Characteristics of adolescent psychiatric patients who engage in problematic behavior while intoxicated.

Although many adolescent psychiatric patients drink and use drugs, not all engage in problematic behaviors or experience social difficulties while intoxicated. The goal of this study was to identify characteristics of adolescent psychiatric patients for whom intoxication leads to behavioral, social, and medical problems. Alcohol-involved adolescent psychiatric inpatients were divided into high and low problem severity groups and compared on a number of measures. The groups did not differ in alcohol or drug consumption or psychiatric diagnoses. High problem severity was primarily associated with drinking in response to unpleasant affect and the belief that alcohol enhances social behavior. Explanations for the results are discussed, along with clinical implications.

Incarcerated adolescents' attributions for drug and alcohol use.

Incarcerated adolescents' attributions for drug use were investigated. A new 50-item questionnaire, the Inventory of Drug Taking Situations (IDTS), was used to assess reasons for use. The IDTS yields eight subscales corresponding to risky situations identified by Marlatt and others. On the IDTS, subjects indicate how frequently they used their drug of choice when confronted with each risky situation. The IDTS scales had good internal consistency and higher scores were significantly associated with self-reports of drug use frequency. Furthermore, IDTS scores were most valid for the type of drug the measure was filled out about. Adolescents reported that they tended to use more frequently in response to positive and/or interpersonal experiences, as opposed to negative and/or internal ones. Positive, negative, interpersonal, and internal reasons for use were all equally correlated with frequency of use. In the most heavily drug-involved adolescents, however, negative reasons were more highly correlated with frequency of use than positive reasons. Treatment implications are discussed.

Family dysfunction and alcohol and drug use in adolescent psychiatric inpatients.

This report examines the relationship between family functioning and substance abuse in adolescent psychiatric inpatients. The adolescents, who had been hospitalized after acute psychiatric crises, provided reports of drug and alcohol use, intoxication-related problems, and family functioning during the 4 months preceding hospitalization. Greater degrees of family dysfunction in the areas of affective responsiveness and role functioning were associated with higher levels of substance abuse. When age, sex, and diagnosis were controlled for, family dysfunction in these areas was still significantly associated with alcohol consumption but not with drug use or intoxication-related problems. Implications for treatment are discussed.