More money more problems? Rich teens and drugs

Teens raised in affluent homes display the highest rates of depression, anxiety, and drug abuse according to a recent article in Monitor on Psychology, the APA‘s monthly magazine.

One of our recent posts dealt with some of the issues unique to teens and drugs. In addition to the issues we’d already mentioned, the article named a number of reasons for the high prevalence of mental-health issues among affluent teens. Among them were an increasingly narcissistic society, overbearing parents, and an common attitude of perfectionism.

Each of these reasons are likely contributors to the prevalence of mental health and drug abuse issues among upper-middle-class (and above) teens. Still, as far as I’m concerned, the main take home message of the article is this:

Money truly doesn’t buy happiness – Rich teens and drug use.

While drug abuse research often focuses on the lower socioeconomic strata these recent findings indicate that being financially stable offers little in the way of protection from some of the most common psychological difficulties.

Thankfully, the researchers cited in the article gave some simple advice to parents:

  • Give children clear responsibilities to help around the house.
  • Take part in community service (to unite the family and reduce narcissism).
  • Reduce TV watching (especially of reality TV shows that glorify celebrity and excess).
  • Monitor internet use.
  • Stop obsessing about perfect grades and focus instead on the joy of learning for its own sake.

I couldn’t agree more with these recommendations. Having taught a number of classes myself, I have witnessed the ridiculous inflation in students’ expectations of top grades. I think it’s time we turned attention back to the family and reintroduce some of the basic skills that many addicts find themselves learning much too late… Often in recovery.

Does alcohol on T.V. make for more alcohol in the hand?

Dirk Hanson

The title of the Dutch study, published in the journal Alcohol & Alcoholism, is unambiguous: “Alcohol Portrayal on Television Affects Actual Drinking Behaviour.”

It is an easy and familiar accusation that has been levied at violent video games, drug use heavy movies, and alcohol advertising. But what is the actual evidence for it? Leave it to a group of Dutch scientists to design a practical experiment to test the proposition when it comes to drinking.  In a noble attempt to get around the self-reporting problem, the authors of the study went directly to the heart of the problem. They built a “bar laboratory” on the campus of Radboud University, Nijmegen, The Netherlands. Continue reading “Does alcohol on T.V. make for more alcohol in the hand?”

A&E’s Intervention: The Johnson Model, Motivational Interviewing, and more

A&E’s “Intervention” is a reality series that follows one individual struggling with addiction per episode.  Family and friends gather with an interventionist toward the end of the episode and an intervention is planned.  The addict is then given a choice between leaving immediately for rehab or risk losing contact, financial support or some other privileges from their family and friends.

All interventions are not the same

This style of intervention used in A&E’s “Intervention” is known as The Johnson Model (JM), as thought up by Dr. Vernon Johnson in the 1960s. This intervention model has, because of the show, become the most recognizable version of addiction intervention.  An interventionist using this style aims to abruptly break the denial that is harbored by the chemically independent individual.  By assembling loved ones and presenting an ultimatum, the addict is forced to hit “bottom”, in hopes of pushing them toward recovery and avoiding further destruction.

There are alternative intervention approaches, including Motivational Interviewing (MI), and CRAFT (Community reinforcement and family training).  These relatively more recent and less confrontational approaches also employ professional counselors or interventionists who seeks to move the addict into a state in which they themselves are motivated to change their behavior (MI) or who focus on teaching behavior change skills to use at home (CRAFT).

By using common psychological techniques such as mirroring and reflecting, MI practitioners gradually make the client face the consequences of their action, taking the burden of motivation away from loved ones. CRAFT practitioners, on the other hand, use a manual-drive method to improve the addict’s awareness of negative consequences, reinforce non-drinking behavior, and improve communication skills and participation in competing activities. Both methods also prepare family members (or friends) to initiate treatment, if necessary, when the patient was ready. Though far less dramatic and “TV worthy,” MI has been shown in research to be very effective at increasing clients’ motivation to change in many different setting including addiction. It’s also my favorite technique because it allows for amazing, non-confrontational, change.

Some of the reasons to question the confrontational Johnson Model used in A&E’s “Intervention” have to do with the fact that although they’ve been shown to increase treatment entry rates once a successful intervention has been performed, they haven’t been shown to do much for treatment completion rates. Even more important is the fact that multiple studies have found that a small percentage of those who seek consultation in this method actually go through with the family confrontation portion. Instead, the more collaborative and supportive MI and CRAFT methods have greater participation and have been shown to provide even better treatment entry as well as improvement in communication and overall relationship satisfaction between the families and the addicts (which JM interventions provide as well). Additionally, a significant portion of individuals who enter treatment after a JM intervention end up leaving treatment early or relapsing quickly since they themselves have not yet internalized the motivation to quit.

Pressure and shame can backfire

This phenomenon can be seen in Corinne’s episode of A&E’s Intervention.  Addicted to heroin and crystal meth, Corinne had lost control of her life and her family was desperate to save her.  Corinne is a diabetic and had not been taking her insulin for years, using her needles to shoot-up instead. When Corinne overdosed nine months prior to taping, Corinne’s family knew they needed to intervene.  During taping, an interventionist was brought in to meet with the family.  She helped them to plan out how they will address Corinne.  She started by emphasizing how desperate the situation has become and encouraged them to be forceful with Corinne. She explained that this is a life or death situation and that if Corinne refuses treatment, they might consider turning her in to be arrested.  As Corinne arrives, she reacts harshly and explains that she is not “ready” for treatment.  She flees the room for a short time only to return and agree to go into rehabilitation as they had requested.

As is too often the case, Corinne struggles at the first treatment center and is quickly transferred. Eventually after getting clean, her family is overjoyed.  Unfortunately this is short lived when three weeks after taping, she relapses several times. As usual, I think it’s important to know every tool available when considering how to help an addict – that’s why I believe that knowing about MI and CRAFT (as well as other intervention methods) in case the more popular Johnson Model Intervention doesn’t work is crucial. It’s a matter of life and death.

Citation:

Miller, W.R., Meyers, R.J., and Tonigan, J.S. (1999). Engaging the unmotivated in treatment for alcohol problems: Comparison of three strategies for intervention through family members. Journal of Consulting and Clinical Psychology, 67, 688-697.

Rollnick, S., Allison, J. (2003) Motivational Interviewing, in The Essential Handbook Of Treatment and Prevention of Alcohol Problems (2003)

They do it in the movies!!! Smoking, teens, and being cool

Contributing co-author: Jamie Felzer

Celebrities get their fair share of flack for inappropriate behavior on screen. Only recently, research regarding the effects of onscreen violence, even in cartoons, making youngsters act more aggressively made some serious noise.

So what about smoking? If kids see their favorite stars smoking cigarettes in films, would they be more inclined to light up as well?

Smoking, movies, and research

A recent study revealed that adolescents in 4th to 9th grade of all backgrounds and ethnicities are in fact more likely to smoke after watching such movies. However, it wasn’t simply watching the movies that increased the likelihood of smoking. The researchers found that if a teen viewed movies where any type of smoking was present their expectancies about smoking became more positive and they were more likely to try it themselves.

teen-smokingTeens see their idolized movie stars looking relaxed and satisfied after smoking so they believe the same effects (physically and emotionally) will happen to them as well. Many movies portray smoking in a social setting, so they assume that with smoking comes the positive social setting. Parents also may not realize that their own smoking effectively promotes the behavior (I’d mentioned this sort of effect with drinking in this post).

Targeting movies for teens

The type of movies that contain many smoking scenes may appeal to youngsters who are already predisposed to smoking; such as those who were older, male, more rebellious, sensation seeking or who had low self-esteem. There were also gender-based differences: females were more likely to begin smoking if their peers did whereas parental smoking status mattered less to females.

The participants were asked to answer the same questions 8 months after the initial interview date. Over time, smoking expectancies became more positive. Whether this had to do with participants aging, peer influence or the viewing of more movies involving smoking scenes is unclear.

One result was cleara higher number of movies with smoking scenes increased the likelihood of teens lighting up because it planted the seed in these young minds that smoking was pleasurable and the it has physical, as well as social benefits. Though the research didn’t look into other behaviors, it wouldn’t surprise me if the same process also affects teens’ likelihood of starting to do other drugs and engage in other negative, and positive, acts.

Maybe it’s time to show the other side of smoking: morning coughing, yellowing teeth, and long, often cold trips to the street.

Citation:

Wills, Sargent, Stoolmiller, Gibbons, and Gerrard (2008). Movie smoking exposure and smoking onset: A longitudinal study of mediation processes in a representative sample of U.S. adolescents. Psychology of Addictive Behaviors, 22, 269-277.

Ellen and Gladis – Alcoholic and funny

I don’t normally like to make fun of the disease of alcoholism, but sometimes, you just have to let go and enjoy the entertainment. Check out this video from the Ellen DeGeneress show, in which she talks to Gladis, an avid watcher who wrote in. Gladis (the funny alcoholic, I wasn’t saying anything about Ellen in the title) seems to have resigned herself to being an alcoholic and seems to have a lot to say about pretty much everything. Apparently, she’s made many more appearances on the show.


Great coverage of the prescription drug abuse problem – The oxycontin express on Vanguard

On the way to New York city to visit my father this morning (he’s not doing so well), I saw an amazing journalistic piece on the prescription drug problem, especially as it relates to loose prescription-record keeping laws in Florida, which is apparently the reason for the five times higher rates of prescription pain medication rates in that state!

We’ve talked about this problem here before, and it’s one of (if not THE) the fastest growing drug abuse problems in this country, but what can I say, Mariana van Zeller knows how to tell a story. I’m now not only a fan of hers but also of the Current TV team, and especially of Vanguard Journalism. I’ll be watching them – you should be too.