Effectiveness of a Selective, Personality-Targeted Prevention Program for Adolescent Alcohol Use and Misuse A Cluster Randomized Controlled Trial

JAMA Psychiatry (Impact Factor: 12.01). 01/2013; 70(3):1-9. DOI: 10.1001/jamapsychiatry.2013.651
Source: PubMed


CONTEXT Selective school-based alcohol prevention programs targeting youth with personality risk factors for addiction and mental health problems have been found to reduce substance use and misuse in those with elevated personality profiles. OBJECTIVES To report 24-month outcomes of the Teacher-Delivered Personality-Targeted Interventions for Substance Misuse Trial (Adventure trial) in which school staff were trained to provide interventions to students with 1 of 4 high-risk (HR) profiles: anxiety sensitivity, hopelessness, impulsivity, and sensation seeking and to examine the indirect herd effects of this program on the broader low-risk (LR) population of students who were not selected for intervention. DESIGN Cluster randomized controlled trial. SETTING Secondary schools in London, United Kingdom. PARTICIPANTS A total of 1210 HR and 1433 LR students in the ninth grade (mean [SD] age, 13.7 [0.33] years). INTERVENTION Schools were randomized to provide brief personality-targeted interventions to HR youth or treatment as usual (statutory drug education in class). MAIN OUTCOME MEASURES Participants were assessed for drinking, binge drinking, and problem drinking before randomization and at 6-monthly intervals for 2 years. RESULTS Two-part latent growth models indicated long-term effects of the intervention on drinking rates (β = -0.320, SE = 0.145, P = .03) and binge drinking rates (β = -0.400, SE = 0.179, P = .03) and growth in binge drinking (β = -0.716, SE = 0.274, P = .009) and problem drinking (β = -0.452, SE = 0.193, P = .02) for HR youth. The HR youth were also found to benefit from the interventions during the 24-month follow-up on drinking quantity (β = -0.098, SE = 0.047, P = .04), growth in drinking quantity (β = -0.176, SE = 0.073, P = .02), and growth in binge drinking frequency (β = -0.183, SE = 0.092, P = .047). Some herd effects in LR youth were observed, specifically on drinking rates (β = -0.259, SE = 0.132, P = .049) and growth of binge drinking (β = -0.244, SE = 0.073, P = .001), during the 24-month follow-up. CONCLUSIONS Findings further support the personality-targeted approach to alcohol prevention and its effectiveness when provided by trained school staff. Particularly novel are the findings of some mild herd effects that result from this selective prevention program. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00776685.

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Available from: Nicola C Newton, Oct 21, 2015
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    • "Comparisons with the UK are of particular interest due to the similar drinking cultures and same legal purchase age of alcohol in Australia and UK (World Health Organisation, 2014). In addition to these broad aims, we propose a number of hypotheses in line with previous research (Castellanos-Ryan, O'Leary-Barrett, Sully, & Conrod, 2013b): i) Hopelessness will be associated with substance use, drinking problems , and depression symptoms; (ii) Anxiety sensitivity will not be associated with increased substance use at this age, but will be associated with emotional problems; (iii) Impulsivity will be associated with substance use, as well as hyperactivity and conduct problems; and (iv) Sensation Seeking will be related to substance use and hyperactivity . This will be the first study to examine these relationships in Australia. "
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    ABSTRACT: Aims: This study investigated the validity of a brief personality screening measure for substance use in adolescents, the Substance Use Risk Profile Scale (SURPS), among Australian adolescents. Design and participants: A total of 527 adolescents (mean age: 13.38years, SD=0.43) from seven Australian schools were assessed at two time points 24months apart. The concurrent and predictive validity of the SURPS was determined using a series of linear and logistic regressions, and was compared to the results in a United Kingdom (UK) sample. SURPS subscale scores for the Australian population were also reported and compared to those in the UK. Findings: Overall, the SURPS subscale scores for Australian adolescents were similar to those for adolescents from the UK. Tests of concurrent and predictive validity in the Australian sample demonstrated that the all four personality profiles - Hopelessness (H), Anxiety Sensitivity (AS), Impulsivity (IMP), and Sensation Seeking (SS) - were related to measures of substance use and other behavioural and emotional characteristics. In addition, all the predicted specific prospective relationships between the personality profiles and particular substance use and other behavioural problems were confirmed except that H was not associated with illicit drug use. Overall, the results were similar between the Australian and UK samples. Conclusions: The SURPS is a valid and useful measure for identifying Australian adolescents at high-risk for substance use and other emotional and behavioural problems. Implications for prevention are discussed.
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    • "Prior research suggests that AS-based interventions may be useful in reducing substance use in individuals high in AS. For example, AS-based interventions have been effective for nonclinical or youth samples at risk for development of alcohol use disorder (e.g., Conrod et al. 2013; Watt et al. 2006). These studies matched individuals high in AS to an AS-based treatment and found reductions in alcohol use frequency and quantity, but change in AS level or anxiety was not assessed. "
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    ABSTRACT: Substance use disorders (SUDs) and anxiety disorders commonly co-occur, yet to date no empirically-supported treatments for this combination of disorders has been developed. One potential way of treating these issues simultaneously may be to target anxiety sensitivity (AS), which is a risk factor for development of both SUDs and problematic anxiety. The objectives of the current study were to develop and pilot test a brief treatment aimed at reducing AS and substance use. Twenty-one individuals concurrently participating in a community-based intensive outpatient SUD treatment program received six 1.5-h sessions of an AS-targeted intervention, primarily utilizing interoceptive exposures, cognitive challenging, and psychoeducation about the relationship between substance use and anxiety. At post-treatment, participants had significant reductions in AS as measured by the Anxiety Sensitivity Index (d = 1.62; ASI; Reiss et al. in Behav Res Ther 24(1):1–8, 1986), and significant decreases in percent days abstinent from substances (Cohen’s d = 1.35). Average scores on the ASI at pre-treatment were in the clinical range (M = 41.5, SD = 9.97) but had moved to the nonclinical range on the ASI at 3 months follow-up (M = 20.8, SD = 9.39; intent to treat analysis). Participants had large reductions in the Depression–Anxiety–Stress Scale (Lovibond and Lovibond in Manual for the Depression Anxiety Stress Scales. Psychology Foundation Monograph, Sydney, 1995) anxiety subscale scores but remained in the moderate range on this subscale at follow-up. Subjective reports of both participants and therapists described the intervention as tolerable, effective, and desired. Results of the current open trial suggest that a relatively brief (
    Full-text · Article · Jan 2015 · Cognitive Therapy and Research
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    • "In the introduction it was already mentioned that the Act On Upbringing in Sobriety and Counteracting Alcoholism (1982) raises the problem of prevention. The above results confirm that efforts should be focused of necessity on prevention programs at schools, colleges and other facilities for young people (Borucka et al. 2008, Conrod 2013). It is also important to develop tools improving the estimation of the risk of the development of alcohol dependence among students (Sławińska et al. 1989). "
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    ABSTRACT: Background: Alcohol consumption in our society is a known, and a widely discussed problem, due to the proven negative impact of excessive usage of spirits on health. Aim of the study was to evaluate the rate of consumption, and risk of an alcoholic disease among Polish students. Subjects and methods: Study was carried out using an authors' own questionnaire, made of a queries about amount and frequency of alcohol consumption, risky behaviors and knowledge about alcoholism. Research was conducted through community portals (f.e. facebook.com), and within 3 weeks time (from a 10(th) of January to 31(st) of January 2013) 1300 students from different Polish universities participated in it. Out of them, after removal of inadequate questionnaires, group of 1259 students (822 females, 437 males) was selected for further analysis. Average age equaled to 21.5, with the maximum of 27 and minimum of 18 years. For the statistical analysis StatSoft "Statistica" 10.0 software was used. Results: The study shows that 95.5% of students use alcohol (mostly beer and vodka) and they tend to overuse it. 28.86% of respondents drank excessively more than 3 times during the month preceding research, 46% of subjects also had an alcoholic palimpsest more than once, 12.7% need an alcohol to enjoy a party and 0.83% of respondents can't control the amount of a one-time alcohol consumption. 3.32% of students may be in the group of a high alcoholism risk. Conclusions: Alcohol consumption is a common problem among Polish students. Most of respondents, mostly males, drink excessively and potentially risky for their health. There is a remarkable group of students endangered with alcohol addiction.
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