Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the cooccurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth.This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.vii The co-occurrence of alcohol and other drug (AOD) use and sexual risk behaviors (SRBs) is a serious public health problem that has been linked to deleterious outcomes among adolescents. Consequently, understanding how relations among putative risk factors increase the co-occurrence of AOD use and SRBs is crucial for developing developmentally-appropriate prevention and treatment efforts. Chapter One of this dissertation has a specific structure. First, this chapter presents a rationale for studying co-occurring AOD use and SRBs from a multivariate perspective. Second, this chapter presents a summary of existing research studies examining putative risk factors associated with both AOD use and SRB among adolescents. Third, this chapter provides a brief discussion regarding the integrative model that guided the current study. Last, the significance of the current study for the development of prevention and intervention programs targeting high risk samples of adolescents is summarized. Current Research on Co-Occurring Alcohol and other Drug Use, and Sexual Risk BehaviorsCurrent research on the co-occurrence of sexual risk behaviors (SRBs) and alcohol and other drug (AOD) use supports the importance of a multivariate framework that specifies the influence of multi-level factors (e....

Evaluation of an alcohol expectancy typology : group differences in psychosocial functioning and developmental history in a treatment sample of adolescents" (2006 Montgomery for their guidance and continued encouragement in the development of this research project.Also, I am very grateful for the friendly support that has been extended to me by my fellow graduate students and friends particularly, Rona Carter, Calonie Gray, and AssafOshri. The goals of the present study were (a) to identify distinct and meaningful groups of adolescents on the basis of their self-reported alcohol expectancies and, (b) to document multivariate group differences between alcohol expectancy clusters and specific adjustment outcomes. Six distinct homogenous subgroups were identified via Cluster Analysis. Subsequent validation analyses involving between-cluster comparisons of psychosocial adjustment outcomes identified significant group differences. Clusters with stronger endorsement of positive alcohol expectancies were more likely to receive a lifetime diagnosis of conduct disorder, engage in negative social interactions, have higher ratings of perceived stress, and reckless behaviors. Between-cluster differences were also identified for age, school grade, family structure and ethnicity. The results of this study supported the merit of using a person-centered analytic strategy to describe heterogeneity in patterns of alcohol expectancies and their relations with specific adjustment outcomes among high-risk samples of adolescents.v Consequently, understanding factors that place adolescents at risk for AOD-related problems is essential. This chapter first provides a historical overview to place in context the evolution of the study of consequences related to AOD use. Second, it presents a summary about the prevalence of AOD use among adolescents. Third, this chapter introduces a brief discussion regarding a conceptual model that has guided this research area. Lastly, the significance of the current study for the development of prevention and intervention programs targeting high-risk samples of adolescents is discussed. Historical PerspectiveAlcohol and other drug (AOD) use and related consequences have had profound impacts on society (SAMHSA, 2004). However, AOD use and misuse are not new phenomena. Early attempts to describe maladaptive drinking patterns were often moralistic in tone. For many centuries, alcohol use and related problems were perceived as reflecting character defects or moral weaknesses that were subjects of religious concern and social action. In the late 19th century, Dr. Benjamin Rush published an article in which he revolutionized notions of alcohol-related behaviors by stating that maladaptive patterns of drinking or alcoholism were a disease (Blum, 1991). Much later, Jellinek (1960) advanced a theory in which he presented a disease model of alcoholism.He contended that alcoholism is a disease that, if left untreated, could be fatal or cause 1 serious medical and psychological complications to both the drinking in...