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Legalization of use and retail sales of recreational marijuana in U.S. states and the associated potential increase in access to marijuana and normalization of its use by adults could lead to increased use by adolescents. Studies have found that states with legal recreational marijuana have higher rates of adolescent use and frequency of use compared to states without legal use. We examined changes in student office discipline referrals (ODRs) for substance use offenses in Oregon middle and high schools before and after the legalization of recreational marijuana relative to comparison schools in other states. We found that rates of substance use related ODRs in middle schools increased by 0.14 per 100 students (30% of the mean) with legalization relative to comparison schools. This increase was moderated by the presence of a marijuana outlet within one mile of the school. We found no statistically discernible changes in high school ODRs. Marijuana use in adolescence has been linked to negative health and social consequences, including academic problems, mental health issues, and impaired driving. Potential adverse impact on adolescents and investments in school‐based prevention programs could be important considerations for policymakers and public health officials when evaluating marijuana legalization. [ABSTRACT FROM AUTHOR]

Background: Mental health conditions are common among individuals with intellectual disability. Under recognition of mental health disorders leading to unmet treatment needs is common in this population. This article addresses one major contributing factor, the lack of cognitively accessible self‐report measures for individuals with intellectual disability. Method: In this literature‐informed overview of the state of the field, we discuss the need for, and complexities of, including individuals with intellectual disability in mental health assessments. Results: With appropriate supports, many individuals with intellectual disability can respond to mental health questions. We discuss evidence‐based strategies to make mental health assessments more accessible. Conclusion: We highlight the need to engage individuals with intellectual disability to provide first‐hand information about their health and well‐being. New instruments and research procedures should be developed in partnership with individuals with intellectual disability. Self‐report may be essential to advancing the science of mental health research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine parent–teacher congruent perceptions of middle school structures to support parent monitoring of children's behavior. We examined family educational involvement and school's communication and support to families as predictors of congruence, as well as congruence as a predictor of children following school rules and expectations. Participants were 415 teachers and 5003 parents across 40 public middle schools in the northwest region of the United States. Mixed‐effects regression was used to examine the cross‐sectional data. School size and student eligibility of free or reduced price school lunch were included as school‐level covariates. Results suggested that higher levels of teacher‐reported family involvement and school communication and support to families were significantly associated with greater parent–teacher congruence. In addition, results suggested that greater parent–teacher congruence was significantly associated with higher levels of teacher‐report of children following school rules and expectations. Implications for research on parent–teacher congruence and family–school collaboration are discussed at the school system level in terms of parent monitoring of children's behavior. Practical applications are reviewed for public middle schools. [ABSTRACT FROM AUTHOR]

Aims To estimate cannabis use disorder (CUD) trajectory classes from ages 14 to 30 years and compare classes on clinical characteristics, risk factors and psychosocial outcomes. Design Four waves (T1-T4) of data from an epidemiological study of psychopathology among a regionally representative sample. Trajectory classes described risk for CUD as a function of age. The number of classes was determined by model fit. Setting Participants were selected randomly from nine high schools in western Oregon, USA. Participants The sample included 816 participants [age at T1 mean = 16.6, standard deviation (SD) = 1.2; 44% male; 8% non-white]. Measurements Participants completed diagnostic interviews, Child Trauma Questionnaire, Social Adjustment Scale and items adapted from the Wisconsin Manual for Assessing Psychotic-Like Experiences. Findings There were three CUD trajectory classes (Lo-Mendell-Rubin likelihood ratio test < 0.001): (1) persistent increasing risk; (2) maturing out, with increasing risk then decreasing risk; and (3) stable low risk. The persistent increasing class had later initial CUD onsets ( η2 = 0.16, P < 0.001) and greater cumulative CUD durations ( η2 = 0.26, P < 0.001). Male sex [odds ratio (OR) = 2.57, P = 0.018], externalizing disorders between ages 24 and 30 years (OR = 2.64, P < 0.001) and psychotic experiences during early adulthood (Cohen's d = 0.44, P = 0.016) discriminated between the persistent increasing and the maturing-out classes. Conclusions Evidence suggests three distinguishable types of trajectory for development of cannabis use disorder starting in early teens: (1) persistent increasing risk; (2) maturing out, with increasing risk then decreasing risk; and (3) stable low risk. [ABSTRACT FROM AUTHOR]

Objective This study sought to test the feasibility of a web-based Acceptance and Commitment Training (ACT) prototype prevention program called ACT on College Life (ACT-CL). Method A sample of 234 university students was randomized to either the ACT-CL website or a mental health education (MHE) website. Results Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website. There were no significant differences between conditions on outcome measures at post or follow-up. However, statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline. There were no differences between conditions on ACT process of change measures. Changes in psychological flexibility were predictive of changes in mental health across conditions, but relations dissipated over time. Furthermore, greater engagement in some components of ACT-CL predicted improvements in psychological flexibility, though not on mental health outcomes. Conclusions The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website, although there was a lower level of program engagement with ACT-CL. Findings are discussed in the context of feasibility issues and lessons learned for program revisions. [ABSTRACT FROM AUTHOR]

Aims We investigated the risk of cannabis use disorder (CUD) among probands as a function of parental psychopathology and explored parent-offspring gender concordance as a mechanism of parental CUD transmission to offspring. Design Four waves of data collection from a longitudinal epidemiological study of psychopathology among a regionally representative sample. Setting Participants were selected randomly from western Oregon, USA, and were initially assessed during mid-adolescence. Participants The reference sample included 719 probands and their biological mothers and fathers. Measurements CUD episodes among probands were assessed with semistructured diagnostic interviews between mid-adolescence and young adulthood. Life-time psychiatric disorders among parents of probands were assessed when probands were approximately 24 years of age. Findings There was an increased risk for CUD onset among probands with parental histories of CUD [hazard ratio (HR) = 1.93, 95% confidence interval (CI) = 1.30-2.88], hard drug use disorders (HR = 1.96, 95% CI = 1.32-2.90) or antisocial personality disorder (HR = 1.73, 95% CI = 1.06-2.82). A significant parent-offspring gender concordance effect indicated that females with a maternal CUD history were at higher risk for CUD onset compared with females without a maternal CUD (HR = 3.10, 95% CI = 1.52-6.34). Maternal CUD was not associated with CUD onset among males ( P = 0.570), nor was there evidence for parent-offspring gender concordance effects for paternal CUD-specific transmission ( P = 0.114). Conclusions Parental histories of antisocial personality and illicit substance use disorders are associated with increased risk for cannabis use disorder onset in offspring, especially among females with maternal cannabis use disorder histories. [ABSTRACT FROM AUTHOR]

Background Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). Method Eight hundred and sixteen adolescents were assessed using interviews and questionnaires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult outcomes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). Results In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). Conclusions Adolescent suicide attempters are at high risk of protracted and wide-ranging impairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to examine the prospective relationship between a history of attention-deficit/hyperactivity disorder (ADHD) assessed in mid-adolescence and the onset of major depressive disorder (MDD) through early adulthood in a large school-based sample. A secondary aim was to examine whether this relationship was robust after accounting for comorbid psychopathology and psychosocial impairment. Method One thousand five hundred seven participants from the Oregon Adolescent Depression Project completed rating scales in adolescence and structured diagnostic interviews up to four times from adolescence to age 30. Results Adolescents with a lifetime history of ADHD were at significantly higher risk of MDD through early adulthood relative to those with no history of ADHD. ADHD remained a significant predictor of MDD after controlling for gender, lifetime history of other psychiatric disorders in adolescence, social and academic impairment in adolescence, stress and coping in adolescence, and new onset of other psychiatric disorders through early adulthood (hazard ratio, 1.81; 95% confidence interval, 1.04, 3.06). Additional significant, robust predictors of MDD included female gender, a lifetime history of an anxiety disorder, and poor coping skills in mid-adolescence, as well as the onset of anxiety, oppositional defiant disorder, and substance-use disorder after mid-adolescence. Conclusions A history of ADHD in adolescence was associated with elevated risk of MDD through early adulthood and this relationship remained significant after controlling for psychosocial impairment in adolescence and co-occurring psychiatric disorders. Additional work is needed to identify the mechanisms of risk and to inform depression prevention programs for adolescents with ADHD. [ABSTRACT FROM AUTHOR]

Evaluations of assessment instruments using classical test theory typically rely on indices of internal consistency, test-retest reliability, and construct validity. However, the use of models from item response theory (IRT) allows comparison of instruments (and items) in terms of the information they provide and where they provide it along the continuum of severity of the construct being assessed. Such results help to identify the measures most appropriate for specific clinical and research contexts. The present study examined the functioning of the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies - Depression (CES-D) scale, and the nine primary symptoms from the depression module of the Schedule for Affective Disorders and Schizophrenia - Children (K-SADS) using IRT methods. A large sample of adolescents ( n = 1709) completed the BDI, CES-D scale, and K-SADS. IRT calibration analyses demonstrated that the BDI and CES-D scale performed well in similar ranges of depressive severity (approximately −1 to +3 standard deviations [SDs]), although the BDI provided more information at higher severity levels and the CES-D scale at lower severity levels. The K-SADS depression items, which are dichotomous and focused on clinical disorder, provided the least information that was restricted to the narrowest range (approximately +1 to +3 SDs). This work finds consistency between past rationale for the use of the BDI in clinical samples while using the CES-D scale in epidemiological studies. The results for the K-SADS suggest that interview measures may benefit from increasing the number of items and/or response options to collect more psychometric information. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of a family life education program for stepfamilies that is self-administered, interactive, and web-based. The program uses behavior-modeling videos to demonstrate effective couple, parenting, and stepparenting practices. A diverse sample of 300 parents/stepparents of a child aged 11-15 years were randomized into either treatment or delayed-access control groups. Findings suggest that participation in the stepfamily education program positively influenced several key areas of parenting and family functioning at postprogram and follow-up. No gender differences were noted in the findings. [ABSTRACT FROM AUTHOR]

Aim To examine various methods to impute missing binary outcome from a web-based tobacco cessation intervention. Design The ChewFree randomized controlled trial used a two-arm design to compare tobacco abstinence at both the 3- and 6-month follow-up for participants randomized to either an enhanced web-based intervention condition or a basic information-only control condition. Setting Internet in the United States and Canada. Participants Secondary analyses focused upon 2523 participants in the ChewFree trial. Measurements Point-prevalence tobacco abstinence measured at 3- and 6-month follow-up. Findings The results of this study confirmed the findings for the original ChewFree trial and highlighted the use of different missing-data approaches to achieve intent-to-treat analyses when confronted with substantial attrition. The use of different imputation methods yielded results that differed in both the size of the estimated treatment effect and the standard errors. Conclusions The choice of imputation model used to analyze missing binary outcome data can affect substantially the size and statistical significance of the treatment effect. Without additional information about the missing cases, they can overestimate the effect of treatment. Multiple imputation methods are recommended, especially those that permit a sensitivity analysis of their impact. [ABSTRACT FROM AUTHOR]

Background: There has been increasing interest in the distinction between subthreshold and full syndrome disorders and specifically whether subthreshold conditions escalate or predict the onset of full syndrome disorders over time. Most of these studies, however, examined whether a single subthreshold condition escalates into the full syndrome form of that disorder. Equally important, though, is whether subthreshold conditions are likely to develop other full syndrome disorders and whether these associations are maintained after adjusting for comorbidity. Methods: A 15-year longitudinal study of subthreshold psychiatric conditions was conducted with 1,505 community-drawn young adults. We examined whether 1) subthreshold major depression, bipolar, anxiety disorders, alcohol use, substance use, conduct disorder and/or ADHD were precursors for the corresponding (homotypic) full syndrome disorder; 2) subthreshold conditions were precursors for other (heterotypic) full syndrome disorders; and 3) these homotypic and heterotypic precursors persisted after adjusting for comorbidity. Results: Subthreshold major depression, anxiety, alcohol use, substance use, and conduct all escalated into their corresponding full syndrome and nearly all homotypic developments were maintained after adjusting for comorbid subthreshold and full syndrome conditions. Many heterotypic associations were also observed and most remained after controlling for comorbidity, particularly among externalizing disorders (e.g., alcohol, substance, conduct/antisocial personality disorder). Conclusions: Many subthreshold conditions have predictive validity as they may represent precursors for full syndrome disorders. Alternatively, dimensional conceptualizations of psychopathology which include these more minor conditions may yield greater validity. Subthreshold conditions may represent good targets for preventive interventions. [ABSTRACT FROM AUTHOR]

Background: A large community sample [n=591, 57% women, M age=51.01] was administered the Revised Temperament and Character Inventory [TCI-R; Cloninger, 1999]: The Temperament and Character Inventory—Revised. St. Louis, MO: Center for Psychobiology of Personality, Washington University] and a modified version of the Center for Epidemiologic Studies–Depression Scale [CES-D; Radloff, 1977]: Appl Psychol Measure 1:385–401] at Time 1 [T1] and the Center for Epidemiologic Studies–Depression Scale again 4 years later at Time 2 [T2].Methods: Whereas three of the seven personality dimensions were significantly and uniquely associated with depressed mood at T1, only harm avoidance emerged as a significant unique positive predictor of depressed mood at T2. Results: When participants were grouped according to the level of stability versus change in depressed mood during the 4-year period, reward dependence, self-directedness, and cooperativeness were found to be significantly lower among those low in depressed mood at T1 who subsequently evidenced moderate to high levels of depressed mood at T2 when compared to those with low depressed mood on both assessment occasions. Additional analyses indicated that those who evidenced moderate to high levels of depression at T1 and T2 were distinctly higher on harm avoidance and lower on self-directedness when compared to those who had consistently low or variable levels of depressed mood across the two assessment occasions. Conclusions: Findings from this research are discussed in terms of personality-related vulnerability and risk factors for future episodes of depressed mood. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Aim To examine self-efficacy and program exposure as possible mediators observed treatment effects for a web-based tobacco cessation intervention. Design The ChewFree trial used a two-arm design to compare tobacco abstinence at both the 3- and 6-month follow-up for participants randomized to either an enhanced intervention condition or a basic information-only control condition. Setting Internet in US and Canada. Participants Our secondary analyses focused upon 402 participants who visited the web-based program at least once, whose baseline self-efficacy rating showed room for improvement, who reported that they were still using tobacco at the 6-week assessment, and for whom both 3- and 6-month follow-up data were available. Intervention An enhanced web-based behavioral smokeless tobacco cessation intervention delivered program content using text, interactive activities, testimonial videos and an ask-an-expert forum and a peer forum. The basic control condition delivered tobacco cessation content using static text only. Measurements Change in self-efficacy and program exposure from baseline to 6 weeks were tested as simple and multiple mediators on the effect of treatment condition on point-prevalence tobacco abstinence measured at 3- and 6-month follow-up. Findings While both participant self-efficacy and program exposure satisfied the requirements for simple mediation, only self-efficacy emerged as a mediator when we used the more robust test of multiple mediation. Conclusions Results confirm the importance of self-efficacy change as a probable underlying mechanism in a successful web-based behavioral intervention. While program exposure was found to be a simple mediator of tobacco abstinence, it failed to emerge as a mediator when tested with self-efficacy change in a multiple mediator test suggesting that self-efficacy and program exposure share a complex, possibly reciprocal relationship with the tobacco abstinence outcome. Our results underscore the utility of searching for mediators in research on web-based interventions. [ABSTRACT FROM AUTHOR]

Dentists and dental hygienists can be effective in providing advice and brief counseling to tobacco-using patients. However, lack of training in effective interventions is a barrier to incorporating tobacco cessation interventions into routine practice. After we developed and evaluated an interactive CD-ROM tobacco cessation training program, we evaluated the effect of using the program on the knowledge level and attitudes of forty-seven third-year dental students and thirty dental hygiene students and also obtained their opinions of program quality and utility. Significant change was observed from pre- to post-intervention (t (46) = -11.62, p <.001; Cohen's d = 1.36). Program use was strongly related to change in the measure of tobacco cessation knowledge, attitudes, and beliefs (semi-partial r = .57, p <.001). In addition, participants rated the program highly on measures of satisfaction. The results of our evaluation provide strong support for the efficacy of the program with dental and dental hygiene students. An interactive educational program such as the one reported herein could be a useful tool for enabling dental professionals to obtain the skills necessary to help their patients quit using tobacco. [ABSTRACT FROM AUTHOR]

The goals of the present study were to describe the psychometric properties of the Life Attitudes Schedule-Short Form (LAS-SF) in adolescents and provide criterion and construct validity data, including bivariate and multivariate associations with related risk behaviors. Anonymous questionnaires containing the LAS-SF and related measures were administered to 1,742 high school students in three states. Psychometric properties for LAS-SF items and total score were very good, and the LAS-SF was correlated with almost all of the examined risk behaviors, illustrating the broad range of problems measured by the instrument. LAS-SF total scores were associated with past suicide attempt, even after controlling for the impact of current depression. Clinical and research uses for the LAS-SF are discussed. [ABSTRACT FROM AUTHOR]

Presents information on a study which compared the problematic eating behaviors and attitudes in young men and women. Reasons for the increase in eating problems among men; Assessment of eating disorder symptoms; Pychometric analysis; Association between psychopathology and the Eating Disorders Symptoms Questionnaire scales.

Objectives: To compare the incidence and prevalence of bipolar disorder (BD) between adolescence and young adulthood; to explore the stability and consequences of adolescent BD in young adulthood; to determine the rate of switching from major depressive disorder (MDD) to BD; and to evaluate the significance of subsyndromal BD (SUB). Methods: A large, randomly selected community sample (n=1507) received diagnostic assessments twice during adolescence, and a stratified subset (n=893) was assessed again at 24years of age. In addition, direct interviews were conducted with all available first-degree relatives. Five mutually exclusive groups, based on diagnoses in adolescence, were compared: BD (n=17), SUB (n=48), MDD (n=275), disruptive behavior disorder (n=49), and no-disorder (ND) controls (n=307). Results: Lifetime prevalence of BD was approximately 1% during adolescence and 2% during young adulthood. Lifetime prevalence for SUB was approximately 5%. Less than 1% of adolescents with MDD ‘switched’ to BD by age 24. Adolescents with BD had an elevated incidence of BD from 19 to 23 years, while adolescents with SUB exhibited elevated rates of MDD and anxiety disorders in young adulthood. BD and SUB groups both had elevated rates of antisocial symptoms and borderline personality symptoms. Compared to the ND group, adolescents with BD and SUB both showed significant impairment in psychosocial functioning and had higher mental-health treatment utilization at age 24 years of age. The relatives of adolescents with BD and SUB had elevated rates of MDD and anxiety disorders. The relatives of SUB probands had elevated BD, while the relatives of BD had elevated rates of SUB and borderline symptoms. Conclusions: Adolescent BD showed significant continuity across developmental periods and was associated with adverse outcomes during young adulthood. Adolescent SUB was also associated with adverse outcomes in young adulthood, but was not associated with an... [ABSTRACT FROM AUTHOR]

This article is an attempt to describe and then discuss how and why and with what consequence, the psychoanalytic viewpoint, albeit trimmed, truncated, vulgarized and sweetened, came so much, so deeply and so soon to perfuse American thought. The essay is now fifteen to twenty years old, and the questions are as to what has ensued since that time what defects, describable then and merely deficiencies of analysis, or describable only in the light of subsequent unfolding events are now identifiable and definable. In contrast, with those who live by the liberative art of psychoanalysis, for those who view the problem of human healing or whole-making with its strangely unhuman view of what it is to be human as a science. Since psychoanalysis lends itself less, indeed somewhat unreadily to such uses, it becomes at least for the moment, spinster in this sphere of powerful social marriages, and thus to a degree "irrelevant" to the struggle mounting toward crisis for the next revolutionary phase in the life of humanity or for its indefinite delay, crippling.

The article focuses on the definition of theory and its relation to an individual and the society in general. Theory arises out of, flows back into, exists in, and is an aspect of, an active, passionate and willful attempt to secure one outcome rather than another in an external and internal world. Theory is thus only an ingredient in action. It is an aspect of practice, of struggle and of praxis. Theory is what differentiates human from the rest, for humans themselves are in large part, theory. The society is a society constituted as to quality and determined as to degree by the suppositions or theories that individuals have about themselves. While true so far as it goes, society is more than that because individuals each have suppositions and theories about society. And with society, as with persons, the theory, belief, faith or supposition is neither outside nor really in any ordinary sense about society. Theory is therefore, not about an individual but it is the individual and it is not about the society but rather it is the society itself. Apathy, frustration, loneliness and despair relate to the personal and social theories within which people live.

In this report, we (a) present descriptive information about the extent and the kinds of treatments being provided to depressed adolescents; (b) identify the factors that are related to treatment utilization; and (c) examine whether the provision of treatment during adolescence reduced the risk for the occurrence of depression during young adulthood (19-24 years). The sample consisted of 1,507 randomly selected high school students who were diagnostically assessed on two occasions with an interval of approximately one year; 627 were assessed a third time when they reached the age of 24. The findings may be summarized as follows: 60.7% of those with major depressive disorder were provided with treatment. The modal treatment was outpatient, individual psychotherapy administered by a mental health provider. Inpatient treatment and medications were rare. Factors found to be related to treatment utilization were the severity of the depression, the existence of a comorbid nonaffective disorder, the number of previous episodes of depression, history of suicide attempt, academic problems, lack of intact family, and female gender. Unexpectedly, those who had received treatment were not less likely to relapse into another episode of depression during young adulthood. [ABSTRACT FROM AUTHOR]