Universal Prevention Approach Research Articles

Interpersonal violence and suicide risk: Examining buffering effects of school and community connectedness

BackgroundExposure to interpersonal violence is associated with elevated suicide risk. Preventing suicide among high-risk adolescents is most often discussed from a clinical treatment perspective, resulting in a gap in research examining whether school and community connectedness can buffer the relationships between forms of interpersonal violence and suicide risk in clinical samples of adolescents. MethodsBaseline data from 294 adolescents who received substance use treatment were analyzed to help fill this gap in research. Adolescents in this sample were at greater risk for suicidal thoughts and behaviors given their histories of substance use disorders and high rates of interpersonal violence, with 57% reporting experiencing at least one form of abuse/violence. Independent variables included lifetime exposure to physical abuse, sexual abuse, and weapon violence; moderators included various measures of school and community connectedness. Multinomial logistic regression models were estimated to examine the main and interaction effects predicting a three-category measure of suicide risk: non-suicidal, suicidal ideation only, and prior suicide attempts. ResultsSexual abuse survivors had the highest predicted probability of a prior suicide attempt when reporting lower levels of teacher support, school-based positive peer interactions, or neighborhood social connection, but at higher levels of these protective factors, their predicted probability was similar to those not exposed to sexual abuse. The same protective pattern was observed for physical abuse survivors with high neighborhood social connection. ConclusionThe buffering effects observed in this study identified dimensions of school and community social connectedness as protective factors for youth exposed to abuse. Although promoting social connectedness is often cited as a universal suicide prevention approach, tailored efforts to enhance connectedness within this population may also be a promising secondary prevention strategy. Thus, in addition to clinical treatment, more emphasis should be placed on systems-level approaches to reducing risk among youth most vulnerable to suicide.

Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders

Despite ample evidence for transdiagnostic interventions in clinical populations and in universal prevention approaches, there are only a few controlled trials examining their role for indicated prevention. This study is the first randomized controlled trial to assess the effectiveness of a brief, 8-session group version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), called PROCARE-I (Preventive Transdiagnostic Intervention for Adolescents at Risk for Emotional Disorders-Indicated), delivered online, and including a booster session, in reducing symptoms of anxiety and depression in adolescents compared to an active control condition. Sixty-four adolescents (53% identifying as female) with elevated levels of anxiety and/or depression were randomly assigned to either the 8-week PROCARE-I or the active control condition. Self-report, parent, and clinician measures were collected before and after the interventions, at the 6-month follow-up, and 1 month after the booster session. After the intervention, participants in the PROCARE-I group showed improved scores on 9 of the 13 primary and secondary outcome measures, including reduction of anxiety and mood symptomatology, level of risk of developing emotional disorders, resilience, as well as increase of psychological flexibility, and emotional regulation. In contrast, those in the control group showed improvements in only 2 of the 13 outcome measures. After the booster session, significant differences were found between the PROCARE-I and control condition on measures of overall anxiety and depression symptoms, emotional risk, resilience, and quality of life. Low dropout rates and limited incidence of emotional disorders were observed at follow-ups. The interventions were well-accepted, with high satisfaction rates.

A randomized controlled trial of a brief internet intervention to prevent anxiety and depression among college students

Brief, scalable, and transdiagnostic prevention efforts are needed to prevent depression and anxiety among college students. Growth mindset interventions are brief, often web-based interventions to prevent or reduce depression symptom severity that have not yet been evaluated within a college student population. In this study, college students (n = 371) were randomized to either a web-based growth mindset intervention or a psychoeducation control. We examined acceptability and usability ratings as well as the impact of the intervention on new-onset depression and anxiety and symptom trajectories as assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) over a six-month period. Results indicated that participants found the intervention to be acceptable and usable. Assessing the potential of the intervention as a universal prevention approach among participants below clinical cutoffs at baseline (GAD-7 or PHQ-9 <10, N = 239 and N=229, respectively), the intervention was not associated with a reduction in new-onset depression or anxiety, nor a reduction in depression symptom trajectories compared with the control group. Control group participants experienced a greater increase in anxiety symptoms severity than participants receiving the intervention (d = 0.24). Among individuals above clinical cutoffs at baseline (GAD-7 ≥ 10; N=132, or PHQ-9 ≥ 10; N=142), the intervention reduced symptom severity to the extent that it changed beliefs about emotions. While the intervention was acceptable among college students and demonstrated promising effects on anxiety symptom severity and changes in beliefs about emotions, more work is needed to strengthen this approach to prevent new-onset depression and anxiety.Trial registration: ClinicalTrials.gov Identifier: NCT03707522

Predictors and comorbidity patterns of maternal birth-related posttraumatic stress symptoms: A Latent Class Analysis

Birth-related posttraumatic stress symptoms (PTSS) place a significant burden on mothers and their families. The aim was to (1) identify differential profiles of maternal birth-related PTSS; (2) determine the predictive value of established risk factors; (3) examine comorbidity patterns related to depression and anxiety symptoms. As part of the Norwegian Ahus Birth Cohort, 2,088 (expectant) mothers completed self-report questionnaires from 17 weeks of gestation to 2 years postpartum. The Impact of Event Scale was used to assess PTSS 8 weeks after birth. Latent class analysis revealed four latent classes: a High birth-related PTSS class (4%), a Moderate birth-related PTSS class (16%) particularly characterized by endorsement of intrusion symptoms, a Mild birth-related PTSS class (47%), as well as a No birth-related PTSS class (33%). We found similar (younger age, worse subjective birth experience, higher fear of childbirth) and differential predictors (prior posttraumatic stress disorder, lower education, birth complications). Women classified with High, Moderate, or Mild birth-related PTSS showed higher depression and anxiety symptoms compared to women with No birth-related PTSS. A considerable number of mothers experienced birth-related PTSS, most on a subclinical level, but these women still showed signs of mental distress 2 years postpartum, calling for more universal prevention approaches.

Brief Alcohol Interventions are Effective through 6 Months: Findings from Marginalized Zero-inflated Poisson and Negative Binomial Models in a Two-step IPD Meta-analysis

To evaluate and optimize brief alcohol interventions (BAIs), it is critical to have a credible overall effect size estimate as a benchmark. Estimating such an effect size has been challenging because alcohol outcomes often represent responses from a mixture of individuals: those at high risk for alcohol misuse, occasional nondrinkers, and abstainers. Moreover, some BAIs exclusively focus on heavy drinkers, whereas others take a universal prevention approach. Depending on sample characteristics, the outcome distribution might have many zeros or very few zeros and overdispersion; consequently, the most appropriate statistical model may differ across studies. We synthesized individual participant data (IPD) from 19 studies in Project INTEGRATE (Mun et al., 2015b) that randomly allocated participants to intervention and control groups (N = 7,704 participants, 38.4% men, 74.7% White, 58.5% first-year students). We sequentially estimated marginalized zero-inflated Poisson (Long et al., 2014) or negative binomial regression models to obtain covariate-adjusted, study-specific intervention effect estimates in the first step, which were subsequently combined in a random-effects meta-analysis model in the second step. BAIs produced a statistically significant 8% advantage in the mean number of drinks at both 1–3 months (RR = 0.92, 95% CI = [0.85, 0.98]) and 6 months (RR = 0.92, 95% CI = [0.85, 0.99]) compared to controls. At 9–12 months, there was no statistically significant difference in the mean number of drinks between BAIs and controls. In conclusion, BAIs are effective at reducing the mean number of drinks through at least 6 months post intervention. IPD can play a critical role in deriving findings that could not be obtained in original individual studies or standard aggregate data meta-analyses.

Effectiveness and Moderators of an Internet-Based Mobile-Supported Stress Management Intervention as a Universal Prevention Approach: Randomized Controlled Trial

BackgroundEmerging evidence indicates the effectiveness of internet-based mobile-supported stress management interventions (iSMIs) in highly stressed employees. It is yet unclear, however, whether iSMIs are also effective without a preselection process in a universal prevention approach, which more closely resembles routine occupational health care. Moreover, evidence for whom iSMIs might be suitable and for whom not is scarce.ObjectiveThe aim of this study was to evaluate the iSMI GET.ON Stress in a universal prevention approach without baseline inclusion criteria and to examine the moderators of the intervention effects.MethodsA total of 396 employees were randomly assigned to the intervention group or the 6-month waiting list control group. The iSMI consisted of 7 sessions and 1 booster session and offered no therapeutic guidance. Self-report data were assessed at baseline, 7 weeks, and at 6 months following randomization. The primary outcome was perceived stress. Several a priori defined moderators were explored as potential effect modifiers.ResultsParticipants in the intervention group reported significantly lower perceived stress at posttreatment (d=0.71, 95% CI 0.51-0.91) and at 6-month follow-up (d=0.61, 95% CI 0.41-0.81) compared to those in the waiting list control group. Significant differences with medium-to-large effect sizes were found for all mental health and most work-related outcomes. Resilience (at 7 weeks, P=.04; at 6 months, P=.01), agreeableness (at 7 weeks, P=.01), psychological strain (at 6 months, P=.04), and self-regulation (at 6 months, P=.04) moderated the intervention effects.ConclusionsThis study indicates that iSMIs can be effective in a broad range of employees with no need for preselection to achieve substantial effects. The subgroups that might not profit had extreme values on the respective measures and represented only a very small proportion of the investigated sample, thereby indicating the broad applicability of GET.ON Stress.Trial RegistrationGerman Clinical Trials Register DRKS00005699; https://www.drks.de/DRKS00005699

What do Support Professionals do in Schools? Construction and Validation of an Instrument for Assessing Whole-School Prevention and Promotion Strategies

Education policies worldwide have encouraged the entry and permanence of nonteaching support professionals in schools. During the last decade, Chilean regulations have allowed a massive incorporation of these professionals—mostly school psychologists and social workers—in publicly funded schools. However, there is scarce evidence regarding the actions of these professionals, including whether and how they align with whole-school approaches. In this study, we constructed and validated scales to assess professional practices aligned with universal prevention and whole-school approaches deployed by nonteaching professionals in schools. Participants were 329 professionals from municipal, private subsidized, and private Chilean schools. Psychometric properties were analyzed through exploratory and confirmatory factor analyses for construct validation and with Cronbach’s alpha for internal consistency. The results show that the instruments had adequate psychometric properties in terms of validity and reliability, allowing the assessment of four types of practices: individual socioemotional and academic support, group socioemotional and academic support, leadership practices, and interdisciplinary collaborative practices. We argue that these practices can be theoretically organized based on whole-school prevention and promotion strategies. Preliminary mean comparisons show that the most prevalent practice is through individual supports. We highlight the need to provide sound instruments that may allow comprehensive assessments of the actions deployed by nonteaching support professionals in whole-school improvement efforts.

Empirically Evaluated Suicide Prevention Program Approaches for Older Adults: A Review of the Literature from 2009-2021

ABSTRACT Mental health in later life and suicide risk among older adults are important topics for social work. There is evidence-based research to support the use selective and indicated strategies for suicide prevention, yet, universal prevention approaches are also needed. However, the extent to which the broader contexts of suicide have been examined remains largely absent from the literature. This article presents findings from a systematic review of articles published between 2009 and 2021, focusing what types of empirically evaluated suicide prevention programs effectively prevent and reduce suicidality in older adults. Using the PICO and PRISMA guidelines, a final sample of 8 articles were reviewed in this systematic review. The articles were categorized into three types of programs: 1) primary and home health care, 2) community-based outreach, and 3) counseling. The articles also examined the involvement of social workers in these programs. Following a description of the articles, the authors assess each study using the GRADE rating system. Lastly, the authors discuss the role of the social worker in mental health promotion and prevention strategies.

Overview of Evidence Concerning School-Based Interventions for Improving the Health of School-Aged Children and Adolescents.

Universal prevention approaches that target the general population can be effective for promoting children's health. This overview aims to summarize evidence presented in existing reviews of school-based interventions. We present an overview of evidence sourced from Campbell and Cochrane systematic reviews. These reviews examined randomized controlled trials concerning school-based health-promotion programs for children (mostly aged 4-18 years) in the general population. We identified 56 high-quality reviews. The reviews focused on emotional and behavioral outcomes, infectious diseases, injury reduction, mental health, nutrition intake, oral health, physical and developmental changes, sense-organ diseases, sexual-health outcomes, and substance use/abuse. Positive evidence-such as vision screening plus provision of free spectacles for spectacle wear increase and a combination of social competence and social-influence approaches for preventing illicit drug use-were considered high certainty. Of the various interventions implemented in school settings that involved people from various occupations, some positive effects were found. In most cases, evidence certainty was negatively affected by a high risk of bias within studies, inconsistencies within the estimates, and insufficient sample sizes. Further primary studies in these areas would be helpful for accumulating evidence to promote stronger cooperation between health and education stakeholders.

La promotion d’une image corporelle positive chez les jeunes

Positive body image is a recent concept that includes several facets, such as the acceptance of one&#8217;s body and the ability to take care of it with safe, nurturing methods. The purpose of this article is to explain this concept and its importance, and to review prevention and health promotion interventions that might be effective for its development. We conducted a narrative review, including the latest publications that summarize the concept&#8217;s usefulness and the effectiveness of prevention programs that may contribute to the&#160;development of positive body image in youth. The development of a positive body image is proposed as a key factor that would allow integrated prevention of the entire spectrum of weight and eating issues in young people, as well as other problems such as depression. Three approaches used for prevention interventions developed primarily to target body dissatisfaction as a risk factor might promote certain aspects of positive body image. It would be advisable to adopt a universal and ecological prevention approach, in order to standardize the messages received throughout the social environment regarding healthy eating, an active lifestyle, and respect for the diversity of weight, shape, and beauty. This review highlights the importance of positive body image for public health, as well as the various preventive interventions that have proven effective for youth and young adults, so that future developments can build on what has already been performed.

Effects of a universal prevention program on externalizing behaviors: Exploring the generalizability of findings across school and home settings

Universal prevention approaches have significantly reduced children's conduct problems and aggressive behavior in the school setting, but it has not been clear whether the effects generalize into children's behavior in home and community settings in later elementary school years. The present study examined this issue using a classroom-randomized design, with 1030 students in 70 fourth and fifth grade Italian classes. The intervention model is the Coping Power Universal and the classroom teachers delivered it. Coping Power Universal produced a significant reduction in both parents' and teachers' rated conduct problems, relative to control classes, indicating that universal prevention can produce significant reductions in children's conduct problems that generalize into the home and community settings. The intervention also increased children's prosocial behaviors in school and home settings. The Coping Power Universal is a short intervention model that is believed to be a useful strategy for children's behavioral problems in the broad population.

Developing the universal unified prevention program for diverse disorders for school-aged children

BackgroundPsychological problems during childhood and adolescence are highly prevalent, frequently comorbid, and incur severe social burden. A school-based universal prevention approach is one avenue to address these issues.ObjectiveThe first aim of this study was the development of a novel, transdiagnostic cognitive-behavioral universal prevention program: The Universal Unified Prevention Program for Diverse Disorders (Up2-D2). The second aim of this study was to examine the acceptability and fidelity of the Up2-D2.MethodsClassroom teachers who attended a 1-day workshop implemented the Up2-D2 independently as a part of their regular curricula. To assess the acceptability of the Up2-D2, 213 children (111 boys and 102 girls) aged 9–12 years completed questionnaires about their enjoyment, comprehension, attainment, applicability, and self-efficacy after completing Lessons 1–12. For fidelity, research assistants independently evaluated audio files that were randomly selected and assigned (27.3%).ResultsOur preliminary evaluation revealed the program was highly enjoyable, clear, and applicable for students. In addition, self-efficacy demonstrated a trend of gradually increasing over the 12 sessions. The total fidelity observed in the two schools was sufficient (76.2%), given the length of the teacher training.ConclusionsThe results of this study supported the theory that the Up2-D2 could be feasible in real-world school settings when classroom teachers implement the program. We discussed current research and practical issues of using universal prevention to address mental health problems in school, based on implementation science for user-centered design.

Moderators of the efficacy of a web-based stress management intervention for college students.

High levels of stress are common among college students. Web-based interventions may be one way to teach students stress management skills. Although previous research has demonstrated the overall efficacy of web-based stress management interventions, little attention has been paid to who might benefit most from these interventions. In this study, we analyzed data from 3 prior studies (N = 782) to examine moderators of the efficacy of a web-based stress management intervention that focused on increasing perceived present control (i.e., aspects of stressors that are controllable in the present). Specific moderators assessed in regression analyses were baseline scores on outcome measures (perceived stress, stress symptoms, anxiety, depression) and the putative mechanism (perceived present control) of the intervention. Baseline symptom levels moderated the effects of the intervention on all outcomes, such that the intervention was more effective for students with more baseline symptoms. Baseline levels of present control had less consistent moderating effects, but significant interactions indicated that the intervention was more effective for those with lower levels of present control. The novel Johnson-Neyman technique was used to identify specific cutoff scores on these measures, below which the effect of the intervention was not significant, and scores on the measures associated with varying effect sizes. Findings from the Johnson-Neyman analyses can inform the development of screening criteria for future research and clinical application. Because the intervention was more effective for students with higher levels of baseline distress, it may be better suited for an indicated rather than universal prevention approach. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Risk and protective factors for heroin use in a nationally representative sample of Ecuadorian youth

IntroductionRecent reports from a variety of sources indicate that heroin use among Ecuadorian adolescents is on the rise. In order to design effective prevention and intervention programs, research is needed that quantifies use and assesses risk and protective factors associated with use. MethodsThis study analyzed the National Survey of Drug Use, a nationally representative survey of 50,145 adolescents (49.6% female; M age = 14.92 years, SD = 1.74) conducted in Ecuador in 2015. ResultsOverall, 2.3% of the sample reported lifetime heroin use. Logistic regression analysis revealed that higher lifetime heroin use was associated with lifetime use of alcohol (Adj OR = .71 CI[.58, .86]), marijuana (Adj OR = 3.79 CI[3.17, 4.52]), and hard drugs (Adj OR = 16.33 CI[13.89, 19.21]), as well as with greater perceived access to heroin (Adj OR = 2.13 CI[1.93, 2.36]) and repeating more school grades (Adj OR = 1.66 CI[1.37, 2.01]). Higher levels of parental involvement (Adj OR = .95 CI[.91, .99]) were associated with a reduced risk of use. Risk and protective factors operated similarly across age and gender. ConclusionThese data suggest that targeting substance use early in adolescence, focusing on school engagement, enhancing parenting skills, and improving family climate may be important approaches to curbing heroin use among Ecuadorian teens. The relative absence of age and gender differences in patterns of risk and protection suggest that a universal prevention approach versus a targeted approach may be most effective.

Small Talk: A Community Research Collaboration to Increase Parental Provision of Language to Children

Early language input contributes to children’s healthy brain development and sets the stage for life-long achievement and wellness. Parents vary in their ability to offer rich language support within the home environment due to social and contextual factors. There is a lack of research on the effectiveness of a universal prevention approach to equip all parents to provide an enriching home language environment. A team including university researchers, a public library, and a community non-profit agency worked together to test the effectiveness of a universal, community-based intervention to increase parents’ child-directed speech, back-and-forth interactions with their child, and knowledge of child development. Over a period of 2 years, three cohorts of parents and caregivers completed the program (n = 153). Using translational research principles, a pre/post longitudinal repeated measures data analytic strategy examined the growth in parent talk (total number of adult words and conversational turns directed to the child) and parent knowledge of child development. This objective quantitative language data was collected automatically, with innovative wearable technology that was a part of the intervention and data collection. In each of the cycles of the intervention, a significant increase in the amount of child-directed speech and in the number of conversational turns between the caregiver and child was demonstrated. In addition, parents significantly increased their knowledge of child development. Conclusion: Universal programs delivered in the community have potential to help parents provide the type of enriching language environments that lead to optimal brain development for young children.

Treating eating disorders in the real world — MaiStep: A skill-based universal prevention for schools

Eating disorders are difficult to treat and often associated with morbidity and mortality. Universal prevention approaches are increasingly focusing on enhancing skills, but few eating disorder programs are available for under-15-year-olds. This study aimed to develop and examine a school-based universal prevention program (‘MaiStep’) for adolescent boys and girls.A three-arm randomized controlled trial with baseline, post-intervention and 12-month follow-up was conducted with 1654 adolescents (M = 13.35, SD 0.76). ‘MaiStep’ was delivered by psychologists in the first intervention group (IG1) and teachers in the second intervention group (IG2), and compared to an active control group (ACG). Primary outcomes were eating disorder-related risk factors measured with scales of the Eating Disorder Inventory-2 (e.g. ‘drive for thinness’, ‘interoceptive awareness’), cognitions and affect related to the body (Body Shape Questionnaire, BSQ-8), and behaviors (Body Image Avoidance Questionnaire, BIAQ). The total sample (N1) was divided into a healthy subsample (N2) and a sample fulfilling DSM-5 criteria for a subthreshold eating disorder (N3) measured with the self-report Structured Inventory for Anorexic and Bulimic Syndromes (SIAB-S).Significant improvements in ‘interoceptive awareness’ (EDI-2) and lower BIAQ scores emerged in N1 at post-intervention and at 12-month follow-up (F(4; 3038) = 3.068, p = .016, ηpart2 = 0.004 and F(4; 2900) = 2.993, p = .018, ηpart2 = 0.004) and in N2 at post-intervention and at 12-month follow-up (F(4; 2812) = 3.147, p = .014, ηpart2 = 0.004 and F(4; 2684) = 3.674, p = .005, ηpart2 = 0.005). The healthy subsample N2 additionally showed significantly lower scores on ‘drive for thinness’ (EDI-2) and on the BSQ-8c at post-intervention (F(2; 1446) = 3.091, p = .046, ηpart2 = 0.004 and F(2; 1453) = 3.505, p = .030, ηpart2 = 0.005) but not at 12-month follow-up. No significant results emerged for N3.The positive findings of improved ‘interoceptive awareness’ (EDI-2) and reduced body image avoidance (BIAQ) indicate that broad disseminated universal prevention under the age of 15 is possible.Trial registration MaiStep is registered at the German Clinical Trials Register (DRKS00005050).

Light and heavy drinking in jurisdictions with different alcohol policy environments

BackgroundA basic, yet untested tenet underlying alcohol control policies is that they should affect both light and heavy drinking, thereby shifting the entire population in a favourable direction. The aim of this study was to test this assumption in young Swiss men. MethodsCross-sectional self-reported data — from 5755 young Swiss men participating in the Cohort Study on Substance Use Risk Factors (C-SURF), a large cohort study on young men living within 21 jurisdictions across Switzerland — were analysed via nested logistic regression. With this approach, a set of increasingly-heavy drinking patterns was broken down into a set of nested regression models, each one estimating the probability of heavier drinking, conditional on the lighter drinking pattern. Drinking patterns relating to heavy episodic drinking (HED), heavy volume drinking (HVD) on weekends, and workweek drinking, as well as alcohol use disorder (AUD) were examined. The explanatory variable was a previously-used alcohol policy environment index (APEI) reflecting the number of alcohol control policies implemented in each jurisdiction. Conventional and multilevel logistic regression models were tested, adjusted for age, education, linguistic region, urban/rural status, attention-deficit/hyperactivity disorder, depression, sensation seeking, antisocial personality disorder, and unobserved heterogeneity between jurisdictions. ResultsFor HED, weekend HVD, and AUD, negative relationships with the APEI were found, such that with a higher APEI the probability of lighter drinking patterns was increased while the probability of heavier patterns was reduced, including a reduced probability of the heaviest patterns. These relationships were non-linear, however, and tapered off towards the heavy end of the drinking spectrum. No relationship was identified between the APEI and workweek drinking patterns. ConclusionAmong young Swiss men, stricter alcohol policy environments were associated with a global shift towards lighter drinking, consistent with the basic tenet behind the universal prevention approach.

College students’ knowledge about Sickle Cell Disease

ABSTRACTSickle Cell Disease (SCD) is a serious health problem affecting millions around the world. Key to prevention is knowledge about the disease and the reproductive implications. This study explored college students’ knowledge about SCD. Participants included 416 college students at a North Texas campus between October and December 2014. A cross-sectional survey design using an 18-question survey was used. Although most participants had heard of SCD, 21% had never heard of the disease. Furthermore, participants lacked knowledge regarding the differences between the disease and carrier status, prevalence, reproductive implications, prevention, and testing. Findings showed that couples had more knowledge about SCD compared to singles and there were no significant differences between those with children and those without indicating a need for education before they start dating. Most participants had not undergone SCD carrier screening and had no interest in screening. The Universal Prevention approach would be a suitable approach and should be utilized in improving knowledge about SCD.

Sexual orientation disparities in prescription drug misuse among a nationally representative sample of adolescents: Prevalence and correlates

ObjectiveSexual minority adolescents (SMA) may be at disproportionate risk for misusing prescription psychotropic medications compared to their heterosexual peers. However, generalizable studies specific to this age group are lacking. The current study aimed to describe the prevalence of sexual orientation disparities in prescription drug misuse among a nationally representative sample of adolescents as well as to examine key correlates of misuse. MethodUsing data from the National Youth Risk Behavior Survey, we conducted stepwise multivariable weighted logistic regressions, sequentially controlling for demographics, experiences of victimization, mental health, and other illicit substance use. ResultsAdjusting for grade and race/ethnicity, female SMA and gay and unsure males had significantly elevated odds of ever misusing a prescription drug compared to heterosexual adolescents (ORs from 1.7–2.5). Most sexual orientation disparities among females remained significant with the addition of victimization and mental health covariates but attenuated completely after controlling for other illicit drug use. The effect for unsure males attenuated when victimization variables were included, but the effect for gay males remained significant through the final model. Controlling for other illicit drug use, mental health variables remained significant correlates for females whereas only forced sex was significant for males. ConclusionThese results suggest experiences of victimization and mental health partially account for the disparities in prescription drug misuse between SMA and heterosexual adolescents, and their effects may differ by sex. A combination of structural, individual coping, and universal drug prevention approaches should be used to make the largest impact on reducing these disparities.

Prospective associations between personality and bullying among Australian adolescents.

This study aimed to examine whether high-risk personality dimensions increased susceptibility to bullying victimisation and perpetration among Australian adolescents. Longitudinal cohort study of 527 secondary school students in Australia (baseline average age = 13 years, 67% female and 93% Australian-born). Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Personality was measured using the Substance Use Risk Profile Scale. The data were analysed using mixed models, examining the association between baseline personality scores and frequency of victimisation/perpetration 12 months later. Baseline hopelessness and baseline impulsivity were positively associated with frequency of victimisation 12 months later. Baseline anxiety sensitivity was negatively associated with victimisation 12 months later for males. There was a positive association between baseline impulsivity and frequency of bullying perpetration 12 months later. High-risk personality dimensions predicted later bullying victimisation and bullying perpetration among Australian adolescents. This indicates that adding a personality-focused intervention for high-risk adolescents to existing universal bullying prevention approaches may be effective in improving the prevention of bullying among adolescents, as well as reducing other associated emotional and behavioural problems.