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Ken C Winters

Publications and source records attributed to Ken C Winters.

15 recordsLinked to original sources
PubMed2006

Prospective study of adolescent drug use among community samples of ADHD and non-ADHD participants.

OBJECTIVE: To describe the late adolescent drug use outcomes from a relatively large, community-identified sample of children with attention-deficit/hyperactivity disorder (ADHD) who have been assessed longitudinally from childhood through late adolescence. METHOD: Adolescent drug use outcomes were compared between ADHD-only (n = 27), ADHD-externalizing (mostly oppositional defiant disorder) (n = 82), and normal control (n = 91) groups. RESULTS: The ADHD-externalizing group revealed significantly worse drug use outcomes (drug use frequency and substance use disorders) compared to the other two groups, and the ADHD-only group showed outcomes comparable to the community control group. CONCLUSIONS: ADHD without a comorbid externalizing disorder is not associated with an increased risk of drug abuse. ADHD with a comorbid externalizing disorder, primarily oppositional defiant disorder, is associated with an elevated risk of drug use, particularly with respect to marijuana and tobacco involvement.

Adolescent↗
PubMed2005

Diagnosis, course, and assessment of alcohol abuse and dependence in adolescents.

Risk for the onset of an alcohol use disorder (AUD) peaks during adolescence and the transition to young adulthood, highlighting the public health significance of alcohol use by adolescents. This chapter summarizes recent research on the diagnosis, course, and assessment of adolescent AUDs. This review focuses on developmental considerations in assessment of AUD criteria, the prevalence of DSM-IV AUDs among adolescents, typical alcohol symptom profiles in youth, and limitations of DSM-IV AUD criteria when applied to adolescents. In addition, studies of AUD course in adolescents, as well as factors influencing the course of AUDs are summarized. The chapter also provides an overview of brief alcohol screening instruments and other measures used in more comprehensive assessment of AUDs in adolescents.

Adolescent↗
PubMed2005

Alcohol use and prior substance abuse treatment in relation to gambling problem severity and gambling treatment outcome.

Recent research has made it clear that problematic gambling is often accompanied by problematic alcohol use. Unfortunately, little is known about the nature of this association, especially as it relates to gambling treatment outcome. The purpose of this study is to explore the effect of current alcohol use level and previous substance abuse treatment on the symptoms of a large cohort of pathological gamblers as well as on their response to treatment for pathological gambling. The sample included 464 men and 301 women recruited at six gambling treatment programs in Minnesota. Gambling treatment patients were assessed on a number of gambling problem severity and related clinical variables using the Gambling Treatment Outcome Monitoring System (GAMTOMS). Patients with frequent alcohol use had greater gambling involvement at baseline than infrequent alcohol users. Patients with a previous history of substance abuse treatment had more severe psychosocial problems, ostensibly resulting from their gambling behavior, than patients without past substance abuse treatment. A MANOVA with repeated measures showed that neither pretreatment alcohol use, nor past substance abuse treatment exerted significant effects on gambling treatment outcome. While the level of pretreatment alcohol use and a history of substance abuse treatment are markers for greater gambling problem severity, treatment outcome for pathological gambling was not adversely impacted by these variables.

Adult↗
PubMed2005

Pathways of youth gambling problem severity.

Prospective studies are needed to advance knowledge of the developmental features of gambling involvement and associated problems. Developmental pathways of youth gambling problem severity (no problem gambling, at-risk gambling, and problem gambling) are described on the basis of a 3-wave data set that spans midadolescence to young adulthood (N=305). The most prevalent group was the resistors (no problem gambling at all data points); 60% of study participants were in this group. New incidence cases (no problem gambling followed by at-risk or problem gambling) and desistors (at-risk or problem gambling followed by no problem gambling) were found among 21% and 13% of participants, respectively. Only 4% of cases were persistors, that is, at-risk or problem gambling at all 3 data waves. Findings are discussed in light of extant research on adolescent gambling that heretofore has not benefited from a developmental pathway perspective.

Adolescent↗
PubMed2005

Conversion and validation of the Teen-Addiction Severity Index (T-ASI) for Internet and automated-telephone self-report administration.

This study converted the Teen-Addiction Severity Index (T-ASI) into self-report formats using Internet (Net) and interactive voice response (IVR) automated-telephone technologies. Reliability and convergent validity were assessed among 95 inpatient adolescent participants. Current functioning scores obtained by clinician interview correlated well with self-report Net (mean r=.74, SD=.14) and IVR (mean r=.72, SD=.16). Lifetime history items obtained by clinicians were consistent with self-report Net (mean r=.60, SD=.32; mean kappa=.67, SD=.24) and IVR formats (mean r=.60, SD=.30; mean kappa=.64, SD=.26). Participants rated "ease of use" as being high for both Net and IVR formats. These findings suggest that automated T-ASI administration is a valid and potentially less expensive alternative to clinician-administered T-ASI interviews.

Adolescent↗
PubMed2004

Limitations in the assessment of DSM-IV cannabis tolerance as an indicator of dependence in adolescents.

The usefulness of the Diagnostic and Statistical Manual's (4th ed.; DSM-IV; American Psychiatric Association, 1994) tolerance criterion as an indicator of dependence has been debated. The authors of this study evaluated the performance of DSM's cannabis tolerance criterion, operationally defined as a percentage increase in quantity needed to get high, in distinguishing adolescents with and without cannabis dependence. Two samples of adolescent cannabis users (ages 12-19) provided data (ns = 417 and 380). Tolerance, defined as a percentage increase (median increase = 300% and 175%, respectively, in the samples), had only moderate overall sensitivity and specificity in distinguishing those with and without cannabis dependence. Results suggest limitations of the DSM-IV and change-based operational definition of tolerance in adolescents.

Adolescent↗
PubMed2004

Measuring adolescent drug abuse and psychosocial factors in four ethnic groups of drug-abusing boys.

There is an absence of empirical work on the measurement of adolescent drug abuse among non-White ethnic youths. The field would benefit from psychometrically sound measures for ethnic groups. The psychometric properties of a multi-scale assessment tool for adolescent drug abuse, the Personal Experience Inventory (PEI), have been examined largely in White samples. The current study reports reliability and validity data for the PEI across four samples of boys (White, African American, Native American, and Hispanic). The results provide general psychometric support for the non-White groups. The use and limitations of the PEI in different ethnic/racial groups are discussed.

Adolescent↗
PubMed2004

Moving evidence-based drug abuse prevention programs from basic science to practice: "bridging the efficacy-effectiveness interface".

This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.

Adolescent↗
PubMed2003

Integrated family and cognitive-behavioral therapy for adolescent substance abusers: a stage I efficacy study.

This study evaluated the efficacy of Integrated Family and Cognitive-Behavioral Therapy (IFCBT), a multisystems treatment for adolescent drug abuse, versus a Drugs Harm Psychoeducation curriculum (DHPE). A randomized controlled trial assessed youth and parents at baseline and at 1, 3 and 6-month posttreatment points. Youth participants (N=43) met diagnostic criteria for one or more psychoactive substance use disorders with most youth meeting criteria for alcohol and marijuana use disorders. IFCBT produced significant reductions in posttreatment substance use when compared against DHPE. Throughout the 6-month posttreatment period, youth receiving IFCBT used alcohol an average of 2.03 days each month, which was significantly lower than the average number of 6.06 days that DHPE youth used alcohol during the same period. Similarly, youth receiving IFCBT used marijuana an average of 5.67 days each month during the initial 6 posttreatment months which was also significantly lower than the average number of 13.83 days that DHPE youth used marijuana each month during the same period. IFCBT also reduced rates of any marijuana use and produced significant changes in targeted psychosocial risk and protective factors. IFCBT youth exhibited significantly higher levels of rational problem solving and learning strategy skills, and significantly lower levels of problem avoidance when compared with DHPE youths. IFCBT parents exhibited significantly more adaptive scores on communication, involvement, control, and values/norms indices when compared with DHPE parents. No iatrogenic effects were exhibited among youth in either IFCBT or DHPE conditions on the outcome measures examined. The present study findings suggest that IFCBT is a promising approach for the treatment of adolescents with psychoactive substance use disorders.

Adolescent↗
PubMed2003

Treatment issues pertaining to pathological gamblers with a comorbid disorder.

Evidence of an increased risk for various psychiatric disorders among pathological gamblers far exceeds our understanding of the impact that this psychiatric comorbidity has on the outcome of treatment for pathological gambling. One major source of the problem is that treatment efficacy and effectiveness studies for pathological gambling typically have not addressed comorbidity's impact on outcome. This paper discusses epidemiological, clinical, health service delivery, and research issues pertaining to the intersection of pathological gambling treatment outcome and comorbid psychiatric disorders. It is argued that this topic suffers from major knowledge gaps in terms of the nature of comorbidity of pathological gambling and other psychiatric disorders and the role of client characteristics on treatment outcome for pathological gambling. Research priorities are identified.

Combined Modality Therapy↗
PubMed2003

Course of alcohol problems in treated adolescents.

Knowledge of the clinical course in treated adolescents is fundamental to determining the influence of treatment on long-term functioning and the factors associated with change in the severity of alcohol problems over time. This symposium, held at the 2002 annual Research Society on Alcoholism meeting and organized by Tammy Chung and Christopher S. Martin, presented research on the course of alcohol-related problems in treated adolescents who were followed prospectively for 1 to 8 years. Presentations included (1) Alcohol use outcomes at 1 year among adolescents in the drug abuse treatment outcomes studies (DATOS-A), by Christine E. Grella; (2) Pathways and predictors of the course of adolescent alcohol problems across 1- and 3-year follow-ups, by Tammy Chung; (3) Young adult outcomes of an adolescent clinical sample at 5-year follow-up, by Ken C. Winters; and (4) Trajectories of alcohol involvement following addiction treatment through 8-year follow-up in adolescents, by Ana M. Abrantes, Denis M. McCarthy, Gregory A. Aarons, and Sandra A. Brown. Sandra A. Brown, discussant, commented on the presentations. Results from these studies indicate multiple pathways of change, distinguished by fluctuations in the chronicity and severity of alcohol problems. Across studies, most adolescents showed reductions in alcohol use and problems after treatment, with concurrent improvements in psychosocial functioning. Findings highlight the influence of other drug use on posttreatment patterns of alcohol involvement and the need to consider the effect of normative developmental transitions on the course of adolescent-onset substance use disorders.

Adolescent↗
PubMed2002

Measuring risks and outcomes in substance use disorders prevention research.

Assessment planning in substance use disorder prevention research entails the identification of measurement domains and the selection of corresponding instruments needed to fulfill specific project goals. The study design, developmental periods examined, feasibility constraints, and anticipated statistical analyses are important considerations in optimally designing the assessment protocol. As a conceptual framework to organize the domains considered here as examples, the multifactorial model of complex disorders with elaborations emphasized by the discipline of developmental psychopathology is applied. Risks reviewed include family history, childhood maltreatment, peer relationships, and psychopathology. The substance involvement dimensions germane as outcomes include substance type, consumption quantity and frequency, and substance-related problems. Comprehensive diachronic evaluation over critical developmental periods provides the technical foundation for etiology and intervention research.

Adolescent↗
PubMed2002

A prospective study of youth gambling behaviors.

Little is known about the course and outcomes of adolescent gambling. This prospective study describes findings from a 3-wave (Time 1 [T1], Time 2 [T2], and Time 3 [T3]) assessment of gambling behaviors among youth (N = 305). Stable rates of any gambling and regular gambling (weekly or daily) were observed across T1, T2, and T3. The rate of at-risk gambling significantly increased at T3 (young adulthood), whereas the rate of problem gambling remained stable over time. Several adolescent risk factors were associated with either T3 at-risk or problem gambling, many of which are risk factors for adolescent substance abuse. Findings suggest that important to the origins of young adult gambling problems are risk factors associated with the problem behavior syndrome of adolescence.

Adolescent↗
PubMed2002

Gender differences in psychiatric comorbidity among adolescents with substance use disorders.

The authors examined gender differences in rates of comorbid psychiatric disorders among adolescents with I or more psychoactive substance use disorders. Baseline diagnostic data were obtained from 135 adolescents, ages 12 to 19, and their parents-guardians, who participated in a study to develop and efficacy test Integrated Family and Cognitive-Behavioral Therapy. Rates of attention-deficit/hyperactivity disorder and conduct disorder were higher among drug-abusing male adolescents compared with drug-abusing female adolescents. However, high rates of disruptive behavior disorders also characterized drug-abusing female adolescents. Similarly, drug-abusing female adolescents exhibited a higher rate of major depression compared with drug-abusing male adolescents. However, rates of dysthymia, double depression (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders.

Adolescent↗