Adolescent Substance Abuse

Abstract

Adolescence is a stage in which young children are transitioning into adulthood and during this time there are challenges that can be encountered that can impact development. Prior to reaching adulthood substance abuse is an issue that many adolescents are faced with.  The National Institute on Drug Abuse (2014), states that nearly 70 percent of high school students will have consumed alcohol by the time they become seniors, 50 percent will have engaged in the use of illegal drugs, almost 40 percent tried smoking a cigarette on more than one occasion, and a little over 20 percent experimented with prescription drugs for recreational use.  There are many factors that influence adolescent substance abuse and it is a serious problem that can affect cognitive, physical and social development and providing a breakdown of those factors will allow the opportunity to identify successful intervention techniques.

  Substance Abuse

The act of ingesting, inhaling, or injecting something that can be detrimental to the health of an individual, “usually for psychoactive (mood-altering) purposes” (Wulffson, 2015) is known as substance abuse.  Alcohol, tobacco, prescription drugs and medications purchased over-the counter are commonly used products that are legal substances and cocaine, marijuana, hallucinogens, methamphetamine, and heroin are illegal substances.  Substance abuse is a problem that has been increasing amongst our youth and efforts have been made to gain a better understanding on the issue by examining biological and environmental factors that could be contributing factors in adolescents deciding to experiment with substances.  The National Survey on Drug Use and Health performed a study in 2014 stated that approximately 27 million Americans 12 years of age and older was reportedly used illegal substances within one month of the survey being conducted.  Therefore, it is imperative that an explanation on how adolescents develop substance abuse issues is provided.

During the adolescent years, the human brain is experiencing major changes that involve their “emotional/social network outpace development of the cognitive-control network” (Berk, 2014, p. 368) and because of these changes they are more than likely to engage in risky behavior such as substance use.  As the brain is developing during this period there are biological and environmental factors that could increase the chances of adolescents developing substance abuse problems.  Substance abuse and addiction disorders have been linked to biological factors such as genetics.  Research is continuously being performed to determine if substance abuse and addiction disorders can be inherited though genetics and thus far it has been acknowledged that inherited factors do exist, however there has not been any concrete evidence to determine what is inherited.  For example, an adolescent with a family history of drug abuse can “have an increased susceptibility or sensitivity to the effects of drugs with reinforcing properties” (Biological Components of Substance Abuse and Addiction, 1993) and those reinforcing properties are environmental factors.

Factors that Influence Substance Abuse

Environmental factors that influence adolescent substance abuse problems include access to substances, exposure to substance abuse through observing others and socioeconomic status.  Socioeconomic status is an individual’s social status which represents their place in society and is “earned through actions or accomplishments” (Campbell, 2016).  Adolescents that live in an environment of a lower socioeconomic status, meaning that education levels and income are less than average, tend to have more access to illegal substances because there is a high level of the availability of drugs in those types of communities and are exposed to substance abuse though the observation of others.  Communities that are of a lower socioeconomic status often have a high presence of outlets that distribute alcoholic beverages and tobacco sales that increase the exposure to adolescents and “facilitate substance use and initiation and potential abuse” (Mennis, Stahler, & Mason, 2016).  Albert Bandura’s Social Learning Theory suggest that human behavior is learned through observing others and that is a contributing factor to how adolescents begin to abuse substances in environments that are of a lower socioeconomic status, by simply watching others such as older teenagers and/or adults partake in these behaviors without receiving any consequences. Biological and environmental factors increase risk factors associated with adolescents who develop addictive disorders.

  

Addiction

Addiction is a mental disorder associated with functions of the brain and is related to substance abuse because when an individual reaches a point in which they are doing something and not able to stop then they have developed an addiction (O'Driscoll, 2014).  Adolescents that continuously abuse drugs and alcohol impact their physical, psychological and cognitive development.  Substance abuse can impact physical development because adolescents are most likely not receiving the proper nutrition needed to ensure the proper development.  Psychological development is effected because cognitive functions are impaired because of the effects that alcohol and drugs have on the human brain.  Substance abuse alters human behavior which affects psychological development because adolescents are engaging in risky behavior that could be detrimental to the health of themselves and others. 

Developmental Theories

Erik Erickson developed a theory on eight stages of human development that can provide some insight on adolescent’s engaging in substance abuse.  The adolescent stage is identity vs. role confusion and is focused on fidelity.  (Gould, 2015) states that during this stage individuals are focused on what they do and often struggle with finding their own identity, peer relations and determining their place in society.  The identity vs. identity confusion stage can influence substance abuse because adolescents are trying to fit in societal norms that often involve drugs and alcohol.  Adolescents that partake in drug and alcohol abuse to fit in often can develop an addiction because of the feelings that are experienced when under the influence.

Intervention

Intervention can be identified as a method used to “produce an effect or to interrupt or stop the progression of a disease” (Frey, 2015) such as substance abuse and addiction.  In efforts community should join forces to develop intervention techniques.  Early detection of possible drug and alcohol abuse is the most effective because adolescents can be referred to treatment programs to help combat those issues.  A change of environment has always been the most recommended solution; however, it is not always the most feasible decision, therefore community efforts should be made to deter adolescents from partaking in the use of drugs and alcohol. Drug Abuse Resistance Education (DARE) is a proactive intervention technique that was designed to teach students about making decisions that will help them lead a safe and healthy life that is free from risky behaviors that involve substance abuse. 

Conclusion

Substance abuse is a serious problem in society and providing an explanation on how adolescents develop substance problems can help with developing intervention techniques that can assist with reducing the risk of the urge to experiment with alcohol and drugs.  There are several biological and environmental factors that contribute to adolescents developing addictive disorders and developmental theories have provided information on the different stages and how they relate to how substance abuse is dealt with.  Developing intervention techniques is the most appropriate and effective method that can be used to reduce the risk of adolescent experimenting with drug and alcohol abuse and it is important for everyone to be a part of the efforts.

  References

Berk, L. E. (2014). Development Through the Lifespan (Vol. Sixth Edition). Upper Saddle River, New Jersey: Pearson.

Biological Components of Substance Abuse and Addiction. (1993). Retrieved from Princeton.edu: www.princeton.edu/~ota/disk1/1993/9311/931103.PDF

Campbell, J. (2016). Social status. Salem Press Encyclopedia.

Frey, R. P. (2015). Intervention. Salem Press Encyclopedia of Health.

Gould, M. A. (2015). Erikson's Eight Stages of Development. Research Starters: Sociology (Online Edition).

Mennis, J., Stahler, G. J., & Mason, M. J. (2016). Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research. International Journal of Environmental Research and Public Health, 13(6). doi:10.3390/ijerph13060607

NIDA. (2014). Retrieved from Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide: www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide

O'Driscoll, C. (2014). Addiction: A Guide to Understanding Its Nature and Essence. Hauppauge, New York: Nova Science Publishers, Inc.

Wulffson, R. M. (2015). Substance abuse. Salem Press Encyclopedia of Health.

The Strange Situation Review

The Strange Situation

The attachment theory provides an explanation on the importance of how bonding and attachment is to personal development in infancy and childhood. The emotional tie between a mother and infant is known as bonding and often occurs shortly after birth. Attachment is a relationship that develops during infancy and John Bowlby a British psychiatrist believes that there are four phases in the development of attachment.  In phase 1, newborns are still in the bonding face, therefore attachment has not begun.  In phase 2, which occurs around two months, infants demonstrate the ability to recognize the difference between caregivers, however attachment has not yet developed.  In phase 3 is when attachment begins around seven months and “infants clearly discriminate the caregiver from other people and begin to show preferential treatment toward the caregiver” (Rieser-Danner & Slaughter, 2016).  Phase 4 is when infants secure the bond with caregivers and attachment becomes relevant to their relationship. This paper will provide a review of a study conducted by psychologist Mary Ainsworth in which she explored different aspects of mother and infant attachments.

Experiment Details

The Strange Situation was an assessment that was conducted by Psychologist Mary Ainsworth as a method to investigate “how attachment might vary between children” (McLeod, 2008).  There were 56 infants that were participants from middle class white families and they were divided into subsamples, one included 23 infants, “who had been observed longitudinally from birth onward, were observed in the strange situation when 51 weeks old” (Ainsworth & Bell, 1970) and the other included 33 infants who were observed at 49 weeks of age.  The observation was conducted in a room that was intended to “be novel enough to elicit exploratory behavior, and yet not so strange that it would evoke fear and heighten attachment behavior at the outset” (Ainsworth & Bell, 1970).  The room was furnished but it was arranged in a way that a significant amount of empty space was left open.  There was a chair for the child and toys were present on one side and a chair for the mother and opposite that chair was a chair for a stranger on the other side.  The experiment begun with the infant being placed in the area that was purposely left empty and was “left free to move where he wished” (Ainsworth & Bell, 1970).  There was a total of eight different scenarios used to initiate, measure and record behaviors that occurred.  The scenarios involved mother-infant and the observer; mother-infant; mother-infant and stranger; mother departs leaving infant alone with stranger; mother departs leaving infant alone; stranger comes back while infant is alone; mother comes back while infant was with stranger and stranger leaves.  The results of those scenarios were recorded to demonstrate the difference in the behavior of the infants as it relates to attachment.

The behaviors that were described during the research were categorized in four different ways, proximity and contact-seeking behaviors; contact-maintaining behaviors; proximity and interaction-avoiding behaviors; contact and interaction-resisting behaviors.  Proximity and contact-seeking behaviors involved the infant actively attempting to make contact gestures such as reaching, approaching or crying.  Contact-maintaining behaviors occurred once the infant made contact, they made every effort to maintain that contact through “resisting release by intensified clinging on” (Ainsworth & Bell, 1970).  Proximity and interaction behaviors occurred when someone other than the caretaker attempted to interact with the infant and the infant purposely ignored that adult by looking away and then moving away. Contact and interaction-resisting behavior occurred with the infant resisting contact from someone other than the caregiver and throws temper tantrums trying to get away from the unfamiliar person. 

Main Points

The research determined that “patterns of attachment is believed to be the result of the history of interaction between the caregiver and infant” (Rieser-Danner & Slaughter, 2016), therefore it does not occur by chance but rather it is based on the circumstances.  If the infant is exposed to an unfamiliar environment they may experience fear and that will result in attachment intensifying and those feelings can only be resolved with reuniting the infant with their caretaker. The findings from the research suggest that levels of attachment are based on individual differences that is dependent upon the relationship developed between a mother and her child.  If a mother is consistently responsive to the needs of their child in a sensitive manner a secure attachment will develop and mothers that are less sensitive when responding to the needs of their child are more than likely to develop an insecure attachment.

Examining the main points that were presented in the research study and reflecting on my own personal experience, I would have to say that I agree with the conclusion to the experiment.  I believe that children whom are accustomed to always being with their mother will experience heightened levels of anxiety if someone must care for them not in the presence of their mother and/or father.  I can support this claim through personal experience with my now 11-year-old daughter who was cared for by her father for the first six months of her life and when it was time for her to go to daycare, she demonstrated contact and interaction behaviors for the first week of being in the care of someone else.  When an infant or young child’s normal routine is altered and they are exposed to a different environment and unfamiliar people are present I believe they develop a sense of fear and may struggle to adapt to that environment. 

 Intervention

German psychoanalyst Erik Erikson developed a psychosocial theory that focused on infant/toddler development in relation to the parent-infant relationship.  Erikson’s theory state that “a healthy outcome during infancy depends on the quality of care giving; relieving discomfort promptly and sensitively and holding the infant gently” (Berk, 2014, p. 184), therefore developing a level of trust can ensure a healthy attachment.  Many parents have reservations about having others care for their children at such a young age and opt out of childcare arrangements, however I personally believe that the best way for infants and toddlers to develop levels of trust outside of their parents is to be in different environments.  When infants and toddlers are exposed to environments that promote healthy interactions amongst each other healthy attachments can develop making it easier on the parents to separate from their children for short periods of time.  Having a complete understanding of developmental milestones is also important to intervention because that allows caretakers to make informed decisions regarding the level of care the child should be receiving.  Understanding child development ensures that caretakers are implementing age-appropriate interactions and activities with children that will not increase levels of anxiety due to frustration and fear of the unknown.

Conclusion

Several experiments have been conducted to measure mother-infant attachments and The Strange Situation was a specific experiment that caught a lot of attention.  The experiment was conducted in a laboratory setting instead of the home environment because researchers believed that was the only way to produce valid results.  The goal was to identify different levels of attachment by exposing the infant to different conditions involving the caretaker and strangers. The results concluded that there were high levels of attachment in the infants when left in the presence of strangers without the mother being present, therefore supporting the attachment theory claim on the importance of bonding and attachment is to personal development.  The review of the strange situation was designed to summarize the experiment, discuss the main points that were made by the researchers and provide an opinion on whether I agreed or disagreed with the viewpoints.  Finally, the review discussed specific techniques that are applicable to ensuring infants and toddlers develop healthy attachments with caregivers.

References

Ainsworth, M. S., & Bell, S. M. (1970). Attachment, exploration, and separation: Illustrated by the behavior of one-year-old in a strange situation. Child Development, 41(1), 49-67.

Berk, L. E. (2014). Development Through the Lifespan (Vol. Sixth Edition). Upper Saddle River, New Jersey: Pearson.

McLeod, S. (2008). Strange Situation. Simply Psychology. Retrieved from www.simplypsychology.org/mary-ainsworth.html

Rieser-Danner, L. A., & Slaughter, V. (2016). Attachment and bonding in infancy and childhood. Salem Press Encyclopedia Of Health.

PF Model Psychological Assessment

Psychological Assessment

Psychological assessments are designed to measure “individual differences in behaviors, and applying this knowledge to a single person for his and society’s interest” (Laak, Desai, & Gokhale, 2013) and must demonstrate reliability and validity.  Determining the validity of an assessment has been accomplished through implementing the correlation method which involves examining the relationship between results and criterion, however Bornstein published an article that provided an explanation on how using the process-focused model is more effective when providing evidence of validity. Selecting an appropriate method for determining the validity of an assessment that identifies problem behaviors in school-aged children is important to ensuring the accuracy of the measurement so that the proper treatment methods and interventions are implemented.  Even though human behavior is constantly changing, and often the results of an assessment may not be accurate of one’s true behavior, The Clinical Assessment of Behavior has been rated as a valid measurement tool because the reliability coefficients range from .77 to .95 and .88 or higher across the three forms on the scale and cluster internal consistency. This paper will provide information supporting the validity of The Clinical Assessment of Behavior by comparing the process-focus model and the traditional model to determine which method is most applicable of assessing the validity.  

The Clinical Assessment of Behavior

A psychological assessment that is intended to “assist in the identification of children and adolescents across a wide range who need behavioral, educational, or psychiatric treatment or intervention” (Clinical Assessment of Behavior, 2004).  The Clinical Assessment of Behavior measures behaviors on a clinical scale and adaptive scale.  The clinical scale measures internalized behaviors that relate to feelings that children may have towards themselves, such as depression, anxiety and somatization.  Externalized behaviors are also measured on the clinical scale and include problem behaviors that are directed towards others such as anger, aggression and bullying.  Behaviors that are associated with Sociopathy and Psychopathology are also measured on the clinical scale.  The adaptive scale measures social skills related to how children interact with peers and adults as well as competence and adaptive behaviors.  Competence refers to cognitive and language development and adaptive behaviors involve social responsibility and independent performance of daily activities.  The Clinical Assessment of Behavior has three forms, parent rating form, teacher rating form an extended rating form and takes nearly 15 minutes to complete and 30 minutes for the extended rating form.  The assessment includes 70 questions that must be answered according to the five-point rating scale that range from always or very frequently to never and is completed by parents, caretakers and/or teachers based upon the behaviors that were directly observed.  Once the forms are completed the data will be entered in The Clinical Assessment of Behavior scoring program to generate results.  This process is designed to validate the assessment of children’s behavior by assessing the knowledge that participants have on human behavior which is why Bornstein believe that a substantial amount of time and effort has been dedicated by researchers to “maximize test score validity by ensuring assessment tools measure what we think they do” (Bornstein, 2011). 

Traditional Models of Validity

Content, criterion-referenced and construct validity are traditional models of validity that are utilized to conceptualized assessment validity.  Content validity provide evidence that is based on the content of the assessment and involves a reasonable examination and evaluation of the test content.  To ensure content validity for The Clinical Assessment of Behavior, (Miller, 2016) states that researchers must examine the format of the test, questions and wording to verify that the content represents the concepts related to identifying problem behaviors in children and adolescents and evaluating adaptive skills “without underrepresenting those concepts or including elements that are irrelevant to their measurement”.  Criterion-referenced validity refers to correlational relationships between variables and involves comparing test scores of The Clinical Assessment of Behavior “with other measures to determine whether those scores are related to other measures to which we would expect them to relate” (Miller, 2016, p. 185).  Construct validity provides evidence that the test is measuring what it claims to measure.  (Miller, 2016) defines constructs as “attributes, traits, or characteristics that are not directly observable and can only be inferred by examining observable behaviors”.  The content of The Clinical Assessment of Behavior is an important component to construct validity because it demonstrates that the assessment provides “a balanced theoretical framework of both competence-based qualities and problem-based concerns that is useful for evaluating adaptive strengths and clinical risks in children and adolescents” (Clinical Assessment of Behavior, 2004).  While traditional models of validity are commonly used, the validity coefficient indicates strengths and weaknesses of measured variables and Bornstein (2011) believes that improvements can be made to the process by adapting the process-focus model that will allow the validity of assessments to be examined in a different context.

Process-Focused Model of Validity

The Process-Focused model of validity is another method of providing evidence of validity on assessments that measure psychological constructs by applying an experimental method to manipulate variables.  Manipulating variables in the process-focused model allow researchers the opportunity to examine other factors involving psychological processes and how they influence test scores.  Borstein describes the process-focused model as an “outcome-based validity assessment with a process-driven approach” (Bornstein, 2011) that is designed to improve the assessment procedure.  Examining other factors involve psychological processes links psychological disciplines in the process-focused model and Borstein designed a four-step model to demonstrate how manipulating variables incorporates ideas from different psychology subfields.

Borstein’s (2011) four-step model.

Borstein has provided an outline on a procedure that is applicable to assessing the validity of any psychological construct. The Clinical Assessment of Behavior focuses on defining the measurement of psychological constructs that are not directly observable using the process-focused approach.  Psychological constructs such as internalized behaviors, externalized behaviors and critical behaviors can be measured using the four-step model designed by Borstein.

Step 1. Deconstruct assessment instrument has two separate components, the first component involves specifying underlying processes in the behavior of school-aged children that should occur when children respond to motivational techniques that occur during observation for testing purposes and then identifying circumstances that can alter their behavior.    

Step 2. Operationalize and evaluate process-outcome links has three components that can be used in the assessment of a psychological construct such as human behavior.  Bornstein (2011) identified those components as “turning process-altering variables into manipulations, delineating hypothesized outcomes, and experimental design”.  This step involves developing hypotheses on the behavior of young children and adolescents relating to the school environment that will require performing a research experiment. 

Step 3. Interpreting the outcome involves evaluating the results of the assessment and interpreting the data collected on the behavior of young children and adolescents in relation to limiting conditions that can alter the assessment process.  The test-retest method is applicable in this step because it will identify behavioral changes that were caused by limiting factors.

Step 4. Evaluate generalizability and ecological validity is the final step in assessing the validity of psychological constructs in the process-focused model and involves putting the data collected on the behavior of young children and adolescent into context.  Inconsistencies in the research design is a limiting condition that can influence the assessment process which is why the test-retest method is important to the process.  The Clinical Assessment of Behavior includes three forms that are completed in different context, therefore assessing the behavior of young children and adolescents can occur through validating the data across the three forms. 

With these steps in mind, a comparison of the Traditional and Process-Focused Models is necessary to determine which method is best suited for The Clinical Assessment of Behavior because of Borstein’s belief on using “experimental manipulations to alter respondents’ psychological processes during testing” (Bornstein, 2011, p. 5), examining the similarities and differences will provide clarity.

Comparison of the Traditional and Process-Focused Models

                                    Differences

Bornstein (2011) article on the process-focused model explains how this method differs from the traditional method by outlining key points to the process that determines validity as it relates to the outcome.  The traditional method limits the variables associated with the assessment and the test score through correlational methods that are designed to “quantify the relationship between test scores and criterion” (Bornstein, 2011, p. 1).  On the contrary, process-focused model theorizes the idea of validity is based on the point in which participants can demonstrate their participation in an anticipated set of psychological processes during the assessment.  Experimental procedures are applied that are designed to manipulate variables that balance the connection between criterion and test scores in the process-focused model. 

            Similarities.

After carefully examining the information pertaining to the traditional method and the process-focused method the only similarity that was obvious was the goal to provide evidence of validity through different processes.  The traditional and process-focused model both examine and evaluate data, however these functions are performed differently.  Each model is designed to provide evidence that will prove the data collected from an assessment measuring psychological constructs is an accurate measure.

            Bornstein’s Claims.

 Bornstein promotes the use of the process-focused model because he believes that it enhances the goals of providing evidence of validity by switching the direction of the relationship between test scores and conducting experiments.  Borstein (2011) believes that validating test scores can only be achieved by conducting experimental procedures as part of the method that requires changing the direction of the relationship between test scores and experiments from unidirectional to bidirectional.  This will allow variables to be manipulated and that can form a connection between psychological testing to other areas in psychology.  

Summary

Psychological assessments are used in a variety of settings to measure constructs that cannot be directly observed, therefore validity is important to the process to ensure the accuracy of results.  The Clinical Assessment of Behavior is an assessment that is used in a school setting to identify problem behaviors in young children and adolescents and contains three forms that are completed by parents/caretakers and teachers to determine what if any additional services are needed to assist the child in the classroom environment.  Evidence of validity for this assessment can be demonstrated through the traditional method or the process-focused method, however Borstein believes that researchers should shift towards the process-focused method because it improves psychological processes and enhances the knowledge of the researchers and participants.  A four-step model was developed by Borstein to support his theory on the importance of moving in the direction of utilizing the process-focused model and is included as part of the discussion.  Borstein provides substantial information to support his claims by providing the main differences between the two models that were outlined to show how providing evidence of validity is evolving.

References

Bornstein, R. F. (2011). Toward a Process-Focused Model of Test Score Validity: Improving Psychological Assessment in Science and Practice. Psychological Assessment, 23(2), pp. 532-544.

Clinical Assessment of Behavior. (2004). Retrieved from Buros Center For Testing: http://www4.parinc.com

Laak, J. T., Desai, D., & Gokhale, M. (2013). Understanding Psychological Assessment: A Primer on the Global Assessment of the Client's Behavior in Educational and Organizational Setting. New Delhi: Sage Publications Pvt. Ltd.

Miller, L. A. (2016). Foundations of Psychological Testing: A Practical Approach. Thousands Oaks, California: Sage. Retrieved from ://mbsdirect.vitalsource.com/#/books/9781483369273