Personality characteristics in the mid-forties predict women's smoking cessation in their mid-sixties.

This study examined whether personality characteristics measured when a woman is in her mid-40s can predict success in sustained smoking cessation 22 years later, when the woman is in her mid-60s. Multivariate logistic regression analyses were conducted on data from a sample of 195 women (M ages 43 and 65, respectively), who were regular smokers and participated in a longitudinal study from 1983 to 2009. The results suggest that women who exhibited low self-control, high resistance to rules, impulsivity, and sensation seeking in their mid-40s were significantly less likely to succeed in quitting smoking for a period of 5 years or more by the time they reached their mid-60s. Addressing some personal characteristics in smoking cessation programs might enhance their effectiveness and success.

Risk factors for distress in the adolescent children of HIV-positive and HIV-negative drug-abusing fathers.

In contrast to previous research on parental drug abuse, the present study examined comorbid drug addiction and HIV infection in the father as related to his adolescent child's psychological distress. Individual structured interviews were administered to 505 HIV-positive and HIV-negative drug-abusing fathers and one of their children, aged 12-20. Structural equation modelling tested an hypothesized model linking paternal latent variables, ecological factors and adolescent substance use to adolescent distress. Results demonstrated a direct pathway between paternal distress and adolescent distress, as well as an indirect pathway; namely, paternal distress was linked with impaired paternal teaching of coping skills to the child, which in turn was related to adolescent substance use and, ultimately, to the adolescent's distress. There was also an association between paternal drug addiction/HIV and adolescent distress, which was mediated by both ecological factors and adolescent substance use. Findings suggest an increased risk of distress in the adolescent children of fathers with comorbid drug addiction and HIV/AIDS, which may be further complicated by paternal distress. Results suggest several opportunities for prevention and treatment programmes for the children of drug-abusing fathers.

Personal, interpersonal, and cultural predictors of stages of cigarette smoking among adolescents in Johannesburg, South Africa.

OBJECTIVE: This study examined the personal, parental, peer, and cultural predictors of stage of smoking among South African urban adolescents. DESIGN: A cross-sectional design was employed. A stratified random approach based on census data was used to obtain the sample. Analyses were conducted using logistic regression. SETTING: The study took place in communities in and around Johannesburg, South Africa. SUBJECTS: Participants consisted of 731 adolescents in the age range of 12-17 years old. The sample was 47% male and 53% female, and contained four ethnic classifications: white, black, Indian, and "coloured" (a South African term for mixed ancestry). METHODS: A structured, in-person interview was administered to each participant in private by a trained interviewer, after obtaining consent. MAIN OUTCOME MEASURES: The dependent variables consisted of three stages of smoking: non-smoking, experimental smoking, and regular smoking. The independent measures were drawn from four domains: personal attributes, parental, peer, and cultural influences. RESULTS: Factors in all four domains significantly predicted three different stages of smoking. Personal attributes (internalising and externalising) distinguished among the three stages. Parental factors (for example, affection) reduced the odds of being a regular smoker compared with an experimental smoker or non-smoker, but did not differentiate experimental smokers from non-smokers. Findings from the peer domain (for example, peer substance use) predicted an increase in the risk of being a regular smoker compared with an experimental smoker or non-smoker. In the cultural domain, ethnic identification predicted a decrease in the risk of being a regular smoker compared with an experimental smoker, whereas discrimination and victimisation predicted an increase in the risk of being an experimental smoker compared with a non-smoker. CONCLUSIONS: All the domains were important for all four ethnic groups. Four psychosocial domains are important in distinguishing among the three stages of smoking studied. Some predictors differentiated all stages of smoking, others between some of the stages of smoking. Therefore, intervention and prevention programmes which are culturally and linguistically sensitive and appropriate should consider the individual's stage of smoking.

Risk factors for adolescent marijuana use across cultures and across time.

An integrated analysis of the data from 3 different studies was conducted to examine the early psychosocial predictors of later marijuana use among adolescents. Longitudinal analysis of interview data was performed. The data used in the analysis were derived from (a) a sample of 739 predominantly White adolescents representative of the northeastern United States, (b) a sample of 1,190 minority adolescents from the East Harlem section of New York City, and (c) a sample of 1,374 Colombian adolescents from two cities in Colombia, South America. In 2 of the samples, participants were interviewed in their homes, and in the 3rd study, participants were assessed in school. The predictors included a number of variables from (a) the personality domain, reflecting the adolescents' conventionality and intrapsychic functioning; (b) the family domain, representing the parent-child mutual attachment relationship and parental substance use; (c) the peer domain, reflecting the peer group's delinquency and substance use; and (d) the adolescents' own use of legal drugs. The dependent variable was adolescent marijuana use. The results of the analysis demonstrated remarkable consistency in the risk and protective factors for later marijuana use across the 3 samples, attesting to the robust nature of these predictors and their generalizability across gender, time, location, and ethnic/cultural background. These findings have important implications for designing intervention programs. Programs aimed at preventing adolescent marijuana use can be designed to incorporate universal features and still incorporate specific components that address the unique needs of adolescents from different groups.

Aggression in toddlers: associations with parenting and marital relations.

This study examined the relation among parenting factors, marital relations, and toddler aggression. A structured questionnaire was administered to both parents of 254 2-year-olds. The authors used correlation and hierarchical multiple regression analyses to assess the extent to which certain personality traits, drug use, parenting style, and marital conflicts were related to the toddlers' aggressive behavior. Results showed that the maternal child-rearing and parental aggression domains had a direct effect on toddler aggression. The domain of maternal child rearing also served as a mediator for the domains of marital relations, paternal child rearing, parental aggression, and parental drug use. The findings indicated that maternal child-rearing practices, personality attributes, and drug use were more important than paternal attributes in relation to toddler aggression. Implications for prevention among families at risk are discussed.

Adolescent illegal drug use: the impact of personality, family, and environmental factors.

This study examined the relationship between the domains of environmental factors, family illegal drug use, parental child-rearing practices, maternal and adolescent personality attributes, and adolescent illegal drug use. A nonclinical sample of 2,837 Colombian youths and their mothers were interviewed about intrapersonal, interpersonal, and environmental factors in their lives. Results indicated that certain environmental factors (e.g., violence, drug availability, and machismo), family drug use, a distant parent-child relationship, and unconventional behavior are risk factors for adolescent illegal drug use. As hypothesized, results showed that the adverse effects of family illegal drug use on adolescent drug use can be buffered by protective parental child-rearing practices and environmental factors, leading to less adolescent illegal drug use. Prevention and treatment efforts should incorporate protective environmental, familial, and intrapersonal components in order to reduce adolescent illegal drug use.

Behavioral medicine in medical education: report of a survey.

Behavioral medicine has become increasingly important in medical education over the past two decades, but adoption of its principles and methods has been slow. Behavioral medicine stresses the effects of human behavior on health and illness using a biopsychosocial approach. It also focuses on the use of the doctor-patient relationship, which, if developed using appropriate communication skills, can result in greater patient satisfaction and increased compliance. The authors surveyed all 124 American medical schools to assess both national trends and specific efforts in the teaching of behavioral medicine principles and methods. A review of the types of behavioral medicine programs offered reveals that eight percent of U.S. medical schools had integrated programs of behavioral medicine. Several successful and effective programs were identified, as were a number of specific curricular components. There are several options available to medical schools to integrate behavioral medicine into medical education. The authors conclude that medical education must include behavioral medicine in order to improve the health of the public and to meet the demands of a changing health care system.

Needle sharing: a longitudinal study of female injection drug users.

The objective of this study was to examine the psychosocial risk and protective factors related to needle-sharing behavior among female intravenous drug users (IDUs) positive (N = 96) and negative (N = 128) for human immunodeficiency virus (HIV). Participants in this longitudinal study were interviewed individually at two points in time, with a 6-month interval between interviews. The interviewers used a structured questionnaire, which included psychosocial measures and questions about drug and sexual risk behaviors. Data were analyzed using Pearson correlations and hierarchical regression analyses. The findings supported a developmental model in which the psychosocial domains and HIV status predicted T1 (initial) needle-sharing behavior, which in turn was related to T2 (follow-up) needle-sharing behavior. In addition, the relationship between personality and peer risk factors and T2 needle sharing was buffered by family-related protective factors. While HIV-positive status had a direct effect on T1 needle sharing with strangers, its effect was mediated by all of the psychosocial variables in its relation to T1 needle sharing with familiar people. Comparisons of these results were made with a companion study of male IDUs. The results suggest several intervention and treatment approaches that can be implemented at different points in the developmental pathways leading to risky needle-sharing practices among female IDUs.

The influence of maternal smoking during pregnancy on the toddler's negativity.

OBJECTIVE: To extend previous studies by looking at the effect of the mother's smoking during pregnancy on her toddler's negative behavior. DESIGN: A survey consisting of a structured questionnaire was administered to the mothers of 2-year-old toddlers. SETTING: The subjects were drawn from a community sample, as part of a larger study of mothers and their children. SUBJECTS: The subjects were 99 toddlers and their mothers taken from a community sample. Fifty-two of the mothers smoked throughout pregnancy, while 47 either stopped smoking during pregnancy or started smoking after childbirth. MEASURES: The measures consisted of scales with adequate psychometric properties, which, for the most part, were adapted from the literature. Measures included assessment of smoking behavior, the mother's personality/behavior, perinatal variables, demographic variables, and aspects of the mother-child relationship. RESULTS: Using logistic regression analyses, maternal smoking during pregnancy was found to be related to negativity in the child, controlling for demographic factors, perinatal factors, maternal personality attributes, and the mother-child relationship. CONCLUSIONS: The findings suggest that maternal smoking during pregnancy has an adverse effect on the child's negativity, and that a decrease in maternal smoking during pregnancy might be expected to lead to a decrease in the child's negativity. The relationship of maternal smoking during pregnancy and early childhood negativity to other problem behaviors remains to be explored.

Longitudinal pathways to condom use: a psychosocial study of male IDUs.

This longitudinal study examined the psychosocial risk and protective factors involved in condom use among 265 male IDUs. Subjects were individually interviewed at two points in time using a structured questionnaire, which included psychosocial measures and questions about drug use and condom use. Data were analyzed using Pearson correlations and hierarchical regression analyses. T1 condom use was the most powerful predictor of T2 condom use, with or without control on other variables. T1 family support for condom use, friends' support for condom use, adaptive coping with AIDS or the threat of AIDS, and planning to use condoms were significantly related to T2 condom use. Protective father factors enhanced the effects of other protective psychosocial factors, increasing T2 condom use. The results suggest several approaches for changing risk-taking sexual behavior in male IDUs: enhancing coping abilities, selecting peers who take fewer risks, and planning to use condoms.

Coping strategies of HIV-positive and HIV-negative female injection drug users: a longitudinal study.

This study longitudinally examined the psychosocial correlates of coping strategies among 165 HIV positive and 179 HIV negative female injection drug users (IDUs). Participants were interviewed twice using a structured questionnaire, with a 6-month interval between interviews. The questionnaire included psychosocial measures as well as measures of general coping and specific HIV-related coping. Data were analyzed using logistic regression analyses. The findings indicated that favorable factors in the psychosocial domains at Time 1 were significantly associated with an increased likelihood at Time 2 of the use of general coping and specific adaptive coping strategies, such as problem solving and seeking social support, and with a decreased likelihood at Time 2 of the use of maladaptive coping strategies, such as aggression and the use of illicit drugs. These findings highlight particular areas of psychosocial functioning that can be targeted by intervention programs to promote adaptive coping and minimize maladaptive coping among HIV positive and HIV negative female IDUs.

Transmission of risk factors across three generations.

The present study examined the association between the parent-grandmother relationship, the parenting of toddlers, and toddlers' anger. Parent-grandmother relations were assessed when the parents were adolescents. Patient-toddler relations were examined when the toddlers were two years of age. The sample consists of 185 2-yr-old toddlers, one of the parents of each toddler, and the corresponding grandmother of each toddler. The findings support our hypothesis that there would be an indirect effect of the grandmothers' personalities and child-rearing practices on their grandchildren through the influence of the grandmothers on the parents. The influence of both the grandmothers' and the parents' smoking behaviors on the toddlers' anger was mediated by their child-rearing practices. The significance of the findings from a multigenerational study are discussed with reference to incorporating them into prevention programs. The findings are consistent with the notion of the intergenerational transmission of risk factors--from grandparents to parents to toddlers.

Older sibling correlates of younger sibling drug use in the context of parent-child relations.

The purpose of this study was to examine older brother correlates of younger brother drug use in the context of parental influences and younger brother personality. The sample consisted of 278 White male college students and their oldest brothers, who volunteered to answer self-administered questionnaires. Results indicated that 3 domains of influence each had an independent impact on younger brother drug use: (a) parent-younger brother relationships and parent drug use, (b) older brother-younger brother relationships and older brother drug use, and (c) younger brother personality. Modeling of nondrug use and a strong attachment relationship in the parent-younger brother and sibling dyads, as well as younger sibling traits of conventionality, had strong links to low younger brother drug use. Our findings highlight the importance of modeling and mutual parent-child attachment relationships as well as sibling relationships as they relate to the possible etiology of drug use.

A multiple group psychotherapy approach to adolescents with psychiatric and substance abuse comorbidity.

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.

Coping among HIV negative and HIV positive female injection drug users.

The study examined the psychosocial determinants of coping ability in a cohort of 249 HIV positive and HIV negative female injection drug users (IDUs), using a cross-sectional retrospective design. Information collected using a structured questionnaire included data on psychosocial risk and protective factors in the personality, family, and peer domains, HIV status, and coping ability. Coping ability was associated with conventionality, greater control of emotions, less psychopathology, and family cohesion in both HIV positive and HIV negative subjects. The psychosocial factors affected coping in HIV positive and HIV negative IDUs via two different mediational models. The interactional findings supported the influence of risk/protective interactions in both groups. The findings demonstrate the impact of the interplay between personality factors and external support on coping ability in female IDUs.

The role of parents in protecting Colombian adolescents from delinquency and marijuana use.

OBJECTIVES: To identify general and differentiating risk and protective factors from domains of culture and ecology, peer, family, and personality, related to adolescent delinquency and marijuana use, and to study the protective role of the parent-child mutual attachment in offsetting cultural and ecological risk factors, leading to less delinquency and marijuana use. DESIGN: Cross-sectional analyses of interview data collected in Colombia. PARTICIPANTS: A total of 2837 Colombian adolescents, 12 to 17 years of age. SETTING: Adolescents were interviewed in their homes. MAIN MEASURES: Independent variables included measures from 4 domains: culture and ecology, peer, family, and personality. The dependent variables were delinquency and marijuana use. RESULTS: Several risk factors, such as tolerance of deviance and sensation seeking, were similarly related to both delinquency and marijuana use, suggesting that a common cause underlies the propensity to engage in different deviant behaviors. Some risk factors were more involved in delinquency and other risk factors were more highly related to the adolescent's marijuana use. Finally, when violence is endemic and illegal drugs are readily available, a close parent-child bond was capable of mitigating these risk factors, leading to less marijuana use and delinquency. CONCLUSIONS: The findings have implications for public health policy related to interventions in countries in which violence and drug use are prevalent. The results point to interventional procedures aimed at adolescents vulnerable to marijuana use and delinquency as well as efforts aimed at specific vulnerabilities in these areas. For example, reducing the risk factors and enhancing the protective factors for marijuana use and delinquency may result in less adolescent marijuana use and delinquency.

Pathways to marijuana use among adolescents: cultural/ecological, family, peer, and personality influences.

OBJECTIVE: To examine the linkages, cultural/ecological factors, and major psychosocial risk factors as they relate to drug use in a sample from Colombia, South America. METHOD: The participants were 1.687 adolescents living in mixed urban-rural communities in Colombia, South America. An individual interview was administered to youths in their homes by Colombian interviewers. The scales used were based on item intercorrelations grouped into the following risk categories: (1) adolescent personality, (2) family traits, (3) peer factors, and (4) cultural/ecological variables. RESULTS: Pearson correlations were computed for each variable and the frequency of marijuana use. Results show that each of the domains was related to adolescent marijuana use, with some notable gender differences. As regards the interrelation of domains, a mediational model was operative. CONCLUSIONS: Findings support a family interactional theory. The domains of family, personality, and peer factors had a direct effect on the adolescents' marijuana use. Implications for prevention are also addressed.

Psychosocial risk and protective factors for condom use among female injection drug users.

The authors examined the influences of domains of psychosocial risk and protective factors on male-partner condom use in a cobort of 209 female HIV-positive (HIV+) and HIV-negative (HIV-) injection drug users (IDUs) by use of a cross-sectional, retrospective design. Information collected from a structured questionnaire included data on psychosocial risk and protective factors in the personality, family, and peer domains; HIV status; and condom use. Among HIV+ IDUs, personality risk factors (e.g., unconventionality), family (e.g., low maternal identification), and peer factors were related to less male-partner condom use. Resources and condom availability were associated with greater male condom use with both HIV+ and HIV- IDUs. The psychosocial domains affected male condom use with both HIV+ and HIV- female IDU patients via two different mediational models. The findings suggest the need to use specific psychosocial interventions for risky sexual behavior among HIV+ and HIV- female IDUs.

Longitudinal study of co-occurring psychiatric disorders and substance use.

OBJECTIVE: To examine temporal priority in the relationship between psychiatric disorders and drug use. METHOD: Psychiatric assessments and drug use were completed at three different points in time, spanning 9 years. Structured interviews were administered to a cohort of youths and their mothers. Subjects were selected on the basis of their residence in either of two counties in upstate New York. The sample was predominantly white male and female youths, aged 1 through 10 years upon initial collection of data. Psychiatric diagnoses were assessed by a supplemented version of the Diagnostic Interview Schedule for Children Version 1, using computer algorithms designed to match DSM-III-R criteria to combine information from mothers and youths. Substance use information was obtained in the interviews. RESULTS: A significant relationship was found to exist between earlier adolescent drug use and later depressive and disruptive disorders in young adulthood, controlling for earlier psychiatric disorders. Earlier psychiatric disorders did not predict changes in young adult drug use. CONCLUSIONS: Implications for policy, prevention, and treatment include (1) more medical attention needs to be given to the use of legal and illegal drugs; and (2) a decrease in drug use may result in a decrease in the incidence of later psychiatric disorders.