Depressive symptomatology and role function in a general population.

Depressive symptomatology, marital satisfaction and functioning, job satisfaction, and social relationships were investigated in 320 respondents comprising 160 married couples. Responses to the Zung Self-Rating Depression Scale indicated that 13% of the respondents had scores similar to those obtained by patients with diagnosed depressions and an additional 27% had scores comparable to those of persons with other psychiatric problems. Responses to a variety of questions about the respondents' social life, job satisfaction, and marital function indicate that increased depressive symptomatology in this general population is associated with a decline in satisfaction and functioning in these areas. The data suggest that this association is not solely due to response bias but is associated with a real decline in function, particularly in the area of child rearing.

Reliability of the Group for Advancement of Psychiatry Diagnostic Categories in Child Psychiatry.

A total of 403 multiple diagnoses were independently assigned to 41 patient protocols by 73 psychiatrists, psychologists, and social workers to determine the levels of interrater reliability of the Group for the Advancement of Psychiatry (GAP) diagnostic categories. With the exception of the psychotic disorders category, these diagnostic categories were found to have low levels of interdiagnostician reliability. Differences in the reliabilities across disciplines and levels of training were found. It is noted, however, that neither years of experience, kind of training, nor direct contact with the patient can be regarded as a substitute for improvements in the classification system itself. The importance of a reliable classification system for child psychiatry is emphasized and suggestions for improvements in the present GAP system are made.

An elementary school-based alcohol misuse prevention program: a follow-up evaluation.

An alcohol misuse prevention study (AMPS) curriculum for fifth- and sixth-grade students was developed, implemented and evaluated with over 5,000 students. The AMPS program emphasized social pressures resistance training, focusing on the immediate effects of alcohol, risks of alcohol misuse and social pressures to misuse alcohol. Schools were randomly assigned to curriculum, curriculum plus booster or control groups with half of each group pretested and all posttested. Measures focused on susceptibility to peer pressure, internal health locus of control, understanding of the curriculum material, alcohol use and alcohol misuse. After 26 months, there was a significant treatment by occasion interaction on internal health locus of control (sixth grade). A significant treatment by occasion interaction effect was also found with respect to curriculum measures in both grades. There was no significant treatment by occasion interactions with respect to alcohol use or misuse when the groups as a whole were considered. When subgroup analyses based on type of prior drinking experience were conducted, however, significant program effects on alcohol misuse were found among sixth-grade students who had experienced unsupervised as well as supervised drinking prior to the prevention program.

Longitudinal evaluation of an enhanced alcohol misuse prevention study (AMPS) curriculum for grades six-eight.

For students progressing from sixth to eighth grade, an enhanced Alcohol Misuse Prevention Study (AMPS) curriculum that emphasized social pressure resistance training, peer support, and norm-setting was developed, implemented, and evaluated. Schools were randomly assigned within communities to curriculum or control groups. Students were pretested early in sixth grade before the intervention and posttested at the end of sixth, seventh, and eighth grades. Results indicated the curriculum was effective in increasing students' knowledge of curriculum material, and among the subgroup of students who had used alcohol unsupervised by adults before the pretest, in reducing the rate of increase of alcohol misuse. The findings result from a replication of the analytic approach used with the initial AMPS cohort data.

Susceptibility to peer pressure as an explanatory variable for the differential effectiveness of an alcohol misuse prevention program in elementary schools.

A school-based alcohol misuse prevention program had differential effects on students' susceptibility to peer pressure, depending on prior experience with alcohol. These effects paralleled those on alcohol use and misuse, indicating program effects on use and misuse were mediated by reductions in the rate of increase on susceptibility to peer pressure. Experimental group students with prior unsupervised use of alcohol showed a significantly greater reduction than their controls in the rate of increase in susceptibility to peer pressure, alcohol use, and alcohol misuse. This difference was not found among students without prior unsupervised use of alcohol.

Differential effectiveness of an elementary school-based alcohol misuse prevention program.

An elementary school social skills/peer pressure resistance curriculum for the prevention of alcohol misuse was developed, implemented, and evaluated. Schools were randomly assigned to curriculum and control groups, with half of each group pretested prior to intervention and all students posttested two months, 14 months, and 26 months following intervention. Students in grade five at the beginning of the study were randomly assigned to treatment, treatment plus booster, and control conditions. Students in grade six were randomly assigned to treatment and control conditions. Three way repeated measures analyses of covariance (treatment condition by type of prior drinking experience by occasion) were conducted for each grade level on indices of "frequency/quantity of alcohol use" and "total alcohol misuse." Results indicated the intervention was effective in reducing the rate of increase of alcohol use and misuse among grade six students who entered the study with prior unsupervised as well as supervised alcohol use. After corrections for intraclass correlations on the dependent variables, the significant finding regarding the alcohol misuse variable was maintained.

Validity of adolescents' self-reports of alcohol use and misuse using a bogus pipeline procedure.

Past research, particularly in the area of adolescent smoking behavior, has suggested that more valid self-reports of socially undesirable behavior can be obtained when a bogus pipeline procedure is implemented. "Bogus pipeline" refers to a methodology in which subjects are informed that their self-reports can and will be objectively verified by the researcher through a procedure such as a biochemical test. In actuality, no verification takes place. Recent studies using this methodology have produced mixed results. In the current study, a bogus pipeline procedure designed to increase the validity of adolescents' self-reports of alcohol use and misuse was devised and evaluated as part of the pilot work for an alcohol misuse prevention study in southeastern Michigan schools. A total of 291 students in grades seven through nine were tested in the pilot study. Of these, 173 experienced the bogus pipeline approach in which saliva samples were collected, while 118 served as controls. The differences between the two conditions were examined with respect to nine variables concerning alcohol use and misuse. An overall frequency of use index and an overall misuse index were also examined. Two-way analyses of variance (treatment by grade level and treatment by gender) were conducted. The F values for a main effect of treatment ranged from .00 to 1.27 for the 11 variables. None of these was significant at the prespecified alpha level of .20. In addition, there was no interaction of the treatment procedure with either grade level or gender. In the context of a school-based study in which confidentiality was assured, adolescents' self-reports of alcohol use and misuse were not significantly affected by a bogus pipeline procedure.

Health locus of control and self-esteem as related to adolescent health behavior and intentions.

A health behavior and attitudes questionnaire was administered to 246 fifth-grade and 265 sixth-grade students during class time. The questions included 20 children's health locus of control (CHLC) items reported by Parcel and Meyer (1978), 17 children's self-esteem (CSE) items modified from those reported by Coopersmith (1967), and questions concerning past and current behavior and future intentions with respect to cigarette smoking, alcohol use, and marijuana use. The results indicate that the relationships between dimensions of children's health locus of control and self-esteem and their behaviors and intentions are not large enough to suggest that intervention programs directed at the prevention of detrimental health behaviors focus on the enhancement of self-esteem or the internal locus of control. An appropriate test of the efficacy of such an approach requires a longitudinal rather than a cross-sectional study, monitoring changes in the levels of self-esteem and health locus of control and associated changes in health behavior.

Dimensionality, internal consistency and interrater reliability of clinical performance ratings.

A total of 6444 ratings of the financial performance of 424 third- and fourth-year medical students were made by house officers and attending teachers during 12 separate internal medicine rotations. Ratings were based on 13 behaviourally anchored rating scales. One rating was randomly selected per student per evaluator type (house officer and attending teacher) during each of the 12 rotation periods. Ratings were factor analysed separately within each rotation period. Two factors emerged consistently, and congruence coefficients across the 12 occasions were high (0.88 or greater). The factors were labelled 'problem-solving (10 items) and 'interpersonal skills' (three items) on the basis of their content. Internal consistency coefficients of the indices constructed from items in the two factors and the total of the 13 items were high (0.9 or greater) and did not differ substantially when computed separately on the ratings from house officers and attending teachers. Interrater reliabilities on the individual items ranged from 0.14 to 0.33.

Structural equation model tests of patterns of family interaction, peer alcohol use, and intrapersonal predictors of adolescent alcohol use and misuse.

A survey of 1,340 students in grades six through twelve was conducted to test, in the context of structural equation models, the predictive validity of a theoretical model of antecedents of adolescent alcohol use and misuse. Constructs including parents' alcohol use, older siblings alcohol use, parents' approval of students alcohol use, older sibling approval of students alcohol use, peer use and approval of alcohol use (PUA), parental nurturance, parental permissiveness, child's grade in school, susceptibility to peer pressure (SPP), and deviant self-image, were included. The final iterations of the models accounted for more than half of the variance in both alcohol use and alcohol misuse. In a standardized solution, the two largest direct effects on both adolescent alcohol use and misuse were from SPP and PUA. When a seven item measure of SPP, including three items specific to alcohol use was used, the SPP latent variable accounted for a somewhat greater percentage of the variance in adolescent alcohol use and misuse than did the latent variable of PUA. When the three alcohol-specific items were deleted from SPP, however, PUA accounted for more variance than SPP. Other predictors, including parental behaviors, proved to be significant when their indirect effects were evaluated. Models predicting alcohol use and alcohol misuse were similar. SPP, PUA, and other significant predictors should be included in future models predicting adolescent alcohol use and misuse, as well as in future interventions targeting these behaviors. Longitudinal studies should be used to test these findings. Evaluation of prevention should include examination of possible interactions of these predictors with each other and with subject subgroup classifications.

Measurement of alcohol use and misuse in a cohort of students followed from grade 6 through grade 12.

In following a cohort of students from grade 6 through grade 12 for the purpose of evaluating an Alcohol Misuse Prevention Study curriculum, a substudy of the measurement of alcohol use and misuse was conducted. The 6-year follow-up of young people over time afforded a good opportunity to assess the adequacy of the initially chosen measures to 1) provide data with statistically desirable properties, and 2) be sensitive to and representative of the wide range of alcohol use and misuse patterns among adolescents as they mature. Revised measures of alcohol use and misuse were developed from the data responding to the same questionnaire items that had been used throughout the study. The revised measures demonstrated good psychometric properties and may be useful in other studies.

CROSS-VALIDATIONAL EVIDENCE ON THE DIMENSIONS OF PROBLEM BEHAVIOR IN THE EARLY GRADES.

One hundred forty-seven children in the first through the third grades were rated by their teachers on a behavior problem inventory employed in previous studies. The data were subjected to a principal axis factor analysis and rotated to an oblique position. Congruence coefficients were computed among the twelve factors resulting from the current analysis, and the eight factors extracted in an earlier study. Six of the factor matches were significant at or beyond the .O1 level. Five of these matches had a sufficient number of salient variables common to the two studies. The five dimensions meeting the consideration of significance of congruence across samples and sufficient common salients were termed, in an earlier study, Hyperactivity, Sluggishness, Paranoid Tendencies, Social Withdrawal, and Acting Out. The evidence of the predictive validity of these was briefly discussed.