Disorders - Substance Use Disorders
Conrod, P. J., Castellanos-Ryan, N., Strang, J.
Context: Objective: Design: Setting: Participants: Intervention: Main Outcome Measures: Results: Conclusion: Trial Registration: Selective interventions targeting personality risk are showing promise in the prevention of problematic drinking behavior, but their effect on illicit drug use has yet to be evaluated.To investigate the efficacy of targeted coping skills interventions on illicit drug use in adolescents with personality risk factors for substance misuse.Randomized controlled trial.Secondary schools in London, United Kingdom.A total of 5302 students were screened to identify 2028 students aged 13 to 16 years with elevated scores on self-report measures of hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. Seven hundred thirty-two students provided parental consent to participate in this trial.Participants were randomly assigned to a control no-intervention condition or a 2-session group coping skills intervention targeting 1 of 4 personality profiles.The trial was designed and powered to primarily evaluate the effect of the intervention on the onset, prevalence, and frequency of illicit drug use over a 2-year period.Intent-to-treat repeated-measures analyses on continuous measures of drug use revealed time x intervention effects on the number of drugs used (P < .01) and drug use frequency (P < .05), whereby the control group showed significant growth in the number of drugs used as well as more frequent drug use over the 2-year period relative to the intervention group. Survival analysis using logistic regression revealed that the intervention was associated with reduced odds of taking up the use of marijuana (beta = -0.3; robust SE = 0.2; P = .09; odds ratio = 0.7; 95% confidence interval, 0.5-1.0), cocaine (beta = -1.4; robust SE = 0.4; P < .001; odds ratio = 0.2; 95% confidence interval, 0.1-0.5), and other drugs (beta = -0.7; robust SE = 0.3; P = .03; odds ratio = 0.5; 95% confidence interval, 0.3-0.9) over the 24-month period.This study extends the evidence that brief, personality-targeted interventions can prevent the onset and escalation of substance misuse in high-risk adolescents.clinicaltrials.gov Identifier: NCT00344474.
Archives of General Psychiatry, 67(1) : 85-93
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Fang, Lin, Schinke, Steven P., Cole, Kristin C. A.
Purpose: Methods: Results: Conclusions: This study examined the efficacy and generalizability of a family-oriented, web-based substance use prevention program to young Asian-American adolescent girls.Between September and December 2007, a total of 108 Asian-American girls aged 10-14 years and their mothers were recruited through online advertisements and from community service agencies. Mother-daughter dyads were randomly assigned to an intervention arm or to a test-only control arm. After pretest measurement, intervention-arm dyads completed a 9-session web-based substance use prevention program. Guided by family interaction theory, the program aimed to improve girls' psychological states, strengthen substance use prevention skills, increase mother-daughter interactions, enhance maternal monitoring, and prevent girls' substance use. Study outcomes were assessed using generalized estimating equations.At posttest, relative to control-arm girls, intervention-arm girls showed less depressed mood; reported improved self-efficacy and refusal skills; had higher levels of mother-daughter closeness, mother-daughter communication, and maternal monitoring; and reported more family rules against substance use. Intervention-arm girls also reported fewer instances of alcohol, marijuana, and illicit prescription drug use, and expressed lower intentions to use substances in the future.A family-oriented, web-based substance use prevention program was efficacious in preventing substance use behavior among early Asian-American adolescent girls.
Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Journal of Adolescent Health, 47(5) : 529-532
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Skills training, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Kristjansson, Alfgeir Logi, James, Jack E., Allegrante, John P., Sigfusdottir, Inga Dora, Helgason, Asgeir R.
Objective: Methods: Results: Conclusion: To examine 12-year changes in alcohol use and cigarette smoking in response to community-based prevention activities among Icelandic adolescents.This study used a quasi-experimental, non-randomized control group design to compare outcomes in 4 Icelandic communities (n=3117) that participated in community-based substance use prevention activities designed to increase levels of parental monitoring and adolescent engagement in healthy leisure-time activities and a matched group of 7 comparison communities (n=1,907). Annual, nationwide, population-based cross-sectional surveys of the prevalence of adolescent substance use were conducted among cohorts of Icelandic adolescents, aged 14-15 years (N=5,024), in all communities from 1997 to 2009.Parental monitoring and adolescent participation in organized sports increased in communities that adopted the intervention program compared to communities that did not, whereas unmonitored idle hours and attendance at unsupervised parties decreased. Over time, alcohol use (OR=0.89, 95% CI 0.82, 0.98, p=0.012) and being intoxicated during the last 30 days (OR=0.86, 95% CI 0.78, 0.96, p=0.004) decreased more in the intervention than control communities.Community-based prevention designed to strengthen parental monitoring and participation in organized sports may confer some protection against adolescent substance use.
Copyright 2010 Elsevier Inc. All rights reserved.
Preventive Medicine, 51(2) : 168-171
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Clark, Heddy Kovach, Ringwalt, Chris L., Hanley, Sean, Shamblen, Stephen R., Flewelling, Robert L., Hano, Mary C.
Project SUCCESS is a selective and indicated substance use prevention program that targets high risk students in secondary school settings. We evaluated the effects of Project SUCCESS on adolescents' substance use immediately following program implementation, and again one year later. Two successive cohorts of alternative high schools were randomly assigned to an intervention or control group, yielding seven schools per condition. Main outcomes included 30-day use of alcohol, marijuana, and illegal drugs excluding marijuana, and drinking to intoxication. We conducted exploratory analyses on 30-day cigarette use. Using Hierarchical Linear Modeling, we found that students in the control schools reported significantly less use of illegal drugs excluding marijuana than those in the intervention group at the first posttest; however, this effect did not persist one year later. There were no other outcome effects of even a marginal nature. While results of this study do not provide evidence of Project SUCCESS' effectiveness, students' program exposure was low. It is possible that Project SUCCESS would perform better in schools with higher and more regular rates of attendance.
Copyright 2009 Elsevier Ltd. All rights reserved.
Addictive Behaviors, 35(3) : 209-217
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Macgowan, Mark J., Engle, Bretton
This article reviews behavior therapies, motivational interviewing interventions, and combined behavioral-psychosocial therapies across 34 peer-reviewed publications. Studies were included if they involved youth with alcohol and other drug (AOD) use, included measures of AOD outcomes, and used controlled research designs with a control or comparison condition. The level of empirical support of the interventions was evaluated using established guidelines. The article determined that behavior therapies were "probably efficacious," and motivational interviewing interventions easily met the criteria for "promising." Because of small sample sizes, combined behavioral-psychosocial therapies marginally met the criteria for "promising." The findings from this article underscore the value of individual and group behavior therapies and motivational interviewing in helping reduce mild to serious AOD use among adolescents.
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Child & Adolescent Psychiatric Clinics of North America, 19(3) : 527-545
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Konghom, S., Verachai, V., Srisurapanont, M., Suwanmajo, S., Ranuwattananon, A., Kimsongneun, N., Uttawichai, K.
Background: Inhalants are being abused by large numbers of people throughout the world, particularly socio-economically disadvantaged children and adolescents. The neuropsychological effects of acute and chronic inhalant abuse include motor impairment, alterations in spontaneous motor activity, anticonvulsant effects, anxiolytic effects, sensory effects, and effects and learning, memory and operant behaviour (e.g., response rates and discriminative stimulus effects).Objectives: To search and determine risks, benefits and costs of a variety treatments for inhalant dependence or abuse.Search methods: We searched MEDLINE (1966 - February 2010), EMBASE (Januray 2010) and Cochrane Central Register of Controlled Trials (CENTRAL) (February 2010). We also searched for ongoing clinical trials and unpublished studies via Internet searches.Selection criteria: Randomised-controlled trials and controlled clinical trails (CCTs) comparing any intervention in people with inhalant dependence or abuse.Data collection and analysis: Two reviewers independently selected studies for inclusion, assessed trial quality and extracted data.Main results: No studies fulfilling the inclusion criteria have been retrieved.Authors' conclusions: Implications for practice: due to the lack of studies meeting the inclusion criteria, no conclusion can be drawn for clinical practice.Implications for research: as a common substance abuse with serious health consequences, treatment of inhalant dependence and abuse should be a priority area of substance abuse research.
Cochrane Database of Systematic Reviews, (12) : CD7537
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
O'Leary-Barrett, Maeve, Mackie, Clare J., Castellanos-Ryan, Natalie, Al-Khudhairy, Nadia, Conrod, Patricia J.
Objective: Method: Results: Conclusion: This trial examined the efficacy of teacher-delivered personality-targeted interventions for alcohol-misuse over a 6-month period.This randomized controlled trial randomly allocated participating schools to intervention (n = 11) or control (n = 7) conditions. A total of 2,506 (mean age, 13.7 years) were assessed for elevated levels of personality risk factors for substance misuse: sensation-seeking, impulsivity, anxiety sensitivity, and hopelessness. Six hundred ninety-six adolescents were invited to participate in teacher-delivered personality-targeted interventions, and 463 were assigned to the nontreatment condition. Primary outcomes were drinking, binge-drinking status, quantity by frequency of alcohol use, and drinking-related problems.School delivery of the personality-targeted intervention program was associated with significantly lower drinking rates in high-risk students at 6-month follow-up (odds ratio, 0.6), indicating a 40% decreased risk of alcohol consumption in the intervention group. Receiving an intervention also predicted significantly lower binge-drinking rates in students who reported alcohol use at baseline (odds ratio, 0.45), indicating a 55% decreased risk of binge-drinking in this group compared with controls. In addition, high-risk intervention-school students reported lower quantity by frequency of alcohol use (beta = -.18) and drinking-related problems (beta = -.15) compared with the nontreatment group at follow-up.This trial replicates previous studies reporting the efficacy of personality-targeted interventions and demonstrates that targeted interventions can be successfully delivered by teachers, suggesting potential for this approach as a sustainable school-based prevention model. Clinical trial registration information-Personality-Targeted Interventions for Adolescent Alcohol Misuse, URL: http://www.clinicaltrials.gov, unique identifier: NCT00344474.
2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Journal of the American Academy of Child & Adolescent Psychiatry, 49(9) : 954-963.e1
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Oesterle, Sabrina, Hawkins, J. David, Fagan, Abigail A., Abbott, Robert D., Catalano, Richard F.
Universal community-oriented interventions are an important component in the prevention of youth health and behavior problems. Testing the universality of the effects of an intervention that was designed to be universal is important because it provides information about how the program operates and for whom and under what conditions it is most effective. The present study examined whether the previously established significant effects of the universal, community-based Communities That Care (CTC) prevention program on the prevalence of substance use and the variety of delinquent behaviors held equally for boys and girls and in risk-related subgroups defined by early substance use, early delinquency, and high levels of community-targeted risk at baseline. Interaction analyses of data from a panel of 4,407 students followed from Grade 5 to Grade 8 in the first randomized trial of CTC in 12 matched community pairs suggests that CTC reduced students' substance use and delinquency equally across risk-related subgroups and gender, with two exceptions: The effect of CTC on reducing substance use in 8th grade was stronger for boys than girls and the impact of CTC on reducing 8th-grade delinquency was stronger for students who were nondelinquent at baseline.
Prevention Science, 11(4) : 411-423
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
O'Leary-Barrett, M, Al-Khudhairy, N., Conrod, P.
Context: Preventure (Conrod, Castellanos and Mackie, 2008) has been found to be effective in reducing drinking and binge drinking in adolescents attending mainstream schools. Objective: To determine whether educational professionals such as teachers, mentors or individuals in a pastoral role, who are trained in carrying out the Preventure personality-targeted interventions will be similarly effective in reducing alcohol use and misuse in a group of adolescents. Participants: 3096 adolescents (mean age 13.7 years) in 21 schools across London. Schools were randomly assigned to control or intervention condition, and students in intervention schools who met the criteria for any of the 4 personality risk subscales of the Substance Use Risk Profile Scale (Negative Thinking, Anxiety Sensitivity, Sensation Seeking and Impulsivity) were invited to participate in a personality-targeted intervention by trained members of staff from their schools. 1409 students met the criteria for personality risk for substance abuse, of which 609 were in school assigned to the intervention condition and received interventions. Intervention: A randomised control trial of a brief, personality-targeted intervention carried out by educational staff such as teachers, mentors or individuals in a pastoral role. Main Outcome Measures: The main outcome measures of this ongoing trial are drinking status, binge drinking status and illicit drug use at 6, 12, 18 and 24-months post-baseline in students meeting the personality risk criteria for substance use. Secondary measures will include psychiatric symptoms and reckless behaviours. This paper will present 6-month drinking outcomes. Results: Preliminary analyses indicate a significant effect of the intervention on quantity by frequency (QF) of alcohol use over 6 months, with the intervention condition associated with less growth in QF of drinking. F(1,843)=5.910, p=0.015. Results also indicate a trend for the intervention to prevent the growth of binge drinking over a 6-month period, (chi)2(1,N=896)=3.286, p=0.070. This is especially pronounced in teenagers who reported having consumed alcohol at baseline, (chi)2(1,N =357)=4.977, p=0.026, NNT=8.3. Conclusions: These findings provide preliminary evidence demonstrating that educational professionals can be successfully trained in the delivery of a brief personality-targeted substance misuse prevention programme, and have wider implications for the delivery and sustained use of such programmes in schools.
Alcoholism: Clinical & Experimental Research, 33 : 42A
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Newton, Nicola C., Andrews, Gavin, Teesson, Maree, Vogl, Laura E.
Objective: Method: Results: Conclusions: To establish the efficacy of an internet based prevention program to reduce alcohol and cannabis use in adolescents.A cluster randomised controlled trial was conducted with 764 13-year olds from ten Australian secondary schools in 2007-2008. Half the schools were randomly allocated to the computerised prevention program (n=397), and half to their usual health classes (n=367). The Climate Schools: Alcohol and Cannabis prevention course is facilitated by the internet and consists of novel, evidence-based, curriculum consistent lessons aimed at reducing alcohol and cannabis use. Participants were assessed at baseline, immediately post, and at six months following the intervention.Compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge at the end of the course and the six month follow-up. In addition, the intervention group showed a reduction in average weekly alcohol consumption and frequency of cannabis use at the six month follow-up. No differences between groups were found on alcohol expectancies, cannabis attitudes, or alcohol and cannabis related harms.The course is acceptable, scalable and fidelity is assured. It increased knowledge regarding alcohol and cannabis, and decreased use of these drugs.
Preventive Medicine, 48(6) : 579-584
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Moore, M. J., Werch, C.
This article reports the efficacy of a brief substance use preventive reintervention for suburban high school students funded by NIAAA. Participants were randomly assigned to receive a brief consultation or control brochure in Fall 2002. Significant positive effects at the 3- and 12-month follow-up have been reported elsewhere. A total of 346 10th- and 12th-grade students were recruited from the original sample for the reintervention study in Fall 2003. Students remained in their originally assigned group and received a brief iterative consultation or control brochure. The same survey was used to collect information on ATOD use and risk/protective factors at all data points. MANCOVAs revealed no group differences 18 months after the initial study baseline. Analysis examining interactions between substance users and nonusers by treatment group indicated significant positive effects for substance-using adolescents who received reintervention. Study limitations, implications, and suggestions for future research are discussed. (copyright) 2009 Informa UK Ltd All rights reserved.
Substance Use & Misuse, 44(7) : 1009-1020
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Pan, Wei, Bai, Haiyan
The Drug Abuse Resistance Education (D.A.R.E.) program is a widespread but controversial school-based drug prevention program in the United States as well as in many other countries. The present multivariate meta-analysis reviewed 20 studies that assessed the effectiveness of the D.A.R.E. program in the United States. The results showed that the effects of the D.A.R.E. program on drug use did not vary across the studies with a less than small overall effect while the effects on psychosocial behavior varied with still a less than small overall effect. In addition, the characteristics of the studies significantly explained the variation of the heterogeneous effects on psychosocial behavior, which provides empirical evidence for improving the school-based drug prevention program.
International Journal of Environmental Research & Public Health, 6(1) : 267-277
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training