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Biomedical subjects

M Windle

Publications and source records attributed to M Windle.

At least 37 records · Page 2Linked to original sources
PubMed1996

Individual and situational markers of condom use and sex with nonprimary partners among alcoholic inpatients: findings from the ATRISK Study.

Alcoholics in treatment have demonstrated increased rates of HIV risk behavior and infection. This study explored individual and situational variables associated with HIV risk behaviors such as condom nonuse and sex with nonprimary partners reported during structured interviews of 802 male and female alcoholic inpatients. Logistic regression analyses indicated that person variables, sexual history variables, and situation variables were independently associated with sexual risk behavior in the most recent episode. Results of paired t tests revealed that participants who had engaged in sex with both primary and nonprimary partners during the previous 6 months reported significantly more frequent alcohol and condom use in situations involving sex with nonprimary partners. Prevention efforts need to target alcoholic inpatients as a group and, within this group, to focus on both high-risk individuals and high-risk situations.

Adult↗
PubMed1996

On the discriminative validity of a family history of problem drinking index with a national sample of young adults.

OBJECTIVE: This study used data from the National Longitudinal Survey of Youth (NLSY) to test hypotheses relevant to the discriminative validity of a trichotomous family history of problem drinking index. Early onset substance use, adolescent antisocial behaviors and lifetime alcohol and illicit drug use were used as criterion variables. METHOD: Prospective, longitudinal survey data from over 9,000 young adult subjects (ages 23-30 yrs) in the NLSY archive were used to evaluate several hypotheses regarding familial risk of alcoholism. RESULTS: General support for discriminant validity was indicated, as the high density familial risk group differed from the moderate (paternal or maternal problem drinking only) and low-risk groups with regard to a somewhat earlier onset of marijuana use, higher levels of antisocial behaviors in adolescence (especially substance-related offenses and property offenses) and higher levels of lifetime marijuana and cocaine use. The high- and moderate-risk groups differed from the low-risk group with regard to alcohol use and alcohol-disordered problems (e.g., negative consequences, dependency symptoms). CONCLUSIONS: Risk associated with high familial problem-drinking density includes an earlier onset of illicit substance use, higher rates of lifetime marijuana and cocaine use and more frequent adolescent antisocial behavior. The general pattern of the findings was robust for men and women and suggests that high-risk status may reflect both a high genetic loading and a high environmental risk loading.

Adolescent↗
PubMed1996

An alcohol involvement typology for adolescents: convergent validity and longitudinal stability.

OBJECTIVE: This study used data from over 1,000 adolescents to evaluate the convergent validity and longitudinal stability of a five-group drinker typology (abstainers, light, moderate, heavy and problem drinkers). Drinker types were compared on a range of variables from the domains of childhood behavior problems, drinking motives, early substance use onset, family and peer relations. METHOD: Prospective, longitudinal survey data were collected from 10th and 11th graders and from their primary caregivers (principally mothers) to evaluate hypotheses about correlates of adolescent substance use. RESULTS: General support was indicated for the distinctiveness of the adolescent drinker types. Moderate drinkers differed systematically from light drinkers and abstainers on several variables (e.g., disinhibitory behavior while drinking, percentage of friends who drink); heavy drinkers differed from moderate drinkers (e.g., percentage of friends who use drugs, illicit drug use); and problem drinkers differed from heavy drinkers (e.g., childhood behavior problems, coping motives for drinking, percentage of friends who use drugs, disinhibitory behavior while drinking). Over 50% of problem drinkers and 62% of abstainers remained similarly categorized across a 1-year interval. CONCLUSIONS: The heterogeneity of alcohol-related behaviors among adolescents may be usefully represented via a drinker status typology that incorporates data on alcohol consumption, heavy-drinking episodes and adverse consequences. Different correlates for the drinker types highlight the need for a more distinctive approach to the prevention and treatment of adolescent drinking behaviors.

Adaptation, Psychological↗
PubMed1996

The onset and cross-temporal patterning of sexual intercourse in middle adolescence: prospective relations with behavioral and emotional problems.

This study examined precursors and correlates of sexual intercourse patterns (e.g., earlier/later onset, persistence across time) among tenth and eleventh graders. Data regarding intercourse were collected for lifetime and for 6-month periods at 4 occasions of measurement over a 2-year span. Significant differences in behavioral (e.g., delinquency) and emotional (e.g., depression) problems were indicated via repeated-measures MANOVA analyses. Significant interactions among intercourse patterns, gender, and time on emotional and behavioral problems indicated synergistic relations. Planned comparisons indicated that the transition to the onset of sexual intercourse was associated with increases in delinquency and a slower rate of increase for school grades. Earlier onset and a more persistent pattern of sexual intercourse were associated with more childhood problem behaviors, earlier alcohol use, and higher levels of preadolescent antisocial behavior.

Adolescent↗
PubMed1995

Adolescent suicidal behaviors as a function of depression, hopelessness, alcohol use, and social support: a longitudinal investigation.

Surveyed two high school cohorts (ns = 698 and 283) to study independent, prospective predictors of adolescent suicidal behaviors (thoughts, communication to others, attempts). Within each cohort, there were two measurements conducted 6 months apart. Structural equation models were tested, with depressive symptoms, hopelessness, alcohol consumption, social support, and gender serving as predictors. In the larger cohort, depression predicted later levels of all three suicidal behaviors controlling for baseline suicidal behaviors. Also, suicidal thoughts predicted later communications, and suicide attempts predicted future thoughts. In the smaller cohort, alcohol consumption predicted all three suicidal behaviors at the later measurement, whereas depression was predictive only of later thoughts. Major issues regarding prevention, theories of suicide and negative affect, and methodological/analytical approaches were discussed.

Adolescent↗
PubMed1995

Physical and sexual abuse and associated mental disorders among alcoholic inpatients.

OBJECTIVE: The purpose of this study was to investigate the adult psychiatric correlates of childhood abuse among alcoholic inpatients. METHODS: The 802 patients, who included 321 women, were admitted to one of five New York State alcohol treatment inpatient centers. Each patient was interviewed, and sexual and physical abuse history, DSM-III diagnosis, and other characteristics were recorded. RESULTS: The overall prevalence of reported childhood abuse was 59% for women and 30% for men. Family history of alcoholism was associated with higher levels of physical and sexual abuse. Gender differences in types of childhood abuse (i.e., sexual abuse only, physical abuse only, dual abuse) were evident; 49% of the women and 12% of the men reported sexual abuse (with or without physical abuse), 33% of the women and 24% of the men reported physical abuse (with or without sexual abuse), and 23% of the women and 5% of the men reported dual abuse. Abuse status, and especially dual abuse, was associated with higher rates of antisocial personality disorder and suicide attempts among women and men, with generalized anxiety disorder among women, and with major depression among men. CONCLUSIONS: The findings highlight the long-term associations between sexual and physical abuse and adult coexisting mental disorders among alcoholic inpatients. Addressing unresolved intrapsychic trauma associated with childhood abuse may increase the efficacy of treatment outcomes and reduce relapse rates among alcoholics.

Adult↗
PubMed1995

A revised Alcohol Expectancy Questionnaire: factor structure confirmation, and invariance in a general population sample.

OBJECTIVE: The alcohol expectancy construct has become prominent in contemporary psychosocial approaches to understanding alcohol use and abuse. In 1980 Brown and colleagues developed the 90-item Alcohol Expectancy Questionnaire (AEQ) to assess experiences. Rohsenow modified this instrument to create the 40-item Alcohol Effects Questionnaire (AEQ-2). In the present study, we replaced the dichotomous response format of the AEQ-2 with a six-point scale to create the AEQ-3. The purpose of the study was to evaluate the AEQ-3 for factor structure confirmation and invariance across gender and race subgroups. METHOD: We administered the AEQ-3 to a large general population sample (N = 1,260). The instrument was self-administered during a structured interview. RESULTS: Confirmatory factor analyses were conducted to test a correlated eight-factor model consisting of six positive expectancies and two negative expectancies. Fit indices revealed that the eight-factor model fit the data moderately well. Furthermore, the fit of the eight-factor model was largely invariant across race and gender subgroups. Nonetheless, factor intercorrelations and modification indices revealed inadequate discriminant validity. CONCLUSIONS: Based on these findings, we cautiously recommend the AEQ-3 as a measure of alcohol expectancies. Specific recommendations and limitations are discussed regarding future use of the AEQ-3.

Adult↗
PubMed1995

The alcoholics in treatment HIV risk (ATRISK) study: gender, ethnic and geographic group comparisons.

OBJECTIVE: This study attempted to identify alcoholic inpatients as a population at elevated risk for HIV infection in comparison with other groups. Modes of risk across gender, ethnic and geographic subgroups were explored in order to guide targeted preventive efforts in the future. METHOD: Structured interviews were conducted with 802 alcoholic inpatients (481 males, 321 females) in New York City and western New York State. RESULTS: Measures of sexual risk behavior indicated low rates of condom use and high rates of multiple or nonprimary sex partners. Trading sex for drugs or money was common. Injection drug use was reported by nearly one-fifth of these patients. Most subjects (59.9%) reported at least one sexually transmitted disease. Self-reported HIV status yielded a seroprevalence rate of 6.7% among those who knew their HIV status. CONCLUSIONS: Findings indicated rates of HIV infection and associated risk behaviors similar to, and in some instances exceeding, those of other high-risk subpopulations. Subgroup differences indicated unique patterns of risk behavior across gender, ethnic and geographic subgroups. Findings are discussed with regard to prevention and treatment implications of high-risk behaviors among alcoholic inpatients.

Adult↗
PubMed1994

Coexisting problems and alcoholic family risk among adolescents.

A substantial subset of nonclinical adolescents reported single or multiple problems with regard to drinking behavior, depressive symptoms, and delinquency. Similar to previous research, boys reported higher levels of heavy and problematic drinking, whereas girls reported higher levels of depressive symptoms. Higher levels of alcohol involvement were associated with higher levels of delinquency for both boys and girls. Family history of alcoholism was associated with an overrepresentation of problem drinkers (as well as abstainers). These findings are fairly consistent with the adult alcohol typology literature in identifying coexisting problem patterns for the triumvirate of problem drinking, depressive symptoms, and antisocial behavior. Furthermore, these data support the manifestation of these patterns prior to the onset of alcohol dependence (and maybe alcohol abuse). Future longitudinal research needs to focus on the short- and long-term patterns of problem behaviors among adolescents and to identify common and unique precursors, correlates, and consequences associated with varying levels of alcohol involvement.

Adolescent↗
PubMed1994

Alcoholic subtypes: psychosocial functioning in Vietnam era men.

Data from the Vietnam Experience Study (Centers for Disease Control [CDC], 1988a) were used to investigate differences in sociodemographic characteristics, psychological functioning, and social support among five groups: (a) controls; (b) alcohol use disorder only; (c) alcohol use disorder and major depression; (d) alcohol use disorder and generalized anxiety, and (e) alcohol use disorder and antisocial personality (ASP). Consistent with prior findings, alcoholics with co-occurring disorders were more pervasively dysfunctional across the domains measured than the controls, and in some instances, than the alcohol use disorder only group. Differences among alcohol-comorbid groups also were found. The alcohol-depression group had the highest number of elevated MMPI scores, the highest levels of negative affect, and along with the alcohol-ASP group, the lowest levels of perceived social support. The alcohol-ASP group had the highest school dropout rate and, along with the alcohol-depression group, the earliest onset of problem drinking. Results were discussed regarding the importance of identifying distinctive psychosocial variables associated with alcoholic subtypes that may enhance perspectives on etiology, prevention, and treatment.

Adult↗
PubMed1994

Substance use, risky behaviors, and victimization among a US national adolescent sample.

Data from the National Adolescent Student Health Survey were used to study the interrelations among substance use, risky (dangerous) behaviors, and victimization among 8th and 10th graders. Pearson correlations indicated significant associations between substance use and both higher levels of risky behaviors (e.g., hitchhiking, going on a blind date) and victimization among adolescents. Regression analyses indicated the potency of risky behaviors as a predictor of victimization for male adolescents, and a significant risky behavior by illicit drug use interaction for female adolescents. Results are discussed with regard to potential short- and long-term health consequences of risky behaviors and violent victimization for psychological development in adolescence and adulthood.

Adolescent↗
PubMed1994

A study of friendship characteristics and problem behaviors among middle adolescents.

Exploratory and confirmatory factor analyses were used with a 15-item adolescent self-report measure to identify 4 salient friendship characteristics--Reciprocity of Relations, Overt Hostility, Covert Hostility, and Self-Disclosure--with a sample of about 1,100 middle adolescents. Higher levels of Overt and Covert Hostility and lower levels of Reciprocity of Relations with one's closest friend were associated with higher levels of alcohol consumption, percentage of friends who drink, delinquent activity, depressive symptoms, and suicidal behaviors. Self-Disclosure was positively correlated with some adolescent problem behaviors, possibly reflecting developmental changes toward greater interpersonal involvement with friends in concert with age normative tasks such as increased alcohol use. Longitudinal, prospective analyses indicated that delinquent activity and depressive symptoms were significant lagged predictors of Overt and Covert Hostility, but that friendship characteristics were not significant lagged predictors of adolescent problem behaviors.

Adolescent↗
PubMed1994

Characteristics of alcoholics who attempted suicide: co-occurring disorders and personality differences with a sample of male Vietnam era veterans.

Data from the Vietnam Experience Study were used to examine differences among alcoholic suicide attempters and alcoholic nonattempters with regard to co-occurring psychiatric disorders and MMPI scale scores. Comparisons between the 83 alcoholic suicide attempters and the remaining 978 alcoholic nonattempters indicated that suicide attempters had significantly higher rates of co-occurring disorders as well as an MMPI-based personality pattern characterized by higher levels of pathology. A discriminant function analysis yielded an overall classification accuracy of 74.08%, with significant MMPI scale scores suggestive of personality differences in impulsivity, destructiveness and assaultiveness (especially code 4-9-6). Suicide attempts may be a manifestation of self-destructive behavior that typifies a subset of alcoholics with pervasive difficulties.

Alcoholism↗
PubMed1993

A discriminant function analysis of various interferon parameters among alcoholics and heavy smokers.

A three-group design of alcoholics, heavy smokers and controls was used to investigate the status of the interferon system, including natural killer cell activity. Group differences were indicated via discriminant function analysis which correctly classified 86% of subjects. Test-retest relations were investigated for 14 subjects following a 30-day alcoholic inpatient program. Whereas significant immune suppression was indicated at the time of detoxification, recovery was evident at the 30-day follow-up. Results are discussed in terms of the significance of alcohol abuse on immune system functioning with consequences for susceptibility to viruses, bacteria and medical illnesses.

Adult↗
PubMed1993

Intrapersonal and interpersonal functioning among middle-aged female adult children of alcoholics.

This study examined group differences among a middle-aged, middle-class, community sample (N = 616) of female adult children of alcoholics (ACOAs) and female non-ACOAs with regard to features of intra- and interpersonal functioning. Consistent with previous research, ACOAs reported higher levels of depression and lower levels of self-esteem. ACOAs also reported lower levels of perceived social support, family cohesion, and marital satisfaction and higher levels of marital conflict. ACOAs also indicated more parental role distress and perceived themselves as more powerless than non-ACOAs to control the actions of their offspring. ACOAs were more likely to drink for coping purposes (e.g., to relieve stress), although their level of alcohol consumption did not differ significantly from that of non-ACOAs. Although consistent differences were indicated between groups, ACOAs were still functioning in the nonpathological range on all measures.

Adaptation, Psychological↗
PubMed1993

A retrospective measure of childhood behavior problems and its use in predicting adolescent problem behaviors.

Confirmatory factor analysis was used to support the dimensional structure of a four-factor retrospective measure of childhood behavior problems with a large, nonclinical adolescent sample. Acceptable levels of internal consistency and low-to-moderate levels of parent-adolescent interrater agreement were indicated for the four factors of attentional deficit/hyperactivity, oppositional behavior, conduct disorder symptoms and avoidance behaviors. The externalizing childhood problems (i.e., attentional deficit/hyperactivity, oppositional behavior, conduct disorder) were associated significantly with both internalizing (depression) and externalizing (e.g., alcohol consumption, delinquent activity) adolescent problem behaviors, as well as with an earlier age of onset for substance use. Avoidant behaviors in childhood were associated specifically with depressive symptomatology in adolescence. Results are discussed with regard to the role of childhood problems as precursors to adolescent/adult disorders.

Adolescent↗
PubMed1991

The difficult temperament in adolescence: associations with substance use, family support, and problem behaviors.

This study investigated interrelations between the number of difficult temperament factors (e.g., arrhythmicity, inflexibility, high distractibility) and substance use, perceived family support, and problem behaviors for a sample of 297 adolescents (M age = 15.7 years). The number of adolescent difficult temperament factors was associated significantly with more childhood behavior problems (e.g., hyperactivity, conduct disordered symptoms), which suggests some continuity of disordered behavior from childhood to adolescence. Number of adolescent difficult temperament factors also was associated with a higher percentage of substance users (for cigarettes, alcohol, marijuana, hard drugs), lower perceived family support, higher levels of depressive symptoms, and more delinquent activity. Number of difficult temperament factors was not associated significantly with gender or age of respondents.

Adolescent↗