Efficacy of Cognitive–Behavioral Interventions Targeting Personality Risk Factors for Youth Alcohol Misuse

Department of Psychological Medicine and Psychiatry, Section of Addiction, King's College London, University of London, London, UK.
Journal of Clinical Child & Adolescent Psychology (Impact Factor: 1.92). 01/2007; 35(4):550-63. DOI: 10.1207/s15374424jccp3504_6
Source: PubMed

ABSTRACT Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies, including alcohol misuse. Manuals contained psychoeducational information on the target personality risk factor and how it is associated with maladaptive coping, as well as exercises targeting maladaptive cognitions and behaviors specific to each personality type. We tested the efficacy of these novel interventions on reducing drinking behavior by randomly assigning 297 Canadian high school students (56% girls, mean age 16, mean grade 11) to personality-targeted interventions (group format; 2 sessions) or to a no-treatment control group. Intent-to-treat analyses indicated beneficial effects of the intervention and Intervention x Personality interactions on drinking rates, drinking quantity, binge drinking, and problem drinking symptoms at 4-month follow-up.

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Available from: Sherry H Stewart, Sep 27, 2015
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    • "TVEM flexibly estimates how the association between a predictor and outcome differs as a function of age without assuming that the association follows a parametric function of time [17]. TVEM uses all available data for every individual over time; thus, time-specific observations with missing values are excluded from the model at that time point [30]. First, we ran intercept-only models to estimate the pattern of change in alcohol outcomes by age. "
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    ABSTRACT: We examined the time-varying effects of sensation seeking, lack of perseverance, and parental monitoring on heavy drinking and alcohol-related harms from ages 16 to 28 years. Participants were from the Victoria Healthy Youth Survey, followed six times, biennially, between 2003 and 2013 (N = 662; mean age at Time 1 = 15.52, range = 12-18). Analyses used time-varying effect models, which estimate how the association between a predictor and an outcome differs over time without assuming the association follows a parametric function of time. Sensation seeking was a stable risk factor for heavy drinking, and lack of perseverance was stable risk factor for alcohol-related harms at each age. Parental monitoring was associated with lower rates of heavy drinking in adolescence and lower rates of alcohol harm until the age of 24 years. Moreover, high levels of parental monitoring moderated the association between personality traits and rates of harm at ages 17-20 years but only for youth high on lack of perseverance and low on sensation seeking. The results provide a better understanding of age-related changes in risk and protective factors of alcohol use across the transition to adulthood. Impulsive personality traits are stable risk factors for alcohol outcomes until the late-20s despite typical age-related declines in these traits and drinking. Moreover, parental monitoring buffers the association between personality traits and alcohol harm for specific youth during the transition to adulthood. Personality-targeted interventions may be effective beyond adolescence, and parenting interventions may help reduce harm among low perseverance, low sensation-seeking youth. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
    Journal of Adolescent Health 07/2015; 57(3). DOI:10.1016/j.jadohealth.2015.05.005 · 3.61 Impact Factor
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    • "Previous literature supports the usefulness of early prevention efforts before alcohol use becomes problematic or ingrained (Stewart et al., 2005). For example, Conrod et al. (2006) developed a brief intervention addressing personality risk factors for early-onset alcohol use including hopelessness , anxiety sensitivity, impulsivity, and sensation seeking, which has found support (Conrod et al., 2008). Similar principles could be applied to preventative interventions targeting SP symptoms as a risk factor for alcohol use. "
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    ABSTRACT: Objective: The current study examined whether social phobia (SP) symptoms in early adolescence prospectively predicted alcohol use through middle adolescence in a community sample of youth. Method: Data from an ongoing longitudinal study (N = 277) of mechanisms of HIV-related risk behaviors in youth were used to assess the extent to which SP symptoms in early adolescence (mean [SD] age = 11.00 years [0.81]) would predict alcohol use across five annual assessment waves. Adolescents completed measures of SP symptoms, depressive symptoms, and alcohol use at each wave. Results: Higher SP symptoms at baseline predicted higher average odds of alcohol consumption during subsequent waves but did not significantly predict an increase in the odds of alcohol use as a function of time. Within a lagged model, SP symptoms measured at a prior assessment point (1 year earlier) predicted greater odds of drinking alcohol at the following assessment point. Importantly, alcohol use did not significantly predict SP symptoms over time. These results suggest that early SP symptoms are an important risk factor for increased odds of subsequent alcohol use. Conclusions: The present findings highlight that elevated SP symptoms place adolescents at risk for early alcohol use. Early interventions targeting SP symptoms may be crucial for the prevention of problematic alcohol use in early to mid-adolescence. Implications for prevention and treatment approaches are discussed.
    Journal of studies on alcohol and drugs 11/2014; 75(6):929. DOI:10.15288/jsad.2014.75.929 · 2.76 Impact Factor
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    • "Conrod et al. [49] developed a school-based group version (2 × 90 minute sessions) of PI, providing cognitive behavioral coping skills training targeting the motivational processes linking the adolescents’ dominant personality style to alcohol use. Three separate randomized controlled trials (RCTs) have demonstrated the efficacy of this approach for reducing the rates of alcohol use, binge drinking and alcohol-related problems, compared to no treatment at 4[49], 6[46,50], 12 and 24 month follow up [38,51]. "
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    ABSTRACT: Background Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.
    BMC Emergency Medicine 08/2014; 14(1):19. DOI:10.1186/1471-227X-14-19
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