Nuorisorikollisuuden esiintyvyys, taustatekijät ja sovittelu

Tausta Vaikka nuorisorikollisuus on kriminologisen tutkimuksen perinteinen kohde, on edelleen tarvetta pitkittäistutkimuksille, joissa on laaja, koko väestöä edustava otos. Kriminaalipolitiikan alalla puolestaan rikosten sovittelu ja muut restoratiivisen oikeuden muodot ovat nousseet Suomessakin haastamaan perinteiset rikoskontrollin paradigmat, rangaistuksen ja hoidon. Tutkimuskysymykset Tutkimuksen pääkysymyksenä oli, mitkä lapsuudessa (8 v.) ja nuoruudessa (18 v.) mitatut psykososiaaliset tekijät ovat yhteydessä nuorisorikollisuuden (16-20 v.) määrään ja lajiin. Lisäksi yhtenä kysymyksenä oli, miten varusmiespalvelun aikaiset psykiatriset diagnoosit liittyvät nuorisorikollisuuteen. Lisäksi tutkimme nuorisorikollisuuden esiintyvyyttä ja palvelujen käyttöä, ja vertailimme eri informanttien (tutkimushenkilöt itse, vanhemmat ja opettajat) vastausten ennusvoimaa lasten tulevan rikollisuuden suhteen. Rikosten sovittelun osalta kysymyksenä oli, miten suomalainen sovittelukäytäntö vastaa restoratiivisen oikeuden teoriaa ja miten sovittelua pitäisi kehittää. Aineisto ja metodit Pitkittäistutkimuksemme aineistona oli valtakunnallisesti edustava satunnaisotos, joka vastasi 10% vuonna 1981 Suomessa syntyneistä suomenkielisistä pojista. Ensimmäinen tiedonkeruu tapahtui 1989, kun pojat olivat 8-vuotiaita. Tietoa kerättiin lomakekyselyin pojilta itseltään sekä heidän vanhemmiltaan ja opettajiltaan. Tietoja saatiin 2946 pojasta. Lasten lomakkeena oli Children’s Depression Inventory, vanhemman lomakkeena Rutter A2 ja opettajan lomakkeena Rutter B2. Toinen tiedonkeruu järjestettiin, kun pojat osallistuivat kutsuntoihin 1999. Tietoja saatiin 2330 pojasta. Lomakkeena oli Young Adult Self-Report . Puolustusvoimien rekisteristä saatiin tiedot poikien kutsunnoissa ja palvelusaikana (vuosina 1999-04) saamista psykiatrisista diagnooseista, jotka luokiteltiin kuuteen luokkaan: antisosiaalinen persoonallisuushäiriö, päihdehäiriöt, psykoottiset häiriöt, ahdistuneisuushäiriöt, masennustilat ja sopeutumishäiriöt. Tieto mahdollisesta diagnoosista saatiin 2712 pojasta. Rikollisuus operationalisoitiin poliisin ns. RIKI-rekisteriin vuosina 1998-2001 rekisteröityjen tekojen avulla, kun pojat olivat pääasiassa 16-20-vuotiaita. Rikosten määrän mukaan pojat jaettiin neljään ryhmään: ei rikoksia, 1-2 rikosta (satunnainen rikollisuus), 3-5 rikosta (uusintarikollisuus) ja yli 5 rikosta (aktiivinen uusintarikollisuus). Rikoslajeista muodostettiin viisi kategoriaa: huume-, väkivalta-, omaisuus-, liikenne- ja rattijuopumusrikollisuus. Analyysivaiheessa rekisteridatasta poistettiin liikennerikkomukset. Kaikkiaan tiedot mahdollisista poliisikontakteista saatiin 2866 pojasta. Sovitteludata koostui 16 sovittelujutun havainnoinnista Turussa vuosina 2001- 2003. Tulokset Kaikkiaan 23% pojista oli rekisteröity rikoksesta (poissulkien liikennerikkomukset) nelivuotisen tutkimusperiodin aikana 16-20-vuotiaana. Satunnaisia rikoksentekijöitä oli 15%, uusijoita 4% ja moninkertaisia uusijoita 4%. Rikokset kasautuivat moninkertaisille uusijoille: tämä 4%:n ryhmä teki 72% kaikista rikoksista . Omaisuus- ja liikennerikollisia oli eniten (kumpiakin 11%), ja huumerikollisia vähiten (4%). Kaikki rikoslajit korreloivat keskenään tilastollisesti merkitsevästi. Nuorisorikollisuuden itsenäisiä ennustekijöitä lapsuudessa olivat rikkinäinen perherakenne, vanhempien alhainen koulutustaso, lapsen käytösongelmat ja hyperaktiivisuus. Kun verrattiin eri informantteja (lapset itse ja heidän vanhempansa ja opettajansa), etenkin opettajien vastaukset ennustivat lasten tulevaa rikollisuutta. Nuoruudessa rikollisuuden itsenäisiä korrelaatteja olivat pienellä paikkakunnalla asuminen, vanhempien ero, seurustelu, itse ilmoitettu antisosiaalisuus ja säännöllinen tupakointi ja humalajuominen. Ennus- ja taustatekijöille oli tyypillistä se, että ne olivat lineaarisessa yhteydessä rikosten määrään (ongelmat ja rikosten määrä lisääntyivät käsi kädessä) ja että ne liittyivät useaan rikoslajiin yhtä aikaa. Huumerikollisuudella oli kuitenkin vähemmän itsenäisiä ennus- ja taustatekijöitä kuin muilla rikoslajeilla. Joka kymmenes poika kärsi psykiatrisista häiriöistä. Tämä ryhmä teki noin puolet kaikista rikoksista, ja lähes joka toinen poika, jolla oli psykiatrinen häiriö, oli rekisteröity rikoksista. Rikolliseen käytökseen liittyivät etenkin antisosiaalinen persoonallisuushäiriö ja päihdehäiriöt. Masennustilat olivat kuitenkin ainoa diagnoosiryhmä, joka ei ollut yhteydessä rikollisuuteen. Myös psykiatristen häiriöiden esiintyvyys kasvoi lineaarisesti rikosten määrän kanssa; aktiivisista uusintarikollisista yli puolella (59%) oli psykiatrinen diagnoosi. Rikollisuuden lisäksi erilaiset psykososiaaliset ongelmat kasautuivat pienelle vähemmistölle. Aktiivisten uusijoiden ryhmään olivat tilastollisesti merkitsevästi yhteydessä lähes kaikki ongelmat mitä tutkimme. Kuitenkin tästä ryhmästä vain alle 3% oli käyttänyt mielenterveyspalveluja viimeisen vuoden aikana. Rikossovittelun havainnointitutkimuksen perusteella sovittelussa monet perusasiat ovat kunnossa, ja toiminta on mielekästä niin asianosaisten kuin yhteiskunnankin kannalta. Useimmiten osapuolet kohtasivat ja saivat aikaan sopimuksen, johon he vaikuttivat tyytyväisiltä. Rikoksentekijät olivat motivoituneita korvaamaan aiheuttamansa vahingot. Osapuolet saivat kertoa tarinansa omin sanoin, heitä kuunneltiin ja he ymmärsivät mitä sovittelussa puhutaan ja sovitaan. Sovittelun kuluessa jännitys väheni ja asiat saatiin loppuunkäsiteltyä. Asianosaiset saivat vaikuttaa prosessiin ja sopimukseen, ja uhrin oikeudet olivat sovittelussa keskeisellä sijalla. Restoratiivisen teorian perusteella sovittelussa havaittiin myös kehittämisen varaa: Etenkin nuoria rikoksentekijöitä oli hankala saada osallistumaan tosissaan, ja aikuiset helposti hallitsivat keskustelua. Etukäteistapaamisia ja tukihenkilöitä ei juuri hyödynnetty. Sovitteluja hallitsi puhe sopimuksesta ja rahasta. Työkorvauksia ei käytetty eikä rehabilitaatiota käsitelty. Sekä sovitteluun pääsy että sovittelumenettely riippuivat yksittäisistä henkilöistä. Johtopäätökset Rikosten tekeminen nuoruudessa on melko yleistä ja monimuotoista. Rikokset ja psykososiaaliset ongelmat kasautuvat pienelle ryhmälle ja kulkevat käsi kädessä. Myös psykiatriset häiriöt ovat lineaarisessa yhteydessä rikosten määrään. Rikosriskiä voidaan ennustaa jo lapsuudessa, ja etenkin opettajat ovat tarkkanäköisiä lasten ongelmien suhteen. Eri rikoslajeilla on varsin samanlaisia taustatekijöitä. Aktiiviset rikoksentekijät vastaavat suuresta osasta kokonaisrikollisuutta, tarvitsevat eniten apua, mutta eivät kuitenkaan hakeudu psykososiaalisten palvelujen piiriin. Rikosten sovittelu tarjoaa keinon puuttua ongelmiin varhaisessa vaiheessa ilman leimaamista. Sovittelun kehitystehtävät liittyvät etenkin dialogiin, valmisteluihin, tukihenkilöihin, työkorvauksiin, palveluunohjaukseen ja sovittelun sovellusalaan. Sovittelua ja muita restoratiivisia menettelyjä on kehitettävä ja laajennettava esimerkiksi niin, että niitä voitaisiin käyttää palveluunohjauksen välineenä.

EXPLORING THE DEVELOPMENT AND PSYCHOSOCIAL CORRELATES OF SPIRITUALITY /RELIGIOSITY ACROSS ADOLESCENCE

The goal of the four studies that comprised this dissertation was to examine how spirituality/religiosity (SIR), as both an institutional and personal phenomenon, developed over time, and how its institutional (i.e., religious activity involvement) and personal (i.e., sense of connection with the sacred) components were uniquely linked with psychosocial adjustment. In Study 1, the differential longitudinal correlates of religious service attendance, as compared to involvement in other clubs, were evaluated with a sample of adolescents (n=1050) who completed a survey in grades 9, 11 and 12. Religious attendance and involvement in non-religious clubs were uniquely associated with positive adjustment in terms of lower substance use and better academic marks, particularly when involvement was sustained over time. In Study 2, the direction of effects was tested for the association between religious versus non-religious activities and both substance use and academic marks. Participants (n= 3993) were surveyed in grades 9 through 12. Higher religious attendance (but not non-religious club involvement) in one grade predicted lower levels of substance use in the next grade. Higher levels of nonreligious club involvement (but not religious service attendance) in one grade predicted higher academic achievement in the next grade, and higher academic achievement in one grade predicted more frequent non-religious club involvement in the next grade. The results suggest that different assets may be fostered in religious as compared to nonreligious activities, and, specifically, religious activity involvement may be important for the avoidance of substance use. The goal of Study 3 was to assess the unique associations between the institutional versus personal dimensions of SIR and a wide range of domains of psychosocial adjustment (namely, intrapersonal well-being, substance use, risk attitudes, parental relationship quality, academic orientation, and club involvement), and to examine the direction of effects in these associations. Participants (n=756) completed a survey in grades 11 and 12. Personal and institutional dimensions of SIR were differentially associated with adjustment, but it may only be in the domain of risk-taking (Le., risk attitudes, substance use) that SIR may predict positive adjustment over time. Finally, in Study 4, the goal was to examine how institutional and personal aspects of SIR developed within individual adolescents. Configurations of mUltiple dimensions of spirituality/religiosity were identified across 2 time points with an empirical classification procedure (cluster analysis), and sample- and individual-level development in these configurations were assessed. A five cluster-solution was optimal at both grades. Clusters were identified as aspirituallirreligious, disconnected wonderers, high institutional and personal, primarily personal, and meditators. With the exception of the high institutional and personal cluster, the cluster structures were stable over time. There also was significant intraindividual stability in all clusters over time; however, a significant proportion of individuals classified as high institutional and personal in Grade 11 moved into the primarily personal cluster in Grade 12. This program of research represented an important step towards addressing some of the limitations within the body of literature; namely, the uniqueness of religious activity involvement as a structured club, the differential link between institutional versus personal SIR and psychosocial adjustment, the direction of effects in the associations between institutional versus personal SIR and adjustment, and the way in which different dimensions of SIR may be configured and develop within individual adolescents over time.

Pratiques parentales, fréquentation d'amis déviants et consommation problématique de substances psychoactives à l'adolescence : effets modérateurs des symptômes dépressifs et du sexe

La consommation et la consommation problématique de substances psychoactives sont des phénomènes répandus à l’adolescence qui ont suscité beaucoup d’intérêt dans les pays occidentaux au cours des dernières décennies. La recherche a souligné la nécessité d’établir un modèle examinant les effets conjoints du groupe de pairs et de la famille sur ces phénomènes. Deux grandes lignées théoriques émergent de la littérature, soit les courants de la socialisation et de la sélection. De plus, de nombreuses études ont tenté d’expliquer la fréquente cooccurrence de ces phénomènes avec la symptomatologie dépressive, généralement associée à un pronostic plus lourd. Toutefois, la nature et le sens de cette association demeurent peu clairs. Une clarification des mécanismes en jeu est nécessaire afin de pouvoir mieux orienter les efforts de prévention et d’intervention. Le premier objectif de cette thèse est de contribuer à clarifier l’étiologie de la consommation problématique à l’adolescence, en examinant comment elle s’articule avec certains facteurs familiaux, comportementaux et affectifs, et avec l’association à des amis déviants et consommateurs, en testant conjointement deux modèles de médiation compétitifs. Le deuxième objectif est de clarifier l’association entre ces différentes dimensions et la symptomatologie dépressive, en testant l’effet modérateur des symptômes dépressifs dans la chaîne médiatrice proposée. Le troisième objectif est de spécifier les particularités pouvant exister entre les garçons et les filles en testant l’effet modérateur du sexe sur cette même chaîne médiatrice. Les données utilisées proviennent d’une cohorte de l’échantillon longitudinal de la Stratégie d’Intervention Agir Autrement (SIAA) comprenant plus de 3000 jeunes fréquentant des écoles de milieux majoritairement défavorisés du Québec, qui ont été suivis pendant leur secondaire (2003-2007). Lorsque testés séparément, le modèle de socialisation (Patterson) se reproduit dans notre échantillon, mais pas le modèle de sélection (Brown). Lorsque testés simultanément, les modèles structurels de régressions croisées suggèrent toutefois qu’aucun des liens postulés par les modèles ne semble se reproduire, au profit de liens médiateurs de stabilité, à l’exception d’un lien de médiation proposé par le modèle de Patterson chez les garçons. Les analyses de modération (multi-groupes) suggèrent que le sexe a bien un effet modérateur, le contrôle comportemental parental semblant particulièrement important dans l’étiologie des comportements problématiques des garçons, alors que les conflits familiaux semblent plus centraux pour les filles. Les analyses de modération suggèrent également un effet modérateur par les symptômes dépressifs, mais alors qu’il était attendu que ces symptômes exacerberaient les liens à l’étude, il apparaît qu’au contraire, aucun des liens ne se révèle significatif dans le groupe des dépressifs. Cette étude suggère donc que la symptomatologie dépressive et la consommation problématique se présentent conjointement dans un profil plus global de risque. À notre connaissance, cette thèse est la première à s’intéresser spécifiquement au rôle modérateur des symptômes dépressifs sur les liens existant entre les différentes dimensions à l’étude. Les résultats soulignent l’importance d’une intervention psychosociale précoce auprès des jeunes à risque et aux prises avec des symptômes dépressifs, en ciblant des aspects spécifiques pour les garçons et pour les filles.

La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

Recognition, assessment and treatment of social anxiety disorder: summary of NICE guidance

Social anxiety disorder is one of the most persistent and common of the anxiety disorders, with lifetime prevalence rates in Europe of 6.7% (range 3.9-13.7%).1 It often coexists with depression, substance use disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder.2 It can severely impair a person’s daily functioning by impeding the formation of relationships, reducing quality of life, and negatively affecting performance at work or school. Despite this, and the fact that effective treatments exist, only about half of people with this condition seek treatment, many after waiting 10-15 years.3 Although about 40% of those who develop the condition in childhood or adolescence recover before adulthood,4 for many the disorder persists into adulthood, with the chance of spontaneous recovery then limited compared with other mental health problems. This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on recognising, assessing, and treating social anxiety disorder in children, young people, and adults.5

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE

ADOLESCENCE AND DRUG USE THROUGH THE LENS OF PSYCHOANALYSIS: SUFFERING AND ECSTASY IN THE PASSAGE The purpose of this study is to reflect upon the psychological factors of adolescent drug addiction according to a psychoanalytic perspective. First we consider adolescence as a social-historical category and then we discuss the psychoanalytic understanding of the adolescent transition. This theoretical path builds the approach that considers drug use as a phenomenon that serves as a passage ritual to contemporary adolescence. This phenomenon is modulated by the drive organization, which determines how the individual will take ownership of the use of psychoactive substances. We conclude that the substance use may function as a buffer-object, activated to deal with the structural fragility of the contemporary affective bonds.

Dispositional self-control capacity and trait anxiety as relates to coping styles

In the present article, we analyzed the relationship between dispositional self-control capacity, trait anxiety, and coping styles. Since self-control is often crucial for adapting one’s behavior to be positive, we predicted that dispositional differences in the capacity to exert self-control play a role in determining individuals coping styles. To test this assumption, we assessed participants’ (N = 163) dispositional self-control capacity using the Self-Control Scale, and their dispositional coping styles by using the short version of the German Coping Questionnaire SVF78 (German: Stressverarbeitungsfragebogen). A path analysis supported our hypothesis; higher levels of dispositional self-control capacity were positively associated with positive coping style and negatively associated with negative coping style. Basing on attentional control theory, we further assumed that this relationship was mediated by trait anxiety. In a second study based on a sample of N = 98 participants, we additionally applied the trait version of the State-Trait Anxiety Inventory. The results of a path analysis revealed that trait anxiety mediated the relationship between dispositional self-control capacity and coping styles. The results suggest that it may be useful to take a closer look at the role of self-control in the anxiety-coping relationship.

Reciprocal Prospective Associations Between Depressive Symptoms and Perceived Relationship With Parents in Early Adolescence

Objective: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent–child relationships: communication and conflict. Methods: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. Results: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. Conclusion: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent–child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent–child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified.

Adolescent Illicit Drug Use and Subsequent Academic and Psychosocial Adjustment : an Examination of Socially-Mediated Pathways

Background: Questions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy. Method: 4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10–11, adjusting for potential confounders. We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8. Results: Illicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10–11. These associations were mediated by peer deviancy and school engagement (conduct problems only). Conclusion: Adolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

Reciprocal Prospective Associations Between Depressive Symptoms and Perceived Relationship With Parents in Early Adolescence

Objective: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent–child relationships: communication and conflict. Methods: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. Results: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. Conclusion: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent–child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent–child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified.

Adolescent Illicit Drug Use and Subsequent Academic and Psychosocial Adjustment : an Examination of Socially-Mediated Pathways

Background: Questions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy. Method: 4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10–11, adjusting for potential confounders. We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8. Results: Illicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10–11. These associations were mediated by peer deviancy and school engagement (conduct problems only). Conclusion: Adolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

Analysis of the memorial presented by the Secretary of the Treasury to the first constitutional Congress of the United Mexican States; being the substance of a report of the Financial Committee of the Chamber of Senators,

Mode of access: Internet.

Effect of Depression and Substance Abuse on Antiretroviral Therapy (ART) Adherence in Men Who Have Sex With Men (MSM) of Mexican Descent on the US-Mexico Border

Thesis (Master's)--University of Washington, 2016-06

An evaluation of coping ability as a guide to the treatment of persons diagnosed with schizophrenia and substance abuse

This dissertation introduced substance abuse to the Dynamic Vulnerability Formulation (DVF) and the social competence model to determine if the relationship between schizophrenic symptomatology and coping ability in the DVF applied also to the dually diagnosed schizophrenic or if these variables needed to be modified. It compared the coping abilities of dually and singly diagnosed clients in day treatment and identified, examined, and assessed the relative influence of relevant mediating variables on two dimensions of coping ability of the dually diagnosed: coping skills and coping effort. These variables were: presence of negative and nonnegative symptoms, duration of mental illness, type of substance used, and age of first substance use.^ A priori effect sizes based on previous empirical research were used to interpret the results related to the comparison of demographic, socioeconomic, and treatment characteristics between the singly and dually diagnosed study samples. The data suggested that the singly diagnosed group had higher coping skills than the dually diagnosed group, particularly in the areas of housing stability, work affect, and total social adjustment. The dually diagnosed group had lower scores on one aspect of coping effort--agency or self-efficacy. The data supported the presence of an inverse relationship between symptom severity and coping skills, particularly for the dually diagnosed group. The data did not support the presence of an inverse relationship between symptom severity and coping effort, but did suggest a positive relationship between symptom severity and one measure of coping effort, agency, for the dually diagnosed group. Regression equations using each summary measure of coping skill--social adjustment and role functioning--yielded statistically significant F-ratios. Thirty-six percent of the variance in social adjustment and thirty-one percent of the variance in role functioning were explained by the relative influence of the relevant variables. Both negative and non-negative symptoms were the only significant predictors of social adjustment. The non-negative symptoms variable was the sole significant predictor of role functioning. The results of this study provided partial support for the use of the Dynamic Vulnerability Formulation (DVF) with the dually diagnosed. ^

Relational predictors of condom use among adolescents in outpatient substance abuse treatment

Past HIV interventions have been critiqued for their failure to incorporate relational factors linked to condom use. Furthermore, few studies have focused on the relational context of sexual risk behavior among adolescents at elevated risk for HIV/STI exposure in the context of substance use. Therefore, this study evaluated the influence of three key relational factors (rejection sensitivity, intimacy dating goals, intercourse-related anxiety) salient for understanding condom use among adolescents in outpatient substance abuse treatment in South Florida. Structural equation modeling was used to test relational factors as direct and indirect predictors of condom use. Specifically, the current study investigated the influence of rejection sensitivity and intimacy dating goals on percentage of protected intercourse, with intercourse-related anxiety modeled as a mediator of this association. ^ Results obtained from the hypothesized structural model suggest rejection sensitivity and intimacy dating goals are significant predictors of percentage of protected intercourse. As expected, rejection sensitivity was related to lower levels of percentage of protected intercourse via heightened levels of intercourse-related anxiety and was not related directly to percentage of protected intercourse. Intercourse-related anxiety was indicated as a partial mediator between rejection sensitivity and percentage of protected intercourse. In contrast, intimacy dating goals was related to lower levels of percentage of protected intercourse directly. The findings demonstrate the importance of relational factors in condom use among adolescents in outpatient substance abuse treatment. Levels of protected intercourse are likely to increase when relational factors are targeted among adolescents in this high-risk population. Implications for prevention strategies targeting this high-risk subgroup of adolescents are discussed. ^