Al Khor buy Heroin

__________________________

📍 Verified store!

📍 Guarantees! Quality! Reviews!

__________________________

▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼

▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲

Al Khor buy Heroin

Official websites use. Share sensitive information only on official, secure websites. Correspondence may be sent to Julia Shadur at the above postal address, jshadur umd. The current study examined between- and within-person processes related to friendship intimacy, close-friend substance use, negative affect, and self-medication. We tested between-person hypotheses that global negative affect, friendship intimacy, and close-friend drug use predict increased substance use, and the within-person hypothesis that friendship intimacy and close-friend substance use moderate the temporal relationship between daily negative affect and subsequent substance use i. Experience sampling methodology ESM was employed to capture daily variations in mood and substance use, and multilevel modeling techniques were used to parse between- versus within-person differences in risk for use. Findings supported between-person hypotheses that higher levels of negative affect and lower levels of friendship intimacy predicted greater substance use, and a consistent trend indicated that friendship intimacy and close-friend drug use interact to predict substance use more generally though not for self-medication. Risk and protective mechanisms emerged from this interaction such that the effect of friendship intimacy on adolescent use depends on the degree of close-friend drug use. More specific reformulations of the risk processes involving friendships and self-medication among younger youth are indicated. Keywords: adolescence, friendship, negative affect, quantitative methods, self-medication, substance use. The self-medication hypothesis purports that individuals will use drugs as a direct means to minimize and regulate states of increased negative affect Khantzian, Self-medication describes a within-person mechanism focusing on the negative reinforcement model of substance use whereby the use of drugs is a learned pattern of behavior motivated by the desire to alleviate negative mood in-the-moment. Self-medication is thus an important potential target for early intervention designed to reduce long-term risk for substance use disorders. The substance use literature generally supports a strong association between increased negative affect and substance use, which reflects both within- and between-person processes. The concept of self-medication requires within-person temporal specificity, linking changes in affect and drug use within time. Between-person associations between affect and substance use, on the other hand, indicate that groups of individuals who report higher levels of negative affect also tend to be those who engage in higher levels of substance use more generally e. This between-person effect is evidenced, for example, in the high rates of comorbidity between negative affect disorders e. Findings supporting the self-medication hypothesis are consistently evidenced with adult and college-aged samples, showing that higher rates of substance use occur when individuals experience higher levels of negative affect relative to baseline e. Within-person negative affect-motivated substance use in adolescence is less extensively studied and the findings are more mixed, such that some have found evidence for self-medication while others have not see Kassel et al. Methodology offers one potential explanation for these inconsistent findings. Different methodologies are employed across studies, and few of these capture within-person daily variations in negative affect and substance use. As noted above, between-person measures of negative affect and substance use more generally do not capture the within-person daily fluctuations in affect and drug use which are required in order to test the self-medication hypothesis Kassel et al. In between-person cross-sectional designs, the direction of effect cannot be determined and self-medication cannot be isolated from other potential mechanisms underlying the negative affect-use relationship e. Longitudinal designs that capture changes in negative affect and use are more promising, but they typically use long time lags e. Such subgroups may not be represented in all samples, yielding mixed results. Despite some findings showing mixed results or no support for negative affect-motivated use in adolescence Crooke, Reid, Kauer, McKenzie, Hearps, Khor, et al. Moreover, adolescence is a period during which youth are more vulnerable to increases in negative affect, but developmentally lack the neurobiological systems to appropriately regulate these changes in affect, leading them to seek maladaptive coping methods including substance use Steinberg et al. For some youth, self-medication becomes a way to self-regulate. Gaining a better understanding of which adolescents may be more likely to engage in self-medication will help to further resolve the inconsistent findings and will also help identify appropriate targets for prevention. With an ultimate goal to understand how friendship qualities impact risk for adolescent self-medication within-person , a helpful first step is to examine main effects that explain how the friendship context impacts risk for substance use more generally between-person. In sum, there is clear support that substance use more generally is impacted by the context of friendships. Adolescents whose friendships involve both higher levels of positive and negative friendship qualities are more likely to use substances Hussong, , and greater hostility and less reciprocity within close friendship dyads predicts greater alcohol use Windle, Additional research examining between-person differences in drug use suggests that friendship intimacy has the potential to either increase or decrease risk for adolescent substance use, depending on other characteristics of the friend. Indeed, one of the greatest risk factors for substance use is affiliation with drug-using peers e. The contribution of the present study is to explore this question. Among adults, self-medication is more effective in reducing negative affect when in the company of friends Armeli et al. This suggests that friendships play a critical role in the use of substances to cope. It is unknown if the same pattern regarding friendships and self-medication emerges during adolescence. Without adaptive strategies for minimizing negative affect e. Support for this notion comes from findings showing that college students with less intimate friendships were more likely to engage in substance use following days when they experienced higher levels of negative affect relative to baseline Hussong et al. If less intimate friendship contexts also include drug using friends, then teens may be even more likely to self-medicate due to easy access and joint engagement in drug use. Though these questions have not yet been tested among younger adolescents, findings from Hussong et al. Social Learning Theory Bandura, offers a second mechanism of risk for substance use. Such models of social influence suggest that for those in more intimate and supportive friendships with drug using peers, interactions with these friends may provide an environment that encourages drug use and is conducive to self-medication, particularly for adolescents who are prone to negative affect. Adolescents may be more likely to behave in ways similar to their friends when their friendships are more positively characterized. Friends who use drugs may motivate, teach, and reinforce adolescents to self-medicate as a way of using substances. Thus, adolescents with high levels of friendship intimacy and with greater exposure to friends who use substances may also be more likely to self-medicate. The current study examined both between- and within-person processes related to close-friend intimacy, close-friend substance use, negative affect, and adolescent substance use. Specifically, we tested the following set of hypotheses see Figure 1 : Hypothesis 1: Higher levels of global negative affect will predict increased substance use between-person effects. Hypothesis 2: Adolescents will engage in more substance use generally if they have less intimate friendships or have intimate friendships with substance using close friends between-person effects. Hypothesis 3: The self-medication hypothesis will be supported such that daily increases in negative affect will predict daily increases in substance use within-person effects. Hypothesis 4: Close-friend intimacy and close-friend drug use will both moderate the relationship between within-person variability in daily negative affect and substance use i. Models of stress and coping and social learning indicate that adolescent self-medication may be moderated both by how much intimacy exists in these friendships and also who is delivering it i. Hypothesis 4 thus reflects two predictions: the within-person association between negative affect and substance use will be strongest for those in friendships with higher levels of intimacy and higher levels of close-friend substance use reflecting social learning and for those in friendships with lower levels of intimacy regardless of close-friend substance use, reflecting stress and coping , as compared to others. The goal of the current study was to use novel methodology and design to examine how friendship qualities impact adolescent self-medication during the transition period to high school. Specifically, the use of a daily experience sampling design allows for examination of within-person variability in daily negative affect and substance use in addition to between-person variability , which is critical for testing the self-medication hypothesis Swendsen et al. Thus, in the current study the theory of self-medication is matched to the appropriate methodology i. These experience sampling procedures also capture affect and substance use patterns in real-world contexts and circumstances, which increases the external validity Swendsen et al. Participants in the current study completed all study procedures in the spring of their eighth grade year Phase I and the summer before starting ninth grade Phase II. In Phase I, out of enrolled eighth grade students from seven schools in a single county completed one-time school-based surveys. Valid data were provided by students, determined by an honesty item assessing whether or not participants felt they were honest in their responses to the questionnaire. Recruitment for Phase II began with rank-ordering the participants based on a risk index that indicated any current substance use, any initiation of substance use by eighth grade, or affiliation with peers who had been involved in substance use prior to ninth grade. Participants were contacted by phone and screened in order of risk, such that the adolescents with the highest substance use risk indices were contacted first, yielding an elevated-risk sample. Of the original with valid data, there were only participants who indicated any level of risk for substance use. We attempted to contact these participants, as well as 27 additional randomly selected participants who indicated no risk on this index but were included in our recruitment efforts in order to yield an initial recruitment list of that was large enough to yield an adequate sample size. In order to be eligible, participants had to speak English with enough proficiency in order to complete consent procedures. Participants were not excluded based on gender, ethnicity, or socioeconomic status. A total of 81 individuals completed the study i. Twenty-eight individuals who did not participate provided no reason. The current sample evidences greater risk than the Phase I school-based sample indicated by more frequent alcohol use, delinquency, and a greater number of friends who use substances, suggesting the successful recruitment of an elevated-risk sample. To be eligible for analysis in the current study, participants had to complete the assessment involving the experience sampling methodology ESM. Of the original 81 from Phase II, two participants did not complete the ESM procedures and six were missing more than 16 of the 21 days of ESM data and were not included in the analyses. Thus, the final sample includes 73 target adolescents from Phase II, with a total of observations of both daily negative affect and substance use scores 1. In the summer between eighth and ninth grade, students completed in-home assessments during both an initial and final session three weeks apart and completed an experience sampling procedure during the three weeks between sessions. During the initial session, students completed computer-administered interviews and received instructions and materials for the experience sampling procedure i. Adolescents were asked to provide the names and contact information for their top three closest friends so that staff could contact them to participate in the final session of the study three weeks later. Thus, the friends who participated in the study were identified as one of three top close friends, but may not have been the identified closest friend. Additionally, because the three close friends were identified by target-adolescent-report and not by friend-report , the friendship dyads are not necessarily comprised of reciprocal best friends. The experience sampling procedure occurred during the 21 days in between the initial and final sessions. Target adolescents were asked to complete brief surveys 1—2 minutes in response to a pre-programmed wristwatch alarm. Each day, three pre-set alarms prompted participants to rate their levels of negative affect sad, mad, worried, and stressed at the moment that the alarm sounded. Reports of daily negative affect were recorded by using a small pad of pre-labeled paper and a pen that were both kept securely in an unobtrusive plastic container that was attached to the wristwatch. A fourth and final daily alarm prompted adolescents to record their substance use alcohol, marijuana, and other illicit drugs for the entire day. Additional precautions were taken to further prevent the disclosure of personal information, which included acquiring a Certificate of Confidentiality. All assessments for this analysis were completed during the initial and final sessions and during the three-week experience sampling period during Phase II. All measures yielded manifest variables. During the initial session, adolescents self-reported gender, age, and ethnicity, and parents self-reported their highest level of education. The highest level of education obtained between both parents was used to indicate parent education. The five items included frequency of alcohol, marijuana, and other illicit drug use, frequency of heavy alcohol use 5 or more drinks at one time , and frequency of being drunk. For reports of alcohol use, frequency item responses ranged from 0 not at all to 7 everyday; frequency item responses for number of times drunk, heavy alcohol use, marijuana use, and use of other drugs, ranged from 0 not at all to 4 once a week. The experience sampling of substance use involved adolescents recording their daily use of alcohol, marijuana, and other illicit substances each day for 21 days. Nightly recordings of drug use were completed at pm in response to the final pre-set alarm, or before going to bed if after pm. Alcohol use was rated on a 6-point scale from 0 to 5 or more standard drinks of alcohol per day. In order to protect reports of alcohol use, recordings were made by using numbers 0—5. The outcome measure for overall daily substance use was dichotomized to represent any use versus no use. During the day experience sampling period, Variation in negative affect was assessed through the experience sampling of daily mood across the three-week period. Adolescents reported the degree to which they felt sad, mad, worried, and stressed when prompted by three daily random pre-set alarms. For each of the four types of negative affect, item responses ranged from 1 not at all to 5 very much, indicating the degree to which adolescents endorsed feeling each emotion at that moment. Items reflecting negative affect were chosen based on the dimensions that are often used in self-medication research e. To create a daily negative affect composite score for each of the 21 days, the maximum ratings given to each type of emotion sad, mad, worried, and stressed were averaged together within any given day. Results from the current sample yielded a mean global negative affect score of 1. Although results from the current sample indicated that our adaptation of the MAACL-R was adequately reliable, a notable limitation is that we did not establish psychometric properties of the adapted version prior to including it in the current study. The loyalty subscale was supplemented with an additional item in order to capture a broader dimension of loyalty, and the affection subscale was supplemented with an additional item in order to assess reciprocation within the friendship Barrera, Chassin, and Rogosch, , yielding a total of 14 items. The item responses ranged from 1 little to none to 5 the most possible. CFA results yielded acceptable model fit and large factor loadings for all items onto one intimacy factor, with factor loadings ranging from. The analysis sample consists of 73 target adolescents, however only 57 had complete data on all between-person variables for analysis. Of the individuals who had incomplete data for any of the key predictors of interest, two were missing on target-report of intimacy, sixteen were missing on close-friend report of intimacy, and fifteen were missing on close-friend substance use. Initial attrition analyses were conducted in order to determine if target adolescents with missing close-friend-reports of key predictor variables differed significantly from those who had complete data. A series of t -tests showed that there were no significant differences across key variables, including target-report of close-friend intimacy, target-report of substance use in the general peer network, and target self-report of substance use. These findings suggest that missingness in these data is not related to key variables of interest, and values are likely missing at random. Predictors in the multiple imputation analysis included control variables, close-friend-reports of substance use, both close-friend and target reports of intimacy, target reports of daily mood and substance use, and target reports of substance use in their general peer network. Multilevel models can parse between- and within-person variability, which is necessary in order to test the self-medication hypothesis. Between-person level 2 predictors of substance use intercepts included control variables i. Within-person level 1 predictors included whether ESM data were collected on a weekend or weekday to control for variation of substance use based on time of the week and daily negative affect ratings. Thus, repeated measures were nested within person. Two- and three-way interactions between daily negative affect, close-friend intimacy, and close-friend substance use were added to the model to test study hypotheses. All continuous between-person predictors were grand-mean centered, and the daily within-person negative mood predictor was person-centered. The random effect of the model intercept and the fixed effect for the slope for daily effect of negative affect on substance use were estimated as well. We used a non-linear multilevel modeling approach to test study hypotheses following established guidelines for distinguishing within- i. Nine points of quadrature were used in order to increase the chances for successful model convergence. The multilevel model was estimated twice, once for target-report model 1 and once for close-friend-report model 2 of close-friend intimacy. Probing of this between-person interaction indicated two trends for increased risk: 1 increasing levels of close-friend substance use predicted adolescent substance use more strongly for those who also have high levels of close-friend intimacy compared to those with low levels of close-friend intimacy consistent with social learning theory , and 2 at low levels of close-friend substance use, adolescents with the lowest levels of close-friend intimacy are also more likely to use substances compared to those with high levels of close-friend intimacy consistent with the stress and coping model; see Figure 2. The probed between-person interaction also shows a buffering effect such that the lowest risk for substance use occurs in the context of low levels of close-friend substance use and high intimacy see Figure 2. Reported values are unstandardized betas. Marginally significant two-way interaction between close-friend substance use and target-report of close-friend intimacy. Plotting of this interaction indicates a trend for increasing levels of close-friend substance use to predict adolescent substance use more strongly for those who also have high levels of close-friend intimacy. Close-friend substance use values are grand-mean centered. The current study examined whether close-friend substance use and close-friend intimacy predict risk for self-medication among adolescents within-person effects as well as main effects and interactions between global negative affect, close-friend intimacy, and close-friend substance use in predicting adolescent drug use more generally between-person effects. There was clear support for the between-person effects showing that increased global negative affect and lower levels of target-reported close-friend intimacy predicted higher levels of substance use more generally. Findings also provided some support for the interaction between close-friend intimacy and close-friend substance use in predicting daily adolescent substance use. However, the self-medication hypothesis was not supported in the current study. Potential explanations and interpretations of these findings are discussed further. Findings supported our hypothesis that adolescents will engage in more substance use if they have less intimate friendships or have intimate friendships with substance using friends, reflecting between-person effects. The marginally significant interaction between close-friend substance use and close-friend intimacy indicates that the two proposed mechanisms i. This interaction shows a trend for the positive association between close-friend substance use and adolescent daily use to be strongest for target adolescents who report high levels of close-friend intimacy, reflecting the social learning model. The stress and coping model is also indicated in this interaction such that even at low levels of close-friend substance use, adolescents with the lowest levels of close-friend intimacy are at increased risk for use. Finally, a buffering effect can be seen in the interaction as well, showing that the lowest risk for substance use appears to be the combination of low levels of close-friend substance use and high intimacy. Thus, the one interaction effect and the subsequent main effects indicate a consistent trend for the effect of intimacy and close-friend substance use on adolescent daily use, such that close-friend intimacy may be either protective or risky depending on the degree of close-friend substance use. Although these patterns are consistent with the two different risk mechanisms, the interaction is only marginally significant and thus further exploration of this relationship within the context of ESM data is certainly needed. There are four potential explanations for why the self-medication hypothesis Hypothesis 3 and the proposed within-person interaction between daily negative affect, close-friend intimacy, and close-friend drug use in predicting daily drug use Hypothesis 4 were not supported in the current study. First, friendship-based risk processes for self-medication may be more complex than what is captured by the current study, and omitted variables may have resulted in non-significant findings. For example, there could be a gender effect such that close-friend substance use and close-friend intimacy predict self-medication only for girls. With friendships holding such value and import for girls, those who struggle to maintain intimate friendships may be at greater risk both for increased levels of negative affect and subsequently for self-medication. In the current study it was not feasible to explore a gender effect due to the modest sample size; however, this is an important area for further exploration. Second, because the proposed risk mechanism for self-medication was not supported among younger youth , but others have found that lower levels of friendship intimacy predicts self-medication in young adults Hussong et al. In other words, the close friendship context may operate independently from intimacy and close-friend substance use levels in predicting this particular style of drug use among adolescents. To speculate, components of the friendship context that may predict self-medication for younger youth might include close relationships with older teens, the prevalence of affective disorders among friends e. Third, the adolescent close friendship context may not be related to self-medication for this younger age group — rather, there may simply be other mechanisms that moderate the relation between negative affect and substance use for adolescent youth. Although cross-sectional designs show that close-friend substance use and friendship intimacy impact substance use more generally and there is support for this in the current study , the friendship context may be less critical in predicting risk for self-medication among younger adolescents. Thus, contrary to ESM research findings with adult samples suggesting that the social context matters in predicting self-medication as a coping method e. Other factors and mechanisms may be more appropriate predictors of self-medication for such youth. Thus, both risk for and protection against negative affect-motivated substance use among younger adolescents may be best indicated by specific characteristics of the parent-child relationship. Fourth, consistent with between-person effects in the current study, we might expect that more chronically high levels of adolescent negative affect may be more predictive of increased substance use rather than the hypothesized short-term temporal relations between affect and substance use as in self-medication. Thus, within-person short-term associations between mood and substance use may be weaker among adolescents given the frequent fluctuations of extreme moods within any given day, combined with limited access to drugs or alcohol, as compared to adults. Nonetheless, self-medication research supports the idea that a subgroup of teens may be most at risk for this style of use, increasing the need for better identification of the individuals who are at heightened risk for self-medication Chassin et al. The current findings preliminarily rule out one potential contextual factor the close friendship context that does not seem to predict such risk. This argument is made cautiously given that the sample size is relatively small, and this study was the first to test the moderating effect of the close friendship context on self-medication in teens; thus findings are considered preliminary. Strengths of the current study include the use of experience sampling methods to capture daily variations in mood and substance use as an index of self-medication, and the use of multiple reporters of close-friend intimacy. The sample is relatively diverse, and the majority of experience sampling studies to date have been employed with mostly Caucasian adult samples e. Moreover, this study is the first to test multiple mechanisms of risk related to the close friendship context as moderators of self-medication among youth. There are several limitations of the current study that must be noted. First, quantitative methods do not currently include power calculations for multilevel models with binary outcomes that include interactions, but given the modest sample size of 73, power to detect interactions may still be limited. Nonetheless, we found significant effects with these data in several other sets of analyses. Second, the low base rate of daily substance use in the current sample limits the extent to which the proposed mechanisms can be tested, given that only 77 of observations of drug use were endorsed positively, and only 20 of 73 adolescents reported any use during the day experience sampling period. Although the overall rates of use are low, it is important to note that we selected an elevated risk sample, and thus the current findings may not generalize to the broader population given that rates of use would be even lower. Third, the self-report measure of close-friend intimacy may limit the extent to which closeness and supportive behaviors within dyads are truly captured. An observational measure of intimacy would allow greater insight into enacted friendship behaviors, and future studies should consider employing such alternative methods of measuring the friendship intimacy construct. The current study employed experience sampling methodology and multilevel modeling techniques to assess between-person and within-person differences in risk for substance use. Between-person effects suggest that adolescents who have higher mean levels of negative affect and lower levels of close-friend intimacy are at greatest risk for substance use. These findings indicate that interventions focused on minimizing the experience of negative affect for youth as well as facilitating close friendships with non-using peers may help minimize risk for substance use more generally. However, findings do not indicate which individuals are at risk for self-medication, as the close friendship context did not moderate the within-person relation between daily variations in negative affect and substance use. Thus, the results encourage greater exploration of other factors that help to further identify vulnerable subgroups who may be more likely to use self-medication as a way to cope. An additional direction for future research includes further exploration of alternative within-person affective-based processes i. In most cases, the adolescents participated only once as either a target or as a close friend. There were sixteen adolescents who participated twice, once as a target and once as a friend. Of those, there were eight or four friendship dyads who participated once as target and once as a friend for one another. Eight other adolescents participated once as a target and once as a friend for other targets who themselves were not reciprocally chosen as friends. One of these adolescents participated three times, once as a target and also as a friend for two other targets. As a back-up source of data collection of daily reports, and to minimize data loss, all participants were asked to also place a phone call into the study office phone to leave a message with their daily recordings three assessments of mood, one substance use assessment. As a library, NLM provides access to scientific literature. J Soc Pers Relat. Published in final edited form as: J Soc Pers Relat. Find articles by Julia Shadur. Andrea Hussong , Ph. Find articles by Andrea Hussong. PMC Copyright notice. The publisher's version of this article is available at J Soc Pers Relat. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.