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Calihan JB, Matson P. Engaging caregivers to prevent substance use by at-risk adolescents in pediatric primary care. Curr Opin Pediatr 2024:00008480-990000000-00179. [PMID: 38655792 DOI: 10.1097/mop.0000000000001359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Improving adolescent substance use prevention and treatment is an urgent public health priority in the United States. Current intervention models do not address how adolescents with a history of caregiver substance use are at particular risk for problematic substance use. We, therefore, reviewed the evidence on adolescent substance use prevention programs integrating caregiver-focused components and propose opportunities to incorporate adaptations of existing programs into pediatric primary care to improve outcomes for at-risk adolescents exposed to caregiver substance use. RECENT FINDINGS There are multiple evidence-based universal prevention programs that target adolescent substance use and incorporate caregivers; however, these programs do not address the specific concerns of caregivers with substance use. Caregiver-focused programs efficaciously address family and child risk factors for adolescent substance use but are not accessible to many families and have not been longitudinally studied to assess impact on adolescent substance use. SUMMARY Adaptation of existing prevention programs to pediatric primary care settings may open opportunities to improve engagement of families with caregiver substance use in targeted prevention strategies. Family Screening, Brief Intervention, and Referral to Treatment (F-SBIRT) is one model that can be incorporated into pediatric primary care to contextualize evidence-based practices to address substance use in a family-focused approach. To develop F-SBIRT, further research is needed to validate caregiver-focused screening tools, determine brief intervention (BI) best practices, and adapt existing evidence-based and caregiver-focused adolescent prevention programs for use with caregivers with substance use in pediatric primary care settings.
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Affiliation(s)
- Jessica B Calihan
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Pamela Matson
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Welsh JW, Dopp AR, Durham RM, Sitar SI, Passetti LL, Hunter SB, Godley MD, Winters KC. Narrative review: Revised Principles and Practice Recommendations for Adolescent Substance Use Treatment and Policy. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00140-0. [PMID: 38537736 DOI: 10.1016/j.jaac.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE In 2014, the U.S. National Institute on Drug Abuse released the "Principles of Adolescent Substance Use Disorder Treatment," summarizing previously established evidence and outlining principles of effective assessment, treatment, and aftercare for substance use disorders (SUD). Winters et al. (2018) updated these principles to be developmentally appropriate for adolescents. This review builds on that formative work and recommends updated adolescent assessment, treatment, and aftercare principles and practices. METHOD The Cochrane, MEDLINE-PubMed, and PsychInfo databases were searched for relevant studies with new data about adolescent substance use services. This article updates the 13 original principles; condenses the 8 original modalities into 5 practices; and highlights implications for public policy approaches, future funding, and research. RESULTS Key recommendations from the principles include integrating care for co-occurring mental health disorders and SUDs, improving service accessibility including through the educational system, maintaining engagement, and addressing tension between agencies when collaborating with other youth service systems. Updates to the treatment practices include adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT), investment in social programs and family involvement in treatment, expanding access to behavioral therapies and medications, increasing funding to harm reduction services, supporting reimbursement for continuing care services, and increasing investment in research. CONCLUSION These revised principles of adolescent assessment, treatment, and aftercare approaches and practices aim to establish guidance and evidence-based practices for treatment providers, while encouraging necessary support from policymakers and funding agencies to improve the standard of care for adolescent SUD services.
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Lozano A, Fernandez A, Rhodes CA, Estrada Y, Graefe B, Tapia MI, Prado G. Does Binge-Watching eHealth Intervention Content Impact Outcomes? J Adolesc Health 2023; 73:664-671. [PMID: 37422740 PMCID: PMC10526969 DOI: 10.1016/j.jadohealth.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Advancements in technology have made it possible to deliver parenting interventions online, known as eHealth interventions. Little is known about the rate at which parents participate in eHealth interventions, characteristics of parents who watch eHealth interventions at an accelerated pace (i.e., binge-watching), and if binge-watching impacts intervention outcomes. METHODS The sample included 142 Hispanic parents who were randomly assigned to an eHealth family-based intervention and completed 100% of eight online, prerecorded and self-paced video group sessions delivered across 12 weeks. We examined baseline predictors (parent sociodemographic characteristics, report of child's externalizing behaviors, and family functioning) of watching group sessions in two weeks or less (n = 23, 16.2%). Using latent growth curve modeling, we tested the impact of binge-watching on the trajectory of adolescent drug use, condomless sex, and depressive symptoms across 36 months. We also examined the impact of binge-watching on changes in family functioning from baseline to 6 months postbaseline. RESULTS Parents with high levels of education and of children with attention problems were more likely to binge-watch. Conversely, parents of children with conduct disorder symptoms were less likely to binge-watch. The trajectory of depressive symptoms increased for adolescents with parents who binge-watched the intervention, but the trajectory of condomless sex decreased. There was no impact on drug use. Binge-watching was also associated with decreases in parental monitoring. DISCUSSION The findings of this study have implications for eHealth interventions; the pace that parents watch eHealth interventions may subsequently impact adolescent outcomes, such as condomless sex and depressive symptoms.
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Affiliation(s)
- Alyssa Lozano
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida.
| | - Alejandra Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center, School of Public Health, Dallas, Texas
| | - C Aubrey Rhodes
- Department of Psychology, REACH Institute, Arizona State University, Tempe, Arizona
| | - Yannine Estrada
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
| | - Beck Graefe
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Florida
| | - Maria I Tapia
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
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Slade T, Chapman C, Conroy C, Thornton L, Champion K, Stapinski L, Koning I, Teesson M, Newton NC. 24-month outcomes of an eHealth universal program for students and parents to prevent adolescent alcohol use: A cluster randomized controlled trial in schools. Internet Interv 2023; 33:100648. [PMID: 37533974 PMCID: PMC10392073 DOI: 10.1016/j.invent.2023.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/25/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
Background Parents play a critical role in delaying adolescent initiation of alcohol and other drug use. However, the majority of prevention programs focus on adolescents only. This study tested the acceptability and effectiveness of an eHealth universal program for students and parents to prevent adolescent alcohol use. Methods A cluster randomized controlled trial (RCT) was conducted between 2018 and 2020 with students from one grade level (aged 12-14 years) from 12 Australian secondary schools randomly allocated to the intervention or control conditions. Students accessed a web-based program in class and parents accessed the program online at their convenience. Data were collected via online questionnaires from students (N = 572) and parents (N = 78) at baseline, and 12- and 24- months post baseline. Multilevel, mixed effects regression models were used to analyse student data. Findings More students in the control group reported having at least one standard alcoholic drink and engaging in heavy episodic drinking in the previous 12 months at both 12- and 24-month follow up compared to students in the intervention, however, these differences were not statistically significant. Students in the intervention group reported greater increases in alcohol-related knowledge, compared to the control students. Qualitative data from parents indicated that they found the program useful, however, the number of parents who enrolled in the research study (13.9 %) was low. Parent engagement increased following implementation of an interactive parent/adolescent homework task. Conclusions Small sample size, low prevalence of alcohol use and parental engagement, and relatively short follow-up period may have contributed to lack of observed intervention effect, other than on alcohol-related knowledge. Parents who engaged with the program found it useful, however, implementation strategies that encourage parent-child interaction and communication may increase parent engagement for future programs.
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Affiliation(s)
- Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Chloe Conroy
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ina Koning
- Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
| | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW 2006, Australia
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Trucco EM, Fallah-Sohy N, Cristello JV, Hartmann SA. The Role of Socialization Contexts on Adolescent Substance Use across Racial and Ethnic Groups. CURRENT ADDICTION REPORTS 2023; 10:412-421. [PMID: 37691834 PMCID: PMC10491413 DOI: 10.1007/s40429-023-00496-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 09/12/2023]
Abstract
Purpose of Review This review summarizes theories and empirical work regarding socialization contexts contributing to substance use across marginalized adolescents. Future directions and recommendations to minimize the perpetuation of racial stereotypes are provided. Recent Findings Neighborhoods high in social cohesion may offset substance use risk. Promoting school connectedness via increased support from teachers and peers could reduce school-based discrimination and enhance feelings of belongingness. The influence of peers on substance use engagement largely differs across racial groups and level of acculturation. Family cultural values emphasizing respect, obedience, and collectivism offer protection from substance use. Summary Despite lower prevalence rates of adolescent substance use within racial/ethnic groups, rates of negative consequences due to substances are far greater compared to White adolescents. Transcultural factors (e.g., strong family ties), as well as culture-specific factors, should be leveraged to delay the onset of substance use and prevent negative sequelae resulting from substance use initiation.
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Affiliation(s)
- Elisa M Trucco
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- University of Michigan, Psychiatry Department, 4250 Plymouth Road, Ann Arbor, MI 48109
| | - Nilofar Fallah-Sohy
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
| | - Julie V Cristello
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
| | - Sarah A Hartmann
- Florida International University, Psychology Department, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
- Florida International University, Center for Children and Families, 11200 SW 8 Street, AHC-1, Miami, FL, 33199
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Fishbein DH, Sloboda Z. A National Strategy for Preventing Substance and Opioid Use Disorders Through Evidence-Based Prevention Programming that Fosters Healthy Outcomes in Our Youth. Clin Child Fam Psychol Rev 2023; 26:1-16. [PMID: 36542196 PMCID: PMC9768412 DOI: 10.1007/s10567-022-00420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions.
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Affiliation(s)
- Diana H Fishbein
- Frank Porter Graham Child Development Institute, University of North Carolina-Chapel Hill, 105 Smith Level Road, Chapel Hill, NC, 27599, USA.
- The Pennsylvania State University, State College, PA, USA.
- National Prevention Science Coalition to Improve Lives, Oakland, CA, USA.
| | - Zili Sloboda
- National Prevention Science Coalition to Improve Lives, Oakland, CA, USA
- Applied Prevention Science International, Ontario, OH, USA
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Mehus CJ, Patrick ME, Schulenberg J, Maggs JL. 35-Year-Old Parents Do Not Approve of 17-Year-Olds' Cigarette, Marijuana, or Alcohol Use: U.S. National Data 1993-2018. J Adolesc Health 2022; 70:989-992. [PMID: 35241361 PMCID: PMC9124671 DOI: 10.1016/j.jadohealth.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Parents' attitudes about adolescent substance use likely guide their parenting behaviors. This study documents prevalence of parents' disapproval of adolescent substance use and characteristics associated with disapproval. METHODS Survey data from national samples of 35-year-old parents from the U.S. Monitoring the Future study were collected 1993-2018. Multivariable logistic regression examined predictors of disapproving attitudes about substance use by a hypothetical 17-year-old child, including occasional marijuana use or drunkenness, and regular cigarette, marijuana, or alcohol use. RESULTS Across all cohorts, rates of disapproving attitudes ranged from 93.7% disapproving of getting drunk occasionally to 97.2% disapproving of regular cigarette use, with some erosion in disapproval for some substances across cohorts. Parents' own recent abstinence from substance use predicted greater odds of disapproval. CONCLUSIONS The overwhelming majority of 35-year-old parents disapprove of adolescent substance use. Prevention and public health messaging can support parenting by sharing this important information.
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Affiliation(s)
- Christopher J. Mehus
- Center for Applied Research and Educational Improvement, University of Minnesota,Department of Family Social Science, University of Minnesota
| | | | - John Schulenberg
- Institute for Social Research, University of Michigan,Department of Psychology, University of Michigan
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Long-term Effects of Adolescent Substance Use Prevention on Participants, Partners, and their Children: Resiliency and Outcomes 15 Years Later During the COVID-19 Pandemic. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1264-1275. [PMID: 35614368 PMCID: PMC9132568 DOI: 10.1007/s11121-022-01384-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 10/31/2022]
Abstract
We examined whether participation in adolescent substance use prevention programming can enhance long-term resilience into adulthood such that individuals were better able to cope with adversities during the initial months of the COVID-19 pandemic, yielding benefits for the individuals, their partners/spouses, and children; 197 adults (28-30 years old) who entered the PROSPER randomized trial of substance use prevention programming as 6th graders and subsequently had become parents-and 128 of their partners-participated in two waves of long-term follow-up data collection. Respondents completed questionnaires on substance use, adjustment, parenting quality, and children's mood and behavior problems 15 years after baseline, and again via an online survey in the first three months of the COVID-19 pandemic. Results were mixed, with some indications of better adjustment of PROSPER intervention compared to control participants during the early phase of the pandemic (less increase in alcohol use and less decrease in parenting warmth) and their children (lower levels of externalizing and internalizing problems) but several null results as well (no differences in other substance use behaviors, other parenting measures, or parent depression). Adolescent substance use prevention programs can foster long-term individual and interpersonal resilience factors that allow participants-as well as their children-to adapt and cope with unforeseen periods of acute stress and adversity with less deterioration in health and well-being.
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Stefanek E, Bleis T, Schwab M, Spiel G. Outcomes and Mechanisms of Change of the Strengthening Families Program in a Clinical Sample of Children and Their Families in Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1074. [PMID: 35162098 PMCID: PMC8833924 DOI: 10.3390/ijerph19031074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022]
Abstract
Family context and parenting behavior have the greatest influence on children's mental health and well-being, and interventions that take the whole family system into account are promising. This study aims to evaluate the outcomes, i.e., family strength, parenting behavior, and child behavior, of the Strengthening Families Program (SFP), developed by Kumpfer which was implemented in an outpatient clinic of a community-based non-governmental organization in Austria between 2012 and 2018. Furthermore, the program's mechanism of change as formulated by the program authors (i.e., to what extent parenting behavior mediates the relationship between family strength and child behavior) was tested in this clinical sample. Instruments measuring family strength, parenting behavior, and child behavior were administered before, immediately after, and 6 months after participation in the SFP. To test the mechanisms of change, a half-longitudinal model was applied with two measurement points (before and after). A total of 62 families (50 boys, 24 girls, and 69 parents) participated in the culturally adapted SFP. Regarding the outcomes of the program, all variables yielded significant improvement in all variables. With respect to the mechanism of change, no significant association between the variables could be found. Implications for the implementation of the SFP in a clinical population and how further adaptation of the program could enhance the adherence of this target group are discussed.
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Affiliation(s)
- Elisabeth Stefanek
- Pro Mente Forschung (Pro Mente Research), 1050 Vienna, Austria; (M.S.); (G.S.)
| | - Tanja Bleis
- Pro Mente: Kinder Jugend Familie (Pro Mente: Children Youth Family), 9020 Klagenfurt, Austria;
| | - Markus Schwab
- Pro Mente Forschung (Pro Mente Research), 1050 Vienna, Austria; (M.S.); (G.S.)
| | - Georg Spiel
- Pro Mente Forschung (Pro Mente Research), 1050 Vienna, Austria; (M.S.); (G.S.)
- Pro Mente: Kinder Jugend Familie (Pro Mente: Children Youth Family), 9020 Klagenfurt, Austria;
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Fosco GM, Brinberg M, Ram N. Day-to-day changes in parent-adolescent connectedness: Relations with daily subjective well-being and eudaimonia differ for parents and adolescents. THE JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2020.1791945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Gregory M. Fosco
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Miriam Brinberg
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Nilam Ram
- Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Predictors of Attendance Patterns in a Universal Family-Based Preventive Intervention Program. J Prim Prev 2021; 42:409-424. [PMID: 34014433 DOI: 10.1007/s10935-021-00636-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
Achieving sustained engagement in family-based preventive intervention programs is a serious challenge faced by program implementers. Despite the evidence supporting the effectiveness and potential population-level impacts for these programs, their actual impact is limited by challenges around retention of participants. In order to inform efforts to better retain families, it is critical to understand the different patterns of attendance that emerge across the duration of program implementation and the factors that are associated with each attendance pattern. In this study, we identified latent classes of attendance patterns across the seven program sessions of the Strengthening Families Program: For Parents and Youth Ages 10-14 (SFP 10-14). Youth and their parents who attended at least one SFP 10-14 program session together were included in the analysis. Four distinct classes emerged: First-Session Attenders (7%), Early Attenders (9%), Declining-High Attenders (18%), and Consistent-High Attenders (66%). An examination of individual, family, and sociodemographic predictors of class membership revealed that adolescent school bonding predicted families having relatively high attendance, adolescent involvement with deviant peers predicted early dropout, and family low-income status predicted early dropout. Findings point to the need for potential targeted strategies for retaining these groups, such as involving school personnel, employing brief interventions to identify and address barriers at the outset, and leveraging the positive influence of Consistent-High Attenders. Findings also shed light on ways to reach those who may continue to drop out early, such as restructuring program content to address critical material early in the program. This study adds to the growing body of literature that seeks to understand for whom, when, and in which ways program dropout occurs.
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Fosco GM, Lydon-Staley DM. Implications of Family Cohesion and Conflict for Adolescent Mood and Well-Being: Examining Within- and Between-Family Processes on a Daily Timescale. FAMILY PROCESS 2020; 59:1672-1689. [PMID: 31802491 DOI: 10.1111/famp.12515] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 05/22/2023]
Abstract
Family-level conflict and cohesion are well-established predictors of adolescent mental health. However, traditional approaches focusing on between-family differences in cohesion and conflict may overlook daily intrafamily variability that might provide important new information. We used data from a 21-day daily diary protocol in a sample of 151 caregivers (95.3% female) and their adolescent child (61.5% female) in two-caregiver families to test whether daily changes in family functioning are associated with daily changes in adolescent well-being and whether adolescent well-being depends on average levels of family functioning. We examined family cohesion and conflict in relation to adolescent angry, depressed, and anxious mood, as well as happiness, life satisfaction, and meaning and purpose in life in multilevel models. Both cohesion and conflict exhibited meaningful daily variation. Adolescent-reported cohesion and conflict had unique within-family associations with all six adolescent outcomes. Models using parent reports of family functioning yielded fewer associations than models with adolescent reports; however, several findings remained. Cross-level interactions indicated that within-family variations in cohesion were only associated with adolescent depression in families with lower average levels of cohesion across days. In sum, this study provides compelling evidence that families exhibit meaningful variability from day to day and that daily variation has important implications for adolescent well-being.
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Affiliation(s)
- Gregory M Fosco
- Edna Bennett Pierce Prevention Research Center, Human Development and Family Studies, The Pennsylvania State University, State College, PA
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LoBraico EJ, Brinberg M, Ram N, Fosco GM. Exploring Processes in Day-to-Day Parent-Adolescent Conflict and Angry Mood: Evidence for Circular Causality. FAMILY PROCESS 2020; 59:1706-1721. [PMID: 31710103 PMCID: PMC7418182 DOI: 10.1111/famp.12506] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Parent-adolescent conflict has been studied both as a precursor of long-term macrolevel developmental risks and as an outcome of microlevel, moment-to-moment interaction patterns. However, the family-level processes underlying the maintenance or regulation of conflict in daily life are largely overlooked. A meso-level understanding of parent-adolescent conflict offers important practical insights that have direct implications for interventions. The present study explores day-to-day reciprocal processes and carryover in parents' and adolescents' experiences of anger and conflict. Daily diary data provided by parent-adolescent dyads (N = 151) from two-caregiver households (adolescents: 61.59% female, mean age = 14.60 years) over 21 days were examined using a multivariate Poisson multilevel model to evaluate the circular causality principle in parents' and adolescents' daily conflict and anger. Findings offer empirical support for the theory, suggesting that parents' and adolescents' anger and conflict exist together in a feedback loop wherein conflict is both a consequence of past anger and also an antecedent of future anger, both within and across persons. Increased understanding of the daily interaction patterns and maintenance of parent-adolescent conflict can guide more informed, targeted, and well-timed interventions intended to ameliorate the consequences of problematic parent-adolescent conflict sequences.
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Affiliation(s)
| | - Miriam Brinberg
- Human Development and Family Studies, Pennsylvania State University
| | - Nilam Ram
- Human Development and Family Studies, Pennsylvania State University
- German Institute for Economic Research (DIW), Berlin
| | - Gregory M. Fosco
- Human Development and Family Studies, Pennsylvania State University
- Prevention Research Center, Pennsylvania State University
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Cultural Adaptation Process of the Strengthening Families Program (10–14) Around the World: an Integrative Review. TRENDS IN PSYCHOLOGY 2020. [DOI: 10.1007/s43076-020-00053-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Elaborating on premature adolescent autonomy: Linking variation in daily family processes to developmental risk. Dev Psychopathol 2020; 31:1741-1755. [PMID: 31455441 DOI: 10.1017/s0954579419001032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study revisits the premature autonomy model by examining parents' use of positive behavior support (PBS) practices on a daily timescale to better understand underlying processes in developmental changes in family disengagement and the implications for adolescent problem behavior and substance use. This study included 151 9th and 10th grade adolescents (61.5% female) and their caregivers, who participated in a baseline assessment, a 21-day daily diary burst, and a 1-year follow-up assessment. Four key findings emerged: (a) on days when parents used more PBS, adolescents felt more close and connected to their caregivers; (b) adolescents who exhibited a larger-magnitude of change in connectedness with caregivers in relation to variation in positive parenting (termed fragile connectedness) were at higher risk for antisocial behavior, deviant peer involvement, and substance use one year later; (c) individual differences in initial levels of antisocial behavior and effortful control accounted for between-person variation in fragile connectedness; and (d) day-level adolescent anger and parent-adolescent conflict predicted within-family variation in parents' use of PBS. Implications for the premature autonomy model and intervention science are discussed.
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Fadus MC, Squeglia LM, Valadez EA, Tomko RL, Bryant BE, Gray KM. Adolescent Substance Use Disorder Treatment: an Update on Evidence-Based Strategies. Curr Psychiatry Rep 2019; 21:96. [PMID: 31522280 PMCID: PMC7241222 DOI: 10.1007/s11920-019-1086-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW To examine the most recent published evidence (2016-2019) regarding the treatment of adolescent substance use disorders and to provide an update on evidence-based strategies, adjunctive interventions, and methods to improve currently established treatment approaches. RECENT FINDINGS Recent evidence suggests that psychosocial treatments such as family-based therapy, cognitive behavioral therapy, and multicomponent approaches remain the most effective methods of treatment; however, innovative ways of improving these treatment strategies may include digital and culturally based interventions. New advances in adjunctive treatments such as pharmacotherapy, exercise, mindfulness, and recovery-oriented educational centers may have some clinical utility. Well-established psychosocial interventions remain the primary modality of treatment. Promising new adjunctive treatments and improvements in our currently established treatments may yield significant improvements.
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Affiliation(s)
- Matthew C Fadus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA.
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | - Emilio A Valadez
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | - Brittany E Bryant
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA
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