7 resultados para adolescence, anxiety, coping, substance use, mediation analysis

em DRUM (Digital Repository at the University of Maryland)


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Substance use is prevalent among adolescents, with two-thirds trying alcohol and half trying an illicit drug by twelfth grade (Miech et al., 2015). Substance use is known to affect academic performance. This study utilized nationally representative data from the 2013 Monitoring the Future twelfth grade survey to examine the relationships between substance use, skipping school, grades, and academic engagement. One-quarter of respondents (26%) had never used a substance. The majority (67%) had used at least one substance during the past year. Substance use during their lifetime but not during the past year was uncommon (7%). Lifetime non-users were less likely than past-year users to skip school during the past month and to have low grades. Lifetime non-users also had greater academic self-efficacy and emotional academic engagement relative to past-year users. These findings underscore the importance of screening and intervention for substance use to promote academic achievement and adolescent wellbeing.

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Poor medication adherence is problematic among HIV positive, low-income African-American substance users. Substance use has been shown to be associated with poor medication adherence, though we do not know the mechanism that underlies this relationship. Lack of positive environmental rewards and the propensity to discount delayed rewards may be possible mechanisms to explain this relationship. Using baseline data from a randomized controlled trial, we examined the relationships between substance use and medication adherence, testing both environmental rewards and delay discounting as independent mediators. There was a main effect of substance use on adherence, such that high frequency of substance use predicted poor adherence. There was also a main effect of environmental rewards on adherence, such that a lack of environmental reinforcement predicted poor adherence. This study shed light on the processes that contribute to low adherence, namely substance use and lack of environmental contingencies, and suggests important targets for intervention.

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HIV-positive individuals engage in substance use at higher rates than the general population and are more likely to also suffer from concurrent psychiatric disorders and substance use disorders. Despite this, little is known about the unique clinical concerns of HIV-positive individuals entering substance use treatment. This study examined the clinical characteristics of clients (N=1712) entering residential substance use treatment as a function of self-reported HIV status (8.65% HIV-positive). Results showed higher levels of concurrent substance use and psychiatric disorders for HIV-positive individuals, who were also significantly more likely to meet criteria for bipolar disorder and borderline personality disorder. Past diagnoses of depression, posttraumatic stress disorder, and social phobia were also significantly more common. Study findings indicate a need to provide more intensive care for HIV-positive individuals, including resources targeted at concurrent psychiatric problems, to ensure positive treatment outcomes following residential substance use treatment discharge.

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The purpose of this study is to explore the relationship between various collegiate experiences including substance use, religiosity, campus climate, academic life, social life, self-concept, satisfaction with college, and perceived feelings of depression among Asian American college students compared to other racial groups. Employing Astin’s (1993) I-E-O model, the study utilized the 2008 Cooperative Institutional Research Program (CIRP) the Freshman Survey (TFS) and the follow up College Senior Survey (CSS) in 2012 with the final sample of 10,710 students including 951 Asian American students. Descriptive analysis, cross-tabulations, blocked hierarchical multiple regression analysis, the equality of the unstandardized beta coefficients from the regression analyses, and a one-way ANOVA were conducted for the data analysis. Asian American students who are female, from low SES backgrounds, academically less achieved, frequent substance users, less religiously involved, and less satisfied with overall college experiences showed higher levels of feeling depressed. For the rate of feeling depressed across racial groups, Asian American college students showed the highest rate of feeling depressed while White students reported the lowest rate of feeling depressed. For Asian American college students, feeling depressed in high school, hours spent per week on studying and homework, and self-confidence in intellectual ability were the most significant predictors of feelings of depression while drinking beer, drinking liquor, spirituality, failing to complete homework on time, hours spent per week on socializing, self rated self-confidence in social ability, and satisfaction with overall college experiences were significant predictors of feelings of depression. Asian American college students spent the longest hours on studying and homework, reported the highest GPA, but showed the lowest self-confidence on intellectual ability. For all four racial groups, feeling depressed in high school and self-confidence in intellectual ability were significant predictors of feelings of depression in common. Implications for practice and directions for future research emphasize the need for better understanding the unique cultural background and impact of academic life associated with feelings of depression among Asian American college students and developing customized psycho-educational and outreach programs to meet unique needs for psychological well-being for each racial group on campus.

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Human immunodeficiency virus (HIV) is a condition in which immune cells become destroyed such that the body may become unable to fight off infections. Engaging in risk-taking behaviors (e.g., substance use) puts people at heightened risk for HIV infection, with mid-to-late adolescents at increasing risk (Leigh & Stall, 1993). Environmental and neurological reasons have been suggested for increased risk-taking among adolescents. First, family-level precursors such as parent-adolescent conflict have been significantly associated with and may pose risk for engaging in substance use and risk-taking (Duncan, Duncan, Biglan, & Ary, 1998). Thus, parent-adolescent conflict may be an important proximal influence on HIV risk behaviors (Lester et al., 2010; Rowe, Wang, Greenbaum, & Liddle, 2008). Yet, the temporal relation between parent-adolescent conflict and adolescent HIV risk-taking behaviors is still unknown. Second, at-risk adolescents may carry a neurobiological predisposition for engaging in trait-like expressions of disinhibited behavior and other risk-taking behaviors (Iacono, Malone, & McGue, 2008). When exposed to interpersonally stressful situations, their likelihood of engagement in HIV risk behaviors may increase. To investigate the role of parent-adolescent conflict in adolescent HIV risk-taking behaviors, 49 adolescents ages 14-17 and their parent were randomly assigned to complete a standardized discussion task to discuss a control topic or a conflict topic. Immediately after the discussion, adolescents completed a laboratory risk-taking measure. In a follow-up visit, eligible adolescents underwent electrophysiological (EEG) recording while completing a task designed to assess the presence of a neurobiological marker for behavioral disinhibition which I hypothesized would moderate the links between conflict and risk-taking. First, findings indicated that during the discussion task, adolescents in the conflict condition evidenced a significantly greater psychophysiological stress response relative to adolescents in the control condition. Second, a neurobiological marker of behavioral disinhibition moderated the relation between discussion condition and adolescent risk-taking, such that adolescents evidencing relatively high levels of a neurobiological marker related to sensation-seeking evidenced greater levels of risk-taking following the conflict condition, relative to the control condition. Lastly, I observed no significant relation between parent-adolescent conflict, the neurobiological marker of behavioral disinhibition and adolescent engagement in real-world risk-taking behavior.

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Adolescence is characterized by dramatic hormonal, physical, and psychological changes, and is a period of risk for affective and anxiety disorders. Pubertal development during adolescence plays a major role in the emergence of these disorders, particularly among girls. Thus, it is critical to identify early biomarkers of risk. One potential biomarker, the error-related negativity (ERN), is an event-related potential following an erroneous response. Individuals with an anxiety disorder demonstrate a greater ERN than healthy comparisons, an association which is stronger in adolescence, suggesting that pubertal development may play a role in the ERN as a predictor of anxiety. One form of anxiety often observed in adolescence, particularly among girls, is social anxiety, which is defined as anxiety elicited by social-evaluative contexts. In adults, enhancements of the ERN in social-evaluative contexts is positively related to social anxiety symptoms, suggesting that the ERN in social contexts may serve as a biomarker for social anxiety. This dissertation examined the ERN in and its relation with puberty and social anxiety among 76 adolescent girls. Adolescent girls completed a flanker task in two different

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Suburban lifestyle is popular among American families, although it has been criticized for encouraging automobile use through longer commutes, causing heavy traffic congestion, and destroying open spaces (Handy, 2005). It is a serious concern that people living in low-density suburban areas suffer from high automobile dependency and lower rates of daily physical activity, both of which result in social, environmental and health-related costs. In response to such concerns, researchers have investigated the inter-relationships between urban land-use pattern and travel behavior within the last few decades and suggested that land-use planning can play a significant role in changing travel behavior in the long-term. However, debates regarding the magnitude and efficiency of the effects of land-use on travel patterns have been contentious over the years. Changes in built-environment patterns is potentially considered a long-term panacea for automobile dependency and traffic congestion, despite some researchers arguing that the effects of land-use on travel behavior are minor, if any. It is still not clear why the estimated impact is different in urban areas and how effective a proposed land-use change/policy is in changing certain travel behavior. This knowledge gap has made it difficult for decision-makers to evaluate land-use plans and policies. In addition, little is known about the influence of the large-scale built environment. In the present dissertation, advanced spatial-statistical tools have been employed to better understand and analyze these impacts at different scales, along with analyzing transit-oriented development policy at both small and large scales. The objective of this research is to: (1) develop scalable and consistent measures of the overall physical form of metropolitan areas; (2) re-examine the effects of built-environment factors at different hierarchical scales on travel behavior, and, in particular, on vehicle miles traveled (VMT) and car ownership; and (3) investigate the effects of transit-oriented development on travel behavior. The findings show that changes in built-environment at both local and regional levels could be very influential in changing travel behavior. Specifically, the promotion of compact, mixed-use built environment with well-connected street networks reduces VMT and car ownership, resulting in less traffic congestion, air pollution, and energy consumption.