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


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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    • "First, the results indicate that individuals with elevated AS do not necessarily consume more alcohol, but they experience increased problems because of their alcohol use. Second, AS can be reduced through targeted interventions (Schmidt et al., 2007, 2014; Smits et al., 2008); furthermore, reductions in AS appear to decrease problematic drinking (Conrod et al., 2006; Watt et al., 2006). Although prior work has suggested a role of specifi c AS subfactors in alcohol problems (Harwell et al., 2011; Koven et al., 2005; Stewart et al., 2001), the current study indicates that general AS is the sole factor associated with problematic alcohol use. "
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    ABSTRACT: Objective: The misuse of alcohol is related to numerous detrimental health effects. Research has determined anxiety sensitivity (AS) to be a risk factor for problematic alcohol use. To date, no studies have investigated this relationship using a bifactor model of AS. This study used a bifactor model to determine the effects of the general AS factor and the cognitive, physical, and social concerns subfactors on alcohol-related outcomes. Method: The sample consisted of 329 participants selected from a larger sample of individuals in a brief smoking-cessation intervention. Latent factor models were used to determine the effects of the bifactor model of AS on alcohol use behavior. Results: The general AS factor was significantly associated with alcohol use problems but not alcohol consumption. The AS subfactors of cognitive, physical, and social concerns were not significantly related to either alcohol variable. Conclusions: The findings are inconsistent with previous research that has found associations between the AS subfactors and alcohol-related outcomes. The use of a bifactor model of AS allowed the variance associated with AS to be parceled out of the subfactors, indicating that general AS accounts for the relationship between AS and alcohol misuse.
    Journal of studies on alcohol and drugs 11/2015; 76(6):957-961. · 2.76 Impact Factor
    • "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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