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Southeast > News > Prevention News > Dec 05 News this Month |
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New this Month - December 2005 Below are citations/abstracts of recently published articles and publications that have been authored and/or co-authored by Pacific Institute staff. Calverton Bob Voas Voas R.B., Furr-Holden D., Lauer E., Bright K., Johnson M.B., & Miller B. (2006). Portal surveys of time-out drinking locations: A tool for studying binge drinking and AOD use. Evaluation Review, 30(1), 44-65. [with D. Furr-Holden of PIRE/Calverton, E. Lauer of PRC/San Diego, K. Bright of PRC, M.B. Johnson of PIRE/Calverton, and B. Miller of PRC]. Portal surveys, defined as assessments occurring proximal to the entry point to a high-risk locale and immediately on exit, can be used in different settings to measure characteristics and behavior of attendees at an event of interest. This methodology has been developed to assess alcohol and other drug (AOD) use at specific events and has included measuring intentions to use collected at entry and reported use on exit, as well as chemical tests for AOD consumption at both entrance and exit. Recent applications of the portal survey procedure to electronic music dance events that occur in established venues (e.g., bars or nightclubs) are discussed. Chapel Hill Denise Hallfors Hallfors D., Brodish P.H., Sanchez V., Khatapoush S., Cho H., & Steckler A. (2005). Feasibility of screening adolescents for suicide risk in "Real World" high school settings. American Journal of Public Health, 2005 Dec 27; [Epub ahead of print] [with P.H. Brodish, V. Sanchez, H. Cho & A. Steckler of Chapel Hill]. Objectives. We evaluated the feasibility of a population-based approach to preventing adolescent suicide. Methods. A total of 1323 students in 10 high schools completed the Suicide Risk Screen. Screening results, student follow-up, staff feedback, and school responses were assessed. Results. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screening after 2 semesters. In further analyses, about half of the students identified were deemed at high risk on the basis of high levels of depression, suicidal ideation, or suicidal behavior. Priority rankings evidenced good construct validity on correlates such as drug use, hopelessness, and perceived family support. Conclusions. A simpler, more specific screening instrument than the Suicide Risk Screen would identify approximately 11% of urban high school youths for assessment, offering high school officials an important opportunity to identify young people at the greatest levels of need and to target scarce health resources. Our experiences from this study show that lack of feasibility testing greatly contributes to the gap between science and practice. Hallfors, D., Cho, H., Brodish, P., Flewelling, R., & Khatapoush, S. (2006). Identifying high school students at risk for substance abuse and other behavioral problems: Implications for prevention. Substance Use and Misuse, 41(1), 1-15. [with H. Cho, P. Brodish, & R. Flewelling of Chapel Hill]. Attendance and grade point average (GPA) data are universally aintained in school records and can potentially aid in identifying students with concealed behavioral problems, such as substance use. Researchers evaluated attendance (truancy) and GPA as a means to identify high school students at risk for substance use, suicide behaviors, and delinquency in 10 high schools in San Antonio, Texas, and San Francisco, California, during the spring and fall of 2002. A screening protocol identified students as "high risk" if (1) in the top quartile for absences and below the median GPA or (2) teacher referred. Survey responses of 930 high-risk students were compared with those from a random sample of 393 "typical" students not meeting the protocol. Bivariate and multivariate analyses assessed associations between the screening protocol variables and demographics, risk and protective factors, and problem outcomes. The individual contribution of each of the variables was also assessed. Students identified as high risk were significantly more likely than typical students to use cigarettes, alcohol, and marijuana, evidence suicide risk factors, and engage in delinquent behavior. Norms varied between the two districts; nevertheless, high-risk students showed consistent differences in risk and protective factors, as well as problem behaviors, compared with typical students. Because of site differences in data collection and teacher participation, the comprehensive protocol is recommended, rather than individual indicators alone (e.g., truancy). Strengths of the screening protocol are the ready availability of school record data, the ease of use of the adapted protocol, and the option of including teacher referral. More research is recommended to test the generalizability of the protocol and to ensure that there are no unintended negative effects associated with identification of students as high risk. Beth Moracco Campbell JC, Martin SL, Moracco KE, Manganello JA, Macy RJ. (2006). Survey data sets pertinent to the study of intimate partner violence and health. Trauma, Violence & Abuse, 7(1), 3-18. Knowledge regarding intimate partner violence has evolved from a somewhat fragmentary and incomplete understanding of the topic to a more cohesive, multifaceted body of research. Despite these accomplishments, there are still many critical knowledge gaps about this important problem. In this age of fiscal restraint, using existing information to address research questions is extremely appealing. This article describes some currently available survey data sets that contain information regarding women's experiences of intimate partner violence and health, identifies a number of the strengths and limitations of these data sets, and makes recommendations concerning the types of survey data that should be gathered in the future to help move the field forward. Providence Bob StoutSkodal, A. E., Gunderson, J. G., Shea, M. T., McGlashan, T. H., Morey, L. C., Sanislow, C. A., Bender, D. S., Grilo, C. M. Zanarini, M. C., Yen, S., Pagano, M. E., & Stout, R. L. (2005). The Collaborative Longitudinal Personality Disorders Study (CLPS): Overview and implications. Journal of Personality Disorders, 19(5), 487-504. The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional personality traits appear to be the foundation of behaviors described by many PD criteria. Taken together, our results lead us to hypothesize that PDs may be reconceptualized as hybrids of stable personality traits and intermittently expressed symptomatic behaviors. Phillips, K. A., & Stout, R. L. (2005). Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive compulsive disorder, and social phobia. Neuropsychopharmacology, 30:S231. Poster Session presented at the 44th Annual Meeting of the American College of Neuropsychopharmacology (ACNP), December 11-15, 2005. Background: Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in one’s physical appearance, is a relatively common and severe somatoform disorder that is highly comorbid with certain other Axis I disorders. BDD is widely conceptualized as an OCD-spectrum disorder, based on its prominent obsessions and compulsions, high comorbidity with OCD, apparent referential response to SRIs, and increased frequency in first-degree relatives of OCD probands compared to community controls. BDD has also been hypothesized to be related to mood disorders, given its high comorbidity with major depression and response to antidepressants (SRIs). In Eastern cultures, in contrast, BDD is considered a form of social phobia. However, differences have been found between BDD and these frequently comorbid disorders, suggesting that BDD is not identical to any of them. The relationship between BDD and these putative “near neighbor” disorders has received little investigation, however. To investigate these relationships, which have treatment implications, we examined longitudinal associations between the course of BDD and that of comorbid major depression, OCD, and social phobia in the first prospective study of BDD’s course. Methods: 161 subjects with DSM-IV BDD were prospectively followed over 1 to 3 years. The course of BDD and comorbid disorders was assessed with the reliable Psychiatric Status Rating Scale (PSR); ratings were assigned for each week of follow-up. To examine the longitudinal association between improvement in BDD and improvement in each comorbid disorder, we used proportional hazard regression analyses with time-varying covariates. This approach enables examination, among subjects with both disorders in a given pair at baseline (e.g., both BDD and major depression), of whether changes in course are correlated. If they are, that strongly suggests they are etiologically linked to each other or to a third factor leading to the correlated change. In the prediction of remission of a particular disorder, the time-varying predictor was the PSR rating for the comorbid disorder during the week preceding the time point being analyzed. Hazard (risk) ratios provided an estimate of strength of association between the predictor and dependent variables. Results: BDD had significant longitudinal associations with major depression—that is, change in the status of BDD and major depression were closely linked in time. Improvement in major depression predicted remission from BDD (HR=.604, p=.0006), and, conversely, improvement in BDD predicted remission from major depression (HR=.745, p=.0028). Improvement in OCD also predicted remission from BDD (HR=.506, p=.005); however, BDD improvement did not predict OCD remission (HR=.878, p=.542). No significant longitudinal associations were found for BDD and social phobia. Among those subjects who remitted from major depression,OCD, or social phobia, a majority continued to experience BDD symptoms over the following three months. Discussion: These findings suggest that BDD may be etiologically linked to both major depression and OCD; the association was strongest for depression.However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a majority of subjects who remitted from these disorders. This finding implies that BDD symptoms specifically (not just those of these commonly comorbid disorders) need to be targeted in treatment. Additional research, including neurobiological research, is needed to further elucidate BDD’s relationship to co-occurring disorders, which has both theoretical and clinical implications. William H. Zywiak Maisto. S. A., Zywiak, W. H., & Connors, G. C. (2006). Course of functioning 1 year following admission for treatment of alcohol use disorders. Addictive Behaviors, 31(1), 69-70. Research on alcohol treatment outcomes has the potential to advance nowledge about how treatment combines with other variables to influence cost treatment course of functioning. The purpose of this study was to replicate and extend Connors, Maisto, and Zywiak's (1996) [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatment functioning. Addiction, 91 (Suppl.), S 173-S 189] test of a multivariate model of course by testing the model's fit to data from a larger sample and the use of stronger statistical methods. The participants were 400 men and women presenting for alcohol treatment in two cities in the US. These individuals completed a pretreatment (baseline) assessment battery at treatment initiation and then completed follow-up assessments bimonthly for a period of 1 year. The model included pretreatment, treatment (months 1-6), and post-baseline (months 1-6) factors to predict alcohol use (percent days abstinent, drinks/drinking day, and total number drinks/month, all for months 7-12). The application of structural equation modeling methods revealed that the model fit the data adequately for all three dependent variables, with the major significant findings of direct effects of treatment setting, coping skills, and the mediation of treatment effects through coping skills. Overall, the data replicated several findings from the Connors et al.'s study and point to the importance of investigating the mechanisms underlying treatment effects and the mediation of treatment effects by coping skills in future research.
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