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1.
Subst Use Misuse ; 59(4): 549-557, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38073312

RESUMO

Background: Normative perceptions are strongly related to risk behaviors among emerging adults but the role of gender-specific normative perceptions remain unclear. Objectives: The current study examined the differential effects of same-gender and gender-neutral normative perceptions on self-reported substance use and sexual risk behavior. College students (n = 389, ages 18-25) reported binge drinking, cannabis use and prescription drug misuse, sexual risk behavior, and the perceived frequency of these behaviors by both the average- and same-gender adult. Results: Binge drinking was positively associated with same-gender norms only, whereas cannabis use and sexual risk behavior were also positively associated with gender-neutral norms perceptions. For binge drinking only, same-gender norms explained more variance in behavior than gender-neutral norms. Conclusions: Findings indicate perceptions of same-gender norms play a particularly important role in binge drinking during this developmental period. Interventions targeting emerging adult risk behavior should include within-group normative perceptions related to demographic and social group characteristics.


Assuntos
Consumo de Bebidas Alcoólicas , Consumo Excessivo de Bebidas Alcoólicas , Adulto , Humanos , Adolescente , Adulto Jovem , Grupo Associado , Assunção de Riscos , Comportamento Sexual , Universidades , Normas Sociais
2.
J Urban Health ; 100(3): 436-446, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37221300

RESUMO

The third wave of the opioid overdose crisis-defined by the proliferation of illicit fentanyl and its analogs-has not only led to record numbers of overdose deaths but also to unprecedented racial inequities in overdose deaths impacting Black Americans. Despite this racialized shift in opioid availability, little research has examined how the spatial epidemiology of opioid overdose death has also shifted. The current study examines the differential geography of OOD by race and time (i.e., pre-fentanyl versus fentanyl era) in St. Louis, Missouri. Data included decedent records from the local medical examiners suspected to involve opioid overdose (N = 4420). Analyses included calculating spatial descriptive analyses and conducting hotspot analyses (i.e., Gettis-Ord Gi*) stratified by race (Black versus White) and time (2011-2015 versus 2016-2021). Results indicated that fentanyl era overdose deaths were more densely clustered than pre-fentanyl era deaths, particularly those among Black decedents. Although hotspots of overdose death were racially distinct pre-fentanyl, they substantially overlapped in the fentanyl era, with both Black and White deaths clustering in predominantly Black neighborhoods. Racial differences were observed in substances involved in cause of death and other overdose characteristics. The third wave of the opioid crisis appears to involve a geographic shift from areas where White individuals live to those where Black individuals live. Findings demonstrate racial differences in the epidemiology of overdose deaths that point to built environment determinants for future examination. Policy interventions targeting high-deprivation communities are needed to reduce the burden of opioid overdose on Black communities.


Assuntos
Overdose de Opiáceos , Missouri/epidemiologia , Humanos , Overdose de Opiáceos/epidemiologia , Overdose de Opiáceos/mortalidade , Negro ou Afro-Americano , Brancos , Adulto , Masculino , Feminino , Fatores Raciais , Fatores de Tempo
3.
Harm Reduct J ; 20(1): 5, 2023 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-36639769

RESUMO

BACKGROUND: Black individuals in the USA face disproportionate increases in rates of fatal opioid overdose despite federal efforts to mitigate the opioid crisis. The aim of this study was to examine what drives increases in opioid overdose death among Black Americans based on the experience of key stakeholders. METHODS: Focus groups were conducted with stakeholders providing substance use prevention services in Black communities in St. Louis, MO (n = 14). One focus group included peer advocates and volunteers conducting outreach-based services and one included active community health workers. Focus groups were held at community partner organizations familiar to participants. Data collection was facilitated by an interview guide with open-ended prompts. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using grounded theory to abstract line-by-line codes into higher order themes and interpret their associations. RESULTS: A core theme was identified from participants' narratives suggesting that opioid overdose death among Black individuals is driven by unmet needs for safety, security, stability, and survival (The 4Ss). A lack of The 4Ss was reflective of structural disinvestment and healthcare and social service barriers perpetuated by systemic racism. Participants unmet 4S needs are associated with health and social consequences that perpetuate overdose and detrimentally impact recovery efforts. Participants identified cultural and relationship-based strategies that may address The 4Ss and mitigate overdose in Black communities. CONCLUSIONS: Key stakeholders working in local communities to address racial inequities in opioid overdose highlighted the importance of upstream interventions that promote basic socioeconomic needs. Local outreach efforts utilizing peer services can provide culturally congruent interventions and promote harm reduction in Black communities traditionally underserved by US health and social systems.


Assuntos
Overdose de Drogas , Overdose de Opiáceos , Transtornos Relacionados ao Uso de Substâncias , Humanos , Analgésicos Opioides , Agentes Comunitários de Saúde , Overdose de Drogas/prevenção & controle
4.
J Ethn Subst Abuse ; : 1-14, 2022 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-35343396

RESUMO

Little is known about the mechanisms of the relationship between racial discrimination and substance use among Black youth. The current study examined the role of collective self-esteem and personal self-esteem in this relationship among Black adolescents in grades 5 through 12 (N = 1514; 57% female). Regression analyses estimated direct effects of perceived racial discrimination on substance use and indirect effects of discrimination on substance use through personal and collective self-esteem. Controlling for grade and sex, results revealed significant indirect effects such that experiences of discrimination were positively associated with substance use through lower reports of collective and personal self-esteem. Findings suggest that bolstering personal and race-related esteem may mitigate the deleterious influence of discrimination among Black youth.

5.
Arch Sex Behav ; 49(6): 1939-1964, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32157486

RESUMO

Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.


Assuntos
Infecções por HIV/epidemiologia , Disparidades em Assistência à Saúde/normas , Infecções Sexualmente Transmissíveis/epidemiologia , Meio Social , Adolescente , Adulto , Negro ou Afro-Americano , Feminino , Heterossexualidade , Humanos , Masculino , Estados Unidos , Adulto Jovem
6.
Dev Psychopathol ; 32(2): 719-734, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31452473

RESUMO

Current adolescent substance use risk models have inadequately predicted use for African Americans, offering limited knowledge about differential predictability as a function of developmental period. Among a sample of 500 African American youth (ages 11-21), four risk indices (i.e., social risk, attitudinal risk, intrapersonal risk, and racial discrimination risk) were examined in the prediction of alcohol, marijuana, and cigarette initiation during early (ages 11-13), mid (ages 16-18), and late (ages 19-21) adolescence. Results showed that when developmental periods were combined, racial discrimination was the only index that predicted initiation for all three substances. However, when risk models were stratified based on developmental period, variation was found within and across substance types. Results highlight the importance of racial discrimination in understanding substance use initiation among African American youth and the need for tailored interventions based on developmental stage.


Assuntos
Racismo , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Negro ou Afro-Americano , Criança , Humanos , População Branca , Adulto Jovem
7.
J Ethn Subst Abuse ; 19(3): 371-387, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30346911

RESUMO

Alcohol expectancies are important determinants of adolescent drinking, but this relationship may differ based on race/ethnicity. This study used time-varying effect modeling to examine racial/ethnic differences in positive and negative alcohol expectancies and their relationship with drinking among White, African American, and Hispanic youth. Youth reported alcohol expectancies and drinking frequency from 5th grade to 10th grade. African Americans initially endorsed higher positive alcohol expectancies than Whites, but the relationship with drinking was stronger among Whites. Hispanic youth reported slightly higher negative alcohol expectancies in high school, but the relationship between negative expectancies and alcohol use was comparable across groups. The effect of expectancies on alcohol use outcomes may be more robust for Whites, which warrants investigation of risk factors for minority youth.


Assuntos
Desenvolvimento do Adolescente , Negro ou Afro-Americano/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispânico ou Latino/psicologia , Consumo de Álcool por Menores/etnologia , População Branca/etnologia , Adolescente , Criança , Feminino , Humanos , Masculino
8.
Am J Addict ; 28(1): 29-35, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30576034

RESUMO

BACKGROUND AND OBJECTIVES: Substance use behaviors have been identified as a risk factor that places juveniles at greater risk for engaging in delinquent behaviors and continual contact with the juvenile justice system. Currently, there is lack of research that explores comorbid factors associated with substance use, such as post-traumatic stress disorder (PTSD) symptoms, that could help identify youth who are at greatest risk. The aim of the present study was to examine if PTSD symptomology moderated the relationship between substance use disorder (SUD) symptoms and externalizing behaviors and commission of a violent crime; hypothesizing that risk would be heightened among youth with elevated SUD and PTSD symptomology compared to those with elevated SUD symptoms but lower PTSD symptoms. METHOD: The study included 194 predominantly male (78.4%), non-White (74.2%) juvenile justice youth between the ages of 9-18 (M = 15.36). Youth provided responses to assess PTSD symptoms, SUD symptoms, and externalizing behaviors. Commission of a violent crime was based on parole officer report. RESULTS: Findings indicated that SUD symptomology was associated with greater externalizing behaviors at high levels of PTSD symptomology. At low levels of PTSD symptomology, SUD symptoms were inversely associated with externalizing behaviors. An interactive relationship was not observed for commission of violent crimes. CONCLUSIONS: Findings suggest that the association between SUD symptoms and externalizing behaviors among juvenile offenders may be best explained by the presence of PTSD symptomology. SCIENTIFIC SIGNIFICANCE: Addressing PTSD rather than SUD symptoms may be a better target for reducing risk for externalizing behaviors among this population of youth (Am J Addict 2019;28:29-35).


Assuntos
Crime/psicologia , Delinquência Juvenil/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Criança , Comorbidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
9.
Am J Drug Alcohol Abuse ; 45(3): 313-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30620228

RESUMO

BACKGROUND: Adolescent cannabis use is associated with increased risk for psychological problems, with evidence for more severe problems among youth who use cannabis in combination with other substances (i.e., polysubstance use). Juvenile offenders engage in both cannabis use and polysubstance use at higher rates than the general adolescent population. Yet, limited research has examined the relationship between cannabis poly-use (e.g., cannabis and alcohol use) and functional or psychological problems among juvenile offenders. OBJECTIVES: The current study addresses this gap by examining the association of polysubstance use of cannabis compared to cannabis only use with cognitive functioning, psychological distress, and substance-related problems among juvenile detainees. METHODS: Participants were 238 detained youth ages 12-18 (80.4 % male, 77.3% non-White) who completed assessments of substance use, intellectual functioning, psychological symptoms, and substance-related problems. Youth were also assessed by a clinical psychologist for substance use disorder. RESULTS: Four cannabis-use typologies were identified; cannabis and alcohol use was the largest class, followed by cannabis only use, cannabis, alcohol and other drug use, then cannabis and other drug use. Polysubstance use was associated with lower scores on measures of intellectual functioning, more externalizing and internalizing symptomology, and more substance-related problems relative to cannabis only use. However, the relationship between polysubstance use and problems varied by typology. CONCLUSIONS: Findings suggest that justice-involved youth engaged in polysubstance use may be at greater need for concurrent academic, affective, and behavioral support in their rehabilitation and transition back to the community.


Assuntos
Comportamento do Adolescente , Cannabis , Delinquência Juvenil , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Criança , Feminino , Humanos , Indiana , Masculino , Transtornos Relacionados ao Uso de Substâncias/psicologia
10.
Subst Use Misuse ; 54(1): 156-165, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30395759

RESUMO

BACKGROUND: Perceived discrimination has been found to increase substance use vulnerability among adolescent populations. However, less is known about individual level factors which may moderate this risk. OBJECTIVES: The aim of the current study is to examine whether two emotion-based personality traits (i.e., distress tolerance and negative urgency) moderates the effect of perceived discrimination on substance use. We hypothesized that high distress tolerance would decrease risk, while high negative urgency would increase risk for substance use as a consequence of discrimination. METHODS: 108 youth ages 12-18 (68.6% male; 56.2% African-American) provided data on perceived discrimination, distress tolerance, negative urgency, and substance use (i.e., alcohol and marijuana use). RESULTS: Contrary to our hypothesis, no moderating effect was observed for negative urgency. Distress tolerance was found to moderate the relationship, but in the opposite direction than expected. CONCLUSIONS: It is speculated that this counterintuitive finding may be due to the racial/ethnic composition of the sample, suggesting that distress tolerance may operate differently among minority youth. Further research examining these relationships among minority youth is warranted.


Assuntos
Abuso de Maconha/psicologia , Fumar Maconha/psicologia , Grupos Minoritários/psicologia , Racismo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Negro ou Afro-Americano/psicologia , Criança , Feminino , Hispânico ou Latino/psicologia , Humanos , Masculino , Estresse Psicológico/psicologia
11.
Child Psychiatry Hum Dev ; 49(2): 290-297, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28791492

RESUMO

Although many juvenile offenders report experiencing police injustice, few studies have examined how this source of strain may impact youths' behavioral outcomes, including risk for future recidivism. This study begins to address that gap in the literature. We applied the general strain theory as our theoretical framework to examine the interactive effect of perceived police injustice and moral disengagement on juvenile aggressive behavior. Our sample included 95 juvenile offenders who completed questionnaires on measures of perceived police injustice and moral disengagement. Results supported our hypothesis, such that moral disengagement predicted past month aggression among juvenile offenders, but only by youth who reported mean and high levels of perceived police injustice. While more research is needed in this area, this study's findings underscore the need to address both perceived police engagement and moral disengagement among youth at-risk of engaging in delinquent behaviors. Implications for intervention programs are also presented.


Assuntos
Agressão/psicologia , Criminosos/psicologia , Delinquência Juvenil/psicologia , Princípios Morais , Percepção , Polícia , Preconceito , Adolescente , Feminino , Humanos , Masculino , Inquéritos e Questionários
12.
Alcohol Clin Exp Res ; 41(6): 1129-1136, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28423479

RESUMO

BACKGROUND: Among general population studies, lower rates of binge drinking tend to be found among African Americans and Hispanics compared to Whites. However, among older adult populations, minority groups have been shown to be at higher risk for binge drinking, suggesting the presence of a crossover effect from low to high risk as a function of age. To date, limited research has examined the crossover effect among African American and Hispanic populations compared to non-Hispanic Whites across large developmental time frames or explored variation in risk based on income or gender. This study aimed to fill these gaps in the literature. METHODS: Data were compiled from the 2010 to 2013 National Survey on Drug Use and Health surveys, which provide annual, nationally representative data on substance use behaviors among individuals aged 12 and older. Hispanic, non-Hispanic African American, and non-Hispanic White respondents were included (N = 205,198) in the analyses. RESULTS: A crossover effect was found for African American males and females among the lowest income level (i.e., incomes less than $20,000). Specifically, after controlling for education and marital status, compared to Whites, risk for binge drinking was lower for African American males at ages 18 to 24 and for females at ages 18 to 34, but higher for both African American males and females at ages 50 to 64. No crossover effect was found for Hispanic respondents. CONCLUSIONS: Although African Americans are generally at lower risk for binge drinking, risk appears to increase disproportionately with age among those who are impoverished. Explanatory factors, such as social determinants of health prevalent within low-income African American communities (e.g., lower education, violence exposure, housing insecurity) and potential areas for intervention programming are discussed.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/tendências , Negro ou Afro-Americano/psicologia , Inquéritos Epidemiológicos/tendências , Hispânico ou Latino/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Consumo Excessivo de Bebidas Alcoólicas/economia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Estudos Cross-Over , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , População Branca/psicologia , Adulto Jovem
13.
Subst Use Misuse ; 52(8): 992-1002, 2017 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-28318348

RESUMO

BACKGROUND: Dispositional impulsivity has been consistently implicated as a risk factor for problem drinking among college students and research suggests that this relationship may be explained in part by alcohol expectancies. A subset of alcohol expectancies, sex-related alcohol expectancies, is particularly linked to problem drinking among college students. The acquired preparedness model of risk postulates that people with dispositional impulsivity develop stronger sex-related alcohol expectancies, are subsequently more likely to drink at problematic levels in sexual situations, and thus, engage in more problem drinking. OBJECTIVES: Using this model, the current study examined whether sex-related alcohol expectancies and alcohol use at sex mediated the relationship between impulsivity and problem drinking among college students. METHODS: College students (N = 101) completed self-report measures of alcohol use, sex-related alcohol expectancies, and five dimensions of impulsivity: negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance. RESULTS: Two facets of impulsivity-sensation seeking and lack of premeditation-provided unique contributions to problem drinking. Sex-related alcohol expectancies significantly mediated the effects of lack of premeditation and sensation seeking on problem drinking. In support of the acquired preparedness model, the relationship between the impulsivity traits and problem drinking was serially mediated by sex-related alcohol expectancies and alcohol use at sex. CONCLUSIONS: Results suggest that sensation seeking and lack of premeditation continue to be areas of intervention for problem drinking among college students, and implicate sex-related alcohol expectancies as an area of intervention for alcohol use at sex and problem drinking.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Comportamento Impulsivo/fisiologia , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Modelos Psicológicos , Personalidade/fisiologia , Autorrelato , Estudantes/psicologia , Adulto Jovem
14.
J Youth Adolesc ; 46(8): 1702-1715, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27830403

RESUMO

Ethnic identity is an important buffer against drug use among minority youth. However, limited work has examined pathways through which ethnic identity mitigates risk. School-aged youth (N = 34,708; 52 % female) of diverse backgrounds (i.e., African American (n = 5333), Asian (n = 392), Hispanic (n = 662), Multiracial (n = 2129), Native American (n = 474), and White (n = 25718) in grades 4-12 provided data on ethnic identity, drug attitudes, and drug use. After controlling for gender and grade, higher ethnic identity was associated with lower past month drug use for African American, Hispanic, and Multiracial youth. Conversely, high ethnic identity was associated with increased risk for White youth. An indirect pathway between ethnic identity, drug attitudes, and drug use was also found for African American, Hispanic, and Asian youth. Among White youth the path model was also significant, but in the opposite direction. These findings confirm the importance of ethnic identity for most minority youth. Further research is needed to better understand the association between ethnic identity and drug use for Multiracial and Hispanic youth, best ways to facilitate healthy ethnic identity development for minority youth, and how to moderate the risk of identity development for White youth.


Assuntos
Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Atitude , Etnicidade , Feminino , Humanos , Masculino , Grupos Minoritários , Grupos Raciais , Instituições Acadêmicas
15.
Am J Orthopsychiatry ; 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38546560

RESUMO

Black and Latinx people are disproportionately impacted by HIV, COVID-19, and other syndemic health crises with similar underlying social determinants of health. Lessons learned from the HIV pandemic and COVID-19 response have been invoked to improve health equity at the systemic level in the face of other emergent health crises. However, few have examined the potential translation of strategies between syndemics at the individual level. The current mixed-methods study examined strategies used to manage HIV during the COVID-19 pandemic and the extent to which they were helpful in managing COVID-19 vulnerability among Black and Latinx people living with HIV. Participants (n = 30) were interviewed by telephone and completed demographic, mental health, alcohol and substance use, health literacy, and clinical measures in October and November 2020 in Los Angeles County. Rapid qualitative analysis, descriptive statistics, and mixed-methods merging were used to analyze the data. Qualitative results demonstrated that participants found HIV self-management strategies translated to aspects of the COVID-19 pandemic including hygiene and social distancing and coping with a health-related stressor. Although telemedicine provided continuity of HIV care for most participants, technology access and literacy posed a potential barrier, particularly to those facing other sociodemographic marginalization (i.e., low education, disability). Findings suggest providers can encourage leveraging individual HIV self-management strategies in response to other public health crises. However, these interventions must be culturally responsive and address intersecting social determinants of health. Future research should examine mechanisms that predict individual translation of HIV management strategies to other health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

16.
J Addict Med ; 17(3): 356-359, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37267191

RESUMO

OBJECTIVES: Pregnant and postpartum women and people (PPWP) who use opioids experience higher rates of morbidity, preterm labor, and stillbirth than those who do not. Although medication for opioid use disorder (MOUD) is the standard of treatment, utilization among PPWP has remained low because of MOUD stigma and misconceptions. The current report examined general and pregnancy-related MOUD attitudes, norms, and self-efficacy among PPWP seeking treatment. METHODS: Participants (n = 33) receiving MOUD at a Midwestern clinic reported beliefs about MOUD in general using the Attitudes toward Methadone Questionnaire (modified to include all MOUD) and during pregnancy/postpartum using an investigator-generated scale based on previous research. Participants responded using a 5-point scale from "strongly agree" to "strongly disagree" with higher scores indicating more positive attitudes. Analyses examined the bivariate association of attitudes with MOUD subjective norms and self-efficacy, also measured via investigator-generated scales. RESULTS: Respondents reported positive attitudes toward MOUD use during pregnancy, with most agreeing it was safe. However, up-to-half of participants reported uncertainty regarding the appropriate dosage of MOUD and its impact on the fetus and/or neonate. Both general and pregnancy/postpartum-related MOUD attitudes were positively associated with subjective norms toward MOUD. CONCLUSIONS: Pregnant and postpartum women and people reported high uncertainty about MOUD use despite currently using it, emphasizing the need for strategies that assess and mitigate MOUD-related stigma. Findings suggest that familial support and stigma impact attitudes toward MOUD and highlight the importance of accurate psychoeducation and social supports for patients and their families to improve the acceptance and utilization of MOUD among PPWP.


Assuntos
Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Recém-Nascido , Gravidez , Humanos , Feminino , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Analgésicos Opioides , Estigma Social , Período Pós-Parto , Metadona , Atitude , Tratamento de Substituição de Opiáceos
17.
Am J Orthopsychiatry ; 93(4): 293-303, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37155290

RESUMO

Experiences of racial discrimination are pervasive among Black youth, resulting in psychosocial problems such as depression and anxiety. Rumination plays a key role in linking racial discrimination and internalizing concerns. Developmental age has also been shown to influence the extent to which racial discrimination and rumination impact mental health; however, studies have yet to explore the interplay between these factors. This study examined the association between racial discrimination and internalizing concerns among Black youth, whether racial discrimination was indirectly associated with internalizing concerns through rumination, and whether developmental age moderated these direct and indirect effects. Participants included 158 pre- and early-adolescent youth recruited from a community sample (Mage = 11.56 years; 53% female). Data were from baseline questionnaire responses from a larger longitudinal study conducted in the Southeastern United States examining the effects of interpersonal stressors on youth mental health outcomes. Racial discrimination was directly and indirectly associated with internalizing concerns through rumination. Developmental age moderated the indirect link between racial discrimination and depressive symptoms via rumination with the association being stronger as participant age increased. The impact of racial discrimination on mental health among Black youth is informed by maladaptive coping strategies such as rumination and developmental age. Such factors help to identify who is most at risk for the impact of racial discrimination and potential intervening targets. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Ansiedade , População Negra , Depressão , Racismo , Ruminação Cognitiva , Adolescente , Criança , Feminino , Humanos , Masculino , Ansiedade/psicologia , População Negra/psicologia , Depressão/psicologia , Estudos Longitudinais , Racismo/psicologia , Desenvolvimento do Adolescente , Estresse Psicológico/psicologia , Sudeste dos Estados Unidos , Fatores Etários , Saúde Mental , Adaptação Psicológica
18.
Front Psychiatry ; 14: 1241002, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38107000

RESUMO

Background: Structural oppression affects health behaviors through residence in suboptimal neighborhoods and exposure to community violence. Youth and parents report perceptions of neighborhood factors that can affect youth substance use behaviors. Given that Latinx youth report higher levels of perceived community violence than other racial and ethnic groups, it is imperative to examine how youth- and parent-perceived neighborhood-level factors may relate to youth substance use. Methods: Data were collected using clinical interviews with family triads (fathers, mothers, and youth) and parent-child dyads (father or mother and youth) enrolled in the Seguimos Avanzando study of 344 Mexican-origin families in Indiana. Neighborhood measures, including perceptions of exposure to violence, neighborhood characteristics, and neighborhood collective efficacy, were included in parent and youth surveys. Self-report measures for past year alcohol and drug use were included in the youth survey only. T-tests were conducted to estimate differences in neighborhood reports among the sample triads. A series of linear regression models were used to estimate the associations between youth-, mother-, and father-reported perceptions of neighborhood factors and youth substance use. Results: Preliminary results indicate that fathers reported higher levels of exposure to violence than mothers [t(163) = 2.33, p = 0.02] and youth [t(173) = 3.61, p < 0.001]. Youth reported lower negative neighborhood characteristics than mothers [t(329) = 6.43, p < 0.001] and fathers [t(169) = 3.73, p < 0.001]. Youth reported significantly better neighborhood collective efficacy than mothers [t(296) = 3.14, p = 0.002], but not statistically different from fathers. Results from the primary analysis showed that youth exposure to violence was positively associated with youth substance use (b = 0.24, SE = 0.06, p < 0.0001), but the youth's neighborhood characteristics and collective efficacy were not significantly associated with youth substance use. None of the parent-reported neighborhood variables were associated with youth substance use. Conclusion: The discrepant findings between parent and youth reports of perceived neighborhood characteristics and substance use have important implications for researchers and community stakeholders, and for developing targeted interventions and prevention strategies. Our study highlights the need to address youth experience of community violence and to prioritize creating safe and inclusive neighborhood environments. Potential strategies include improving community resources, strengthening social support networks, promoting open communication about neighborhood risks, and fostering collaborative efforts to address substance use behaviors.

19.
Healthcare (Basel) ; 11(17)2023 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-37685426

RESUMO

Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. "High-risk" participants self-identified as "not being engaged in treatment" or "new or early in their recovery" (n = 11); "low-risk" participants self-identified as being "well-established" or "in long-term recovery" (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond.

20.
Addict Behav ; 135: 107455, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35933943

RESUMO

BACKGROUND: Ecological momentary assessment (EMA) is well-suited to measure adolescent substance use. Previous research with adolescents, particularly racially minoritized adolescents, has predominantly provided mobile devices to participants as a strategy to reduce structural barriers to technology access. This report examined feasibility and acceptability of a text-message-delivered EMA protocol to adolescents' personal phones. METHODS: Non-Hispanic Black and White adolescents aged 14-18 years with mobile phone access and past-30-day substance use were recruited from community settings. Respondents (n = 36; 55.5 % female; 55.5 % White) completed a 14-day diary assessing substance use. RESULTS: Respondents completed M = 13.8 (SD = 1.36) diaries for a compliance rate of 93.5 %. Black respondents completed significantly fewer diaries (87.9 %) than White respondents (97.9 %) although compliance rates were high among both groups. Adolescents reported high acceptability of the protocol, with 97.1 % willing to participate again. CONCLUSION: Findings suggest text-message-based EMA delivered to personal phones is acceptable and feasible for assessing substance use among adolescents. As the sociodemographic "digital divide" narrows among adolescents, this cost-effective and equitable method becomes more feasible.


Assuntos
Telefone Celular , Transtornos Relacionados ao Uso de Substâncias , Envio de Mensagens de Texto , Adolescente , Criança , Avaliação Momentânea Ecológica , Estudos de Viabilidade , Feminino , Humanos , Masculino
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