Externalizing and self-medicating: Heterogeneity among repeat DUI offenders

Typologies of Canadian young adults who drive after cannabis use: A two-step cluster analysis

Young adults that drive after cannabis use (DACU) may not share all the same characteristics. This study aimed to identify typologies of Canadians who engage in DACU. About 910 cannabis users with a driver's license (17-35 years old) who have engaged in DACU completed an online questionnaire. Two-step cluster analysis identified four subgroups, based on driving-related behaviors, cannabis use and related problems, and psychological distress. Complementary comparative analysis among the identified subgroups was performed as external validation. The identified subgroups were: (1) frequent cannabis users who regularly DACU; (2) individuals with generalized deviance with diverse risky road behaviors and high levels of psychological distress; (3) alcohol and drug-impaired drivers who were also heavy frequent drinkers; and (4) well-adjusted youths with mild depressive-anxious symptoms. Individuals who engaged in DACU were not a homogenous group. When required, prevention and treatment need to be tailored according to the different profiles.

Excessive All-Trans Retinoic Acid Inhibits Cell Proliferation Through Upregulated MicroRNA-4680-3p in Cultured Human Palate Cells

Cleft palate is the second most common congenital birth defect, and both environmental and genetic factors are involved in the etiology of the disease. However, it remains largely unknown how environmental factors affect palate development. Our previous studies show that several microRNAs (miRs) suppress the expression of genes involved in cleft palate. Here we show that miR-4680-3p plays a crucial role in cleft palate pathogenesis. We found that all-trans retinoic acid (atRA) specifically induces miR-4680-3p in cultured human embryonic palatal mesenchymal (HEPM) cells. Overexpression of miR-4680-3p inhibited cell proliferation in a dose-dependent manner through the suppression of expression of ERBB2 and JADE1, which are known cleft palate-related genes. Importantly, a miR-4680-3p-specific inhibitor normalized cell proliferation and altered expression of ERBB2 and JADE1 in cells treated with atRA. Taken together, our results suggest that upregulation of miR-4680-3p induced by atRA may cause cleft palate through suppression of ERBB2 and JADE1. Thus, miRs may be potential targets for the prevention and diagnosis of cleft palate.

Evaluating the Computerized Assessment and Referral System (CARS) Screener: Sensitivity and Specificity as a Screening Tool for Mental Health Disorders among DUI Offenders

Background/Purpose: A growing body of evidence suggests that people who are arrested for driving under the influence (DUI) of alcohol are more likely to screen positive for psychiatric disorders than the general population. Additionally, psychiatric comorbidity has been shown to increase vulnerability to criminal re-offense. However, DUI programs face many barriers to screening for psychiatric disorders. This paper evaluates the sensitivity and specificity of a screening tool developed for these programs, the Computerized Assessment and Referral System (CARS) Screener. Methods: We used data from 381 DUI offenders in Massachusetts, as well as a secondary data source, the National Comorbidity Survey-Replication (NCS-R: N = 9,282) to examine the accuracy of the CARS Screener when compared to full assessment. Results: Based on both sets of analyses, we found that the CARS Screener offers a sensitive and specific method to screen for many psychiatric disorders. Specifically, the CARS Screener has a high sensitivity and specificity for bipolar disorder, intermittent explosive disorder, depressive disorders, generalized anxiety disorder, alcohol and drug use disorders, gambling disorder, post-traumatic stress disorder, panic attacks, and social phobia. Conclusion: The CARS Screener appears to be an effective tool that will help DUI programs better understand and address the mental health issues facing their clients.

Impaired driving among rural female drug-involved offenders

OBJECTIVE

Very little is known about rural female impaired drivers despite disproportionate rates of impaired driving arrests and associated traffic fatalities in rural areas. The present study examined past-year impaired driving histories and impaired driving correlates in a sample of rural female drug-involved offenders.

METHODS

Female drug-involved offenders (N = 400) from 3 rural jails completed a confidential interview focused on substance use and related risk behaviors. After removing cases with missing data (n = 23), participants self-reporting past-year impaired driving (n = 254) were compared to those who did not (n = 123) on demographic characteristics, substance use, mental health, and criminal histories. Impaired drivers also reported the substances involved in their past-year impaired driving episodes.

RESULTS

A significantly higher percentage of impaired drivers reported past-year use of 8 of the 11 substances (including alcohol) examined when compared to other drug-involved offenders. Though symptoms of major depressive and posttraumatic stress disorders were similar, significantly more impaired drivers (49.6%) reported symptoms of generalized anxiety disorder than did other drug-involved offenders (35.0%). No differences in criminal histories were found. Nearly all (94.9%) impaired drivers reported driving under the influence of drugs in the past year; less than one-fourth reported driving under the influence of alcohol. Prescription opioids were the most prevalent substance type involved in impaired driving episodes (84.6%), followed by anti-anxiety medications (40.9%). Approximately one-third of impaired drivers reported driving under the influence of methamphetamine (33.9%), marijuana (31.5%), and alcohol (30.7%) in the past year.

CONCLUSIONS

Findings indicate that rural female impaired drivers may have more extensive substance use and mental health problems than other rural female drug-involved offenders. In addition, study results suggest that a recent history of impaired driving may serve as a marker for a more extensive substance use history. Other implications include that early identification of impaired drivers in at-risk groups may be an important opportunity to prevent future traffic injuries and fatalities.

Psychiatric comorbidity among first-time and repeat DUI offenders

Driving under the influence of alcohol or other substances is a serious public health concern. Previous research has shown that psychiatric comorbidity is more prevalent for repeat offenders than the general population, and that first-time offenders exhibit elevated rates of psychiatric comorbidity, but few studies have directly compared first-time and repeat DUI offenders. The current study compares psychiatric comorbidity among repeat and first-time DUI offenders. First-time and repeat DUI offenders completed the screener module of the Computerized Assessment and Referral System (CARS), adapted from the Composite International Diagnostic Interview (CIDI: Kessler & Ustun, 2004), to measure potential psychiatric comorbidity. For 16 of 19 psychiatric disorders, repeat DUI offenders were more likely to screen positive during their lifetime compared with first-time DUI offenders. Similarly, repeat DUI offenders were more likely to screen positive during the past year for 11 of 16 assessed psychiatric disorders. Overall, repeat DUI offenders screened positive for an average of 6.3 disorders during their lifetime, compared to first-time offenders who screened positive for an average of 3.7 disorders. Repeat DUI offenders also screened positive for more past-year disorders (M = 3.3) than first-time offenders (M = 1.9). Compared to first-time offenders, repeat DUI offenders evidence more severe and pervasive psychiatric comorbidity. Further research is necessary to determine whether psychiatric comorbidity among first-time offenders directly predicts re-offense. If so, screening for mental health issues among first-offenders could provide valuable information about how best to allocate resources for these offenders.