Development and psychometric properties of the Multidimensional Inventory of Recovery Capital (MIRC).

BACKGROUND: Researchers have developed several instruments to measure recovery capital-the social, physical, human, and cultural resources that help people resolve alcohol and other drug problems. However, existing measures are hampered by theoretical and psychometric weaknesses. The current study reports on process and psychometric outcomes for the Multidimensional Inventory of Recovery Capital (MIRC), a novel measure of recovery capital. METHODS: We used a three-phase, mixed methods approach to develop the MIRC. Individuals who identified as having resolved alcohol problems were recruited in each phase. Phase one focused on item development, with participants providing qualitative feedback on potential items. In phase two (pilot testing) and phase three (final psychometric evaluation), participants completed revised versions of the MIRC to assess its psychometric strength and item performance. RESULTS: Phase one (n=44) resulted in significant item alteration, culminating in a 48-item pilot measure. Pilot testing analyses (n=497) resulted in the deletion or replacement of 17 items. In the final psychometric evaluation (n=482), four additional items were deleted, resulting in a 28-item MIRC comprising four subscales measuring social, physical, human, and cultural capital. The psychometric properties of the final MIRC and its subscales ranged from sound to strong, with high response variability suggesting appropriate item discrimination. CONCLUSION: Results confirm the psychometric strength of the MIRC and underscore the importance of incorporating the insights of diverse samples of people in recovery. The MIRC holds promise as an assessment tool in future research and is available for use at no cost in treatment and community-based settings.

Cannabis Adaptation During and After Alcohol Ignition Interlock Device Installation: A Longitudinal Study.

OBJECTIVE: A common intervention to prevent alcohol-impaired driving are alcohol ignition interlock devices (IIDs), which prevent drivers with a blood alcohol concentration greater than .025% from starting the car. These devices force drivers to adapt their drinking to accommodate the device. Prior studies indicated a transfer of risk as some drivers with an IID may increase cannabis use as they decrease alcohol use. This study examines whether this increase in cannabis use persists after IID removal when alcohol use reverts to pre-IID levels. METHOD: The data are from the Managing Heavy Drinking (MHD) study of drivers in New York State. The MHD is a comprehensive three-wave study of drivers convicted of driving under the influence from 2015 to 2020. Participants (N = 189) completed all waves, and provided oral fluid/blood and hair samples to measure cannabis and alcohol use, respectively. Mixed between-within analysis of variance was conducted to assess cannabis use at IID installation (Time 1), removal (Time 2), and at 6-month follow-up (Time 3). RESULTS: In aggregate, participants increased their cannabis use over the course of the study. Drivers who decreased their alcohol use while the IID was installed on their car significantly increased their cannabis use while the IID was in place and further increased cannabis use after the device's removal. CONCLUSIONS: IIDs are efficacious in preventing alcohol-impaired driving. However, in some cases, they may have the unintended effect of increasing other substance use. The current study outlines the need for supplemental treatment interventions while on IID to prevent a transfer of risk to other substances, or polysubstance use after the device is removed.

Examining the role of trauma in alcohol interlock performance: A structural pathway analysis.

OBJECTIVE: Self-medication using alcohol is a common coping response among individuals dealing with trauma as is driving under the influence of alcohol (DUI). A common intervention for drivers convicted of DUI, is an alcohol ignition interlock device (IID)-which requires breath samples before starting the car. If the sample is above a predetermined limit (.025), the car will not start, thus preventing impaired driving. IIDs are an effective intervention to reduce rates of drinking and driving among high risk populations; however, limited research has examined how traumatic experiences may impact performance on IIDs. METHODS: This study is an archival analysis of the Managing Heavy Drinking (MHD) study of drivers in New York state. The MHD is a comprehensive study of drivers convicted of a DUI from 2015-2020. Participants (N = 121) completed questionnaires and provided consent to retrieve information from interlock providers. Outcome variable included high BAC lockout ratios (number of high BAC lockouts [BAC>.08]/number of clean blows [BAC ≤ .025]). Other variables included demographic variables, alcohol treatment history, trauma experiences, and prior DUI history. Variables were entered into a structural equation model. RESULTS: In the final structural model, pathways that demonstrated a p-value of greater than .10 were dropped from the model. This produced acceptable overall model fit statistics (χ2 = 27.059(10), p=.003; CFI = .900; NFI = .898; RMSEA = .063). A significant pathway was found from the trauma measure to alcohol use (ß = .132), and from alcohol use to interlock performance (ß = .636). However, no significant relationship was found between trauma and interlock performance other than through alcohol use. CONCLUSIONS: The current study provides a useful framework upon which to understand the role traumatic experiences have on alcohol IID performance. Traumatic experiences are in of themselves insufficient to impact IID performance directly, but it may indirectly impact IID performance through increasing alcohol use.

Twelve-month organizational study examining the associations among behavioral healthcare worker's perceptions of autonomy, decision-making power, organizational commitment, and burnout: Reconceptualizing the role of commitment in shaping staff member experiences of the work environment.

Previous research has demonstrated that behavioral healthcare workers' experiences of autonomy and decision-making power in the workplace are positively associated with their commitment to the organization and negatively associated with occupational burnout. Models examining the relationships between workplace climate and staff member well-being generally conceptualize workplace climates as predictors of individual commitment and burnout. However, the relationships among these constructs have primarily been explored in cross-sectional study designs. The current study adds to the existing literature by examining the relationships among perceived autonomy and decision-making power in the organizational climate, and individual levels of organizational commitment and burnout over a 12-month period (N = 43). The study was done in a public hospital's behavioral healthcare department in the Western New York region. Cross-lagged panel analyses were conducted to assess if time-one scores on perceived autonomy and decision-making power predicted time-two scores of organizational commitment and burnout. Findings indicate that, contrary to popular conceptualization, individual staff member's commitment to the organization predicted future states of perceived autonomy and decision-making power. Individual commitment to the organization may be a driving factor in how staff members experience and perceive the service environment.

Qualitative insights in item development for a comprehensive and inclusive measure of recovery capital.

Background: Item specification is foundational to measurement development but rarely reported in depth. We address this gap by explicating our use of qualitative methods to ground and develop items for a new recovery capital measure, the Multidimensional Inventory of Recovery Capital. Method: We recruited a diverse sample of service providers (n = 9) and people in recovery from alcohol problems (n = 23) to provide feedback on an item pool assessing social, human, physical, community, and cultural capital. Using applied qualitative analysis, we coded findings from interviews and focus groups and made final decisions by consensus regarding item elimination, retention, or revision. This process yielded a 49-item draft measure. Results: Only nine items from an initial 90-item list were retained in their original form. Participant feedback guided item elimination, addition, and revision for linguistic or conceptual clarity. We detected little systematic variation in feedback based on income or race; however, there were stark divergences on particular items based on recovery pathway (i.e. 12-step versus other approaches). Conclusions: The high degree of alteration to the item pool highlights the importance of establishing validity with respondents. Response variation based on recovery pathway suggests the need for broad heterogeneity in respondents. Measures that are sensitive, psychometrically sound, and aligned with theory are critical for advancing research on recovery capital and related disparities for diverse populations.

Convicted drinking and driving offenders: Comparing alcohol use before and after the pandemic outbreak.

BACKGROUND: Before the COVID-19 pandemic, very little was known about the impact of social isolation on individuals' alcohol use and misuse. This study examines how socially isolated individuals with a history of heavy drinking used alcohol during the pandemic. METHODS: Data for this study came from an add-on to the Managing Heavy Drinking (MHD) longitudinal study of drivers convicted of DWI that was conducted in Erie County, New York. Pre-COVID information (October 2019-March 2020) was augmented with a COVID-19 questionnaire collected between July and August 2020. A total of 92 participants completed the COVID-19 survey. RESULTS: The sample of problem drinkers showed a significant increase after the pandemic outbreak in the average number of drinking days from 1.99 to 2.49 per week (p = 0.047), but a significant decrease in the average number of drinks per drinking day, from 3.74 to 2.74 (p = 0.003). The proportion of individuals who drank more frequently was greater among those who, before the outbreak had an Alcohol Use Disorders Identification Test (AUDIT) score <8 (26% increase) compared with those with an AUDIT score of >8 (13%). Alcohol treatment was also associated with the frequency of drinking, with individuals who were not in alcohol treatment showing a 16% increase in frequency compared with a 10% increase among those in treatment. Further, individuals who, after the outbreak worried about their health (30%) or finances (37%) reported greater increases in the frequency of drinking than those who did not worry about their health (17%) or finances (10%). CONCLUSIONS: Overall, the individuals in our sample showed small changes in the frequency andheaviness of drinking after the outbreak of COVID-19, effects that opposite in direction from one another and thus resulted in no overall change in drinks consumed. Nonetheless, we identified factors that influenced the effects of the pandemic on drinking behavior among individuals convicted of DWI, which emphasizes the need to individualize these individuals' treatment, particularly in the context of dramatic environmental change.

Changes in Alcohol Use and Drinking and Driving Outcomes From Before Arrest for Driving Under the Influence to After Interlock Removal.

BACKGROUND: Half of the offenders convicted of impaired driving in the United States are sentenced to install alcohol ignition interlock devices (IIDs), which prevent them from starting their vehicles if they have been drinking. No research has yet explored offenders' patterns of alcohol consumption and driving under the influence of alcohol (DUI) from the time before the arrest to the time period after the IID is installed. This study aims to fill that gap in knowledge. METHODS: Using the Timeline Follow-back interview procedure, we assessed the daily drinking of 153 convicted DUI offenders' self-reported total alcohol consumption and rates of self-reported driving after drinking over 4 phases: before DUI arrest, between arrest and IID installation, during the phase on the interlock, and after the interlock is removed. Because information about behaviors in each period was not available for every participant, comparisons were made using paired-sample contrasts. RESULTS: Compared with before the arrest, total alcohol use decreased by 50% in the 4-month phase following arrest and before IID installation, though it did not change much afterward. The frequency of drinking and driving decreased sharply after the arrest (-82%), with further decrease upon installation of the interlock (-58%, p = 0.05). The frequency of drinking and driving after the IID was removed returned to preinstallation drinking and driving status (+58%, p = 0.01). CONCLUSIONS: Participants made significant adjustments to their drinking behavior by adhering to the traditional DUI driving restrictions in the postarrest phase. Although installation of an IID was not associated with a significant change in drinking, it further reduced the frequency of drinking and driving. Evaluations of the IID experience should take into account information on an individual's drinking and DUI behaviors not only before the IID was installed, but before the individual was arrested.

Understanding non-installers of the ignition interlock device: A qualitative analysis.

INTRODUCTION: Literature notes the efficacious use of alcohol ignition interlock devices (IID) in reducing rates of drinking and driving while installed on the vehicle. Some drivers who are convicted of driving while intoxicated (DWI) elect to have their license suspended/revoked instead of installing the device. These individuals represent a high-risk subsample of drivers, yet limited literature has addressed this concern. The current study seeks to fill this gap using qualitative interviews addressing: (i) why do non-installers make the choice to not install a mandated IID; and (ii) how are non-installers managing without the IID? METHODS: The study utilises the Managing Heavy Drinkers study of drivers in Erie County, New York, USA. Participants were purposively sampled from a group of non-installers (n = 6; four females, two males) who completed semi-structured interviews. Constructed grounded theory was used to develop a theoretical understanding of participant's experiences. RESULTS: To understand why participants elect not to install the IID, thematic analysis revealed: alleviating constraints, predominantly the financial burdens associated with an IID, and institutional mistrust. Additionally, data revealed that participants are managing without the IID by mitigating apprehension. This included driving cautiously to avoid detection and utilising alternative transportation. DISCUSSION AND CONCLUSIONS: This study furthers understanding of why drivers convicted of a DWI elect not to install an IID. Future research should seek to identify barriers to IID installation. This work provides evidence for establishing institutional protocols that ensure drivers convicted of a DWI receive consistent and correct information about the IID process.

Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers.

PURPOSE: Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. METHODS: A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. RESULTS: Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. CONCLUSION: Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.

Typologies of Drivers Convicted of Driving Under the Influence of Alcohol as Predictors of Alcohol Ignition Interlock Performance.

Background: Alcohol ignition interlock devices (IIDs) reduce rates of drinking and driving when installed on the vehicles of offenders. While the IID is installed on their vehicle, some drivers adapt their drinking behaviors, while others cannot. Heavy alcohol use and mental health concerns reduce treatment adherence in clinical settings, but it has not yet known how they pertain to behavioral adaptation to IIDs. Objectives: This study focuses on identifying driver typologies as predictors of performance while on alcohol IIDs. Methods: The study utilizes the Managing Heavy Drinking study of drivers in New York state. Participants (N = 101; 59 males, 42 females) completed questionnaires assessing demographic information, drinking behaviors, driving history and mental health measures. All participants had been convicted of a DUI, and installed an IID. Latent class analysis was used to establish typologies and predict lockout ratios. Results: Four typologies emerged and drivers with elevations in mental health concerns had significantly worse lockout ratios than those in other classes. Conclusions: The current study may provide support for interventions designed to identify drivers with comorbid mental health concerns and tailor appropriate interventions to administer while the IID is installed with the aim of improving behavioral adaptation to the device.

The impact of interlock installation on driving behavior and drinking behavior related to driving.

OBJECTIVE: There is a substantial body of evidence that the recidivism of impaired-driving offenders is reduced while an ignition interlock device (IID) is on their vehicles. This study examines changes in driving behaviors and drinking behaviors used by DWI offenders to manage driving with the IID. METHODS: A total of 166 IID participants who completed two surveys covering the period from arrest to IID installation (T1) and during IID use (T2) were examined. Four domains were covered: demographics, driving environments and transportation needs, reported driving activity, and reported drinking activities. Participants were on average 38 years old, 43% were female, 35% completed college, 34% had an income of more than $50,000, and 83% were employed. For those who provided it, the mean blood alcohol content (BAC) at arrest was .184 g/dL, with only 8 (5%) individuals below .08 g/dL, and 93 (56%) at over .18 g/dL. About 45% were repeat DWI offenders. RESULTS: Between T1 and T2 there was a slight increase in acknowledging public transportation was available (p=.001), an increase in other individuals driving the interlock-equipped vehicle (p=.002), an increase in the number of vehicles in the household not registered to the DWI offender (p< .001), and an increase in the number of participants who reported that driving was important to their lifestyle (p=.008). Initial (T1) expectations about whether the interlock would be a problem were significantly different from actual experiences reported in T2 (p<.001). With respect to alcohol consumption, 14% reported abstinence at T2 compared to 2% at T1 (p=.001) and the number of drinks per drinking occasion decreased from a mean of 4.90 at T1 to 3.14 at T2 (p=.001), but the number of drinking occasions increased by a third (p=.003). The number of drinking locations (p=.001), the frequency of stopping after work for a drink (p=.001), and drinking at a bar all decreased (p<.001). CONCLUSIONS: Interlock users make some adjustments in how they drink, the amount they drink, and where they drink. This finding suggests that there may be methods that can be used to extend the benefits of the IID beyond the sanction period.

Potential for cannabis adaptation among participants in a drunk driving intervention.

BACKGROUND: Some alcohol interventions have been found to have the adverse outcome of increasing non-alcohol-related substance use. It is unknown, however, how changes in alcohol use over the course of alcohol ignition interlocks - a common DUI intervention - may impact other substance use. METHODS: Alcohol and cannabis use were measured using hair ethylglucuronide and Delta-9-Tetrahydrocannabinol concentrations in blood, respectively. Participants (N = 69) were measured at the interlock installation period and again 6-months later while the interlock was installed. A mixed ANOVA was conducted to examine changes in levels of ethanol and THC over time. RESULTS: On measures of marijuana use, there was a significant interaction effect between the group that increased alcohol use and time F(2, 66) = 7.863, p =.001; partial η 2 =.192; as well as a main effect for time F(2, 66) = 21.106, p <.001; partial η 2 =.242. CONCLUSIONS: Installing interlocks may inadvertently increase cannabis use among those who decrease alcohol use. Crash risk associated with cannabis use is notably less than that of alcohol use, however, continued cannabis use may be problematic when the device is removed and alcohol use is expected to return to the higher pre-interlock levels.

Psychometric Properties of the Assessment of Recovery Capital (ARC) Instrument in a Diverse Low-Income Sample.

Background: Recovery capital is a theoretical construct elucidating the resources that support recovery from addiction. The 50-item Assessment of Recovery Capital (ARC) instrument and related brief-format versions are the predominant measures of this construct. However, some of the ARC's psychometric properties are not well-established, particularly in racially and economically diverse populations. Objectives: We aimed to determine if the ARC is a valid and reliable measure of recovery capital in a diverse sample. Methods: Paper-and-pencil survey data were collected between March 2017 and May 2018 from a low-income, racially diverse sample of adults in recovery (N = 273). Participants were recruited from nontreatment community settings throughout a mid-sized northeastern U.S. city. They completed the ARC and sociodemographic questions. To determine the ARC's reliability and factor structure, we used item-level analyses and Cronbach's alpha, followed by confirmatory and exploratory factor analyses. Results: Several items performed poorly, having means close to response extremes and problematically small variances. Cronbach's alpha for the full measure was α = .92; however, alphas for the majority of subscales were below .70. The a priori 10-factor model solution failed, preventing interpretation of the confirmatory factor analysis results. Exploratory factor analysis revealed that although the 10-factor model marginally fit the data, items did not load together as proposed. Not once did all five subscale items load highly on the same factor. Conclusions/Importance: The ARC has substantial weaknesses in its theoretical alignment, item performance, and psychometric properties with diverse populations. We recommend the development of a new multidimensional, theory-aligned measure, following a rigorous measurement development protocol.

Is deployment status the critical determinant of psychosocial problems among reserve/guard soldiers?

A general assumption that deployment is the primary catalyst for psychological and social difficulties may contribute to underrecognition and undertreatment of problems among never-deployed service members (i.e., having no history of ever being deployed). We aimed to determine if ever-deployed (i.e., having a history of at least one deployment) and never-deployed United States Army Reserve and National Guard (USAR/NG) soldiers differed in mental health, substance use, and resiliency factors, and to determine the relative influence of deployment status and each of these factors on poor psychosocial outcomes. We analyzed a subset of data from Operation: SAFETY (Soldiers and Families Excelling Through the Years) (N = 404), an ongoing study examining the health and well-being of USAR/NG soldiers. Bivariate analyses demonstrated that soldiers did not significantly differ across a range of measures on the basis of deployment status (ps > 0.05). In fact, Factor Analyses and Discriminant Function Analysis revealed that deployment status was the least salient factor to psychosocial problems among the measured variables and that the observed variables could not accurately discriminate between ever-deployed and never-deployed soldiers, F(8, 374) = 1.34, p > .05. Measures of mental health and substance use were more salient to psychosocial problems (ps < .05). Measures of resiliency loaded negatively onto psychosocial problems (ps < .05), indicating that they contribute to better well-being. Targeting screening and intervention efforts only on soldiers who have been deployed will miss opportunities to intervene on an equally affected group. Resiliency factors should be considered as intervention targets. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A structural regression analysis of trauma-informed climate factors, organizational commitment, and burnout among behavioral healthcare providers in a large public hospital.

As an approach to organizational change, trauma-informed care is contextualized within the broader organizational literature by examining the associations between organizational conditions (i.e., psychological experiences of choice and collaboration in the work environment) with precursors to organizational effectiveness (i.e., affective commitment and burnout). The study occurred within a large public hospital's behavioral health department located in the Western New York region (N = 197). Structural regression analyses were conducted, and the primary findings, while nuanced, include support for choice and collaboration's prediction of employee commitment and burnout. Organizational interventions that improve worker's experiences of choice and collaboration may result in increased commitment, reduced burnout, and possibly improved effectiveness. Future research should employ longitudinal designs to further examine the condition-performance relationship and include direct measures of clinical effectiveness.

Gender Differences in Complex Posttraumatic Stress Symptoms, and Their Relationship to Mental Health and Substance Abuse Outcomes in Incarcerated Adults.

Complex trauma (CT; for example, childhood abuse) has been associated with significant behavioral health problems (i.e., mental health and substance use disorders) and symptoms that are consistent with complex posttraumatic stress disorder (C-PTSD). CT is prevalent in adult forensic populations, and particularly important for women as they tend to report more adverse consequences of exposure to traumatic stressors and are entering the criminal justice system at a heightened rate compared with men. However, no studies have empirically tested the relationship among CT, C-PTSD, and behavioral health problems with gender among incarcerated adults. The present study examined the relationship between gender and childhood abuse history, C-PTSD symptom severity, and behavioral health problems in 497 incarcerated adults. Findings indicate that women were more likely to report a history of childhood abuse, and more severe C-PTSD symptoms and behavioral health problems than men. Childhood abuse history significantly accounted for the gender difference observed in C-PTSD symptom severity. C-PTSD partially mediated the gender difference in psychiatric morbidity and in risk of hard drug use. Implications for trauma-informed and gender-responsive services and research in the adult criminal justice system are discussed.

Understanding the ecological context of mental, emotional, and behavioral health problems: A person-centered approach.

AIMS: The social/environmental context of youth is important for mental, emotional, and behavioral (MEB) health. This study used person-oriented methods to examine the influences of family, neighborhood, and poverty on late adolescent MEB outcomes. METHODS: Latent class analysis was used to discern significant clusters of at-risk, diverse young men (N = 625) based on contextual factors; differences in MEB outcomes were examined. RESULTS: Four classes emerged. Resourced and Protected youth had low risk across all indicators. Non-resourced and Protected youth lived in poverty, poor neighborhoods, but had good parenting; despite low delinquency, substance use was elevated. Resourced but High Risk youth had negative parenting but good neighborhoods. Outcomes included elevated delinquency and mental health problems. Non-resourced and High Risk youth were poor, lived in bad neighborhoods, and experienced abusive parenting; MEB outcomes were poor. CONCLUSION: Findings confirm the unique effects that negative parenting, neighborhoods, and poverty have on adolescent development. Implications are discussed.

Evaluating moderators of beneficial effects of severity-based assignment to substance use treatments in impaired drivers.

Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based on a severity-based assignment scheme, where individuals assessed to have greater problems or be at higher risk are assigned to longer, more intensive interventions. Recent research, using regression discontinuity analyses, provided support for severity-based assignment schemes in demonstrating that those with higher problem or risk levels assigned to longer and more intensive programming showed a significant reduction in drinking days over a follow-up interval, attributable to program assignment. Regression discontinuity analyses can also be used to assess moderators of this assignment benefit. We report an assessment of the impact of eight potential moderators of assignment benefit, derived from a factor analysis of the Research on Addictions Self-Inventory screening instrument. Five of the eight factors were found to moderate the assignment benefit: Negative Affect, Sensation Seeking, High Risk Lifestyle, Alcohol Problems, and Family History. The significance of these results for developing more effective program assignment procedures is discussed.

A resilience framework: Sexual health trajectories of youth with maltreatment histories.

There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants' sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.

A parenting education program for women in treatment for opioid-use disorder at an outpatient medical practice.

Opioid use during pregnancy poses serious risks for the mother and the unborn child. Opioid-use disorder may be managed with medication-assisted treatment (MAT) in an outpatient setting, but few MAT practices specifically address the challenges faced by pregnant women. This article describes a medical office-based educational support group for women in MAT for opioid-use disorder who were pregnant and/or parenting young children. Focus groups were conducted to elicit patient feedback. Women indicated that they found the educational support groups beneficial and offered suggestions. In-office educational support groups for pregnant women in treatment for opioid-use disorder are feasible and well received.