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ABSTRACT: Recent research on adolescent smokers suggests that there are important differences in the types of nicotine dependence (ND) symptoms that emerge and different patterns of ND symptoms. The purpose of this study was to use data from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study to identify latent subgroups of adolescent experimental and nondaily smokers varying in number and types of endorsed ND symptoms. Profiles were identified using baseline level of smoking, individual patterns of ND symptoms and other ND risk factors. Discrete time survival analysis was used to examine profile differences in probability of becoming daily smokers 48 months later. Four distinct subgroups of smokers with different patterns of smoking behavior, ND symptoms, and alcohol and other substance use emerged. Heavier smoking adolescents with high symptom endorsement, particularly the need to smoke in the morning, were most likely to become daily smokers 48 months later. A subgroup of social smokers had high smoking exposure and symptom endorsement (except need to smoke in the morning), and high levels of other substance use. Despite lower rates of smoking frequency and quantity compared to the heavier smoking class, 36% of these adolescents smoked daily by 48 months, with a steeper decline in survival rates compared to other lighter smoking classes. Morning smoking symptoms and symptoms prioritizing smoking (i.e., choosing to spend money on cigarettes instead of lunch or smoking when ill or where smoking is forbidden) might quickly identify adolescent non-daily smokers with more severe dependence and higher risk for daily smoking. A focus on skills for avoiding social situations involving use of alcohol and other drugs and reducing peer smoking influences may be an important focus for reducing smoking and other substance use among social smokers.
Addictive behaviors 05/2012; 37(10):1093-100. · 2.25 Impact Factor
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ABSTRACT: Little is known about the psychometric properties of alcohol abuse and dependence criteria among recent-onset adolescent drinkers, particularly for those who consume alcohol infrequently. This study evaluated how well DSM-IV alcohol dependence criteria measure an alcohol use disorder (AUD) construct for recent onset adolescent drinkers at different levels of drinking frequency.
Data were drawn from the National Survey on Drug Use and Health, a nationally representative sample of 9356 recent-onset adolescent drinkers, aged 12-21, who began drinking within the past year. Multiple group item response theory analysis was conducted to assess the 11 DSM-IV alcohol abuse and dependence criteria.
Criteria most likely to be endorsed at lower AUD severity included "withdrawal," "problems at home, school or work" and "tolerance." The criteria "drinking larger amounts/longer period of time," "unsuccessful efforts to cut down" and "continuing to drink despite related health problems" were more likely to be endorsed at higher AUD severity. Two criteria, "tolerance" and "time spent getting, using or recovering from alcohol" showed differential item functioning between drinking frequency groups (<7 vs. ≥ 7 days in past month), with lower discrimination and severity for more frequent drinkers. DSM-IV criteria were most precise for intermediate levels of AUD severity.
All but two DSM-IV criteria had consistent psychometric properties across drinking frequency groups. Symptoms were most precise for a narrow, intermediate range of AUD severity. Those assessing AUD in recent onset adolescent drinkers might consider additional symptoms to capture the full AUD continuum.
Drug and alcohol dependence 01/2012; 124(1-2):88-94. · 3.60 Impact Factor
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ABSTRACT: We sought to identify possible subgroups of elders that varied in depressive symptomatology and to examine symptom patterns and health status differences between subgroups.
The Cache County Memory Study is a population-based epidemiological study of dementia with 5092 participants. Depressive symptoms were measured with a modified version of the Diagnostic Interview Schedule-Depression. There were 400 nondemented participants who endorsed currently (i.e., in the past 2 weeks) experiencing at least one of the three "gateway" depressive symptoms and then completed a full depression interview. Responses to all nine current depressive symptoms were modeled using the latent class analysis.
Three depression subgroups were identified: a significantly depressed subgroup (62%), with the remainder split evenly between a subgroup with low probability of all symptoms (21%), and a subgroup with primarily psychomotor changes, sleep symptoms, and fatigue (17%). Latent class analysis derived subgroups of depressive symptoms and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition depression diagnostic group were nonredundant. Age, gender, education, marital status, early or late onset, number of episodes, current episode duration, and functional status were not significant predictors of depression subgroup. The first subgroup was more likely to be recently bereaved and had less physical health problems, whereas the third subgroup were less likely to be using antidepressants compared with the second subgroup.
There are distinct subgroups of depressed elders, which are not redundant with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition classification scheme, offering an alternative diagnostic approach to clinicians and researchers. Future work will examine whether these depressive symptom profiles are predictive of incident dementia and earlier mortality. Copyright © 2011 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry 12/2011; 27(10):1061-9. · 2.42 Impact Factor
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ABSTRACT: This study examined prevalence of alcohol dependence symptoms and diagnosis among a nationally representative sample of recent onset adolescent drinkers aged 12-21 years (mean 17 years) across different levels of drinking drawn from National Survey of Drug Use and Health (N=9490). We assessed whether the relationship between level of alcohol use and alcohol dependence was similar for individuals from different socio-demographic groups (i.e., gender, age group, ethnic group, family income, and substance use in the past year). The most prevalent DSM-IV alcohol dependence criteria at low levels of alcohol use were "unsuccessful efforts to cut down", "tolerance", and "time spent" in activities necessary to obtain alcohol or recover from its effect. Logistic regression with polynomial contrasts indicated increasing rates of each criterion and an overall dependence diagnosis with increasing alcohol exposure that differed most between the lowest levels of recent drinking frequency. After controlling for drinking quantity, younger adolescents, females, Native American/Alaskans and Asian/Pacific Islanders were most likely to experience alcohol dependence symptoms and a diagnosis of dependence, suggesting that these demographic subgroups may experience dependence symptoms or develop dependence more quickly after beginning to drink. Recognizing early symptoms of alcohol dependence may assist in early identification and intervention of those at risk for heavier drinker in the future.
Addictive behaviors 07/2011; 36(12):1160-7. · 2.25 Impact Factor
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ABSTRACT: Taiwanese professionals have adopted information about adolescent psychosocial development from Western societies. However, scholars know little about whether they have properly applied the models to both rural and urban youth. The purpose of this study was to examine the development of cognitive autonomy and ego identity in Taiwanese adolescents from Taipei City and surrounding rural counties. We controlled for gender and examined both situational (residential location, family income, and school type) and agential factors (culture value affiliation, attachment, and resiliency) to determine the extent to which each predicted psychosocial developmental outcomes. Among all the factors in this study, resiliency had the most distinctive relationship with adolescent psychosocial development. Each factor successfully predicted specific aspects of psychosocial development for these youth. We conclude with a discussion of the utility of using Western models of development.
International Journal of Psychology 07/2011; 47(1):39-50. · 0.40 Impact Factor
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ABSTRACT: In an effort to validate the use of a Western model of adolescent development with Asian youth, 781 urban and rural Taiwanese high school students (56% female) completed questionnaires about their development. Adolescents were first divided into cultural value orientations (i.e. collectivistic, individualistic, or transitional) and compared geographically. There were statistically significant differences in cultural value orientations only for rural youth. Identity statuses and levels of cognitive autonomy were then compared according to cultural value orientations and gender. Adolescents who self-identified as collectivistic were significantly more likely to self-identify as achieved rather than diffused compared to transitional adolescents. Gender, more than cultural value identifications, significantly differentiated these youth in regard to issues of cognitive autonomy measured in this study (i.e. evaluative thinking, voicing opinions, making decisions, self-assessing, and comparative validation). Taken in whole, these findings support the use of a Western model of adolescent development for Taiwanese youth.
Journal of Youth and Adolescence 08/2010; 39(8):882-93. · 2.72 Impact Factor
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Chien-Ti Lee
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ABSTRACT: The purpose of this study was to investigate Taiwanese adolescent psychosocial development (i.e., autonomy and identity development) based on psychosocial theoretical models developed in western societies. Data were collected from both public senior high and vocational high schools in both urban and rural areas in Taiwan. Adolescent participants, with an average age of 17 years old, included 447 (about 54% were females) from urban areas, and 702 (62% were females) from rural areas. The results of this study revealed that Taiwanese adolescents from both urban and rural areas were similar to adolescent developmental ranges suggested in western theories. There were a few variations revealed in this study, such as scores of internal consistency, average scores of each scale, associations among indicators, and the numbers of youth classified of certain developmental status. In general, the relationships between factors and adolescent psychosocial developmental outcomes did not moderate by regional differences. Identity development of Taiwanese youth from both areas was more likely to be predicted by both situational (e.g., family income and school type) and agential factors (e.g., collectivism, parent attachment, and resiliency) than Taiwanese adolescent cognitive, emotional, and behavioral autonomy. Higher family income level and greater resiliency scores were positively associated with high autonomy and/or achieved identity status. Strong beliefs in collectivism and secure attachments with parents did not significantly correlate with autonomy but did correlate with foreclosure identity status. Across the analysis models in this study, resiliency was the strongest factor which was associated with high autonomous status and identity achievement. Implications and further recommendations for research and practical uses were further discussed.
All Graduate Theses and Dissertations.
