Substance Use Disorder Stigma and Professional Decision Making Among Pre-Professional Healthcare Trainees.

Provider stigma toward people who have substance use disorders (SUDs) may be a barrier to effective treatment delivery. The purpose of this study was to measure provider stigma among healthcare professionals-in-training and determine whether stigma levels were associated with professional decision making. A sample of 240 participants were recruited from the following academic programs at a large university in the southeastern United States: Nursing, Social Work, Counseling, Marriage and Family Therapy, and Psychology. Through an online, anonymous survey, provider stigma and other constructs were measured. The participants were also asked to make two hypothetical professional decisions: one regarding their choice to provide treatment for an SUD patient and the other regarding their likelihood of attending a professional development event (i.e., conference session) on the topic of SUDs. Results showed that self-reported stigma toward patients with SUDs was associated with a reduced likelihood of choosing to provide treatment for a patient with SUD (compared to patients with other conditions) and a reduced likelihood of attending SUD training at an upcoming conference (compared to other conference topics). Results have potential implications for the development of training programs for pre-professional healthcare trainees.

Bystander Motivations and Barriers to Helping Intoxicated Peers.

We examined the prevalence of self-reported motivations and barriers to helping intoxicated peers among emerging adults (N = 377; Mage = 18.64; 75% women, 88% White) attending a Southeastern university and whether motivations and barriers differed by age, gender, race, and class standing. Respondents aged 19-24 were more likely to endorse the motivation item "Because it was your "turn" to be the helper/designated driver (DD) that night" than eighteen-year-olds. Race differences were also reported for the motivation item, "Because the person was your friend", where White participants were more likely to endorse this item than non-White participants. Men also reported more Burden/Hassles-related barriers than did women.

An Analysis of Social and Coping Alcohol Use Motives for College Students with Autistic Traits.

Background: Little is known about alcohol use among college students with autism spectrum disorder (ASD), despite the increasing prevalence of college students with this diagnosis and/or with no formal diagnosis but who would meet criteria. Of concern, previous research suggests that individuals with ASD may be particularly vulnerable to the coping and social facilitation effects of alcohol use. Objectives: The present study examined the associated between autistic traits and alcohol use motives (social, coping, conformity, enhancement) in a sample of college students. Symptoms of social anxiety were assessed as a moderator and thought to enhance the associations between autistic traits and social and coping motives. Results: Findings revealed that both autistic traits and social anxiety were significantly and positively correlated with coping and conformity drinking motives. Additionally, a significantly negative correlation emerged between autistic traits and social drinking motives for participants with low social anxiety, and a similar pattern emerged for enhancement drinking motives. Conclusions: These findings suggest that college students with autistic traits may experience daily encounters or emotions that are alleviated by the mood-altering effects of alcohol; however, the specific feelings, emotions, or experiences that these individuals are looking to seek relief from remain understudied.

Contextual Use of Protective Behavioral Strategies for College Drinking.

Background: Alcohol use on college campuses in the United States is a public health concern. Some students engage in protective behavioral strategies (PBS) before, during, or after their alcohol consumption (e.g., designated driver) to try to mitigate negative alcohol-related negative consequences. There is a gap in the literature on the use of different PBS in different situations commonly experienced by students (e.g., game day). The goal of the present study was to determine whether students would use different PBS for different situations, and to determine which PBS they would encourage their peers to use in these same situations. Objectives: A total of 182 undergraduate students were presented with three different hypothetical drinking scenarios (i.e., a friend's 21st birthday celebration, football game day, and a house party) and asked which PBS they would use (i.e., limit drinking, change their manner of drinking, serious harm reduction strategies) and which they would recommend to their friends. They were also given the option to not drink at all. Results: Overall, students chose different strategies for different situations: they chose to limit their drinking at their friend's 21st birthday or the game day tailgating event, to alter the manner of their drinking for the game day tailgating event, to reduce the potential of harm at the house party, and to not drink at their friend's 21st birthday or the house party event. Students' personal choices matched their recommended choices for their friends. Conclusions: Results may have implications for prevention programs that teach harm reduction strategies such as PBS.

Stigma Surrounding the Use of Medically Assisted Treatment for Opioid Use Disorder.

PURPOSE: This study sought to determine whether certain factors influenced public stigma toward the use of medication to treat opioid use disorders (MOUD). Method: In a series of 3 studies using between-subjects designs, hypothetical MOUD patients matched in age and educational status with the participants were varied in systematic ways to determine whether certain factors influenced stigmatizing views of the patients. Results: Study 1 (n = 142) determined that stigma levels were elevated for hypothetical patients receiving agonist medication for OUD compared to other medications or no medication at all. Study 2 (n = 144) found that hypothetical patients receiving opioid agonist medication for either heroin or pain pills were equally stigmatized and stigmatized more than hypothetical patients on nicotine agonist medication. Study 3 (n = 151) showed that stigmatizing attitudes did not change as a result of enhanced treatment services for hypothetical MOUD patients (i.e. therapy as a supplement to medication). Conclusions/Importance: Results indicate that patients receiving agonist medication for an OUD may be the target of public stigma. Public education on the efficacy of agonist medications for OUD is urgently needed to help reduce such stigma, which may facilitate treatment delivery, treatment adherence, and treatment success.

Trauma Exposure and Problem Drinking in Late Adolescence: A Latent Profile Analysis.

Exposure to early traumatic events has been implicated in problem drinking during late adolescence, and this association may be stronger among youth with emotion regulation deficits. The purpose of this study was to identify subgroups of late adolescents based on trauma type, including loss, posttraumatic stress disorder (PTSD) symptoms; and emotion regulation deficits that confer the risk for problematic drinking behaviors. A sample of 946 participants (M age = 18.84 years, SD = 1.06) was analyzed with mixed-indicator latent profile analysis to identify subgroups and explore whether these subgroups displayed significant differences regarding elevated drinking frequency, alcohol quantity, and problematic alcohol use. A four-profile model yielded the best fit to the data, and four groups were identified and labeled "high functioning" (29.4%), "loss regulated" (32.3%), "loss dysregulated" (28.1%), and "multiple trauma dysregulated" (10.1%). Individuals in the high functioning group reported the lowest rates on all three measures of alcohol misuse (14.6-24.9%), whereas those in the multiple trauma dysregulated group reported the highest rates on all three measures (31.6-71.5%). Individuals in the multiple trauma dysregulated group (M = 0.25) differed significantly from those in the other three groups (Ms = 0.42-0.72) on the measure of problematic alcohol use but scored similarly to those in the loss dysregulated group on measures of drinking frequency (M = 0.32 and 0.24, respectively) and quantity (M = 0.43 and 0.39, respectively). These findings have implications for prevention programs targeted for alcohol use disorders among older adolescents.

Factors Influencing Stigma Toward Individuals Who Have Substance Use Disorders.

OBJECTIVE: This study investigated whether certain misperceptions of substance use disorders (SUDs) would influence stigmatizing attitudes toward individuals who have SUDs. METHOD: Using a between-subjects design, 1059 young adults (77.2% women) read vignettes describing characters with high or low levels of the following factors: responsibility, controllability, immorality, willpower, consequences, and accountability. Participants then completed measures of stigma toward each character (i.e., affective reactions, negative judgments, and social distancing). RESULTS: Characters described as having low levels of accountability (i.e., denial), low levels of willpower, and severe consequences for their SUDs elicited higher levels of stigma compared to characters without these qualities. However, experimental manipulations of responsibility for one's SUD, controllability of one's SUD, and level of immorality associated with one's SUDs had no significant effect on stigmatizing attitudes. CONCLUSIONS: These findings have important implications for educational programs aimed at reducing public stigma toward SUDs.

The role of perceived sleep norms in subjective sleep appraisals and sleep-related illness behavior.

The present investigation sought to extend extant research on subjective sleep complaints by examining their relation to perceived sleep norms. Results from two studies showed that individuals' distress and illness behavior in response to symptoms of fatigue and non-restorative sleep was influenced by their perceptions of peer norms for those symptoms. Individuals who believed they experienced a greater degree of fatigue and non-restorative sleep than their peers reported more distress arising from those symptoms, and were also more likely to seek social support and medical treatment for them. Furthermore, participants who scored higher in neuroticism were more likely to believe they experienced worse fatigue and non-restorative sleep than their peers, and thus reported higher symptom-related distress, and higher likelihood of engaging in illness behaviors. These results provide preliminary evidence of the clinical relevance of perceived norms in the way individuals respond to and manage sleep related problems.

Social Norms for Intimate Partner Violence: A Replication With College Students.

This study replicated prior research on college students' perceived descriptive norms (i.e., prevalence estimates) for intimate partner violence (IPV). In this study, male and female college students were instructed to estimate the prevalence of physical forms of IPV for "typical students" of their same gender on campus. Perpetrators of IPV-both male and female-made higher estimates than nonperpetrators. When compared to actual prevalence rates, both perpetrators and nonperpetrators overestimated the prevalence of IPV on campus. Findings have implications for prevention programs that address social norms.

Is It Dating Violence or Just "Drunken Behavior"? Judgments of Intimate Partner Violence When the Perpetrator Is Under the Influence of Alcohol.

BACKGROUND: Previous research has shown a strong bias for laypersons to believe alcohol use and aggression to go hand-in-hand (see Quigley & Leonard, 2006 ). Furthermore, research has shown that alcohol use can be seen as a mitigating circumstance for aggression, resulting in a reduction of blame and accountability (Bullock, 2002 ; Katz & Arias, 2001 ; Tryggvesson, 2004 ). OBJECTIVES: The present study investigated observers' judgments of intimate partner violence (IPV) when the perpetrator was under the influence of alcohol. We hypothesized that participants would view violent behavior as more common and less abusive if they thought the perpetrator was under the influence of alcohol. METHODS: College students (n = 79) viewed a video depicting an increasingly abusive interaction between college-age dating partners (see Witte & Kendra, 2010 ) and half of the participants were lead to believe that the perpetrator was drinking alcohol prior to the interaction. Participants rated the videotaped vignette at four timepoints to assess the degree to which they believed the interaction was normal/common and abusive. RESULTS: Observers judged the abusive behavior as more common and less abusive when alcohol was involved, but only for psychologically abusive behaviors and moderately severe physically abusive behaviors. CONCLUSIONS/IMPORTANCE: The results of this study provide support for the notion that direct observers of IPV judge moderately abusive behavior as more common and less abusive when alcohol is involved. With this, theories concerning alcohol expectancies and interpretations of interpersonal violence can be more readily applied to real-life scenarios, such as in the validity of eye-witness testimony.

Perceived Social Norms for Intimate Partner Violence in Proximal and Distal Groups.

This study investigated students' perceived descriptive social norms for intimate partner violence (IPV) among proximal and distal groups at college. Male and female college students estimated the prevalence rates for IPV among same-sex friends (proximal group) and same-sex "typical students" (distal group). In separate regression equations for men and women, perceived estimates of IPV rates for same-sex friends, but not estimates for same-sex typical students, were positively related with the participants' own IPV behaviors. Findings have important implications for IPV prevention and intervention programs for college students.

Youth Aggression and Peer Victimization as Predictors of Adolescent Alcohol and Marijuana Use: A Longitudinal Analysis of Youth with Aggressive Behavior Problems.

Youth who are behaviorally aggressive and victimized by their peers comprise a significant population with specific risks and vulnerabilities relative to substance use. The goals of the current study were to examine the roles that youth aggression and peer victimization play in determining the timing of alcohol and marijuana use initiation and the frequency of use 5-years later in a sample of at-risk, aggressive youth. 360 youth (Mage= 10.17 years; 65% boys, 35% girls; 78.1% African American, 20.3% Caucasian, 1.4% Hispanic, and 0.3% other) recruited for a prevention program for at-risk youth were followed for 5 years (4th - 9th grade). Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 5 years later. Results showed that peer victimization inferred decreased risk of alcohol use initiation. However, this effect was only observed for youth with relatively moderate, and low levels of aggression. Findings suggest that differences in youth aggression and victimization interact to predict distinct outcomes, suggesting the need for a more comprehensive approach when working with aggressive youth who have experienced peer victimization.

Social norms for intimate partner violence.

This study investigated perceived descriptive norms (i.e., perceived prevalence) for intimate partner violence (IPV) among college students. Male and female college students were asked to estimate the prevalence of IPV for same-sex "typical students" on their campus. Perpetrators of IPV made higher estimates than nonperpetrators. Both perpetrators and nonperpetrators overestimated the prevalence of IPV when compared to actual prevalence rates. Findings lend support for using social-norms-based prevention programs on college campuses.

Traumatic stress and alcohol-related disordered eating in a college sample.

OBJECTIVE: The current study examined the association between posttraumatic stress symptoms and disordered eating behaviors related to alcohol consumption (i.e., "drunkorexia"). Participants: Participants were 478 undergraduate students at a university in the southeastern United States. Method: Participants completed online self-report questionnaires related to alcohol-related disordered eating and compensatory behaviors, posttraumatic stress symptoms, problematic drinking, and weight and shape concerns. Results: Results found that posttraumatic stress symptoms, body weight and shape concerns, and problematic drinking were independent predictors of alcohol-related disordered eating. Conclusion: These findings confirm previous research that symptoms of eating disorders and symptoms of problem drinking predict disordered eating patterns surrounding alcohol use and further indicate that trauma may play an important role in such behaviors. Results have implications for trauma-informed treatment for college students presenting with "drunkorexia."

Secondary Trauma and Parenting Practices in Internet Crimes against Children Task Force Investigators.

Investigating cases of child pornography requires daily exposure to sexually explicit material involving children and may have negative implications on the mental well-being of those in this line of work. This study aimed to identify whether secondary traumatic stress symptoms were associated with participants' parenting behaviors and concerns about their own children's use of the internet. Internet Crimes Against Children Task Force workers (n = 212) completed online questionnaires measuring work exposure to sexually explicit material, secondary traumatic stress symptoms, and parenting behaviors. Professionals in this field reported a wide range of secondary trauma symptoms, and their parenting behaviors were both directly and indirectly (via secondary trauma) affected by prolonged exposure to sexually explicit material involving children. Internet monitoring behaviors were more prevalent for parents of younger children, and mothers' parenting behaviors were more strongly associated with secondary trauma symptoms than were fathers. Results have implications for mental health and parenting services for professionals in this field.

The Causal Influence of Perceived Social Norms on Intimate Partner Violence Perpetration: Converging Cross-Sectional, Longitudinal, and Experimental Support for a Social Disinhibition Model.

Across three studies, we develop a model of the direct and indirect paths through which the perceived prevalence (perceived descriptive norms [PDN]) of intimate partner violence (IPV) among peers may influence individuals' likelihood of engaging in IPV. Study 1 replicated and extended previous cross-sectional research by demonstrating a positive longitudinal association between PDN and subsequent IPV perpetration. Study 2 further showed the influence of PDN on IPV perpetration to be mediated through its relation to perceived peer acceptance of IPV (perceived injunctive norms [PIN]), which in turn predicted personal IPV acceptance. Study 3 built on this model using an experimental paradigm to show that increasing PDN leads to corresponding increases in PIN and, in turn, personal IPV acceptance, which both predicted IPV perpetration. Furthermore, the effects of PIN on personal IPV acceptance and IPV propensity were strongest for dominance-oriented individuals. Results bear important implications for social norms-based interventions for IPV.

Bystander interventions for sexual assault and dating violence on college campuses: Are we putting bystanders in harm's way?

OBJECTIVE: The present study investigated the well-being of bystanders who witness and intervene in sexual assault and dating violence situations on campus. PARTICIPANTS: Participants were 321 young men and women from a large university in the southeastern United States. METHODS: Participants completed a survey at the end of the Spring semester of 2015 about risky situations they had witnessed, with follow-up questions about their responses to the situations (eg, whether they intervened or not) and feelings about their responses. Participants also completed standardized measures of posttraumatic stress disorder and depression. RESULTS: Over 90% of the participants reported witnessing at least 1 of the risky events presented to them, and approximately 50% reported intervening in events. Intervening was associated with positive feelings, but traumatic stress symptoms were related to witnessing events and intervening. CONCLUSIONS: Results have direct implications for developing appropriate training programs for bystander intervention programs on college campuses.

Service outcomes in physical and sexual abuse cases: a comparison of child advocacy center-based and standard services.

Child Advocacy Centers (CACs) were developed to improve on child abuse investigative services provided by child protective service (CPS) agencies. However, until very recently, there has been little research comparing CAC-based procedures and outcomes to those in CPS investigations not based in CACs. The current study tracked 76 child abuse cases that were reported to authorities and investigated through either a private, not-for-profit CAC or typical CPS services in a mid-south rural county. Comparisons between CAC and CPS cases were made in terms of involvement of local law enforcement in the investigation, provision of medical exams, abuse substantiation rates, mental health referrals, prosecution referrals, and conviction rates. Analyses revealed higher rates of law enforcement involvement, medical examinations, and case substantiation in the CAC-based cases compared to the CPS cases. Despite limitations due to sample size and non-randomization, this study found preliminary support for the assumptions underlying the establishment of CACs.

Sociocultural and Victimization Factors That Impact Attitudes Toward Intimate Partner Violence Among Kenyan Women.

This study investigates the association between acceptance of intimate partner violence (IPV) and reported IPV victimization among Kenyan women, taking into consideration select sociocultural factors that may also influence acceptance of IPV. Data from a nationally representative, cross-sectional, household survey conducted between November 2008 and February 2009 in Kenya were analyzed. Hierarchical multiple regression was conducted to estimate the effect of select sociodemographic characteristics and reported IPV victimization on acceptance of IPV. The results showed that while both sociodemographic characteristics and reported IPV victimization were significantly associated with IPV acceptance, sociocultural factors had a greater impact. Programs aimed at empowering women and culturally competent IPV prevention strategies may be the key elements to reducing IPV.

Silencing the self and feminist identity development.

The present study investigated the relation between Jack's 1991 concept of "silencing the self" and Downing and Roush's 1985 stage model of feminist identity development among college women. Analysis indicated that passively accepting women's oppression and adhering to traditional gender roles in interpersonal relationships (Passive Acceptance) was related to silencing the self. These results have important implications for silencing the self and women's development. Specifically, these findings may encourage many young women to acknowledge women's oppression and question the traditional gender roles that promote submission and thereby decrease the potential risk for self-silencing.