Influence of family and school-level factors on age of sexual initiation.

Purpose: This study examined the association of individual, family, and school-level characteristics with age of sexual initiation (ASI) and focused specifically on school context as a moderator of known predictors of ASI.

Methods: Data are from Waves I and IV of the National Longitudinal Study of Adolescent Health (N = 10,596). Predictors include grade point average, physical development, attitudes about sex, likelihood of higher education, alcohol use, delinquency, family structure, parents' education level, childhood abuse, maternal approval of sex, parental monitoring, and parent-child relationship quality.

Trends in psychotropic polypharmacy among youths enrolled in Ohio Medicaid, 2002-2008.

Objective: This study examined polypharmacy patterns and rates over time among Medicaid-enrolled youths by comparing three enrollment groups (youths in foster care, with a disability, or from a family with low income).

Methods: Serial cross-sectional trend analyses of Medicaid claims data were conducted for youths age 17 and younger who were continuously enrolled in Ohio Medicaid for a one-year period and prescribed one or more psychotropic medications during fiscal years 2002 (N=26,252) through 2008 (N=50,311). Outcome measures were any polypharmacy (three or more psychotropic medications from any drug class) and multiclass polypharmacy (three or more psychotropic medications from different drug classes).

Clinical characteristics and outpatient mental health service use of transition-age youth in the USA.

This study examines diagnostic and service utilization patterns of transition-age youth in outpatient care derived from the 2007 nationally representative Client/Patient Sample Survey. Comparisons between 16-17, 18-21, and 22-25 year olds are highlighted. Among transition-age outpatients, the oldest youth had the highest rates of depression and bipolar disorder and co-occurring medical and substance use problems.

Service utilization of Asians and other racial-ethnic groups: comparisons in a state substance abuse treatment system.

Based on an administrative data base of 410,000 substance abuse treatment clients in New York State, Asians are a small minority who differ significantly from other racial-ethnic groups on income, primary language, treatment setting, substance of abuse, referral source, and discharge status. In particular, relative to other race-ethnicity groups such as whites, blacks, and Hispanics, significantly greater percentages of Asians are referred from drinking-driving programs and completed treatment. However, most of the significant differences between Asians and other groups are found among clients with a first admission, and tended to attenuate among clients with a second or third admission.

Substance abuse treatment readmission patterns of Asian Americans: comparisons with other ethnic groups.

Background And Significance: According to New York statewide substance abuse treatment and discharge data, Asians are a small minority who differ significantly from other racial-ethnic groups on income, primary language, treatment setting, substance abuse, referral source, and discharge status.

Objectives: The present study further compares alcohol and substance abuse service utilization patterns of Asians with those of Whites, Blacks, and Hispanics in New York State.

Methods: Cox regressions were employed to examine the differences in treatment admission patterns among Asians and other ethnic groups, while controlling a number of demographic, treatment-related, and non-treatment-related factors.

Childhood maltreatment among Hispanic women in the United States: an examination of subgroup differences and impact on psychiatric disorder.

Prevalence rates of childhood maltreatment among Hispanic women in the United States are presented separately for nativity status and ethnic origin subgroups, and the associations between different types of maltreatment and the development of anxiety and depressive disorders are examined. Analyses used self-report data from 1,427 Hispanic women who participated in the National Latino and Asian American Survey. Foreign-born Hispanic women compared to U.

The role of nurse practitioners in meeting the need for child and adolescent psychiatric services: a statewide survey.

The high prevalence of child and adolescent mental health disorders coupled with shortages in age-appropriate mental health services pose a significant problem likely to be exacerbated over time. A survey was designed to identify the current status of and need for child and adolescent psychiatrists (CAPs) and mental health services, as well as strategies and recommendations to address identified needs in the state of New York. Key informants from each county and New York City were surveyed by telephone (N = 58).

Social Relationships, Social Assimilation, and Substance-Use Disorders among Adult Latinos in the U.S.

Based on social control perspectives and results from prior studies we test hypotheses about the extent to which characteristics of family and social networks are associated with substance use disorders (SUD), and whether these associations vary by sex. In this study SUD is alcohol or illicit drug abuse or dependence as defined by criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association. With nationally representative data of adult Latinos from the National Latino and Asian American Survey (NLAAS), we found that respondents' language use with family, rather than language proficiency, appears to be a more efficient proxy for social assimilation to represent differential levels of risk of SUD.

US patterns of mental health service utilization for transition-age youth and young adults.

This study examines rates of admission and patterns of mental health service use by persons of transition age (16-25 years) in the USA based on the nationally representative 1997 Client/Patient Sample Survey and population data from the US Census Bureau. A precipitous decline in utilization was observed at the age of emancipation: the yearly admission rate for inpatient, outpatient, and residential services was 34 per 1,000 for 16- and 17-year-olds and 18 per 1,000 for 18- and 19-year-olds. Among 20- and 21-year-olds, more were referred from criminal justice and fewer from family or friends and social services, and proportionately more were Medicaid recipients.

Initiation and change of psychotropic medication regimens among adolescents in inpatient care.

Objective: The purpose of this study was to compare clinical and service utilization profiles of adolescents admitted to inpatient treatment with and without a psychotropic medication regimen, and estimate correlates of medication use separately for the two groups.

Method: Comprehensive data on clinical characteristics and service utilization of 517 adolescents enrolled in Medicaid who were admitted to three inpatient hospitals (one for-profit and two nonprofit) in a mid-Atlantic state were used. Medication correlates were examined with bivariate statistics (chi-square and t-test) and multivariate logistic regressions.

Racial differences in mental health service utilization among low-income women.

The authors present data on mental health outpatient services in non-specialty settings in a sample of low-income women by exploring service use in the general medical sector, specialty mental health/substance services, the human service sector, and self-help groups. Findings are reported from 668 African American and White women in the Mothers' Well-Being Study (MWS). The MWS measured a range of psychiatric and substance dependence disorders using the Composite International Diagnostic Interview, Version 2.

Alcohol initiation experiences and family history of alcoholism as predictors of problem-drinking trajectories.

Objective: The purpose of this study was to identify developmental trajectories of problem drinking from adolescence into young adulthood and to determine if alcohol use initiation experiences and family history of alcoholism, as well as their interactions, would predict trajectory group membership.

Method: Five waves of data were collected from respondents who were 12 years old at the time of recruitment to the Rutgers Health and Human Development Project and followed until age 31 (n = 438). A standardized measure of problem drinking (Rutgers Alcohol Problem Index) was used to develop trajectories with growth-mixture modeling.

Medical problems among adolescents in U.S. mental health services: relationship to functional impairment.

This study provides information about the extent of comorbidity between medical and behavioral problems among adolescents in mental health services, describes the clinical and sociodemographic characteristics of adolescents with both problems, and discusses the consequences or comorbidity for service delivery. Nationally representative mental health service use data for adolescents (age 12-17) in inpatient, outpatient, and residential mental health service settings (weighted N=296,755) were used. Close to one fifth (18.

Hispanic drug abuse in an evolving cultural context: an agenda for research.

Drug abuse in the U.S. Hispanic population appears to be in a dynamic state of acceleration, although there are differences in drug use patterns between U.

Youths living away from families in the US mental health system: opportunities for targeted intervention.

This study examines the clinical characteristics of youths who lived away from families at the time of admission to specialty mental health services, and investigates the association between type of nonfamily living situation and admission to residential versus outpatient programs. Of 3995 youths sampled from 1598 mental health programs in the United States, 14% lived away from their own families, either in foster care, group care settings, or correctional settings, or were emancipated. As a group, youths living away from families were more seriously emotionally disturbed and more likely to receive treatment in residential care programs.

Remission from drug dependence symptoms and drug use cessation among women drug users in puerto rico.

Background: Studies of remission from drug dependence have most often been based on treatment samples, with limited generalizability to persons who may benefit from but never seek substance abuse treatment. Little is known about remission patterns among drug users in the community.

Objective: To identify patterns and predictors of remission in a community sample of drug users followed up prospectively.

Low-income women's use of substance abuse and mental health services.

This paper examines the utilization of mental health, alcohol, and drug treatment in a sample of low-income women. We analyze data from the Women's Employments Study, a study examining the barriers to employment for welfare recipients, and compare prevalence rates of mental health disorders and service utilization with the National Comorbidity Survey. Fewer than one in five of the respondents with a current mental health and/or substance dependence problem in the Women's Employment Study (WES) received treatment in the past 12 months.

Use of psychotropic medications by youths with psychiatric diagnoses in the U.S. mental health system.

This study estimated the overall rate of use of psychotropic medications among youths (less than 18 years of age) in the U.S. mental health service system and compared rates of use for youths with a single diagnosis and those with co-occurring diagnoses.

Longitudinal effects of age at onset and first drinking situations on problem drinking.

The purpose of this study was to describe aspects of the first alcohol-use experience, and examine the predictive relations among age of first use, context of alcohol use initiation, and problem drinking with and without controls for psychosocial risk factors. Data were from the Rutgers Health and Human Development Project, a five-wave, prospective study of substance-use behaviors in a community sample. Respondents, who were first interviewed at age 12 (1979-81) and most recently at age 30 or 31 (1999-2000) (N=371), reported on their first drinking experience, and on a range of known risk factors for alcohol abuse.

Ante- and postpartum substance abuse treatment and antiretroviral therapy among HIV-infected women on Medicaid.

Objective: To examine temporal associations between obstetrics/gynecology (ob/gyn) care, substance abuse treatment (SAT), and antiretroviral therapy (ART) during and after pregnancy among HIV-infected women on Medicaid.

Method: We identified 345 women, representing 378 deliveries, from merged New Jersey AIDS/HIV surveillance data and paid Medicaid claims data between 1992 and 1998. T-tests were used to analyze person-level differences in service use before and after delivery.