ADHD, depression, and substance abuse risk among beginning college students.

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18-25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.

Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms.

Schemas and Borderline Personality Disorder symptoms in incarcerated women.

There is increasing interest regarding the role of maladaptive cognition in Borderline Personality Disorder (BPD). The current study examined the relationship between early maladaptive schema (EMS) domains and BPD symptoms as well as whether schema domains account for the relationship between childhood maltreatment and BPD severity. Incarcerated women (N=105) were assessed for BPD symptoms via semi-structured diagnostic interview. Disconnection/Rejection and Impaired Limits were associated with BPD pathology although these domains shared variance with depression and antisocial personality disorder pathology, respectively. In addition, the relationship between childhood abuse and BPD severity was non-significant after controlling for schema domains. Related findings and the implications for cognitive treatment of BPD are discussed.

The role of antisocial and borderline personality features in substance dependence among incarcerated females.

This study examined the association of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) with substance dependence among incarcerated females (N=105) as well as the influence of the co-occurrence of BPD and ASPD on psychosocial functioning in substance-dependent participants. The severity of BPD and ASPD both were associated with drug dependence, but BPD was not associated with alcohol dependence. After controlling for ASPD severity, BPD severity was no longer associated with drug dependence. The ASPD features of criminal activity and recklessness were most uniquely associated with drug and alcohol dependence (respectively). None of the BPD features was uniquely associated with alcohol or drug dependence after controlling for ASPD. A co-occurring BPD diagnosis was associated with mood disturbance and experiential avoidance among substance-dependent participants. An ASPD diagnosis was associated with an earlier age at first arrest, along with greater childhood abuse and severity of alcohol dependence. These findings have important implications for further understanding and developing ways to help substance-dependent incarcerated females.

Psycho-educational evaluations for university students in one clinic.

The number of university students requesting services based on the Americans with Disabilities Act for learning disabilities and ADHD-related difficulties has increased, although there are limited reports in the literature describing these evaluations. The current study describes a sample of 140 individuals (59% women) who presented for psycho-educational evaluation at the university psychology clinic. The students were individually administered self-report, cognitive, academic, and attention measures as indicated, and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Difficulties with mathematics, attention, and reading concerns were the most frequent presenting complaints. 46 students met criteria for one or more learning disorders and 20 students met criteria for a diagnosis of ADHD. Test scores are summarized and findings compared with the literature.

Help seeking for alcohol problems in a college population.

Despite the availability of effective treatments for problem drinkers, only a minority seek professional assistance. The authors investigated the influences on help seeking for alcohol-related difficulties in two separate studies. In Study 1, 59 men and 74 women completed questionnaires regarding their alcohol use, related problems, readiness to change, and help-seeking interest. The authors also developed a measure of stigma related to alcohol help seeking. Problem recognition, anxiety symptoms, and stigma predicted a global rating of help-seeking. Students (22 men and 60 women) participated in Study 2, which incorporated a multi-item measure of help-seeking intentions as well as attitude and personality measures. Positive attitudes, less perceived stigma, and greater self-efficacy increased help seeking. The findings highlight the importance of both approach and avoidance factors that affect help-seeking decisions, and the authors suggest directions for further research.

Transition to college: A classification and regression tree (CART) analysis of natural reduction of binge drinking.

Approximately one in five teens that drank heavily in high school reduces or discontinues consumption while in college. Multiple paths might lead to the common outcome of natural reduction in heavy drinking. Statistical modeling of this complex process of natural reduction is a challenge with standard linear statistics. The purpose of this paper is to use a new statistical procedure, Classification and Regression Tree (CART), to model the equifinality of reduction in drinking by college students who drank heavily as adolescents. An appealing aspect of CART is that the resulting tree model that can easily be interpreted and applied by those who work with adolescents during the important transition from high school to college. Of 201 college students who first binged on alcohol while in high school, 71 (35.3%) denied heavy or binge drinking within the previous three months (Natural Reducers). The final model accurately classified 84.6% of the students as either continued heavy drinkers or natural reducers. Sensitivity was modest (accurate identification of 67.6% of the reducers); however, specificity was strong (correct classification of 93.8% of the continued heavy drinkers). The model revealed four pathways to natural reduction in drinking. Predominant in each path was the influence of social factors that maintain continued drinking (e.g., social facilitation outcome expectancies, perception of friends' drinking) or facilitate natural reduction (e.g., regular church attendance). The results support the application of CART to model health behaviors across the transition from adolescence to young adulthood.

Factors associated with suicide attempts in female inmates: the hegemony of hopelessness.

In this study factors associated with past suicide attempts in female inmates were examined. Female inmate participants (N = 105) were given structured diagnostic assessments of antisocial and borderline personality disorders and substance dependence, as well as measures of depression, hopelessness, problem-focused coping styles, and reasons for living. There was a high lifetime prevalence of past suicide attempts (38.1%). Suicide attempts were positively associated with personality disorders, hopelessness, depression, childhood physical/emotional abuse, and family history of suicide and mood disorders, and negatively associated with income, reasons for living, and problem-focused coping. Controlling for hopelessness, borderline personality disorder and family history of suicide attempts were the only variables that remained uniquely associated with suicide attempts.

Borderline personality disorder and deliberate self-harm: does experiential avoidance play a role?

The theory that borderline personality disorder (BPD) is associated with experiential avoidance, and that experiential avoidance mediates the association between BPD and deliberate, nonsuicidal self-harm was examined. Female inmate participants (N = 105) were given structured diagnostic assessments of BPD, as well as several measures of experiential avoidance. There was a high lifetime prevalence of past self-harm (47.6%). Higher dimensional scores representing BPD severity were associated with higher self-harm frequency and greater experiential avoidance. Structural equation modeling analyses indicated that experiential avoidance did not mediate the association between BPD and self-harm, although thought suppression was associated with self-harm frequency.

Comparing stage of change measures in adolescent smokers.

This study compared stage of change measures among adolescent smokers. Participants were 56 adolescents who had received smoking tickets. They filled out an assessment packet including readiness to change measures [i.e., algorithm, Crittenden's measure, University of Rhode Island Change Assessment (URICA), and Ladder], smoking history, a 30-day calendar, Fagerstrom, self-efficacy measures, locus of control, and a problem screen. The Crittenden algorithm was correlated with the Ladder and URICA motivation scores as well as with decreased frequency/amount of smoking and past quit attempts. Ladder scores were correlated with less cigarettes smoked, self-efficacy, and fewer adolescent problems. Readiness to change was unrelated to nicotine dependence and locus of control. The classification of participants into stages by the Crittenden algorithm was associated with a significant MANOVA (Wilks' Lambda F=1.56, P<.025), with group differences on reported quit attempts, abstinence self-efficacy, and adolescent problems. The Crittenden measure and the URICA motivation score were sensitive to a MET intervention.

Cognitive impairment in substance abuse.

Conventional wisdom, and even well-reasoned theoretical mechanisms, suggests that the chronic use of psychoactive substances would impair cognitive functioning of individuals. This article summarizes the research literature with regard to specific drugs of abuse. Undoubtedly, acute intoxication and immediate and protracted withdrawal produce transient alterations of cognitions that can persist for weeks to months. Some subtle residual effects remain for up to 1 year for certain drugs. Evidence of irreversible effects is less clear. Even subtle lingering effects can impact treatment efforts, yet they often go undetected or unaddressed.

Natural reduction of binge drinking among college students.

Considerable evidence indicates that alcohol problems can resolve without formal treatment [Addiction 95 (2000) Clin. Psychol.: Sci. Pract. 5 (1998) 1]. Such changes, called "natural recovery," are not infrequent in the general population [Institute of Medicine. (1990). Broadening the base of treatment for alcohol problems. Washington, DC: National Academy Press]. The goal of this study was to determine if some college students with a history of binge drinking during high school reduced their bingeing without intervention while in college. A second goal was to identify individual characteristics that differentiate between current and reduced bingers. Ninety-one college students with a history of bingeing in high school and no prior drug treatment completed questionnaires about prior and current drinking. Results revealed that 22% of the students with a history of adolescent bingeing had reduced their alcohol consumption while still in college and without treatment. Key factors that differentiated between groups included marital status, church attendance, and outcome and efficacy expectancies.