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Social recovery capital (SRC) is the combination of social resources that can be used to initiate and sustain addiction recovery through friends, family, and peers. Broadly, understanding one's SRC allows us to get a sense of where one has social support for recovery and where there may be social barriers to their recovery process. SRC is often a vital component of many people's recovery journey, yet our understanding of how best to use this concept in research and practice remains underdeveloped. To improve understanding of the role of social recovery capital and strategies to measure and increase it, we present a roadmap involving a five-pronged research agenda to: (1) Refine the measurement of social recovery capital; (2) Model the complexity of social recovery capital empirically; (3) Integrate personality science with social recovery capital research; (4) Optimize evidence-based behavior change techniques of social recovery capital; and (5) Incorporate an intersectional framework when examining or applying social recovery capital. Overall, this five-pronged research agenda seeks to enhance the clinical utility of SRC research to maximize the impact of SRC on one's recovery.
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The COVID-19 pandemic resulted in significant changes in daily life, potentially impacting mental health and substance use behavior. Research on COVID-related changes in adolescent substance use have yielded mixed findings. The current cross-sectional chart review study compared rates of past-year substance use before and during COVID-19 among adolescent psychiatric inpatients, and investigated how motives for coping with COVID-19 changes were related to psychiatric acuity, and past-year substance use. Count models assessed if the number of past-year days of alcohol and cannabis use was higher among adolescents (n = 491, 11-18 years, 61% female) hospitalized during COVID-19 (3/14/20 to 4/5/21) versus adolescents hospitalized before COVID-19 (8/30/2019 to 3/13/20). For a subsample of COVID-19 inpatients (n = 124; 75% female), we evaluated psychiatric correlates of endorsing substances to cope with COVID-19 changes/rules. Results indicated adolescents admitted during COVID-19 reported significantly more past-year alcohol and cannabis use days than adolescents admitted before COVID-19. Adolescents endorsed using alcohol (19%), cannabis (33%), and e-cigarettes/vaping (25%) to cope with COVID-19. E-cigarette/vaping to cope with COVID-19 was significantly related to lifetime suicide attempt. Endorsing alcohol or cannabis to cope with COVID-19 was associated with a significantly greater number of past-year use days for each respective substance. Adolescent psychiatric inpatients admitted during COVID-19 reported more substance use days than adolescents admitted before COVID-19. Using substances to cope was linked to psychiatric correlates (e.g., suicidality). Assessing the presence and function of substance use in this population may be important to identify, treat, and prevent compounding negative outcomes during times of community stress.
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Substance use disorders commonly onset during adolescence, yet the best available treatments yield only modest and transient effects. Elucidating treatment mediators is essential for improving treatment options. This review summarizes over 20 years of research on mediators of adolescent substance use treatment; k = 17 studies assessing both treatment or treatment ingredient to mediator (a path) and mediator to treatment outcome (b path) paths were included. Mediators were categorized using the Science of Behavior Change target class framework. Overall, mediation tests supported four of eight self-regulation, two of 10 stress resilience and reactivity, six of 19 interpersonal and social process, and two of four treatment engagement and adherence mediators. To enhance the capacity of this work to inform clinical practice, we recommend future research examine theoretically informed mechanisms using temporally sequenced data among other methodological guidelines.
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Parenting style refers to the emotional climate in which parents nurture and guide their child's social development. Despite the prominence of parenting style research, many studies still create their own psychometrically untested measures of parenting styles, use measures that do not capture the uninvolved parenting style, or use median splits to convert dimensional assessments into parenting style typologies. To address these measurement issues, the current studies developed the Parenting Styles Circumplex Inventory (PSCI) which is rooted in Contemporary Integrative Interpersonal Theory and provides a framework to unite typology and dimensional parenting style measurement approaches. The current article describes the development and initial validation of the PSCI across three samples of college students (Ns = 571, 361, 385). The 32-item PSCI consists of eight octant scales which each assess unique combinations of parental responsiveness and demandingness. The measure asks respondents to answer each question about their mother- and/or father-figure. The circumplex structure of the PSCI was confirmed and replicated across studies and the PSCI demonstrated meaningful associations with indicators of parenting practices, relationship functioning, psychopathology symptoms, and substance use. Results from this study provide initial support for the PSCI as a path forward for measuring parenting styles.
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INTRODUCTION: The Family Assessment Task (FAsTask) is an observer-rated parent-child interaction task used in adolescent substance use intervention. The parental monitoring component of the FAsTask is thought to provide an objective assessment of parental monitoring that can guide treatment planning and circumvent the potential limitations of self-report measures. Yet, the factor structure, measurement invariance, and concurrent validity of the parental monitoring FAsTask has not been evaluated; doing so is essential to effectively guide clinical care. This study examined if the parental monitoring FAsTask can be reliably administered across adolescent age and sex, and to identify which components of the parental monitoring FAsTask are most consistently associated with adolescent substance use. METHODS: The study pooled data from 388 adolescent-caregiver dyads across six separate clinical trials (adolescents [Mage = 15.7, 57.5% male, 61.9% White, 31.2% Latine]; caregivers [Mage = 42.14, 88.7% female, 72.7% White, 24.2% Latine]). Dyads completed the FAsTask and the Timeline Followback at baseline, prior to randomization. Analyses proceeded in three steps. First, exploratory factor analysis (EFA) was conducted in half of the sample, followed by a confirmatory factor analysis (CFA) in the second half of the sample. Second, measurement invariance was tested as a function of adolescent age and biological sex. Third, a series of structural equation models were used to assess the associations of each factor with alcohol use, binge drinking, and cannabis use. RESULTS: EFA and CFA indicated the presence of four factors (labeled Supervised/Structured, Active Monitoring, Task Engagement, and Parental Rules/Strategies). Evidence of measurement invariance was found across adolescent age and sex. The Supervision/Structure was negatively associated with adolescent alcohol use, binge drinking, and cannabis use. CONCLUSIONS: The parental monitoring FAsTask demonstrates validity and retains its structure across adolescent age and sex. Items focused on parental supervision and structure are most strongly associated with adolescent substance use and may best inform clinical care for adolescent substance use.
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Consumo Excesivo de Bebidas Alcohólicas , Trastornos Relacionados con Sustancias , Humanos , Masculino , Adolescente , Femenino , Psicometría , Trastornos Relacionados con Sustancias/diagnóstico , Consumo de Bebidas Alcohólicas , Etanol , PadresRESUMEN
Understanding how treatments for alcohol use disorder (AUD) facilitate behavior change has long been recognized as an important area of research for advancing clinical care. However, despite decades of research, the specific mechanisms of change for most AUD treatments remain largely unknown because most prior work in the field has focused only on statistical mediation. Statistical mediation is a necessary but not sufficient condition to establish evidence for a mechanism of change. Mediators are intermediate variables that account statistically for the relationship between independent and dependent variables, whereas mechanisms provide more detailed explanations of how an intervention leads to a desired outcome. Thus, mediators and mechanisms are not equivalent. To advance mechanisms of behavior change research, in this critical review we provide an overview of methodological shortfalls of existing AUD treatment mechanism research and introduce an etiologically informed precision medicine approach that facilitates the testing of mechanisms of behavior change rather than treatment mediators. We propose a framework for studying mechanisms in alcohol treatment research that promises to facilitate our understanding of behavior change and precision medicine (i.e., for whom a given mechanism of behavior change operates and under what conditions). The framework presented in this review has several overarching goals, one of which is to provide a methodological roadmap for testing AUD recovery mechanisms. We provide two examples of our framework, one pharmacological and one behavioral, to facilitate future efforts to implement this methodological approach to mechanism research. The framework proposed in this critical review facilitates the alignment of AUD treatment mechanism research with current theories of etiologic mechanisms, precision medicine efforts, and cross-disciplinary approaches to testing mechanisms. Although no framework can address all the challenges related to mechanisms research, our goal is to help facilitate a shift toward more rigorous and falsifiable behavior change research.
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BACKGROUND: Interventions for youth cannabis use have limited efficacy. Sleep is likely to affect treatment response, as sleep difficulties are cross-sectionally associated with use and common during treatment. This analysis examined how sleep duration and subjective trouble sleeping related to next-day cannabis use among youth during cannabis treatment. METHOD: Participants (N=64) received a psychosocial intervention plus topiramate versus placebo while completing a 6-week ecological momentary assessment study. Time-varying effect modeling (TVEM) examined within- and between-person associations between sleep and cannabis use and how the strength of within-person associations varied over the course of treatment. RESULTS: TVEM resvealed that, between-participants, youth with longer average sleep duration used cannabis less often controlling for baseline cannabis use, topiramate, and weekend status. Daily within-person fluctuations in sleep duration and trouble were not associated with use. CONCLUSIONS: Findings suggest regularly shorter sleep may impede treatment outcomes. Adolescents who regularly have insufficient sleep durations likely need additional intervention to improve sleep difficulties in tandem with cannabis use reduction.
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Cannabis , Terapia Cognitivo-Conductual , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Adolescente , Adulto Joven , Topiramato/uso terapéutico , Sueño/fisiologíaRESUMEN
The Continuous Assessment of Interpersonal Dynamics (CAID) is an observational tool that measures warmth and dominance dynamics in real time and is sensitive to individual, dyadic, and contextual influences. Parent-adolescent interpersonal dynamics, which conceptually map onto parenting styles, are an integral part of positive adolescent adjustment and protect against risky outcomes. The current study's goal was to test the degree to which sources of influence on CAID data observed in a previous study of married couples generalize to a sample of parent-adolescent dyads. We examined data from ten raters who rated moment-to-moment warmth and dominance using CAID in a sample of 61 parent-adolescent dyads (N = 122) who were largely non-Hispanic White (62%) or African American (30%) based on parent report (adolescent M age = 14; 57% female). Dyads interacted in four different discussion segments (situations). We applied Generalizability Theory to delineate several sources of variance in CAID parameters and estimated within and between-person reliability. Results revealed a number of different influences, including the person, kinsperson (adolescent versus parent), dyad, rater, situation, and interactions among these factors, on ratings of parent-adolescent interpersonal behavior. These results largely replicate results from married couples, suggesting that the factors that influence ratings of interpersonal interactions largely generalize across sample types.
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Conducta del Adolescente , Relaciones Interpersonales , Humanos , Femenino , Adolescente , Masculino , Reproducibilidad de los Resultados , Esposos , Relaciones Padres-Hijo , Responsabilidad ParentalRESUMEN
BACKGROUND: Although peers figure prominently in developmental models of alcohol use, our understanding of the influence of peer social context in cue reactivity paradigms with adolescents and emerging adults in the human laboratory and the natural environment is limited. This study tested associations between alcohol craving among youth in the human laboratory using alcohol-related images, with and without peers, and in the natural environment using ecological momentary assessment (EMA). METHODS: Data for this preregistered secondary analysis were collected prior to randomization in two medication trials (N = 115). Participants completed an image cue exposure paradigm at the baseline laboratory session followed by approximately 7 days of EMA. RESULTS: In the laboratory, model-based mean comparisons from multilevel models (MLMs) showed that all drinking images elicited greater craving than neutral images. No differences were observed across the three image categories containing alcohol. Image category by age interactions demonstrated that, compared to older youth, younger youth displayed lower craving in response to neutral versus social drinking context with peers images and older, compared to younger, youth displayed higher craving in response to nonsocial drinking images versus social drinking contexts with peers images. In the natural environment, craving was greatest when youth were in the presence of alcohol-using peers and alcohol-related cues, regardless of age. Laboratory craving to alcohol images was positively associated with craving in the natural environment. CONCLUSIONS: For youth, peers are a salient social context associated with increased craving, particularly in the natural environment. Laboratory cue reactivity to alcohol images predicted real-world craving, further supporting the ecological validity of this paradigm in youth.
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PURPOSE: We examined the influence of parental heterosexism on in vivo negative affect and substance craving among sexual minority youth (SMY) who use nicotine and other substances, and if that relation was strengthened when in the presence of their parent(s). METHODS: SMY (n = 42, ages 15-19) completed baseline assessments, including experiences of parental heterosexism (PH), and a 30-day ecological momentary assessment. Ecological momentary assessment reports included affective states (i.e., anger, anxiety, depression), substance craving (i.e., nicotine, cannabis, alcohol), and other contextual factors (e.g., presence of parents). Multilevel logistic regression models evaluated the study hypotheses. RESULTS: PH was associated with greater odds of reporting in-the-moment anger, depression, cannabis craving, and alcohol craving. Parental presence was associated with lower odds of reporting anxiety or depression, and greater odds of reporting nicotine craving. There was a significant interaction when predicting the odds of reporting anxiety. For SMY low in PH, parental presence was related to lower odds of reporting anxiety. As PH increased, parental presence had diminishing associations with the odds of reporting anxiety. DISCUSSION: Parenting behaviors can serve as protective and risk factors for negative affect and substance craving among SMY. Improving family-based interventions for SMY may be integral for enhancing healthy development and reducing health disparities.
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Ansia , Minorías Sexuales y de Género , Humanos , Adolescente , Adulto Joven , Adulto , Consumo de Bebidas Alcohólicas/psicología , Nicotina , Afecto , PadresRESUMEN
BACKGROUND: Social media is a central context in which teens interact with their peers, creating opportunities for them to view, post, and engage with alcohol content. Because adolescent peer interactions largely occur on social media, perceptions of peer alcohol content posting may act as potent risk factors for adolescent alcohol use. Accordingly, the preregistered aims of this study were to (1) compare perceived friend, typical person, and an adolescent's own posting of alcohol content to social media and (2) examine how these perceptions prospectively relate to alcohol willingness, expectancies, and use after accounting for offline perceived peer alcohol use. METHODS: This longitudinal study included 435 adolescents (Mage = 16.91) in 11th (48%) and 12th grade (52%). Participants completed measures of alcohol content social media posts, perceived peer alcohol use, willingness to drink alcohol, alcohol expectancies, and alcohol use at two time points, 3 months apart. RESULTS: Consistent with preregistered hypotheses, adolescents reported that 60.3% of the typical person their age and 30.6% of their friends post alcohol content on social media. By contrast, only 7% of participants reported that they themselves posted such content to social media. After accounting for offline perceived peer drinking norms, neither perceived friend nor typical person alcohol content social media posts were prospectively associated with willingness to drink or positive or negative alcohol expectancies. Perceived friend alcohol content posts were prospectively positively associated with past 30-day alcohol consumption even after controlling for offline perceived peer drinking norms. CONCLUSIONS: Adolescents misperceived the frequency of alcohol-related posting to social media among their peers, and perceptions of friend alcohol content posts prospectively predicted alcohol use. Given the results from the current study and the ubiquity of social media among adolescents, prevention efforts may benefit from addressing misperceptions of alcohol-related posting to social media.
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Medios de Comunicación Sociales , Adolescente , Humanos , Adulto , Estudios Longitudinales , Consumo de Bebidas Alcohólicas , Grupo Paritario , ActitudRESUMEN
BACKGROUND: Although siblings are conceptualized as a salient social influence during adolescence, few studies have examined how adolescent siblings influence each other's substance use and risky sexual behavior. Objectives: In this study, we investigated the influence of alcohol use days, cannabis use days, and cannabis and alcohol co-use days on the sexual risk behavior of siblings while accounting for dyadic influence. METHODS: At the baseline visit for a randomized controlled trial for adolescents referred due to parents' concerns about their substance use ("referred adolescents"; n = 99; Mage=15.95; 38.38% female), we assessed alcohol and cannabis use days as well as sexual risk behavior of the referred adolescents and their sibling (Mage=15.03; 51.52% female). We computed the number of days in the 30 days prior to the baseline that alcohol and cannabis use occurred on the same day. Using a cross-sectional actor partner interdependence model, we tested two models of how adolescents' substance use is associated with their own ("actor effect") and their siblings' ("partner effect") sexual risk behavior-one model for alcohol and cannabis use, and one model for daily co-use. RESULTS: For referred adolescents and their siblings, within an individual, greater alcohol, cannabis, and daily co-use was significantly associated with sexual risk behavior (actor effects). Furthermore, more sibling co-use days was positively associated with referred adolescent sexual risk behavior (partner effect), representing interdependence. CONCLUSION: These findings confirm the influence siblings have on one another's risky behavior in adolescence and have implications for prevention and intervention efforts for adolescent substance use.
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Conducta del Adolescente , Cannabis , Trastornos Relacionados con Sustancias , Adolescente , Estudios Transversales , Etanol , Femenino , Humanos , Masculino , Asunción de Riesgos , Conducta Sexual , Hermanos , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Assessing parent-child interactions is critical for understanding family dynamics, however tools available for capturing these dynamics are limited. The current study sought to examine the validity of the Continuous Assessment of Interpersonal Dynamics (CAID) for understanding the dynamics of parent-adolescent substance use discussions. Specifically, we examined how CAID parameters were related to indicators of parenting and substance use. Sixty-one parent-adolescent dyads (M adolescent age = 14.02, 57% female; M parent age = 46.40; 98% female) completed three 9-minute video-taped conflict, alcohol, and cannabis discussions as well as self-report measures of parenting (e.g., monitoring, psychological control) and substance use behaviors (e.g., intentions, use with parental permission). Interactions were coded using the CAID which provides continuous assessments of parent and adolescent warmth and dominance. Parental warmth, adolescent warmth, and dominance complementarity CAID parameters were positively associated with adaptive parenting and negatively associated with maladaptive parenting factors. Parental warmth in the cannabis discussion was negatively associated with the substance use and intentions factor. These findings support CAID as a reliable and valid assessment of interpersonal dynamics that characterize parent-adolescent substance use discussions and suggest that substance use conversations may be most effective when parents and adolescents act warmly throughout the discussion and exhibit dominance complementarity.
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Conducta del Adolescente , Trastornos Relacionados con Sustancias , Adolescente , Femenino , Humanos , Persona de Mediana Edad , Masculino , Relaciones Padres-Hijo , Padres/psicología , Responsabilidad Parental/psicología , Trastornos Relacionados con Sustancias/diagnóstico , Conducta del Adolescente/psicologíaRESUMEN
BACKGROUND: Naltrexone is an efficacious medication for the treatment of alcohol use disorder in adults. As an opioid receptor antagonist, naltrexone blocks activation of the endogenous opioid system, which is involved in the affectively reinforcing properties of substance use. Few studies, however, have examined the moderating effect of naltrexone on the association between affect and alcohol use. Additionally, most existing research on naltrexone has been with adults in the human laboratory. METHOD: We conducted a secondary analysis of ecological momentary assessment data from a randomized, double-blinded, placebo-controlled cross-over study that compared naltrexone (50 mg/daily) and placebo in 26 adolescents (15 to 19 years old) who exhibited problematic drinking patterns. Multilevel models tested whether naltrexone moderated associations of alcohol use with both positive and negative affect (PA, NA). RESULTS: Results indicated that, during naltrexone treatment, greater estimated blood alcohol concentration (eBAC) levels were associated with greater NA further into drinking episodes. In turn, greater NA after the first drink of an episode was associated with reduced subsequent eBAC values during naltrexone treatment. Low PA was also associated with lower subsequent eBAC levels in the naltrexone condition after the first drink. CONCLUSIONS: These findings support the idea that naltrexone can disrupt the association between affect and alcohol use, effects that emerge later in drinking episodes. Greater attention to the effects of naltrexone on affect and reinforcement may help to tailor psychotherapy to maximize the benefits of naltrexone. However, in the present study, as most drink reports were in the first 2 h of the drinking episode and participants reported affect only at the first three end-drink reports of a drinking episode (limiting the number of drinks reported), we had reduced power to detect effects in the continuation phase. Thus, replication of the findings is needed using a design that assesses the impact of naltrexone across the entire episode.
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Disuasivos de Alcohol/uso terapéutico , Alcoholismo/tratamiento farmacológico , Naltrexona/uso terapéutico , Consumo de Alcohol en Menores/psicología , Adolescente , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , MasculinoRESUMEN
Studies of reward effects on behavior in adolescence typically rely on performance metrics that confound myriad cognitive and non-cognitive processes, making it challenging to determine which process is impacted by reward. The present longitudinal study applied the diffusion decision model to a reward task to isolate the influence of reward on response caution from influences of processing and motor speed. Participants completed three annual assessments from early to middle adolescence (N = 387, 55% female, Mage = 12.1 at Wave 1; Mage = 13.1 at Wave 2, Mage = 14.1 at Wave 3) and three annual assessments in late adolescence (Mages = 17.8, 18.9, 19.9). At each assessment, participants completed a two-choice reaction time task under conditions of no-reward and a block in which points were awarded for speeded accuracy. Reward reduced response caution at all waves, as expected, but had a greater impact as teens moved from early to middle adolescence. Simulations to identify optimal response caution showed that teens were overly cautious in early adolescence but became too focused on speed over accuracy by middle adolescence. By late adolescence, participants adopted response styles that maximized reward. Further, response style was associated with both internalizing and externalizing symptoms in early-to-middle adolescence, providing evidence for the construct validity of a diffusion model approach in this developmental period.
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Toma de Decisiones , Recompensa , Adolescente , Simulación por Computador , Toma de Decisiones/fisiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Tiempo de Reacción/fisiologíaRESUMEN
The current study examined how parenting and adolescent interpersonal styles jointly influence youths' abilities to form close relationships - a central developmental milestone - yet avoid substance use, which predominantly occurs in the presence of peers. Nine annual waves from an adolescent sample (N = 387) were used to assess (a) combinations of interpersonal and parenting styles from early to middle adolescence using longitudinal latent profile analysis, (b) the validity of these profiles on indicators of adjustment, and (c) the relationships between the profiles and growth in substance use across adolescence as well as substance-related consequences in late adolescence. The results supported five distinct combinations of interpersonal and parenting styles, and validity analyses identified both risk and protective profiles. The protective profile submissive-communal interpersonal style + high-warmth-authoritative parenting style was associated with indicators of positive social adjustment (e.g., friendship quality, resistance to peer influence) as well as lower levels of substance use. Significant differences also emerged with respect to substance-related consequences. The findings of this study highlight how combinations of adolescent interpersonal style and parenting render adolescents more or less successful at navigating peer relationships while avoiding substance use behaviors.
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Conducta del Adolescente , Trastornos Relacionados con Sustancias , Adolescente , Humanos , Relaciones Padres-Hijo , Responsabilidad Parental , Grupo Paritario , Ajuste SocialRESUMEN
RATIONALE: Topiramate is an anticonvulsant currently under study for treating substance use disorders. Topiramate is thought to reduce substance use by attenuating craving and the rewarding effects of acute substance use through its concurrent GABAergic agonism and glutamatergic antagonism. Importantly, topiramate also impacts mood states central to many models of substance use. Despite this, little previous research has examined whether topiramate attenuates the respective associations of affect and craving with substance use. OBJECTIVES: We conducted a secondary analysis of 63 youths that exhibited heavy cannabis use, aged 15-24 years, who were randomized in a double-blinded 6-week clinical trial comparing the effects of topiramate (up to 200 mg/day) and placebo on cannabis use. Ecological momentary assessment data were leveraged to model the role positive affect, negative affect, and craving on use over the 6-week period and whether topiramate attenuated associations between these feeling states and cannabis use. RESULTS: Findings showed that craving was positively associated with use at the within-person level, while positive affect was negatively associated with use at the between-person level. Topiramate appears to attenuate the negative association of between-person positive affect (i.e., average) and cannabis use. Specifically, those in the placebo condition exhibited this inverse association between average positive affect and use while those in topiramate condition did not. No other significant affect or affect × medication condition interactions were observed. CONCLUSIONS: These findings implicate craving and low positive affect as important risk factors for cannabis use in youth in treatment. Topiramate may attenuate this association for positive affect.
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Cannabis , Trastornos Relacionados con Sustancias , Adolescente , Afecto , Ansia , Evaluación Ecológica Momentánea , Humanos , TopiramatoRESUMEN
OBJECTIVE: Social context plays a critical role in youth cannabis use. Yet few studies have examined if and when social contexts shift during cannabis use treatment. This study examined daily shifts in youths' social contexts with the goal of characterizing how specific social contexts (e.g., time with cannabis-using friends or siblings) relate to cannabis craving and use during cannabis treatment. METHOD: Participants were 65 cannabis users (51% male), ages 15-24 years, who participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapies plus either adjunctive pharmacotherapy or placebo on cannabis craving and use. Ecological momentary assessment (EMA) data, collected from a pre-randomization period through the completion of the six-week intervention, assessed youths' social contexts, cannabis use, and craving. RESULTS: Time-varying effects models identified shifts in social contexts during treatment. Overall, time spent with cannabis-using friends and siblings decreased, where time spent with non-using friends or alone increased across the trial. Time with parents or non-using siblings was unchanged. Comparing the relative associations of social contexts with same-day craving and use, more time with cannabis-using friends and with siblings was uniquely associated with greater craving and use. CONCLUSIONS: Social context is an important factor in youth substance-use treatment. While time spent with cannabis-using friends and siblings decreased over treatment for all participants, those who continued to spend time with using individuals reported greater craving and use. This research supports increased attention to shifting youths' social contexts to enhance treatment success. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Terapia Cognitivo-Conductual/métodos , Ansia , Evaluación Ecológica Momentánea , Fumar Marihuana/terapia , Medio Social , Trastornos Relacionados con Sustancias/terapia , Adolescente , Método Doble Ciego , Femenino , Amigos , Humanos , Masculino , Fumar Marihuana/psicología , Motivación , Trastornos Relacionados con Sustancias/psicología , Adulto JovenRESUMEN
BACKGROUND: Theoretical models of behavior change argue that youth should decrease their time with cannabis-using friends and increase their time with non-using friends during treatment. Informed by behavior-change models of recovery and socialization and selection peer-influence models, the current study examined whether combining evidence-based psychosocial treatment with adjunctive pharmacotherapy helps youth decrease their affiliations with cannabis-using friends and increase their affiliations with non-using friends during cannabis misuse treatment. METHODS: Youth ages 15-24 years (51 % male), participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapy (MET-CBT) plus topiramate (N = 39) or placebo (N = 26) on cannabis craving and use. Ecological momentary assessment data, collected via smartphones throughout the six-week intervention, assessed youths' time with cannabis-using and non-using friends, cannabis use, and craving in daily life. Multiple group multilevel structural equation modeling tested study hypotheses. RESULTS: Across the topiramate (48 % completion rate) and placebo (77 % completion rate) conditions, greater time spent with cannabis-using friends promoted greater next day cannabis use and craving (socialization effect). In turn, cannabis craving, but not use, promoted continued selection of cannabis-using friends. This indirect effect was only supported in the placebo condition due to the selection piece of this cycle not being significant for youth who received topiramate. Neither cannabis craving nor use were associated with time with non-using friends the next day. CONCLUSIONS: MET-CBT and adjunctive topiramate pharmacotherapy interrupted youth selection processes. This finding suggests that changing peer affiliations could be one mechanism by which treatments can work.
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Cannabis , Abuso de Marihuana , Entrevista Motivacional , Adolescente , Adulto , Amigos , Humanos , Abuso de Marihuana/tratamiento farmacológico , Topiramato , Adulto JovenRESUMEN
OBJECTIVES: Agentic (status/independence) and communal (acceptance/connectedness) social goals are thought to shape how adolescents transact with their social environments. Despite their theoretical importance, little work has focused on the development of these higher order personality dimensions. Informed by developmental neuroscience and evolutionary psychology theoretical frameworks, the current study examined associations between pubertal status, a person's level of pubertal development at a single point in time, and agentic and communal social goals across early to middle adolescence. METHODS: This longitudinal study consisted of 387 (55% female) adolescents (Wave 1 M age = 12.1) who were assessed annually across three waves. Hierarchical linear modeling was used to examine growth in pubertal status and agentic and communal goals and to distinguish between- and within-person associations between pubertal status and social goals. RESULTS: Within-person pubertal status was concurrently associated with higher levels of agentic and communal goals. In the cross-sectional and longitudinal models, between-person pubertal status was associated with higher levels of agentic social goals. No support was found for social goals prospectively predicting pubertal status. CONCLUSIONS: These findings provide support for the hypothesis that puberty, in part, may drive developmental shifts in the value adolescents place on close peer relationships and obtaining status and independence.