Social anxiety disorder (SAD) is highly comorbid with alcohol use disorders (AUDs) and cannabis dependence. However, the temporal sequencing of these disorders has not been extensively studied to determine whether SAD serves as a specific risk factor for problematic substance use. The present study examined these relationships after controlling for theoretically-relevant variables (e.g., gender, other Axis I pathology) in a longitudinal cohort over approximately 14 years. The sample was drawn from participants in the Oregon Adolescent Depression Project. After excluding those with substance use disorders at baseline, SAD at study entry was associated with 6.5 greater odds of cannabis dependence (but not abuse) and 4.5 greater odds of alcohol dependence (but not abuse) at follow-up after controlling for relevant variables (e.g., gender, depression, conduct disorder). The relationship between SAD and alcohol and cannabis dependence remained even after controlling for other anxiety disorders. Other anxiety disorders and mood disorders were not associated with subsequent cannabis or alcohol use disorder after controlling for relevant variables. Among the internalizing disorders, SAD appears to serve as a unique risk factor for the subsequent onset of cannabis and alcohol dependence.

Background-There has been increasing interest in the distinction between subthreshold and full syndrome disorders and specifically whether subthreshold conditions escalate or predict the onset of full syndrome disorders over time. Most of these studies, however, examined whether a single subthreshold condition escalates into the full syndrome form of that disorder. Equally important, though, is whether subthreshold conditions are likely to develop other full syndrome disorders and whether these associations are maintained after adjusting for comorbidity.

Objective-To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30).Method-A subset of the participants of the Oregon adolescent depression project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and concurrent reports of current mental illness at age 16, and were then followed prospectively until age 30. Diagnostic assessments were conducted twice during adolescence, and again at ages 24 and 30. Based on diagnosis during childhood/adolescence, the subjects were partitioned into four orthogonal groups: SAD (n = 42), other anxiety disorders (n = 88), a heterogeneous psychiatric disorders control group (n = 389), and a not mentally ill control group (n = 297). Adjusting for demographic variables that were significantly associated with group status and for comorbid disorders prior to age 19, the results were analyzed with hierarchical multiple logistic regression.Results-SAD was a strong (78.6%) risk factor for the development of mental disorders during young adulthood. The major vulnerabilities were for panic disorder and depression.Conclusions-Because SAD creates a major vulnerability for mental disorders during young adulthood, clinicians should be sensitive to the presence of SAD, and children and adolescents with SAD should be provided with treatment. Future research should evaluate whether successful treatment for SAD and/or the provision of a preventative intervention during childhood/adolescence reduce the risk for future psychopathology.

The authors examined whether substance use disorder (SUD) before age 19 was associated with functioning at age 30. Participants (N = 773) were assessed twice during adolescence and at ages 24 and 30. Eight of 14 adult measures were associated with adolescent SUD: education, unemployment, income, risky sexual behavior, suicide attempt, coping, stressful life events, and global adjustment. After adolescent comorbidity and functioning and adult SUD were controlled for, education and unemployment remained associated, and three variables emerged as significant: being a parent (significant only for participants without adult SUD), being currently married, and having decreased life satisfaction (significant only for participants with adult SUD). Adolescent SUD is associated with numerous functioning difficulties at age 30, some of which appear to be related to recurrent SUD, comorbid adolescent disorders, or functioning problems already evident in adolescence.

The field of early intervention is currently faced with the challenge of reducing the prevalence of antisocial behavior in children. Longitudinal outcomes research indicates that increased antisocial behavior and impairments in social competence skills during the preschool years often serve as harbingers of future adjustment problems in a number of domains including mental health, interpersonal relations, and academic achievement. This article reports the results of a cross-site randomized controlled trial, in which 128 preschool children with challenging behaviors were assigned to either a Preschool First Step to Success (PFS) intervention (i.e., experimental) or a usual-care (i.e., control) group. Regression analyses indicated that children assigned to the Preschool First Step intervention had significantly higher social skills, and significantly fewer behavior problems, across a variety of teacher- and parent-reported measures at postintervention. Effect sizes for teacher-reported effects ranged from medium to large across a variety of social competency indicators; effect sizes for parent-reported social skills and problem behaviors were small to medium, respectively. These results suggest that the preschool adaptation of the First Step intervention program provides early intervention participants, staff, and professionals with a viable intervention option to address emerging antisocial behavior and externalizing behavior disorders prior to school entry.

In recent years, the science of developing and implementing interventions addressing school-related risk factors has produced many advances. This article addresses the promise of a cross-disciplinary practice approach known as motivational interviewing in school settings. Specifically, the supporting evidence as well as the process and principles of motivational interviewing are described for those unfamiliar with motivational interviewing nomenclature. A description of recent school-based innovations using the principles of motivational interviewing is then provided. Next, some potential applications for applying the motivational interviewing approach in educational settings to enhance the adoption, development, and implementation of effective school-based interventions designed to promote academic achievement and prevent or ameliorate challenging behavior are proposed. The article concludes with a discussion of future directions of motivational interviewing approaches within the context of school mental health.

This study evaluated the efficacy of the FirstStep to Success early intervention for students meeting criteria for attention-deficit/hyperactivity disorder (ADHD). FirstStep is a targeted intervention for students in grades K-3 with externalizing behavior problems, and addresses secondary prevention goals and objectives. As part of a larger randomized controlled trial conducted within the Albuquerque Public School system, the efficacy of the First Step program was evaluated on a subsample of 42 students meeting DSM-IV criteria for ADHD who were randomly assigned to either the intervention group or a usual care control group. The First Step program was found to have significant and moderate-to-large post-intervention effects on school-based measures of ADHD and disruptive behavior symptoms, social functioning, and academic functioning. The intervention effects on the home-based assessments of problem behaviors and social skills were less robust and nonsignificant. Implications and limitations of the study are discussed.

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