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New this Month - November 2006
C'de Baca, J., McMillan, G. P., & Lapham, S. C.
(2006). Reclassifying DIS-III-R alcohol use disorders to DSM-IV criteria
in a sample of convicted impaired drivers. Journal of Studies on Alcohol,
67(6), 898-903.
OBJECTIVE: This study used data gathered from the Diagnostic Interview
Schedule, Version Three, Revised (DIS-III-R), which calculated diagnoses
based on the Diagnostic and Statistical Manual of Mental Disorders, Third
Edition, Revised (DSM-III-R), criteria and rescored the data to be compatible
with the criteria of the Fourth Edition of the DSM (DSM-IV) for lifetime
alcohol abuse and dependence. METHOD: A psychologist reassigned questions
from the DIS-III-R according to DSM-IV criteria. Another clinician evaluated
the rescoring criteria and discrepancies were discussed and resolved.
Using these criteria, SAS code was written to automate the rescoring of
responses to DIS-III-R questions to DSM-IV diagnoses from a population
of DWI offenders. RESULTS: There was a fair-to-good level of agreement
between the DSM-III-R and rescored DSM-IV diagnoses (kappa = .65). Three
hundred forty-eight subjects classified as alcohol dependent using DSMIII-
R were reclassified as alcohol abuse in the DSM-IV rescore. Among subjects
who were alcohol dependent based on DIS-III-R criteria, the distribution
of DSM-IV diagnoses was similar across gender, age, and ethnic groups.
There was no difference in agreement between DSMIII- R and the rescored
DSM-IV diagnoses by age category. However, women and Hispanics had significantly
higher weighted kappa statistics than men and non-Hispanic whites. CONCLUSIONS:
Our rescoring results were consistent with earlier studies that compared
DSM-III-R and DSM-IV diagnoses. Here, we offer an approach that may be
useful to investigators who used the DIS-III-R in earlier studies. The
DIS-III-R questions corresponding to DSM-IV criteria for alcohol abuse
and alcohol dependence are on our Web site at www.bhrcs.org, along with
the scoring algorithm.
McMillan, G. P., & Lapham, S. (2006). Effectiveness
of bans and laws in reducing traffic deaths: Legalized Sunday packaged
alcohol sales and alcohol-related traffic crashes and crash fatalities
in New Mexico. American Journal of Public Health, 96(11), 1944-1948.
We determined the relative risk of alcohol-related motor vehicle accidents
and fatalities after New Mexico lifted its ban on Sunday packaged alcohol
sales. We extracted all alcohol-related crashes from New Mexico police
reports for 3652 days between July 1, 1990, and June 30, 2000, and found
a 29% increase in alcohol-related crashes and a 42% increase in alcohol-related
crash fatalities on Sundays after the ban on Sunday packaged alcohol sales
was lifted. There was an estimated excess of 543.1 alcohol-related crashes
and 41.6 alcohol-related crash fatalities on Sundays after the ban was
lifted. Repealing the ban on Sunday packaged alcohol sales introduced
a public health and safety hazard in New Mexico.
Gorman, D. M., Mezic, J., Mezic, I., & Gruenewald, P. J.
(2006). Agent-based modeling of drinking behavior: A preliminary model
and potential applications to theory and practice. American Journal of
Public Health, 96(11), 2055-2060.
OBJECTIVES: We developed a preliminary agent-based simulation model designed
to examine agent-environment interactions that support the development
and maintenance of drinking behavior at the population level. METHODS:
The model was defined on a 1-dimensional lattice along which agents might
move left or right in single steps at each iteration. Agents could exchange
information about their drinking with each other. In the second generation
of the model, a "bar" was added to the lattice to attract drinkers.
RESULTS: The model showed that changes in drinking status propagated through
the agent population as a function of probabilities of conversion, rates
of contact, and contact time. There was a critical speed of population
mixing beyond which the conversion rate of susceptible nondrinkers was
saturated, and the bar both enhanced and buffered the rate of propagation,
changing the model dynamics. CONCLUSIONS: The models demonstrate that
the basic dynamics underlying social influences on drinking behavior are
shaped by contacts between drinkers and focused by characteristics of
drinking environments.
Ponicki, W. R., & Gruenewald, P. J. (2006). The impact
of alcohol taxation on liver cirrhosis mortality. Journal of Studies on
Alcohol, 67(6), 934-938.
OBJECTIVE: The objective of this study is to investigate the impact of
distilled spirits, wine, and beer taxes on cirrhosis mortality using a
large-panel data set and statistical models that control for various other
factors that may affect that mortality. METHOD: The analyses were performed
on a panel of 30 U.S. license states during the period 1971-1998 (N =
840 state-by-year observations). Exogenous measures included current and
lagged versions of beverage taxes and income, as well as controls for
states' age distribution, religion, race, health care availability, urbanity,
tourism, and local bans on alcohol sales. Regression analyses were performed
using random-effects models with corrections for serial autocorrelation
and heteroscedasticity among states. RESULTS: Cirrhosis rates were found
to be significantly related to taxes on distilled spirits but not to taxation
of wine and beer. Consistent results were found using different statistical
models and model specifications. CONCLUSIONS: Consistent with prior research,
cirrhosis mortality in the United States appears more closely linked to
consumption of distilled spirits than to that of other alcoholic beverages.
Weiss, C. H., & Birckmayer, J. (2006). Social experimentation
for public policy. In M. Moran, M. Rein & R. E. Goodin (Eds.), The
Oxford handbook of public policy. Oxford; New York: Oxford University
Press.
Coben, J. H., Steiner, C. A., & Miller, T. R. (2007).
Characteristics of motorcycle-related hospitalizations: Comparing states
with different helmet laws. Accident; Analysis and Prevention, 39(1),
190-196.
This study compares U.S. motorcycle-related hospitalizations across states
with differing helmet laws. Cross-sectional analyses of hospital discharge
data from 33 states participating in the Healthcare Cost and Utilization
Project in 2001 were conducted. Results revealed that motorcyclists hospitalized
from states without universal helmet laws are more likely to die during
the hospitalization, sustain severe traumatic brain injury, be discharged
to long-term care facilities, and lack private health insurance. This
study further illustrates and substantiates the increased burden of hospitalization
and long-term care seen in states that lack universal motorcycle helmet
use laws.
Miller, T. R., Zaloshnja, E., & Hendrie, D. (2006).
Cost-outcome analysis of booster seats for auto occupants aged 4 to 7
years. Pediatrics, 118(5), 1994-1998.
OBJECTIVES: The purpose of this work was to analyze the societal return
on investment in booster seats and in laws requiring their use in the
United States. Booster seats reduce crash-related injury. Their use is
mandatory for vehicle occupants aged 4 to 7 years in most of the United
States. This study estimates the injury cost savings attributable to booster
seat use. METHODS: Seat cost came from pricing on the Web and at retailers.
Costs of passing and enforcing a legal mandate were estimated as a percentage
of the costs of seat use. Injury risk when belted absent a seat was computed
from national probability samples of crashes in the last years before
booster seats entered into general use (1993-1999). Published estimates
were used of the percentage of reduction in injuries achieved with booster
seats, the mix of diagnoses reduced, and injury cost by diagnosis. The
computations used a 3% discount rate. We studied the net cost per quality-adjusted
life year saved, benefit-cost ratio, and net savings per seat. RESULTS:
A booster seat costs 30 dollars plus 167 dollars for maintenance and time
spent on installation and use. This investment saves 1854 dollars per
seat, a return on investment of 9.4 to 1. Even lower bound estimates in
sensitivity analysis indicated that society would benefit from the use
of booster seats. Seat laws offer a return of 8.6 to 1. CONCLUSIONS: Belt-positioning
booster seats offer a sound return on investment. Booster seat use laws
should be passed, publicized, and enforced nationwide.
Hanna, C. L., Taylor, D. M., Sheppard, M. A., & Laflamme,
L. (2006). Fatal crashes involving young unlicensed drivers in
the U.S. Journal of Safety Research, 37(4), 385-393.
INTRODUCTION: Young unlicensed drivers' involvement in fatal crashes is
a recurrent problem in the United States. METHODS: This descriptive study
extracted cross-sectional data on fatal crashes from the Fatality Analysis
Reporting System from 1998 to 2002. Young unlicensed driver fatal crashes
are examined by age, gender, and region. RESULTS: There were 2,452 young
unlicensed driver fatal crashes representing 10.8% of all young drivers'
fatal crashes. By age, 72.5% are over 15 years, males are involved in
74.5%, and southern and western states have a higher percent of young
unlicensed driver fatal crashes. CONCLUSIONS: Subgroups of young people
based on their age, gender, and region are over-represented in fatal crashes
as unlicensed drivers. Further studies are needed to investigate the context
and factors of young unlicensed drivers, essential to tailor interventions.
IMPACT ON INDUSTRY: Young unlicensed drivers circumvent the established
licensing process and pose a serious threat to themselves and other road
users.
Zaloshnja, E., Miller, T., Jones, P., Litovitz, T., Coben, J.,
Steiner, C., & Sheppard, M. (2006). The potential impact
of poison control centers on rural hospitalization rates for poisoning.
Pediatrics, 118(5), 2094-2100.
OBJECTIVE: This study tested the hypothesis that underutilization of poison
control centers is associated with increased rates of hospitalizations
attributable to poisonings in rural areas. METHODS: To measure the potential
impact of poison control centers on hospitalization rates in rural areas
among people who visit emergency departments because of poisoning, we
estimated the reduction in hospitalization rates associated with increased
rates of calls to centers. We used the 2003 State Inpatient Database and
State Emergency Department Database from the Healthcare Cost and Utilization
Project to calculate the numbers of emergency department visits and hospitalizations
for each county in the 12 states analyzed. We used Toxic Exposure Surveillance
System data from the American Association of Poison Control Centers to
calculate the number of human exposure calls per capita according to county.
RESULTS: In rural counties, a 1% higher poison control center human poison
exposure call rate was associated with a 0.19% lower hospitalization rate
among people who visited emergency departments because of poisoning. If
the observed association is causative, then 43.3 calls would prevent 1
hospital admission, yielding 7321 dollars in net cost savings and a return
on investment of 5.9:1 (from the health care system perspective). CONCLUSIONS:
Our results establish the existence of the hypothesized association between
rural poison control center utilization rates and hospitalization rates
among emergency department-treated poisoning patients.
Edwards, J. M., Halpern, C. T., & Wechsberg, W. M.
(2006). Correlates of exchanging sex for drugs or money among women who
use crack cocaine. AIDS Education and Prevention, 18(5), 420-429.
This study examined the correlates of trading sex for drugs or money among
women who use crack cocaine. Using baseline data (n = 669) from a woman-focused
HIV intervention study among African American women who use crack cocaine,
we conducted logistic regression analysis to examine the odds of trading
sex associated with distal and proximal factors. The results indicate
that heavier crack use, homelessness, and unemployment are associated
with trading sex. In addition, childhood abuse is associated with trading
sex and this relationship is, in part, mediated by psychological distress.
This suggests that distal factors may underlie the relationship between
current variables and sex trading. These findings underscore the importance
for public health interventions to address both distal and proximal factors
that contribute to and/or co-occur with women's drug use which, in turn,
may affect their HIV risk and overall well-being.
Ringwalt, C., & Bliss, K. (2006). The cultural tailoring
of a substance use prevention curriculum for American Indian youth. Journal
of Drug Education, 36(2), 159-177.
In this article we discuss the importance of the cultural tailoring (CT)
of classroom-based prevention curricula to ensure their relevance to,
and increase their receptivity by, racial and ethnic minority adolescent
populations. Following a review of the pertinent literature, we develop
an integrated model of CT that conceptualizes such adaptations into "superficial/peripheral,"
"deep structure/sociocultural," and "evidential,"
and subclassifies the first of these into "language" and "images."
We then describe the results of the application of this model post hoc
to the adaptation of a specific alcohol use prevention curriculum, "Protecting
You/Protecting Me," to enhance its suitability for youth in three
American Indian tribes in Nebraska. We conclude with a discussion of the
adequacy of the model of CT we developed and the potential challenges
and benefits of subjecting other curricula to this process.
Sanchez, R. P., Waller, M. W., & Greene, J. M. (2006).
Who runs? A demographic profile of runaway youth in the United States.
Journal of Adolescent Health, 39(5), 778-781.
Prevention and treatment programs for runaways have been hindered by an
inadequate population profile. Using Add Health data to determine 12-month
prevalence and demographic predictors of running away, we found that over
6% of youths reported running away. Running was predicted by biological
gender, age, region, urbanicity, and family structure.
Goodwin, A. H., Waller, M. W., Foss, R. D., & Margolis, L.
H. (2006). Parental supervision of teenage drivers in a graduated
licensing system. Traffic Injury Prevention, 7(3), 224-231.
OBJECTIVES: Most states now have lengthy learner periods for young, beginning
drivers as part of their graduated driver licensing (GDL) systems. Although
parents play a vital role during the learner stage of GDL by supervising
driving practice, virtually nothing is known about the nature and quality
of parental supervision. The objectives of this study were to investigate
parents' supervisory behavior and parent-teen relationships during the
learner stage of graduated licensing and to evaluate two approaches for
assisting parents in supervising their teenager's early driving experience.
METHODS: Families of teenagers applying for a learner permit received
either a booklet describing highly structured practice sessions for beginning
drivers, a series of "tip sheets" offering more generalized
guidance, or no special materials. Questionnaires were sent separately
to parents and teenagers three to six months after teenagers obtained
their permit. RESULTS: Of 1,190 participating families, 653 parents (55%)
and 609 teenagers (51%) responded. Both parents and teenagers perceived
parents as supportive and helpful during driving sessions. Parents often
demonstrated positive behaviors, such as complimenting their teenager
and pointing out possible hazards; they also exhibited less desirable
behaviors, such as raising their voice, but these were less frequent.
A majority of parents (71%) and teenagers (52%) reported that they enjoyed
spending this time together. About four months after obtaining a permit,
most parents believed their teenager did not yet have enough experience
and was not ready to drive unsupervised. Although the reported behaviors
are encouraging, within-family agreement was low on most items. Finally,
efforts to assist parents proved unsuccessful. Although parents thought
the booklet and tip sheets were helpful, most used these materials only
in a general way. CONCLUSIONS: The extended learning experience required
by GDL programs is a positive experience for many families. However, finding
a method for helping parents achieve maximum benefits during this process
will be challenging. The results also suggest that current requirements
in the learner phase of most state GDL systems (six months; 30-50 hours)
may be inadequate to ensure that teenagers obtain a sufficient amount
of experience to begin driving safely on their own.
Maisto, S. A., Clifford, P. R., Stout, R. L., & Davis, C.
M. (2006). Drinking in the year after treatment as a predictor
of three-year drinking outcomes. Journal of Studies on Alcohol, 67(6),
823-832.
OBJECTIVE: Previous research suggests that abstinence from alcohol during
the first year posttreatment for alcohol-use disorders (AUDs) is an important,
independent predictor of longer-term alcohol consumption and related functioning.
The purpose of this study was to test the hypothesis that abstinence during
the first year posttreatment initiation predicts alcohol use at Months
37-39. A second aim of this study was to explore the relationship between
"moderate" drinking in the first year and drinking at Months
37-39. METHOD: Secondary data analyses were conducted on the outpatient
Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity)
sample (N = 952 at baseline and 802 at Months 37-39). For these analyses,
participants were classified first as abstainers, moderate drinkers, or
heavy drinkers based on their alcohol use in the first year posttreatment
initiation. RESULTS: Analyses of covariance showed that the first-year
drinker classification predicted both percentage of days abstinent and
drinks per drinking day at Months 37-39. Subsequent analyses showed that
the abstainers functioned significantly better than (1) both of the other
drinker groups combined and (2) either of the other two groups, which
did not differ from each other on either measure of alcohol use. A third
set of exploratory analyses evaluated first-year abstinence and heavy
drinking as continuous variables and showed an essentially linear relationship
between them and drinking at 3 years. CONCLUSIONS: This study confirmed
the strong relationship between first-year abstinence and later drinking
but did not show that participants who engaged in moderate drinking during
the first year had positive alcohol-use outcomes at 3 years. The clinical
implications of the findings, their generalizability to different populations
of individuals presenting for specialty alcohol treatment, and future
research directions are discussed.
Zywiak, W. H., Stout, R. L., Longabaugh, R., Dyck, I., Connors,
G. J., & Maisto, S. A. (2006). Relapse-onset factors in Project
MATCH: The Relapse Questionnaire. Journal of Substance Abuse Treatment,
31(4), 341-345. Previously, items on the relapse-onset section of the
Relapse Questionnaire have been grouped together based on face validity.
In the present article, an empirical scoring method for this measure is
derived through a factor analysis of Project MATCH data. Three factors
replicate the factor solutions of other measures of alcohol relapse onset
and relapse risk. The three factors found in this study include the following:
Negative Affect/Family Influences, Craving/Cued, and Social Pressure.
This study also replicates earlier findings that social pressure relapses
are most likely to repeat, and that negative affect relapses are more
severe. Earlier studies typing relapses have hypothesized that this may
be one method to detect treatment effects that might otherwise be missed
if relapses are not differentiated and only generic measures (such as
time to first drink) are used. This hypothesis is tested in the present
article, and Motivational Enhancement Therapy is revealed to offer protection
against social pressure relapses that is less than those offered by Cognitive-Behavioral
Coping Skills Therapy or Twelve-Step Facilitation Therapy.
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