Biomedical subjects

Kristen G Anderson

Publications and source records attributed to Kristen G Anderson.

At least 19 recordsLinked to original sources

PubMed2006

Substance use treatment outcomes for youth: integrating personal and environmental predictors.

This investigation examined personal and environmental predictors of substance treatment outcomes in youth. A 424 adolescents (M=15.9 years, S.D.=1.3) completed comprehensive assessments, including substance use, environmental factors (e.g., family history, social supports), and person-centered variables (e.g., Axis I diagnosis, motivation, self-esteem), at study intake and throughout the year following inpatient treatment. Youth treatment outcomes were assessed by relapse status (abstaining, minor relapse, major relapse) and DSM-IV dependence symptoms at 1 year. Relapse status was predicted by demographic (age), environmental (social supports), and person-centered factors (diagnosis) while dependence symptoms were best predicted by substance use variables alone. Consideration of the general and specific nature of risk and protection within the adolescent developmental context were explored.

Adolescent↗

PubMed2006

Life stress, coping and comorbid youth: an examination of the stress-vulnerability model for substance relapse.

The stress-vulnerability model of addiction relapse states that the impact of life stress on alcohol and other drug use is influenced by several types of psychosocial risk and protective factors. Coping skills have been shown to be protective against alcohol or other drug use in adolescents and adults. To date, the influence of life stress and coping on addiction relapse has not been investigated among substance use disordered youth with comorbid Axis I psychopathology. In the present study, 80 adolescents, ages 13 to 17, were followed six months after treatment for substance use and Axis I disorders. Participants completed measures of psychopathology, substance use, life stressors and coping during treatment and at three and six months following treatment. Coping ability best predicted youth substance use at six months. Negative life events moderated the relation between coping and frequency of substance use. These results suggest that coping is a protective factor for return to substance involvement post-treatment, particularly for comorbid youth who have experienced high levels of life stress.

Adaptation, Psychological↗

PubMed2006

Adolescent self-selection of service formats: implications for secondary interventions targeting alcohol use.

A novel motivational enhancement based secondary alcohol intervention has been shown to increase quit attempts for youth with heavier alcohol use histories (Brown et al., 2005). In the present study, we examined rates of self-selection into the three formats of this alcohol intervention: group, individual, and website; and examined differences between intervention participants and the general school population and across the three formats. Over four years, students at four schools were surveyed (n=6000) and were provided the opportunity to participate in Project Options (PO). Youth who were selected into PO (n=1147) were younger and more likely to identify as African American or Multiple/Other ethnicity than the school populations. More teens in PO reported lifetime alcohol use (65% vs. 60%); however, the school population reported more current (past 30 day) drinking. Boys were more likely to utilize the group format and minority youth were more likely to select the individual format. Findings highlight the utility of multiple intervention formats to engage youth in early intervention for alcohol problems.

Adolescent↗

PubMed2005

Characteristics of relapse to substance use in comorbid adolescents.

UNLABELLED: This study examined the factors associated with the relapse process for substance use disordered (SUD) youth with comorbid psychiatric disorders. Temporal and situational characteristics as well as psychiatric symptoms, self-efficacy, and developmentally relevant experiences preceding first relapse after treatment were evaluated as part of a youth focused addiction relapse model. METHOD: Adolescents (N = 81) with a DSM-III-R substance use disorder (SUD) and another Axis I psychiatric disorder were recruited from inpatient substance abuse and psychiatric treatment. Face-to-face interviews were conducted while youth were in treatment and monthly telephone interviews were conducted in the six months following treatment to ascertain length of time to first substance use episode and characteristics of the episode. RESULTS: Youth who relapsed within the first month were more likely to report use of drugs other than alcohol or marijuana in their first use, while use among late relapsers was more often preceded by direct social pressure to use. Those relapsing in the first 3 days after treatment were less likely to view substance use as a problem and less likely to report passive emotional states (e.g., boredom) prior to use. Psychiatric symptoms were associated with relapse in conflict/life stress, negative emotional states and active emotional states. Self-efficacy was related to relapse among youth with conflict/life stress, and when youth were experiencing a desire to use in the two weeks prior to relapsing. CONCLUSIONS: Findings highlight some of the factors that are most important in understanding the process of relapse in comorbid adolescents. Research and treatment implications are discussed.

Adolescent↗

PubMed2005

Facilitating youth self-change through school-based intervention.

Early interventions for youth with high rates of alcohol use have often suffered from lack of willing participation due to negative stereotypes about treatment and the impression that alcohol interventions are not developmentally relevant for adolescents. This study evaluated the effectiveness of a school-based voluntary secondary intervention for alcohol use (Project Options). 1254 high school students (55% girls; M age = 15.9, SD = 1.2) with a history of lifetime drinking completed survey measures after the first year of Project Options in 3 schools. These results suggest that the intervention was successful in recruiting high-frequency drinkers into the intervention as well as facilitating attempts to cut down or quit alcohol use in this group of adolescents. This study provides preliminary support for a consumer-based approach to alcohol intervention and design and use of voluntary secondary interventions in a school-based population.

Adolescent↗

PubMed2005

An examination of self-medication and rebound effects: Psychiatric symptomatology before and after alcohol or drug relapse.

This study evaluated psychiatric symptoms preceding and following initial posttreatment substance use episodes. 125 veterans meeting DSM-IV criteria for alcohol, cannabis, and/or stimulant dependence at treatment entry were followed with quarterly interviews for one year. Approximately half of the sample met criteria for substance use disorders only (n = 65; SUD-only) and half additionally met criteria for an independent non-substance related Axis I disorder (n = 60; SUD-PSY). SUD-PSY adults reported more psychiatric symptoms preceding and following substance use compared to SUD-only adults. Depression and anxiety symptoms were commonly reported by both groups. Symptoms typically did not change or worsened after substance use, with depression worsening more than anxiety or psychotic symptoms. Findings are discussed in relation to the Self-Medication Hypothesis and the Rebound Hypothesis.

Adult↗

PubMed2005

Treatment of adolescent alcohol-related problems. A translational perspective.

In the present chapter we have sought to articulate a translational perspective linking development during adolescence to alcohol treatment and its evaluation. Clearly adolescents with alcohol use disorders cannot be treated as younger versions of adults. The unique demands of their developmental stage permeate all aspects of their behavior, including alcohol use and abuse. Multi-dimensional developmental models help inform the design, implementation, and evaluation of alcohol and drug treatment programs. While an understanding of individual risk factors is informative, only through models integrating multiple risk pathways embedded in the context of adolescent development can we hope to build more efficacious and effective systems of intervention for youth with AUDs. Effective treatment of adolescent AUDs not only urges translation of the developmental perspective into pre-existing treatment approaches but argues for a paradigm shift towards alternative intervention designs and evaluation procedures and foci.

Adaptation, Psychological↗

PubMed2005

Elementary school drinking: the role of temperament and learning.

Drinking in elementary school, despite its low base rate, has been shown to predict alcohol use in middle school (Wilson, Battistich, Syme, & Boyce, 2002), which in turn predicts alcohol abuse or dependence in young adults (Guo, Collins, Hill, & Hawkins, 2000). The authors report 1 of the 1st examinations of the relationship between personality and psychosocial learning risk factors and drinking behavior among elementary school students. Fifth-grade students completed measures of disinhibition, positive and negative alcohol expectancies, and drinking. MIMIC modeling, tests of mediation, and tests of moderation were completed to test these relations. It was found that disinhibition and positive alcohol expectancies were each related to drinking in 5th graders. Disinhibition moderated the relation between positive alcohol expectancies and drinking in some cases. Mediation was not supported.

Alcohol Drinking↗

PubMed2005

Relapse in alcohol- and drug-disordered adolescents with comorbid psychopathology: changes in psychiatric symptoms.

This study examined reciprocal relationships between posttreatment substance use and psychiatric symptoms in adolescents with both a substance use disorder and an Axis I mental health disorder. Participants (13-18 years old) were recruited from inpatient treatment centers and interviewed during treatment and monthly for 6 months. Participants who relapsed (N=103; 48% female) reported the incidence and severity of psychiatric symptoms experienced before and after their 1st posttreatment substance use. The number of symptoms and depression symptoms experienced were related to use of stimulants and other drugs during relapse. There was evidence for both self-medication (symptom reduction) and rebound (symptom exacerbation) effects of substance use on symptom severity. These results demonstrate that, for adolescents with both substance use and mental health disorders, psychiatric symptoms are 1 factor influencing posttreatment substance use.

Adolescent↗

PubMed2005

Evaluation of a level of response to alcohol-based structural equation model in adolescents.

OBJECTIVE: A low level of response (LR) to alcohol relates to a family history of alcoholism and predicts future heavier drinking and alcohol-related problems. The current analyses evaluate how LR functions within the context of a Social Information Processing Model, using 238 subjects aged 13 to 19 years from the Collaborative Study on the Genetics of Alcoholism (COGA). METHOD: A structural equation model (SEM) was used to evaluate the relationship among (1) a family history (FH) of alcoholism, (2) the LR to alcohol, (3) expectations as measured by the Alcohol Expectancy Questionnaire and (4) the recent pattern of drinking among parents in the home as predictors of the maximum recent quantity of drinking, the maximum number of drinks ever consumed in 24 hours and the number of alcohol problems in the teenage subjects. RESULTS: When tested in the SEM, LR functioned as a mediator of the relationship between an FH of alcoholism and alcoholic outcome, and expectancy functioned as a partial mediator of the relationship between LR and outcome. Invariance testing revealed that the SEM performed similarly in light and heavy drinkers, the two sexes, and older versus young subjects. Both the measurement model and SEM had good characteristics of fit, and direct paths within the model explained 49% of the variance of outcome. CONCLUSIONS: Consistent with results from the San Diego Prospective Study, when tested in the more heterogeneous COGA population, LR functioned as a mediator of the relationship between the FH and alcoholic outcome. In these adolescents, LR not only had a direct relationship to alcoholic outcome but, in contrast to prior results in adults, also appeared to operate through expectations of the effects of alcohol in predicting heavier drinking and a higher rate of alcohol-related problems among teenagers.

Adolescent↗

PubMed2005

Examining personality and alcohol expectancies using functional magnetic resonance imaging (fMRI) with adolescents.

OBJECTIVE: Personality and alcohol expectancies have been examined as risk factors for the initiation and maintenance of alcohol use in adolescents and young adults. Differences in processing appetitive stimuli are seen as a mechanism for personality's influence on behavior, and that mechanism predisposes individuals to form more positive expectancies for alcohol. The go/no-go task has been used to show how personality differences influence responding to appetitive stimuli in adolescents and adults, and functional magnetic resonance imaging (fMRI) has been used to examine the relation of go/no-go responding to personality in adult males. However, no study to date has examined the relation between fMRI responding, personality and alcohol expectancies in adolescents. METHOD: Forty-six adolescents (ages 12-14 years; 61% male) with minimal substance use histories completed measures of neuroticism, extraversion, and alcohol expectancies, and performed a go/no-go task during fMRI acquisition. RESULTS: Greater blood oxygen level-dependent (BOLD) response to inhibition predicted fewer expectancies of cognitive and motor improvements but more expectancies of cognitive and motor impairment from alcohol. In addition, extraverted youths reported more positive alcohol expectancies. However, BOLD response did not predict neuroticism or extraversion. CONCLUSIONS: These preliminary results suggest that decreased inhibitory neural processing may contribute to more positive and less negative expectancies, which can eventually lead to problem drinking. Further, extraversion may also yield more positive expectancies and could underlie a vulnerability to disordered alcohol use.

Adolescent↗

PubMed2004

Similarities and differences between women and men on eating disorder risk factors and symptom measures.

Researchers studying eating disorders in men often use eating disorder risk and symptom measures that have been validated only on women. Using a sample of 215 college women and 214 college men, we report on the validity of doing so with a set of measures chosen to reflect a wide range of risk factors and symptoms. The Bulimia Test-revised (BULIT-R), the restraint scale (RS), the three-factor eating questionnaire (TFEQ), the Eating Expectancy Inventory, and the eating attitudes test (EAT) all had the same factor structures for both genders, and tests of invariance showed that factor loadings, factor variances, and intercorrelations among factors were equivalent across gender. A modified Structured Clinical Interview for DSM-IV anorexic symptoms questionnaire did not perform adequately for either gender. Men produced slightly less reliable scores on virtually all measures, with the result that Pearson-based estimates of correlations among the measures were slightly lower for men. Men had lower scores on symptom and risk measures, but not on other eating measures.

Adult↗

PubMed2004

Coping with distress by eating or drinking: role of trait urgency and expectancies.

The authors propose that trait urgency (the tendency to act rashly when distressed) is a risk factor for both alcohol abuse and bulimic symptoms, that disorder-specific expectancies influence whether one engages in one behavior or the other, and that expectancies moderate urgency's influence on those behaviors. Cross-sectional findings were consistent with the model. Problems from alcohol use were comorbid with binge eating and purging. Trait urgency was associated with both behaviors. Alcohol expectancies were associated with drinking levels and with problem drinking, but not with eating. Eating expectancies were associated with binge eating, but not with alcohol use or problems. Urgency's effect on binge eating was moderated by expectancies, but its effect on alcohol use and problem drinking was not.

Adolescent↗

PubMed2004

Testing the level of response to alcohol: social information processing model of alcoholism risk--a 20-year prospective study.

BACKGROUND: The low level of response (LR) to alcohol is a genetically influenced characteristic associated with an enhanced risk for alcohol use disorders (AUDs). An optimal understanding of how this intermediate phenotype relates to the AUD risk requires evaluation of the milieu in which LR operates, and this study tested an LR/social information processing model in adult men. METHODS: Almost 300 Caucasian males (97% of those eligible, to date) from the San Diego Prospective Study participated in an alcohol challenge at approximately age 20 and were evaluated with a structural equation model regarding their expectations of the effects of alcohol, drinking among peers, use of alcohol to cope with stress, and alcohol-related problems during follow-up. RESULTS: The direct paths in the structural equation model in these 40-year-old men explained 58% of the variance of the alcoholic outcome at age 40 and 35% at age 35 while demonstrating good fitness characteristics. The LR to alcohol was related to the family history of AUDs and to the alcoholic outcome; the latter primarily operated through the use of alcohol to cope with stress. Although drinking in peers and expectations of the effects of alcohol both contributed to the model in these 40-year-old men, they were not directly related to LR. CONCLUSIONS: The results continue to support the importance of the low LR to alcohol as a predictor of AUDs, even when evaluated in the context of additional relevant characteristics. Future evaluations of adolescent and young adult subjects will also explore the potential importance of expectations of the effects of alcohol and drinking among peers as mediators or moderators of alcoholism risk among subjects with a low LR.

Adaptation, Psychological↗

PubMed2004

Comparability of the Eating Disorder Inventory-2 between women and men.

Researchers studying eating disorders in men often use eating-disorder risk and symptom measures that have been validated only on women. Using a sample of 215 college women and 214 college men, this article reports on the validity the Eating Disorder Inventory-2 (EDI-2), one of the best-validated among women and the most widely used risk and symptom measure for women. The EDI-2 had the same, standard eight-factor structure for both genders, and tests of invariance showed that factor loadings, factor variances, and factor intercorrelations were equivalent across gender. The EDI-2 scales correlated with questionnaire measures of bulimic and anorexic symptomatology equivalently across gender. However the EDI-2 scales were generally less reliable for men, leading to slightly lower Pearson-based estimates of correlations among the measures for men.

Adolescent↗

PubMed2003

Clarifying the role of impulsivity in bulimia nervosa.

OBJECTIVE: With the goal of demonstrating that urgency impulsivity is associated with bulimic symptoms, not (lack of) planning impulsivity, the authors conducted two studies assessing these personality traits and bulimic symptoms in undergraduate women. METHOD: In study 1 291 women completed urgency and deliberation scales of the NEO PIR and the BULIT-R. In study 2 101 women completed alternative measures tapping these personality constructs and the BULIT-R. RESULTS: In both studies, what is commonly assessed with impulsivity measures, a lack of planning, was not significantly associated with bulimic symptoms. However, urgency, the tendency to act rashly when experiencing negative affect, was positively correlated with bulimic symptoms. DISCUSSION: The authors suggest that future researchers assess urgency, not lack of planning, when assessing impulsivity as a risk factor for bulimia nervosa.

Adolescent↗

PubMed2003

Personality and depression in women.

Personality disorders and traits should be assessed in studies concerned with the etiology and treatment of depression in women. There has been a considerable amount of research concerned with the effect of personality functioning on the etiology and treatment of depression, and much of this research has concerned personality traits and disorders for which significant gender differences and issues apply. The importance of personality functioning, and the particular relevance to women and gender-related issues, is illustrated in this paper with regard to dependent personality disorder and dependent personality traits. Implications for future research on the etiology and treatment of depression in women are provided.

Adult↗

PubMed2003

Expectancy influences the operation of personality on behavior.

The authors investigated the moderating effect of expectancies on personality for 2 different addictive behavior processes: (a) drinking and (b) binge eating and purging characteristic of bulimia nervosa. Study 1 found that positive expectancies for social facilitation from drinking moderated the effect of extraversion on drinking behavior among undergraduate men and women. Study 2 found that the expectancy that eating will help manage negative affect moderated the effect of trait urgency on bulimic symptoms among undergraduate women. Thus, the relationships of the trait risk factors to these 2 addictive behaviors are stronger if one also holds certain expectancies for reinforcement from those behaviors.

Adolescent↗