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Biomedical subjects

R E Tarter

Publications and source records attributed to R E Tarter.

At least 37 records · Page 2Linked to original sources

The Drug Use Screening Inventory for adults: psychometric structure and discriminative sensitivity.

The psychometric structure and characteristics of the adult version of the Drug Use Screening Inventory were examined in alcohol and drug abusers (n = 119) and normal controls (n = 119). It was found that each of the 10 DUSI domains is unidimensional. Inter-item, split half and internal reliability ranged from good to excellent. A score of 4 or higher on the Substance Use Domain correctly classified 80% of the substance abusers whereas a score of 3 or less accurately detected 100% of the normal control subjects. These results demonstrate that the DUSI is a practical and psychometrically sound screening instrument.

Adult↗

Isokinetic muscle strength and its association with neuropsychological capacity in cirrhotic alcoholics.

Alcoholic cirrhotics (n = 49), nonalcoholic cirrhotics (n = 42), and normal controls (n = 50) were compared on measures of isokinetic muscle strength and neuropsychological capacity. Alcoholic cirrhotics were deficient on measures of eccentric and concentric muscle movements, compared with normal controls but were not different from nonalcoholic cirrhotics. Nor were differences observed between the two cirrhotic groups on neuropsychological tests of cognitive and psychomotor capacity, suggesting that cirrhosis rather than alcoholism per se is responsible for the manifest deficits. Psychomotor capacity correlated negatively with isokinetic strength in cirrhotic subjects. These findings suggest that muscle weakness, due either directly to advanced liver disease or mediated by subclinical hepatic encephalopathy, accounts for a portion of the variance on the neuropsychological test performance of cirrhotic alcoholics.

Adult↗

Multivariate typology of adolescents with alcohol use disorder.

Adolescent patients qualifying for a DSM-II-R diagnosis of alcohol use disorder were studied to determine whether a multidimensional schema could classify subjects into subgroups. The Drug Use Screening Inventory was administered to 151 subjects. To test the concurrent validity of the subtypes, subjects also received a structured diagnostic psychiatric evaluation along with measures of personality, academic achievement, and drinking behavior. Two clusters were identified for each gender. Differences between clusters were reflected primarily on indicators of severity of disorder. Young women were more inclined toward affective disturbances, whereas conduct disorder was the most frequent disorder in young men. This study underscores the heterogeneity of the adolescent population qualifying for a diagnosis of alcohol use disorder. The differential pattern of alcohol involvement and comorbid psychopathology within clusters and between genders demonstrates the need for interventions tailored to specific clinical presentation.

Adolescent↗

Violence, suicidality, and alcohol/drug use involvement in adolescent females with a psychoactive substance use disorder and controls.

This study had three aims: (1) to determine the relations between behavioral dysregulation, negative affectivity, and familial impairment with violence and suicidality (i.e., severity of ideation and attempts) in a sample of adolescent females with a psychoactive substance use disorder and controls; (2) to determine whether these relations are mediated by internalizing (depression/anxiety) and externalizing (nonviolent antisocial behavior) symptomatology; and (3) to determine whether severity of alcohol/drug use involvement moderates the relations between the mediating variables with violence and suicidality. Multiple behavioral, psychiatric interview, and self-report measures were used to index behavioral dysregulation, negative affectivity, familial impairment, internalizing and externalizing symptomatology, and violence and suicidality in one hundred sixty-one 14- to 18-year-old adolescent females with a psychoactive substance use disorder and in 80 controls. Structural equation modeling was used to determine the proposed relations. Results indicated that behavioral dysregulation, negative affectivity, and familial impairment were related to violence, whereas only familial impairment was related to suicidality. Internalizing symptomatology mediated the relation between familial impairment and suicidality, and was related to violence, whereas externalizing symptomatology mediated the relations between behavioral dysregulation, negative affectivity, and familial impairment with violence. Severity of alcohol/drug use involvement did not moderate the relations between internalizing or externalizing symptomatology with suicidality or violence. Nevertheless, the relation between internalizing symptomatology and suicidality was stronger in females with a greater degree of alcohol/drug use involvement, compared with those with a milder degree of involvement. Therefore, from a prevention standpoint, behavioral dysregulation, negative affectivity, familial impairment, as well as internalizing and externalizing symptoms, may serve as clinical "points of intervention" for altering the development of violence and suicidality in high risk and substance abusing youth.

Adolescent↗

Mating assortment and the liability to substance abuse.

Assortative mating can exert a profound influence on the phenotypic composition of the population since it may result in an increase in the frequency of the genotypes associated with extreme phenotypes. Applied to the risk for a disorder such as substance abuse, this would mean a possibility for an increase in the risk and severity of the disorder in consecutive generations. This paper reviews the theoretical and empirical literature on mechanisms related to mate resemblance for the liability to substance abuse, sources and consequences of such resemblance, and suggests directions for further research.

Alcoholism↗

Executive cognitive functioning predicts reactive aggression in boys at high risk for substance abuse: a prospective study.

This study assessed the ability of executive cognitive functioning (ECF) to predict reactive aggression in boys at high and low risk for substance abuse using a 2-year prospective design. ECF is defined as the self-regulation of goal-directed behavior. Reactive aggression involves impulsive hostile reactions committed with little forethought. ECF was measured using five neuropsychological tests in 198 10- to 12-year-old boys with (SA+) and without (SA-) a paternal history of substance abuse/dependence. Reactive aggression was measured, 2 years later, using a composite index of items derived from two self-report measures. It was hypothesized that ECF would predict reactive aggression, and that this relation would be stronger for the SA+ compared with the SA- boys. SA+ subjects demonstrated lower ECF scores and higher reactive aggression scores, compared with SA- controls. ECF predicted reactive aggression in the SA+ group (beta = 0.37, p = 0.001), but not in the SA- group (beta = 0.09, p = NS). This suggests that compromised ECF may be a risk factor for reactive aggression in SA+ youth. The hypothesis that the relation between ECF and reactive aggression is a manifestation of a mild dysfunction of the prefrontal cortex is discussed.

Aggression↗

Polydrug use in adolescent drinkers with and without DSM-IV alcohol abuse and dependence.

Alcohol and other substance use disorders are highly comorbid, but little is known about patterns of polydrug use in adolescents with different levels of alcohol involvement. This research examined patterns and correlates of polydrug use in 176 adolescent drinkers with DSM-IV alcohol dependence (n = 61), alcohol abuse (n = 57), and no alcohol diagnosis (n = 58). Alcohol and other Substance Use Disorders were assessed using a modified version of the Structured Clinical Interview for the DSM. Lifetime histories of alcohol use and other drug use were assessed using a structured interview. Subjects also completed a questionnaire measure of the frequency of use of specific alcohol-drug combinations. The total number of illicit drugs ever used was greater in the alcohol dependence (mean = 3.8, SD = 2.1) and abuse groups (mean = 3.0, SD = 2.1), compared with the no-alcohol diagnosis group (mean = 1.9, SD = 1.3). Consistent with previous findings, there was a consistent pattern in the age of onset of psychoactive substance use: alcohol, followed by marijuana, followed by other drugs. The recent use of alcohol and other drugs in combination was reported by a greater percentage of subjects in the alcohol dependence (69%) and abuse groups (72%), compared with drinkers without an alcohol diagnosis (45%). The most common alcohol-drug combination was alcohol with marijuana (58% of the total sample), followed by alcohol-hallucinogens (16%). The frequency and extent of polydrug use was associated with being older and having higher levels of behavioral undercontrol and negative emotionality. Adolescent polydrug use, particularly the use of alcohol and other drugs in combination, is an important area for research, treatment, and prevention.

Adolescent↗

Executive cognitive functioning and aggressive behavior in preadolescent boys at high risk for substance abuse/dependence.

OBJECTIVE: This study had three purposes; (1) to assess the underlying factor structure of a battery of neuropsychological tests putatively measuring executive cognitive functioning (ECF) in a sample of boys at high and low risk for substance abuse/dependence; (2) to assess the relationship between ECF and aggressive behavior; and (3) to determine the interactive effects of ECF and a family history (FH) of substance dependence on aggressive behavior. METHOD: Multiple measures of ECF and aggressive behavior were used to test these relationships in a sample of 291 10-12 year old boys with and without a FH of substance dependence. RESULTS: Analyses indicated that the measures of ECF loaded on one factor. ECF was related to aggressive behavior even when accounting for IQ and SES. The interaction between ECF and a FH of substance dependence was also associated with aggressive behavior. CONCLUSIONS: The central finding of this investigation indicates that ECF and its interaction with a FH of substance dependence are associated with aggressive behavior. These results suggest that violence prevention and treatment efforts in high risk groups should incorporate cognitive habilitation focusing on training in ECFs.

Adolescent↗

Interaction between childhood temperament and parental discipline practices on behavioral adjustment in preadolescent sons of substance abuse and normal fathers.

We conducted this study with a sample of sons of fathers having a Psychoactive Substance Use Disorder (PSUD+, n = 55) and sons of fathers who did not qualify for a PSUD (PSUD-, n = 97). Parental discipline practice from the child's perspective was investigated in relation to the child's difficult temperament to determine their association with sons' externalizing and internalizing behavior problems reported by mothers. PSUD+ status, difficult temperament in the boys, and their ratings of parental discipline practices accounted for a significant proportion of variance with respect to their externalizing behavior (11%), but only PSUD+ status had a main effect on internalizing behavior. However, the main finding of this study was that the interaction of parental discipline and difficult temperament in the child moderated both externalizing and internalizing behavior problems, accounting for an additional 5% of an explained variance. Thus, this study illustrates the importance of the conjoint influence of children's temperament characteristics and parental discipline practices on the children's adjustment. These results support the findings from previous studies showing that a difficult temperament disposition places the child at risk for maltreatment by parents and for development of a disruptive behavior disorder. Both outcomes have been found in many investigations to presage alcohol and drug abuse in adolescence. The findings also underscore the importance of both individual and contextual variables for understanding the development of psychopathology. In this regard, the results show the need for prevention and treatment to encompass strategies directed at disaggregating the basis of maladaptive family interaction patterns.

Adult↗

Neuropsychological impairment in a patient with a normal liver and long-standing portacaval anastomosis: studies obtained before and after liver transplantation.

A case report of the neuropsychiatric consequence of long-standing portal caval shunting in a man without intrinsic liver disease is described. Because of his neuropsychiatric status he underwent liver transplantation. Over the succeeding 8 months he had progressive improvement in his neuropsychiatric performance. These data document the adverse effects of portal caval shunting on neuropsychiatric performance in the absence of intrinsic liver disease as well as their reversibility with shunt closure.

Humans↗

Preliminary evidence for an association of a dinucleotide repeat polymorphism at the MAOA gene with early onset alcoholism/substance abuse.

An association between the liability to early onset alcoholism/substance abuse and a recently discovered dinucleotide repeat length polymorphism at the MAOA gene (MAOCA-1) was examined using polymerase chain reaction (PCR). A significant correlation between the presence/absence of the disorder and the length of the MAOCA-1 repeat was found in males, but not females, with "long" alleles (repeat length above 115 bp) associated with both increased risk for the disorder and lower age of onset of substance abuse. These preliminary data suggest that further exploration of the relationship between the MAOA gene and behavioral traits in an expanded sample is warranted.

Adolescent↗

Cognitive capacity in female adolescent substance abusers.

Female adolescents who qualified for a DSM-III-R diagnosis of psychoactive substance use disorder (n = 106) were compared to normal controls (n = 74) on a battery of cognitive, intellectual and achievement tests. It was found that the substance abuse group performed deficiently on tests requiring language skills, sustained attention and perceptual efficiency and scored lower than controls on standardized tests of intelligence and academic achievement. No relationship between magnitude of cognitive deficit and severity of substance abuse was observed. The implications of these findings are discussed with respect to the etiology and maintenance of drug use.

Adolescent↗

The association between childhood irritability and liability to substance use in early adolescence: a 2-year follow-up study of boys at risk for substance abuse.

The aim of this investigation was to determine whether irritability, defined as the propensity to experience and express anger following actual or perceived provocation, is a component of the liability to alcohol and drug abuse. Sons of substance abusing fathers (n = 40) and normal fathers (n = 56) were studied when they were 10-12 years of age and followed-up 2 years later. Hierarchical regression analysis revealed that resting salivary cortisol concentration, impulsivity and family discord measured when the subjects were 10-12 years of age explained 35% of the variance on a scale measuring irritability 2 years later. At follow-up, when the boys were 12-14 years of age, it was observed that irritability scale scores and family discord were the only variables that accounted for significance variance on a scale measuring coping via alcohol and drug use. Latency and amplitude of the N1 and P3 event-related potentials of an auditory oddball task, measured at age 10-12, were not associated with drug use at age 12-14. These results indicate that family dysfunction, stress state of the child, and low behavioral self-control additively account for a significant proportion of variance on irritability scale scores 2 years later, and that this trait, in conjunction with family discord, is associated with substance use as a coping response by early adolescence.

Adolescent↗

Abstracting capacity in cirrhotic alcoholics: negative findings.

OBJECTIVE: Alcoholic and nonalcoholic cirrhotics and normal controls were compared to determine the extent to which the cognitive deficits frequently observed in alcoholics are attributable to hepatic encephalopathy. METHOD: A battery of neuropsychological tests was administered measuring verbal and nonverbal abstracting capacity. RESULTS: No significant differences between the three groups were observed. Both the alcoholic (n = 43) and nonalcoholic (n = 63) subjects performed comparably to normal controls (n = 21) and the former two groups performed comparably to each other on seven indicators of abstracting capacity. CONCLUSIONS: Deficits in reasoning ability are not invariably associated with chronic alcoholism. In addition, low grade hepatic encephalopathy concomitant to cirrhosis in both alcoholics and nonalcoholics does not impact adversely on abstracting capacity.

Adult↗

Aggressivity, inattention, hyperactivity, and impulsivity in boys at high and low risk for substance abuse.

Aggressivity, inattention, hyperactivity, and impulsivity are cardinal dimensions of externalizing behavior problems of childhood. They are diagnostic and clinical features of childhood disorders, and are thought to be linked to the subsequent development of adult disorders such as substance abuse (SA). Little is known, however, about the convergent and discriminant validity of these four constructs. We used multiple measures to develop indices of aggressivity, inattention, hyperactivity, and impulsivity in a sample of 10- to 12-year-old boys (N = 183) with and without a family history of SA. Data were taken from mother reports, child reports, teacher reports, and laboratory tasks. The study aims were (1) to test the convergent and discriminant validity of aggressivity, inattention, hyperactivity, and impulsivity; (2) to examine whether the data were consistent with a model specifying the four constructs as indicators of one superordinate factor; and (3) to differentiate boys with and without a family history of SA in construct scores. The results supported the convergent and discriminant validity of the four constructs. Although discriminable, the constructs covaried strongly and were consistent with a model specifying them as indicators of a single superordinate factor. Boys with a family history of substance abuse scored higher than control boys on aggressivity, inattention, and impulsivity scores, but the groups did not differ on hyperactivity scores. The results are discussed in terms of the role of childhood behavior problems in vulnerability to SA.

Aggression↗