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This study examined the utility of the MMPI-2 in detecting substance-abuse problems in an outpatient mental health setting. Specifically, the utility of the Addiction Acknowledgment Scale (AAS; N. C. Weed, J. N. Butcher, T. McKenna, & Y. S. Ben-Porath, 1992), the Addiction Potential Scale (APS; N. C. Weed et al., 1992), and the MacAndrew Alcoholism Scale-Revised (MAC-R; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegan, & B. Kaemmer, 1989) in the prediction of substance abuse was evaluated. In addition, the incremental validity of the AAS and the APS in comparison to the MAC-R scale was evaluated. The sample consisted of 500 women and 333 men from a large community mental health center in Northeastem Ohio. Results indicated that the MAC-R scale, the AAS, and the APS were related to interviewer ratings of substance abuse in this outpatient treatment setting. Specifically, the results pointed to the superiority of AAS over APS in substance-abuse identification and the significant contribution of AAS to the information available from the MAC-R scale alone.

Adolescents (24 boys, 37 girls) from public school settings were given the MMPI-A on 2 occasions with approximately 1 year between testing sessions. Long-term stability of validity, clinical, content, supplementary, and the new Psychopathology Five scales are examined and correlation coefficients are presented. The reliabilities of the MMPI-A scales are consistent with previously reported data. In addition, improvements made during development of the MMPI-A may have led generally to modest increases in stability of the clinical scales for adolescents. Given the importance of both short-term and long-term test-retest data in the evaluation of the validity of an assessment instrument, this study represents an important step in evaluating the validity of the MMPI-A for assessment of personality.

Background The Organizational Process Improvement Intervention (OPII), conducted by the NIDA-funded Criminal Justice Drug Abuse Treatment Studies consortium of nine research centers, examined an organizational intervention to improve the processes used in correctional settings to assess substance abusing offenders, develop case plans, transfer this information to community-based treatment agencies, and monitor the services provided by these community based treatment agencies. Methods/Design A multi-site cluster randomized design was used to evaluate an inter-agency organizational process improvement intervention among dyads of correctional agencies and community based treatment agencies. Linked correctional and community based agencies were clustered among nine (9) research centers and randomly assigned to an early or delayed intervention condition. Participants included administrators, managers, and line staff from the participating agencies; some participants served on interagency change teams while other participants performed agency tasks related to offender services. A manualized organizational intervention that includes the use of external organizational coaches was applied to create and support interagency change teams that proceeded through a four-step process over a planned intervention period of 12 months. The primary outcome of the process improvement intervention was to improve processes associated with the assessment, case planning, service referral and service provision processes within the linked organizations. Discussion Providing substance abuse offenders with coordinated treatment and access to community-based services is critical to reducing offender recidivism. Results from this study protocol will provide new and critical information on strategies and processes that improve the assessment and case planning for such offenders as they transition between correctional and community based systems and settings. Further, this study extends current knowledge of and methods for, the study of evidence-based practice adoption and implementation. Electronic supplementary material The online version of this article (doi:10.1186/2194-7899-2-1) contains supplementary material, which is available to authorized users.

The comparative validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scores for African American (n = 123) and Caucasian (n = 561) clients from a community mental health center was investigated by contrasting mean MMPI-2 scores and correlations between those scores and conceptually related therapist rating scales for the 2 groups. The African American men scored significantly higher on the Lie scale and Fears content scale than did their Caucasian counterparts, and the African American women scored higher than Caucasian women on Hypomania. Caucasian women scored higher on the Low Self Esteem content scale. Correlations between MMPI-2 scores and patient description form ratings were not significantly different between racial groups, indicating that the differences in MMPI-2 mean scale score elevations reflect actual differences in client psychopathology. There was no evidence of test bias in the current study. Suggestions are made for additional research.

Motivational interviewing (MI) has been found to be an effective treatment for substance using populations, including incarcerated adolescents. Although some studies suggest MI is more successful with individuals from minority backgrounds, the research remains mixed. The current study investigated the impact of ethnicity on treatment in reducing alcohol and marijuana use among incarcerated adolescents. Adolescents (14–19 years of age) were recruited from a state juvenile correctional facility and randomly assigned to receive MI or relaxation therapy (RT) (N = 147; 48 White, 51 Hispanic, and 48 African American; 126 male; 21 female). Interviews were conducted at admission to the facility and 3 months after release. Results suggest that the effects of MI on treatment outcomes are moderated by ethnicity. Hispanic adolescents who received MI significantly decreased total number of drinks on heavy drinking days (NDHD) and percentage of heavy drinking days (PHDD) as compared to Hispanic adolescents who received RT. These findings suggest that MI is an efficacious treatment for an ethnic minority juvenile justice-involved population in need of evidence-based treatments.

Background Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, Motivational Interviewing with Computer Assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12 months after release; and (3) decrease unsafe sexual activity. Methods/Design This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women’s jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12 months post release and assessed for STIs, pregnancy, and reported condom use. Discussion Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community. Trial registration NCT01132950

Medication-assisted treatment (MAT) is underutilized in the treatment of drug-dependent, criminal justice populations. This study surveyed criminal justice agencies affiliated with the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) to assess use of MAT and factors influencing use of MAT. A convenience sample ( N = 50) of criminal justice agency respondents (e.g., jails, prisons, parole/probation, and drug courts) completed a survey on MAT practices and attitudes. Pregnant women and individuals experiencing withdrawal were most likely to receive MAT for opiate dependence in jail or prison, whereas those reentering the community from jail or prison were the least likely to receive MAT. Factors influencing use of MAT included criminal justice preferences for drug-free treatment, limited knowledge of the benefits of MAT, security concerns, regulations prohibiting use of MAT for certain agencies, and lack of qualified medical staff. Differences across agency type in the factors influencing use and perceptions of MAT were also examined. MAT use is largely limited to detoxification and maintenance of pregnant women in criminal justice settings. Use of MAT during the community reentry period is minimal. Addressing inadequate knowledge and negative attitudes about MAT may increase its adoption, but better linkages to community pharmacotherapy during the reentry period might overcome other issues, including security, liability, staffing, and regulatory concerns. The CJ-DATS collaborative MAT implementation study to address inadequate knowledge, attitudes, and linkage will be described.

Sources of sexual health information exert strong influence on adolescents' sexual behavior.The current study was undertaken to understand how family serve as sexual information sources, the messages adolescents recall from family, and how family learning experiences affect sexual behavior among at-risk adolescents.Individual interviews were conducted with 69 teens, ages 15-18 years, from an alternative high school and a juvenile correctional facility to capture adolescents' early sexual health learning experiences involving family and evaluate their association with teens' recent sexual behavior. Sexual learning narratives were compared among gender and sexual experience groups.Many participants identified family as sexual health information sources. Primary messages recalled: risks of sex, protection, and relationship advice. Many adolescents portrayed learning experiences as negative, cautionary, lacking detail and not always balanced with positive messages. Participants who reported four or more sexual risks were the only group to identify pornography as a sexual health information source. Participants who reported fewer than four sexual risks were most likely to identify family sexual health information sources.Participants identified family members as sources of sexual health information, with variations by gender. Negative/cautionary messages require teens to seek additional sexual information elsewhere (primarily friends/media). Males, in particular, appear to often lack familial guidance/education.Sexual health messages should be tailored to adolescents' needs for practical and sex-positive guidance regarding mechanics of sex and formation of healthy relationships, and balanced with cautions regarding negative consequences.

Much of what is understood regarding gamma hydroxybutyrate (GHB) treatment is based on hospital case studies for overdose and withdrawal, and there are currently no measures developed specifically for GHB or its analogs (e.g., gamma butyrolactone and 1,4-butanediol) to assess drug effect expectancies, reasons for starting use, withdrawal effects, and knowledge and opinions about use.This pilot study (N = 61) was conducted to begin measures development to assess experiences, functions of use, and opinions regarding use as indicated by respondents taking a Web-based survey.Minimum average partial correlation and parallel analysis procedures are employed to create scales.Scales were developed to assess expectancies, reasons for use, withdrawal, and knowledge/opinions of use with median α = .79 and that account for 8.69-24.17% of the variance.Scales have relatively good psychometric properties and replication is needed.GHB-specific measures may greatly assist in furthering our understanding of protective and risk factors for use, and withdrawal phenomena.

The purpose of this study was to evaluate a brief version of the Marijuana Effect Expectancy Questionnaire (MEEQ; Schafer & Brown, 1991). The original MEEQ was reduced to 6 items (MEEQ-B). Principal component analysis (PCA) was performed and two factors were identified (positive effects and negative effects) accounting for 52.3% of the variance. Internal consistencies (0.42 to 0.60) were slightly lower than those of the original MEEQ. The negative effect expectancy scale correlated with criterion variables that assess marijuana use (p ≤ .05). This measure is a helpful tool for clinicians to use when assessing youth expectancies. Replication across different samples of adjudicated youth is recommended.

The impact of depressed mood on Motivational Interviewing (MI) to reduce risky behaviors and consequences in incarcerated adolescents was examined in this brief report.Adolescents (N=189) were randomly assigned to receive MI or Relaxation Training (RT).At 3-month follow-up assessment, MI significantly reduced risks associated with marijuana use, with a trend towards reducing risks associated with alcohol use. There was also a trend for depressive symptoms to be associated with reduced risks after release. Interaction effects were non-significant, indicating no moderating effects for depressed mood on treatment outcome.MI may be a useful treatment for incarcerated adolescents in order to reduce risks and consequences associated with substance use after release.

Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated.Adolescents (N = 162, 84% male; M = 17.10 years old) were randomly assigned to receive motivational interviewing or relaxation training, with follow-up assessment 3 months after release.Compared with those who received relaxation training, adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up, with some evidence for moderating effects of depression. At low levels of depression, adolescents who received motivational interviewing had lower rates of use. Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training.This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release. In addition, depressive symptoms early in incarceration should be considered in treating these adolescents, but more work is needed to extend follow-up period and account for the impact of depression on outcomes.

Grant proposal writing in the behavioral sciences is important for fiscal reasons and scientific reasons at many universities. This report describes a grant proposal–writing seminar series provided to University faculty ( N = 20) and explores factors facilitating and impeding writing. Summary statistics are provided for quantitative data. Free responses were sorted by independent raters into meaningful categories. As a consequence of the training, 45% planned to submit within 18 months; 80% of grant proposals targeted NIH. At 1-year follow-up, 40% actually submitted grants. Factors impeding grant proposal writing included competing professional demands; factors facilitating writing included regularly scheduled feedback on written proposal sections and access to expert collaborators. Obtaining grants generates financial resources, facilitates training experiences, and vastly contributes to the growth and dissemination of the knowledge base in an area.

Mindfulness has been proposed as a useful adjunct to alcohol abuse treatment. However, very little research has examined the basic relationship between alcohol use and mindfulness. Inconsistency in definition and measurement of mindfulness across studies makes such research difficult to interpret and conduct. Therefore, the current research sought to validate an emerging mindfulness measure, the Five Facet Mindfulness Questionnaire (FFMQ), and examine its relationship with alcohol use and alcohol-related negative consequences among a sample of 316 college-aged adults. The purported factor structure of the FFMQ was examined using confirmatory factor analysis. Structural equation modeling was used to examine relations among mindfulness, alcohol use, and alcohol-related negative consequences. Consistent with past research, results supported the five-factor structure of the FFMQ. Structural equation modeling analyses revealed that two awareness-based factors of mindfulness were negatively related to alcohol use. After controlling for alcohol use, one acceptance-based factor (nonjudging of thoughts and feelings) was negatively related to alcohol-related consequences, and one awareness-based factor was positively related to consequences (all ps < .05). Effect sizes were small-medium. The results reported here inform the burgeoning development of mindfulness-based addiction treatment and provide additional psychometric validation of the FFMQ.

Adolescents have been reported to be less motivated to engage and remain in substance abuse treatment than adults. When they appear motivated, it is often due to external motivators such as family pressure or court mandated treatment. The purpose of this study was to determine if adolescents' motivation to change alcohol use was related to treatment engagement while incarcerated and alcohol use after release. Participants (N=114) were youth in a state correctional facility in the Northeast and included adolescents who engaged in at least monthly drinking. Motivation to change alcohol use was measured by the Alcohol Ladder (AL), and treatment engagement was measured by the Treatment Participation Questionnaire (comprised of positive and negative treatment engagement). Measures were administered at baseline, 2 months in facility follow up, and 3 months post release follow up. Analysis indicated acceptable test-retest stability (r=.388, p≤.001). The AL at 3 months post release significantly predicted quantity and frequency of alcohol use after release. The AL at baseline also significantly predicted positive and negative treatment engagement at 2 months into incarceration (i.e., 2 months in facility follow up) indicating predictive validity. These results suggest that the AL is a reliable, valid, and useful instrument for incarcerated youth.

Introduction: The study objectives were to examine smoking abstinence and reinstatement effects on subjective experience and cognitive performance among adolescent smokers. Methods: Adolescents (aged 14-17 years, 60 daily smokers and 32 nonsmokers) participated. Participants completed baseline assessments (Session 1) and returned to the laboratory 1-3 days later to repeat assessments (Session 2); half of the smokers were randomly assigned to 15-17 hr tobacco abstinence preceding Session 2. Results: During Session 2, abstaining smokers reported significantly greater increases in withdrawal symptoms, smoking urges, and negative affect compared with smokers who did not abstain and compared with nonsmokers. Smoking reinstatement reversed abstinence effects, returning to baseline levels for smoking urges and negative affect. Abstaining smokers showed significantly enhanced cognitive performance on two of six tasks (two-letter search compared with nonabstaining smokers; serial reaction time compared with nonsmokers); smoking reinstatement resulted in significant decrements on these two tasks relative to nonabstaining smokers. Discussion: Effects of smoking abstinence and reinstatement on self-report measures are consistent with earlier research with adolescent as well as adult smokers and may help to elucidate the motivational underpinnings of smoking maintenance among adolescent smokers. Effects found on cognitive performance were contrary to hypotheses; further research is needed to understand better the role of cognitive performance effects in smoking maintenance among adolescents.

The purpose of this study is to examine the problem behavior and self-medication models of alcohol abuse in incarcerated male adolescents. Male adolescents (N = 56) incarcerated in a juvenile correction facility were administered a battery of psychological measures. Approximately 84% of adolescents with clinically significant alcohol-related problems prior to incarceration indicated use of alcohol for purposes of self-medication and 73% indicated that their alcohol use was associated with aggressive and rebellious behavior. Further, adolescents with clinically significant alcohol-related problems prior to incarceration reported higher levels of affective symptoms, mood-related cognitive distortion, and less use of social support during incarceration than adolescents without clinically significant alcohol-related problems. They also reported more symptoms associated with oppositional defiant but not conduct disorder. For the majority of incarcerated male adolescents in this sample, alcohol-related problems appeared to be associated with both self-medication and problem behavior. Incarcerated adolescents with a history of alcohol-related problems may require skills training in addition to substance abuse services to address affective symptoms and coping skill deficits.

A substantial number of the injured patients who go to the emergency department (ED) for treatment will have alcohol use issues and may be intoxicated at the time of treatment (Becker et al., 1995; Cherpitel, 1999; Freedland et al., 1993), and they are at risk from continuing to experience adverse health and psychosocial consequences (D’Onofrio et al., 2005; Dinh-Zarr et al., 2000; McDonald et al., 2004). As ED treatment presents a brief opportunity for the health-care professional to screen for and to address patients’ hazardous alcohol use, it is important that emergency-care professionals determine the most efficacious way to help individuals who may be amenable to changing their alcohol-related behaviors and reduce the likelihood of future negative consequences (Crawford et al., 2004; D’Onofrio et al., 2005). Brief motivational interviewing (BMI) is a therapeutic approach that has been employed to change patient behavior in a variety of clinical settings. This brief client-centered intervention focuses on helping patients identify behaviors that need to be changed, increased patient ambivalence, motivation, and planning for changing identified behaviors (Field et al., 2005;Miller and Rollnick, 2002). A meta-analysis on the use of BMI in randomized clinical trials in primary care settings has demonstrated effectiveness in reducing alcohol consumption in patients when compared with standard care (Burke et al., 2003; Moyer et al., 2002; Rounsaville et al., 2001). A more recent review of the literature suggests that BMI is generally more effective than standard care in the ED for reducing hazardous alcohol use, such as binge drinking, and in reducing alcohol-related injuries and negative consequences (P. Nilsen et al., unpublished data). However, treatment regimes such as BMI should not only demonstrate efficacy but also should provide an explanation of the mechanisms by which the treatment facilitates change in the patient (Rounsaville et al., 2001). In reviewing research on the treatment components for alcohol use, Miller (1985) concluded that therapist characteristics were seldom investigated as a predictor of patient motivation and treatment compliance (Miller, 1985). In explaining how treatments such as BMI work, it is important to understand what works by also looking at therapists’ behaviors, rather than only focusing on the patient characteristics that moderate treatment. This current investigation was conducted as a secondary analysis of data from a large-scale randomized clinical trial which demonstrated that injured ED patients, randomized into BMI with a booster BMI session, experienced better long-term outcomes than ED patients receiving standard care (SC), including reduced alcohol-related injuries and negative consequences (Longabaugh et al., 2001). Using an intention-to-treat model, the original study compared treatment effectiveness of injured ED patients (n = 539) randomization to: (1) SC (n = 188), (2) 1 session of BMI delivered in the ED setting (BI; n = 182), and (3) 2 sessions of BMI (BIB; n = 169) (one delivered in the ED and a later booster session delivered outside of the ED). In the original study, all recruited participants were at-risk drinkers by virtue of having a score of 8 or greater in the AUDIT, and/or having alcohol in their system at the time of injury or ED visit. The Institutional Review Board of the hospital and university approved the original research protocol. The outcome data analyzed in the present paper were provided by those participants recruited into the study who were interviewed 12 months after their initial injury-related ED visit (84%). These follow-up interviews were conducted by research assistants who were blinded to participant group assignment. The original study demonstrated that those participants assigned to the BIB condition as compared with those assigned to the SC, had fewer alcohol-related injuries and negative consequences during the 12 months after treatment (Longabaugh et al., 2001). However, because only 68% of the participants assigned to the BIB condition actually received the second BMI session, it is important to examine why some participants did not complete the second BMI session and to determine if completion of the second BMI was important in predicting treatment outcomes. As participants were demonstrating a selection bias in deciding whether or not to return to complete the treatment assignment, it was important (1) to determine what effect that this lack of treatment completion had on participant outcomes and (2) to examine what therapists behaviors may have influenced the decisions of the participants to complete treatment, after we have ruled out competing theories of participant characteristics that were associated with treatment completion.

Little is known about treatment process for behavior change for brief interventions. Patient ratings of treatment process during a patient-centered brief intervention for alcohol were used to predict post-treatment alcohol use and consequences. We use data from a randomized clinical trial that compared the effects of BI (1 session) to BI and booster (BIB, 2 sessions) to reduce harmful drinking and alcohol consequences. Subjects were n=167 (BI) and n=82 (BIB). Five of the 12 ratings were rated significantly higher by those in the BIB condition compared to BI. The only predictor of reduced alcohol consequences at 12-months was higher ratings of, “I have obtained some new understanding,” for BIB participants (t=−2.50, p < .05). Patient perspectives on treatment may have a role in patient outcomes and should be explored as a dimension of treatment process.

Correctional staff knowledge, attitudes, and perceptions of incarcerated juveniles' mental health needs, including suicide prevention, have not been studied empirically. This study measured juvenile correctional officers' knowledge and attitudes regarding suicide risk factors and mental health and substance abuse issues through administration of the Mental Health Knowledge and Attitude Test (MHKAT) before and after a staff training on suicide prevention. Seventy-six participants completed the pre- and post-training MHKAT. They demonstrated significant improvement in knowledge of and attitudes toward mental health treatment of incarcerated youth as reflected by higher post-training MHKAT scores. Findings suggest that correctional staff are receptive to increasing knowledge of critical mental health issues. Studies of the retention and implementation of this new knowledge by direct care staff over time and the optimal type and frequency of new staff training and continuing education are indicated.

Study objective: This study compares the effect of a brief motivational intervention for alcohol plus a booster given to emergency department (ED) patients with subcritical injuries from a motor vehicle crash with the effect of brief motivational intervention for alcohol plus a booster in patients treated for non-motor vehicle crash-related injuries. Methods: A randomized controlled trial (n=539) was conducted at an urban Level I trauma center of brief intervention (1 ED session of brief intervention), brief motivational intervention for alcohol plus a booster (1 ED session plus booster session), or standard care for injured ED patients with an alcohol use problem who were being discharged home. At 12 months, alcohol-related negative consequences and injuries were measured. We performed a secondary analysis comparing motor vehicle crash–injured patients and non–motor vehicle crash–injured patients in the study sample. Results: Subcritically injured ED patients with harmful or hazardous alcohol use who received brief motivational intervention for alcohol plus a booster had fewer alcohol-related negative consequences and alcohol-related injuries than those receiving brief intervention or standard care at 12-month follow-up (previously reported). A secondary analysis of this result showed that motor vehicle crash patients (n=133) given brief motivational intervention for alcohol plus a booster (n=34) had fewer alcohol-related injuries than those receiving standard care (n=46; P=.001). Moreover, there were no significant differences in alcohol-related injuries among the non–motor vehicle crash–injured patients who received brief intervention or standard care. Conclusion: Brief motivational intervention for alcohol plus a booster is a useful intervention for subcritically injured ED patients with harmful or hazardous alcohol use. Its effects may be moderated by the cause of injury. [Ann Emerg Med. 2005;45:620-625.]

The purpose of this study was to determine if a modified version of the Contemplation Ladder, a measure of motivation to change marijuana use among incarcerated adolescents (Marijuana Ladder; ML), was related to marijuana use and treatment engagement. Participants (N = 122) in this study were all incarcerated at a state juvenile correctional facility in the Northeast. Adolescents were assessed at the beginning of their incarceration, 2 months into their incarceration, and 3 months after their release. There was a significant negative relationship between ML scores and marijuana use and a significant positive relationship between ML scores and treatment engagement. When controlling for prior marijuana use and age, ML scores at baseline significantly added to the prediction of marijuana use and treatment engagement among incarcerated adolescents. Results support the concurrent validity and the predictive validity of the ML. This measure has the potential to provide important information for Juvenile Justice Facilities that might aid in treatment planning and discharge planning for incarcerated adolescents. In addition, researchers may find a quick visual analog measure of motivation to change marijuana use with good psychometric properties useful.

The ability of respondents to underreport successfully on substance abuse and validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) was evaluated. Incarcerated teens (67 substance abusing, 59 non-substance abusing) completed the MMPI-A twice: once under standard instructions (SI) and once under instructions to fake good (FG). Under SI, substance scales correctly classified about 60% to 85% of adolescents. Under FG, substance- and non-substance-abusing juveniles produced lower scores on substance scales. However, the Lie Scale (L) was able to detect more than 75% of deceptive profiles and about 77% of honest profiles. When scale L and the best substance scale were used in combination, only about 18% of faking substance abusers were not identified as either substance abusers or as underreporting. For feigning substance abusers, only about 10% of substance abusers were detected, with about 72% being categorized as faking and needing further assessment.

The purpose of the current investigation was to pilot the Family Check-Up (FCU; see T. J. Dishion & K. Kavanagh, 2003) with 10 incarcerated adolescents and their parents or guardians. The FCU is based on principles of motivational interviewing (W. R. Miller & S. Rollnick, 2002). The authors delivered FCU with a high degree of fidelity and adherence on the basis of ratings from parents, therapists, and observers. Results suggest that the FCU positively impacted families (effect sizes were generally in the medium range). After our intervention, adolescents were more confident in their ability to resist drug use, and parents were more confident in their ability to impact their adolescents' risky behaviors. Parents and adolescents both reported being highly satisfied with this intervention. These results warrant further investigation of the FCU with incarcerated adolescents and their families in a controlled clinical trial.

The validities of 7 MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, & Kaemmer, 2001) measures of general maladjustment were compared using a composite criterion measure based on self-reported symptom severity and clinicians' ratings of symptom severity and level of functioning. Participants were 274 male and 425 female clients at a community mental health center and 105 male and 247 female clients at a university psychological clinic. All MMPI-2 measures were significantly related to the composite criterion measure for both male and female clients in both settings. The mean score on 8 clinical scales (M8) consistently was the best indicator of maladjustment. Although other MMPI-2 measures sometimes added significantly to the variance accounted for in the criterion measure, increments were small and probably not clinically meaningful. However, M8 added significantly and meaningfully to each of the other MMPI-2 measures in predicting maladjustment. Implications for using the MMPI-2 to assess general maladjustment in outpatient mental health settings are discussed.

Driving while impaired is a serious national health problem, and there is a need to develop effective treatments for persons arrested for Driving While Intoxicated (DWI). Motivation for changing substance use behaviors may be critical for avoiding further infractions. Once motivated, the client may more readily develop skills that enhance efficacy to cope with situations leading to DWI. Motivational Interviewing (MI; Miller & Rollnick, 1991) was delivered to DWI-involved clients to enhance motivation to change. It was followed by Relapse Prevention (RP; Marlatt & Gordon, 1985) to develop coping skills. Clients rated MI/RP more favorably than standard care, evidenced improved coping skills, and showed general improvement at the end of the four-week treatment. This pilot study (N = 25) indicates that more well controlled clinical trials are warranted to study the effectiveness of MI/RP in treating persons engaged in DWI

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

Background In the United States, tobacco use among prisoners is nearly three times that of the general population. While many American prisons and jails are now tobacco-free, nearly all inmates return to smoking as soon as they are released back into the community. Methods To better understand the role that personal relationships may play in enabling return to smoking, we enrolled former-smokers who were inmates in a tobacco-free prison. Baseline assessments were conducted six weeks prior to inmates’ scheduled release and included measures of smoking prior to incarceration, motivation, confidence and plans for remaining quit after release. We also assessed global social support (ISEL) and a measure of social support specific to quitting smoking (SSQ). Smoking status was assessed three weeks after prison release and included 7-day point-prevalence abstinence validated by urine cotinine, days to first cigarette and smoking rate. Results A diverse sample comprised of 35% women, 20% Hispanic, and 29% racial minorities (average age 35.5 years) provided baseline data (n = 247). Over 90% of participants provided follow up data at 3-weeks post-release. Prior to incarceration participants had smoked an average of 21.5 (SD = 11.7) cigarettes per day. Only 29.2% had definite plans to remain smoking-abstinent after release. Approximately half of all participants reported that “most” or “all” of their family (42.2%) and friends (68%) smoked, and 58.8% reported their spouse or romantic partner smoked. SSQ scores were not significantly predictive of smoking outcomes at three weeks, however, social support from family and friends were each significantly and positively correlated with motivation, confidence, and plans for remaining abstinent (all p values

Importance Millions of Americans are forced to quit smoking as they enter tobacco-free prisons and jails, but most return to smoking within days of release. Interventions are needed to sustain tobacco abstinence after release from incarceration. Objective To evaluate the extent to which the WISE intervention (Working Inside for Smoking Elimination), based on motivational interviewing (MI) and cognitive behavioral therapy (CBT), decreases relapse to smoking after release from a smoke-free prison. Design Participants were recruited approximately 8 weeks prior to their release from a smoke-free prison and randomized to 6 weekly sessions of either education videos (control) or the WISE intervention. Setting A tobacco-free prison in the United States. Participants A total of 262 inmates (35% female). Main Outcome Measure Continued smoking abstinence was defined as 7-day point-prevalence abstinence validated by urine cotinine measurement. Results At the 3-week follow-up, 25% of participants in the WISE intervention (31 of 122) and 7% of the control participants (9 of 125) continued to be tobacco abstinent (odds ratio [OR], 4.4; 95% CI, 2.0-9.7). In addition to the intervention, Hispanic ethnicity, a plan to remain abstinent, and being incarcerated for more than 6 months were all associated with increased likelihood of remaining abstinent. In the logistic regression analysis, participants randomized to the WISE intervention were 6.6 times more likely to remain tobacco abstinent at the 3-week follow up than those randomized to the control condition (95% CI, 2.5-17.0). Nonsmokers at the 3-week follow-up had an additional follow-up 3 months after release, and overall 12% of the participants in the WISE intervention (14 of 122) and 2% of the control participants (3 of 125) were tobacco free at 3 months, as confirmed by urine cotinine measurement (OR, 5.3; 95% CI, 1.4-23.8). Conclusions and Relevance Forced tobacco abstinence alone during incarceration has little impact on postrelease smoking status. A behavioral intervention provided prior to release greatly improves cotinine-confirmed smoking cessation in the community. Trial Registration clinicaltrials.gov Identifier: NCT01122589

This study examined the extent to which the validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) could identify adolescents who were faking-bad. This study also examined the extent to which the validity scales could differentiate between nonclinical adolescents instructed to fake-bad and both clinical and nonclinical adolescents who received standard instructions. Participants were 58 male and 80 female high school students and 58 male and 80 female adolescents from clinical settings. Results indicated that the mean profiles resembled those previously reported for adults on the MMPI (Graham, 1987) and MMPI-2 (Graham, Watts, & Timbrook, 1991) and for adolescents on the original MMPI (Archer, Gordon, & Kirchner, 1987). Accurate identification of students who were faking-bad was achieved. It was possible to differentiate between the clinical adolescents and nonclinical adolescents who were faking, and it was possible to differentiate between nonclinical adolescents who were faking and nonclinical adolescents with standard instructions; however, different cutoff scores were needed for these two discriminations. Optimal cutoff scores were presented.

Background Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U.S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence. Methods/Design This paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine. Discussion Effective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group. Trial Registration NCT01122589