These data, combined with results from two previous studies which examined reliability, indicate that the SSAGA is a highly reliable and valid instrument for use in studies of a variety of psychiatric disorders, including alcohol and drug dependence.

Marijuana-dependent young adults (N = 136), all referred by the criminal justice system, were randomized to 1 of 4 treatment conditions: a motivational/skills-building intervention (motivational enhancement therapy/cognitive-behavioral therapy; MET/CBT) plus incentives contingent on session attendance or submission of marijuana-free urine specimens (contingency management; CM), MET/CBT without CM, individual drug counseling (DC) plus CM, and DC without CM. There was a significant main effect of CM on treatment retention and marijuana-free urine specimens. Moreover, the combination of MET/CBT plus CM was significantly more effective than MET/CBT without CM or DC plus CM, which were in turn more effective than DC without CM for treatment attendance and percentage of marijuana-free urine specimens. Participants assigned to MET/CBT continued to reduce the frequency of their marijuana use through a 6-month follow-up. Keywordscognitive-behavioral therapy; contingency management; criminal justice populations; marijuana dependence; motivational enhancement therapy Marijuana is the most commonly used illicit substance in the United States, with approximately 5.5 million regular weekly users (Anthony, Warner, & Kessler, 1994) and high prevalence among young adults (Kandel, Chen, Warner, Kessler, & Grant, 1997). In recent years, there has been a significant increase in marijuana use as well as in rates of marijuana use disorders among adults in the 18-to 29-year-old age range, most markedly among members of ethnic minority groups (Compton, Grant, Colliver, Glantz, & Stinson, 2004). Increased prevalence of marijuana use is significant because longitudinal epidemiological studies have consistently identified marijuana as a gateway drug for progression to use of other illicit substances among young adults (Kandel & Faust, 1975;Kandel, Yamaguchi, & Chen, 1992). Furthermore, frequent marijuana use during young adulthood significantly increases the risk of lifetime experiences and greater involvement with other illicit drugs, earlier onset of substance dependence, poorer educational and occupational outcomes, multiple health and psychiatric problems, and higher levels of involvement with the criminal justice system (Chen & Kandel, 1995;Ellickson, Martino, & Collins, 2004;Windle & Wiesner, 2004).Because frequent marijuana use in early adulthood is the best predictor of persistent use, and initiation of marijuana use after age 29 is comparatively rare, providing effective interventions for marijuana use disorders to young adults is a strategy of great potential significance in , 1988). The point at which drug abusers confront legal consequences of their substance use may be a particularly important opportunity to intervene, given that more drug users are involved with the legal system than with the drug abuse treatment system (Weisner & Schmidt, 1995).However, despite increased demand for effective interventions for marijuana dependence, only a few randomized clinical trials evaluating well-defined treatments for individu...

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Aims To evaluate reciprocal enhancement (combining treatments to offset their relative weaknesses) as a strategy to improve cannabis treatment outcomes. Contingency management (CM) with reinforcement for homework completion and session attendance was used as a strategy to enhance cognitive–behavioral therapy (CBT) via greater exposure to skills training; CBT was used as a strategy to enhance durability of CM with rewards for abstinence. Setting Community-based out-patient treatment program in New Haven, Connecticut, USA. Design Twelve-week randomized clinical trial of four treatment conditions: CM for abstinence alone or combined with CBT, CBT alone or combined with CM with rewards for CBT session attendance and homework completion. Participants A total of 127 treatment-seeking young adults (84.3% male, 81.1% minority, 93.7% referred by criminal justice system, average age 25.7 years). Measurements Weekly urine specimens testing positive for cannabis, days of cannabis use via the time-line follow-back method. Findings Within treatment, reinforcing homework and attendance did not significantly improve CBT outcomes, and the addition of CBT worsened outcomes when added to CM for abstinence (75.5 versus 57.1% cannabis-free urine specimens, F = 2.25, P = 0.02). The CM for abstinence condition had the lowest percentage of cannabis-negative urine specimens and the highest mean number of consecutive cannabis-free urine specimens (3.3, F = 2.33, P = 0.02). Attrition was higher in the CBT alone condition, but random effect regression analyses indicated this condition was associated with the greatest rate of change overall. Cannabis use during the 1-year follow-up increased most rapidly for the two enhanced groups. Conclusions Combining contingency management and cognitive–behavioural therapy does not appear to improve success rates of treatment for cannabis dependence in clients involved with the criminal justice system.

Experimental research on alcohol-related aggression has focused largely upon male participants, providing only a limited understanding of the proximal effects of acute alcohol use on aggression among females extrapolated from the male literature. The current meta-analysis was undertaken to summarize the effects of alcohol, compared to placebo or no alcohol, on female aggression as observed across experimental investigations. Method. A review of the literature yielded 11 articles and 12 effect sizes for further analysis. Results. The overall effect size of alcohol on female aggression was small and reached statistical significance (d = .17, p = .02, 95% CI = .03–.30). Discussion. Meta-analytic examination of the experimental literature indicated that alcohol is a significant factor in female aggression. The overall alcohol-aggression effect was smaller than has been observed among male samples. Additional research is required to evaluate the influence of other factors on alcohol-related aggressive responding among female participants.

This pilot study evaluated the efficacy of a twelve-session cognitive behavioral group therapy for alcohol-dependent males with co-occurring interpersonal violence (IPV). Participants were 85 alcohol-dependent males who were arrested for domestic violence within the past year. Seventy-eight male adults were randomized to either a cognitive behavioral Substance Abuse Domestic Violence (SADV) group (N = 40) or a Twelve-Step Facilitation (TSF) Group (N = 38). There was no significant difference between SADV versus TSF in the number of sessions attended. Regarding substance use, the group assigned to SADV reported using alcohol significantly fewer days (eg, 90 days of abstinence across the 12 weeks of treatment) as compared to the TSF group. Regarding physical violence, there was a trend for participants in the SADV condition to achieve a greater reduction in the frequency of violent episodes across time compared to individuals in the TSF group. These data suggest the promise of the SADV group therapy approach for alcohol-dependent males with a history of IPV who present for substance abuse treatment.