Adolescent Substance Abuse : Psychiatric Comorbidity and High Risk Behaviors

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ISBN: 9780789031723 | 0789031728
Cover: Paperback
Copyright: 4/21/2008

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In the field of adolescent substance abuse treatment, dual diagnosis is the rule rather than the exception, making assessment and treatment complicated. Adolescent Substance Abuse: Psychiatric Comorbidity and High-Risk Behaviors comprehensively discusses the magnitude, etiology, and characteristics of problems and substance use disorders (SUD), and extensively explains ways to assess, treat, and develop services for adolescents. This unique text is based on Evidence-Based Practice literature and clinical experience. It closely examines the assessment and treatment of psychiatric comorbid disorders among adolescents such as depression, anxiety disorders, ADHD, and high-risk behaviors including suicidal behavior, self-harm behavior, and gambling behavior. The text is extensively referenced and several chapters include helpful tables and figures to clearly display the data. Book jacket.

About the Editors	p. xiii
Contributors	p. xv
Acknowledgments	p. xix
Introduction	p. 1
Etiology of Substance Use Disorder: Developmental Perspective	p. 5
Introduction	p. 5
Substance Use Disorder: Outcome Phenotype	p. 6
The Concept of Liability to SUD	p. 7
Modeling SUD Etiology Within a Developmental Framework	p. 7
Determinants of SUD Liability Variation	p. 9
Components of SUD Liability	p. 15
Research to Practice	p. 20
Adolescent Substance Use, Abuse, and Dependence: Prevalence, Course, and Outcomes	p. 29
Introduction	p. 29
Substance Use Prevalence in Adolescents	p. 30
Diagnosis of SUDs	p. 33
Course of Adolescent-Onset SUDs	p. 40
Future Directions	p. 46
Summary and Conclusions	p. 46
Assessing Adolescent Substance Use and Abuse	p. 53
Introduction	p. 53
Principles of Assessment	p. 54
Assessment Domains	p. 54
Methods of Assessment	p. 63
Sources of Assessment	p. 63
Clinical Considerations	p. 66
Overview of Select Assessment Tools	p. 68
Summary	p. 75
Treatment Planning, Matching, and Placement for Adolescents with Substance Use Disorders	p. 87
Introduction	p. 87
Features of the Current Delivery System	p. 87
General Principles of Treatment Matching and Planning	p. 90
American Society of Addiction Medicine Patient Placement Criteria (ASAM-PPC)	p. 91
Future Directions	p. 106
Conclusion	p. 108
Most Common Psychosocial Interventions for Adolescent Substance Use Disorders	p. 111
Introduction	p. 111
Family Therapy	p. 112
Twelve-Step Mutual-Help Programs and Youth	p. 116
Brief Motivational Interventions	p. 127
Cognitive-Behavioral Therapy	p. 130
Randomized Clinical Trials for Adolescent Substance Abuse Treatment	p. 131
Clinical Implications and Future Research Directions	p. 134
Pharmacological Interventions for Adolescent Substance Use Disorders	p. 145
Introduction	p. 145
State of Research and Clinical Practice	p. 146
General Pharmacologic Strategies	p. 147
Approaches to the Pharmacotherapy in Specific Types of SUDs	p. 153
The Practice of Pharmacotherapy in Adolescents with SUDs	p. 157
Clinical Implications and Future Research Needs	p. 158
Conduct Disorder and Oppositional Defiant Disorder and Adolescent Substance Use Disorders	p. 163
Introduction	p. 163
Theoretical Considerations	p. 163
Epidemiology	p. 164
Etiology of ODD and CD	p. 165
Features of ODD and CD	p. 168
Clinical Issues	p. 169
Relationship Between DBD and Substance Use Disorders	p. 169
Screening and Assessment	p. 171
Interventions	p. 175
Conclusions and Recommendations	p. 180
Attention-Deficit/Hyperactivity Disorder and Adolescent Substance Use Disorders	p. 195
Introduction	p. 195
ADHD in Adolescents and Adults with SUDs	p. 196
Diagnostics and Treatment	p. 205
Diversion of Stimulants	p. 209
Summary	p. 210
Depressive Disorders and Adolescent Substance Use Disorders	p. 221
Introduction	p. 221
Epidemiology	p. 221
Demographics	p. 223
Etiology and Pathogenesis	p. 225
Clinical Presentation and Course	p. 225
Screening and Assessment	p. 227
Treatment	p. 228
Conclusions and Future Directions	p. 233
Bipolar Disorder and Adolescent Substance Use Disorders	p. 243
Introduction	p. 243
Epidemiologic Findings	p. 244
Relationship with SUDs	p. 246
Phenomenology	p. 252
Retrospective Findings from Adults	p. 254
Family History	p. 255
Assessment	p. 258
Treatment	p. 260
Future Directions	p. 264
Anxiety Disorders and Adolescent Substance Use Disorders	p. 271
Overview	p. 271
Definitions and Characteristics	p. 272
Epidemiology	p. 273
Anxiety Disorders and SUDs	p. 274
Theoretical Models	p. 276
Assessment	p. 278
Treatment	p. 279
Future Directions and Conclusions	p. 282
Trauma and Post-Traumatic Stress Disorder in Adolescent Substance Use Disorders	p. 291
Introduction	p. 291
Trauma Exposure	p. 291
Post-Traumatic Stress Disorder	p. 293
Functioning and Impairment	p. 295
Complex PTSD and Developmental Trauma Disorder	p. 296
Screening and Assessment	p. 298
Cognitive-Behavioral Treatment Approaches	p. 303
Pharmacological Interventions	p. 309
Future Directions for Research on Youth with Comorbid PTSD and SUDs	p. 310
Suicidal and Nonsuicidal Self-Harm Behaviors in Adolescent Substance Use Disorders	p. 323
Introduction	p. 323
The Relationship Between Substance Abuse and Self-Harm Behaviors	p. 324
Epidemiology	p. 325
Parental and Family Factors	p. 327
Vulnerability and Resilience Factors	p. 330
Assessment and Screening of Suicidality and Self-Harm	p. 335
Prevention and Treatment Considerations	p. 338
Future Directions and Conclusions	p. 342
Comorbidity of Schizophrenia and Substance Use Disorders in Adolescents and Young Adults	p. 355
Introduction	p. 355
Epidemiology and Demographic Correlates	p. 355
Etiology	p. 358
Interrelationship and Course of Illness	p. 360
Assessment	p. 364
Treatment	p. 366
Conclusion	p. 370
Eating Disorders and Adolescent Substance Use Disorders	p. 379
Introduction	p. 379
Overview of Eating Disorders	p. 380
Prevalence of Comorbid Substance Use and Eating Disorders	p. 382
Ethnicity, Gender, and Socioeconomic Status	p. 384
Abuse of "Other" Substances in Individuals with Eating Disorders	p. 385
Assessment of Comorbid Eating and Substance Use Disorders	p. 389
Treatment for Eating Disorders and Substance Use Disorders	p. 390
Future Directions in Treatment	p. 392
Conclusions	p. 393
Gambling Behaviors and Adolescent Substance Use Disorders	p. 403
Introduction	p. 403
Adolescent Gambling Behavior	p. 404
Adolescent Problem Gambling	p. 405
Measuring Pathological Gambling Among Adolescents	p. 408
Correlates and Risk Factors Associated with Problem Gambling: Our Current Knowledge	p. 409
Protective Factors	p. 413
Treatment	p. 415
Prevention Initiatives	p. 420
Conclusions	p. 423
Integrated Substance Use and Mental Health Services for Adolescents: Challenges and Opportunities	p. 435
Introduction	p. 435
System and Economic Barriers to Integrated Treatment	p. 437
Integrated Care for Mental Health and Substance Use Disorders: Do We Have Models That Work?	p. 440
Managed Care: Organizational and Financial Incentives for Integrated Care	p. 443
Overcoming the Barriers: Where Do We Go from Here?	p. 446
Conclusion	p. 448
Ethical, Legal, and Policy Issues in the Treatment of Co-Occurring Substance Use and Psychiatric Disorders Among Adolescents	p. 453
Introduction	p. 453
Consent to Treat and Informed Consent	p. 455
Consent for Disclosure	p. 456
Special Consent Issues Concerning Adolescents	p. 458
Professional Relationship Boundaries	p. 466
Policy Issues	p. 469
Index	p. 473
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Adolescent Substance Abuse : Psychiatric Comorbidity and High Risk Behaviors

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