Impulsiveness, and trait displaced aggression among drug using female sex traders

HIGHLIGHTS

• Women who traded sex for both drugs and money used crack, powder cocaine, and alcohol more.
• Women trading sex for both were higher on Impulsiveness Scales.
• Women trading for drugs only injected more and were higher on Displaced Aggression.
• Women trading for money only used marijuana more and more likely to use before sex.

OBJECTIVE:

This study compared women who sex trade for drugs, money, or both compared to neither (did not sex trade), and introduced the concept of trait displaced aggression to the literature on sex trading.

METHODS:

Female participants (n=1055) were recruited from a low-income area of southern California. Measures included: the Risk Behavior Assessment (RBA), Barratt Impulsivity Scale (BIS), Eysenck Impulsiveness Scale (EIS), and the Displaced Aggression Questionnaire (DAQ).

RESULTS:

Women who traded sex for both drugs and money used crack cocaine, powder cocaine, and alcohol significantly more, scored higher on the BIS, and the EIS, and were significantly older. Those who only sex traded for drugs used more amphetamine, heroin, and injected drugs more days. They were also higher on the DAQ and all of the DAQ subscales. Those who traded for money only used marijuana more and were more likely to use marijuana before sex.

CONCLUSIONS:

This study may help address specific issues unique to those who sex trade for different commodities in that the drugs used are different and the underlying personality characteristics are different.

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By:  Clingan SE1, Fisher DG2, Pedersen WC1, Reynolds GL3, Xandre P4.

• 1Psychology Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA.
• 2Psychology Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA. Electronic address: dennis.fisher@csulb.edu.
• 3Health Care Administration Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA.
• 4School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA.
• Addict Behav. 2016 Apr 6;60:24-31. doi: 10.1016/j.addbeh.2016.03.027. 

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Prevalence & Correlates of Transactional Sex among an Urban Emergency Department Sample: Exploring Substance Use & HIV Risk

Men and women involved in transactional sex (TS) report increased rates of HIV risk behaviors and substance use problems as compared with the general population. When people engaged in TS seek health care, they may be more likely to utilize the emergency department (ED) rather than primary care services. 

Our goal was to examine the prevalence and correlates of TS involvement among an ED sample of men and women. Adults ages 18-60 were recruited from an urban ED, as part of a larger randomized control trial. Participants (n = 4,575; 3,045 women, 1,530 men) self-administered a screening survey that assessed past 3-month substance use (including alcohol, marijuana, illicit drugs, and prescription drugs) and HIV risk behaviors, including TS (i.e., being paid in exchange of a sexual behavior), inconsistent condom use, multiple partners, and anal sex. 

Of the sample, 13.3% (n = 610) reported TS within the past 3 months (64.4% were female). Bivariate analysis showed TS was significantly positively associated with alcohol use severity, marijuana use, and both illicit and prescription drug use, and multiple HIV risk behaviors. These variables (except marijuana) remained significantly positively associated with TS in a binary logistic regression analysis. 

The prevalence of recent TS involvement among both male and female ED patients is substantial. These individuals were more likely to report higher levels of alcohol/drug use and HIV risk behaviors. 

The ED may be a prime location to engage both men and women who are involved in TS in behavioral interventions for substance use and sexual risk reduction.

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By:  Patton R1, Blow FC2, Bohnert AS2, Bonar EE2, Barry KL2, Walton MA2.

• 1The Substance Abuse Research Center, University of Michigan.
• 2Department of Psychiatry, University of Michigan. 
• Psychol Addict Behav. 2014 Jun;28(2):625-30. doi: 10.1037/a0035417.

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Substance abuse and personality disorder comorbidity in adolescent outpatients: Are girls more severely ill than boys?

Background

Substance use disorders (SUDs) constitute a major health problem and are associated with an extensive psychiatric comorbidity. Personality disorders (PDs) and SUDs commonly co-occur. Comorbid PD is characterized by more severe addiction problems and by an unfavorable clinical outcome. The present study investigated the prevalence of SUDs, PDs and common Axis I disorders in a sample of adolescent outpatients. We also investigated the association between PDs and SUDs, and how this association was influenced by adjustment for other Axis I disorders, age and gender.

Methods

The sample consisted of 153 adolescents, aged 14–17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. SUDs and other Axis I conditions were assessed using the mini international neuropsychiatric interview. PDs were assessed using the structured interview for DSM-IV personality.

Results

18.3 % of the adolescents screened positive for a SUD, with no significant gender difference. There was a highly significant association between number of PD symptoms and having one or more SUDs; this relationship was practically unchanged by adjustment for gender, age and presence of Axis I disorders. For boys, no significant associations between SUDs and specific PDs, conduct disorder (CD) or attention deficit hyperactivity disorder (ADHD) were found. For girls, there were significant associations between SUD and BPD, negativistic PD, more than one PD, CD and ADHD.

Conclusions

We found no significant gender difference in the prevalence of SUD in a sample of adolescents referred to a general mental health outpatient clinic. The association between number of PD symptoms and having one or more SUDs was practically unchanged by adjustment for gender, age and presence of one or more Axis I disorders, which suggested that having an increased number of PD symptoms in itself may constitute a risk factor for developing SUDs in adolescence. The association in girls between SUDs and PDs, CD and ADHD raises the question if adolescent girls suffering from these conditions may be especially at risk for developing SUDs. In clinical settings, they should therefore be monitored with particular diligence with regard to their use of psychoactive substances.

Below:  PD symptoms in adolescents with SUD and other Axis I disorders. PD Symptoms any PD criteria meeting a score of 1,2 or 3 when measured with the SIDP-IV; SUD substance use disorders; alcohol and/or drug abuse or dependence. Alcohol alcohol abuse or dependence; CannabisCannabis abuse or dependence; Anxiety anxiety disorders, simple phobias, generalized anxiety disorder, panic disorder, agoraphobia, social phobia and post-traumatic stress disorder; Mood mood disorders, dysthymia and major depressive episode; CD conduct disorder; ADHDattention deficit hyperactivity disorder. ** p < 0.05

Full article at:   http://goo.gl/szh4O2

By:  Hans Ole Korsgaard, Svenn Torgersen, Tore Wentzel-Larsen, and Randi Ulberg

Department for Child and Adolescent Mental Health (The Nic Waal Institute), Lovisenberg Diakonale Hospital, Oslo, Norway

Department of Psychology, University of Oslo, Oslo, Norway

Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway

Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway

Vestfold Hospital Trust, Tønsberg, Norway

Institute of Clinical Medicine, University of Oslo, Oslo, Norway

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The Influence of Sensation-Seeking & Parental & Peer Influences in Early Adolescence on Risk Involvement through Middle Adolescence

This study examined the relationships between youth and parental sensation-seeking, peer influence, parental monitoring and youth risk involvement in adolescence using structural equation modeling. 

Beginning in grade-six, longitudinal data were collected from 543 students over three years. Youth sensation-seeking in grade six contributed to risk involvement in early adolescence (grades six and seven) indirectly through increased peer risk influence and decreased parental monitoring but did not have a direct contribution. It contributed directly and indirectly to risk involvement in middle adolescence (grades eight and nine). 

Parent sensation-seeking at baseline was positively associated with peer risk influence and negatively associated with parental monitoring; it had no direct effect on adolescent risk involvement. Parental monitoring buffers negative peer influence on adolescent risk involvement. 

Results highlight the need for intervention efforts to provide normative feedback about adolescent risky behaviors and to vary among families in which parents and/or youth have high sensation-seeking propensities.

Proportions of youth involved in risky behaviors at baseline, 12, 24, and 36 months

Risky behaviors	Baseline	12 months	24 months	36 months	z
Sample size	543	494	458	451
Delinquent behaviors
Was suspended from school	1.9%	2.5%	11.9%	16.9%	9.12c
Was truant	3.2%	1.9%	3.8%	3.6%	0.82
Carried a weapon	4.4%	4.1%	5.3%	9.7%	3.45c
Engaged in a fight	33.2%	21.8%	22.5%	24.6%	3.20b
Substance use behaviors
Smoked cigarettes	2.0%	1.6%	2.4%	1.8%	0.01
Drank alcohol	18.5%	14.7%	18.6%	29.3%	3.60c
Used marijuana	0.4%	1.0%	1.1%	2.7%	2.97b
Sold or carried drugs	1.1%	0.6%	1.3%	2.2%	1.58
Been asked to sell drugs	1.5%	1.6%	2.4%	2.7%	1.47
Sexual behaviors
Ever had sex	3.6%	9.6%	20.8%	28.6%	13.90c
Had sex in the last 6 months	1.0%	3.1%	7.9%	13.7%	9.15c
Ever had anal sex	0.8%	2.1%	6.8%	8.7%	8.14c
Had multiple sex partners	0.2%	0.6%	2.9%	4.4%	6.12c
Did not use a condom during last sexual encounter	66.7%	59.6%	44.0%	27.3%	5.04c

Full article at:   http://goo.gl/IZYp7q

By:  Bo Wang,1 Lynette Deveaux,2 Sonja Lunn,2 Veronica Dinaj-Koci,1 Xiaoming Li,1 and Bonita Stanton1

¹Pediatric Prevention Research Center, Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA

²Office of HIV/AIDS, the Bahamas Ministry of Health, Nassau, The Bahamas

Corresponding author: Bo Wang, Ph.D., Pediatric Prevention Research Center, Wayne State University School of Medicine, 4707 St. Antoine, Suite W534, Detroit, MI 48201, Phone: 313-966-2366, Fax: 313-745-4993

Youth Soc. 2016 Mar; 48(2): 220–241.

Published online 2013 May 6. doi:  10.1177/0044118X13487228

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Normalising Desistance: Contextualising Marijuana & Cocaine Use Careers in Young Adults

Although there is a vast literature on drug use and addiction, there is little work that addresses the long-term use of drugs within the general population. 

We take a more contextual look in examining longitudinal drug use patterns over the course of 14 years for a representative sample of young adults in their late teens and early twenties in the United States using the National Longitudinal Survey of Youth (NLSY). We use a growth trajectory modelling approach for cocaine and marijuana users to determine general use careers. 

Using contextual and life-course variables, we then estimate a multinomial logistic regression model to predict group membership. In addition to establishing general use career groups, we ask how well mainstream theories comport with our findings and how the different chemical makeup of cocaine and marijuana influence our findings. 

We find four general use career groups: 

1. high use/late desistance; 
2. peaked use/strong desistance; 
3. low use; and 
4. stable use/gradual desistance. 

Our results suggest similar careers for users of both drugs, with desistance over time as the rule for all groups. We also find some support for life-course and contextual factors in drug using patterns, but our findings challenge other psychological and criminological theories.

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By:  Roussell A1, Omori M2.

• 1Department of Criminal Justice & Criminology, Washington State University, Pullman, USA.
• 2Department of Sociology, University of Miami, USA.
• Sociol Health Illn. 2016 Apr 1. doi: 10.1111/1467-9566.12421. 

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Trajectories of Marijuana Use from Adolescence to Adulthood as Predictors of Unemployment Status in the Early Forties

Objectives

To study the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unemployment status at mean age 43.

Methods

We gathered longitudinal data on a prospective cohort taken from a community sample (N = 548). Forty nine percent of the original participants were females. Over 90% of the participants were white. The participants were followed from adolescence to early midlife. The mean ages of participants at the follow-up interviews were 14.1, 16.3, 22.3, 27.0, 31.9, 36.6, and 43.0, respectively. We used the growth mixture modeling (GMM) approach to identify the trajectories of marijuana use over a 29 year period.

Results

Five trajectories of marijuana use were identified: chronic users/decreasers (8.3%), quitters (18.6%), increasing users (7.3%), chronic occasional users (25.6%), and nonusers/experimenters (40.2%). Compared with nonusers/experimenters, chronic users/decreasers had a significantly higher likelihood of unemployment at mean age 43 (Adjusted Odds Ratio =3.51, 95% Confidence Interval = 1.13 – 10.91), even after controlling for the covariates.

Conclusions and Scientific Significance

The results of the associations between the distinct trajectories of marijuana use and unemployment in early midlife indicate that it is important to develop intervention programs targeting chronic marijuana use as well as unemployment in individuals at this stage of development. Results from this study should encourage clinicians, teachers, and parents to assess and treat chronic marijuana use in adolescents.

Below:  Developmental Trajectories of Marijuana Use Extending From Adolescence to Mean Age 43

Full article at:   http://goo.gl/pS2NuJ

By:  Chenshu Zhang, Ph.D.,1 Judith S. Brook, Ed.D.,1 Carl G. Leukefeld, DSW,2 and David W. Brook, M.D.1

¹Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA

²Department of Behavioral Sciences, University of Kentucky, Lexington, KY 40506-9983, USA

Correspondence should be sent to Dr. Judith S. Brook, Department of Psychiatry, New York University School of Medicine, 215 Lexington Ave., 15^th Floor, New York, NY 10016, USA. Phone (212) 263-4662; Fax (212) 263-4660;

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Using Client's Routine Urinalysis Records From Multiple Treatment Systems to Model Five-Year Opioid Substitution Treatment Outcomes

BACKGROUND:

At global, national, and local level, the need for ongoing, timely and cost efficient, comprehensive drug treatment monitoring, and evaluation systems have clearly been well recognized.

OBJECTIVES:

To test the feasibility of linking laboratory data and client intake data and its usefulness for modeling retrospectively, for the first time, 5-year longitudinal drug treatment outcomes in an Irish opiate treatment setting.

METHODS:

A multisite, retrospective, longitudinal cohort study was implemented to evaluate outcomes for opiate users based on 1.7 million routine urinalysis results collected from 4,518 individuals presenting for opioid substitution treatment in Ireland from January 2006 to December 2010.

RESULTS:

Analysis of opiates, cocaine, benzodiazepine, and cannabis use at treatment intake, 6 months and at 1-5 year follow-ups revealed differences in urinalysis protocols; significant differences in age of first drug use between those using and not using opiates at 5 years; significant decreases in opiate use; increases in benzodiazepine use and significant increasing effects of concurrent cocaine and benzodiazepine use on the odds of using opiates. Time series analysis of weekly proportions opiate positive predicted 16% (95% confidence interval: 7%-25%) of clients would be opiate positive 5 years postinitial intake. 

CONCLUSIONS: 

Underutilized urinalysis data can be used to address the need for cost effective, efficient evidence of drug-treatment outcomes across time, place, and systems. Linking and matching the cross-sectional data across sites and times also revealed where improvements in electronic records could be made.

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By:  Comiskey CM1, Snel A1.

• 1 School of Nursing and Midwifery, Trinity College, University of Dublin , Dublin , Ireland.
• Subst Use Misuse. 2016 Mar 20;51(4):498-507. doi: 10.3109/10826084.2015.1126738. Epub 2016 Mar 4. 

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Age of Sexual Debut and Cannabis Use in the United States

BACKGROUND:

Understanding the interrelationships between risky health behaviors is critical for health promotion efforts. Conceptual frameworks for understanding substance misuse (e.g. stepping-stone models) have not yet widely incorporated other risky behaviors, including those related to sexual health.

OBJECTIVES:

The goals of this study were to assess the relationship between early sexual debut and cannabis use, examine the role of licit substance use in this association, and evaluate differences by gender and race/ethnicity.

METHODS:

Data came from the National Comorbidity Survey-Replication (NCS-R). Primary analysis was restricted to respondents who reported sexual debut at ≥12 years (n = 5,036). Age at sexual debut was categorized as early (<18 years), average (18 years) and late (>18 years). Logistic regression was used to assess the relationship between age at sexual debut and cannabis use. Interaction terms were used to evaluate effect modification by gender and race/ethnicity.

RESULTS:

Later age of sexual debut was associated with lower odds of cannabis use relative to the average age of debut (AOR = 0.50, 95% CI = 0.37-0.66). For every year that respondents delayed their sexual debut, the relative odds of lifetime cannabis use declined by 17%. After accounting for alcohol and tobacco use the association between early sexual debut and cannabis was attenuated (AOR = 0.90, 95% CI = 0.68-1.20), while later age of debut remained protective (AOR = 0.57, 95% CI = 0.42-0.78). Results were generally consistent across race/ethnicity and gender.

CONCLUSIONS:

Multifactorial intervention strategies targeting both sexual health and substance use may be warranted.

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By:  Cha S1, Masho SW1,2,3, Mezuk B1,4.

• 1 Department of Family Medicine and Population Health , School of Medicine, Virginia Commonwealth University , Richmond , Virginia , USA.
• 2 Department of Obstetrics and Gynecology, School of Medicine , Virginia Commonwealth University , Richmond , Virginia , USA.
• 3 Institute for Women's Health , Virginia Commonwealth University , Richmond , Virginia , USA.
• 4 Virginia Institute for Psychiatric and Behavioral Genetics , Virginia Commonwealth University , Richmond , Virginia , USA.
• Subst Use Misuse. 2016 Mar 20;51(4):439-48. doi: 10.3109/10826084.2015.1110177. Epub 2016 Feb 16. 

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Adolescent Sexual Minority Girls Are at Elevated Risk for Use of Multiple Substances

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