D 2014 %T Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health. %A Logan-Greene, Patricia %A Green, Sara %A Nurius, Paula S %A Longhi, Dario %K Adaptation, Psychological %K Adolescent %K Adult %K Age Distribution %K Aged %K Behavioral Risk Factor Surveillance System %K Child Abuse %K Cohort Studies %K Female %K Health Status %K Humans %K Life Change Events %K Male %K Mental Health %K Middle Aged %K Regression Analysis %K Resilience, Psychological %K Self Concept %K Stress, Psychological %K Washington %K Young Adult %X

Although evidence is rapidly amassing as to the damaging potential of early life adversities on physical and mental health, as yet few investigations provide comparative snapshots of these patterns across adulthood. This population-based study addresses this gap, examining the relationship of adverse childhood experiences (ACEs) to physical and mental health within a representative sample (n = 19,333) of adults, comparing the prevalence and explanatory strength of ACEs among four birth cohorts spanning ages 18-79. This assessment accounts for demographic and socioeconomic factors, as well as both direct and moderating effects of resilience resources (social/emotional support, life satisfaction, and sleep quality). Findings demonstrate (1) increasing trends of reported ACEs across younger cohorts, including time period shifts such as more prevalent family incarceration, substance abuse, and divorce, (2) significant bivariate as well as independent associations of ACEs with poor health within every cohort, controlling for multiple covariates (increasing trends in older age for physical health), and (3) robust patterns wherein resilience resources moderated ACEs, indicating buffering pathways that sustained into old age. Theoretical and practice implications for health professionals are discussed.

%B Soc Work Health Care %V 53 %P 776-97 %8 2014 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/25255340?dopt=Abstract %R 10.1080/00981389.2014.944251 %0 Journal Article %J J Stud Alcohol Drugs %D 2014 %T Exploring heavy drinking patterns among black and white young adults. %A Klima, Tali %A Skinner, Martie L %A Haggerty, Kevin P %A Crutchfield, Robert D %A Catalano, Richard F %K Adolescent %K African Continental Ancestry Group %K Alcohol Drinking %K Alcoholic Intoxication %K European Continental Ancestry Group %K Female %K Humans %K Male %K Socioeconomic Factors %K Young Adult %X

UNLABELLED: ABSTRACT.

OBJECTIVE: This investigation examined patterns of heavy drinking among Black and White young adults from a person-centered perspective and linked family and individual factors in adolescence to young adult drinking patterns.

METHOD: The analysis focuses on 331 10th-grade students (168 Whites, 163 Blacks; 51% males) who were followed into young adulthood (ages 20 and 22). Cluster analyses using heavy episodic drinking, drunkenness, and alcohol problems in young adulthood resulted in groups of drinkers with different patterns. Groups were examined across and within race. Associations between young adult drinking groups and adolescent family and individual factors were tested.

RESULTS: Groups followed well-established race differences, with Whites clustering into frequent drinking groups more than Blacks, and Blacks clustering into non-heavy drinking groups more than Whites. Further, Black heavy drinkers reported fewer alcohol problems than White counterparts. Parental monitoring, consistent discipline, ethnic identity, and delinquency were associated with adult heavy episodic drinking groups for both races. Monitoring and delinquency, along with parental norms, were associated with drunkenness groups for both races. However, race differences were observed for drunkenness clusters such that attachment was predictive for White clusters, and parental guidelines and discipline were predictive for Black clusters.

CONCLUSIONS: Large race differences in heavy drinking at young adulthood were confirmed. Family dynamics in 10th grade were identified as important for the development of different drinking patterns in the early 20s, when many individuals have left home, which suggests a key target for substance use prevention programs. (J. Stud. Alcohol Drugs, 75, 839-849, 2014).

%B J Stud Alcohol Drugs %V 75 %P 839-49 %8 2014 Sep %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25208202?dopt=Abstract %0 Journal Article %J Drug Alcohol Depend %D 2014 %T General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: replication in two samples. %A Bailey, J A %A Samek, D R %A Keyes, M A %A Hill, K G %A Hicks, B M %A McGue, M %A Iacono, W G %A Epstein, M %A Catalano, R F %A Haggerty, K P %A Hawkins, J D %K Adolescent %K Adult %K Alcohol-Related Disorders %K Antisocial Personality Disorder %K Child %K Family Health %K Female %K Humans %K Male %K Minnesota %K Northwestern United States %K Risk Factors %K Substance-Related Disorders %K Tobacco Use Disorder %K Twins %K Unsafe Sex %K Young Adult %X

BACKGROUND: This paper presents two replications of a heuristic model for measuring environment in studies of gene-environment interplay in the etiology of young adult problem behaviors.

METHODS: Data were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10-18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25).

RESULTS: Results from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder.

CONCLUSIONS: Organizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence.

%B Drug Alcohol Depend %V 138 %P 161-8 %8 2014 May 1 %G eng %R 10.1016/j.drugalcdep.2014.02.023 %0 Journal Article %J AIDS Behav %D 2014 %T Prospective predictors of unprotected anal intercourse among HIV-seropositive men who have sex with men initiating antiretroviral therapy. %A Pantalone, David W %A Huh, David %A Nelson, Kimberly M %A Pearson, Cynthia R %A Simoni, Jane M %K Adult %K Anti-HIV Agents %K Drug Administration Schedule %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seropositivity %K Homosexuality, Male %K Humans %K Interviews as Topic %K Latin America %K Logistic Models %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Sexual Behavior %K Socioeconomic Factors %K Stress, Psychological %K Substance-Related Disorders %K Surveys and Questionnaires %K Unsafe Sex %K Vulnerable Populations %K Washington %K Young Adult %X

Contemporary HIV prevention efforts are increasingly focused on those already living with HIV/AIDS (i.e., "prevention with positives"). Key to these initiatives is research identifying the most risky behavioral targets. Using a longitudinal design, we examined socio-demographic and psychosocial factors that prospectively predicted unprotected anal intercourse (UAI) in a sample of 134 HIV-seropositive men who have sex with men (MSM) initiating, changing, or re-starting an antiretroviral therapy regimen as part of a behavioral intervention study. Computer-based questionnaires were given at baseline and 6 months. In a sequential logistic regression, baseline measures of UAI (step 1), socio-demographic factors such as Latino ethnicity (step 2), and psychosocial factors such as crystal methamphetamine use, greater life stress, and lower trait anxiety (step 3) were predictors of UAI at 6 months. Problem drinking was not a significant predictor. Prevention efforts among MSM living with HIV/AIDS might focus on multiple psychosocial targets, like decreasing their crystal methamphetamine use and teaching coping skills to deal with life stress.

%B AIDS Behav %V 18 %P 78-87 %8 2014 Jan %G eng %N 1 %R 10.1007/s10461-013-0477-1 %0 Journal Article %J Am J Community Psychol %D 2014 %T Racial/ethnic identity and subjective physical and mental health of Latino Americans: an asset within? %A Ai, Amy L %A Aisenberg, Eugene %A Weiss, Saskia I %A Salazar, Dulny %K Acculturation %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Female %K Health Status %K Hispanic Americans %K Humans %K Male %K Mental Health %K Middle Aged %K Religion %K Self Concept %K Social Identification %K Social Support %K Young Adult %X

Social Identity Theory indicates that ethnic identity could benefit minority members in a society because of its promotion of a sense of belonging, or of its buffering of the damage of discrimination. Despite growing investigation about Latinos' overall health, few studies have simultaneously examined the influence of multiple cultural strength factors, especially racial/ethnic identity, social support, and religious attendance, on these outcomes. Using the National Latino and Asian American Study, we examine the potential predictive value of these cultural strength factors on Latinos' Self-Rated Mental and Physical Health (SRMH and SRPH). Two separate two-step regression models revealed significant positive effects of racial/ethnic identity on both mental and physical health of Latinos, above and beyond the effect of known demographic and acculturation factors, such as discrimination. Religious attendance had a positive effect on SRMH but not on SRPH. The deteriorating roles of discrimination, in mental health only, and that of Length in the US in both outcomes, however, was primarily not altered by entry of these cultural strength factors. The independent direct effect of racial/ethnic identity among Latinos nationwide may suggest that this cultural strength is an internalized protective asset. Longitudinal data is needed to explore its underlying mechanism and long-term impact.

%B Am J Community Psychol %V 53 %P 173-84 %8 2014 Mar %G eng %N 1-2 %R 10.1007/s10464-014-9635-5 %0 Journal Article %J J Sex Res %D 2014 %T Sexual risk behavior in young adulthood: broadening the scope beyond early sexual initiation. %A Epstein, Marina %A Bailey, Jennifer A %A Manhart, Lisa E %A Hill, Karl G %A Hawkins, J D %K Adolescent %K Adolescent Behavior %K Adult %K Child %K Female %K Humans %K Longitudinal Studies %K Male %K Risk-Taking %K Sexual Behavior %K Time Factors %K Young Adult %X

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation was a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10 to 15) and sexual risk taking (ages 21 to 24 and 30 to 33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood.

%B J Sex Res %V 51 %P 721-30 %8 2014 %G eng %N 7 %R 10.1080/00224499.2013.849652 %0 Journal Article %J Arch Sex Behav %D 2014 %T Sexual victimization, alcohol intoxication, sexual-emotional responding, and sexual risk in heavy episodic drinking women. %A George, William H %A Davis, Kelly Cue %A Masters, N Tatiana %A Jacques-Tiura, Angela J %A Heiman, Julia R %A Norris, Jeanette %A Gilmore, Amanda K %A Nguyen, Hong V %A Kajumulo, Kelly F %A Otto, Jacqueline M %A Andrasik, Michele P %K Adult %K Alcoholic Intoxication %K Child %K Child Abuse, Sexual %K Crime Victims %K Ethanol %K Female %K HIV Infections %K Humans %K Libido %K Rape %K Risk %K Risk-Taking %K Sexual Behavior %K Unsafe Sex %K Young Adult %X

This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women's sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol's effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.

%B Arch Sex Behav %V 43 %P 645-58 %8 2014 May %G eng %N 4 %R 10.1007/s10508-013-0143-8 %0 Journal Article %J Arch Sex Behav %D 2014 %T Sexually explicit online media and sexual risk among men who have sex with men in the United States. %A Nelson, Kimberly M %A Simoni, Jane M %A Morrison, Diane M %A George, William H %A Leickly, Emily %A Lengua, Liliana J %A Hawes, Stephen E %K Adolescent %K Adult %K Cross-Sectional Studies %K Erotica %K HIV Infections %K Homosexuality, Male %K Humans %K Internet %K Male %K Middle Aged %K Risk-Taking %K Socioeconomic Factors %K United States %K Unsafe Sex %K Young Adult %X

This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the 3 months prior to interview, more than half (57 %) of the men reported viewing SEOM one or more times per day and almost half (45 %) reported that at least half of the SEOM they viewed portrayed UAI. Compared to participants who reported that 0-24 % of the SEOM they viewed showed UAI, participants who reported that 25-49, 50-74, or 75-100 % of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past 3 months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.

%B Arch Sex Behav %V 43 %P 833-43 %8 2014 May %G eng %N 4 %R 10.1007/s10508-013-0238-2 %0 Journal Article %J J Sex Res %D 2014 %T Women's unprotected sex intentions: roles of sexual victimization, intoxication, and partner perception. %A Masters, N Tatiana %A George, William H %A Davis, Kelly Cue %A Norris, Jeanette %A Heiman, Julia R %A Jacques-Tiura, Angela J %A Gilmore, Amanda K %A Nguyen, Hong V %A Kajumulo, Kelly F %A Otto, Jacqueline M %A Stappenbeck, Cynthia A %K Adult %K Adult Survivors of Child Abuse %K Alcoholic Intoxication %K Child %K Female %K Humans %K Intention %K Sex Offenses %K Social Perception %K Unsafe Sex %K Young Adult %X

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.

%B J Sex Res %V 51 %P 586-98 %8 2014 %G eng %N 5 %R 10.1080/00224499.2012.763086 %0 Journal Article %J Accid Anal Prev %D 2013 %T Adolescent exposure to drink driving as a predictor of young adults' drink driving. %A Evans-Whipp, Tracy J %A Plenty, Stephanie M %A Toumbourou, John W %A Olsson, Craig %A Rowland, Bosco %A Hemphill, Sheryl A %K Adolescent %K Alcohol Drinking %K Automobile Driving %K Child %K Dangerous Behavior %K Female %K Follow-Up Studies %K Humans %K Imitative Behavior %K Logistic Models %K Male %K Multivariate Analysis %K Risk Factors %K Self Report %K Victoria %K Young Adult %X

The purpose of this study was to investigate the influence of exposure to others' drink driving during adolescence on self-reported driving under the influence (DUI) of alcohol in young adulthood. Data were drawn from 1956 participants with a driving license enrolled in the International Youth Development Study from Victoria, Australia. During 2003 and 2004, adolescents in Grades 7, 9 and 10 (aged 12-17) completed questionnaires examining whether they had ridden in a vehicle with a driver who had been drinking, as well as other demographic, individual, peer and family risk factors for DUI. In 2010, the same participants (aged 18-24) then reported on their own DUI behaviour. 18% of young adults with a driving license reported DUI in the past 12 months. Exposure to others' drink driving during adolescence was associated with an increased likelihood of DUI as a young adult (OR=2.13, 95% CI 1.68-2.69). This association remained after accounting for the effects of other potential confounding factors from the individual, peer and family domains (OR=1.62, 95% CI 1.23-2.13). Observing the drink driving behaviours of others during adolescence may increase the likelihood of DUI as a young adult. Strategies to reduce youth exposure to drink driving are warranted.

%B Accid Anal Prev %V 51 %P 185-91 %8 2013 Mar %G eng %R 10.1016/j.aap.2012.11.016 %0 Journal Article %J Drug Alcohol Depend %D 2013 %T Alcohol and tobacco use disorder comorbidity in young adults and the influence of romantic partner environments. %A Meacham, Meredith C %A Bailey, Jennifer A %A Hill, Karl G %A Epstein, Marina %A Hawkins, J D %K Adolescent %K Adult %K Alcoholism %K Comorbidity %K Conflict (Psychology) %K Depression %K Diagnostic and Statistical Manual of Mental Disorders %K Ethnic Groups %K Female %K Humans %K Male %K Regression Analysis %K Sex Factors %K Sexual Partners %K Social Environment %K Socioeconomic Factors %K Tobacco Use %K Treatment Outcome %K Young Adult %X

BACKGROUND: Although there is considerable evidence that the development of tobacco dependence (TD) and that of alcohol use disorder (AUD) are intertwined, less is known about the comorbid development of these disorders. The present study examines tobacco dependence and alcohol use disorder comorbidity in young adulthood within the context of romantic partner relationships.

METHODS: Data were drawn from the Seattle Social Development Project, a contemporary, ethnically diverse, and gender balanced longitudinal panel including 808 participants. A typological person-centered approach was used to assign participants to four outcome groups: no disorder, tobacco dependence (TD) only, alcohol use disorder (AUD) only, and comorbid (both). Multinomial logistic regression was used to determine the association between partner general and substance-specific environments and single or dual alcohol and tobacco use disorder diagnosis in young adulthood (ages 24-33, n=628). Previous heavy alcohol and tobacco use were controlled for, as were dispositional characteristics, gender, ethnicity, adult SES, and adult depression.

RESULTS: Greater partner conflict increased the likelihood of being comorbid compared to having TD only or AUD only. Having a smoking partner increased the likelihood of being comorbid compared to having AUD only, but having a drinking partner did not significantly distinguish being comorbid from having TD only.

CONCLUSIONS: Findings demonstrated the utility of a comorbidity-based, person-centered approach and the influence of general and tobacco-specific, but not alcohol-specific, partner environments on comorbid alcohol and tobacco use disorders in young adulthood.

%B Drug Alcohol Depend %V 132 %P 149-57 %8 2013 Sep 1 %G eng %N 1-2 %R 10.1016/j.drugalcdep.2013.01.017 %0 Journal Article %J Dev Psychol %D 2013 %T The association between parent early adult drug use disorder and later observed parenting practices and child behavior problems: Testing alternate models. %A Bailey, Jennifer A %A Hill, Karl G %A Guttmannova, Katarina %A Oesterle, Sabrina %A Hawkins, J D %A Catalano, Richard F %A McMahon, Robert J %K Adolescent %K Adult %K Child %K Child Behavior Disorders %K Child Rearing %K Family Relations %K Female %K Humans %K Male %K Models, Psychological %K Parent-Child Relations %K Parenting %K Personality %K Psychiatric Status Rating Scales %K Substance-Related Disorders %K Young Adult %X

This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following 3 theoretically derived models explaining this link: (a) a disrupted parent adult functioning model,(b) a preexisting parent personality factor model, and (c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking 2 generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The preexisting parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing his or her own problem behavior, interactions with his or her child, and his or her child's problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors.

%B Dev Psychol %V 49 %P 887-99 %8 2013 May %G eng %N 5 %R 10.1037/a0029235 %0 Journal Article %J AIDS Educ Prev %D 2013 %T A cautionary tale: risk reduction strategies among urban American Indian/Alaska Native men who have sex with men. %A Pearson, Cynthia R %A Walters, Karina L %A Simoni, Jane M %A Beltran, Ramona %A Nelson, Kimberly M %K Adolescent %K Adult %K Alaska %K Condoms %K Cross-Sectional Studies %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seronegativity %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Risk Factors %K Risk Reduction Behavior %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Surveys and Questionnaires %K Truth Disclosure %K Unsafe Sex %K Urban Population %K Young Adult %X

American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduction strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serostatus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices.

%B AIDS Educ Prev %V 25 %P 25-37 %8 2013 Feb %G eng %N 1 %R 10.1521/aeap.2013.25.1.25 %0 Journal Article %J Public Health %D 2013 %T Educational inequalities in the co-occurrence of mental health and substance use problems, and its adult socio-economic consequences: a longitudinal study of young adults in a community sample. %A Lee, J O %A Herrenkohl, T I %A Kosterman, R %A Small, C M %A Hawkins, J D %K Adult %K Anxiety Disorders %K Comorbidity %K Depressive Disorder %K Educational Status %K Female %K Follow-Up Studies %K Health Status Disparities %K Humans %K Male %K Prospective Studies %K Social Class %K Socioeconomic Factors %K Substance-Related Disorders %K Young Adult %X

OBJECTIVES: To examine the relationship between the co-occurrence of mental health and substance use problems and socio-economic status (SES).

STUDY DESIGN: A prospective longitudinal study of 808 males and females followed to age 30.

METHODS: Survey data were used to derive latent classes (profiles) of mental health (depression, anxiety) and substance use (alcohol, nicotine, and marijuana [cannabis]) problems at age 27. Analyses examined the associations of these profiles with earlier educational attainment (high school diploma) and indicators of SES at age 30.

RESULTS: Latent Class Analysis produced four profiles: a low disorder symptoms group, a licit substance use disorder symptoms group (alcohol and nicotine), a mental health disorder symptoms group, and a comorbid group. Earning a high school diploma by age 21 decreased the odds of belonging to the comorbid group or the licit substance use disorder symptoms group when compared to the low disorder symptoms group. These disorder profiles also were found to adversely impact subsequent adult SES. The adverse impact was more evident in income maintenance and wealth accumulation by age 30 than market or non-market labour force participation.

CONCLUSIONS: Earning a high school diploma lessens the risk of co-occurring mental health and substance use problems which contribute to economic instability in young adulthood. Findings underscore the importance of public health programmes to reduce the incidence of mental health and substance use problems and their associated high costs to individuals and to society.

%B Public Health %V 127 %P 745-53 %8 2013 Aug %G eng %N 8 %R 10.1016/j.puhe.2013.04.005 %0 Journal Article %J Dev Psychol %D 2013 %T The effect of general and drug-specific family environments on comorbid and drug-specific problem behavior: A longitudinal examination. %A Epstein, Marina %A Hill, Karl G %A Bailey, Jennifer A %A Hawkins, J D %K Adolescent %K Adolescent Behavior %K Adult %K Age Factors %K Alcohol Drinking %K Child %K Child Behavior Disorders %K Comorbidity %K Family Relations %K Female %K Humans %K Longitudinal Studies %K Male %K Self Report %K Social Environment %K Tobacco Use Disorder %K Young Adult %X

Previous research has shown that the development of alcohol and tobacco dependence is linked and that both are influenced by environmental and intrapersonal factors, many of which likely interact over the life course. The present study examines the effects of general and alcohol- and tobacco-specific environmental influences in the family of origin (ages 10-18) and family of cohabitation (ages 27-30) on problem behavior and alcohol- and tobacco-specific outcomes at age 33. General environmental factors include family management, conflict, bonding, and involvement. Alcohol environment includes parental alcohol use, parents' attitudes toward alcohol, and children's involvement in family drinking. Tobacco-specific environment is assessed analogously. Additionally, analyses include the effects of childhood behavioral disinhibition, initial behavior problems, and age 18 substance use. Analyses were based on 469 participants drawn from the Seattle Social Development Project (SSDP) sample. Results indicated that (a) environmental factors within the family of origin and the family of cohabitation are both important predictors of problem behavior at age 33; (b) family of cohabitation influences partially mediate the effects of family of origin environments; (c) considerable continuity exists between adolescent and adult general and tobacco (but not alcohol) environments; age 18 alcohol and tobacco use partially mediates these relationships; and (d) childhood behavioral disinhibition contributed to age 33 outcomes, over and above the effects of family of cohabitation mediators. Implications for preventive interventions are discussed.

%B Dev Psychol %V 49 %P 1151-64 %8 2013 Jun %G eng %N 6 %R 10.1037/a0029309 %0 Journal Article %J Child Welfare %D 2013 %T Extent and nature of child maltreatment-related fatalities: implications for policy and practice. %A Sheldon-Sherman, Jennifer %A Wilson, Dee %A Smith, Susan %K Adolescent %K Adult %K Caregivers %K Child %K Child Abuse %K Child Welfare %K Child, Preschool %K Female %K Humans %K Infant %K Infant, Newborn %K Male %K Parent-Child Relations %K Risk Factors %K Social Work %K United States %K Young Adult %X

This article reviews significant research findings regarding child maltreatment fatalities over the last thirty years. Notably, the article focuses on several important subsets of children who die from maltreatment, including young children, children reported to child protective services, and children who live in families with poor parental attachment, mental illness, substance abuse, and domestic violence. The article then sets forth three proposals for broadening the United States' approach to child protection and reducing child maltreatment fatalities.

%B Child Welfare %V 92 %P 41-58 %8 2013 %G eng %N 2 %0 Journal Article %J Matern Child Health J %D 2013 %T Health disparities among childrearing women with disabilities. %A Kim, Miok %A Kim, Hyun-Jun %A Hong, Seunghye %A Fredriksen-Goldsen, Karen I %K Adolescent %K Adult %K Behavioral Risk Factor Surveillance System %K Child Rearing %K Child, Preschool %K Chronic Disease %K Disabled Persons %K Female %K Health Behavior %K Health Services Accessibility %K Health Status Disparities %K Health Status Indicators %K Health Surveys %K Healthcare Disparities %K Humans %K Middle Aged %K Mothers %K Prevalence %K Quality of Life %K Socioeconomic Factors %K Washington %K Young Adult %X

This study examines leading health indicators for childrearing women with disabilities, including health-related quality of life, chronic health conditions, adverse and preventive health behaviors, health care access, and social and emotional support. The study analyzes aggregated data from the Washington State Behavioral Risk Factor Surveillance System (n = 28,629). The weighted prevalence of key health indicators of childrearing women with disabilities (aged 18-59) are compared with childrearing women without disabilities. A series of adjusted logistic regression analyses are applied, controlling for confounding variables. When compared to childrearing women without disabilities, childrearing women with disabilities are less likely to have a partner or spouse, report lower income and education levels and are older. Childrearing women with disabilities, compared to childrearing women without disabilities, report significantly lower health-related quality of life including poor general health (adjusted odds ratio[AOR] = 6.85; p < .001), frequent mental distress (AOR = 4.02; p < .001), and frequent poor physical health (AOR = 9.34; p < .001); higher prevalence of chronic health conditions, including arthritis, cardiovascular diseases, diabetes, asthma, high blood pressure and cholesterol, and obesity (the range of AORs = 1.59 to 5.65; p < .001); higher prevalence of adverse health behaviors including smoking (AOR = 2.14; p < .001) and lack of exercise (AOR = 1.61; p < .001); more financial barriers to health care (AOR = 2.11; p < .001) and lack of social and emotional support (AOR = 2.05; p < .001) while controlling for age, education, income, and relationship status. Based on population level data, the study reveals that childrearing women with disabilities experience elevated risks of health disparities across many key health indicators, many of which are preventable and modifiable. These findings underscore the importance of identifying contributing factors and developing interventions to improve the health and quality of life of childrearing women with disabilities.

%B Matern Child Health J %V 17 %P 1260-8 %8 2013 Sep %G eng %N 7 %R 10.1007/s10995-012-1118-4 %0 Journal Article %J J Consult Clin Psychol %D 2013 %T The immigrant paradox among Asian American women: are disparities in the burden of depression and anxiety paradoxical or explicable? %A Lau, Anna S %A Tsai, William %A Shih, Josephine %A Liu, Lisa L %A Hwang, Wei-Chin %A Takeuchi, David T %K Age Factors %K Anxiety Disorders %K Asian Americans %K Cost of Illness %K Depressive Disorder %K Emigrants and Immigrants %K Female %K Health Status Disparities %K Humans %K Middle Aged %K Risk Factors %K Social Class %K Stress, Psychological %K Young Adult %X

OBJECTIVE: We evaluated potential explanations for advantaged mental health status among immigrant Asian American women compared to U.S.-born Asian American women.

METHOD: In a nationally representative sample of 1,030 women (185 U.S.-born, 368 early-life immigrants [arrived before 25 years of age], 477 late-life immigrants), we examined the hypothesis that increased exposure to social risk factors mediate nativity-based differences in lifetime prevalence of depression and anxiety disorders. Indicators of social class were also examined as protective factors enjoyed by U.S.-born women that may suppress observed nativity-based disparities. We also examined whether there were group differences in reactivity to stress in predicting disorder.

RESULTS: U.S.-born women were twice as likely as late-life immigrants to report lifetime history of depression (odds ratio [OR] = 2.03, 95% CI [1.35, 4.54]) and anxiety (OR = 2.12, 95% CI [1.34, 5.19]). Nativity differences in perceived discrimination, family conflict, and cultural conflict explained disparities in rates of disorder. There was no support for the contention that immigrant women were more psychologically hardy or resilient to social stress.

CONCLUSION: Findings suggest that the gap in mental health status between U.S.- and foreign-born Asian American women would indeed be magnified if differences in social status were accounted for, but also that ready explanations for the so-called immigrant paradox are found in differential levels of reported stress exposure.

%B J Consult Clin Psychol %V 81 %P 901-11 %8 2013 Oct %G eng %N 5 %R 10.1037/a0032105 %0 Journal Article %J J Consult Clin Psychol %D 2013 %T Indicated prevention for college student marijuana use: a randomized controlled trial. %A Lee, Christine M %A Kilmer, Jason R %A Neighbors, Clayton %A Atkins, David C %A Zheng, Cheng %A Walker, Denise D %A Larimer, Mary E %K Adolescent %K Adult %K Feedback, Psychological %K Female %K Follow-Up Studies %K Humans %K Male %K Marijuana Smoking %K Motivation %K Psychotherapy, Brief %K Students %K Treatment Outcome %K Universities %K Young Adult %X

OBJECTIVE: Marijuana is the most frequently reported illicit substance used on college campuses. Despite the prevalence, few published intervention studies have focused specifically on addressing high-risk marijuana use on college campuses. The present study evaluated the efficacy of an in-person brief motivational enhancement intervention for reducing marijuana use and related consequences among frequently using college students.

METHOD: Participants included 212 college students from 2 campuses who reported frequent marijuana use (i.e., using marijuana at least 5 times in the past month). Participants completed Web-based screening and baseline assessments and upon completion of the baseline survey were randomized to either an in-person brief intervention or an assessment control group. Follow-up assessments were completed approximately 3 and 6 months post-baseline. Marijuana use was measured by number of days used in the past 30 days, typical number of joints used in a typical week in the last 60 days, and marijuana-related consequences.

RESULTS: Results indicated significant intervention effects on number of joints smoked in a typical week and a trend toward fewer marijuana-related consequences compared with the control group at 3-month follow-up.

CONCLUSION: This study provides preliminary data on short-term effects of a focused marijuana intervention for college students at reducing marijuana use during the academic quarter.

%B J Consult Clin Psychol %V 81 %P 702-9 %8 2013 Aug %G eng %N 4 %R 10.1037/a0033285 %0 Journal Article %J J Stud Alcohol Drugs %D 2013 %T Patterns of alcohol use and expectancies predict sexual risk taking among non-problem drinking women. %A Stappenbeck, Cynthia A %A Norris, Jeanette %A Kiekel, Preston A %A Morrison, Diane M %A George, William H %A Davis, Kelly Cue %A Zawacki, Tina %A Jacques-Tiura, Angela J %A Abdallah, Devon Alisa %K Adult %K Alcohol Drinking %K Data Collection %K Female %K Humans %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Young Adult %X

OBJECTIVE: Although alcohol consumption and sexual risk taking are associated, not everyone who drinks alcohol engages in risky sexual behavior. The purposes of the present study were to identify patterns of alcohol use behaviors and alcohol expectancies among women who are non-problem drinkers and to examine how these patterns are associated with indices of sexual risk.

METHOD: Data from 758 non-problem drinking women who have sex with men and were not in committed relationships were analyzed using latent profile analysis to determine patterns of alcohol use and alcohol-related expectancies.

RESULTS: Of the four patterns observed, three classes had similar alcohol-related expectancies but differed with respect to drinking behavior (moderate drinking, regular heavy episodes, and frequent heavy episodes), and the fourth class consisted of moderate drinkers with low expectancies (low expectancies). Results revealed that those in the frequent heavy episodes class had the greatest number of sexual partners in the past year and drank the most alcohol before having sex compared with the other women. Both the regular and frequent heavy episodes classes reported greater likelihood of having unprotected sex in the future, more positive beliefs about casual sex, and greater subjective intoxication before having sex than women in the moderate drinking or low expectancies classes. Women in the low expectancies class reported less positive beliefs about condoms than those in the moderate drinking and regular heavy episodes classes.

CONCLUSIONS: Results suggest that different patterns of expectancies and drinking behaviors are associated with different indices of sexual risk taking and highlight the importance of individually tailored programs for prevention of sexually transmitted infections.

%B J Stud Alcohol Drugs %V 74 %P 223-32 %8 2013 Mar %G eng %N 2 %0 Journal Article %J Med Care %D 2013 %T Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States. %A Alegría, Margarita %A Fortuna, Lisa R %A Lin, Julia Y %A Norris, Fran H %A Gao, Shan %A Takeuchi, David T %A Jackson, James S %A Shrout, Patrick E %A Valentine, Anne %K Adolescent %K Adult %K African Americans %K Aged %K Asian Americans %K Continental Population Groups %K Ethnic Groups %K Female %K Hispanic Americans %K Humans %K Male %K Mental Disorders %K Middle Aged %K Patient Acuity %K Prevalence %K Risk Factors %K Social Support %K Socioeconomic Factors %K Stress Disorders, Post-Traumatic %K United States %K Young Adult %X

OBJECTIVES: We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.

METHODS: PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.

RESULTS: Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.

CONCLUSIONS: There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.

%B Med Care %V 51 %P 1114-23 %8 2013 Dec %G eng %N 12 %R 10.1097/MLR.0000000000000007 %0 Journal Article %J J Sex Res %D 2013 %T Sexual scripts among young heterosexually active men and women: continuity and change. %A Masters, N Tatiana %A Casey, Erin %A Wells, Elizabeth A %A Morrison, Diane M %K Adolescent %K Adult %K Female %K Heterosexuality %K Humans %K Interpersonal Relations %K Male %K Sexual Behavior %K Young Adult %X

Whereas gendered sexual scripts are hegemonic at the cultural level, research suggests they may be less so at dyadic and individual levels. Understanding "disjunctures" between sexual scripts at different levels holds promise for illuminating mechanisms through which sexual scripts can change. Through interviews with 44 heterosexually active men and women aged 18 to 25, the ways young people grappled with culture-level scripts for sexuality and relationships were delineated. Findings suggest that, although most participants' culture-level gender scripts for behavior in sexual relationships were congruent with descriptions of traditional masculine and feminine sexuality, there was heterogeneity in how or whether these scripts were incorporated into individual relationships. Specifically, three styles of working with sexual scripts were found: conforming, in which personal gender scripts for sexual behavior overlapped with traditional scripts; exception-finding, in which interviewees accepted culture-level gender scripts as a reality, but created exceptions to gender rules for themselves; and transforming, in which participants either attempted to remake culture-level gender scripts or interpreted their own nontraditional styles as equally normative. Changing sexual scripts can potentially contribute to decreased gender inequity in the sexual realm and to increased opportunities for sexual satisfaction, safety, and well-being, particularly for women, but for men as well.

%B J Sex Res %V 50 %P 409-20 %8 2013 %G eng %N 5 %R 10.1080/00224499.2012.661102 %0 Journal Article %J Suicide Life Threat Behav %D 2013 %T Trajectories of depressive symptoms and externalizing behaviors across adolescence: associations with histories of suicide attempt and ideation in early adulthood. %A Kerr, David C R %A Reinke, Wendy M %A Eddy, J Mark %K Adolescent %K Behavioral Symptoms %K Case-Control Studies %K Child %K Depression %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Male %K Risk %K Risk Factors %K Sex Factors %K Suicidal Ideation %K Suicide, Attempted %K Surveys and Questionnaires %K Young Adult %X

We examined associations between adolescent problem trajectories and suicide risk outcomes in 361 community participants. Depressive symptoms (self-report) and externalizing behaviors (parent report) were assessed six times from grades 5 to 10. Parallel process linear growth curves indicated that lifetime suicide attempt history assessed to age 25 was associated with higher intercept (grade 5) and slope (increases from grades 5 to 10) of depressive symptoms and higher slope of externalizing behaviors. Both problem intercepts predicted suicidal ideation at ages 18 to 25 years. Adolescent depressive and externalizing symptom trajectories showed independent associations with suicide risk. Preventive intervention that occurs prior to the developmental period in which suicidal thoughts and behaviors show peak prevalence is expected to prevent suicide.

%B Suicide Life Threat Behav %V 43 %P 50-66 %8 2013 Feb %G eng %N 1 %R 10.1111/j.1943-278X.2012.00127.x %0 Journal Article %J Women Health %D 2013 %T Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. %A Tabb, Karen M %A Gavin, Amelia R %A Guo, Yuqing %A Huang, Hsiang %A Debiec, Kate %A Katon, Wayne %K Adult %K Depression %K Depression, Postpartum %K Female %K Follow-Up Studies %K Humans %K Interviews as Topic %K Maternal Health Services %K Mothers %K Postpartum Period %K Pregnancy %K Pregnancy Complications %K Risk Factors %K Stress, Psychological %K Suicidal Ideation %K Surveys and Questionnaires %K Young Adult %X

INTRODUCTION: Perinatal suicidality (i.e., thoughts of death, suicide attempts, or self-harm during the period immediately before and up to 12 months after the birth of a child) is a significant public health concern. Few investigations have examined the patients' own views and experiences of maternal suicidal ideation.

METHODS: Between April and October 2010, researchers identified 14 patient participants at a single university-based medical center for a follow-up, semi-structured interview if they screened positive for suicidal ideation on the Patient Health Questionnaire-9 (PHQ-9) short form. In-depth interviews followed a semi-structured interview guide. Researchers transcribed all interviews verbatim and analyzed transcripts using thematic network analysis.

RESULTS: Participants described the experience of suicidality during pregnancy as related to somatic symptoms, past diagnoses, infanticide, family psychiatric history (e.g., completed suicides and family member attempts), and pregnancy complications. The network of themes included the perinatal experience, patient descriptions of changes in mood symptoms, illustrations of situational coping, and reported mental health service use.

IMPLICATIONS: The interview themes suggested that in this small sample, pregnancy represented a critical time period to screen for suicide and to establish treatment for the mothers in the study. These findings may assist health care professionals in the development of interventions designed to identify, assess, and prevent suicidality among perinatal women.

%B Women Health %V 53 %P 519-35 %8 2013 %G eng %N 5 %R 10.1080/03630242.2013.804024 %0 Journal Article %J J Behav Med %D 2012 %T Beyond conventional socioeconomic status: examining subjective and objective social status with self-reported health among Asian immigrants. %A Gong, Fang %A Xu, Jun %A Takeuchi, David T %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Asia %K Data Collection %K Emigrants and Immigrants %K Female %K Health Status %K Health Status Disparities %K Humans %K Male %K Mental Health %K Middle Aged %K Self Report %K Social Class %K Stress, Psychological %K United States %K Young Adult %X

Despite mounting evidence for a strong and persistent association between socioeconomic status (SES) and health, this relationship is largely unknown among Asian immigrants, a fast growing minority group in the US population. Previous research has typically focused on objective SES (primarily education and income) and ignored self-perceived SES. Using data from the National Latino and Asian American Study (NLAAS) (N = 1,570), we examined the impact of subjective as well as objective SES upon multiple self-reported health outcomes among Asian immigrants. Results indicated that conventional SES indicators by and large were non-significantly related to self-rated physical health, physical discomfort, self-rated mental health, and psychological distress. In contrast, subjective SES relative to people in the United States and people in the community showed strong associations with health outcomes above and beyond conventional SES markers. This study suggested a promising avenue to incorporate subjective SES in health disparities research, especially among immigrants.

%B J Behav Med %V 35 %P 407-19 %8 2012 Aug %G eng %N 4 %R 10.1007/s10865-011-9367-z %0 Journal Article %J Addiction %D 2012 %T Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial. %A Larimer, Mary E %A Neighbors, Clayton %A Lostutter, Ty W %A Whiteside, Ursula %A Cronce, Jessica M %A Kaysen, Debra %A Walker, Denise D %K Adult %K Biofeedback, Psychology %K Cognitive Therapy %K Cost of Illness %K Female %K Gambling %K Humans %K Internal-External Control %K Male %K Patient Compliance %K Treatment Outcome %K Young Adult %X

AIMS: The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population.

DESIGN: Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers.

SETTING: College campus.

PARTICIPANTS: At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51).

MEASUREMENTS: Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs.

FINDINGS: Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency.

CONCLUSIONS: A single-session personalized feedback intervention and a multi-session cognitive-behavioral intervention may be helpful in reducing disordered gambling in US college students.

%B Addiction %V 107 %P 1148-58 %8 2012 Jun %G eng %N 6 %R 10.1111/j.1360-0443.2011.03776.x %0 Journal Article %J Compr Psychiatry %D 2012 %T Can patterns of alcohol use disorder in young adulthood help explain gender differences in depression? %A Lee, Jungeun O %A Kosterman, Rick %A McCarty, Carolyn A %A Hill, Karl G %A Hawkins, J D %K Adult %K Age Factors %K Alcohol-Related Disorders %K Cohort Studies %K Comorbidity %K Cross-Sectional Studies %K Depressive Disorder, Major %K Female %K Humans %K Longitudinal Studies %K Male %K Risk Factors %K Sex Factors %K Washington %K Young Adult %X

OBJECTIVE: To test whether gender differences in the prevalence of major depressive disorder differ by longitudinal patterns of alcohol use disorder symptoms.

METHOD: Data are from a prospective longitudinal study examining a broad range of mental health and substance use problems. A gender-balanced sample of 808 participants was interviewed at ages 21, 24, 27, and 30. The sample was divided into subgroups corresponding to longitudinal patterns of alcohol use disorder derived from latent class growth analysis.

RESULTS: Four patterns of alcohol use disorder symptoms were identified: A "low disorder symptom" group, a "decreaser" group, an "increaser" group, and a "chronic disorder symptom" group. Rates of depression were significantly higher for females only among those with a pattern of chronic or decreasing alcohol disorder symptoms.

CONCLUSIONS: Elevated rates of depression among females in young adulthood may depend on patterns of co-occurring alcohol disorder symptoms. Practitioners should pay particular attention to signs of chronic alcohol use disorders and associated risks for depression among young adult women.

%B Compr Psychiatry %V 53 %P 1071-7 %8 2012 Nov %G eng %N 8 %R 10.1016/j.comppsych.2012.03.012 %0 Journal Article %J Addiction %D 2012 %T Co-occurrence of sexual risk behaviors and substance use across emerging adulthood: evidence for state- and trait-level associations. %A King, Kevin M %A Nguyen, Hong V %A Kosterman, Rick %A Bailey, Jennifer A %A Hawkins, J D %K Adult %K Alcohol-Related Disorders %K Female %K Humans %K Male %K Risk-Taking %K Substance-Related Disorders %K Time Factors %K Unsafe Sex %K Young Adult %X

AIMS:   Prior research has suggested that problematic alcohol and drug use are related to risky sexual behaviors, either due to trait-level associations driven by shared risk factors such as sensation seeking or by state-specific effects, such as the direct effects of substance use on sexual behaviors. Although the prevalence of both high-risk sexual activity and alcohol problems decline with age, little is known about how the associations between substance use disorder symptoms and high-risk sexual behaviors change across young adulthood.

DESIGN, SETTING AND PARTICIPANTS:   Using a community sample (n = 790) interviewed every 3 years from age 21 to age 30 years, we tested trait- and state-level associations among symptoms of alcohol and drug abuse and dependence and high-risk sexual behaviors across young adulthood using latent growth curve models.

MEASUREMENTS:   We utilized diagnostic interviews to obtain self-report of past-year drug and alcohol abuse and dependence symptoms. High-risk sexual behaviors were assessed with a composite of four self-reported behaviors.

FINDINGS:   Results showed time-specific associations between alcohol disorder symptoms and risky sexual behaviors (r = 0.195, P < 0.001), but not associations between their trajectories of change. Conversely, risky sexual behaviors and drug disorder symptoms were associated only at the trait level, not the state level, such that the levels and rate of change over time of both were correlated (r = 0.35, P < 0.001).

CONCLUSIONS:   High-risk sexual behaviors during young adulthood seem to be driven both by trait and state factors, and intervention efforts may be successful if they are either aimed at high-risk individuals or if they work to disaggregate alcohol use from risky sexual activities.

%B Addiction %V 107 %P 1288-96 %8 2012 Jul %G eng %N 7 %R 10.1111/j.1360-0443.2012.03792.x %0 Journal Article %J Gen Hosp Psychiatry %D 2012 %T Depression in pregnancy is associated with preexisting but not pregnancy-induced hypertension. %A Katon, Wayne J %A Russo, Joan E %A Melville, Jennifer L %A Katon, Jodie G %A Gavin, Amelia R %K Adult %K Antidepressive Agents %K Depression %K Female %K Humans %K Hypertension %K Pregnancy %K Pregnancy Complications %K Prospective Studies %K Regression Analysis %K Surveys and Questionnaires %K Young Adult %X

BACKGROUND: The aim was to examine whether depression is associated with preexisting hypertension or pregnancy-induced hypertension in a large sample of women attending a university-based obstetrics clinic.

METHODS: In this prospective study, participants were 2398 women receiving ongoing prenatal care at a university-based obstetrics clinic from January 2004 through January 2009. Prevalence of depression was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria based on the Patient Health Questionnaire-9 as well as the self-reported use of antidepressant medication. Evidence of preexisting hypertension, pregnancy-induced hypertension and preeclampsia/eclampsia was determined by obstetrician International Classification of Diseases, Ninth Revision codes. Logistic regression was used to quantify the association between hypertension in pregnancy and antenatal depression.

RESULTS: After adjusting for sociodemographic variables, chronic medical conditions, smoking and prior pregnancy complications, women with preexisting hypertension had an increased risk of any depression (minor, major, use of antidepressants) [odds ratio (OR)=1.55, 95% confidence interval (CI) 1.08-2.23) and major depression and/or use of antidepressants (OR=1.65, 95% CI 1.10-2.48) compared to women without hypertension. No differences were seen in risk of depression in women with pregnancy-induced hypertension or preeclampsia/eclampsia compared to those without hypertension.

CONCLUSION: Women with preexisting hypertension, but not pregnancy-induced hypertension, are more likely to meet criteria for an antenatal depressive disorder and/or to be treated with antidepressants and could be targeted by obstetricians for screening for depression and enhanced treatment.

%B Gen Hosp Psychiatry %V 34 %P 9-16 %8 2012 Jan-Feb %G eng %N 1 %R 10.1016/j.genhosppsych.2011.09.018 %0 Journal Article %J Clin Ther %D 2012 %T Efficacy and safety profile of fluticasone furoate administered once daily in the morning or evening: a randomized, double-blind, double-dummy, placebo-controlled trial in adult and adolescent patients with persistent bronchial asthma. %A Medley, Hilary %A Orozco, Socorro %A Allen, Ann %K Administration, Inhalation %K Adolescent %K Adult %K Analysis of Variance %K Androstadienes %K Asthma %K Bronchodilator Agents %K Chile %K Double-Blind Method %K Drug Administration Schedule %K Equipment Design %K Europe %K Female %K Forced Expiratory Volume %K Glucocorticoids %K Humans %K Hydrocortisone %K Lung %K Male %K Mexico %K Middle Aged %K Models, Biological %K Nebulizers and Vaporizers %K Peak Expiratory Flow Rate %K South Africa %K Time Factors %K Treatment Outcome %K Young Adult %X

BACKGROUND: Fluticasone furoate (FF) is an inhaled corticosteroid that is structurally and functionally distinct from fluticasone propionate and is under development as a once-daily therapy for asthma.

OBJECTIVE: The objective of this study was to estimate the treatment differences (with 95% CI) in efficacy and safety profile between FF administered once daily in the morning and evening via Rotadisk Diskhaler (see text) in patients with persistent asthma. No hypothesis testing was performed for this comparison.

METHODS: This was a randomized, double-blind, double-dummy, placebo-controlled, parallel-group study. Patients (ages 16-55 years; peak expiratory flow [PEF] 50%-90% predicted) were randomized to receive 1 of 3 doses of FF Rotadisk or placebo daily for 4 weeks. The sponsor, GlaxoSmithKline, designed the study and selected the study sites. The primary end point was change from baseline in daily trough (pretreatment, prebronchodilator) PEF during the treatment period with FF Rotadisk 100 μg once daily in the morning compared with 100 μg once daily in the evening. Other end points included change from baseline in forced expiratory volume in 1 second, asthma symptom score, adverse events (AEs), 24-hour urinary cortisol excretion, and FF pharmacokinetics.

RESULTS: Five hundred and seventy-five patients (mean age 36.6 years, 56.9% female) formed the intent-to-treat population and were randomly allocated to FF Rotadisk 100 μg once daily in the morning (n = 144), FF Rotadisk 100 μg once daily in the evening (n = 146), FF Rotadisk 250 μg once daily in the evening (n = 142), or placebo (n = 143). Of these patients, 526 (91.5%) completed the study. A smaller proportion of patients in the placebo group (86.7%) than in the active treatment groups completed the study. Mean difference in PEF change from baseline with FF Rotadisk 100 μg once daily in the morning relative to evening was +13.4 L/min (95% CI, 2.3-24.4). However, morning trough values might have been affected by higher placebo response after morning dosing (18.8 vs 8.8 L/min). Trough PEF improved relative to placebo (P ≤ 0.005), with little difference between FF Rotadisk 100 μg morning (19 L/min) and evening (16 L/min) dosing, as with other efficacy measures. Frequencies of all-cause AEs were similar with FF Rotadisk (32%-39%, 2 serious AEs) and placebo (37%, 1 serious AE). No serious AEs were deemed by the investigator to be related to study treatment. Twenty-four-hour urinary cortisol increased from baseline in all groups, but the increase was significantly lower with FF Rotadisk 250 μg group than placebo.

CONCLUSION: FF Rotadisk administered once daily in the morning or evening was well tolerated and associated with improvements in lung function and asthma symptoms compared with placebo. Improvements seen for FF Rotadisk 100 μg appear to be comparable for morning and evening dosing. Clinical.trials.govNCT01499446.

%B Clin Ther %V 34 %P 1683-95 %8 2012 Aug %G eng %N 8 %R 10.1016/j.clinthera.2012.06.024 %0 Journal Article %J J Stud Alcohol Drugs %D 2012 %T Examining explanatory mechanisms of the effects of early alcohol use on young adult alcohol dependence. %A Guttmannova, Katarina %A Hill, Karl G %A Bailey, Jennifer A %A Lee, Jungeun O %A Hartigan, Lacey A %A Hawkins, J D %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Adolescent Development %K Age Factors %K Age of Onset %K Alcohol Drinking %K Alcoholism %K Child %K Female %K Humans %K Longitudinal Studies %K Male %K Young Adult %X

OBJECTIVE: This study examined potential explanatory mechanisms linking childhood alcohol use onset and chronicity of adult alcohol dependence by testing the following three competing hypotheses: (1) a marker hypothesis, where early onset of alcohol use may be simply a marker for other factors that have been linked to both age at initiation and adult alcohol problems; (2) a compromised development hypothesis, where early alcohol initiation may interfere with adolescent development, which can lead to later alcohol problems; and (3) an increased substance use hypothesis, where early onset of alcohol use may lead to increased substance use in adolescence and, in turn, chronic alcohol dependence.

METHOD: Data came from a longitudinal community sample of 808 participants recruited at age 10 in 1985. Participants were followed through age 33 in 2008 with 92% retention.

RESULTS: Childhood onset of alcohol use (before age 11), when compared with initiation during adolescence, predicted an increased chronicity of adult alcohol dependence, even after accounting for the hypothesized confounds from the marker hypothesis. In addition, adolescent compromised functioning did not mediate this relationship between early alcohol use and chronicity of adult dependence (Hypothesis 2), nor did adolescent substance use (Hypothesis 3). However, compromised functioning and substance use in adolescence predicted increased chronicity of alcohol dependence in young adulthood.

CONCLUSIONS: Prevention efforts as early as the elementary grades should focus on delaying the onset of alcohol use and reducing substance use in adolescence as well as improving school functioning, reducing adolescent problem behaviors, and targeting adolescent peer networks.

%B J Stud Alcohol Drugs %V 73 %P 379-90 %8 2012 May %G eng %N 3 %0 Journal Article %J J Homosex %D 2012 %T HIV disclosure and subsequent sexual behaviors among men who have sex with men who meet online. %A St De Lore, Jef %A Thiede, Hanne %A Cheadle, Allen %A Goldbaum, Gary %A Carey, James W %A Hutcheson, Rebecca E %A Jenkins, Richard A %A Golden, Matthew R %K Adult %K HIV Infections %K Homosexuality, Male %K Humans %K Internet %K Interviews as Topic %K Male %K Middle Aged %K Self Disclosure %K Sexual Behavior %K Unsafe Sex %K Washington %K Young Adult %X

To assess HIV disclosure discussions and related sexual behaviors among men who have sex with men (MSM) who meet sex partners online, 28 qualitative interviews with Seattle-area MSM were analyzed using grounded theory methods and themes and behavior patterns were identified. MSM found a greater ease in communicating and could prescreen partners through the Internet. However, no consistent relationship was found between HIV disclosure and subsequent behaviors: some were safer based on disclosure while perceived HIV status led others to risky behaviors. Interventions need to promote accurate disclosure while acknowledging its limitations and the need for men to self-protect.

%B J Homosex %V 59 %P 592-609 %8 2012 %G eng %N 4 %R 10.1080/00918369.2012.665704 %0 Journal Article %J J Altern Complement Med %D 2012 %T Implementation and acceptability of Mindful Awareness in Body-oriented Therapy in women's substance use disorder treatment. %A Price, Cynthia J %A Wells, Elizabeth A %A Donovan, Dennis M %A Brooks, Marissa %K Adaptation, Psychological %K Adult %K Attitude of Health Personnel %K Awareness %K Emotions %K Female %K Health Care Surveys %K Hospitalization %K Humans %K Middle Aged %K Mind-Body Therapies %K Patient Acceptance of Health Care %K Patient Dropouts %K Patient Satisfaction %K Patient Selection %K Stress, Psychological %K Substance-Related Disorders %K Surveys and Questionnaires %K Young Adult %X

OBJECTIVES: The purpose of this study was to examine the implementation and acceptability of Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to substance use disorder (SUD) treatment. The primary aims of the study were to examine implementation of MABT as an adjunct to addiction treatment, and MABT acceptability to study participants and treatment staff.

METHODS: MABT was delivered to participants randomly assigned to the intervention in a larger ongoing trial. This study focuses only on the implementation and acceptability of the intervention, as outcomes are not yet available. MABT was delivered once weekly for 8 weeks (1.5-hour sessions) and spanned inpatient and outpatient programs at a women-only treatment facility. Descriptive statistics were used to examine participant recruitment and retention to the intervention. To measure MABT acceptability, survey and written questionnaires were administered; analysis involved descriptive statistics and content analysis using Atlas.ti software.

RESULTS: Thirty-one (31) of the women enrolled in the study were randomized to MABT. Eighteen (18) participants completed 75%-100% of the MABT sessions. Intervention implementation required flexibility on the part of both the researchers and the clinic staff, and minor changes were made to successfully implement MABT as an adjunct to usual care. MABT was perceived to increase emotional awareness and provide new tools to cope with stress, and to positively influence SUD treatment by facilitating emotion regulation.

CONCLUSIONS: It was feasible to implement MABT and to recruit and retain women to MABT in women's chemical-dependency treatment. MABT acceptability and perceived benefit was high.

%B J Altern Complement Med %V 18 %P 454-62 %8 2012 May %G eng %N 5 %R 10.1089/acm.2011.0126 %0 Journal Article %J Am J Public Health %D 2012 %T Income inequality in health at all ages: a comparison of the United States and England. %A Martinson, Melissa L %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Body Mass Index %K Child %K Child, Preschool %K Continental Population Groups %K England %K Female %K Health Status %K Health Status Disparities %K Humans %K Income %K Male %K Middle Aged %K Nutrition Surveys %K Risk Factors %K Sex Factors %K United States %K Young Adult %X

OBJECTIVES: I systematically examined income gradients in health in the United States and England across the life span (ages birth to 80 years), separately for females and males, for a number of health conditions.

METHODS: Using data from the National Health and Nutrition Examination Survey for the United States (n = 36 360) and the Health Survey for England (n = 55 783), I calculated weighted prevalence rates and risk ratios by income level for the following health risk factors or conditions: obesity, hypertension, diabetes, low high-density lipoprotein cholesterol, high cholesterol ratio, heart attack or angina, stroke, and asthma.

RESULTS: In the United States and England, the income gradients in health are very similar across age, gender, and numerous health conditions, and are robust to adjustments for race/ethnicity, health behaviors, body mass index, and health insurance.

CONCLUSIONS: Health disparities by income are pervasive in England as well as in the United States, despite better overall health, universal health insurance, and more generous social protection spending in England.

%B Am J Public Health %V 102 %P 2049-56 %8 2012 Nov %G eng %N 11 %R 10.2105/AJPH.2012.300929 %0 Journal Article %J Soc Sci Med %D 2012 %T Limited English proficiency and psychological distress among Latinos and Asian Americans. %A Zhang, Wei %A Hong, Seunghye %A Takeuchi, David T %A Mossakowski, Krysia N %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Asian Americans %K Communication Barriers %K Female %K Hispanic Americans %K Humans %K Male %K Middle Aged %K Minority Groups %K Multilingualism %K Prejudice %K Socioeconomic Factors %K Stress, Psychological %K United States %K Young Adult %X

English proficiency is increasingly recognized as an important factor that is related to the mental health of immigrants and ethnic minorities. However, few studies have examined how the association between English proficiency and mental health operates and whether the pattern of association is similar or different among various ethnic minority groups. This paper investigates how limited English proficiency directly and indirectly affects psychological distress through pathways of discrimination for both Latinos and Asian Americans in the United States. Findings suggest that, for Asian Americans, limited English proficiency has an independent relationship with psychological distress over and above demographic variables, socioeconomic and immigration-related factors and discrimination. For Latinos, however, socio-demographic variables and discrimination show a stronger association than limited English proficiency in affecting psychological distress. Different forms of discrimination - everyday discrimination and racial/ethnic discrimination - are equally important for both ethnic groups. Findings underscore the differential role of limited English proficiency for the mental health of Asian Americans and Latinos and suggest the distinctive racial experiences and backgrounds of these two ethnic groups.

%B Soc Sci Med %V 75 %P 1006-14 %8 2012 Sep %G eng %N 6 %R 10.1016/j.socscimed.2012.05.012 %0 Journal Article %J J Interpers Violence %D 2012 %T Men's alcohol intoxication and condom use during sexual assault perpetration. %A Davis, Kelly Cue %A Kiekel, Preston A %A Schraufnagel, Trevor J %A Norris, Jeanette %A George, William H %A Kajumulo, Kelly F %K Adult %K Alcohol Drinking %K Alcoholic Intoxication %K Condoms %K Crime Victims %K Humans %K Internal-External Control %K Male %K Prevalence %K Rape %K Risk-Taking %K Sex Offenses %K Sexual Partners %K Young Adult %X

We assessed the association between alcohol consumption and condom use during penetrative sexual assault acts perpetrated by young adult men. Men aged 21 to 35 who reported inconsistent condom use and heavy episodic drinking (N = 225) completed a questionnaire assessing their perpetration of sexual assault since the age of 15, their consumption of alcohol prior to these acts, and their use of condoms during acts involving penetration. Descriptive statistics and Pearson's chi-square tests were used to examine the simultaneous use of alcohol and condom nonuse during penetrative sexual assault acts. More than one third of respondents reported perpetrating at least one penetrative sexual assault 35.6% (n = 79). Condoms were not used in 70.0% of penetrative sexual assaults. When they had consumed alcohol, perpetrators were significantly less likely to use condoms. The sexual assaults reported by this sample typically consisted of perpetrator alcohol consumption and the nonuse of condoms. Programs targeting sexual health and assault risk reduction would be enhanced by addressing this interplay of alcohol, violence, and risk.

%B J Interpers Violence %V 27 %P 2790-806 %8 2012 Sep %G eng %N 14 %R 10.1177/0886260512438277 %0 Journal Article %J J Subst Abuse Treat %D 2012 %T Mindful awareness in body-oriented therapy as an adjunct to women's substance use disorder treatment: a pilot feasibility study. %A Price, Cynthia J %A Wells, Elizabeth A %A Donovan, Dennis M %A Rue, Tessa %K Adult %K Anxiety %K Cognitive Therapy %K Depression %K Feasibility Studies %K Feeding and Eating Disorders %K Female %K Follow-Up Studies %K Humans %K Middle Aged %K Mind-Body Therapies %K Pilot Projects %K Recurrence %K Stress, Psychological %K Substance-Related Disorders %K Treatment Outcome %K Young Adult %X

This study examined mindful awareness in body-oriented therapy (MABT) feasibility as a novel adjunct to women's substance use disorder (SUD) treatment. As an individual therapy, MABT combines manual and mind-body approaches to develop interoception and self-care tools for emotion regulation. A 2-group randomized controlled trial repeated-measures design was used, comparing MABT to treatment as usual (TAU) on relapse to substance use and related health outcomes. Sixty-one women were screened for eligibility, and 46 enrolled. Participants randomized to MABT received 8 weekly MABT sessions. Results showed moderate to large effects, including significantly fewer days on substance use, the primary outcome, for MABT compared with TAU at posttest. Secondary outcomes showed improved eating disorder symptoms, depression, anxiety, dissociation, perceived stress, physical symptom frequency, and bodily dissociation for MABT compared with TAU at the 9-month follow-up. In conclusion, it is feasible to implement MABT in women's SUD treatment, and results suggest that MABT is worthy of further efficacy testing.

%B J Subst Abuse Treat %V 43 %P 94-107 %8 2012 Jul %G eng %N 1 %R 10.1016/j.jsat.2011.09.016 %0 Journal Article %J Intern Med J %D 2012 %T Obesity does not affect sodium picosulphate bowel preparation. %A Fok, K C %A Turner, I B %A Teoh, W C %A Levy, R L %K Adolescent %K Adult %K Aged %K Body Mass Index %K Cathartics %K Citrates %K Colonoscopy %K Humans %K Male %K Middle Aged %K Obesity %K Organometallic Compounds %K Picolines %K Young Adult %X

BACKGROUND: A previous study utilising oral polyethylene-glycol by Borg et al. concluded that obesity is an independent predictor of inadequate bowel preparation at colonoscopy.

AIM: To compare bowel preparation quality between obese and non-obese individuals as assessed by Boston bowel preparation scale (BBPS) after using sodium picosulphate.

METHODS: Prospective recruitment of patients at a day surgical unit in a New South Wales academic hospital. Bowel preparation was with Picoprep in all patients. Body Mass Index and epidemiological details were collected. Bowel preparation efficacy was assessed using the Boston Bowel Preparation Score.

RESULTS: One hundred and four patients were enrolled prospectively. Five (4.8%) were excluded owing to poor mental capacity. Sixty-three (64%) were non-obese, and 36 (36%) were obese. Fifty-seven (90%) non-obese and 32 (89%) obese patients had good bowel preparation. There was no statistical difference for sodium picosulphate bowel preparation between obese and non-obese individuals (P > 0.99) using Fisher's exact probability tests. The BBPS score in the left colon predicted the overall BBPS score in all patients (P < 0.001). Three of 99 patients (3%) did not tolerate sodium picosulphate, with nausea being the most common side-effect.

LIMITATIONS: Non-randomised study

CONCLUSIONS: There was no difference in bowel preparation quality between obese and non-obese patients using a low-volume bowel preparation (sodium picosulphate) and without dose modification of the bowel preparation. Sodium picosulphate was a welltolerated and an effective bowel preparation for obese individuals. With an increasing incidence of obesity and expanding colonoscopic indications within Australia and other Western countries from government-sponsored programs, it is paramount that procedural quality not be compromised in the obese patient.

%B Intern Med J %V 42 %P 1324-9 %8 2012 Dec %G eng %N 12 %R 10.1111/j.1445-5994.2012.02865.x %0 Journal Article %J J Prim Prev %D 2012 %T Project həli?dx(w)/Healthy Hearts Across Generations: development and evaluation design of a tribally based cardiovascular disease prevention intervention for American Indian families. %A Walters, Karina L %A LaMarr, June %A Levy, Rona L %A Pearson, Cynthia %A Maresca, Teresa %A Mohammed, Selina A %A Simoni, Jane M %A Evans-Campbell, Teresa %A Fredriksen-Goldsen, Karen %A Fryberg, Sheryl %A Jobe, Jared B %K Adolescent %K Adult %K Body Mass Index %K Cardiovascular Diseases %K Community-Based Participatory Research %K Community-Institutional Relations %K Cultural Competency %K Family Relations %K Humans %K Indians, North American %K Inuits %K Life Style %K Male %K Motivational Interviewing %K Northwestern United States %K Parents %K Risk Factors %K Young Adult %X

American Indian and Alaska Native (AIAN) populations are disproportionately at risk for cardiovascular disease (CVD), diabetes, and obesity, compared with the general US population. This article describes the həli?dx(w)/Healthy Hearts Across Generations project, an AIAN-run, tribally based randomized controlled trial (January 2010-June 2012) designed to evaluate a culturally appropriate CVD risk prevention program for AI parents residing in the Pacific Northwest of the United States. At-risk AIAN adults (n = 135) were randomly assigned to either a CVD prevention intervention arm or a comparison arm focusing on increasing family cohesiveness, communication, and connectedness. Both year-long conditions included 1 month of motivational interviewing counseling followed by personal coach contacts and family life-skills classes. Blood chemistry, blood pressure, body mass index, food intake, and physical activity were measured at baseline and at 4- and 12-month follow-up times.

%B J Prim Prev %V 33 %P 197-207 %8 2012 Aug %G eng %N 4 %R 10.1007/s10935-012-0274-z %0 Journal Article %J Addict Behav %D 2012 %T Review of risk and protective factors of substance use and problem use in emerging adulthood. %A Stone, Andrea L %A Becker, Linda G %A Huber, Alice M %A Catalano, Richard F %K Adolescent %K Adult %K Behavior, Addictive %K Family %K Female %K Humans %K Male %K Residence Characteristics %K Risk Factors %K Social Facilitation %K Socioeconomic Factors %K Substance-Related Disorders %K Young Adult %X

This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues (Hawkins, Catalano, & Miller, 1992). Predictors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research.

%B Addict Behav %V 37 %P 747-75 %8 2012 Jul %G eng %N 7 %R 10.1016/j.addbeh.2012.02.014 %0 Journal Article %J J Adolesc Health %D 2012 %T Romantic relationship characteristics and alcohol use: longitudinal associations with dual method contraception use. %A Bailey, Jennifer A %A Fleming, Charles B %A Catalano, Richard F %A Haggerty, Kevin P %A Manhart, Lisa E %K Adult %K Age Factors %K Alcohol Drinking %K Contraception %K Contraception Behavior %K Female %K Humans %K Interpersonal Relations %K Linear Models %K Male %K Multivariate Analysis %K Sexual Behavior %K Sexually Transmitted Diseases %K Time Factors %K Young Adult %X

PURPOSE: Dual method contraception use, or the use of one type of contraceptive intended to prevent pregnancy combined with another type intended to reduce the risk of sexually transmitted infection, may be the most effective method to prevent both unintended pregnancy and sexually transmitted infection. This study tested the association between relationship length, relationship type (married, cohabiting, dating but not cohabiting), global alcohol use, and situational alcohol use and the probability of dual method contraception use from 20 to 23 years of age.

METHODS: Hierarchical linear modeling analyses were conducted using longitudinal data from 754 sexually active male and female young adults aged 20-23 years. Dependent variables included both any dual method contraception use and consistent dual method contraception use.

RESULTS: Between 15% and 20% of respondents reported consistent dual method contraception use at each time point. Longer relationship length and more committed relationship type were associated with a lower probability of both any and consistent dual method contraception use. Situational alcohol use (drinking before sex), but not global alcohol use, also was related to a lower probability of both any and consistent dual method contraception use. Increasing age was associated with a lower probability of any dual method contraception use, but was not related to consistent dual method use.

CONCLUSIONS: Efforts to promote dual method contraception among young adults should include messages discouraging drinking before sex and supporting dual method use even in the context of committed relationships.

%B J Adolesc Health %V 50 %P 450-5 %8 2012 May %G eng %N 5 %R 10.1016/j.jadohealth.2011.09.008 %0 Journal Article %J Lancet %D 2012 %T Worldwide application of prevention science in adolescent health. %A Catalano, Richard F %A Fagan, Abigail A %A Gavin, Loretta E %A Greenberg, Mark T %A Irwin, Charles E %A Ross, David A %A Shek, Daniel T L %K Adolescent Medicine %K Child %K Global Health %K Government Programs %K Health Behavior %K Health Status %K Humans %K Public Health %K Young Adult %X

The burden of morbidity and mortality from non-communicable disease has risen worldwide and is accelerating in low-income and middle-income countries, whereas the burden from infectious diseases has declined. Since this transition, the prevention of non-communicable disease as well as communicable disease causes of adolescent mortality has risen in importance. Problem behaviours that increase the short-term or long-term likelihood of morbidity and mortality, including alcohol, tobacco, and other drug misuse, mental health problems, unsafe sex, risky and unsafe driving, and violence are largely preventable. In the past 30 years new discoveries have led to prevention science being established as a discipline designed to mitigate these problem behaviours. Longitudinal studies have provided an understanding of risk and protective factors across the life course for many of these problem behaviours. Risks cluster across development to produce early accumulation of risk in childhood and more pervasive risk in adolescence. This understanding has led to the construction of developmentally appropriate prevention policies and programmes that have shown short-term and long-term reductions in these adolescent problem behaviours. We describe the principles of prevention science, provide examples of efficacious preventive interventions, describe challenges and potential solutions to take efficacious prevention policies and programmes to scale, and conclude with recommendations to reduce the burden of adolescent mortality and morbidity worldwide through preventive intervention.

%B Lancet %V 379 %P 1653-64 %8 2012 Apr 28 %G eng %N 9826 %R 10.1016/S0140-6736(12)60238-4 %0 Journal Article %J Dev Psychopathol %D 2011 %T Allostasis model facilitates understanding race differences in the diurnal cortisol rhythm. %A Skinner, Martie L %A Shirtcliff, Elizabeth A %A Haggerty, Kevin P %A Coe, Christopher L %A Catalano, Richard F %K Adolescent %K African Continental Ancestry Group %K Allostasis %K Circadian Rhythm %K Continental Population Groups %K European Continental Ancestry Group %K Female %K Humans %K Hydrocortisone %K Longitudinal Studies %K Male %K Saliva %K Sex Factors %K Stress, Psychological %K Young Adult %X

The concept of allostasis suggests that greater cumulative stress burden can influence stress-responsive physiology. Dysregulation of allostatic mediators, including the hypothalamic-pituitary-adrenal (HPA) axis, is thought to precede many other signs of age-related pathology as the persistent burden of stressors accumulates over the individual's life span. We predicted that even in young adulthood, HPA regulation would differ between Blacks and Whites, reflecting, in part, higher rates of stressor exposure and greater potential for stressors to "get under the skin." We examined whether stressor exposure, including experiences with racism and discrimination, explained race differences in waking cortisol and the diurnal rhythm. We also examined whether HPA functioning was associated with mental health outcomes previously linked to cortisol. Salivary cortisol was assayed in 275 young adults (127 Blacks, 148 Whites, 19 to 22 years old), four times a day across 3 days. Hierarchical linear models revealed flatter slopes for Blacks, reflecting significantly lower waking and higher bedtime cortisol levels compared to Whites. Associations of HPA functioning with stressors were typically more robust for Whites such that more stress exposure created an HPA profile that resembled that of Black young adults. For Blacks, greater stressor exposure did not further impact HPA functioning, or, when significant, was often associated with higher cortisol levels. Across both races, flatter slopes generally indicated greater HPA dysregulation and were associated with poor mental health outcomes. These differential effects were more robust for Whites. These findings support an allostatic model in which social contextual factors influence normal biorhythms, even as early as young adulthood.

%B Dev Psychopathol %V 23 %P 1167-86 %8 2011 Nov %G eng %N 4 %R 10.1017/S095457941100054X %0 Journal Article %J Arch Sex Behav %D 2011 %T Associations between changing developmental contexts and risky sexual behavior in the two years following high school. %A Bailey, Jennifer A %A Haggerty, Kevin P %A White, Helene R %A Catalano, Richard F %K Attitude to Health %K Comorbidity %K Condoms %K Female %K Humans %K Interpersonal Relations %K Longitudinal Studies %K Male %K Risk-Taking %K Sexual Partners %K Sexually Transmitted Diseases %K Social Environment %K Socioeconomic Factors %K Substance-Related Disorders %K Unsafe Sex %K Young Adult %X

The present study tested associations between common developmental contexts (relationship involvement, independent living, college attendance, work) and risky sexual behavior (casual sex, inconsistent condom use, high-risk sex) across the 2 years following high school. Data were drawn from the Raising Healthy Children project, and included 801 participants aged 18-21 years. Longitudinal analyses, which controlled for early sexual debut, high school substance use, and high school grades, showed that living with a parent was protective against all three sexual risk behavior outcomes (ORs about 0.70). Being in a romantic relationship was associated with a lower probability of casual sex, but a higher probability of inconsistent condom use. Attending college was associated with a lower probability of high-risk sex (OR = 0.67). Working was not related to the sexual risk behaviors examined. Levels of sexual risk behavior showed little change across the 2 years following high school. Findings from this study suggest that developmental context may affect young adults' engagement in risky sexual behavior. Programs aimed at promoting sexual health and reducing risk behaviors for STIs among young adults should consider targeting those in romantic relationships, those not living with parents, and those not attending college. Further, to develop effective prevention programs for these targeted youth, it is critical that we understand the mechanisms leading to risky sex in these groups.

%B Arch Sex Behav %V 40 %P 951-60 %8 2011 Oct %G eng %N 5 %R 10.1007/s10508-010-9633-0 %0 Journal Article %J AIDS Patient Care STDS %D 2011 %T Buffering effects of general and medication-specific social support on the association between substance use and HIV medication adherence. %A Lehavot, Keren %A Huh, David %A Walters, Karina L %A King, Kevin M %A Andrasik, Michele P %A Simoni, Jane M %K Adult %K Anti-HIV Agents %K Antiretroviral Therapy, Highly Active %K Female %K HIV Infections %K Humans %K Male %K Middle Aged %K Patient Compliance %K Social Support %K Socioeconomic Factors %K Substance-Related Disorders %K Young Adult %X

The success of highly active antiretroviral therapy (HAART) among persons living with HIV is largely dependent on strict medication adherence. Recent research suggests that alcohol and other drug use (AOD) may be an important barrier to HAART adherence. In this study, we examined the impact of AOD on HAART adherence as well as the moderating effects of general and medication-specific social support. The data were collected as part of a longitudinal randomized control trial with 224 HIV-positive patients at an HIV primary care clinic in the northwestern United States. Findings indicated that AOD use was negatively associated with HAART adherence and that medication-specific (but not general) social support moderated the AOD-adherence association at 3 (but not at 6 or 9) months. Results indicate the importance of medication-specific social support to treat comorbid AOD use and HIV; implications for future research and intervention programs for HIV-positive AOD users are discussed.

%B AIDS Patient Care STDS %V 25 %P 181-9 %8 2011 Mar %G eng %N 3 %R 10.1089/apc.2010.0314 %0 Journal Article %J Crim Behav Ment Health %D 2011 %T Bullying at elementary school and problem behaviour in young adulthood: a study of bullying, violence and substance use from age 11 to age 21. %A Kim, Min J %A Catalano, Richard F %A Haggerty, Kevin P %A Abbott, Robert D %K Adolescent %K Alcoholism %K Bullying %K Child %K Female %K Humans %K Longitudinal Studies %K Male %K Marijuana Abuse %K Regression Analysis %K Schools %K Students %K Surveys and Questionnaires %K Violence %K Young Adult %X

AIM: The main aim of this paper is to investigate to what extent self-reported bullying at Grade 5 predicts later violence, heavy drinking and marijuana use at age 21.

METHOD: Univariate and multivariate associations between bullying and later outcomes were examined based on a longitudinal community sample of 957 young people from the Raising Healthy Children project.

RESULTS: Childhood bullying was significantly associated with violence, heavy drinking and marijuana use at age 21. These associations held up after controlling for prior risk factors.

CONCLUSIONS: Childhood bullying had unique associations with risk of later violence and substance use among young adults. Early intervention to prevent childhood bullying may also reduce other adverse outcomes later in life.

%B Crim Behav Ment Health %V 21 %P 136-44 %8 2011 Apr %G eng %N 2 %R 10.1002/cbm.804 %0 Journal Article %J AIDS Behav %D 2011 %T Change in sexual activity 12 months after ART initiation among HIV-positive Mozambicans. %A Pearson, Cynthia R %A Cassels, Susan %A Kurth, Ann E %A Montoya, Pablo %A Micek, Mark A %A Gloyd, Stephen S %K Adult %K Anti-Retroviral Agents %K Female %K Follow-Up Studies %K HIV Infections %K Humans %K Logistic Models %K Male %K Middle Aged %K Mozambique %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Socioeconomic Factors %K Truth Disclosure %K Young Adult %X

We assessed sexual behaviors before and 12-months after ART initiation among 277 Mozambicans attending an HIV clinic. Measured behaviors included the number of sexual partners, condom use, concurrent relationships, disclosure of HIV status, alcohol use, and partners' serostatus. Compared to before ART initiation, increases were seen 12 months after ART in the proportion of participants who were sexually active (48% vs. 64% respondents, P < 0.001) and the proportion of participants with HIV-negative or unknown serostatus partners (45% vs. 80%, P < 0.001). Almost all (96%) concurrent partnerships reported at 12 months formed after ART initiation. Although reported correct and consist condom use increased, the number of unprotected sexual relationships remained the same (n = 45). Non-disclosure of HIV-serostatus to sexual partners was the only significant predictor of practicing unprotected sex with partners of HIV-negative or unknown serostatus. Sexual activity among HIV-positive persons on ART increased 12 months after ART initiation. Ongoing secondary transmission prevention programs addressing sexual activity with multiple partners, disclosure to partners and consistent condom use with serodisconcordant partners must be incorporated throughout HIV care programs.

%B AIDS Behav %V 15 %P 778-87 %8 2011 May %G eng %N 4 %R 10.1007/s10461-010-9852-3 %0 Journal Article %J J Womens Health (Larchmt) %D 2011 %T Diabetes and depression in pregnancy: is there an association? %A Katon, Jodie G %A Russo, Joan %A Gavin, Amelia R %A Melville, Jennifer L %A Katon, Wayne J %K Adult %K Attitude to Health %K Cohort Studies %K Comorbidity %K Cross-Sectional Studies %K Depression %K Diabetes, Gestational %K Female %K Humans %K Pregnancy %K Pregnancy in Diabetics %K Prenatal Care %K Prevalence %K Prospective Studies %K Quality of Life %K Risk Factors %K United States %K Women's Health %K Young Adult %X

BACKGROUND: Prior studies have reported inconsistent findings regarding the association of antenatal depression with pregnancy-related diabetes. This study examined the association of diabetes and antenatal depression.

METHODS: We conducted a cross-sectional analysis of baseline data from a prospective cohort study of pregnant women receiving prenatal care at a single University of Washington Medical Center clinic between January 2004 and January 2009. The primary exposure was diabetes in pregnancy (no diabetes, preexisting diabetes, or gestational diabetes [GDM]). Antenatal depression was defined by the Patient Health Questionnaire-9 (PHQ-9) score or current use of antidepressants. Antenatal depression was coded as (1) any depression (probable major or minor depression by PHQ-9 or current antidepressant use) and (2) major depression (probable major depression by PHQ-9 or current antidepressant use). Logistic regression was used to quantify the association between diabetes in pregnancy and antenatal depression.

RESULTS: The prevalences of preexisting diabetes, GDM, any antenatal depression, and major antenatal depression were 9%, 18%, 13.6%, and 9.8%, respectively. In the unadjusted analysis, women with preexisting diabetes had 54% higher odds of any antenatal depression compared to those without diabetes (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.08-2.21). After adjusting for important covariates the association was attenuated (OR 1.16, 95% CI 0.79-1.71). Results were similar for antenatal major depression. GDM was not associated with increased odds for any antenatal depression or antenatal major depression.

CONCLUSIONS: Neither preexisting diabetes nor GDM was independently associated with increased risk of antenatal depression.

%B J Womens Health (Larchmt) %V 20 %P 983-9 %8 2011 Jul %G eng %N 7 %R 10.1089/jwh.2010.2662 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Early age alcohol use and later alcohol problems in adolescents: Individual and peer mediators in a bi-national study. %A Mason, W A %A Toumbourou, John W %A Herrenkohl, Todd I %A Hemphill, Sheryl A %A Catalano, Richard F %A Patton, George C %K Adolescent %K Adolescent Behavior %K Age of Onset %K Alcohol Drinking %K Alcohol-Related Disorders %K Cross-Cultural Comparison %K Female %K Humans %K Impulsive Behavior %K Longitudinal Studies %K Male %K Models, Statistical %K Peer Group %K Risk Factors %K Risk-Taking %K Social Control, Informal %K Students %K Substance-Related Disorders %K Victoria %K Washington %K Young Adult %X

This paper examines whether there is cross-national similarity in the longitudinal relationship between early age alcohol use and adolescent alcohol problems. Potential mechanisms underlying this relationship also are examined, testing adolescent alcohol use, low self-regulation, and peer deviance as possible mediators. Students (N = 1,945) participating in the International Youth Development Study, a longitudinal panel survey study, responded to questions on alcohol use and influencing factors, and were followed annually over a 3-year period from 2002 to 2004 (98% retention rate). State-representative, community student samples were recruited in grade 7 in Washington State, United States (US, n = 961, 78% of those eligible; Mage = 13.09, SD = .44) and Victoria, Australia (n = 984, 76% of those eligible; Mage = 12.93, SD = .41). Analyses were conducted using multiple-group structural equation modeling. In both states, early age alcohol use (age 13) had a small but statistically significant association with subsequent alcohol problems (age 15). Overall, there was little evidence for mediation of early alcohol effects. Low self-regulation prospectively predicted peer deviance, alcohol use, and alcohol problems in both states. Peer deviance was more positively related to alcohol use and low self-regulation among students in Victoria compared to students in Washington State. The small but persistent association of early age alcohol use with alcohol problems across both samples is consistent with efforts to delay alcohol initiation to help prevent problematic alcohol use. Self-regulation was an important influence, supporting the need to further investigate the developmental contribution of neurobehavioral disinhibition.

%B Psychol Addict Behav %V 25 %P 625-33 %8 2011 Dec %G eng %N 4 %R 10.1037/a0023320 %0 Journal Article %J Exp Clin Psychopharmacol %D 2011 %T The effects of acute alcohol intoxication, partner risk level, and general intention to have unprotected sex on women's sexual decision making with a new partner. %A Purdie, Michele Parkhill %A Norris, Jeanette %A Davis, Kelly Cue %A Zawacki, Tina %A Morrison, Diane M %A George, William H %A Kiekel, Preston A %K Acquired Immunodeficiency Syndrome %K Adult %K Alcohol Drinking %K Alcoholic Intoxication %K Alcoholism %K Breath Tests %K Central Nervous System Depressants %K Cognition %K Computers %K Condoms %K Decision Making %K Dose-Response Relationship, Drug %K Ethanol %K Female %K HIV Infections %K Humans %K Intention %K Models, Psychological %K Risk %K Risk-Taking %K Sexual Behavior %K Sexual Partners %K Software %K Unsafe Sex %K Young Adult %X

Women account for a quarter of all new HIV/AIDS cases, with approximately 65% having contracted the infection via heterosexual contact. Few experimental studies have examined interactions among background, partner, and situational characteristics in predicting women's sexual decisions. The Cognitive Mediation Model provides a useful theoretical framework for assessing likelihood of unprotected sex. Female social drinkers (n = 230) who had answered questions related to their general intention to have unprotected sex were randomly assigned to an experimental condition based on partner risk level (unknown, low, high) and beverage (control, placebo, low dose, high dose). Participants projected themselves into a story depicting a sexual situation with a man and answered questions about their cognitive appraisals, assertive condom request, and likelihood of unprotected sex. Alcohol effects on appraisal of sexual potential differed by partner risk condition. In the unknown and low risk conditions, placebo and alcohol participants appraised the situation as having greater sexual potential than controls whereas in the high risk condition, only those who consumed alcohol did so. Sexual potential appraisals in turn predicted impelling cognitions about having sex, which in turn predicted assertive condom request and unprotected sex intentions. General intention for unprotected sex independently predicted cognitive appraisals and outcomes. These findings highlight the need for prevention programs that focus on teaching women how to pay attention and consider sexual risk cues presented by potential partners, particularly when under the influence of alcohol.

%B Exp Clin Psychopharmacol %V 19 %P 378-88 %8 2011 Oct %G eng %N 5 %R 10.1037/a0024792 %0 Journal Article %J J Adolesc Health %D 2011 %T An examination of the validity of retrospective measures of suicide attempts in youth. %A Mazza, James J %A Catalano, Richard F %A Abbott, Robert D %A Haggerty, Kevin P %K Adolescent %K Anxiety %K Attitude to Health %K Child %K Comorbidity %K Depression %K Female %K Humans %K Impulsive Behavior %K Interpersonal Relations %K Longitudinal Studies %K Male %K Peer Group %K Retrospective Studies %K Risk Factors %K Risk-Taking %K Self Concept %K Socioeconomic Factors %K Suicide, Attempted %K United States %K Young Adult %X

PURPOSE: This study used prospective data to investigate the validity of a retrospective measure of suicide attempts from four different perspectives.

METHODS: Data were retrieved from 883 participants in the Raising Healthy Children project, a longitudinal study of youth recruited from a Pacific Northwest school district. The retrospective measure was collected when participants were 18-19 years of age and results were compared with measures of depressive symptoms collected prospectively.

RESULTS: Results showed strong corroboration between retrospective reports of first suicide attempt and prospective measures of depression, with attempters experiencing significantly more depression than their nonattempting peers, t (df = 853) = 10.26, p < .001. In addition, within the attempter group, depression scores during the year of their reported first attempt were significantly higher than the average depression score across previous years, t (df = 67) = 3.01, p < .01.

CONCLUSIONS: Results from this study suggest that the reports of older adolescents regarding their suicide attempts are corroborated by their prospective reports of depression in childhood and earlier adolescence. Thus, there is support that retrospective measures of suicidal behavior, namely suicide attempts, may be a valid method of assessment.

%B J Adolesc Health %V 49 %P 532-7 %8 2011 Nov %G eng %N 5 %R 10.1016/j.jadohealth.2011.04.009 %0 Journal Article %J Am J Epidemiol %D 2011 %T Health across the life span in the United States and England. %A Martinson, Melissa L %A Teitler, Julien O %A Reichman, Nancy E %K Adolescent %K Adult %K Age Distribution %K Aged %K Aged, 80 and over %K Asthma %K Biomarkers %K Body Mass Index %K Cardiovascular Diseases %K Child %K Child, Preschool %K Chronic Disease %K Cross-Cultural Comparison %K Diabetes Mellitus %K England %K Female %K Health Surveys %K Humans %K Infant %K Infant, Newborn %K Life Expectancy %K Lipids %K Male %K Middle Aged %K Sex Distribution %K United States %K Young Adult %X

This study systematically compared health indicators in the United States and England from childhood through old age (ages 0-80 years). Data were from the 1999-2006 National Health and Nutrition Examination Survey for the United States (n = 39,849) and the 2003-2006 Health Survey for England (n = 69,084). Individuals in the United States have higher rates of most chronic diseases and markers of disease than their same-age counterparts in England. Differences at young ages are as large as those at older ages for most conditions, including obesity, low high-density lipoprotein cholesterol, high cholesterol ratio, high C-reactive protein, hypertension (for females), diabetes, asthma, heart attack or angina (for females), and stroke (for females). For males, heart attack or angina is higher in the United States only at younger ages, and hypertension is higher in England than in the United States at young ages. The patterns were similar when the sample was restricted to whites, the insured, nonobese, nonsmoking nondrinkers, and specific income categories and when stratified by normal weight, overweight, and obese weight categories. The findings from this study indicate that US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role.

%B Am J Epidemiol %V 173 %P 858-65 %8 2011 Apr 15 %G eng %N 8 %R 10.1093/aje/kwq325 %0 Journal Article %J Vaccine %D 2011 %T HPV vaccination among a community sample of young adult women. %A Manhart, Lisa E %A Burgess-Hull, Albert J %A Fleming, Charles B %A Bailey, Jennifer A %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Demography %K Educational Status %K Female %K Health Knowledge, Attitudes, Practice %K Humans %K Interviews as Topic %K Longitudinal Studies %K Male %K Papillomavirus Infections %K Papillomavirus Vaccines %K Patient Acceptance of Health Care %K Smoking %K United States %K Vaccination %K Washington %K Young Adult %X

OBJECTIVES: Despite the high efficacy of the human papillomavirus (HPV) vaccine, uptake has been slow and little data on psychosocial barriers to vaccination exist.

METHODS: A community sample of 428 women enrolled in a longitudinal study of social development in the Seattle WA metropolitan area were interviewed about HPV vaccine status, attitudes, and barriers to HPV vaccination in spring 2008 or 2009 at ∼age 22.

RESULTS: Nineteen percent of women had initiated vaccination, 10% had completed the series, and ∼40% of unvaccinated women intended to get vaccinated. Peer approval was associated with vaccine initiation (adjusted prevalence ratio (APR) 2.1; 95% confidence interval 1.4-3.2) and intention to vaccinate (APR 1.4; 1.1-1.9). Belief the vaccine is <75% effective was associated with less initiation (APR 0.6; 0.4-0.9) or intention to vaccinate (APR 0.5; 0.4-0.7). Vaccine initiation was also less likely among cigarette smokers and illegal drug users, whereas intention to vaccinate was more common among women currently attending school or with >5 lifetime sex partners, but less common among women perceiving low susceptibility to HPV (APR 0.6; 0.5-0.9).

CONCLUSIONS: HPV vaccination uptake was low in this community sample of young adult women. Increasing awareness of susceptibility to HPV and the high efficacy of the vaccine, along with peer interventions to increase acceptability, may be most effective.

%B Vaccine %V 29 %P 5238-44 %8 2011 Jul 18 %G eng %N 32 %R 10.1016/j.vaccine.2011.05.024 %0 Journal Article %J Drug Alcohol Depend %D 2011 %T An initial trial of a computerized behavioral intervention for cannabis use disorder. %A Budney, Alan J %A Fearer, Stephanie %A Walker, Denise D %A Stanger, Catherine %A Thostenson, Jeff %A Grabinski, Michael %A Bickel, Warren K %K Adult %K Cognitive Therapy %K Computer-Assisted Instruction %K Female %K Humans %K Male %K Marijuana Abuse %K Motivation %K Young Adult %X

The most potent outcomes for cannabis use disorders have been observed with a combination of three evidence-based interventions, motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), and abstinence-based contingency-management (CM). Access to this intervention remains limited because of cost and service availability issues. This report describes the initial stages of a project designed to develop and test a computer-assisted version of MET/CBT/CM that could address many of the current barriers to its dissemination. A nonrandomized, 12-week comparison study assigned 38 adults seeking treatment for a cannabis use disorder to either therapist-delivered (n=22) or computer-delivered (n=16) MET/CBT/CM. Attendance, retention, and cannabis use outcomes did not differ significantly between groups, and there were no indications of superior outcomes favoring therapist delivery. Participants provided positive ratings of the computer-delivered sessions. These preliminary findings suggest that computer-assisted delivery of MET/CBT/CM is acceptable to outpatients and does not adversely impact compliance or outcomes achieved during treatment with MET/CBT/CM for cannabis use disorders. Assessment of post-treatment outcomes and replication in randomized trials are needed to determine reliability and longer term effects. As observed in a growing number of studies, computerized therapies have the potential to increase access to, reduce costs, and enhance fidelity of providing evidence-based treatments without sacrificing and possibly enhancing effectiveness.

%B Drug Alcohol Depend %V 115 %P 74-9 %8 2011 May 1 %G eng %N 1-2 %R 10.1016/j.drugalcdep.2010.10.014 %0 Journal Article %J J Interpers Violence %D 2011 %T Intimate partner survivors' help-seeking and protection efforts: a person-oriented analysis. %A Nurius, Paula S %A Macy, Rebecca J %A Nwabuzor, Ijeoma %A Holt, Victoria L %K Adolescent %K Adult %K Aged %K Analysis of Variance %K Battered Women %K Cohort Studies %K Depression %K Female %K Humans %K Interpersonal Relations %K Male %K Middle Aged %K Patient Acceptance of Health Care %K Sexual Partners %K Socioeconomic Factors %K Spouse Abuse %K Surveys and Questionnaires %K Survivors %K Washington %K Young Adult %X

Domestic violence advocates and researchers advocate for a survivor-centered approach for assisting women experiencing intimate partner violence (IPV), with individualized safety plans and services; yet little empirical work has been done to determine IPV survivors' specific combinations of vulnerabilities and assets that might inform such an approach. Using latent profile analysis of a cohort of 448 survivors, five distinct subgroups were previously identified in terms of biopsychosocial asset and vulnerability profiles. The purpose of the current study was to apply person-oriented methodology for survivor-centered investigation of differences in help-seeking and protective actions according to subgroup membership within this cohort. Though not differing demographically, the subgroups were found to differ significantly and meaningfully in their patterns of IPV help-seeking and protective actions. Thus, reliance on population-aggregate linear relationships between IPV exposure and safety efforts may risk overlooking important variation by vulnerability and asset profile, and knowledge of distinct clusters among functioning profiles may help with understanding of survivors' coping strategies.The authors outline service-need considerations across the subgroups and provide guidance for targeted outreach, locating IPV survivors and matching services to their needs.

%B J Interpers Violence %V 26 %P 539-66 %8 2011 Feb %G eng %N 3 %R 10.1177/0886260510363422 %0 Journal Article %J Ann Behav Med %D 2011 %T 'I've had unsafe sex so many times why bother being safe now?': the role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men. %A Nelson, Kimberly M %A Simoni, Jane M %A Pearson, Cynthia R %A Walters, Karina L %K Adult %K Alaska %K Attitude to Health %K Cognition %K Condoms %K Cross-Sectional Studies %K HIV Infections %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Multivariate Analysis %K Risk Factors %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Stress Disorders, Post-Traumatic %K Surveys and Questionnaires %K Unsafe Sex %K Young Adult %X

BACKGROUND: American Indian/Alaska Native (AI/AN) men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) acquisition and transmission.

PURPOSE: This study aimed to investigate a potential area of focus for HIV prevention interventions by assessing the impact of sexual risk cognitions on sexual risk-taking among AI/AN MSM.

METHODS: AI/AN MSM (N = 173) from a national cross-sectional survey were analyzed.

RESULTS: Reporting more frequent sexual risk cognitions overall (high sexual risk cognitions) was associated with multiple HIV risk factors including unprotected anal intercourse and serodiscordant unprotected anal intercourse. Participants with high sexual risk cognitions had a 2.3 (95% Confidence Interval: 1.1, 4.7) times greater odds of engaging in unprotected anal intercourse regardless of childhood sexual abuse, depression, and alcohol dependence. Most individual sexual risk cognitions were associated with unprotected anal intercourse, serodiscordant unprotected anal intercourse, or both.

CONCLUSIONS: Results suggest that sexual risk cognitions may be a productive area for further work on HIV prevention among AI/AN MSM.

%B Ann Behav Med %V 42 %P 370-80 %8 2011 Dec %G eng %N 3 %R 10.1007/s12160-011-9302-0 %0 Journal Article %J Soc Sci Med %D 2011 %T A life course perspective on migration and mental health among Asian immigrants: the role of human agency. %A Gong, Fang %A Xu, Jun %A Fujishiro, Kaori %A Takeuchi, David T %K Acculturation %K Adolescent %K Adult %K Age Factors %K Aged %K Aged, 80 and over %K Asian Americans %K Emigrants and Immigrants %K Female %K Humans %K Life Change Events %K Male %K Mental Health %K Middle Aged %K Motivation %K Stress, Psychological %K United States %K Young Adult %X

The relationship between human agency and health is an important yet under-researched topic. This study uses a life course perspective to examine how human agency (measured by voluntariness, migratory reasons, and planning) and timing (measured by age at immigration) affect mental health outcomes among Asian immigrants in the United States. Data from the National Latino and Asian American Study showed that Asian immigrants (n=1491) with multiple strong reasons to migrate were less likely to suffer from mental health problems (i.e., psychological distress and psychiatric disorders in the past 12 months) than those without clear goals. Moreover, Asian immigrants with adequate migratory planning had lower levels of distress and lower rates of 12-month psychiatric disorders than those with poorly planned migration. Compared with migrants of the youngest age category (six or younger), those who migrated during preteen and adolescent years without clear goals had higher levels of psychological distress, and those who migrated during adulthood (25 years or older) were less likely to suffer from recent depressive disorders (with the exception of those migrating for life-improving goals). Furthermore, we found that well-planned migration lowered acculturative stress, and multiple strong reasons for migration buffered the negative effect of acculturative stress upon mental health. Findings from this study advance research on immigrant health from the life course perspective by highlighting the effects of exercising human agency during the pre-migration stage upon post-migration mental health.

%B Soc Sci Med %V 73 %P 1618-26 %8 2011 Dec %G eng %N 11 %R 10.1016/j.socscimed.2011.09.014 %0 Journal Article %J Violence Against Women %D 2011 %T The long arc of recovery: characterizing intimate partner violence and its psychosocial effects across 17 years. %A Lindhorst, Taryn %A Beadnell, Blair %K Adaptation, Psychological %K Adolescent %K Adult %K Alcohol Drinking %K Anxiety %K Battered Women %K Child %K Depression %K Female %K Follow-Up Studies %K Humans %K Interpersonal Relations %K Male %K Mental Health %K Poverty %K Pregnancy %K Sexual Partners %K Spouse Abuse %K Time %K Young Adult %X

Little is known about how intimate partner violence (IPV) affects women's long-term mental health. Using 17 years of data from adolescent mothers, this study (a) empirically identified three subgroups based on patterns of IPV exposure during 4 years of their adolescence; (b) found that subgroup membership was a predictor of psychosocial outcomes in the subsequent 13 years, and (c) showed that the long-term effects of IPV exposure persisted even while controlling for the role of early poverty. By their 30s, women had recovered from IPV such that there were no significant differences between groups at the final time point.

%B Violence Against Women %V 17 %P 480-99 %8 2011 Apr %G eng %N 4 %R 10.1177/1077801211404548 %0 Journal Article %J Cultur Divers Ethnic Minor Psychol %D 2011 %T Measuring multiple minority stress: the LGBT People of Color Microaggressions Scale. %A Balsam, Kimberly F %A Molina, Yamile %A Beadnell, Blair %A Simoni, Jane %A Walters, Karina %K Adaptation, Psychological %K Adolescent %K Adult %K Aged %K Aggression %K Bisexuality %K Ethnic Groups %K Female %K Focus Groups %K Homosexuality %K Humans %K Male %K Middle Aged %K Prejudice %K Self Report %K Sex Factors %K Social Desirability %K Stereotyping %K Stress, Psychological %K Surveys and Questionnaires %K Washington %K Young Adult %X

Lesbian, gay, and bisexual individuals who are also racial/ethnic minorities (LGBT-POC) are a multiply marginalized population subject to microaggressions associated with both racism and heterosexism. To date, research on this population has been hampered by the lack of a measurement tool to assess the unique experiences associated with the intersection of these oppressions. To address this gap in the literature, we conducted a three-phase, mixed method empirical study to assess microaggressions among LGBT-POC. The LGBT People of Color Microaggressions Scale is an 18-item self-report scale assessing the unique types of microaggressions experienced by ethnic minority LGBT adults. The measure includes three subscales: (a) Racism in LGBT communities, (b) Heterosexism in Racial/Ethnic Minority Communities, and (c) Racism in Dating and Close Relationships, that are theoretically consistent with prior literature on racial/ethnic minority LGBTs and have strong psychometric properties including internal consistency and construct validity in terms of correlations with measures of psychological distress and LGBT-identity variables. Men scored higher on the LGBT-PCMS than women, lesbians and gay men scored higher than bisexual women and men, and Asian Americans scored higher than African Americans and Latina/os.

%B Cultur Divers Ethnic Minor Psychol %V 17 %P 163-74 %8 2011 Apr %G eng %N 2 %R 10.1037/a0023244 %0 Journal Article %J J Stud Alcohol Drugs %D 2011 %T Men's and women's pathways to adulthood and associated substance misuse. %A Oesterle, Sabrina %A Hawkins, J D %A Hill, Karl G %K Adolescent %K Adolescent Behavior %K Adolescent Development %K Adult %K Educational Status %K Female %K Humans %K Longitudinal Studies %K Male %K Parenting %K Prospective Studies %K Risk Factors %K Sex Factors %K Single Person %K Smoking %K Substance-Related Disorders %K Urban Health %K Washington %K Young Adult %X

OBJECTIVE: Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33.

METHOD: Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention.

RESULTS: Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early.

CONCLUSIONS: Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns.

%B J Stud Alcohol Drugs %V 72 %P 763-73 %8 2011 Sep %G eng %N 5 %0 Journal Article %J Addict Behav %D 2011 %T Is nonmedical prescription opiate use a unique form of illicit drug use? %A Catalano, Richard F %A White, Helene R %A Fleming, Charles B %A Haggerty, Kevin P %K Adolescent %K Analgesics, Opioid %K Drug Prescriptions %K Female %K Humans %K Longitudinal Studies %K Male %K Northwestern United States %K Risk Factors %K Self Medication %K Substance-Related Disorders %K Young Adult %X

Nonmedical prescription opiate (NMPO) use is of great concern because of its high addiction potential, cognitive impairment effects, and other adverse consequences (e.g., hormonal and immune system effects, hyperalgesia and overdose). Due to the combination of drugs used by those who are NMPO users, it is difficult to isolate the negative effects of NMPO use from the effects of other legal and illicit drugs. Based on a stage model of substance use, this study tested whether NMPO use represents a unique form of illicit drug use among emerging adults and whether there are unique consequences of early NMPO use. We used longitudinal data from 912 emerging adults from the Raising Healthy Children study who were interviewed at least annually from the first or second grade through age 21. The findings indicated that almost all NMPO users have also used marijuana and a large majority has also used other drugs, such as cocaine and ecstasy. In addition, more frequent users of NMPOs are also more frequent users of other drugs. Except for violent behavior, NMPO use explained little unique variance in negative outcomes of use (e.g., drug use disorder, mood disorder, nonproductive behavior, poor health, and property crime) beyond that explained by other illicit drug use. Future studies examining the predictors or consequences of NMPO use and nonmedical use of other prescription drugs need to consider use within the context of other drug use.

%B Addict Behav %V 36 %P 79-86 %8 2011 Jan-Feb %G eng %N 1-2 %R 10.1016/j.addbeh.2010.08.028 %0 Journal Article %J J Adolesc Health %D 2011 %T Positive childhood experiences and positive adult functioning: Prosocial continuity and the role of adolescent substance use. %A Kosterman, Rick %A Mason, W A %A Haggerty, Kevin P %A Hawkins, J D %A Spoth, Richard %A Redmond, Cleve %K Adolescent %K Adolescent Development %K Adult %K Child %K Efficiency %K Exercise %K Female %K Humans %K Interpersonal Relations %K Male %K Parent-Child Relations %K Parenting %K Rural Population %K Social Responsibility %K Substance-Related Disorders %K Young Adult %X

PURPOSE: To examine positive childhood experiences as predictors of positive adult functioning, including civic involvement, productivity and responsibility, interpersonal connection, and physical exercise; and to examine adolescent substance use as a mediator of prosocial continuity.

METHODS: A total of 429 rural participants were interviewed across seven waves from age 11 to 22 years. Structural equation models examined the relationship between positive childhood experiences and adult functioning, with adolescent substance use added to each model as a possible mediating mechanism.

RESULTS: Positive childhood experiences predicted significantly better adult functioning for each model, even after accounting for adolescent substance use. Positive childhood experiences also consistently predicted significantly less adolescent substance use. In turn, adolescent substance use predicted significantly less civic involvement and less productivity and responsibility, but was not associated with interpersonal connection or physical exercise when accounting for childhood experiences. Results were largely consistent across gender and levels of family income.

CONCLUSION: Findings show the enduring importance of positive childhood experiences in predicting positive functioning in early adulthood. Although adolescent substance use increased risk for poorer functioning in important domains of adult life, results suggest that positive experiences in late childhood continued to have a significant prosocial effect into young adulthood. The study also highlights the late elementary grades as a time when parents, teachers, and others can potentially have a large influence in proactively providing prosocial opportunities for children.

%B J Adolesc Health %V 49 %P 180-6 %8 2011 Aug %G eng %N 2 %R 10.1016/j.jadohealth.2010.11.244 %0 Journal Article %J Child Welfare %D 2011 %T Posttraumatic stress disorder among foster care alumni: the role of race, gender, and foster care context. %A Jackson, Lovie J %A O'Brien, Kirk %A Pecora, Peter J %K Adult %K Adult Survivors of Child Abuse %K African Americans %K European Continental Ancestry Group %K Female %K Foster Home Care %K Humans %K Logistic Models %K Male %K Middle Aged %K Social Class %K Stress Disorders, Post-Traumatic %K Time %K Young Adult %X

Little is known about the prevalence of posttraumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one of the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate, and placement in kinship care) on past year PTSD. Findings revealed significant gender disparities and a moderating influence of kinship care on the relationship between gender and PTSD, as well as increased risk associated with a history of emotional and sexual abuse. Recommendations are made for clinical and systemic intervention.

%B Child Welfare %V 90 %P 71-93 %8 2011 %G eng %N 5 %0 Journal Article %J AIDS Behav %D 2011 %T A preliminary randomized controlled trial of a nurse-delivered medication adherence intervention among HIV-positive outpatients initiating antiretroviral therapy in Beijing, China. %A Simoni, Jane M %A Chen, Wei-Ti %A Huh, David %A Fredriksen-Goldsen, Karen I %A Pearson, Cynthia %A Zhao, Hongxin %A Shiu, Cheng-Shi %A Wang, Xin %A Zhang, Fujie %K Adult %K Anti-HIV Agents %K CD4 Lymphocyte Count %K China %K Counseling %K Cross-Sectional Studies %K Drug Monitoring %K Electronics, Medical %K Female %K HIV Infections %K HIV-1 %K Humans %K Male %K Medication Adherence %K Middle Aged %K Nurses %K Outpatients %K RNA, Viral %K Treatment Outcome %K Viral Load %K Young Adult %X

We evaluated a nurse-delivered adherence intervention in a preliminary randomized controlled trial among 70 HIV-positive outpatients initiating antiretroviral therapy (ART) in Beijing, China. In both arms, participants received a 30-min educational session, a pillbox, and a referral to a peer support group. In the enhanced arm, participants could choose an electronic reminder device, three sessions of counseling either alone or with a treatment adherence partner, or both reminder and counseling. Survey assessments and blood draws occurred at baseline, post-intervention (13 weeks), and follow-up (25 weeks). Primary outcomes were 7-day and 30-day adherence assessed by self-report and electronic drug monitoring (EDM), and secondary outcomes were HIV-1 RNA viral load and CD4 count. The intervention was feasible and well received. It led to some improvement in self-reported and EDM-assessed adherence but not the biological outcomes. Providing counseling and facilitating the use of electronic reminders to patients initiating ART merits further investigation as a culturally viable means of promoting adherence in China.

%B AIDS Behav %V 15 %P 919-29 %8 2011 Jul %G eng %N 5 %R 10.1007/s10461-010-9828-3 %0 Journal Article %J Women Health %D 2011 %T The prevalence and correlates of depressive symptoms among adolescent mothers: results from a 17-year longitudinal study. %A Gavin, Amelia R %A Lindhorst, Taryn %A Lohr, Mary Jane %K Adolescent %K Adult %K Cohort Studies %K Depression %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Male %K Marital Status %K Mothers %K Parity %K Pregnancy %K Pregnancy in Adolescence %K Prevalence %K Public Health %K Sexual Partners %K Smoking %K Social Welfare %K Spouse Abuse %K Young Adult %X

The objective of the authors in this study was to examine the prevalence and correlates of elevated depressive symptoms in a 17-year cohort study of 173 women who were unmarried, pregnant adolescents between June 1988 and January 1990. Multiple logistic regression was used to estimate the associations between correlates and elevated depressive symptoms during five distinct developmental periods of the life course. Depressive symptoms were measured by the Brief Symptom Inventory depression subscale. The prevalence of elevated depressive symptoms in adolescent mothers significantly increased over the 17 years of the study from 19.8% to 35.2%. In adjusted analyses, antenatal depressive symptoms were positively and significantly associated with elevated depressive symptoms at every developmental period. Intimate partner violence was positively and significantly associated with elevated depressive symptoms during all but one developmental period. Other significant correlates of elevated depressive symptoms included welfare receipt, smoking, and parity, all of which were significant at some, but not other, developmental periods. Antenatal depressive symptoms and intimate partner violence were positively and significantly associated with elevated depressive symptoms. Given the public health consequences associated with maternal depression, clinical and community-based interventions should be developed to identify and to treat adolescent mothers at-risk for antenatal depression and intimate partner violence.

%B Women Health %V 51 %P 525-45 %8 2011 Aug 31 %G eng %N 6 %R 10.1080/03630242.2011.606355 %0 Journal Article %J Arch Womens Ment Health %D 2011 %T Prevalence and correlates of suicidal ideation during pregnancy. %A Gavin, Amelia R %A Tabb, Karen M %A Melville, Jennifer L %A Guo, Yuqing %A Katon, Wayne %K Adult %K Attitude to Health %K Comorbidity %K Confidence Intervals %K Cross-Sectional Studies %K Depression %K Ethnic Groups %K Female %K Humans %K Logistic Models %K Odds Ratio %K Pregnancy %K Pregnancy Complications %K Prenatal Care %K Prevalence %K Quality of Life %K Risk Factors %K Suicidal Ideation %K United States %K Young Adult %X

Data are scarce regarding the prevalence and risk factors for antenatal suicidal ideation because systematic screening for suicidal ideation during pregnancy is rare. This study reports the prevalence and correlates of suicidal ideation during pregnancy. We performed cross-sectional analysis of data from an ongoing registry. Study participants were 2,159 women receiving prenatal care at a university obstetric clinic from January 2004 through March 2010. Multiple logistic regression identified factors associated with antenatal suicidal ideation as measured by the Patient Health Questionnaire. Overall, 2.7% of the sample reported antenatal suicidal ideation. Over 50% of women who reported antenatal suicidal ideation also reported major depression. In the fully adjusted model antenatal major depression (OR = 11.50; 95% CI 5.40, 24.48) and antenatal psychosocial stress (OR = 3.19; 95% CI 1.44, 7.05) were positively associated with an increased risk of antenatal suicidal ideation. We found that being non-Hispanic White was associated with a decreased risk of antenatal suicidal ideation (OR = 0.51; 95% CI 0.26-0.99). The prevalence of antenatal suicidal ideation in the present study was similar to rates reported in nationally representative non-pregnant samples. In other words, pregnancy is not a protective factor against suicidal ideation. Given the high comorbidity of antenatal suicidal ideation with major depression, efforts should be made to identify those women at risk for antenatal suicidal ideation through universal screening.

%B Arch Womens Ment Health %V 14 %P 239-46 %8 2011 Jun %G eng %N 3 %R 10.1007/s00737-011-0207-5 %0 Journal Article %J Gen Hosp Psychiatry %D 2011 %T Racial differences in the prevalence of antenatal depression. %A Gavin, Amelia R %A Melville, Jennifer L %A Rue, Tessa %A Guo, Yuqing %A Dina, Karen Tabb %A Katon, Wayne J %K Adult %K Depression %K Female %K Health Status Disparities %K Humans %K Logistic Models %K Pregnancy %K Prenatal Care %K Surveys and Questionnaires %K United States %K Young Adult %X

OBJECTIVE: This study examined whether there were racial/ethnic differences in the prevalence of antenatal depression based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria in a community-based sample of pregnant women.

METHOD: Data were drawn from an ongoing registry of pregnant women receiving prenatal care at a university obstetric clinic from January 2004 through March 2010 (N =1997). Logistic regression models adjusting for sociodemographic, psychiatric, behavioral and clinical characteristics were used to examine racial/ethnic differences in antenatal depression as measured by the Patient Health Questionnaire.

RESULTS: Overall, 5.1% of the sample reported antenatal depression. Blacks and Asian/Pacific Islanders were at increased risk for antenatal depression compared to non-Hispanic White women. This increased risk of antenatal depression among Blacks and Asian/Pacific Islanders remained after adjustment for a variety of risk factors.

CONCLUSION: Results suggest the importance of race/ethnicity as a risk factor for antenatal depression. Prevention and treatment strategies geared toward the mental health needs of Black and Asian/Pacific Islander women are needed to reduce the racial/ethnic disparities in antenatal depression.

%B Gen Hosp Psychiatry %V 33 %P 87-93 %8 2011 Mar-Apr %G eng %N 2 %R 10.1016/j.genhosppsych.2010.11.012 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Social norms and self-efficacy among heavy using adolescent marijuana smokers. %A Walker, Denise D %A Neighbors, Clayton %A Rodriguez, Lindsey M %A Stephens, Robert S %A Roffman, Roger A %K Adolescent %K Adolescent Behavior %K Cross-Sectional Studies %K Diagnostic and Statistical Manual of Mental Disorders %K Female %K Health Behavior %K Humans %K Male %K Marijuana Abuse %K Marijuana Smoking %K Models, Psychological %K Peer Group %K Randomized Controlled Trials as Topic %K Self Efficacy %K Self Report %K Social Conformity %K Social Facilitation %K Young Adult %X

Adolescence is a time in which individuals are particularly likely to engage in health-risk behaviors, with marijuana being the most prevalent illicit drug used. Perceptions of others' use (i.e., norms) have previously been found to be related to increased marijuana use. Additionally, low refusal self-efficacy has been associated with increased marijuana consumption. This cross-sectional study examined the effects of normative perceptions and self-efficacy on negative marijuana outcomes for a heavy using adolescent population. A structural equation model was tested and supported such that significant indirect paths were present from descriptive norms to marijuana outcomes through self-efficacy. Implications for prevention and intervention with heavy using adolescent marijuana users are discussed.

%B Psychol Addict Behav %V 25 %P 727-32 %8 2011 Dec %G eng %N 4 %R 10.1037/a0024958 %0 Journal Article %J Drug Alcohol Depend %D 2011 %T Strategies for characterizing complex phenotypes and environments: General and specific family environmental predictors of young adult tobacco dependence, alcohol use disorder, and co-occurring problems. %A Bailey, Jennifer A %A Hill, Karl G %A Meacham, Meredith C %A Young, Susan E %A Hawkins, J D %K Adolescent %K Alcohol Drinking %K Alcoholism %K Child %K Family %K Female %K HIV Infections %K Humans %K Longitudinal Studies %K Male %K Risk Factors %K Risk-Taking %K Sexual Behavior %K Smoking %K Social Environment %K Tobacco Use Disorder %K Young Adult %X

BACKGROUND: Defining phenotypes in studies of tobacco and alcohol misuse is difficult because of the complexity of these behaviors and their strong association with each other and with other problem behaviors. The present paper suggests a strategy for addressing this issue by conceptualizing and partitioning variance in phenotypes into either general or substance/behavior-specific. The paper also applies the general or substance/behavior-specific conceptualization to environmental predictors of tobacco and alcohol misuse and other problem behaviors.

METHODS: Data were drawn from the Seattle Social Development Project, a contemporary, ethnically diverse and gender-balanced longitudinal panel including 808 participants. Latent variable modeling was used to partition variance in young adult (age 24) nicotine dependence, alcohol abuse and dependence, illicit drug abuse and dependence, involvement in crime, and engagement in HIV sexual risk behavior into general problem behavior and behavior-specific variance. Similarly, measures of general, drinking-specific, and smoking-specific adolescent family environment were constructed.

RESULTS: Consistent with expectations, more positive general family environment during adolescence was associated with lower levels of shared variance in problem behaviors at age 24, but not with unique variance in tobacco or alcohol use disorder. Higher levels of family smoking and drinking environments during adolescence, however, were positively associated with unique variance in tobacco and alcohol use disorder, respectively, but did not predict shared variance in problem behaviors.

CONCLUSIONS: Results support the utility of the proposed approach. Ways in which this approach might contribute to future molecular genetic studies are discussed.

%B Drug Alcohol Depend %V 118 %P 444-51 %8 2011 Nov 1 %G eng %N 2-3 %R 10.1016/j.drugalcdep.2011.05.002 %0 Journal Article %J Horm Behav %D 2011 %T Women's sexual arousal: effects of high alcohol dosages and self-control instructions. %A George, William H %A Davis, Kelly Cue %A Heiman, Julia R %A Norris, Jeanette %A Stoner, Susan A %A Schacht, Rebecca L %A Hendershot, Christian S %A Kajumulo, Kelly F %K Adult %K Alcohol Drinking %K Arousal %K Dose-Response Relationship, Drug %K Erotica %K Ethanol %K Female %K Humans %K Internal-External Control %K Libido %K Sexuality %K Vagina %K Young Adult %X

The basic relationship between alcohol and women's sexual arousal - especially genital arousal - received little research attention for nearly 30 years (e.g. Wilson and Lawson, 1978) until very recently (e.g. George et al., 2009). To investigate hypotheses based on earlier findings and Alcohol Myopia Theory (AMT), two experiments evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of vaginal responding and self-reported sexual arousal. In Experiment 1, self-control instructions to maximize (versus suppress) arousal increased peak and average Vaginal Pulse Amplitude (VPA) change. Self-control also interacted with a target BAC of .08% (versus .00%) to influence latency to peak arousal onset: Intoxicated women instructed to maximize showed a shorter latency to peak arousal than did intoxicated women instructed to suppress; however, sober women showed an undifferentiated pattern. Also, in Experiment 1, the target BAC of .08% had no effect on VPA or subjective arousal measures. In Experiment 2, a target BAC of .10% (versus .00%) attenuated peak change and average change in VPA, but this dosage had no effects on latency to peak achieved arousal, or on subjective arousal. Instructions to maximize arousal (versus no instruction) had no effect on any arousal measures. Overall, among young moderate drinking women, alcohol had attenuating effects but only at the higher dosage. Maximize versus suppress instructions about arousal had predicted effects on arousal and interactive effects on latency, but only at the lower dosage. The findings highlight the importance of dosage and contextual factors in alcohol's impact on the variability of women's sexual responding.

%B Horm Behav %V 59 %P 730-8 %8 2011 May %G eng %N 5 %R 10.1016/j.yhbeh.2011.03.006 %0 Journal Article %J Child Abuse Negl %D 2010 %T Childhood sexual abuse in males and subsequent risky sexual behavior: a potential alcohol-use pathway. %A Schraufnagel, Trevor J %A Davis, Kelly Cue %A George, William H %A Norris, Jeanette %K Adult %K Alcoholism %K Child %K Child Abuse, Sexual %K Humans %K Male %K Risk-Taking %K Surveys and Questionnaires %K Unsafe Sex %K Washington %K Young Adult %X

OBJECTIVE: Childhood sexual abuse (CSA) among boys has been associated with a variety of subsequent maladaptive behaviors. This study explored a potential connection between CSA and an increased likelihood of risky sexual behavior in adulthood. Further, the study examined whether or not alcohol use may contribute to this relationship.

METHOD: As part of a study on alcohol and sexual decision-making, 280 heterosexual men completed multiple background questionnaires pertaining to past and current sexual experiences and patterns of alcohol use. CSA history was obtained and severity ratings were made based on type of contact reported.

RESULTS: CSA was reported by 56 men (20%). Structural equation modeling revealed that CSA positively predicted number of sexual partners directly as well as indirectly, through its effect on alcohol use. Specifically, greater CSA severity predicted significantly lower age of first intoxication, which in turn predicted greater current alcohol consumption, followed by greater use of alcohol before sexual intercourse, leading to an increased number of reported sexual partners. The reported frequency of condom use was not predicted by CSA severity or the alcohol-use pathway.

CONCLUSIONS: These findings suggest that CSA influences risky sexual behavior via multiple pathways and that more severe CSA may lead to elevated sexual risk indices. Moreover, these results suggest that men may elevate their risk of sexually transmitted infections via high numbers of sexual partners versus irregular condom use.

PRACTICAL IMPLICATIONS: These results highlight the need for adequate assessment and early interventions in order to mitigate the effects CSA may have on subsequent alcohol use and risky sexual behavior. Secondly, ensuring that male CSA victims understand the inherent risks of high numbers of sexual partners may be an effective strategy to interrupt the path toward risk-taking.

%B Child Abuse Negl %V 34 %P 369-78 %8 2010 May %G eng %N 5 %R 10.1016/j.chiabu.2009.08.013 %0 Journal Article %J J Am Coll Health %D 2010 %T College women's sexual decision making: cognitive mediation of alcohol expectancy effects. %A Davis, Kelly Cue %A Norris, Jeanette %A Hessler, Danielle M %A Zawacki, Tina %A Morrison, Diane M %A George, William H %K Adolescent %K Alcohol Drinking %K Cognition %K Condoms %K Decision Making %K Female %K Health Behavior %K Health Knowledge, Attitudes, Practice %K Humans %K Models, Psychological %K Multivariate Analysis %K Psychological Tests %K Psychometrics %K Risk Assessment %K Risk-Taking %K Sexual Behavior %K Statistics as Topic %K Unsafe Sex %K Washington %K Young Adult %X

OBJECTIVE: Alcohol has been linked to a variety of risky sexual practices, including inconsistent condom use. Due to the high rates of alcohol consumption among underage college women, greater understanding of the role of alcohol in young women's sexual decision making is warranted.

PARTICIPANTS AND METHODS: Female underage (18- to 20-year-old) social drinkers (N = 94) participated in an experiment in which they projected themselves into a written hypothetical sexual situation with a new partner. One half of the situations portrayed alcohol consumption; one half did not involve alcohol consumption. Their appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and sexual behavior intentions were assessed.

RESULTS: Results revealed that alcohol's expectancy effects on young women's unprotected sexual intentions were mediated by their cognitive appraisals of the situation.

CONCLUSIONS: These findings indicate that alcohol expectancies and their influence on women's sexual decisions should be incorporated into sexual risk reduction efforts.

%B J Am Coll Health %V 58 %P 481-9 %8 2010 Mar-Apr %G eng %N 5 %R 10.1080/07448481003599112 %0 Journal Article %J J Sex Res %D 2010 %T Comparison of daily and retrospective reports of vaginal sex in heterosexual men and women. %A Gillmore, Mary Rogers %A Leigh, Barbara C %A Hoppe, Marilyn J %A Morrison, Diane M %K Adolescent %K Adult %K Coitus %K Data Collection %K Female %K Heterosexuality %K Humans %K Interviews as Topic %K Male %K Medical Records %K Mental Recall %K Reproducibility of Results %K Surveys and Questionnaires %K Truth Disclosure %K Vagina %K Young Adult %X

This study examined the agreement between daily and retrospective reports of vaginal sex over a two-month period in a sample of 376 heterosexually active men and women. We also examined whether gender, age, or method of daily data collection (self-administered vs. interviewer administered) were related to agreement between daily and retrospective reports. Both counts and categorical measures of frequency of the behaviors were examined. There were no gender, age, or data collection method effects. When measured as a count, participants reported more instances of vaginal intercourse in the retrospective reports than on the daily reports. In contrast, comparison of retrospective categorical measures of frequency to daily reports showed considerable variability. Possible reasons for the over-reporting of counts of vaginal sex in retrospective reports are explored.

%B J Sex Res %V 47 %P 279-84 %8 2010 Jul %G eng %N 4 %R 10.1080/00224490903050584 %0 Journal Article %J Obstet Gynecol %D 2010 %T Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. %A Melville, Jennifer L %A Gavin, Amelia %A Guo, Yuqing %A Fan, Ming-Yu %A Katon, Wayne J %K Adolescent %K Adult %K Depressive Disorder %K Female %K Humans %K Middle Aged %K Panic Disorder %K Pregnancy %K Pregnancy Complications %K Prevalence %K Risk Factors %K Spouse Abuse %K Stress, Psychological %K Suicide %K Urban Population %K Young Adult %X

OBJECTIVE: To estimate the prevalence of major and minor depression, panic disorder, and suicidal ideation during pregnancy while also identifying factors independently associated with antenatal depressive disorders.

METHODS: In this prospective study, participants were 1,888 women receiving ongoing prenatal care at a university obstetric clinic from January 2004 through January 2009. Prevalence of psychiatric disorders was measured using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria based on the Patient Health Questionnaire. Multiple logistic regression identified factors associated with probable major depressive disorder and any depressive disorder.

RESULTS: Antenatal depressive disorders were present in 9.9% with 5.1% (97) meeting criteria for probable major depression and 4.8% (90) meeting criteria for probable minor depression. Panic disorder was present in 3.2% (61), and current suicidal ideation was reported by 2.6% (49). Among patients with probable major depression, 29.5% (28) reported current suicidal ideation. Psychosocial stress (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.21-1.36), domestic violence (OR 3.45; 95% CI 1.46-8.12), chronic medical conditions (OR 3.05; 95% CI 1.63-5.69), and race (Asian: OR 5.81; 95% CI 2.55-13.23; or African American: OR 2.98; 95% CI 1.24-7.18) each significantly increased the odds of probable antepartum major depressive disorder, whereas older age (OR 0.92; 95% CI 0.88-0.97) decreased the odds. Factors associated with odds of any depression were similar overall except that Hispanic ethnicity (OR 2.50; 95% CI 1.09-5.72) also independently increased the odds of any depression.

CONCLUSION: Antenatal major and minor depressive disorders are common and significantly associated with clinically relevant and identifiable risk factors. By understanding the high point prevalence and associated factors, clinicians can potentially improve the diagnosis and treatment rates of serious depressive disorders in pregnant women.

LEVEL OF EVIDENCE: II.

%B Obstet Gynecol %V 116 %P 1064-70 %8 2010 Nov %G eng %N 5 %R 10.1097/AOG.0b013e3181f60b0a %0 Journal Article %J Am J Public Health %D 2010 %T Disparities in health-related quality of life: a comparison of lesbians and bisexual women. %A Fredriksen-Goldsen, Karen I %A Kim, Hyun-Jun %A Barkan, Susan E %A Balsam, Kimberly F %A Mincer, Shawn L %K Adolescent %K Adult %K Bisexuality %K Exercise %K Female %K Health Status Disparities %K Homosexuality, Female %K Humans %K Logistic Models %K Mental Health %K Middle Aged %K Obesity %K Poverty %K Quality of Life %K Risk Factors %K Stress, Psychological %K Urban Population %K Washington %K Young Adult %X

OBJECTIVES: We investigated the association of health-related quality of life (HRQOL) with sexual orientation among lesbians and bisexual women and compared the predictors of HRQOL between the 2 groups.

METHODS: We used multivariate logistic regression to analyze Washington State Behavioral Risk Factor Surveillance System population-based data (2003 to 2007) in a sample of 1496 lesbians and bisexual women and examined determinants of HRQOL among lesbians and bisexual women.

RESULTS: For lesbians and bisexual women, frequent mental distress and poor general health were associated with poverty and lack of exercise; poor general health was associated with obesity and mental distress. Bisexual women showed a higher likelihood of frequent mental distress and poor general health than did lesbians. The odds of mental distress were higher for bisexual women living in urban areas as compared with nonurban areas. Lesbians had an elevated risk of poor general health and mental distress during midlife.

CONCLUSIONS: Despite the standard practice of collapsing sexual minority women into a single group, lesbian and bisexual women in this study emerge as distinct groups that merit specific attention. Bisexual women are at elevated risk for poor HRQOL.

%B Am J Public Health %V 100 %P 2255-61 %8 2010 Nov %G eng %N 11 %R 10.2105/AJPH.2009.177329 %0 Journal Article %J J Interpers Violence %D 2010 %T Evaluating the impact of intimate partner violence on the perpetrator: the Perceived Consequences of Domestic Violence Questionnaire. %A Walker, Denise D %A Neighbors, Clayton %A Mbilinyi, Lyungai F %A O'Rourke, Allison %A Zegree, Joan %A Roffman, Roger A %A Edleson, Jeffrey L %K Adult %K Aggression %K Humans %K Interpersonal Relations %K Male %K Middle Aged %K Motivation %K Risk Factors %K Risk Reduction Behavior %K Sexual Partners %K Spouse Abuse %K Surveys and Questionnaires %K Young Adult %X

Surprisingly, little is known about how IPV perpetrators perceive the conse quences of their violent behavior. This article describes the development and evaluation of the Perceived Consequences of Domestic Violence Questionnaire (PCDVQ). The PCDVQ is a 27 item self report instrument designed to assess the consequences of intimate partner violence (IPV) as perceived by the perpetrator. Data from 124 nontreatment seeking, male, IPV perpetrators recruited from the community provided support for the internal consistency of the PCDVQ. Participants reported an average of 9.97 (SD = 4.57) consequences. Scores on the PCDVQ significantly predicted motivation for change, beta =.19, t(113) = 2.03, p < .05, and treatment seeking, chi(2)(df = 1) = 10.79, p < .01, odds ratio = 1.27 (95% CI: 1.10 1.46). Clinical implications of this instrument are discussed.

%B J Interpers Violence %V 25 %P 1684-98 %8 2010 Sep %G eng %N 9 %R 10.1177/0886260509354592 %0 Journal Article %J J Immigr Minor Health %D 2010 %T Examining alternative measures of social disadvantage among Asian Americans: the relevance of economic opportunity, subjective social status, and financial strain for health. %A de Castro, A B %A Gee, Gilbert C %A Takeuchi, David T %K Adolescent %K Adult %K Aged %K Asian Americans %K Body Mass Index %K Data Collection %K Educational Status %K Employment %K Female %K Health Status %K Humans %K Income %K Male %K Middle Aged %K Obesity %K Smoking %K Social Class %K United States %K Young Adult %X

Socioeconomic position is often operationalized as education, occupation, and income. However, these measures may not fully capture the process of socioeconomic disadvantage that may be related to morbidity. Economic opportunity, subjective social status, and financial strain may also place individuals at risk for poor health outcomes. Data come from the Asian subsample of the 2003 National Latino and Asian American Study (n = 2095). Regression models were used to examine the associations between economic opportunity, subjective social status, and financial strain and the outcomes of self-rated health, body mass index, and smoking status. Education, occupation, and income were also investigated as correlates of these outcomes. Low correlations were observed between all measures of socioeconomic status. Economic opportunity was robustly negatively associated with poor self-rated health, higher body mass index, and smoking, followed by financial strain, then subjective social status. Findings show that markers of socioeconomic position beyond education, occupation, and income are related to morbidity among Asian Americans. This suggests that potential contributions of social disadvantage to poor health may be understated if only conventional measures are considered among immigrant and minority populations.

%B J Immigr Minor Health %V 12 %P 659-71 %8 2010 Oct %G eng %N 5 %R 10.1007/s10903-009-9258-3 %0 Journal Article %J J Child Psychol Psychiatry %D 2010 %T Growth in adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders, and risky sex: A comparison of youth from low- versus middle-income backgrounds. %A Mason, W A %A Hitch, Julia E %A Kosterman, Rick %A McCarty, Carolyn A %A Herrenkohl, Todd I %A Hawkins, J D %K Adolescent %K Age Factors %K Alcohol Drinking %K Alcohol-Related Disorders %K Child %K Female %K Follow-Up Studies %K Humans %K Juvenile Delinquency %K Male %K Risk Factors %K Risk-Taking %K Sampling Studies %K Social Class %K United States %K Unsafe Sex %K Violence %K Young Adult %X

BACKGROUND: This study examined adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders (AUDs), and risky sex. Analyses further examined the influences of late childhood involvement in these problem behavior outcomes, with mediation through teen delinquency and alcohol use, and examined differences in the pathways for youth from low- compared to middle-income backgrounds.

METHOD: Multiple-group latent growth curve modeling was conducted using data collected from a sample of 808 youth followed from age 10 to age 24. Self-report assessments included delinquent involvement, alcohol use, and sexual activity in late childhood; delinquency and alcohol use in adolescence; and crime, AUDs, and risky sex in early adulthood.

RESULTS: Late childhood delinquent involvement was associated with young adult crime, AUDs, and risky sex indirectly through adolescent delinquency, and had a persistent direct effect on crime. Adolescent delinquency also mediated the relation between early sex onset and crime. Early alcohol use predicted a higher level of, and a faster rate of increase in, adolescent drinking, which predicted, in turn, young adult AUDs and risky sex. Significant group differences indicated stronger associations between adolescent delinquency and each young adult outcome for youth from low- compared to those from middle-income backgrounds.

CONCLUSIONS: Early intervention may help prevent the development of crime, AUDs, and risky sex behaviors, especially among disadvantaged youth.

%B J Child Psychol Psychiatry %V 51 %P 1377-85 %8 2010 Dec %G eng %N 12 %R 10.1111/j.1469-7610.2010.02292.x %0 Journal Article %J Drug Alcohol Depend %D 2010 %T Person-environment interaction in the prediction of alcohol abuse and alcohol dependence in adulthood. %A Hill, Karl G %A Hawkins, J D %A Bailey, Jennifer A %A Catalano, Richard F %A Abbott, Robert D %A Shapiro, Valerie B %K Adolescent %K Adolescent Behavior %K Adult %K Alcoholism %K Anxiety %K Family %K Female %K Humans %K Inhibition (Psychology) %K Linear Models %K Longitudinal Studies %K Male %K Predictive Value of Tests %K Social Environment %K Young Adult %X

BACKGROUND: Behavioral disinhibition (externalizing/impulsivity) and behavioral inhibition (internalizing/anxiety) may contribute to the development of alcohol abuse and dependence. But tests of person-by-environment interactions in predicting alcohol use disorders are needed. This study examined the extent to which interactions between behavioral disinhibition, behavioral inhibition and family management during adolescence predict alcohol abuse and alcohol dependence at age 27.

METHODS: This study used longitudinal data from a community sample of 808 men and women interviewed from ages 10 to 27 in the Seattle Social Development Project. Zero-order correlations followed by a series of nested regressions examined the relationships between individual characteristics (behavioral disinhibition and behavioral inhibition/anxiety) and environment (good vs. poor family management practices during adolescence) in predicting alcohol abuse and dependence criterion counts at age 27.

RESULTS: Behavioral disinhibition and poor family management predicted increased likelihood of both alcohol abuse and alcohol dependence at age 27. Behavioral inhibition/anxiety was unrelated to both outcomes. Youths high in behavioral disinhibition were at increased risk for later alcohol abuse and dependence only in consistently poorly managed family environments. In consistently well-managed families, high levels of behavioral disinhibition did not increase risk for later alcohol abuse or dependence.

CONCLUSIONS: Behavioral disinhibition increases risk for alcohol abuse and dependence in early adulthood only for individuals who experience poor family management during adolescence. Interventions seeking to reduce environmental risks by strengthening consistent positive family management practices may prevent later alcohol abuse and dependence among individuals at risk due to behavioral disinhibition.

%B Drug Alcohol Depend %V 110 %P 62-9 %8 2010 Jul 1 %G eng %N 1-2 %R 10.1016/j.drugalcdep.2010.02.005 %0 Journal Article %J J Adolesc Health %D 2010 %T Positive youth development as a strategy to promote adolescent sexual and reproductive health. %A Gavin, Lorrie E %A Catalano, Richard F %A Markham, Christine M %K Adolescent %K Adolescent Development %K Female %K Health Promotion %K Humans %K Male %K Reproductive Behavior %K Sexual Behavior %K Young Adult %B J Adolesc Health %V 46 %P S1-6 %8 2010 Mar %G eng %N 3 Suppl %R 10.1016/j.jadohealth.2009.12.017 %0 Journal Article %J Pediatrics %D 2010 %T Pubertal stage and the prevalence of violence and social/relational aggression. %A Hemphill, Sheryl A %A Kotevski, Aneta %A Herrenkohl, Todd I %A Toumbourou, John W %A Carlin, John B %A Catalano, Richard F %A Patton, George C %K Adolescent %K Aggression %K Antisocial Personality Disorder %K Child %K Depressive Disorder %K Female %K Humans %K Interpersonal Relations %K Male %K Prevalence %K Puberty %K Risk Factors %K Spouse Abuse %K Victoria %K Violence %K Washington %K Young Adult %X

OBJECTIVE: We examined associations between pubertal stage and violent adolescent behavior and social/relational aggression.

METHODS: The International Youth Development Study comprises statewide representative student samples in grades 5, 7, and 9 (N = 5769) in Washington State and Victoria, Australia, drawn as a 2-stage cluster sample in each state. We used a school-administered, self-report student survey to measure previous-year violent behavior (ie, attacking or beating up another person) and social/relational aggression (excluding peers from the group, threatening to spread lies or rumors), as well as risk and protective factors and pubertal development. Cross-sectional data were analyzed.

RESULTS: Compared with early puberty, the odds of violent behavior were approximately threefold higher in midpuberty (odds ratio [OR]: 2.87 [95% confidence interval (CI): 1.81-4.55]) and late puberty (OR: 3.79 [95% CI: 2.25-6.39]) after adjustment for demographic factors. For social/relational aggression, there were weaker overall associations after adjustment, but these associations included an interaction between pubertal stage and age, and stronger associations with pubertal stage at younger age were shown (P = .003; midpuberty OR: 1.78 [95% CI: 1.20-2.63]; late puberty OR: 3.00 [95% CI: 1.95-4.63]). Associations between pubertal stage and violent behavior and social/relational aggression remained after the inclusion of social contextual mediators in the analyses.

CONCLUSIONS: Pubertal stage was associated with higher rates of violent behavior and social/relational aggression, with the latter association seen only at younger ages. Puberty is an important phase at which to implement prevention programs to reduce adolescent violent and antisocial behaviors.

%B Pediatrics %V 126 %P e298-305 %8 2010 Aug %G eng %N 2 %R 10.1542/peds.2009-0574 %0 Journal Article %J Adm Policy Ment Health %D 2010 %T The relationship between outpatient mental health treatment and subsequent mental health symptoms and disorders in young adults. %A Van Dorn, Richard A %A Kosterman, Rick %A Williams, James H %A Chandler, Kristen %A Young, M S %A Catalano, Richard F %A Hawkins, J D %K Adult %K Ambulatory Care %K Community Mental Health Services %K Female %K Humans %K Interviews as Topic %K Male %K Mental Disorders %K Young Adult %X

The objective of this study was to evaluate community-based outpatient mental health services for young adults. Participants were interviewed at ages 21, 24, 27, and 30. Outcomes included: (1) symptoms of depression, generalized anxiety, social phobia, dysthymia and post traumatic stress individually and as a global scale; and (2) a dichotomous diagnosis variable inclusive of all above disorders. Treatment was indicated by an outpatient visit to a psychiatrist or other professional. Treatment did not reduce mental disorder or symptoms. Substance use, violence, poverty, community disorganization, and family history of antisocial behavior increased risks for negative outcomes, while social support was protective. The absence of positive findings associated with outpatient treatment is troubling given the empirically supported interventions for the conditions examined. Practitioners, agencies, and managed care organizations share a responsibility to implement effective and comprehensive interventions.

%B Adm Policy Ment Health %V 37 %P 484-96 %8 2010 Nov %G eng %N 6 %R 10.1007/s10488-010-0291-2 %0 Journal Article %J J Youth Adolesc %D 2010 %T Relationships between level and change in family, school, and peer factors during two periods of adolescence and problem behavior at age 19. %A Fleming, Charles B %A Catalano, Richard F %A Haggerty, Kevin P %A Abbott, Robert D %K Adolescent %K Adolescent Behavior %K Antisocial Personality Disorder %K Child %K Child Behavior Disorders %K Conflict (Psychology) %K Crime %K Family %K Female %K Humans %K Interpersonal Relations %K Male %K Parent-Child Relations %K Peer Group %K Risk Factors %K Schools %K Substance-Related Disorders %K Young Adult %X

While prior research has examined family, school, and peer factors as potential predictors of problem behavior, less attention has been given to studying when these factors are most predictive of problems and if and when changes in these factors signal risk. Using annual data on a community sample of 1,040 individuals (47% female; 81% White), this study models growth in risk and protective factors during two developmental periods (Grades 5-8 and Grades 9-12) in order to predict substance misuse and crime at age 19. For protective factors of positive relationships with family and positive bonds to school, both the levels of these factors at Grade 5 and change between Grade 5 and Grade 8 predicted substance misuse and crime in early adulthood. Higher likelihoods of both forms of problem behavior also were predicted by increases in the risk factor of exposure to negative peers between 5th and 8th grade. In the late adolescent period, levels at 9th grade of all risk and protective factors examined predicted both substance misuse and crime. Also, increases in exposure to negative peers in late adolescence predicted greater likelihoods of both forms of problem behavior, while greater risk of substance misuse was predicted by decreases in school bonding and academic achievement, and greater risk of crime was predicted by worsening relationships with family. The results add to prior research by indicating that in addition to the level, change in risk and protective factors during these two stages of development can be signals of risk and are promising targets for intervention.

%B J Youth Adolesc %V 39 %P 670-82 %8 2010 Jun %G eng %N 6 %R 10.1007/s10964-010-9526-5 %0 Journal Article %J J Stud Alcohol Drugs %D 2010 %T Romantic relationship status changes and substance use among 18- to 20-year-olds. %A Fleming, Charles B %A White, Helene R %A Oesterle, Sabrina %A Haggerty, Kevin P %A Catalano, Richard F %K Adolescent %K Adolescent Behavior %K Age Factors %K Depression %K Female %K Humans %K Interpersonal Relations %K Longitudinal Studies %K Male %K Marriage %K Sexual Partners %K Single Person %K Substance-Related Disorders %K Young Adult %X

OBJECTIVE: Changes in romantic relationship status are common in emerging adulthood and may be linked to changes in substance use. This study tested the hypothesis that entry into relationships or transitioning to a more committed status leads to decreases in substance use and that dissolution of relationships or transitioning to a less committed status results in increases in substance use.

METHOD: Data were from a community sample of 939 individuals. Substance use (heavy drinking, marijuana use, and cigarette smoking) and relationship status (single, in a romantic relationship but not cohabiting, cohabiting, or married) were assessed at the beginning and end of three 6-month intervals between the ages of 18 and 20 years. Models were estimated to assess the association between transitions in relationship status and substance use, adjusting for prior levels of use.

RESULTS: There were increases in heavy drinking, marijuana use, and cigarette smoking associated with dissolution of a romantic relationship, as well as increases in marijuana use and cigarette smoking associated with switching partners within a 6-month interval. Mediation analyses found some support for increases in both depressive symptoms and exposure to substance-using peers partially accounting for these associations. Decreases in substance use were not found for individuals entering into a new relationship or transitioning to a more committed relationship status. In fact, cigarette smoking increased among those who went from being single to being in a romantic relationship compared with those whose relationship status did not change.

CONCLUSIONS: Emerging adults who experience dissolution of romantic relationships or quickly move from one relationship to another experience increased substance use. Both depressive symptoms and changes in peer environments may partially account for these changes in use.

%B J Stud Alcohol Drugs %V 71 %P 847-56 %8 2010 Nov %G eng %N 6 %0 Journal Article %J J Health Soc Behav %D 2010 %T Romantic relationships and substance use in early adulthood: an examination of the influences of relationship type, partner substance use, and relationship quality. %A Fleming, Charles B %A White, Helene R %A Catalano, Richard F %K Adolescent %K Courtship %K Data Collection %K Female %K Humans %K Longitudinal Studies %K Male %K Substance-Related Disorders %K Young Adult %X

This study used longitudinal data from 909 young adults to examine associations between substance use and the status and quality of romantic relationships. Heavy alcohol use, marijuana use, and cigarette smoking, as well as relationship status, relationship quality, partner substance use, and other salient life circumstances were assessed at four time points in the two years after high school. Marriage, cohabiting relationships, and noncohabiting dating relationships were associated with reductions in heavy drinking and marijuana use relative to non-dating, after adjusting for adolescent substance use; marriage compared to not dating was associated with reductions in cigarette smoking. For those in romantic relationships, partner substance use moderated the associations between relationship quality and substance use for heavy drinking and for marijuana use, supporting the hypothesis derived from the Social Development Model that the protective effect of stronger social bonds depends on the use patterns of the partner to whom an individual is bonded.

%B J Health Soc Behav %V 51 %P 153-67 %8 2010 Jun %G eng %N 2 %0 Journal Article %J Am J Ind Med %D 2010 %T Smoking and the Asian American workforce in the National Latino and Asian American Study. %A de Castro, A B %A Garcia, Gabriel %A Gee, Gilbert C %A Tsai, Jenny Hsin-Chun %A Rue, Tessa %A Takeuchi, David T %K Adolescent %K Adult %K Aged %K Asian Americans %K Cross-Sectional Studies %K Employment %K Female %K Hispanic Americans %K Humans %K Interviews as Topic %K Male %K Middle Aged %K Occupations %K Prevalence %K Smoking %K United States %K Young Adult %X

BACKGROUND: Smoking among the Asian American workforce has not been extensively researched. This study examines smoking prevalence among a nationally representative sample of Asian Americans with an emphasis on occupational classification.

METHODS: Cross-sectional data come from the National Latino and Asian American Study. Multivariate logistic regression analyses were used to determine smoking prevalence by occupation, gender, and nativity, among 1,528 participants self-identifying as in the labor force.

RESULTS: Blue collar workers reported the highest smoking prevalence (32%) followed by unemployed (19%), other (17%), service (14%), and white collar (10%). Among both employed males and females, blue collar workers had the highest prevalence (45% and 18%, respectively). By nativity, smoking was highest among blue collar workers for immigrants (25%) and highest among the unemployed for U.S. born (16%). Blue collar employment was significantly associated with being a current smoker (OR = 2.52; 95% CI: 1.23-5.16; P < 0.05) controlling for demographics (e.g., age, gender, ethnic group, nativity, etc.).

CONCLUSIONS: Findings reveal that smoking differs by occupation among Asian Americans. Future research should examine factors explaining differences while considering gender and nativity.

%B Am J Ind Med %V 53 %P 171-8 %8 2010 Feb %G eng %N 2 %R 10.1002/ajim.20697 %0 Journal Article %J J Urban Health %D 2010 %T Why the wait? Delayed HIV diagnosis among men who have sex with men. %A Nelson, Kimberly M %A Thiede, Hanne %A Hawes, Stephen E %A Golden, Matthew R %A Hutcheson, Rebecca %A Carey, James W %A Kurth, Ann %A Jenkins, Richard A %K Adolescent %K Adult %K Age Factors %K Delayed Diagnosis %K Health Status %K HIV Infections %K HIV Seropositivity %K Homeless Persons %K Homosexuality, Male %K Humans %K Male %K Middle Aged %K Sexual Behavior %K Socioeconomic Factors %K Substance-Related Disorders %K Young Adult %X

We sought to identify factors associated with delayed diagnosis of human immunodeficiency virus (HIV; testing HIV-seropositive 6 months or more after HIV seroconversion), by comparing delayed testers to non-delayed testers (persons who were diagnosed within 6 months of HIV seroconversion), in King County, Washington among men who have sex with men (MSM). Participants were recruited from HIV testing sites in the Seattle area. Delayed testing status was determined by the Serologic Testing Algorithm for Recent HIV Seroconversion or a self-reported previous HIV-negative test. Quantitative data on sociodemographic characteristics, health history, and drug-use and sexual behaviors were collected via computer-assisted self-interviews. Qualitative semi-structured interviews regarding testing and risk behaviors were also conducted. Multivariate analysis was used to identify factors associated with delayed diagnosis. Content analysis was used to establish themes in the qualitative data. Out of the 77 HIV-seropositive MSM in this sample, 39 (51%) had evidence of delayed diagnosis. Factors associated with delayed testing included being African-American, homeless, "out" to 50% or less people about male-male sex, and having only one sex partner in the past 6 months. Delayed testers often cited HIV-related sickness as their reason for testing and fear and wanting to be in denial of their HIV status as reasons for not testing. Delayed testers frequently did not identify as part of the MSM community, did not recognize that they were at risk for HIV acquisition, and did not feel a responsibility to themselves or others to disclose their HIV status. This study illustrates the need to further explore circumstances around delayed diagnosis in MSM and develop outreach methods and prevention messages targeted specifically to this potentially highly marginalized population in order to detect HIV infections earlier, provide HIV care, and prevent new infections.

%B J Urban Health %V 87 %P 642-55 %8 2010 Jul %G eng %N 4 %R 10.1007/s11524-010-9434-8 %0 Journal Article %J Child & Family Social Work %D 2009 %T Evidence-based intervention and services for high-risk youth: a North American perspective on the challenges of integration for policy, practice and research. %A Whittaker, James K. %K children in need (services for) %K Evidence-Based Practice %K Evidence-based social work %K Intervention (Social services) %K Problem youth -- Services for %K research in practice %K Social work with children %K Social work with youth %K therapeutic social work %K Youth with social disabilities -- Services for %X

This paper explores the cross-national challenges of integrating evidence-based interventions into existing services for high-resource-using children and youth. Using several North American model programme exemplars that have demonstrated efficacy, the paper explores multiple challenges confronting policy-makers, evaluation researchers and practitioners who seek to enhance outcomes for troubled children and youth and improve overall service effectiveness. The paper concludes with practical implications for youth and family professionals, researchers, service agencies and policy–makers, with particular emphasis on possibilities for cross-national collaboration.

%B Child & Family Social Work %V 14 %P 166-177 %8 2009/05/1/ %G eng %N 2 %R 10.1111/j.1365-2206.2009.00621.x %0 Journal Article %J BMC Complement Altern Med %D 2008 %T Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO. %A van Tilburg, Miranda A L %A Palsson, Olafur S %A Levy, Rona L %A Feld, Andrew D %A Turner, Marsha J %A Drossman, Douglas A %A Whitehead, William E %K Abdominal Pain %K Adult %K Complementary Therapies %K Constipation %K Cost-Benefit Analysis %K Delivery of Health Care, Integrated %K Diarrhea %K Female %K Ginger %K Health Maintenance Organizations %K Humans %K Irritable Bowel Syndrome %K Male %K Massage %K Middle Aged %K Patient Satisfaction %K Phytotherapy %K Professional-Patient Relations %K Prospective Studies %K Surveys and Questionnaires %K United States %K Yoga %X

BACKGROUND: Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain.

METHODS: 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims.

RESULTS: CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice.

CONCLUSION: CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

%B BMC Complement Altern Med %V 8 %P 46 %8 2008 %G eng %R 10.1186/1472-6882-8-46