Midterm 2 Flashcards

Question

Family communication style

Answer 1

●Low levels of trust, acceptance, understanding ●Lack of communication ●When communicate: often closed and/or unclear ●High levels of conflict ●Negative contact/hostility ●Lying, evading truth, avoidance ●Limited open discussions with parents about drugs

Answer 2

●Parents’ communication of their own anti-substance beliefs, rules and suggestions to avoid use: ●Related to higher anti-substance use norms in teens ●Parents’ reference to own past use is: Related to lower levels of anti-substance use norms in the children ●Levels are a bit higher if parents discussed regret, bad things that happened, and that they would not use again ●Hypocritical morality: “Do as I say, not as I do” ●What parents DO is more influential than what they say ●Different patterns for smoking

Answer 3

●1 in 4 parents with children aged 12-20 agree that teenagers should be able to drink at home when parents are present ●1 in 4 parents have indicated that they have permitted their teenagers to drink under their supervision in the past 6 months ●1 in 12 parents have allowed their child’s friend to drink under their supervision

Answer 4

●substance use by family members increase chances other family members will use ●Parental modeling of drinking relates to earlier initiation and later alcohol use in teens ●Compared to teens who have not seen their parents drunk, those who have: ●Are 2x more likely to get drunk in a month ●Are 3x more likely to use marijuana and smoke cigarettes ●Modeling use of a substance as a coping skill ●Teen substance use is associated with what teens think their parents feel about substance use - Often these assumptions are based on parental behavior

Answer 5

●25% of teens have reported that underage drinking has occurred with parents present ●2 out of 3 say it is easy to get alcohol from their home without their parents knowing ●2 out of 5 teens say it is easy to get alcohol from friends' parents

Answer 6

●argument: parental supervised alcohol use could reduce problem drinking and teach responsible drinking ●Harm minimization approach ●Concern that if it clashes with norms and laws, this may actually result in increased use ●Reality: Parental or adult supervision of alcohol is actually related to increased alcohol use in teens and harmful alcohol consequences ●These findings are not dependent on context or policies ●Parental provision of alcohol is related to earlier initiation and higher levels of alcohol us

Answer 7

worse outcomes

Answer 8

●role of older siblings is important ●increased risk for substance use if sibling is using: modeling and availability ●peers have strong influence on substance use ●spending more time with friends may shift adolescents view on their parents authority ●peers who use substances and smoke cigarettes is predictor of use

Answer 9

●parents: usher article

Answer 10

●qualitative ●looked for key terms that showed up several times ●8 themes

Answer 11

●parents tormented by behavioral changes in their teens, but teens deny or hide it ●over time, behavior becomes more apparent

Answer 12

●trial and error, but often give in to adolescent needs ●last resort= withdraw (disengage) ●try to use short term consequence and also try to use rewards

Answer 13

●all members of family deal with consequences of teen substance use ●accidents (car), verbal and physical abuse of family members, stealing, teen pregnancy (also emotional)

Answer 14

●often feel others blame them for teen's involvement in drugs, especially mothers ●feel shunned by society because of their role in teen's problem ●(other parents tend to pull kids away from kids who are struggling)

Answer 15

●what can parents do ●actions can have consequences (uber instead of train)

Answer 16

●"ideal child": what we think about our children before we even meet kids ●death of child: parents see child deviating from path of ideal child can lead to grieving

Answer 17

●perceived role in their child's addiction/failings ●have child leave the home (behavior gets so bad)

Answer 18

●try to disengage from teen when stress of the abuse on them and the rest of the family is overwhelming

Answer 19

●parents deny whats happening ●need help realizing when something is happening ●how to stop problem from getting bigger

Answer 20

●confirming suspicion ●struggling to set limits ●dealing with consequences ●living with blame and shame ●trying to keep child safe ●grieving the child that was ●living with guilt ●choosing self-preservation

Answer 21

●Frequent family dinners (5+/week) versus infrequent family dinners (<3/week) ●Infrequent dinners: 4x more likely to use tobacco, 2x more likely use alcohol and 2 ½x more likely use marijuana ●Frequent dinners: Less access to drugs ●increase family knowledge lowers use (parents know about their kids lives, learn little bits of info) ●less family dinners= thinks its ok to use drugs ●positive family relationship relate to lower teen substance use (relationship with both parents)

Answer 22

●Families who eat dinner frequently spend more time together overall ●Frequent family dinners are related to parental knowledge →related to decreased likelihood of using marijuana, alcohol and tobacco ●Dinner: Time to talk, share, catch up with family ●Linked to protective factors: Monitoring, Spending time with parents, Attending religious services, Excellent family relations with parents and siblings ●also shift views on future use (more dinners= less likely to use)

Answer 23

●advantages: Target risk and protective factors, Especially appropriate for high-risk children and adolescents, Adds more than school-based programs, Families across all risk levels attend ●Disadvantages: Reach smaller proportion of the population, Barriers to attendance, especially for high-risk families, Recruitment ●shift toward the family system

Answer 24

●strengthening families ●family matters ●guiding good choices

Answer 25

●designed for high risk children in elementary school (6 to 11 year olds) ●now evolved to: Broader age ranges: pre-school through high school, Universal program, school-based curriculum, Selective intervention for children of substance abusing parent ●manualized program: (tells you about each session), parenting skills, child life skills, family life skills

Answer 26

●To enhance parenting and family strengths in order to: Reduce behavior problems, delinquency, alcohol/drug use ●Improve social competencies, school performance

Answer 27

●Implemented in a number of settings: schools, drug treatment centers, family service agencies, child protection agencies, community mental health centers, homeless shelters, churches, drug courts, prisons ●Implemented in 26 countries with translations including Spanish, Portuguese, French, German, Dutch, Slovenian, Russian, Tai, Burmese, Chinese ●Implemented with ethnically diverse families

Answer 28

●Parents and children come to sessions together 8 families on average) ●Meal time (use family dinner research) ●Attend separate sessions for the first hour with trained group leaders: Videotaped vignettes, manuals, handouts and Learn specific skills (age appropriate) ●Come together in second hour for Family Session ●Home-based activities

Answer 29

●Developmental expectations ●Positive interactions, attention/praise ●Positive family communication (active listening, reduce criticism) ●Holding family meetings for organization and order ●Effective and consistent discipline

Answer 30

●Communication skills to improve family, peer and teacher relationships ●Hopes and dreams ●Problem solving ●Peer resistance ●Feeling identification ●Anger management, coping skills

Answer 31

●Family practice sessions–implement skills and receive coaching ●Practice skills (communication, discipline) ●Engage in therapeutic play or games ●Family meetings, plan family activities

Answer 32

●Rated as exemplary evidence-based program ●Rigorously tested: ●Improved parenting, parental rules, anger management, parental communication ●Reduced risk factors and problem behaviors in high risk children (behavioral, emotional, academic problems) ●Reduced substance use and substance use risk (attitudes toward use, peer pressure)

Answer 33

●Universal substance use prevention program for parents of children in grades 4 –8 (ages 9 –14) (early middle school) ●Evidence-based, multimedia program that gives parents the knowledge and skills needed to prevent the likelihood of substance problems and improve family bonding and communication skills ●Implemented in diverse urban and rural communities in the US ●Parents and children from various ethnic and socioeconomic backgrounds ●Workshops delivered in US, PR, Canada, Cyprus, Spain, Sweden, UK, US Virgin Islands

Answer 34

●2 hour sessions over 5 weeks (short) (children come to 1 session) where parents learn to: ●Establish family policy on drug use ●Teach children resistance skills ●Recognize importance of creating opportunities for adolescents to have meaningful roles in family ●Practice techniques for self-control to reduce conflict ●Interactive skill-based ●Video-based vignettes ●Family ●mainly about parenting

Answer 35

●Session 1: Over view of Family Meeting, Plan a fun family activity ●Session 2: Setting clear family expectations on drugs and alcohol, Monitoring strategies, Rewards & consequences for following or breaking rules, Schedule family meeting to involve children in setting family policy about drugs and alcohol ●Session 3: Peer risk factors, Children attend session with parents to practice refusal skills ●Session 4: Parents reduce family conflict, Parent anger management ●Session 5: Parents learn to express positive feelings and love to children

Answer 36

●Parents: Improved parenting, Less negative interactions, Less antagonistic styles, More proactive communication skills, Better behavior management (communicating rules, rewarding prosocial behaviors), More involvement, Less conflict with spouse, Child management and quality of relationship sustained 1 year post program ●Teens: Stronger norms against alcohol use even 3 ½ year after the intervention, Slower rates of increased use, Slower rates of increased delinquency acts

Answer 37

●Universal prevention program for parents of children ages 12 –14 ●Designed to prevent alcohol and tobacco use ●To reduce family risk factors and enhance protective family factors associated with substance use by: Improving communication and parenting, Increasing positive time together/attachment and reducing conflict, Teaching behaviors that families can influence such as rules and availability of tobacco and alcohol in the house, Helping parents fight negative non-family influences such as media and friends

Answer 38

●Successive mailing of four bookletsto parents: Two weeks after each mailing: a health educator calls the parents to discuss (do whenever) ●Can be implemented by many different types of organizations and individuals: health promotion practitioners in health departments, school health educators or parent-teacher groups in schools, volunteers in community-based programs and national nonprofit organizations

Answer 39

●Adolescent cigarette smoking and alcohol use was reduced 3 months & one year after the program ●Reductions were due to prevention, not decreasing use by current users ●Significant changes in several substance-specific aspects of the family, such as rule setting about tobacco and alcohol use. ●could be good because its low cost and low commitment

Answer 40

●target children, celebrity endorsement, connecting health to smoking (doctors are doing it), escape from reality, bring fun home ●male = masculinity ●female shift to encourage smoking

Answer 41

●attractive to kids ●Marketing was more successful to children than adults- remember the character and found him appealing ●91% of children were able to match Old Joe Camel to a picture of a cigarette –same % who could match Mickey to the Disney logo

Answer 42

●independence, using doctors, healthier, cartoon-like figures,

Answer 43

●aim to young people (subtle) ●masculinity ●thinness ●sex appeal ●independence ●"cool", fit in, popular

Answer 44

●increase after wars ●first real report on bad cigarettes (1964)= slow decline ●report on secondhand= ppl hurting the ppl they care about ●master settlement agreement ●what happens in world works with drug use

Answer 45

●ads against smoking by tobacco companies: deflection against accusations

Answer 46

●Spend $12.4 billion on advertising per year ●Master Settlement Agreement (1998) between the US tobacco companies and Attorneys General of 46 states. ●Tobacco companies agreed to: Decrease or stop tobacco marketing practices, Pay settlements to states for their medical costs due to smoking-related illnesses (minimum $206 billion/25 years), Fund smoking advocacy group (American Legacy Foundation)

Answer 47

●1998: Launched national media campaign for youth smoking prevention- $100 million/year on prevention of teen smoking ●Targeted 10-to 14-year-olds: Print and video ads for teens and encouraged adults to talk to teens about smoking, Suggested that smoking is not “smart” and resisting smoking is as simple as saying “No” ●Campaign aimed at: ●Youth: Think. Don’t Smoke ●Parents: Talk. They’ll Listen ●Public Service: Working to make a difference, the people of Phillip Morris ●Publicized company’s efforts to prohibit cigarette sales to minors ●Elderly, homeless teens, domestic violence, Midwestern floods, Bosnia war zone

Answer 48

●didn't try that hard ●got in trouble and do prevention ads ●give back to community (distraction)

Answer 49

●When asked what comes to mind when PM is mentioned, 57% mentioned tobacco →BRAND RECOGNITION ●Ads were rated less favorably when students were aware the company was a tobacco company →Companies Avoid brand recognition in these ads ●No association between opinions and smoking patterns →NO CHANGE IN BEHAVIOR

Answer 50

●to keep people from associating potential consumers ●didn't want people to stop smoking

Answer 51

●Asked teens to recall which ads they saw in the past month ●19% recalled PM ad ●25% recalled State Sponsored ads ●●Normative issues; not cool; show celebs who do not smoke; do not do well in sports ●6% recalled Outrageous behavior ad ●●Serious, dangerous habit; elicited anger ●50% recalled Serious Illness ad ●●Arouse negative emotion; show health consequences ●Those who recalled seeing PM ads rated the ads less favorably than teens who recalled seeing other ads ●●BUT -younger teens rated PM ads more favorably

Answer 52

●Following “Think. Don’t Smoke” campaign, in 12-to 17-year-olds, greater exposure to campaign resulted in: ●Greater likelihood of smoking the following year or in intent to smoke in the future ●Positive impressions of tobacco industry: ●Viewing the ads made youth less likely to believe that cigarette companies deny that cigarettes cause harmful diseases and less likely to say that they want cigarette companies to go out of business ●Improved impressions of tobacco industry because smoking portrayed as attractive, but forbidden

Answer 53

●Phillip Morris Teen Smoking Prevention Ads: ●Purpose was to buy respectability, not prevent youth smoking ●Ineffective: “fuzzy-warm”, not representative of teen culture ●Lessened negative attitudes toward smoking ●Purpose is to delay smoking not discourage a lifetime of it ●Smoking is presented as a “choice” ●Smoking portrayed as attractive, but forbidden ●Just say NO ●Directive messages not to smoke, smoking is uncool and for adults only (tell teens what NOT TO DO!) ●No mention of the negative effects of smoking ●Anti-smoking advocates accused campaign of intentionally promoting smoking

Answer 54

●encourage youth to be decisive, trust themselves and follow inspiration ●don't be a maybe ●Be > Marlboro ●work because: freedom, defy authority, peers, targeting youths, risk taking ●hook them young so they are a consumer for more years

Answer 55

●Goals: highlight short- and long-term consequences, deglamorize smoking's social appeal by using humor or unflattering portrayals, challenge misconceptions that smoking is widespread among teens

Answer 56

●exposing deceptive tobacco marketing campaigns and denials of tobacco's health and addictive properties ●deglamorizing smoking

Answer 57

●bring death to the moment now ●want to avoid ads from celebrity when we can't connect with ●be careful to share regret when parents talk about their past ●show impact on loved ones

Answer 58

●american legacy foundation-truth (2000) ●largest national anti-smoking campaign, counter messages from tobacco companies ●possibly most effective effort to reduce youth smoking ●provides facts and info about tobacco product and tobacco industry ●gives teens tools to take control and make informed decisions about tobacco use ●provides teens with outlet for expression

Answer 59

●Goal: shift or change beliefs/attitudes (norms), intention to smoke and reduce smoking prevalence ●Builds on behavior change literature: attitudes, perceptions, social norms and intentions related to the specific behavior ●Market the message as a brand ●Expose the tobacco industry and manipulative tactics ●Re-direct teen’s need for rebellion to the tobacco industry ●Promotes teen’s independence and individuality ●Avoid preaching, directing, judging smokers ●Avoid overt direct message that tell teens not to smoke ●National, multiethnic campaign designed to engage teens in innovative ways through: ●Graphic images with facts about death and disease to highlight the toll of tobacco ●Multi-dimensional campaign: TV, Social networking sites, Interactive websites, Grassroots outreach

Answer 60

●Campaign reached ¾ American youth (12 -17) ●Reach and Recognition ●Approach appeals to youth and seems to be effective →positive reactions (reacted well) ●truth campaign may be changing perceptions about how common smoking is in peer groups ●Teens exposed to truth campaign had more accurate views on the number of peers who smoke ●Those with less exposure to the campaign overestimated the number of peers who smoked

Answer 61

●Exposure to truth campaign was related to an increase in anti-tobacco attitudes and beliefs ●increased from 6.6% to 26.4% in first 10 months of campaign ●Attitudes that changed most ●Taking a stand against smoking is important ●Not smoking is a way to express independence ●Cigarette companies deny that cigarettes cause cancer and other harmful diseases VS ●Exposure to PM campaign was not related to anti-tobacco attitudes and beliefs ●More likely to be open to idea of smoking

Answer 62

●MTF -Decline in smoking prevalence (1997 –2002) ●Decline faster after “truth” campaign (2000-2002) ●22% of the decline in youth smoking from 2000-2006 attributed to the truth campaign ●Smoking rates in 2002 were 1.5% lower than they would have been (300,000 fewer youth smokers) ●May have larger impact in 8th graders (more like follower) ●Dose response: youth exposed to more truth ads were less likely to smoke

Answer 63

●Expanded data collection to look at e-cigarettes ●Researchers surveyed 6,000+ 15–24-year-olds in spring 2018 and 2019 ●Asked about brand loyalty, popularity, personality, and awareness as it relates to tobacco → Strong brand loyalty ●Those with strong truth brand awareness and loyalty ●19% lower odds of current e-cigarette use ●17% greater anti-e-cigarette attitudes ●25% lower odds of intention to use e-cigarettes 18 months late ●A small increase in brand equity score (value from consumer perceptions) over the years studied, associated ●21% lower odds of intention to vape ●9% greater odds of having anti-e-cigarette attitudes.

Answer 64

●started by thomas siebel and part of program of partnership at DrugFree.org ●Several states involved (Colorado, Georgia, Hawaii, Idaho, Montana, Wyoming)

Answer 65

●Goal: To increase perceived risk and decrease perceived benefit of trying meth ●Improve and increase communication and discussion between teens and parents ●Stigmatize use, make meth socially unacceptable (similar to cigarettes) ●Depicted the users to be “unhygienic, dangerous, untrustworthy, exploitative”. ●Used explicit images

Answer 66

●did not contribute to changes in meth use over and above pre-existing downward trends ●increasing stigma ●fear, graphic images ●people didn't relate to it

Answer 67

●The FDA launched a national public education campaign in 2/2014 to: ●Prevent tobacco use in teens 12 –17 and ●Reduce the number of regular smokers in teens ●Goal is to influence social normative beliefs about smoking and beliefs that one can reject smoking in the future ●cost to body and minds

Answer 68

●teens value more immediate and visible health effects ●highlight health consequences that matter to teens ●strong desire to have control over their lives ●highlight that every time you smoke you increase your risk of losing control and independence

Answer 69

●89% of youth were aware of the campaign 6-8 months after the campaign launched ●Awareness was higher among smoking experimenters ●Majority of youth found campaign to be effective ●From Feb 2014-Nov 2016, prevented up to 587,000 youth ages 11 to 19 from initiating smoking ●Half of whom might have gone on to become established adult smokers ●In first 2 years, saved over $53 billion by reducing smoking-related costs like early loss of life, costly medical care, lost wages, lower productivity and increased disability. ●Campaign Continues today

Answer 70

●$54 million campaign, started in 2012 ●First federally funded anti-smoking media effort ●National educational campaign featuring real people who are living with the effects of smoking-related diseases, or the effects of secondhand smoke ●Emotional stories told by former smokers ●Increase awareness about dangers and illnesses ●Encourage quitting ●Motivate non-smokers to talk to family and friends about the dangers of smoking ●shows reality of smoking, real story, suffering

Answer 71

●Tips most likely resulted in: ●1.64 million additional smokers attempting to quit and 220,000 remained abstinent at the end of the campaign ●100,000 expected to remain abstinent “for good” ●CDC estimated that 13.6 million Americans attempted to quit smoking before the campaign. = 12% increase ●Increase in non-smokers making recommendations to quit: from 2.6% to 5.1% ●Increase in people talking to friends and family about dangers of smoking: increase from 31.9% to 35.2

Answer 72

●38% drop in calls during 6 weeks ads were not running ●particular ad causing change ●2.8 million wb visits ●more than 150,000 calls

Answer 73

●Government-based campaign of National Youth Anti-Drug Media Campaign sponsored by Office of National Drug Control Policy ●Prevention messages on substances ●Campaign promotes the message to live “above the influence”. Live life above negative influences ●It encourages teens to be themselves and avoid negative influences and pressures to drink and do drugs. ●It targets behaviors to “fit in”.

Answer 74

●Exposure to ATI: ●Reduced initiation of marijuana use ●Reduced pro-marijuana attitudes and fewer drug use intentions ●Reduced marijuana use in 8thgrade females ●Receptive to messages about achievement and living about negative influences ●No similar declines in alcohol and tobacco ●Seems successful because it taps into teens’ need to be independent and self sufficient

Answer 75

●Effective in reducing intentions to smoke are messages about: ●Exposure to the ad (awareness of the ad and the message) + ad is fully attended to (perceived as effective) ●Fear appeals ●Serious health problems, tobacco company deception →death/disease ●Endangering others and family (e.g., secondhand smoke)▪Peer Norms ●Smoking is unattractive, wrong path in life, most do not smoke ●Manipulative practices of tobacco industry ●Images or themes of refusing cigarettes ●Graphic, dramatic, emotional portrayal of serious consequences ●Negative life circumstances ●Arousing strong (negative) emotion, eliciting sadness or fear

Answer 76

●Effective campaigns target behavior change to change beliefs that make a difference in one’s behavior ●Empirical study in identifying the most effective themes to prevent initiation, stop progression to regular smoking and encourage cessation. ●Consequences of smoking for mood ●Social acceptance ●Social popularity

Answer 77

●Not effective in reducing intentions to smoke are messages about: ●Cosmetic effects of smoking (e.g., yellow teeth, bad breath) ●Humorous →aroused positive emotion ●Romantic rejection of smokers ●Long-term health effects ●Addiction ●Celebrities: Only could work when relatable and personal testimonial, emotional appeal, need credibility

Answer 78

●programs targeted at children and adolescents and delivered in schools ●access most children and youth throughout all developmental stages ●access high-risk youth ●many risk and protective factors are school-based ●no family component

Answer 79

●DARE- Drug Abuse Resistance Education ●made in 1983 by LA police department ●led by officers with schools, parents, students and communities ●lots of community support

Answer 80

●School-based drug and violence prevention program ●5thgrade –High School ●Underlying assumption: abstinence only ●Students sign a pledge not to use drugs ●All DARE officers received 80 hours of training (instruction, teaching strategies, classroom management, communication skills, adolescent development, drug information, specific lessons) ●Allows for positive, friendly interactions with officers in a controlled and safe environment

Answer 81

●Motivate students to avoid substances ●Improve ability to make prosocial decisions ●Resist peer pressure to use substances ●Develop and practice refusal skills ●Topics: Tobacco smoking, tobacco advertising, drug abuse, inhalants, alcohol, peer pressure in a social network ●needed to frame the knowledge in the correct way

Answer 82

●Popular with law enforcement agencies, school and parents ●Widely disseminated ●Cost effective ●Implemented in 75% of US school districts and 43 countries ●2009: 36 million children worldwide; 26 million in US ●20 million graduates per year worldwide ●Website got 12 million hits a month ●About 10,000 policemen participated

Answer 83

●Government Agencies: US Department of Justice, US Department of Defense, US Department of State, US Drug Enforcement Administration, US Bureau of Justice Administration, US Office of Justice and Delinquency Prevention ●Private and corporate funding: State and local programs receive funding from state legislature, agencies, counties, cities, schools, police agencies, community fund raisers.

Answer 84

●Recognize, Resist, Report ●report to teachers

Answer 85

●1 to 1.3 billion spent a year ●Failure, after billions of dollars spent over 20 years: ●Over 30 studies conducted on DARE –no evidence that it reduces drug use in short or long-term studies ●2001: Surgeon General declared DARE does not work ●2004: 10-year meta-analysis found no effects ●2007: DARE students may have slightly higher drug abuse rates ●Some effects on mediating variables : Attitudes to drugs, peer pressure resistance (but all short term)

Answer 86

●revamped to Keepin' It Real ●Refuse offers to use substances ●Explain why you do not want to use substances ●Avoid situations in which substances are used ●Leave situations in which substances are used

Answer 87

●Multi-cultural school-based prevention program ●12 –14 year olds ●10 lesson curriculum taught by trained classroom teachers in 45 minute sessions ●Booster sessions in next school year ●Designed to: assess risks associated with substance use, build decision making and resistance strategies, improve antidrug normative beliefs and attitudes, reduce substance use ●SAMSHA/NREPP best programs

Answer 88

●Lower alcohol, marijuana and cigarette use in prevention group ●Effects sustained for 8 to 14 months ●40% of the prevention group who used alcohol at baseline reported reductions in alcohol use post-program (compare to 30% in controls) and 32% reported abstinence (compared to 24% in controls) ●At 8-and 14-month follow-ups, students who received the program reported lower expectations of positive outcomes of using substances (compared to controls) ●Students had greater use of strategies to resist marijuana and cigarettes ●Short-term (2 –8 months) ●No effects after 12 month

Answer 89

●One of the best researched and effective school-based substance abuse prevention program ●●Holistic program based on risk and protective model ●●Prevention of alcohol, tobacco and marijuana use ●●Prevention of violent behaviors ●Universal prevention ●●School-based program for elementary, middle and high school students and their parents ●●Includes the school-based program + boosters ●●Supplemental parenting program available (schools and parents) ●Taught in the classroom (elementary to high school) ●LST program implementers: Classroom teachers, health care professionals, older peer leaders ●LST delivered in interactive format ●Didactics, demonstrations, role plays, behavioral rehearsal, feedback, social reinforcement, behavioral homework ●Cost: $625 for middle school set

Answer 90

●Personal Self-Management Skills ●Social Skills ●Drug-related information and skills

Answer 91

●Targeted Risk / Protective Factor ●●Media portrayal ●●Psychosocial ●Types of Activities ●●Decision-making/Problem Solving ●●Skills to cope with stress/anxiety and anger ●●Behavioral skills for personal behavior change and self-improvement ●●Identification, analysis, resistance of media messages

Answer 92

●Targeted Risk / Protective Factors: ●●Psychological well-being ●●Social factors –negative affect, self-control ●Types of Activities ●●Communication skills ●●Initiating social interactions and conversational skills ●●Verbal and non-verbal assertive skills ●●Skills related to dating relationships

Answer 93

●Targeted Risk / Protective Factors: ●Attitudes and expectations regarding drugs ●Peer influences: Peers’ attitudes and use ●Media messages ●Focus of Activities: ●●Actual rates of drug use ●●Consequences of drug use ●●Declining acceptability of cigarette and other drug use ●●Exercises demonstrating the immediate physiological effects of cigarette smoking ●●Media images of substance use ●●Advertising techniques of alcohol and tobacco companies ●●Techniques for resisting peer pressure to use substances

Answer 94

●Lower normative expectations for smoking, drinking, drug use post and 1 year follow-up ●Higher drug refusal skills at 1 year follow-up ●Significantly lower violence and delinquency at 3 month follow-up ●Effective with: Caucasians, Latino, African-American students, Suburban and inner-city youth ●Follow-Up results: reduced use ●Effective by reducing: ●●Pack a day smoking by 25% ●●Lowers risk of using prescription and opioid misuse ●●Reduces violence (physical aggression by 30%; delinquency by 40%) ●●Reduces risky drinking behavior ●●Decreases use of inhalants, hallucinogens ●●Effects for up to 12 years

Answer 95

●Social norms ●Campus wide marketing campaigns ●Web-based programs ●Environmental Prevention Plans

Answer 96

●Change behavior by changing erroneous beliefs ●Inform students about the actual drinking behaviors and alcohol related norms on their campuses ●Can target higher risk groups (Greek culture, student athletes, students with prior alcohol violations) or full student body ●Include: one-on-one counseling, peer counseling, school-wide prevention efforts, focus on high-risk groups, specific cultural aspects of the student population

Answer 97

●Ads about drinking on campus, health-related facts, email blasts, posters

Answer 98

●Advantages: cheaper alternative to reach many students with a consistent message with a reduced administrative burden; can track who completed it ●Include: education about social norms; prevention strategies; can be tailored to students based on answers ●Disadvantage: may not reach everyone

Answer 99

●1. Alcohol Free Options –Provide social, recreational options that do not include alcohol or drugs (e.g., alcohol-free events, community-service work that is part of the curriculum, expand hours for the gym or student center, student center without alcohol) ●2.Normative Environment –Create an environment that supports health-promoting norms (e.g., offer substance-free residence options, increase academic standards, increase contact with faculty) ●3.Alcohol Availability –Limit Alcohol Availability on and off Campus (e.g., ban or restrict the availability of alcohol on campus, limit the hours of alcohol sales, require keg registrations, prohibit delivery of kegs, prohibit alcohol use in public places, limit container size) ●4.Marketing and Promotion of Alcohol –Restrict on and off campus (e.g., ban or restrict alcohol advertising on campus, require pro-health messages to counter alcohol advertising, limit special pricing agreements) ●5. Policy Development and Enforcement –Develop and enforce campus policies and local, state and federal laws (e.g., revise campus alcohol and drug laws, require on campus events to be registered, increase patrols near parties, increase criminal prosecution, increase ID checks off campus, enforce penalties for fake ID possession, increase enforcement for DUI laws, enforce laws for buying alcohol for minors)

Answer 100

●Universal prevention program ●Targets change of normative behaviors on campus ●An online program to encourage students to make safer, smarter choices about alcohol use ●3-hour, 2-part course all incoming 1styear students must complete ●●Individualized and customization

Answer 101

●Personalized, evidence-based online prevention program ●●Developed at San Diego State University ●Goals: To reduce dangerous drinking on college campuses and to increase a safe and healthy campus by reducing harms ●●Targets freshmen and athletes ●Provides personalized feedback to students on their: ●●Drinking patterns ●●Health and personal consequences ●●Personal and family risk factors ●●Campus and community support, and emergency services ●Additional program: Marijuana eCHECKUP

Answer 102

●AlcoholEdustudents drank less and had a lower blood alcohol level, compared to the other 2 groups. ●significant reduction in comparison to controls ●no significant diff to e-Chug ●e-Chug has significant reduction in comparison to control

Answer 103

●Lower levels of ●●Academic consequences (missing class, failing a project) ●●Driving under influences ●●Trouble with police or college authorities ●●Acceptance of others’ alcohol behaviors

Answer 104

●Classification of mental disorders by mental health professionals in US (psychiatrics, psychologist, social workers, nurses) ●designed for use in multiple clinical and community settings (inpatient, outpatient, day hospital) ●provides menu of symptoms and meets diagnostic criteria base on number of endorsed symptoms from list (meet diagnostic criteria, have to exhibit impairment)

Answer 105

●Each specific substance is addressed separately under its own disorder (e.g., alcohol use disorder, stimulant use disorder, tobacco use disorder) (NOT CAFFEINE) ●Severity of the disease varies: ●Mild disorder: 2 –3 criteria ●Moderate disorder: 4 –5 criteria ●Severe disorder: 6 or more criteria

Answer 106

●Taking the substance in larger amounts or for longer than you meant to ●Wanting to cut down or stop using the substance but not managing to ●Spending a lot of time getting, using, or recovering from use of the substance ●Cravings and urges to use the substance ●Not managing to do what you should at work, home or school, because of substance use ●Continuing to use, even when it causes problems in relationships ●Giving up important social, occupational or recreational activities because of substance use ●Using the substance again and again, even when it puts you in danger ●Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance ●Needing more of the substance to get the effect you want (tolerance) ●Development of withdrawal symptoms, which can be relieved by taking more of the substance

Answer 107

●Early remission: at least 3, but less than 12 months, where the person no longer meets the criteria (except cravings) ●Sustained remission: 12 or more months without meeting the criteria (except cravings) ●On maintenance therapy: taking long-term maintenance medication to help stay in remission (e.g.,. methadone, nicotine replacement) ●In a controlled environment: in an environment where access to a substance is restricted ●can have combination (just not first two)

Answer 108

●highest diagnosis for 18-25 for substance use, alcohol use, and drug use disorder

Answer 109

●Multimodal, multi-informant assessment (lots of means, lots of diff ppl) (History of present and past substance use, Medical and psychiatric assessment: history and current, Social, developmental, family, occupational histories, Cultural history, Multiple reporters) ●Role and function of the substance in individual’s life (Heterogeneity, Type of drugs, Nature, course, duration and severity of problem, Views about drugs and impact on functioning) ●Treatment (History of treatment and relapse, Information on what worked (and did not work), Motivations and reasons for treatment, Views about abuse, addiction and treatment ●Psychiatric comorbidity (Assess whether substance abuse is primary or secondary to other mental health problems, Understand the cultural differences in comorbidity) ●Cultural and historical factors (Select assessments valid for population and period, Consider definition, scoring of abuse by culture and period, Sensitive to threshold issues)

Answer 110

●Standardized screening instruments (CAGE, AUDIT, CRAFFT, Fagerstrom test for nicotine dependence) ●clinical interviews (Additions severity index- ASI)

Answer 111

●screening instruments: interview or self-report measure to identify unrecognized abuse or dependence in person ●standardized: administered and scored in consistent or standard manner ●benefits: Relatively quick screener that points to need for more in depth assessment, Allows for assessment of larger numbers of individuals, Compare to norms of representative sample, Administered by wide range of individuals (limited training required), Economical, time efficient ●want to make sure they accurate and reliable

Answer 112

●widely used screening tool for hazardous and risky drinking (in variety of settings and wide range of populations) ●C- Have you ever felt you should CUT down on your drinking? ●A–Have people ANNOYED you by criticizing your drinking? ●G–Have you ever felt bad or GUILTY about your drinking? ●E–Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Answer 113

●questionnaire ●circle correct answer

Answer 114

●Behavioral health screening tool for use with children and adolescents under the age of 21 ●Recommended by the American Academy of Pediatrics’ Committee on Substance Use ●Clinician and self-report versions ●Translated into several languages ●3 opening questions followed by 6 questions to screen adolescents at high risk for alcohol and other drug use disorders

Answer 115

●Yes or No ●During the PAST 12 months, did you: ●1.Drink more than a few sips of beer, wine, or any drink containing alcohol? ●2.Use any marijuana (cannabis, weed, oil, wax, or hash by smoking, vaping, dabbing, or in edibles) or “synthetic marijuana” (like “K2,” “Spice”)? ●3.Use anything else to get high (like other illegal drugs, pills, prescription or over-the-counter medications, and things that you sniff, huff, vape, or inject)?

Answer 116

●C–Have you ever ridden in a CAR driven by someone (including yourself) who was “high” or had been using alcohol or drugs? ●R–Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in? ●A –Do you ever use alcohol/drugs while you are by yourself, ALONE?●F–Do you ever FORGET things you did while using alcohol or drugs? ●F–Do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use? ●T –Have you gotten into TROUBLE while you were using alcohol or drugs?

Answer 117

●higher school= higher probability of getting DSM-5 substance use disorder diagnosis

Answer 118

●Review screening results ●recommend not to use ●Riding/driving risk counseling ●response elicit self-motivational statements ●reinforce self-efficacy

Answer 119

●Short screen to assess the level of dependence on nicotine. Higher scores typically reflect higher dependence on nicotine. ●Self-assessment (available online) ●Has been adapted and used with adolescents (e.g., school settings) ●high score= higher addiction

Answer 120

●A tool that helps physicians, psychologists and researchers make an accurate diagnosis of a variety of psychiatric illnesses. ●Contain standardized questions so that each individual is interviewed in the same way (Semi-structured: allows open ended) ●Questions usually ask about the nature, severity, onset, and duration of symptoms (May also ask about the degree of impairment) ●Benefits: (1) Economical; (2) time-efficient; and (3) can use lay trained interviewers when fully structured only

Answer 121

●Developed at the University of Pennsylvania, Center for the Studies of Addiction ●Most widely used assessment instrument in addiction ●Translated into 18 languages ●Other versions: Brief, Clinical Training, Self-Report, Special Populations (e.g., Native Americans) ●TEEN Addiction Severity Index (T-ASI) ●Administered in one hour or less ●Assesses level of severity/impact in different domains of life

Answer 122

●Developed by Prochaska & DiCemente ●Assesses an individual’s readiness to act on a new, healthier behavior ●Developed through studies on how smokers were able to give up their habits or addiction ●Model applied to a broad range of behaviors: weight loss, injury prevention, alcohol & drug addiction, medication adherence ●Basis of therapeutic approaches and intervention

Answer 123

●Behavior change does not happen in one step ●People tend to progress through different stages (and at different rates) on their way to successful change ●Each individual must decide for him/herself when a stage is complete and when it is time to move onto the next stage ●Decision must come from within the individual in order for the change to be long term and stable

Answer 124

●Precontemplation ●Contemplation ●Preparation ●Action ●Maintenance ●Relapse (go back to any stage)

Answer 125

●Not Ready ●Not currently considering change and not intending to start a new behavior in near future (within 6 months) ●May be unaware of a need to change ●“Ignorance is bliss”

Answer 126

●Getting ready ●Ambivalent about change –may lead to putting off taking action ●“Sitting on the fence” ●Not considering change in the next month, but within 6 months

Answer 127

●Some experience with change, trying to change ●“Testing the waters” ●Planning to act within 1 month ●Getting ready for change

Answer 128

●Goal is to produce the change ●Practicing new behavior ●Can be in this stage up to 6 months

Answer 129

●Continued commitment to sustaining new behavior ●Post 6 months to 5 years ●can lead to stable improved lifestyle

Answer 130

●Revert to old behaviors

Answer 131

●Contexts in which people receiving care ●Self-help Groups ●Treatment Settings (Brief interventions (often done in medical settings), Outpatient Care, Intensive Outpatient, Partial Inpatient, Wilderness, Inpatient (most restrictive), Therapeutic Communities)

Answer 132

●Mental Health treatment ●next outpatient ●some telehealth treatment and prescription medication ●little inpatient and prison/jail/or juvenile detention center ●1.6 million teens dont need treatment ●9,000 got treatment ●49,000 think they need treatment but don't get it

Answer 133

●Short intervention (1-2 sessions in doctor’s office or hospital) provided by primary physician or nurse) ●Builds on Motivational Interviewing principals and techniques ●Effective for heavy drinkers and binge drinkers ●Raise Problem, Provide Feedback, Assess Readiness

Answer 134

●Treatment for a short duration (e.g. 15 minutes -a few hours) ●Treatments include: Individual counseling, Group therapy, Medication management

Answer 135

●9 hours a week of structured programming (Typically over a few days) ●Individual therapy, therapy groups, educational groups, psychiatric services/medication

Answer 136

●"Day hospital” ●20 hours a week ●Structured programming ●Immediate access to medical and psychiatric services

Answer 137

●Outdoor behavioral health programs ●Varied in the quality of clinical care ●give them the success ●not really the best funded

Answer 138

●Person is admitted to the hospital (Teens can be involuntarily admitted by their parents) ●Most restricted level of care-not allowed to leave ●24-hour access to care team ●Removed from environmental triggers ●Multidisciplinary team: Milieu support social work, psychologists, psychiatrist, medical care, teachers etc

Answer 139

●Individual therapy ●Therapy groups ●Psychoeducation, didactic lectures ●Therapeutic milieu ●Family sessions ●Recreational groups (art, physical education) ●Work assignments or School ●Relapse prevention skills ●Autobiographies, share life history ●AA groups (often the Minnesota Model)

Answer 140

●Long term inpatient care-typical stay is 30-90 days ●Provide treatment and academics ●Similar programming as the inpatient treatment center but more schooling ●Not locked like inpatient programs

Answer 141

●Lots of overlap with residential treatment programs with some key differences ●Fewer staff per student (1 staff to 8 student) vs (1 to 4/5) ●Students often have less complex presentation ●More academically oriented vs treatment oriented ●Different licensure processes

Answer 142

●Residential setting that is highly structured ●All services provided onsite: Addictions counseling and psychoeducation, Social and legal services, Vocational services, Work therapy, Recreation ●Main therapist is community itself: Treatment is seen as happening 24 hours a day as part of the living context ●Run by individuals in recovery and senior residents who act as therapists and role models ●Residents do all the work to maintain community ●Group therapy is main treatment modality: All residents are responsible to confront each other and to reinforce each other ●Last phase of treatment is a live-out phase with contact with TC gradually reduced until graduation (1 year after moving out

Answer 143

●For many people abstinence, or refraining from any use, is the preferred intervention ●In the US abstinence-based interventions often means AA ●AA is a support group ●Support Groups allow people with similar shared experiences to come together and share their experiences, cope and connect

Answer 144

●AA traced back to Oxford Group ●Bill Wilson & Dr. Bob (1930s) ●Chance meeting in Akron Ohio ●Focus on disease model ●Founded group at Akron’s City Hospital ●Over 4 years, 100 sober alcoholics ●Developed Alcoholics Anonymous ●Started AA to welcome all alcoholics interested in religious revival ●Bill wrote the “Big Book” published in 1939 ●Core of 12 steps of recover

Answer 145

●Membership Requirement: You must want to stop drinking (abstinence only) ●Disease concept of addiction: Progressive course of alcoholism ●Emphasis on “character defects”: Powerless over alcohol, Belief in higher power as daily reprieve from urges, thoughts, Make amends, Make lifelong changes in daily living ●Strong spiritual emphasis ●Relapse is expected (“slips”) ●Work through 12 steps in group, closely with sponsor

Answer 146

●Members help one another stay clean and sober: Talk openly about struggles and successes, Develop problem solving skills, Develop friendships, do not feel alone ●Anonymity ●Free to speak (or not) ●Social interaction and activities ●Each new member is encouraged to have a sponsor to act as a mentor ●Meetings are autonomous, non-professional (run by recovering alcoholics) and self-supporting

Answer 147

●Step Meetings (step if you want) ●Discussion Meetings ●Speaker Meetings ●Open Meetings (come to learn)

Answer 148

●Social support (limited cross talk) ●Sober role models ●Strong influence of AA group ideology: Rich ideological framework of 12 steps, Big Book, Strong commitment (and self-efficacy) to abstinence, Controlled drug and alcohol use is not possible ●Sponsor support with behavioral strategies to prevent relapse: Behavior techniques (inherent to AA but not a direct treatment strategy) ●12 steps is key to change

Answer 149

●1. Stimulus control (avoid bars) ●2.Behavioral coping (call your sponsor; do not drink, go to meetings) ●3.Cognitive coping (recite serenity prayer; take one day at a time) ●4.Covert sensitization (remember consequences of your drinking; tell your “story” at meetings) ●5.Self-management(delayed reinforcers versus immediate reinforcers) ●6.Expanding behavioral repertoire (learn social skills, establish social support; implement new reinforcers) ●7.Modeling (watch and learn from senior members)

Answer 150

●Clinic-based AA-based ●Abstinence from alcohol and all other psychoactive substances ●Except tobacco and caffeine ●Usually 4 week/28 day stay ●Can include detoxification

Answer 151

●1) Individuals can modify and change their beliefs, attitudes and behaviors ●2)Goals of treatment include abstinence and general improvement of lifestyle ●3)Disease model: Loss of control over use, Chronic and progressive condition, Can lead to death if not treated ●4)Multimodal approach to treatment

Answer 152

●Effective adjunct to treatment for adults, especially if AA early in treatment (good social component) ●Limitations to research on AA effectiveness ●●Mixed findings ●●AA versus no or alternative treatments ●●Residential AA versus other treatments ●●Little is known on impact on adolescents ●●Reasons for limited research?

Answer 153

●After substance abuse treatment, 12 step group participation is more effective ●AA survey of length of sobriety of members: 26% members have less than a year of sobriety, 24% have 1 to 5 years of sobriety, 14% have 5 to 10 years of sobriety, 36% have more than 10 years of sobriety ●Age of members: 1.5% under age 21, 7.9% 21 to 30

Answer 154

●People are different, not homogeneous ●●Different patterns of onset, discontinuation and course ●●Recovery happens differently ●●People value treatment differently ●Change in environment changes addiction (is it really a disease?) ●Opposed to spiritual basis and powerlessness

Answer 155

●Tentative support, need more research ● Minnesota Model programs ●●42% total abstinence 1-year follow-up ●●23% used drugs and alcohol less than monthly ●●BUT, only 49% of sample retained!! (not good sign) ●Abstinence rates decline 1 or 2 years post treatment ●●17% of abstainers returned to frequent use 2 years later ●Females tend to show more benefits from AA than males over time ●Superior outcomes (abstain or minor use) for completers of inpatient treatment (with AA) at 12-month follow-up ●●53% completers – better outcomes ●●15% non-completers ●●28% wait-list control ●Relapse risk ●●Psychopathology & non-AA attendance post treatment: 4.5 times the risk of relapse

Answer 156

●More motivated to be abstinent ●More hopeless about controlling drinking/using ●●Experience relatively worse alcohol/drug problems ●More likely to have had prior treatment ●●Less parental involvement in treatment ●More likely to attend if completed 90 days + in therapeutic community (recommended to go) ●More likely to be “internalizers (anxiety)” (vs externalizers (ADHD- don't always fit well in groups)) ●Have friends who do not drink/use ●More spiritual orientation ●More females than males ●●Especially if have school, legal and abuse problem

Answer 157

●Professional relationship that encourages participation ●Members in AA close to own age ●Involvement in active work ●AA meetings less focused on spiritual elements and less focused on active steps ●Parents’ support/positive views about AA and attendance (permission to attend, transportation) ●Connection with a sponsor ●Individual Factors: ●●Active participation in the meetings ●●Self-efficacy, motivation ●●Perception about having a problem ●●Goal of abstinence

Answer 158

●86% Of adolescents in treatment programs are referred to 12-step programs for after-care ●●Continued care after treatment is related to reduced relapse rates and maintenance of treatment gains ●Dose effect for attendance (more consistent= stronger outcome) ●●Teens who attend AA post-treatment consistently have better outcomes and higher rates of abstinence or lower rates of drinking ●Active participation is necessary for success ●●Need to embrace program and be truly affiliated with AA (attendance is not enough

Answer 159

●Peer-led groups ●Flexible meeting times ●No authority telling you what to do ●Free meetings ●Confidentiality ●No parent involvement ●Social support

Answer 160

●LABELING: AA urges teens to call themselves an alcoholic or a drug addict ●IDENTITY: Teens do not have an earlier healthy identity to fall back on, Less likely to perceive selves as “hitting rock bottom” ●POWERLESSNESS: May challenge teens’ developmental need for autonomy ●ABSTINENCE: Teens may experience fewer symptoms of dependence and resistance to being abstinent ●SPIRITUALITY: Teens are less likely to have a spiritual orientation compared to adults ●CHOICE: Teens may be placed in treatment involuntarily, and less likely to follow up with AA/NA ●AGE: Limited number of teens, Difficult for teens to relate to adults in groups, Discouraged to attend (“too young”) ●SELF-FULFILLING PROPHECY: If you are called a drunk, will you become a drunk? ●DRINKING PATTERNS: Teens drink differently than adults ●OTHER IMPORTANT FACTORS: Substance abusing teens have other serious problems that AA neglects, Barriers (transportation, meeting times

Answer 161

●AA says teen is in “denial” ●Teens may not be motivated by the 12 steps!! (Powerlessness, Belief in higher power, Sharing personal, Passing on A.A. message, Making amend) ●treatment not meeting the need

Answer 162

●Self-Management and Recovery Training ●Self-empowering addiction recovery group, based on latest scientific research and led by FACILITATORS ●Teaches self-empowerment and self reliance ●Teaches tools and techniques for self-directed change ●Abstinence focus (like AA) ●Program for adults and teens ●Different from AA: science-based, no 12 steps, promotes empowerment, no spiritual basis ●tells us what we can do to achieve change

Answer 163

●1. Build and maintain motivation ●●Finding reasons to change and motivation to keep changing ●2. Help cope with urges ●●Understand why you have urges ●●Learn to cope with urges and control urges ●3. Manage thoughts, feelings and behaviors ●●Problem solving ●●Find new ways to deal with thoughts, feelings and behaviors ●4. Lifestyle balance ●●Set goals, maintain sobriety, find interests and activities

Answer 164

●New Life Acceptance Program ● Power to change of thinking ●Build emotionally and spiritually ●13 statements to accept and use daily ●Images precede our actions ●Leads to a new way of life and thinking ●Use statement consciously all day and every day

Answer 165

●9/10 problem drinkers avoid traditional treatment approaches ●MM is less threatening alternative to AA or treatment ●Mutual aid support group for self-identified problem drinkers ●Goal: To cut back or quit drinking before drinking problems are severe (responsible drinking) ●Premise: Behaviors can change ●Abuse is a learned behavior, not a disease ●Moderation is natural part of process to target problem drinking

Answer 166

●Provides information about alcohol ●Moderate drinking guidelines and limits ●Drinking monitoring exercises ●Goal setting techniques ●Self management strategies

Midterm 2 Flashcards

(190 cards)