This study investigated if the domain of expectancies extended to medications, and subsequently had three distinct goals; (1) to develop a psychometrically sound instrument that measures "pharmaco-expectancy" or beliefs of the anticipated effects of medication use; (2) to determine whether pharmaco-expectancies predict medication use over and above one's willingness or motivations to use medications; and (3) to investigate whether pharmaco-expectancy is a specific risk factor contributing to drug use by healthcare majors. It is hypothesized that healthcare (HC) students should hold stronger pharmaco-expectancy beliefs than non-healthcare (NHC) majors. Healthcare and NHC college students (N=401) completed a questionnaire assessing medication use, the Pharmaco-expectancy Scale (PES) and the Willingness to Use scale. Results. Using principal components analysis pharmaco-expectancy was found to yield four identifiable factors, Instrumental/Positive, Euphoric!, Side Effects and Protective Beliefs. The results of the present study; (1) support the reliability and discriminant validity for the PES. Validity testing found support for the existence of pharmaco-expectancy, as anticipated beliefs that vary across frequency of use; (2) found independent contributions of willingness to use and pharmaco-expectancy to drug use; and (3) in light of a lack of variation in beliefs and motivations across HC and NHC college students, the results suggest that the fruition of these beliefs in HC students possibly begin sometime after college upon exposure to professional and social factors. Conclusion. The results support the construct of pharmaco-expectancy. Theoretical and practical implications of this research are discussed.

To better understand the association between biopsychosocial influences and college drug use, the present study had three distinct goals; (1) to assess predictors that delineate drug use from non-drug use in a sample of college students; (2) to examine whether these same predictors are salient for delineating experimental from frequent drug users; and (3) to consider if psychological influences, such as pharmaco-expectancies (anticipated beliefs that vary across medication taking experience), are associated with college drug use. College students (N=401) completed a questionnaire in the Spring of 2000 assessing drug and medication use, social, psychological and potential biological influences contributing to drug use. Results. (1) Factors found to delineate non-drug users from users were family history of alcohol problems, cigarette use, religiosity and social influence factors; (2) Predictors delineating experimental from frequent drug use were current! cigarette use, social influences (drug offers) and pharmaco-expectancies; (3) Support for two factors of pharmaco-expectancy as independent influences delineating frequent from infrequent drug use in this population was found. Conclusion. The results support the notion that predictors of drug use, such as cigarette use and certain social influences are important at particular levels of drug use and that pharmaco-expectancies may be important predictors delineating frequent from experimental drug use. Practical recommendations are presented.

This study examines mediating and moderating factors that effect change in high risk drinking among freshmen and sophomore drinkers who were proactively recruited by telephone for a brief alcohol risk reduction intervention trial at a large public university. All students who reported drinking more than two drinks in a setting in the past year were eligible to participate. Subjects were representative of the university sample frame of enrolled freshmen and sophomores. The participation rate for the eligible drinkers was 78%. Analyses are reported on the sample of 1,064 students who completed a baseline survey in the fall 2000, a mid-year survey conducted January-February 2001(84% response rate), and an end-of-year survey conducted in April-May 2001(81% response rate). Rates of change in the frequency of high risk drinking (the gender specific 4 and 5 drink "binge" criteria) are described for potential moderating variables age, gender, ethnicity, residence!, and Greek status, and for potential mediating variables such as situational temptation, decisional balance, processes of change, risk perception, intention to change, and intervention group status. Because of data dependency in the outcome measure, the generalized estimating equation (GEE) method was used with longitudinal multiple regression to estimate the independent effects of the potential mediating and moderating variables on the change in frequency of binge drinking. A summary of the preliminary results are presented.

Information about drinking patterns and problems in the general population can provide a basis for understanding the population characteristics that can identify target groups at high risk who may benefit from targeted or tailored health promotion interventions. In recent years, epidemiologic studies of high risk drinking, often referred to as heavy episodic or "binge" drinking, have focused in large measure on the college student population. Although many have found that alcohol use peaks between the ages of 18 and 24 (e.g.Chen & Kandel, 1995), much less is known about high risk drinking patterns of older adults in the general population. This study presents prevalence rates by age group, gender and education level for several measures of high risk drinking as well as for an index of recent alcohol-related problems.
       Data is from a sample of 1,114 adults (ages 18 and older) who responded to a random digit dial survey conducted in New England last year. High-risk drinking was assessed with measures of drinks per drinking day (DDD), maximum # drinks in the past month (PEAK), and frequency of heavy episodic drinking (BINGE). Also measures of frequency of drinking and average drinks per week were assessed. A gender specific measure of heavy episodic drinking was used, and is defined as drinking 4 or more drinks in a row (for women) and drinking 5 or more drinks in a row (for men). Alcohol-related problems was assessed with the SIP-R; the Short Inventory of Problems (Miller & Tonigan, 1995), a 15 item scale designed to be sensitive to problems related to intoxication or high volume drinking. Tests of group differences were performed with MANOVA and ANCOVA. Covariance adjusted prevalence estimates are presented by subgroup.
       Seventy-nine percent (n=832) reported drinking alcohol in the past year, with 26 % of drinkers in the general population reporting heavy episodic drinking in the past month. Drinking patterns differed significantly by age, gender and education. Across all high risk drinking measures there was a significant and linear trend was found for age and level of education. Males experienced significantly greater rates of high-risk drinking and alcohol problems than females. In general, as has been seen elsewhere, younger males, and those with less education reported higher rates of high risk drinking and alcohol related problems. For example, 18- 24 year olds drink approximately 2 ½ more drinks per drinking day (M = 4.63) than do people aged 55 and older (M = 1.72). 18 - 24 year olds also reported the highest peak number of drinks in the past month (M = 6.33) and tend to drink at this high-risk level about 6 times more often than those 55 and older. Older adults are drinking!
as frequently as young adults, but consume much less per occasion (i.e. for those aged 18-24. DDD= 4.63, for those 35-44 DDD= 2.33, and age 55 + DDD=1.72.) Alcohol related problems in the past 3 months as measured by average SIP scores, decreased linearly with age, ranging from 4.0 among 18 to 25 year olds to .9 for those 55 and older. Of special interest is that approximately 1/6th of the 55 and over population (16%) and over 1/3rd (35%) of those between the ages of 25 and 54 report heavy episodic drinking in the past month.
       The results from this survey of a general population sample of adults indicates that while the prevalence of high risk drinking patterns is greater among younger drinkers, many adults of all ages frequently drink at levels that lead to increase risk for alcohol related problems associated with impairment. This data indicates that there are many adults that frequently engage in high risk drinking who might benefit from harm reduction programs to help reduce high-risk behaviors targeted in these groups. This is especially important because in our present our health care system, the vast majority of the drinkers would not be classified as "dependent", and would be unlikely to receive intervention to change their high-risk behaviors.

Few if any studies have examined controlled drug use across major groups of caregivers. Moreover, substance use rates for dentists are almost non-existent. Therefore a major objective of this study was to simultaneously examine the prevalence rates of tobacco and unauthorized controlled substance use by healthcare professionals. With a response rate of almost 69%, a total of 480 physicians (MDs), nurses (RNs), pharmacists (RPhs) and dentists (DMDs) from a northeastern state responded to an anonymous survey during the summer of 2002. Preliminary descriptive analyses from the concluding data collection show lifetime use of marijuana (range 44.4% RPhs - 57.3% RNs) was the second most used drug after cigarettes across all groups. Minor opiates (range 9.7% RNs- 23.8% RPhs) and anxiolytics (range 5.7% RNs - 14.8% RPhs) were the most frequently used prescription drugs. Other than cigarettes and marijuana, few drugs were used monthly, though RNs and MDs reported using the greatest number of drugs. DMDs reportedly twice as much monthly marijuana use (6.7%) as the next closest group, RNs, who reported 3.4%. Past month cigarette use by RNs (12.7%) was four times that of MDs (3.2%) and twice that of RPhs (6.3%) and DMDs (5.8%). DMDs reported the highest lifetime prevalence of prescription drug use (51.3%) and RNs the least (37.1%). Daily use of any drug other than cigarettes was not reported with the exception of daily use of marijuana (.9%), stimulants (.9%) and sedatives (.9%) by RNs. Reasons for use by those without prescriptive authority included 19.8% of RPhs who reported supervising own minor opiate use and 7.3% of RNs originally prescribed minor opiates but now taking on own. In conclusion, compared to other healthcare professionals, non-prescribed opiate and anxiolytic use by RPhs is notable. Considering the health hazards, interventions reducing cigarette use by RNs should be considered. While DMDs reported the highest rate of lifetime prescription drug use, daily use rates would suggest they are no more at risk for abuse than other caregivers. Despite limitations, this initial data provides the first meaningful comparison of substance use behaviors across professionals.

The use of community coalitions and other forms of community-wide intervention in efforts to improve community-wide health is a national priority. Research supporting the effectiveness of these interventions
provides mixed evidence. This monograph reviews several models for community-wide substance abuse prevention and finds that policy change strategies have the best empirical support. Issues in research design and methods for supporting these interventions are also discussed.

Several major issues in the use of technical assistance for community prevention and health promotion are addressed, and recommendations for improved effectiveness are provided.

Smoking rates and attitudes towards smoking and tobacco marketing were explored among 673 Bulgarian high-school students through a self-administered questionnaire. Results revealed alarmingly high prevalence of smoking (75%) and perception of strong presence of protobacco marketing influences. Smokers and nonsmokers were compared revealing the importance of social influences for smoking. Stages of change for cessation and prevention were calculated and discussed. These results underscore the urgent need for effective youth interventions.

Tailored interventions based on stage of change and other Transtheoretical Model constructs have been effective for promoting smoking cessation. Recent cluster analyses based on the Pros and Cons from the Decisional Balance and the Situational Temptations measures performed within the stages have suggested the existence of distinct cluster subtypes. Cluster subtypes would permit the development of tailored interventions focusing on these subtypes. This study attempts to replicate cluster subtypes within the Contemplation stage of change in a secondary analysis of data from a sample of current smokers (N=3967). Method: Four random samples of 400 were selected from the 1734 Contemplators. The cluster analyses were performed using the Pros, Cons and Situational Temptations. Interpretability of the pattern, pseudo F test, and dendograms were used to determine the number of clusters. Results: Four distinct cluster subtypes were found and replicated across samples (Classic Contemplators, Progressing, Early Contemplators, Disengaged). The clusters were externally validated using the ten processes of change and two smoking behavior variables (cigarettes per day and time before first morning cigarette). Statistically significant multivariate effects were found for the ten processes of change (p<.05) in all four samples. The cluster groups differed on 7 or more of the processes in each sample. Significant multivariate effects were also found for the smoking behavior variables in all samples (p<.001). Conclusions: The cluster patterns closely replicate earlier findings and provide evidence for the existence of clusters subtypes within the Contemplation stage of change.

A review of extant psychophysiological research using cardiovascular and electrodermal measures of the autonomic nervous system (ANS) suggests that individuals with autism respond differently than normal and other clinical populations, exhibiting ANS response patterns of under-arousal or over-arousal. The heterogeneous nature of autism and methodological problems associated with this research, however, has qualified the results. Careful control of methodological challenges is needed to replicate a variety of previous findings and for continuing studies of ANS functioning in autism. By calling attention to these areas for improvement in future studies, this review encourages investigators to revisit the possibility and benefits of conducting psychophysiological research in autism using cardiovascular and electrodermal measures.

Recent research on sudden infant death syndrome (SIDS) suggests that maternal alcohol use may be an indirect cause of SIDS. There is limited research, however, focusing on the direct effects of parental alcohol use on SIDS. This paper reviews the literature on parental, particularly maternal, alcohol use and SIDS. Results show that intrauterine alcohol exposure is strongly associated with SIDS. There are, of course, some discrepant findings, in which some studies find a strong relationship and others do not, just as with other variables like breast-feeding and prematurity. Parental postnatal use appears to be linked as well. The implications of these findings are that alcohol ingestion as a risk factor in weakening infants' responses of a life-saving nature must be more rigorously studied in order to develop appropriate interventions.

This report describes a physiological measurement (heart rate) protocol that facilitates clinicians’ and investigators’ exploration of the role of stress in autism. Using a single-case multi-element design, heart rate responses to four stressors were measured in ten individuals (age 13-37 yr.) with autism and other developmental disabilities. Findings include both a tolerable and replicable protocol for assessing heart rate responses to stressor and individual variations in heart rate responses to environmental stressors. Implications of this research and future directions for assessment are discussed.

Children diagnosed with Autism and Anxiety Disorders often present with a variety of behavioral challenges. The child discussed in this report displayed anxious perseveration on various topics of concern to him, aggressive tantrum behavior, a lack of concern for or interest in others, and a collection of intrusive and non-compliant behaviors. He was treated with Delsym for symptoms related to a tracheal infection, the active ingredient of which is Dextromethorphan. Dextromethorphan is an antitussive preparation that is the d isomer of levophenol, a codeine analogue and opioid analgesic. Significant, albeit serendipitous anecdotal and measured behavioral improvements were noted when the child was placed on this medication. While Dextromethorphan is not commonly administered for the treatment of behavioral challenges in this or any population, the reduction of tracked behaviors and anxiety-related symptoms suggests the need for further scientific inquiry.

Individuals with autism often display stereotypical behavior patterns. Researchers have offered three kinds of interpretations to explain the function of those stereotypical patterns: operant conditioning, homeostasis, and neurobiological dysfunction. However, there has been relatively little empirical research in this area. The present poster presents exploratory research by analyzing videotapes and heart rate (HR) records obtained from a previous experimental study in a laboratory setting. Data from four individuals with autism who displayed stereotypical behavior were used in this analysis. Behavior codes were developed for categorizing, recording, and systematically identifying patterns of stereotypical behavior. These behaviors were then correlated with HR records to discover any relationships between HR before, during, or after engagement in stereotypy. Results indicate that 3 of the 4 participants’ HR did not substantially change before, during, or after engagement in stereotypy, ruling out a homeostatic hypothesis. One participant’s HR increased substantially during and after engagement in stereotypy. These results provide descriptive data to support various interpretations or functions of stereotypical behavior for persons with autism. Implications for such concomitant HR and behavioral assessment in a functional behavior analysis are discussed.

Stress is a problem, often overlooked but nonetheless important, in individuals with autism (Gillot, Furniss, & Walter, 2001; Kim, Szatmari, Bryson, Streiner, & Wilson, 2000; Stavrakaki, 1999; Muris, Steerneman, Merckelbach, Holdrinet, & Meesters, 1998). While commonly observed characteristics of persons with autism suggest special vulnerability to stressors (Groden, Cautela, Prince, & Berryman, 1994), there is a dearth of literature examining the role of stress in the lives of such individuals. To further the objective assessment of responses of persons with autism to domain-specific stressors, and the implementation of effective stress reduction interventions, we propose to devise a treatment package amenable to objective evaluation. This would combine the use of relaxation and imagery-based picture rehearsal procedures to reduce responses to stressors in persons with autism. This proposed investigation will (1) assess responses to stressors in persons diagnosed with autism through recording of heart rate (HR) to situational stimuli deemed stressful, and (2) implement and evaluate a relaxation/imagery-based picture rehearsal treatment program to reduce excessive responding of individuals with autism to identified stressors. The hypothesis is that relaxation and imagery-based picture rehearsal will reduce responses to domain-specific stressors in persons with autism.

Suicide is among the first three leading causes of death in young people. The difficulty in predicting suicidal intent begs for a better understanding of the origins of attempts. We provide data here from two lines of research that may throw light on developmental contributors to suicide attempts, which by best estimates involve about 15% of the population by about 40 years of age. Of special interest here, it has been reported by Peck (1985), that 50% of suicides under age 15 have been diagnosed with learning disabilities. The data presented here support the likelihood of an adverse developmental progression from birth risk to cognitive impairment to thoughts of suicide.

Time series analysis (TSA) is a powerful method for assessing differences in responses over time. Its greatest limitation arises is in generalizability, as TSA is restricted to one unit of analysis. Typically, analyzing data from multiple units and then comparing the results ad-hoc addresses this limitation. Unfortunately, this practice lacks the sensitivity of a precise statistical test. The alternative is to utilize a pooled TSA, where two units are stacked to create one dataset. The design matrix is then specified to estimate overall effects as well as person-to-person differences. Currently, there is no applied example of a pooled TSA within psychology, despite the theoretical advantages associated with the procedure. This paper offers an applied example of pooled TSA using heart rate (HR) data gathered from children with autism while exposed to laboratory stressors.