Practice Parameters for the assessment and treatment of children and adolescents with substance misuse disorders

Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 07/2005; 44(6):609-21. DOI: 10.1097/00004583-199710001-00009
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This practice parameter describes the assessment and treatment of children and adolescents with substance use disorders and is based on scientific evidence and clinical consensus regarding diagnosis and effective treatment as well as on the current state of clinical practice. This parameter considers risk factors for substance use and related problems, normative use of substances by adolescents, the comorbidity of substance use disorders with other psychiatric disorders, and treatment settings and modalities.

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    • "Adolescents in residential treatment for substance use disorders (SUDs), as an example, would be labeled antisocial because " a hallmark of SUDs in adolescents is impairment in psychosocial and academic functioning " (Bukstein et al., 2005, p. 610). These authors define impairment as including " family conflict or dysfunction, interpersonal conflict, and academic failure " (Bukstein et al., 2005, p. 610). Thus, in addition to a diagnosis of SUD (reflected in a pattern of both substance abuse and substance dependence), young people in residential substance abuse treatment tend to also struggle in many of life's major domains, including family relationships (Pickrel & Henggeler, 1996), peer relationships (Fallu et al., 2010), work or school (Crowe, 1998; Lynskey & Hall, 2000), and self-care (White, 2012). "
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    ABSTRACT: This exploratory study aimed to measure antisocial tendencies and friendship quality of adolescents in residential substance abuse treatment and to compare the findings to the general population for this age group. Fifty-four adolescents completed Bukowski, Hoza, and Boivin's (1994) Friendship Quality Scale and their counselor completed the antisocial measures of Merrell and Caldarella's (2002) Home and Community Social Behavior Scales. As anticipated, the sample exhibited significantly more antisocial behavior; however, they also reported similar levels of positive and negative friendship quality compared with other adolescent populations. Implications for substance abuse treatment are discussed.
    Journal of Groups in Addiction & Recovery 04/2015; 10(2):141-162. DOI:10.1080/1556035X.2015.1034823
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    • "Substance abuse requires evidence of a maladaptive pattern of substance use with clinically significant levels of impairment or distress (e.g., significant problems in life's major domains, including school, family, or the community) (Bukstein et al., 2005). Substance dependence is more serious in that it requires ''a substantial degree of involvement with a substance as evidenced by the adolescent's meeting at least three criteria from a group of seven criteria'' (Bukstein et al., 2005, p. 3) which include withdrawal, tolerance, loss of control, repeated unsuccessful attempts to quit, much time spent obtaining, using, and recovering, giving up important activities to use, and continued use despite knowledge of adverse consequences (American Psychiatric Association, 2000). "
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    ABSTRACT: This theoretical article traces one of the pathways of adolescent substance abuse from its roots in insecure attachment in childhood through ineffective relational mental models, poor communication skills, peer rejection, and the formation of antisocial friendships that lead to delinquency and substance use disorder. The model suggests communication skills training as a mediator and a means to altering this trajectory through changes to internal working models about relationships and the building of healthy peer relationships and recovery capital. This model focuses on communication as central to this complex process.
    Journal of Child & Adolescent Substance Abuse 01/2015; 24(1):54-65. DOI:10.1080/1067828X.2012.761168 · 0.62 Impact Factor
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    • "Mental health and substance use disorders are among the most common health problems that affect adolescents, with prevalence estimates in population-based surveys as high as 15% for depression and 10% for substance misuse [1,2]. These disorders are associated with serious co-morbidity including underachievement in educational domains, poor socialization, delays in acquiring age-appropriate social skills, delinquency, and an elevated risk of suicide [3,4]. "
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    ABSTRACT: Stressful life events are associated with mood disorders in adults in clinical settings. Less described in the literature is the association between common life stressors and a wide range of psychopathology in young adolescents. This study uses a large non-clinical sample of young adolescents to describe the associations among worry or stress about common life events/difficulties, mental health and substance use. Data on lifetime stress or worry about common life events/difficulties (i.e., romantic breakups, family disruption, interpersonal difficulties, and personal stress (health, weight, school work)), symptoms of depression, conduct disorder symptoms, and substance use were collected from 1025 grade 7 students (mean age 12.9 years; 45% male). The association between each source of stress and each mental health and substance use indicator was modeled in separate logistic regression analyses. The proportion of adolescents reporting worry or stress ranged from 7% for new family to 53% for schoolwork. Romantic breakup stress was statistically significantly associated with all the mental health and substance use indicators except illicit drug use. Family disruption was statistically significantly associated with depression symptoms, marijuana use, and cigarette use. Interpersonal difficulties stress was statistically significantly associated with depression symptoms. All sources of personal stress were statistically significantly related to depression symptoms. In addition, health-related stress was inversely related to binge drinking. Young adolescents may benefit from learning positive coping skills to manage worry or stress about common stressors and in particular, worry or stress related to romantic breakups. Appropriate management of mental health symptoms and substance use related to common stressful life events and difficulties may help reduce emerging psychopathology.
    BMC Psychiatry 08/2012; 12(1):116. DOI:10.1186/1471-244X-12-116 · 2.21 Impact Factor
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