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Biomedical subjects

J C Anthony

Publications and source records attributed to J C Anthony.

At least 91 records · Page 5Linked to original sources
PubMed1996

Associations between drug use and behavioral repertoire in urban youths.

Converging with psycho-social research findings, animal and human laboratory studies indicate that behavioral alternatives are important determinants of drug-taking. To investigate associations between how early adolescents spend their time, i.e. their behavioral repertoire and drug use (use of marijuana, crack/cocaine or inhalants), we analyzed data from an epidemiological sample of 1516 urban middle-school students who had completed private interviews in spring 1993. The interview included a 36-item questionnaire to assess how frequently the youth engaged in different activities; history of drug-taking was assessed separately. Multiple logistic regression was used to estimate associations between drug use and each of seven behavioral domains as well as sex, age and racial-ethnic status. Youths spending a great deal of time working for pay and assuming other adult-like roles were more likely to have initiated drug use (estimated odds ratio, OR = 3.49; p = 0.002). Those who spent much time in religious activities were less likely (OR = 0.2, p <0.001). An exploratory search for interactions disclosed other associations that merit attention in future research. These results corroborate evidence on the potential etiological significance of behavioral repertoire in relation to risk of drug use.

Adolescent↗
PubMed1996

Impact of parent monitoring on initiation of drug use through late childhood.

OBJECTIVE: To examine whether parental supervision and monitoring in middle childhood might have a sustained impact on risk of drug use later in childhood and adolescence. METHOD: An epidemiological sample of 926 urban-dwelling youths were individually interviewed annually, beginning in 1989 when the children were 8 to 10 years old, continuing through 1992. Standardized questions measured drug use, parenting behaviors, and other suspected determinants of drug use. RESULTS: Survival analysis estimates indicated that children in the lowest quartile of parent monitoring initiated drug use at earlier ages. The contrast in risk of initiating alcohol, tobacco, or other drug use across levels of parent monitoring was greatest when children were under 11 years old; at older ages there was no difference in risk. However, in analyses focused specifically on marijuana, cocaine, and inhalant drugs, we observed a sustained higher risk of starting to use these drugs among youths who had been monitored at the lowest levels in middle childhood. CONCLUSION: These results add to the chain of inference that effective supervision and monitoring in middle childhood by parents or guardians might induce a delay or prevent onset of drug use among youths living in urban areas, a hypothesis that now ought to be tested in rigorous field experiments.

Alcohol Drinking↗
PubMed1996

Potential barriers to parent monitoring: social disadvantage, marital status, and maternal psychiatric disorder.

OBJECTIVE: To test whether social disadvantage, marital status, and history of psychiatric disorder might impair mothers' monitoring and supervision of their children. METHOD: An epidemiological sample of 673 mothers of 8- through 11-year-old children, who had been participants in a longitudinal study of children's development, completed standardized telephone interviews about their monitoring and supervision of children. Indicators of social disadvantage also were collected in the telephone interview, and maternal history of psychiatric disorder had been assessed using the National Institute of Mental Health Diagnostic Interview Schedule, administered when the children were 6 years old. RESULTS: Mothers who were never married were twice as likely to be in the lowest quintile of parent monitoring as those who were married (31% versus 16%, p = .001); a similar distribution was found for mothers who did not complete high school compared with those who attended college (31% versus 15%, respectively, p = .001). Mother's history of substance use disorder, anxiety disorder, or major depression was also linked to lower levels of monitoring. Mothers of girls reported higher levels of monitoring than mothers of boys (p < .001). CONCLUSIONS: This study indicates that social disadvantage and maternal psychiatric disorder could have a negative influence on mothers' monitoring behaviors. Although the causal role of these factors is still unclear, interventions that target parenting behaviors should be designed to take them into account.

Child↗
PubMed1996

The latent dimensionality of DIS/DSM-III-R nicotine dependence: exploratory analyses.

Decisions on DSM-IV criteria for alcohol dependence were based in part on latent structure analyses of field survey data on alcohol problems. Analogously, to investigate the latent structure of nicotine dependence in an epidemiological sample, we carried out a dichotomous item factor analysis of DSM-III-R symptom data gathered from 394 young adults who reported a history of sustained daily smoking. Smokers and their dependence symptoms were identified by means of the NIMH Diagnostic Interview Schedule version III revised, administered to a random sample of 1007 21-30-year-olds who were members of a health maintenance organization in the Detroit area. Comparing different latent structure models using LISCOMP software with bootstrap re-sampling, followed by multiple logistic regression, we found that a two-factor model indicating a 'general dependence' and a 'failed cessation' dimension best accounted for the observed data. Current smoking status (persistent vs. past smoking) was associated with the two factors independently. Replication and additional research on construct, discriminant and convergent validity are needed.

Adult↗
PubMed1995

Psychosocial dimensions of work and the risk of drug dependence among adults.

The authors used prospectively gathered data to study whether different psychosocial work environments might signal increased risk of drug dependence syndromes. Adult participants were selected by probability sampling from households in five metropolitan areas of the United States. Subjects were sorted into risk sets defined by age and census tracts. Incident cases were identified using case definitions for drug abuse/dependence syndromes involving controlled substances, assessed by the Diagnostic Interview Schedule (DIS) administered during a baseline interview and at follow-up one year later. When the data were adjusted for baseline sociodemographic risk factors, history of alcoholism, and selected work conditions, increased risk of drug abuse/dependence was observed in subjects characterized by high levels of physical demands and low levels of skill discretion (high strain jobs) (relative odds (RO) = 4.92) and in subjects characterized by high levels of physical demands and decision authority (RO = 5.26). Findings from the present study underscore the importance of previously observed associations linking psychosocial work environments to mental health, and the results extend the range of findings to the drug dependence syndromes.

Adult↗
PubMed1995

Parent monitoring and the incidence of drug sampling in urban elementary school children.

An epidemiologic study of urban-dwelling children aged 8-10 years in Baltimore, Maryland, was undertaken to test the hypothesis that close monitoring and supervision by parents might signal a reduced risk of drug use in the elementary school years. Drug use, monitoring by parents, peer drug use, and other suspected risk factors for early drug use were first assessed in 1989, identifying 947 children with no prior history of drug use. One year later, 4.2 percent of these children were found to have started using alcohol, tobacco, or other drugs on their own for the first time during the follow-up observation interval. Risk of starting drug use was higher for children with lower levels of parent monitoring (relative risk = 4.39, 95% confidence interval 1.48-13.0). In addition, for children with declining levels of parent monitoring, there was an increased risk of starting to use drugs on their own.

Baltimore↗
PubMed1995

Prevalence of carrying a weapon and related behaviors in urban schoolchildren, 1989 to 1993.

OBJECTIVE: To characterize the prevalence of weapon carrying in an epidemiologic sample of about 1500 urban schoolchildren between spring 1989 and spring 1993. DESIGN: A descriptive analysis based on 5 years of cross-sectional confidential survey data. SETTING: An urban public school system in the mid-Atlantic region of the United States. PARTICIPANTS: The study base included all children who were interviewed in each year from 1989 to 1993, disregarding the number of prior or subsequent interviews. The mean age of the participants in the sample was 9 years when the survey began. MAIN OUTCOME MEASURES: Carrying a nonlethal or lethal weapon (eg, a stick, knife, or gun) to defend or to threaten or hurt someone, assessed by self-report. Reports of interpersonal aggression also were obtained. RESULTS: Knife and gun carrying increased with age while stick carrying decreased. In 1989, carrying a lethal weapon (eg, knife or gun) was reported by 11.7% of boys and 3.3% of girls; in 1993, these proportions had increased to 22.2% and 15.3%, respectively. Gun carrying increased over time; by 1993, 9.9% of boys and 1.4% of girls reported that they had carried a gun in the previous year. Carrying a weapon to defend or protect oneself was more commonly reported than to hurt or threaten someone. Various types of interpersonal aggression were frequently reported among boys and girls in each year. Our findings support the hypothesis that early involvement with a weapon is associated with later more serious involvement with a weapon. CONCLUSIONS: Involvement in weapons-related behavior starts young, well before the middle school year. Effective intervention programs may require attention to the early determinants of involvement with weapons, sex differences, and perhaps also the changing profile of reasons given for carrying and using weapons in conjunction with other forms of aggressive behaviors.

Adolescent↗
PubMed1995

Prevalence and correlates of drug use and dependence in the United States. Results from the National Comorbidity Survey.

OBJECTIVES: To analyze nationally representative data on the lifetime and 12-month prevalences of use of and dependence on illegal drugs (marijuana/hashish, cocaine/crack, heroin, hallucinogens), nonmedical prescription psychotropic drugs (sedatives, tranquilizers, stimulants, analgesics), and inhalants; and to examine data on the sociodemographic correlates of use and dependence. METHODS: The data come from the National Comorbidity Survey, a structured diagnostic interview administered to persons aged 15 to 54 years that generates reliable diagnoses according to the definitions and criteria of DSM-III-R. RESULTS: Of the respondents, 51.0% used one of the above drugs at some time in their lives, and 15.4% did so in the past 12 months. These estimates are similar to those obtained in the 1991 National Household Survey of Drug Abuse, where lifetime prevalence was 45.2% and 12-month prevalence was 16.7% among respondents in the age range 15 to 54 years. Of National Comorbidity Survey respondents, 7.5% (14.7% of lifetime users) were dependent at some time in their lives and 1.8% were dependent in the past 12 months. The prevalence estimate for lifetime dependence was reduced to 5.3% when calculated the percentage of respondents in the age range of 28 to 54 years who reported an onset of dependence as of 10 years earlier (ie, when they were 18 to 44 years old) was computed. This is similar to the Epidemiologic Catchment Area Study estimate of 5.1% among respondents in the age range 18 to 44 years, a comparison that matches the two studies on year of assessment, age of risk, and cohort. Males were significantly more likely to report both lifetime and 12-month use and dependence. Use and dependence were found to be more common in cohorts born after World War II than those born before the end of the war. The demographic predictors of lifetime use differed from the predictors of lifetime dependence among users, and these, in turn, differed from the predictors of recent dependence among people with a lifetime history of dependence. CONCLUSIONS: Drug use and dependence are highly prevalent in the general population. The fact that there are differences in the correlates of first use, dependence among users, and persistence of dependence means that future research aimed at pinpointing modifiable risk factors must be based on disaggregated analyses of separate stages of progression.

Adolescent↗
PubMed1995

Early-onset drug use and risk of later drug problems.

Prior research has suggested that among illicit drug users there is an increased risk of drug abuse or dependence problems associated with earlier onset of illicit drug taking. This study examined whether the observed association might be understood best as the result of a process by which earlier onset users accumulate more time during which they can develop a drug problem (that is, more time since first illicit drug taking). Survival data analysis was employed to investigate this issue, with self-report data from 1525 illicit drug using individuals, all of whom were 18-24-year-old participants in the multi-site collaborative Epidemiologic Catchment Area Program. In the first year after initial illicit drug use, there was no appreciable variation in the estimated risk of developing a drug problem. However, with passage of some 5-7 years after initial use, the estimated risk of developing drug problems became clearly greater for youths whose drug taking had started during the pre-adolescent and very early adolescent years. The previously reported relationship between early-onset drug use and subsequent drug problems was not, therefore, an artifact of time. It is possible that duration of drug use should be considered as one 'mechanism' by which early-onset drug users experience greater risk of drug problems, but there also are other interpretations to be investigated in future research.

Adolescent↗
PubMed1995

Inhalants to heroin: a prospective analysis from adolescence to adulthood.

Recent cross-sectional studies have indicated that inhalant use might be a vulnerability marker for the development of heroin use. This study is the first prospective investigation of the hypothesized association between early inhalant use and later heroin use. Analyses were conducted using longitudinal data from a community sample of Woodlawn (an all African American community on the South side of Chicago). Six-hundred subjects participated in both the adolescent and the adult assessments (approximately ages 16 and 32, respectively). Youths with a history of inhalant use by age 16 were over nine times more likely to begin heroin use by age 32, even when other plausible risk factors for the development of heroin use were held constant (RR = 9.3; 95% C.I. = 1.3 - 51.3). These findings add to and are consistent with prior cross-sectional evidence from data based on treatment samples and national survey data. The results from this longitudinal assessment support the idea that youthful inhalant use should be regarded as a vulnerability marker for the development of more serious drug use involvement in the form of heroin use.

Administration, Inhalation↗
PubMed1995

Filters on the pathway to mental health care, I. Incident mental disorders.

This study investigates health and mental health services use by adults with and without newly incident mental disorders and uses prospectively gathered data from the Epidemiologic Catchment Area Program, a multi-site interview survey of adult household residents in the United States. Study subjects were 13,400 participants who completed interviews in the initial survey and also in a follow-up 1 year later, and who reported no contact with mental health services in either the specialized mental health sector or in the general medical sector in the 6 months prior to the initial survey. Case ascertainment was by means of a standardized interview method, the Diagnostic Interview Schedule. Separately, and before the mental health assessments were made, respondents were asked about their use of health and mental health services. 'Hierarchical' and 'filter' models of mental health services provide frameworks useful in understanding the possible effects of specific categories of psychiatric disturbances on use of health services. Only a minority of individuals with newly incident psychiatric disorder report discussion of mental health issues in a health care setting. Persons who developed a mental disorder during the follow-up interval were just as likely to consult a non-psychiatrist physician for their mental health problems as to consult a specialist in mental health, even accounting for other factors known to be associated with differential use of health care services. This large community study of incident psychiatric disorders strengthens prior evidence on the importance of the general medical sector in the care of individuals with psychiatric disturbances.

Adolescent↗
PubMed1995

Filters on the pathway to mental health care, II. Sociodemographic factors.

This study uses the prospectively gathered data of the Epidemiologic Catchment Area Program, a multi-site interview survey of mental disturbances among adult household residents in the United States, to compare health services use by individuals with different sociodemographic characteristics, accounting for the first-time occurrence of psychiatric disorder, over the course of a 1-year follow-up interval. Case ascertainment was by means of a standardized interview method, the Diagnostic Interview Schedule. In the present investigation, 13,400 continuing participants in the household sample who reported no contact with mental health services in the 6 months prior to the initial interview were studied with regard to health services use and sociodemographic characteristics. Separately, and before the mental health assessments were made, respondents were asked about their use of health and mental health services. African-Americans were significantly less likely than whites to have consulted with a specialist in mental health (estimated relative odds, 0.22, 95% confidence interval 0.10 to 0.52), even accounting for coincident psychiatric disorder, gender, and other covariates known to be associated with differential use of health care services. Hispanics and other minorities were also less likely to have consulted a specialist in mental health (estimated relative odds, 0.37 and 0.26, respectively). This large community study extends previous work on mental health services and ethnicity.

Adult↗
PubMed1995

Occupational stress and the risk of alcohol abuse and dependence.

Using prospective data, we examined the relationship between occupational stress and risk for alcohol disorders. Consistent with the Demand/Control model for psychosocial work environments, we hypothesized that individuals working in high-strain occupations (jobs with high demands and low control) would be at increased risk for alcohol abuse-dependence relative to those in low-strain occupations (jobs with low demands and high control). We classified high occupational strain into two categories: (1) jobs with high psychological demands and low control, and (2) those with high physical demands and low control. A total of 18,571 study subjects were selected in 1980-1984 by taking probability samples of adult household residents at five sites of the Epidemiologic Catchment Area Program. At baseline, participants completed standardized interviews that measured sociodemographic variables and assessed whether they had met diagnostic criteria for currently or formerly active alcohol abuse-dependence syndromes. The interviews were readministered 1 year later to identify cases among the participants. Subjects were sorted into risk sets by age and residence census tract, and persons with a previous history of alcohol abuse or dependence, as well as those who were over 64 years or had no history of full-time employment, were excluded. Among the 507 participants included in the risk sets, there were 126 incident cases of alcohol abuse-dependence and 381 age and residence-matched noncases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

The growth of conduct problem behaviors from middle childhood to early adolescence: sex differences and the suspected influence of early alcohol use.

OBJECTIVE: This study investigates the levels and rates of growth of conduct problem behaviors over time in an urban sample of American youth. Our hypotheses focused on differences between the sexes and between youths with and those without early use of alcohol without parental permission. METHOD: Data for this study are from an ongoing epidemiologic study of urban public school students, recruited originally at the time of their entry into Grades 1-2 between 1985 and 1987. Each spring, from 1991 to 1993, a total of 1,212 students were interviewed privately for this study. A total of 408 (54.2% female, 84.7% black) respondents met study criteria as either an "early unsanctioned alcohol user" or an "abstainer." These youths constitute the analytic subsample. RESULTS: Estimates from longitudinal growth modeling analyses showed that boys and girls had different initial levels of conduct problem behaviors, but similar rates of growth. Both the initial level of conduct problem behaviors and the rates of growth were greater for early unsanctioned alcohol users as compared to abstainers. In a combined analysis the difference between early unsanctioned alcohol users and abstainers seemed to offset the initially observed sex difference. CONCLUSION: Early alcohol use without parental permission was associated with higher levels of conduct problem behaviors by the ages of 10-12 years and higher rates of growth in those behaviors during the transition from late childhood to early adolescence for both boys and girls, although the levels differed by sex. It may be that unsanctioned early alcohol use puts youths on an accelerated pathway of conduct problem behaviors and development of conduct disorder in adolescence.

Adolescent↗
PubMed1995

Retaining cocaine-abusing women in a therapeutic community: the effect of a child live-in program.

A clinical trial examined whether retention of cocaine-abusing women in a therapeutic community can be improved by permitting their children to live with them during treatment. Fifty-three women were randomly assigned to either the standard community condition (n = 22), in which children were placed with the best available caretaker, or the demonstration condition (n = 31), in which one or two of the children lived with their mother in the community. Survival analysis distributions indicated that demonstration women remained in treatment significantly longer than standard treatment women. (Mean length of stay was 300.4 days vs 101.9 days, respectively.)

Adult↗
PubMed1994

Low power? Use two-dimensional confidence regions as a graphical method for depicting uncertainty.

Prospective studies of rare outcomes, such as HIV seroconversion or obsessive-compulsive disorder, can often result in small sample sizes with limited power for detecting associations. For this reason, it is useful to develop graphical procedures that enable researchers to depict uncertainty around parameter estimates and examine the direction of association when statistical power is low. Classical procedures include the reporting of confidence intervals, which typically are derived from asymptotic normality of parameters estimated using large samples. In this paper, we present a likelihood-based procedure for the estimation of the confidence region of two parameters from a conditional logistic regression of a nested case-control study with a relatively small number of cases. Graphical depiction of the confidence regions provides an easily comprehensible procedure to quantify the uncertainty of the estimation based on small samples.

Adult↗