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The association of educational achievement and school dropout with risk of alcoholism: a twenty-five-year prospective study of inner-city children.

OBJECTIVE: This prospective study is focused on the characteristics leading to alcohol use disorders in early adulthood among a cohort of black children. The principal aim of this work is to examine the impact of educational attainment, school dropout and early school adaptation on the development of alcohol abuse and dependence in adulthood. METHOD: From a population that consisted of 1,242 first graders in 1966-67, a total of 953 were interviewed at age 32-33 about their current alcohol and drug use, educational attainment, employment and family situation. RESULTS: Diagnoses of alcohol abuse and dependence were defined according to DSM-III-R criteria resulting in identification of 13.5% as having a lifetime alcohol use disorder. Early predictions of an alcohol use disorder in adulthood included early reports of underachievement in first grade by the child's teacher, dropping out of high school, whether the family set definite rules about school during adolescence, and how often the adolescent worked on homework with his/her family. CONCLUSIONS: The results suggest that educational achievement and some early adaptive behaviors in school are associated with risk for alcohol use disorders. The public health importance of the findings are discussed.

Achievement↗

Abortion applicants: characteristics distinguishing dropouts remaining pregnant and those having abortion.

This study, of two groups of women who applied for induced hospital abortion, compares 100 women who had the abortion with 100 women who dropped out to carry to term. Dropout applicants who elected to carry to term had less education, had partners with less education, tended to be indecisive, and when they told their partners tended to receive negative responses toward abortion. In addition, these women expressed greater concern about the procedure and about the moral implications of abortion. Implications of this study for further research on women's and their partners' decision-making about abortion using the Janis-Mann model are discussed.

Abortion Applicants↗

Smoking prevalence in a cohort of adolescents, including absentees, dropouts, and transfers.

This study reports daily smoking rates among older adolescents obtained by a unique follow-up of a cohort originally identified in the seventh grade. Those no longer in their original school districts were located and interviewed by telephone. Smoking rates among dropouts exceeded 70 per cent in all age-sex groups. Smoking rates among transfers were as high as those among absentees. Including these subgroups raised smoking prevalence rates among older adolescents substantially.

Absenteeism↗

Evaluation of indicated suicide risk prevention approaches for potential high school dropouts.

OBJECTIVES: This study evaluated the efficacy of 2 indicated preventive interventions, postintervention and at 9-month follow-up. METHODS: Drawn from a pool of potential high school dropouts, 460 youths were identified as being at risk for suicide and participated in 1 of 3 conditions randomly assigned by school: (1) Counselors CARE (C-CARE) (n = 150), a brief one-to-one assessment and crisis intervention; (2) Coping and Support Training (CAST) (n = 155), a small-group skills-building and social support intervention delivered with C-CARE; and (3) usual-care control (n = 155). Survey instruments were administered pre-intervention, following C-CARE (4 weeks), following CAST (10 weeks), and at a 9-month follow-up. RESULTS: Growth curve analyses showed significant rates of decline in attitude toward suicide and suicidal ideation associated with the experimental interventions. C-CARE and CAST, compared with usual care, also were effective in reducing depression and hopelessness. Among females, reductions in anxiety and anger were greater in response to the experimental programs. CAST was most effective in enhancing and sustaining personal control and problem-solving coping for males and females. CONCLUSIONS: School-based, indicated prevention approaches are feasible and effective for reducing suicidal behaviors and related emotional distress and for enhancing protective factors.

Adaptation, Psychological↗

Drug involvement among potential dropouts and "typical" youth.

Drug involvement, conceptualized as drug use frequency, drug access, drug use control, and adverse use consequences, is described and compared among two randomly selected groups of students aged fourteen to nineteen years: 203 low-risk typical high-school students and 160 youths at high-risk of school problems and dropout. High-risk youth, compared to low-risk youth and national statistics, endorsed a much greater breadth and depth of drug use, greater access to drugs, less drug use control, and greater adverse consequences due to use. A secondary analysis showed low-risk users (experimenters) were similar to high-risk youth in their access to drugs and eroding drug use control, but showed low frequencies of drug use and negligible adverse use consequences. Measuring and exploring these four facets of drug involvement provided a robust picture of the adolescents' drug milieu and revealed differences in patterns of drug involvement that would not have been evident by looking purely at drug use frequency. Implications for prevention programming are suggested.

Adolescent↗

Locus of control of disadvantaged high school dropouts: preliminary data.

Normative data were collected on 197 disadvantaged high school dropouts on the dimension of internal-external control. Findings indicate that this group appears to be external but not markedly so, and a short-term intervention program designed to improve academic and vocational skills did not appear to affect locus of control of 33 subjects.

Adolescent↗

Sibling effects, environmental influences, and school dropout.

Relations were examined between sibling variables, environmental influences, and the likelihood of dropping out of school. Data were collected from Australian adolescents (4,096 boys, 4,570 girls). Findings indicated that, after taking into account measures of distal contexts and proximal learning settings, sibling variables continued to have small but significant associations with adolescents' school dropout behavior.

Adolescent↗

Therapeutic community dropouts: criminal behavior five years after treatment.

Two hundred and two male dropouts, mainly heroin abusers averaging 3 to 6 years out of treatment, were sampled from the 1970-1971 Phoenix House admissions by race and time in program (less than 1 month to more than 2 years). Criminal justice arrest records were compared between three pre- and all posttreatment years. Percent and rate of arrest declined significantly in followup. Magnitude of reductions was uniform across race and legal status, varied by age, but increased systematically by time in program. Results replicated and extended earlier findings, confirming long-term positive change in criminal behavior associated with length of stay in the therapeutic community.

Adult↗

The efficacy of role induction in preventing early dropout from outpatient treatment of drug dependency.

A study was conducted to examine the impact of various role induction modalities in dealing with the problem of early dropout among substance abusing patients. Emphasis was placed on tracing the interdependency between patient misperceptions of treatment, termed level of discrepancy in treatment expectations (Level of DTE) and continuance. Results indicated that patients who were more favorably disposed to the program (low Level of DTE) were more likely to remain in care than those who were not (high Level of DTE) only if role induction was provided; in the absence of the pretreatment intervention, differences between high and low discrepant patients were virtually nonexistent. These data suggest that the real utility of role induction lies in its ability to confirm the expectations of low discrepant patients (in contrast to improving patient knowledge of therapy) while at the same time providing them with a mechanism to learn coping skills necessary for adjusting to a new program. For those classified as high discrepant patients, role induction alone was not sufficient to prevent early termination; the majority did not stay past four sessions. Implications for this group are that greater efforts should be made in responding to their concrete problems, actively engaging "significant other(s)" or providing them with an external support system in the form of a "buddy" at the point of entry, in order to forestall premature termination.

Adult↗

Differences in psychological need hierarchy between program completers and dropouts from a drug abuse treatment program.

Psychological need patterns among 116 drug addicts in treatment were measured with the Adjective Checklist. Compared to program completers, program dropouts had higher needs for autonomy and aggression and lower needs for deference, nurturance, and affiliation. This personality style may form the basis of dropping out, among certain types of addicts in certain types of programs, when faced with situational, environmental, or interactional stress. Results also suggest that we may be able to identify a personality pattern at risk for premature termination before the person experiences the impulse to leave.

Adult↗

Anxiety as a factor in continuance and dropout in treatment.

The present study was conducted to determine whether or not a statistically significant relationship exists between patients' anxiety levels and dropout rates in an inpatient alcoholism treatment program. The anxiety test scores of two groups (20 veterans completing a 4-week rehabilitation program and 20 veterans terminating treatment against staff advice during the initial 2 weeks of treatment) were compared. No significant differences were measured in a between-group comparison. The need for future research to be conducted with the inclusion of a control group is illustrated in regard to the findings of this study.

Alcoholism↗

Methadone applicant dropouts: impact of requiring involvement of friends or family in treatment.

This paper examines attrition among applicants to a methadone maintenance program before and after it began to require that applicants have a relative or close friend willing to act as a treatment sponsor. Few applicants were unable to locate sponsors. The dropout rate was greater for Blacks than for Hispanics and Anglo Whites both before and after the sponsor requirement was introduced. However, young addicts, addicts with recent drug histories, and singles were somewhat less likely to enter treatment after the requirement was introduced. Implications for drug treatment clinicians and administrators are discussed.

Adult↗

The dropout in alcoholism research: a brief report.

Compared to 148 alcoholic men who were successfully followed up after 1 year in a controlled treatment evaluation study, the 18 treatment dropouts reported somewhat less alcohol impairment due to drinking and lower scores on measures of psychopathology when first seen.

Alcoholism↗

Effects of a school-based prevention program for potential high school dropouts and drug abusers.

This study tested the effects of a prevention program based on an integrated social support and psychoeducational model. A semester-long Interpersonal Relations (IPR) class was predicted to deter school drop-out problems and drug abuse among adolescents. Quasi-experimental designs were used to field test the IPR program with 264 high-risk students in one of two conditions: (1) pretest, treatment, and posttest; (2) pretest and posttest. All hypotheses were supported. Significantly more potential dropouts were retained in the treated (74%) versus the comparison group (61%); differences in daily attendance (F = 12.88) and GPA, school achievement (F = 16.89), were significantly better in the treatment group (p less than .0001); drug involvement declined significantly from pre- to posttreatment for IPR program participants (t = 4.61, p less than .0001). Implications for treatment and recommendations for future research are discussed.

Absenteeism↗

Preventing adolescent drug abuse and high school dropout through an intensive school-based social network development program.

Purpose. The hypothesis tested was that experimental subjects, relative to controls, would demonstrate significant increases in school performance and decreases in drug involvement at program exit (5 months) and at follow-up (10 months). Design. A two-group, repeated-measures, intervention trial was the design used. Setting. The study involved four urban Northwest high schools. Subjects. Participants included 259 youth at high risk of potential school dropout, 101 in the experimental group and 158 in the control group. Intervention. The Personal Growth Class experimental condition was a one-semester, five-month elective course taken as one of five or six regular classes. It had a 1:12 teacher-student ratio, and integrated group support and life-skills training interventions. The control condition included a regular school schedule. Measures. School performance measures (semester GPA, class absences) came from school records. Drug use progression, drug control, and adverse consequences were measured by the Drug Involvement Scale for Adolescents. Self-esteem, school bonding, and deviant peer bonding were measured using the High School Questionnaire: Inventory of Experiences. All multi-item scales had acceptable reliability and validity. Results. As predicted, trend analyses revealed significantly different patterns of change over time between groups in drug control problems and consequences; in GPA (but not attendance); and in self-esteem, deviant peer bonding, and school bonding. The program appeared to stem the progression of drug use, but group differences only approached significance. Conclusion. Program efficacy was demonstrated particularly for decreasing drug control problems and consequences; increasing GPA and school bonding; and desired changes in self-esteem and deviant peer bonding. Program effects on progression of drug use were less definitive.

Adolescent↗

The clinical dropout: a view from the client's perspective.

When a client discontinues treatment after a short period, a common response is to consider treatment a failure and to blame the client, therapist, or agency. Results of this study indicate that dropouts experienced positive changes and used resources other than clinical services.

Community Mental Health Services↗

Associate degree nursing students: nonintellective differences between dropouts and graduates.

A comprehensive battery of tests designed primarily to measure nonintellective characteristics was administered to 112 students entering five associate degree nursing programs. At the end of two years, analyses of the entrance data revealed significant differences between the 73 graduates (those who completed the program on schedule) and the 32 nongraduates (those who dropped our of the program for various reasons). Seven students who remained in the programs but who had not completed the requirements were not included in the analyses. The data indicated that at the time of entry into their programs, those students who later completed the program on schedule were more mature--older and married, more achievement oriented, responsible, and self-controlled than dropouts. Successful students also manifested more accepting and nonjudgmental attitudes toward other people.

Education, Nursing, Associate↗

Dropout and completion of treatment among spouse abusers.

This study examines a population of spouse abusers undertaking a treatment program. Its purpose was to identify the variables associated with dropout and completion of treatment and to build a predictive model. Data were collected on 286 men who began group treatment in one of eight community programs in the province of Quebec, Canada. Results show that men who complete treatment are older, better educated and have better economic conditions than men who drop out. They also have a more stable family life, have been in a relationship for a longer period of time and have more children with their actual spouse. Men who completed treatment showed more commitment, better working capacities and a higher level of agreement with their therapists, thus developing a stronger therapeutic alliance. Support provided by people in the environment was significantly related to treatment completion. Social and judicial pressures were not related to completion.

Adult↗