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Objective Establishing positive network resources and rebuilding drug free networks are key components of recovery process for women with substance use disorder (SUDs). Theory of planned behavior (TPB) posits that behaviors are determined by behavioral intentions, which are determined by three factors: attitude toward the behavior, perceived behavioral control, and subjective norms. The current study applied TPB to examine whether women’s personal social network characteristics (as subjective norms) were related to intentions towards, and/or a substance use relapse using prospective research design.Methods Longitudinal data from 300 American women with SUD who received treatment at three county-funded, women-only intensive treatment programs was utilized for the current study.Results Bayesian estimation path analyses indicated that attitude and abstinence self-efficacy at intake were not related to intention at the 6-month follow-up, but abstinence self-efficacy was directly related to substance use relapse by 12 months. Personal social network characteristics, number of treatment related persons in personal social network and sobriety support were significantly associated with intention at 6 months. The interaction between the numbers of treatment related persons and density was found on intention, suggesting that density strengthens the relationship between treatment related persons in network and intention. Intention to use substance was associated with relapse to substance use behavior.Conclusion Our findings support that personal social network characteristics can be considered as subjective norms in the TPB model. Personal social network interventions focusing on rebuilding consistent social norms against drug-using behaviors may decrease intention to use substance, which will lead to abstinence.

INTRODUCTION: In order to investigate patterns of divergence in adolescent adjustment, this study examined the co-occurring patterns of adolescents’ individual assets (e.g., school engagement, values) and substance use and whether the co-occurring patterns were associated with later functioning in emerging adulthood. METHODS: Participants were 358 (54% females), predominantly African American, urban adolescents, recruited at birth for a prospective study on the effects of prenatal substance exposure in the Midwest United States. Individual assets, using the Developmental Assets Profile, substance use (alcohol, tobacco, marijuana), via biologic assays and self-report, and substance use-related problems were assessed at age 15. High school completion, substance use disorder, mental health symptoms, and legal problems were assessed at age 21. RESULTS: Latent class analysis identified five classes: high assets with low substance use (C1, 10.2%); moderate assets with low substance use (C2, 28.7%); low assets with low substance use (C3, 32%); moderate assets with high substance use (C4, 9.4%); and low assets with high substance use (C5, 19.2%). Despite similar levels of assets, adolescents in C5 reported more life adversities (suboptimal caregiving environment, daily hassles, non-birth parents’ care) than those in C3. C4 and C5 reported more substance use disorder at age 21 than the three low substance use classes; adolescents in C5 were less likely to complete high school than those in C2. More females in C5 reported greater mental health symptoms than those in C1 and C3 and criminal justice involvement than those in C1. CONCLUSIONS: The current findings underscore the significance of substance use in adolescence in disrupting healthy transition to adulthood, especially among females in the context of low individual assets.

Prenatal cocaine exposure (PCE) has been associated with child and adolescent externalizing behaviors and early substance use, yet few studies investigated its association with substance use disorder (SUD) in emerging adults. The present study examined the association of PCE with SUD in emerging adulthood, and whether childhood externalizing behaviors and adolescent substance use mediated the relationship.Participants were 367 (187 PCE; 53% female) adults at age 21, primarily urban African American who were recruited at birth. PCE and exposure to alcohol, tobacco, and marijuana were determined using biologic assays for drug metabolites and/or maternal self-report at birth. Offspring externalizing problems were assessed using the Youth Self-Report at age 12, substance use and substance use-related problems via biologic assays and/or self-report at age 15, and SUD determined using DSM-5 diagnostic criteria at age 21.About 32.3% of the emerging adults were determined to have marijuana use disorder, 30.3% tobacco use disorder, and 15.5% alcohol use disorder. PCE was related to greater externalizing behaviors at age 12 (β = 0.12, p = .042), which in turn was related to SUD (β = 0.22, p = .008). PCE was also related to substance use, mainly marijuana, at age 15 (β = 0.22, p = .011), which was related to SUD (β = 0.51, p .001). Total indirect effects including these two pathways were significant (β = 0.19, p = .002).PCE may increase risk for SUD in emerging adulthood through childhood externalizing behaviors and adolescent substance use.

Prenatal cocaine exposure (PCE) has been associated with small but significant effects on language development in childhood and early adolescence. This study examined whether this association persists into later adolescence and what relationship language skills may have with reading proficiency in this population.Enrolled were 338 (167 with PCE, 171 with NCE or no cocaine exposure) 17-year-olds recruited at birth who, together with their current caregiver, were seen as part of a 17-year follow-up. Participants were given assessments of reading achievement (WIAT-III), receptive and expressive language (CELF-IV), and phonological processing (CTOPP). Relationships between PCE status and language outcomes were modeled using multiple linear regression controlling for environmental and caregiver factors, and other prenatal substance exposures.Adolescents with PCE scored lower in areas of phonological processing and reading related skills compared to adolescents with NCE. PCE by sex interactions were identified on language, memory and spoken language comprehension, with lower scores for girls with PCE compared to girls with NCE.These findings suggest the persistence of PCE's relationship with phonological awareness well into adolescence. PCE was also associated with lower scores on measures of skills related to reading ability, which may be a manifestation of the observed deficits in phonological processing.

Adverse developmental effects of prenatal cocaine exposure (PCE) are hypothesized to extend into late adolescence, yet few studies have investigated the association between PCE and late adolescent mental health outcomes. We examined the associations between PCE and self-reported mental health symptoms at age 17, controlling for biologic and environmental confounders. We further explored the potential moderating role of sex and the mediating role of earlier drug use by age 15 in the associations.327 (162 PCE; 165 non-cocaine exposed, NCE) urban adolescents, primarily African Americans, of low socioeconomic status, were prospectively recruited at birth for a longitudinal study and participated in the current study. We administered the Computerized Diagnostic Interview Schedule for Children-IV to assess their mental health symptoms at age 17. Alcohol, tobacco, and marijuana use by age 15 were assessed using biologic samples and self-reports. Confounders included other prenatal drug exposures, caregiving environment, and childhood maltreatment.Although no overall associations between PCE and mental health outcomes were observed, multivariate logistic regression models indicate girls with PCE were 3.60 times (95% CI = 1.45-8.96, p = .006) more likely to have symptoms of oppositional defiance disorder than girls with NCE. This relationship was partially mediated by marijuana use by age 15.Continued studies into emerging adulthood will further elucidate the long-term mental health outcomes associated with PCE.