"The Age of Feeling in-Between": Addressing Challenges in the Treatment of Emerging Adults With Substance Use Disorders

Bergman, Brandon G.; Kelly, John F.; Nargiso, Jessica E.; McKowen, James

doi:10.1016/j.cbpra.2015.09.008

Cited by 41 publications

(42 citation statements)

References 98 publications

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“…Low levels of stigma about drug use among younger adults may lead to a perception that treatment is unnecessary or that levels of drug use are not severe enough to seek treatment. Ideally, younger adults who use stimulants would seek treatment before use becomes a lifelong problem, although treatment response tends to be poorer for substance use disorders among emerging adults than other age groups (Bergman, Kelly, Nargiso, & McKowen, 2016). Modifications to traditional treatment approaches for emerging adults may be needed, such as couching treatment within a developmental model, allowing for non-abstinence substance use goals, utilizing parents for contingency-management approaches, or supplementing treatment with text messages (Bergman et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Stigma, treatment, and health among stimulant users: Life stage as a moderator

Woodhead

Timko

Han

et al. 2019

Journal of Applied Developmental Psychology

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This 3-year study examined associations among drug use stigma, life stage, treatment utilization and health among 710 US adults using stimulants. Consistent with substance use developmental frameworks, life stage was represented by Emerging adulthood (18-25 years old, n=223), Earlymid adulthood (26-44 years old; n=384), and Older adulthood (45-61 years old; n=103). Emerging adults experienced less enacted stigma (i.e., experiences of discrimination) and perceived less public stigma (i.e., unjust treatment) over the course of the study than other life stage groups. More baseline enacted stigma was associated with more mental health and substance use treatment, whereas more baseline self stigma (i.e., negative thoughts about the self) was associated with less treatment utilization. Life stage moderated stigma-outcome associations such that substance use outcomes were worse for Emerging adults reporting more enacted stigma. Although emerging adults experienced less drug use stigma, stigma had a more negative impact on adults in this life stage.

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Section: Discussionmentioning

confidence: 99%

Stigma, treatment, and health among stimulant users: Life stage as a moderator

Woodhead

Timko

Han

et al. 2019

Journal of Applied Developmental Psychology

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“…The abstinence violation effect may be stronger in emerging adults, who are likely to have had fewer experiences recovering after a relapse. In addition, some of the reasons that Bergman et al (2016) propose as challenges to providing treatment to emerging adults may be relevant to the abstinence violation effect. For example, younger adults are more likely to have friends who use alcohol and other drugs at higher rates than adults, so once relapse occurs, younger adults return to environments more saturated with use, and presumably more opposed to the tenants of abstinence so intrinsic to TSMHO.…”

Section: Discussionmentioning

confidence: 99%

“…Age was calculated from date of birth. The definition of “emerging adulthood” has varied from publication to publication, and has been defined variously as 18–25, 18–29, and even 18–39 (Bergman, et al, 2016). Although an age grouping binary variable may be appropriate in some studies (Davis, et al, 2017; Hoeppner, et al, 2014), the analysis of age as a continuous variable allows for the assessment of the treatment effect interacting with EACH age year, and is not restricted to a pre-defined group of young vs. older, and therefore was not dichotomized for these analyses.…”

Section: Methodsmentioning

confidence: 99%

“…Other studies have found that younger adults are less likely to perceive a need for treatment (Sinha, et al, 2003; Wu & Ringwalt, 2004), to enter treatment following detoxification (Shin, Lundgren, & Chassler, 2007), and to comply with recommendations for treatment (Aalto & Sillanaukee, 2000). Potential reasons why younger adults have less success with traditional treatment have been described by Bergman and colleagues (2016) and include: 1) lower initial motivation for treatment engagement and abstinence, 2) social networks composed of others with high rates of substance use, 3) higher rates of co-occurring psychiatric disorders, 4) lower levels of conscientiousness (e.g. ability to make it to scheduled meetings and appointments), and 5) feeling “in-between”, meaning that emerging adults have more freedom and independence than adolescents, but often greater dependence on parents or other caregivers than do older adults.…”

Section: Introductionmentioning

confidence: 99%

“…Group sessions focus on increasing attendance and participation in meetings through five topic areas: 1) acceptance (Step 1); 2) people, places, and things (habits, routines, and relapse triggers); 3) surrender (Steps 2 and 3); 4) getting active in 12-step programs; and 5) managing negative emotions (HALT: hungry, angry, lonely, tired). An explicit focus on people and routines may be particularly important to emerging adults who are more likely to have social networks comprised of people actively engaged in substance use (Bergman, et al, 2016). In addition, STAGE-12 incorporates an intensive referral procedure (Timko & DeBenedetti, 2007) that actively connects participants with a 12-step volunteer in the community who arranges to attend a meeting with them.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Age differences in outcomes among patients in the “Stimulant Abuser Groups to Engage in 12-Step” (STAGE-12) intervention

Garrett

Doyle

Peavy

et al. 2018

Journal of Substance Abuse Treatment

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Younger age was associated with larger treatment effects for stimulant use. Specifically, younger age was associated with greater odds of remaining abstinent from stimulants in STAGE-12 versus Treatment-as-Usual; however, among those who were not abstinent during treatment, younger age was related to greater rates of stimulant use at follow-up for those in STAGE-12 compared to TAU. There was no main effect of age on stimulant use. Younger age was also related to somewhat greater active involvement in different types of TSMHO activities among those in STAGE-12 versus TAU. There were no age-by-treatment interactions for other types of substance use or for treatment attendance, however, in contrast to stimulant use; younger age was associated with lower odds of abstinence from non-stimulant drugs at follow-up, regardless of treatment condition. These results suggest that STAGE-12 can be beneficial for some emerging adults with stimulant use disorder, and ongoing assessment of continued use is of particular importance.

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The Importance of Longitudinal Treatment Engagement for Youths in the Juvenile Justice System

Aalsma

Dir

2021

JAMA Pediatr

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The burden of psychiatric disorders on an individual's life is substantial. Not only does a psychiatric disorder affect a person's mood, but the presence of a psychiatric disorder plays a role in virtually every area of an individual's life, including romantic and social relationships as well as educational and job opportunities. The presence of psychiatric disorders in vulnerable populations is exacerbated by involvement in the justice system. The Northwestern Juvenile Project has been an invaluable source for researchers, clinicians, and advocates to understand how the course of adolescent development is impacted by justice system involvement, particularly among youths with psychiatric disorders.The current study by Teplin et al 1 adds to research indicating the need to intervene early and often with youths involved in the justice system to enable engagement in evidencebased treatment. The burden of psychiatric disorders among youths returning to the community after juvenile detention is substantial, as most of these youths have a psychiatric disorder. 2 Findings from the Teplin et al 1 study indicate that most male youths and a substantial number of female youths continue to have a psychiatric disorder 15 years after detention and into their young adult years. Moreover, the presence of a psychiatric disorder after juvenile detention was associated with an increase in the likelihood of having a psychiatric disorder 15 years later. The research team concluded their article with suggestions to aid pediatricians in the treatment of disruptive behavioral disorders, clarifying factors associated with psychiatric disorder desistance and reiterating the importance of mental health services and Medicaid policies for access to services. These suggestions are important for the provision of successful treatment among the at-risk population. The study also identified 2 additional needs: evidence-based treatment for young adults and treatment engagement.Not only is connection to treatment important while youths are involved in the justice system, but efforts are also needed to engage such individuals when they are no longer connected to the justice system or other youth services systems. The Teplin et al 1 study highlights the importance of treatment for young adults. Young adulthood is a peak time for offending, and rates of substance use and psychiatric disorders are higher among young adults compared with any other age group. 3,4 Despite the high prevalence of psychiatric disorders, the rates of treatment seeking, treatment engagement, and retention are lower among young adults 5 compared with adolescents and older adults. Previous research has addressed the distinct challenges encountered by this age group

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"The Age of Feeling in-Between": Addressing Challenges in the Treatment of Emerging Adults With Substance Use Disorders

Cited by 41 publications

References 98 publications

Stigma, treatment, and health among stimulant users: Life stage as a moderator

Stigma, treatment, and health among stimulant users: Life stage as a moderator

Age differences in outcomes among patients in the “Stimulant Abuser Groups to Engage in 12-Step” (STAGE-12) intervention

The Importance of Longitudinal Treatment Engagement for Youths in the Juvenile Justice System

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