The study will examine the influence of two neglect dimensions, supervisory neglect and emotional neglect, on the onset, course and treatment outcomes of alcohol use disorders (AUDs) during adolescence and young adulthood. Applying concepts derived from attachment theory, neglect is hypothesized to influence AUD and other adverse outcomes through low parental attachment, behavioral undercontrol, negative affectivity, and deviant peer influence. Through secondary data analyses, neglect sales will be empirically derived from adolescent and parent indicators and validated for late childhood and middle adolescence. Scores on these indicators will be used to identify adolescents classified as experiencing supervisory neglect and/or emotional neglect. Models for the influences of neglect on adolescent and young adult outcomes will include consideration of parental substance use disorders and psychopathology, the subject's history of physical abuse and sexual abuse, parent-adolescent attachment, peer relationships, and neighborhood characteristics. Outcomes will include AUD's, other substance use disorders, psychopathology, and suicide attempts examined by repeated assessments. Two complementary datasets will be utilized. The Pittsburgh Adolescent Alcohol Research Center (PAARC) assesses the adolescent and the mother, obtains information about other family members, peers and neighborhood characteristic. The PAARC sample includes a subgroup of adolescents (n=110) participating in treatment for AUD's and assessed monthly for 12 months to study relapse predictors. The Center for Education and Drug Abuse Disorders (CEDAR) family study (n=750 families) includes high-risk children of parents with substance use disorders and low risk children of control parents. CEDAR assesses father, mother, index case (child 10-12 years old), and siblings. The outcomes of PAARC and CEDAR subjects are assessed every 1-3 years into young adulthood. Since data collection, data entry, and variable analyses will be completed prior to the requested funding start date, the proposed studies will be carried out over a one-year period. These analyses will determine the incremental predictive utility of supervisory neglect and emotional neglect outcomes considered in the context of other risk variables. By focusing on the clinically relevant risks and outcomes, these heuristic findings will inform clinical practice with neglected adolescents and guide future prevention and treatment research.
| Clark, Duncan B; Chung, Tammy; Martin, Christopher (2006) Alcohol use frequency as a screen for alcohol use disorders in adolescents. Int J Adolesc Med Health 18:181-7 |
| Clark, Duncan B; Thatcher, Dawn L; Maisto, Stephen A (2005) Supervisory neglect and adolescent alcohol use disorders: effects on AUD onset and treatment outcome. Addict Behav 30:1737-50 |
| Clark, Duncan B; Thatcher, Dawn L; Maisto, Stephen A (2004) Adolescent neglect and alcohol use disorders in two-parent families. Child Maltreat 9:357-70 |
| Cornelius, Jack R; Clark, Duncan B; Weyant, Robert et al. (2004) Dental abnormalities in children of fathers with substance use disorders. Addict Behav 29:979-82 |
| Clark, Duncan B (2004) The natural history of adolescent alcohol use disorders. Addiction 99 Suppl 2:5-22 |
| Clark, Duncan B; De Bellis, Michael D; Lynch, Kevin G et al. (2003) Physical and sexual abuse, depression and alcohol use disorders in adolescents: onsets and outcomes. Drug Alcohol Depend 69:51-60 |
| Clark, Duncan B; Winters, Ken C (2002) Measuring risks and outcomes in substance use disorders prevention research. J Consult Clin Psychol 70:1207-23 |
