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A model incorporating the direct and indirect effects of parental monitoring on adolescent alcohol use was evaluated by applying structural equation modeling (SEM) techniques to data on 4,765 tenth-graders in the 2001 Monitoring the Future Study. Analyses indicated good fit of hypothesized measurement and structural models. Analyses supported both direct and indirect effects of parental monitoring on adolescent alcohol use. Peer influence, perceived alcohol norms, and conventional bonds mediated the relationship between parental monitoring and adolescent alcohol use. Results suggest parental involvement and proactive parenting skills as critical components of prevention and intervention programs that target adolescent alcohol use. (Contains 2 tables and 2 figures.)

A study examines sex differences among dentists with respect to oral effects of eating disorders.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2005.10.001 Byline: James Alan Neff (a), Clayton T. Shorkey (b), Liliane Cambraia Windsor (b) Keywords: Substance abuse treatment; Faith-based treatment; Health disparities; Concept Mapping Abstract: This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear 'spiritual activities, beliefs, and rituals' dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated 'structure and discipline' as more important and 'work readiness' as less important. No differences were found for 'group activities/cohesion' and 'role modeling/mentoring,' 'safe, supportive environment,' and 'traditional treatment modalities.' Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes. Author Affiliation: (a) College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA (b) School of Social Work, University of Texas at Austin, Austin, TX, USA Article History: Received 29 December 2003; Revised 31 August 2005; Accepted 6 October 2005

Notes the rise of the harm-reduction model in the provision of substance abuse services and the history and success of syringe exchange programs. Describes the Xchange Point, a nonprofit community-based AIDS services organization founded in 1996 as a street-based outreach and syringe exchange program. (Contains 15 references.) (GCP)

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of 'spiritual transformation' in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement. Keywords: Substance abuse treatment, spiritual change, behavior change models, INTRODUCTION Recently, there has been increasing attention directed to conceptual and methodological issues surrounding spirituality, religiosity, and their implications for health and well being (1). Unfortunately, systematic empirical research regarding [...]

The study discussed in this article examined the relationship between depression symptomatology and functional impairment among white and African American elderly people and investigated the effect of race, religiosity, and social support on this relationship. Study results indicate that although African American elderly people were more impaired in the performance of activities of daily living (ADL) and instrumental activities of daily living (IADL) than white elderly people, they did not experience higher levels of depression. However, African Americans did report significantly higher levels of religiosity and social support. Key words: depression, elderly people, functional impairment, social support, religiosity, Depression constitutes a major and growing health problem for older adults. Depressive symptoms are considered to be the most common mental health problem in later life and afflict up to [...]

Studies of accidental needlestick exposure to blood containing human immunodeficiency virus (HIV) have shown that the volume of blood in an exposure is a strong predictor of subsequent infection. Illicit drug injectors, a group at elevated risk for HIV transmission, use syringes manufactured in two styles, one of which (the integral cannula type) retains substantially less blood after intravenous use than the other (the detachable needle type). In this report, we examine some of the factors associated with use of syringes with detachable needles among drug injectors in San Antonio, Texas using data from epidemiological surveys, ethnographic studies, and historical observations. We compare personal history of syringe type use with HIV serostatus in a sample of 501 active drug injectors interviewed and screened for HIV in 1997-1998. Ninety-nine percent of these respondents reported that they currently used only integral cannula syringes, but 13% had used a syringe with a detachable needle within the past 2 years, and 37% had used one in their lifetime. Only 9% had ever used one [greater than or equal to] 20 times in a year. Hispanic (Mexican American) respondents were significantly less likely than other ethnic groups to have ever used a detachable needle syringe. HIV seroprevalence was < 1% among heterosexual injectors who had never used a detachable needle syringe compared to 4% among those who had used one (p< 0.05). Keywords: Injecting drug users; HIV; Syringes; Texas; USA

The predictive validity of a treatment readiness measure designed for out-of-treatment drug users, tapping dimensions of perceived problem severity, perceived need for formal treatment, motivation for treatment, and negative attitudes toward treatment is examined using data from a National Institute on Drug Abuse (NIDA)-funded HIV outreach intervention in San Antonio, Texas. Logistic regression is used to predict use of substance abuse treatment services three months after program intake on the basis of readiness scores, controlling for demographic and drug history variables. Analyses of data from 673 drug users in an HIV outreach intervention indicated that treatment readiness dimensions accounted for a 12% increase in variation in 'use of any modality' and 14% for 'use or attempted service use'. Only Motivation to Quit was a significant predictor of 'use of any modality' and both Perceived Need for Treatment and Motivation to Quit were significant predictors of 'use or attempted use'. Findings support the importance of the individual's perception of 'readiness' to change their substance-abusing behavior and enter treatment., INTRODUCTION Identification of injection drug users (IDUs) as an HIV risk group in the early 1980s focused substantial research efforts in the United States (1) and other countries (2) on [...]

Three models of continuing education - full-day, half-day, and brief workshop - for health providers treating patients with HIV/AIDS were compared on measures of effectiveness with regard to knowledge, attitude, and practice outcomes. Analyses of pre- and postintervention data from two years of training events suggest consistent, modest, program effects in the full-day and half-day approaches, specifically in the area of knowledge enhancement.

Data from a random sample of 164 Anglo, 168 African American, and 149 Mexican American male regular drinkers compare the use of cross-sectional data on current consumption patterns versus retrospective lifetime drinking history data in studying ethnic differences in 'maturing out' of heavy drinking among male drinkers. Cross-sectional analyses among males in their 20s, 30s, and 40s on current consumption indexes suggest that maturing out of heavy drinking may be more of an Anglo phenomenon. Drinking history analyses suggest that the process takes place in both majority and minority male drinkers in their 20s, although slightly earlier among Anglos. Although Mexican Americans were less likely to report heavy or problem drinking stages, heavy drinkers in this ethnic group reported heavy drinking earlier and for longer periods of time than did other drinkers. Analyses suggest that ethnic differences in the maturing out phenomenon may be more subtle than is suggested in the cross-sectional analysis., This article examines alternative methodological approaches to evaluating the hypothesis that minority male drinkers (African Americans and Mexican Americans) may differ from non-Hispanic White (Anglo) males in the propensity to [...]

A study of 148 predoctoral psychology internship program applicants investigated their site choice criteria. They rated first, intermediate and last-choice sites by 25 variables associated with internship programs. Eight variables, necessary in choosing a site, differentiated all three preferences. Eleven variables, indicating application process and program design, distinguished the first from the last choice. Interview procedures could be very important.

The results of a survey of clinical and counselling psychologists trained between 1970 and 1992 suggest a preference for a rapid transition into private practice among graduates educated since 1980. Most of the survey respondents gravitated toward private practice by the tenth year after internship. Most respondents report that they make extensive use of neurological and psychological test instruments.

A study of the influence of parental alcoholism and parental mental illness on adult children from racially and ethnically diverse random communities reveals that higher estimates of depression, worry and somatization are seen among male drinkers whose parents had a history of alcoholism. Parental mental illness causes depression, worry, somatization and high drinking among females. The occurrence of these effects in males who reported parental alcoholism indicates the resilience of male Adult Children of Alcoholics who do not drink or drink to mediate parental alcoholism.

An analysis of differences in marital status in depressive symptoms, to examine the influence of race/ethnicity and sex, confirms that the separated and divorced exhibit higher levels of depression and lower levels of distress, respectively. Differences were insignificant among Mexican Americans and blacks. Married black women exhibited higher levels of distress than their never-married counterparts.

A recent development in the provision of substance abuse services has been the rise of the harm-reduction model and non-abstinence-based services. Harm reduction is based on the suppositions that drug [...]

Drinking patterns and alcohol-related problems were studied in 164 Anglo and 149 Mexican-American male regular drinkers. A combination of acculturation and generational status measures indicated the heaviest drinking patterns and the highest prevalence of both alcohol-related problems and escape drinking motives among the least acculturated second-generation Mexican Americans. (JHZ)

This article presents the results of a confirmatory factor analysis expanding and enhancing a previously developed measure of 'machismo' both to explore the dimensionality of the measure and to test the invariance of factor structure in a sample of Anglo, African American, and Mexican American adult male drinkers. Specifically, this article (a) describes the development of a multidimensional 13-item machismo measure, (b) tests the goodness of fit of a series of confirmatory factor models examining single versus multiple factor solutions (e.g., Does a unitary machismo factor fit, or must positive and negative dimensions be modeled?), and (c) tests the invariance of the resulting model across racial-ethnic groups. Results support the use of the measures for cross-ethnic studies and emphasize the importance of a multidimensional measure including both positive and negative dimensions.

Results of a cluster-randomized trial of a Screening and Brief Intervention for heavy drinkers in dental practice are reported. Data were obtained from 103 heavy drinking patients recruited from randomized intervention (7; n = 50) and control (6; n = 53) practices. Analysis of data revealed that 6-month decreases in total drinks per week were significantly (p < .05) greater for heavy drinking intervention (43%) than control patients (21%)—a 4 drink per week difference. Similar decreases were obtained for quantity and frequency among intervention patients compared to control patients. Despite power limitations, the 6-month results support the effectiveness of the Screening and Brief Intervention. [ABSTRACT FROM AUTHOR]

Confirmatory factor analysis (CFA) techniques are used to evaluate the fit of a seven-dimensional concept mapping-based model of key dimensions of faith-based substance abuse treatment, using data from 310 staff and clients of 12 faith-based Teen Challenge programs. The initial seven-dimensional model fit poorly (fit indices of .62-.64), though, after trimming items with low loadings or redundant item content, model fit was increased substantially (fit indices of .87-.89). Overall, the current analyses provide preliminary support for the meaningfulness of the seven-dimensional model of faith-based treatment programs, despite different statistical approaches. [ABSTRACT FROM AUTHOR]

Analyses of the 2002 U.S. National Health and Examination Survey (1,490 adults) examined relationships between alcohol frequency, quantity, and total weekly consumption and preventive and emergency dental service use during the past 12 months. Logistic regression analyses indicated a significant, small percentage of variance in dental service use explained by alcohol use (1%), controlling for predisposing (19%), enabling (18%), or need (4%) covariates. Preventive and emergency service use were associated with higher frequency drinking, but lower total consumption (significant only for preventive services). Limitations and implications for brief alcohol interventions in dental practice are discussed. [ABSTRACT FROM AUTHOR]

This paper replicates and extends previous analyses supporting the dimensionality of a new measure of spirituality-religiosity designed for largely minority participants in substance abuse treatment. Data are presented from participants in explicitly faith-based substance abuse treatment programs (Teen Challenge), and multi-group confirmatory factor analysis techniques are applied to assess the invariance of the factor structure, comparing data from the new Teen Challenge validation sample with the correlation matrix from the initial scale development sample. Model fit in the present analyses reached acceptable levels with the addition of error covariances. Further, invariance tests comparing scale development and Teen Challenge validation samples did not suggest systematic variation in loadings between groups. The present comparisons support the originally proposed four-dimensional structure while supporting the use of the measure in both traditional and faith-based programs. Strengths of the present analyses include: use of diverse treatment programs in several states as well as increased precision of the present CFA findings, as program level effects (i.e., intra-class correlations) have been removed through use of residualized data in the analyses. [ABSTRACT FROM AUTHOR]

The article focuses on spiritual mechanisms underlying substance abuse behavior change in faith-based substance abuse treatment. Several definitions of faith-based organizations are being discussed. An integrative conceptual framework articulating connections between spiritual intervention components, behavior change processes and substance abuse outcomes is presented. Faith-based substance abuse treatment programs concerns the distinction between religion and spirituality. The article states that the ecological perspective and the model of social work practice provide for the incorporation of the element of personal spirituality, and therefore spiritual change, in viewing any individual presenting for services. A number of human and social service organizations have been addressed by faith-based programs. It has been found that religious or spiritual involvement may serve as a protective factor against the development of substance abuse problems. During substance abuse treatment some spiritual changes occur and substance abuse interventions may be effective for those for whom religion or spirituality is salient.

In order to examine the relative importance of general individual orientations (mastery and self-esteem) and specific coping styles with regard to psychological distress among women with HIV, data are examined from a pilot study involving in-depth face-to-face interviews with 32 HIV+ Latinas receiving care at 4 clinics serving the South Texas population. Interviews were conducted to provide preliminary psychometric information on coping and distress instruments in this predominantly Mexican American population as well as to examine psychosocial factors related to individual adjustment to HIV among Latina females. Refusal rates were low in this study (approximately 10%) and measurement instruments generally had acceptable internal consistency reliability. Results of exploratory multiple regression analyses suggest that self-esteem and mastery may be more salient predictors of depression and anxiety symptoms than are specific coping strategies. [ABSTRACT FROM AUTHOR]

gesting interventions should emphasize individual risk perceptions and alcohol expectancies. Understanding these relationships between race/ethnicity and HIV risk behaviors may help design culturally specific intervention and service programs. [ABSTRACT FROM PUBLISHER]

Studies the impact of intensive outpatient mental health interventions on the hospitalization rate and length of stay of adults with mental retardation and severe psychiatric disorder. Attributes of the respondents who were chosen for the study; Decreases in both hospitalizations and length of stay after the respondents' entry in a mental health program.

Evaluates a causal model of the Health Belief Model in HIV infections. Emphasis on possible indirect paths linking distal demographic susceptibility variables to HIV infections; Ethnic comparison of the data; Epidemiology of HIV/AIDS.

The article presents information on a 2-day sexually transmitted disease (STD) and HIV and AIDS curriculum for primary care service providers, and compares the effectiveness of traditional large-scale continuing medical education (CME) conferences with smaller scale clinic workshop (CWs). The rationale for the integrated STD and HIV 2-day curriculum designed for primary care service providers is that HIV and STDs have common modes of transmission and have high likelihood of coinfection. The evaluation design for the study involved pretest assessments using a self-administered evaluation instrument sent to participants prior to the interventions. Two- and 10-month follow-up assessments were conducted to examine short versus long-term program effects. The study found that the smaller scale CWs were providing greater potential for individual participation in the educational process and, as well, greater potential impact on clinic practice given that multiple participants have been trained from a given site.

Background: Although great emphasis has been placed on educating the public regarding HIV and sexually trasmitted disease (STD)prevention, equally important is provider education, as primary care and other health care practitioners have considerable potential for patienteducation.Recentreviews ofthe continuing medical education (CME) literature 1,2 have proposed the need for innovative educational approaches, suggesting limited support for the effectiveness of traditional didactic 1-day or shorter conferences that do not specifically involve enabling or reinforcing approaches such as role modeling, rehearsal, and case discussion. 2 Purposes: To examine short-term (2-month)and long-term (12-month)effects of the interventions with regard to STD knowledge, attitudes toward STD/HIV risk assessment,and frequencyofboth STDdiagnosis and STDpatienteducation and counseling. Methods: Pre- and postintervention (2-month and 12-month)data were obtained from a CME conference (n = 32) and 3 Clinic Workshop interventions (n = 93) held in South Texas. Results: Consistentpre-postgains in outcome measures were found in both CMEand CWmodels and among both STD practitioners and nonpractitioners among participants with lower initial knowledge or practice levels. Analyses did not support the posited facilitative effect of having multiple staff members from specific clinics in the CWcondition. Conclusions: For both models,significantgains frombaseline were found among those with initially lower knowledge/practice levels for knowledge and attitude dimensions, with the largest gains observed for patient education/counseling frequency. [ABSTRACT FROM AUTHOR]

Examines the relationship among ethnicity, gender, alcohol consumption and sexual behaviors in a community survey sample of adults. Description of the predictors used; Independence of alcohol use and sexual relationship with psychosocial background characteristics; Relationship of situated drinking with sexual behavior; AIDS sexual risk behavior.

This paper addresses the phenomenon of ‘solitary drinking’, considering whether Anglo, African American and Mexican American male regular drinkers differ in the propensity to drink in solitary contexts and whether such differences may help to explain observed ethnic variation in patterns of heavy drinking. Further, the paper considers whether apparent relationships between solitary drinking and drinking patterns are explained by individual personality characteristics such as social isolation and/or by endorsement of ‘escape drinking’ motives. Data were analysed from a random community sample of 481 adult male regular drinkers in San Antonio, Texas, USA. Contingency table and logistic regression analyses indicated that initially observed ethnic differences in high quantity and high maximum drinking were largely eliminated by controls for education, escape motives and solitary drinking. Ethnic variation in the role of solitary drinking was suggested as well, with solitary drinking more strongly related to high quantity consumption, in particular, among African Americans than among Mexican Americans. The nature of the observed interactions suggests that fundamental differences between Anglos and African Americans in the roles of solitary drinking and escape drinking motives may underlie seemingly similar frequent, lower quantity drinking patterns in these groups that appear more frequently than among Mexican American males. [ABSTRACT FROM PUBLISHER]

An integrated model of change in knowledge, highlighting the role of technologic and organisational paradigms and the activities of professional and extra-professional groups, is used to clarify the historical development of psychiatry and to account for current specialty choice trends. American psychiatry and medicine stem from disparate scientific/philosophical roots. A review of events leading to the establishment of psychiatry as a medical specialty indicates that the merger of psychiatry and neurology may have stemmed as much from professional competition as from technological or paradigmatic convergence. Recent perceived declines in the choice of psychiatry as a medical specialty are examined in light of this sociology of knowledge perspective. Declining choice of psychiatry as a specialty reflects both underlying paradigmatic conflicts with medicine as well as declining federal support for psychiatric training. Solutions proposed for the perceived problem within psychiatry are designed to solidify ties with medicine, increase political power and prestige, and retain federal support. [ABSTRACT FROM AUTHOR]

Data from a community sample of 1,784 Anglo, African-American, and Mexican-American adults were examined to assess: (I) the nature and magnitude of observed racial/ethnic and acculturation level differences in depression, (2) the relative contribution of sociodemographic and psychosocial factors (fatalism and religiosity) to observed differences, and (3) the joint effects of fatalism and religiosity as sociocultural resources with regard to depression in differing racial/ethnic and acculturation level subgroups. Analyses indicate the most dramatic differences in depression among males- African Americans were roughly similar to Anglos and levels of depression were significantly higher among the least acculturated Mexican Americans relative to Anglos, even after statistical controls. Acculturation level differences among Mexican-American females were explained by statistical controls. Lower levels of depression among more highly acculturated than among less acculturated Mexican Americans provide little support for a simplistic stress formulation of acculturation. Rather, the interplay of acculturation, Fatalism, and religiosity supports a more complex cultural marginality model, emphasizing the consistency of attitudinal elements and language use as facilitators or inhibitors of assimilation into Anglo culture. Both those who successfully acculturate and those who are most insulated in traditional culture appear least depressed from this perspective. [ABSTRACT FROM AUTHOR]

Data are presented on drinking patterns and alcohol-related problems among 164 Anglo and 149 Mexican American male regular drinkers. The paper examines the role of acculturation with regard to alcohol use by categorizing Mexican American respondents into three acculturation groups using a multi-item measure developed for this study. Data from a random sample of males drinking at least 2-3 times a month, aged 20-50, showed that, even after socio-demographic controls, Mexican Americans were less frequent, but higher quantity drinkers than were Anglos. No ethnic differences were found for alcohol-related problems. Quantity was significantly higher among less acculturated Mexican Americans than among the more highly acculturated. "Escape" drinking motives were most common among Mexican Americans, particularly among the least acculturated. Exploratory analyses among Mexican Americans using a combination of acculturation and generational status measures indicated the heaviest drinking patterns and the highest prevalence of both alcohol-related problems and escape drinking motives among the least acculturated second generation males. These suggestive data do not support either a "simple acculturation" or an "acculturation stress" model. Rather, the data suggest a cultural marginality/stress model wherein risk of heavy and problem drinking is greatest among younger Mexican Americans who have not become acculturated. [ABSTRACT FROM PUBLISHER]