Nicotine dependence has been found to be a significant factor in adolescent smoking persistence. However, measures of this construct are primarily adult-derived, limiting their utility as bases for characterizing nicotine dependence and formulating youth intervention strategies. This issue is of particular importance among substance abusing youth who have substantially higher rates of cigarette smoking than do adolescents in the general population. The objectives of this preliminary study were to examine the construct validity of the DSM-IV nicotine dependence criteria and the modified Fagerström Tolerance Questionnaire (mFTQ) and to compare the DSM-IV diagnostic criteria for nicotine dependence with the mFTQ in a sample of 67 adolescent smokers in treatment for substance abuse. Results revealed that more participants were classified as nicotine dependent using DSM-IV criteria than by mFTQ scores. Little evidence was found for construct validity of these measures and convergence between the two measures was low. Findings also suggested that the present measures do not capture optimally broad dimensions of adolescent nicotine dependence.
Families are found to play an important role in adolescent substance abuse. This study examined family variables that may influence adolescent substance use during the 6 months following inpatient treatment: (1) parental substance use; (2) family aftercare attendance; and, (3) adolescent ratings of family helpfulness. It was hypothesized that the effects of parental substance use on adolescent use would be mediated by family aftercare attendance and family helpfulness ratings. Adolescent inpatients (N = 103; Mage = 16) were assessed during treatment and 6 months later. Results revealed no relationship between either parental substance use and family aftercare attendance or reports of family helpfulness. More frequent family aftercare attendance and higher ratings of helpfulness were associated with less adolescent use during follow-up. Findings highlight the importance of family behaviors on adolescent substance abuse treatment outcome.
OBJECTIVE: Research with adolescents has revealed salutary effects for 12-step attendance on substance use outcomes, but no studies have examined the effects of 12-step affiliation, or active involvement, beyond simple measures of attendance. Prior research with adults has shown that measures of affiliation are more predictive than measures of attendance. This study (1) assessed attributes that may influence 12-step attendance and affiliation; (2) tested whether 12-step affiliation in the first 3 months posttreatment possessed unique predictive power above that attributable to attendance alone; and (3) examined the extent to which motivation, coping and self-efficacy measured at 3 months mediated the relation between 12-step affiliation and substance use outcome in the ensuing 3 months.
METHOD: Adolescent inpatients (N = 74, 62% female), who were aged 14-18 years (mean [SD] = 15.9 [1.19] years), were interviewed during treatment and at 3 and 6 months postdischarge.
RESULTS: More severely substance-involved youth were more motivated for abstinence and more likely to attend and affiliate with 12-step groups. A high degree of collinearity between 12-step attendance and affiliation suggested that those attending were also likely to be those actively involved. As a consequence, affiliation did not predict outcome over and above frequency of attendance. Motivation was found to influence the relationship between 12-step affiliation and future substance use outcome.
CONCLUSIONS: Given the widespread treatment recommendations for adolescent 12-step involvement, more study is needed to determine what kinds and what aspects of 12-step groups and fellowships are helpful to adolescent change efforts and what alternatives should be developed.