A total of 12,988 adolescents completed a questionnaire which assessed experience with cigarettes, inhalants, alcohol, marijuana, cocaine, and level of ego identity (EOM‐EIS). Discriminant analyses of substance use, across the achievement, moratorium, foreclosure, and diffusion identity statuses, yielded significant functions for each grade comparison (7th to 12th). Frequencies of experience for diffused respondents were consistently higher than estimates for the achieved and moratorium respondents; and, foreclosed adolescents reported the lowest frequency of experience. Diffused adolescents were about twice as likely to have tried cigarettes and alcohol, three times as likely to have tried marijuana, four times as likely to have tried inhalants, and five times as likely to have used cocaine than their foreclosed peers. The achieved, moratorium, and unclassified respondents reported frequencies of experience that fell between the two extreme groups. Implications for identifying adolescents “at risk”, and tailoring prevention/intervention efforts to address developmental differences are addressed.

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In the past, HIV disease meant an almost invariably downward health course. New highly active antiretroviral therapy (HAART) regimens have improved the health outlook for many persons living with HIV/AIDS but may create new psychological and coping challenges. In this study, open-ended, in-depth interviews were undertaken with an ethnically diverse sample of 44 purposively selected men and women with HIV disease who were on HAART regimens. The interviews were transcribed and qualitatively coded to identify major themes. While patients responding well to the regimens held optimistic views for their future, some who continued to have detectable viral load exhibited depression and feelings of hopelessness. Many patients reported stress associated with the demands of adhering to complex HAART regimens. Other common themes emerging in the interviews involved concerns about employment, romantic and non-romantic relationship formation, sexual behavior and serostatus disclosure, whether to plan families, and experiences of AIDS-related discrimination. There continue to be critical roles for psychological services in the care of persons living with HIV.

This study examines the relationship between cognitive style (i.e., information, normative, and diffuse orientation, and commitment) and alcohol/work-related problems. A random sample of Naval personnel (n = 2000) with less than two years of service toward their first enlistment was sent a questionnaire to assess cognitive style [1] and alcohol/work-related problems. A total of 899 respondents (45.0%) returned their questionnaires. Findings support prevention strategies that incorporate problem-solving, decision-making, and coping strategies, particularly among participants who employ diffuse problem-solving/coping strategies (lack of exploration and commitment, avoidance of problems). Correlations between cognitive style and alcohol/work-related problems are theoretically compatible. Diffuse orientation scores are positively related to both alcohol- and work-related problems, while norm and information orientation scores are negatively related to both measures. Collectively, cognitive style measures explain 11.4 percent of the variability in alcohol-related problems, and 14.0 percent of the variability in work-related problems.

The sulfhydryl status of cells, particularly the intracellular concentration of glutathione, is a critical determinant of the response of tumor and normal cells to cytostatic drugs. Recent data indicate that the administration of mercaptoethane sulfonate (mesna), which is often combined with ifosfamide, markedly decreases the circulating concentration of total cysteine and could thereby influence the response of the organism to the cytotoxic effects of chemotherapy. The aim of the present study was to assess the effects of the combination of ifosfamide/mesna on sulfhydryl and disulfide homeostasis in tumor patients. Ifosfamide was infused into 14 patients with advanced sarcoma for 5 days at a dose of 2.4-3.2 g/m2 per day together with mesna. The plasma concentrations of total mesna, cysteine, glutathione, and homocysteine were measured before and on days 1 and 6 of the first course of ifosfamide/mesna therapy and prior to the next course of chemotherapy, and the urinary excretion of cysteine and mesna was monitored daily using a high-performance liquid chromatography (HPLC) method. Ifosfamide/mesna resulted in a marked depletion of circulating total cysteine, i.e., cysteine, cystine, and cysteine mixed disulfides [from 245 +/- 36 to 50 +/- 14 nmol/ml (mean +/- 95% CI) on day 6], total glutathione (from 6.9 +/- 1.1 to 2.5 +/- 1.1 nmol/ml), and total homocysteine (from 12.3 +/- 2.1 to 1.4 +/- 1.1 nmol/ml). The values returned to baseline levels prior to the next course of chemotherapy. The urinary excretion of cysteine increased significantly from 0.28 to 1.82 mmol/day on the 1st day, whereupon it returned toward baseline. An average of 62% +/- 6% of the delivered dose of mesna was recovered in urine. The combination of ifosfamide/mesna results in depletion of circulating total cysteine, glutathione, and homocysteine. This marked derangement of sulfhydryl and disulfide homeostasis could modulate the efficacy and toxicity of ifosfamide/mesna therapy.