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Biomedical subjects

S F Tapert

Publications and source records attributed to S F Tapert.

10 recordsLinked to original sources
PubMed2001

Adolescent substance use and sexual risk-taking behavior.

PURPOSE: To examine the relationship of adolescent substance use and dependence to sexual risk-taking behavior in late adolescence and young adulthood. METHODS: We prospectively examined self-reported sexual behaviors and substance involvement questionnaires in a sample of youth in substance abuse treatment programs and a comparison sample of sociodemographically similar community youths without histories of substance use disorders recruited from media ads. Assessments of sexual behaviors and substance involvement (78% white, 51% female) were collected at 2, 4, and 6 years after initial assessments, as they transitioned from middle adolescence to young adulthood (from age 15.5 to age 21.5 years, on average). The two samples were compared using Chi-square, analysis of variance, and multivariate analysis of variance approaches. Continuous indicators of high-risk sexual behaviors and substance involvement were analyzed with multiple regression. RESULTS: Earlier age of onset to sexual activity, more sexual partners, less consistent use of condoms, more sexually transmitted diseases (STDs), and greater prevalence of human immunodeficiency virus testing were reported by youth in the clinical treatment sample relative to sociodemographically comparable nonabusing community youth. High rates of STDs were found among females, and more substance-abusing females reported pregnancies than community females. Substance involvement continued to be associated with high-risk sexual behavior throughout the transition into young adulthood. CONCLUSIONS: Youth identified with substance problems are more likely to engage in risky sexual behaviors during adolescence and to continue risky sexual behaviors to the extent that substance problems persist. Risk reduction education should be included with adolescent substance abuse treatment.

Adolescent↗
PubMed2001

Four-year outcomes from adolescent alcohol and drug treatment.

OBJECTIVE: Knowledge of treatment response for alcohol and drug problems among adults is mounting; less is known about long-term outcome for adolescents who receive treatment for alcohol and drug problems. The current study examined youth substance involvement over 4 years (using five waves of data collection) following treatment for alcohol and drug abuse. METHOD: A cohort of youth (N = 162, 60% male) treated during adolescence (mean age = 16 years) was followed into young adulthood, a period associated with stabilization of alcohol use patterns and elevated risk for life problems secondary to both alcohol and drug use. Participants (14-18 years old) were consecutive admissions to inpatient adolescent alcohol and drug treatment centers in San Diego that were abstinence focused and based on the 12-step approach. RESULTS: Alcohol and other drug use were reduced during the 4 years posttreatment, with the exception of nicotine. The greatest prevalence reduction occurred for stimulants; modest changes were evident in alcohol and marijuana use. Nicotine was the most commonly used substance throughout the 4 years after treatment. Several distinct substance involvement trajectories were evident during the 4 years following treatment. CONCLUSIONS: Alcohol and drug use patterns during the 4 years following treatment highlight both changes and diversity in substance involvement as youth make the transitions from middle to late adolescence and into young adulthood. Findings demonstrate the importance of identifying transitional periods and the need for alternative intervention strategies that may help the progression of this population into young adulthood.

Adolescent↗
PubMed2001

fMRI measurement of brain dysfunction in alcohol-dependent young women.

BACKGROUND: Studies of brain functioning in alcohol-dependent adults have produced varied results but generally suggest that alcohol affects brain functioning and that relatively short durations of heavy drinking may adversely affect women. It remains unclear when in the course of alcohol dependency and at which developmental stage these brain changes emerge. Our neuropsychological studies have indicated that drinking-related neurocognitive effects occur as early as adolescence (Brown et al., 2000; Tapert & Brown, 1999). This study seeks to characterize brain regions that subserve the affected neurocognitive functions. METHODS: Alcohol-dependent young women (n = 10) were recruited from a longitudinal study of alcohol- and drug-abusing youth, all of whom met criteria for alcohol dependence. Control participants (n = 10) had no history of alcohol or drug problems and were comparable with alcohol-dependent participants on age (18-25 years), family history of alcohol use disorders, and education. After a minimum of 72 hr of abstinence, functional magnetic resonance imaging, neuropsychological, alcohol/drug involvement, and mood data were collected. Participants performed spatial working memory and vigilance tasks during functional magnetic resonance imaging acquisition to probe brain response. RESULTS: Alcohol-dependent women demonstrated significantly less blood oxygen level-dependent response than controls during the spatial working memory task in the right superior and inferior parietal, right middle frontal, right postcentral, and left superior frontal cortex, after controlling for the baseline vigilance response. CONCLUSIONS: Working memory produces a larger neuronal response in some cortical regions than vigilance. Alcohol-dependent women showed less differential response to working memory than controls in frontal and parietal regions, especially in the right hemisphere. Heavy, chronic drinking appears to produce adverse neural effects that are detectable by functional magnetic resonance imaging.

Adolescent↗
PubMed2000

Substance dependence, family history of alcohol dependence and neuropsychological functioning in adolescence.

AIMS: It was hypothesized that adolescent substance dependence moderates the relationship between family history of alcohol dependence and neuropsychological functioning. DESIGN: This study compared the neuropsychological functioning of non-abusing and alcohol and drug-dependent adolescents with and without a family history of alcohol dependence using hierarchical multiple regressions and general factorial analyses. SETTING: Substance-dependent adolescents were recruited and tested in inpatient alcohol and drug abuse treatment programs after 3 weeks of abstinence. A matched sample of non-abusing adolescents was recruited from the same San Diego-area communities. PARTICIPANTS: Substance-dependent adolescents (n = 101) met DSM-III-R criteria for dependence on alcohol and at least one other substance. Non-abusing adolescents (n = 50) had no substance use disorders. Groups were comparable on socio-economic status. Participants were 44% female, ages 13-18, and had no serious head injuries or neurological disorders. MEASUREMENTS: Information was gathered on demographics, family history, substance involvement, and conduct disorder behaviors and adolescents were administered neuropsychological tests covering language, visuospatial, verbal memory, attention and executive functioning domains. FINDINGS: The hypothesis was supported for language and attention tests. Substance involvement interacted with family history of alcohol dependence to predict language and attention functioning. Family history negative non-abusers performed better than the other adolescents. CONCLUSIONS: The pattern of results suggests that family history of alcohol dependence and adolescent substance use are separate risk factors for poorer neuropsychological performance in youth.

Adolescent↗
PubMed2000

Neurocognitive functioning of adolescents: effects of protracted alcohol use.

BACKGROUND: The present study examined associations between alcohol involvement in early to middle adolescence and neuropsychological (NP) functioning. METHODS: Alcohol-dependent adolescents (n = 33) with over 100 lifetime alcohol episodes and without dependence on other substances were recruited from alcohol/drug abuse treatment facilities. Comparison (n = 24) adolescents had no histories of alcohol or drug problems and were matched to alcohol-dependent participants on age (15 to 16 years), gender, socioeconomic status, education, and family history of alcohol dependence. NP tests and psychosocial measures were administered to alcohol-dependent participants following 3 weeks of detoxification. RESULTS: Alcohol-dependent and comparison adolescents demonstrated significant differences on several NP scores. Protracted alcohol use was associated with poorer performance on verbal and nonverbal retention in the context of intact learning and recognition discriminability. Recent alcohol withdrawal among adolescents was associated with poor visuospatial functioning, whereas lifetime alcohol withdrawal was associated with poorer retrieval of verbal and nonverbal information. CONCLUSIONS: Deficits in retrieval of verbal and nonverbal information and in visuospatial functioning were evident in youths with histories of heavy drinking during early and middle adolescence.

Adolescent↗
PubMed1999

Neuropsychological correlates of adolescent substance abuse: four-year outcomes.

Alcohol and other drug use are common in youth, but neurocognitive sequelae are unclear. This study examines the relationship between neuropsychological functioning and protracted substance use in adolescence. One hundred fifteen adolescents, ages 13 to 19 years, were recruited from inpatient substance abuse treatment programs and followed for 4 years. Adolescents were administered a comprehensive battery of neuropsychological tests and evaluated on substance use involvement during treatment, and at 6-month, 1-year, 2-year, and 4-year follow-up time points. Protracted substance abuse over the 4 years of follow-up was associated with significantly poorer subsequent functioning on tests of attention. In addition, alcohol and drug withdrawal accounted for significant variance in visuospatial functioning, above and beyond demographic, educational, and health variables in detoxified late adolescents and young adults. Results suggest that alcohol and drug withdrawal may be a more powerful marker of protracted neuropsychological impairments than other indices of youthful alcohol and drug involvement.

Adolescent↗
PubMed1999

The role of neurocognitive abilities in coping with adolescent relapse to alcohol and drug use.

OBJECTIVE: Neurocognitive abilities are hypothesized to influence coping with temptations to relapse to alcohol and drug use. In particular, a moderator model was proposed whereby neurocognitive abilities moderate the influence of coping strategies on treatment outcome. METHOD: Participants (N = 79) were consecutive admissions to inpatient alcohol and drug treatment centers in the San Diego, California. area, (age range = 14 to 18 years; 41% female). Treatment programs were abstinence focused, with an average inpatient stay of 5 weeks. Participants met DSM-III-R lifetime criteria for alcohol abuse or dependence and abuse or dependence of at least one other substance. Follow-up assessments were conducted 1 and 2 years following discharge, including a battery of neuropsychological tests, coping questionnaire, and detailed assessment of alcohol and other drug involvement. RESULTS: The interaction between general intelligence and coping diversity significantly predicted alcohol and drug use 1 year later (F = 10.71, 1/72 df, p <.005, R2 change =.08), even when controlling for current use. Attention-coping and problem solving-coping interactions also significantly predicted outcome, but not above the intelligence-coping interaction. CONCLUSIONS: Teens with poor neurocognitive abilities used little or no alcohol and drugs if good coping skills were evidenced, but used more alcohol and drugs if their coping skills were poor. This association between coping skills and outcome did not exist for teens with better neurocognitive abilities. Clinically, teens with poorer neurocognitive skills may maximally benefit from coping skills training programs, and neuropsychological evaluations may be particularly helpful in addressing these individual needs in treatment.

Adaptation, Psychological↗
PubMed1998

Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR): a measure of adolescent alcohol and drug involvement.

OBJECTIVE: The present study was undertaken to assess the psychometric characteristics of the Customary Drinking and Drug Use Record (CDDR), an interviewer-administered questionnaire. The CDDR provides current (past 3 months) and lifetime measures of four alcohol- and other drug-related domains: level of involvement, withdrawal characteristics, psychological/behavioral dependence symptoms, and negative consequences. The present report describes the evaluation of the psychometric properties of the instrument with youth between the ages of 13 and 22 years who had markedly variable histories of involvement with alcohol and other psychoactive substances. METHOD: The sample assessed was composed of 166 adolescents recruited from two inpatient substance abuse treatment programs and 115 adolescents recruited from the community. Of the 281 subjects, 150 were male. Follow-up interviews with each adolescent and a resource person were conducted 6, 12, 24 and 48 months after the initial assessment. RESULTS: Reliability of the CDDR was assessed by examination of internal consistency, test-retest reliability and interrater reliability. Convergent, discriminant and construct validity were evaluated for each of the CDDR domains, and gender and ethnic differences on substance involvement were examined. The CDDR was found to be internally consistent and reliable over time and across interviewers for each major domain assessed. The findings supported the validity of the four domains of alcohol and other drug involvement assessed on the CDDR. CONCLUSIONS: The present results demonstrated convergent validity of the CDDR, ability to differentiate abusing from nonabusing youth and strong diagnostic specificity when compared to other standard instruments. The solid psychometric characteristics of the CDDR support its use for both research and clinical purposes.

Adolescent↗
PubMedDate not supplied

The role of alcohol in adolescent relapse and outcome.

Although adolescents entering treatment for substance abuse typically use several substances, alcohol is seldom the drug of choice. Given alcohol's role as a gateway substance in the initiation of substance misuse, the authors hypothesize that alcohol is substantially involved in adolescent relapse following substance abuse treatment. One hundred fifty-seven youths (39.5% female, mean age 15.91 years) were recruited from adolescent inpatient alcohol and drug treatment centers and assessed at six and 12 months after discharge. Of the youths studied, 79% had used one or more substances by 12-month follow-up. Although only 1% reported alcohol as their substance of choice while hospitalized, alcohol was involved in 46% of initial posttreatment use episodes. Almost a quarter (23%) of initial posttreatment substance use events involved multiple substances. Initial posttreatment use episodes involving multiple substances and preferred substances were associated with poorer outcomes during the year following treatment both in terms of rate of return to and severity of substance involvement. Youths who initially used only alcohol were also likely to resume harmful levels of substance involvement by one year after treatment. Results suggest two routes, gateway and preferred substance, for adolescents in the resumption of harmful substance use following treatment. This gateway role merits consideration by adolescent substance abuse treatment providers and families of treated youths.

Adolescent↗