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ADOLESCENT SUBSTANCE ABUSE (T CHUNG, SECTION EDITOR)
Personality-Targeted Interventions for Substance Use and Misuse
Patricia J. Conrod
1
Published online: 4 November 2016
#The Author(s) 2016. This article is published with open access at Springerlink.com
Abstract
Purpose of Review Personality factors have been implicated
in risk for substance use disorders through longitudinal and
neurobiologic studies for over four decades. Only recently,
however, have targeted interventions been developed to assist
individuals with personality risk factors for substance use dis-
orders manage their risk. This article reviews current practices
in personality-targeted interventions and the eight randomised
trials examining the efficacy of such approaches with respect
to reducing and preventing substance use and misuse.
Recent Findings Results indicate a moderate mean effect size
for personality-targeted approaches across several different
substance use outcomes and intervention settings and formats.
Conclusions Personality-targeted interventions offer several
advantages over traditional substance use interventions, par-
ticularly when attempting to prevent development of problems
in high-risk individuals or when addressing concurrent mental
health problems in brief interventions.
Keywords Prevention .Substance misuse .Adolescents .
Personality .Selective interventions
Substance Misuse in North America
Despite having made great strides in reducing adolescent
binge-drinking rates,illicit substance use remains significantly
above national targets for health promotion and disease pre-
vention in the USA and Canada [1–3]. In 2014, marijuana use
and nonmedical use of psychotherapeutics were the most
common types of illicit drug use by North American adoles-
cents and there is very little evidence that rates of cannabis use
have changed over the past 10 years. More concerning is that
rates of adolescent substance use disorder remain high and
unchanged over this period [3]. These data suggest that there
is a need to shift the focus of prevention efforts away from
universal approaches to more targeted intervention strategies
designed to help those most at risk of transitioning to sub-
stance use disorders.
Personality factors have been identified as robust risk fac-
tors for substance use disorders and have been shown to me-
diate the genetic predisposition to substance misuse and pre-
dict patterns of psychiatric comorbidity and patterns of sub-
stance misuse (see [4•] for review). Inspired by these findings,
the personality-targeted approach to substance use prevention
and brief intervention offers a novel strategy for intervening
on risk factors for substance misuse and offers many advan-
tages over more traditional universal prevention or generic
intervention approaches targeting substance use behaviours
more directly. The current review provides an overview of
current practices and empirical findings on personality-
targeted interventions for substance misuse, as well as a brief
overview of the literature linking personality factors to sub-
stance use risk, which is also addressed in more detail in pre-
vious publications [4•,5•].
This article is part of the Topical Collection on Adolescent Substance
Abuse
*Patricia J. Conrod
Patricia.conrod@umontreal.ca
1
Department of Psychiatry, Université de Montréal, Centre de
Recherche, CHU Ste-Justine, Chercheur Boursier Senior, FRSQ,
3175 Côte-Ste-Catherine, Montréal, QC H3T 1C5, Canada
Curr Addict Rep (2016) 3:426–436
DOI 10.1007/s40429-016-0127-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Substance Use Among Young People
While epidemiologic studies in North America and Europe
are indicating that rates of underage drinking and binge
drinking have been decreasing over the past 10 years,
alcohol- and drug-related harms remain alarmingly preva-
lent among adolescents and young adults. A recent World
Health Organization study [6] reported that alcohol use
alone accounts for almost 4 % of the global burden of
health, with deaths attributed to alcohol greater than those
caused by AIDS, tuberculosis or violence. Heavy drinking
is very common among undergraduate students: 40–60 %
engage in heavy episodic drinking (HED; 5+ drinks/occa-
sion) [7–9]. Recent studies, including one of drinking pat-
terns in 73 countries, show that risky drinking patterns,
such as drinking to intoxication and HED, are on the rise
among young adults [6,10,11]. Heavy alcohol use nega-
tively impacts physical health, psychological well-being
and academic performance [12–14]. Such alcohol-related
negative consequences occur frequently among undergrad-
uates. For example, a large study of Canadian undergrad-
uates estimated that a full 44 % of students reported one or
more indicators of harmful drinking such as experiencing
memoryloss,sufferinganinjury,feelingguiltyorhaving
other concerns about their drinking [7]. An estimated 18–
27 % of undergraduates will experience an alcohol use
disorder in their lifetime [15]. In addition, one third of
undergraduates report one or more indicators of dependent
drinking such as being unable to stop drinking and needing
a drink in the morning or hazardous patterns of drinking
according to the Alcohol Use Disorders Identification Test
[16]. This research suggests that a majority of students are
negatively affected by drinking on campus [7], whether it
is missing classes due to hangover (19 %), engaging in
unplanned sex (14.1 %), driving (7.4 %) or unsafe sex
(6.0 %) after drinking or experiencing negative conse-
quences due to other students’drinking such as being
assaulted (10.0 %) or sexually harassed (9.8 %).
There is also a widespread concern about a prescription
drug crisis currently facing North America [2]. This concern
appears particularly warranted in the case of young people,
where 15–25 year olds report the highest rates of prescription
drug misuse of any age group [3]. Non-medical prescription
drug misuse (NMPDM) is indeed a risk factor for future pre-
scription drug dependence [17] and has been linked to the rise
in heroin abuse in the USA [18]. The number of overdose
deaths from prescription pain relievers has more than quadru-
pled since 1999 in the USA [19]. There is a pressing need for
effective substance abuse prevention and early intervention,
yet very few programmes have been developed to address
illicit drug use among youth and even fewer have been eval-
uated with respect to their efficacy in preventing onset of
prescription drug use.
Personality Factors and Risk for Substance Use
and Misuse
Externalising and internalising personality traits are reliably
associated with increased susceptibility for substance misuse
in youth, with a growing body of evidence suggesting that
these traits play a causal role in substance misuse vulnerabil-
ity. Consequently, these personality profiles have recently be-
come important targets of interventions to reduce such risk.
We previously showed that distinct personality traits are relat-
ed to risk for substance-specific misuse patterns, with impul-
sivity (IMP) specifically associated with misuse of stimulants
(including cocaine and prescription stimulant medications)
and sensation seeking (SS) preferentially associated with al-
cohol and cannabis misuse [20–24]. By contrast, anxiety sen-
sitivity (AS) and hopelessness (HOP) have been shown to be
associated with preferential use/misuse of depressant drugs,
such as alcohol, sedatives and opioids [23,25]. These traits
also appear to predict different motives for drinking and sub-
stance use with SS being consistently associated with en-
hancement motives for drinking and drug use, AS with coping
and conformity motives and HOP with a specific motivation
to manage painful emotions and memories [23,26,27].
Interestingly, IMP has been shown to be associated with a
motivationally undefined pattern of substance use, whereby
all drinking and drug use situations (availability) appear to
motivate substance use in high-impulsive individuals [23,26].
These findings have stimulated an interest in understanding
the cognitive and motivational factors that distinguish individuals
with these personality traits from those without to inform the
development of new interventions. With respect to IMP, a very
large literature points to a specific deficit in response inhibition,
which has been linked to abnormal structural and functional brain
profiles that suggest a brain-related impairment in stopping be-
haviour [28,29]. This research also suggests that these deficits
are directly related to the tendency to drink and try substances in
early adolescence and to be more susceptible to more frequent
and excessive use following onset (compulsive use).
By contrast, SS has also been shown to be associated with a
unique neurocognitive profile that differs from IMP in that it is
necessarily dependent on a motivational state, particularly incen-
tive reward or reward anticipation. Sensation seekers, by defini-
tion, report being highly motivated by (or sensitive to) the pres-
ence or absence of incentive reward. Studies involving self-re-
port, cognitive and neuroimaging measures have shown individ-
uals high in SS to become particularly undercontrolled and reac-
tive when anticipating incentive reward [28,30]. However, under
conditions where behaviour is motivated by avoidance of pun-
ishment, for example, they show normal or superior performance
on tasks of cognitive and behavioural control [28,31]. Sensation
seekers also appear to be sensitive to incentive reward when it is
provided in a pharmacological form. Numerous studies report
that SS is associated with heightened reactivity, or sensitivity,
Curr Addict Rep (2016) 3:426–436 427
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to the pharmacological effects of alcohol and stimulants on indi-
ces of incentive reward, such as subjective high, cardiac acceler-
ation [32,33] and increased post-synaptic availability of dopa-
mine in the nucleus accumbens [34].
AS and HOP are associated with alcohol and prescription
depressant drug use and misuse (including sedatives and nar-
cotics) [22,23] through different motivational processes,
mainly negative reinforcement or removal of negative emo-
tional states. Both traits are associated with elevated risk for
internalising problems in adolescents and adults [31,35],
which are also characterised by a cognitive sensitivity to neg-
ative information [31]. AS might also be associated with a
more specific sensitivity to threat cues, particularly interocep-
tive cues [36], but studies investigating whether youth with
these pre-morbid risk factors are also characterised by atten-
tional biases to threat and negative information have yielded
inconsistent findings [37]. It has yet to be confirmed whether,
or not, cognitive or attentional biases are causally implicated
in risk for substance misuse in youth with high levels of AS or
HOP, but the evidence does demonstrate a direct link between
these traitsand risky motives for substance use, which directly
increase one’s risk for problem drinking (25–27;61).
Targeted Prevention for Youth Substance Misuse
Reviews of school-based drug prevention programmes con-
clude that the majority of such interventions are universal drug
awareness programmes that are either untested or that have
only mild positive or even harmful effects [38,39,40]. There
has been much more systematic research on effective preven-
tion of hazardous drinking in undergraduates [41,42]. Recent
reviews of the characteristics of effective school-based haz-
ardous drinking prevention programmes conclude that
targeting high-risk students and using interactive activities
are components essential to maximising efficacy [43,44]. A
set of recommendations from the National Institute on
Alcohol Abuse and Alcoholism [45] identified three types of
targeted programmes that are most effective (i.e. “Tier I″)in
prevention of hazardous drinking among undergraduates:
programmes employing a combination of cognitive–behav-
ioural skill training and motivational enhancement; those in-
volving brief motivational enhancement; and those challeng-
ing positive alcohol expectancies. Motivational enhancement
techniques also show promise in undergraduate drug use pre-
vention [46]. These identified characteristics are all compo-
nents that can be included in interventions that differentially
target personality risk profiles for substance misuse.
The Substance Use Risk Profile Scale: a Brief Personality
Risk Assessment Scale
The Substance Use Risk Profile Scale (SURPS) was devel-
oped to assess four personality traits relevant to substance
misuse risk: AS, HOP, IMP and SS. The 23-item SURPS
was developed and validated by Woicik, Stewart, Pihl and
Conrod [23] using factor analysis on a battery of personality
and symptom inventories that tap these four personality di-
mensions and is the only brief personality assessment tool that
provides relatively independent measurement of these four
personality traits. It is suitable for self-administration by ado-
lescents and adults [23], and the brevity of the scale is highly
advantageous in applied research contexts where large num-
bers of participants are screened simultaneously or complete
the scale as part of a larger assessment battery. It has also
proven useful in clinical settings where time limitations are
significant barriers to using psychometric tests. The SURPS
has been translated into French, German, Dutch, Czech,
Spanish, Japanese, Sri Lankan, Cantonese, Mandarin,
Hebrew and Turkish and has shown good internal consistency,
test–retest reliability and concurrent and predictive validity
with respect to identifying current and future substance misuse
among adolescents and young adults across many different
cultural and political contexts (e.g. [23,47–49]).
Importantly, the SURPS has also been shown to have incre-
mental validity over the NEO-FFI scales in predicting drink-
ing problems [23] and prospective validity in predicting sub-
stance use outcomes [23,30,50,51], as well as mental health
outcomes [30,37]. These studies also show that the SURPS
subscales are specifically predictive of different patterns of
psychopathology in theoretically relevant ways [28,30,31].
Personality-Targeted Interventions for the Prevention
of Alcohol and Illicit Drug Misuse: the Preventure
Programme
The Preventure Programme was designed to target known
personality risk factors for substance misuse based on the
evidence accumulated thus far on effective interventions for
youth alcohol and substance misuse [52]. Unlike universal
programmes that tend to universally promote generic coping
skills and balance normative attitudes around substance use,
this selected personality-targeted approach targets four
personality-specific motivational pathways to substance mis-
use: HOP, AS, IMP and SS.
After selection on personality scales (often using the
SURPS), high-risk individuals are invited to participate in brief
individual- or group-based intervention sessions that target their
dominant personality profile. Interventions are generally two-to-
sixsessionsinduration,with1weekseparating(each-remove)
session, each generally 90 min in duration. The interventions are
conducted using manuals that (remove which) incorporate psy-
cho-educational, motivational enhancement therapy (MET;
[53]) and cognitive–behavioural (CBT; [53]) components and
include real-life ‘scenarios’shared by local youth with similar
personality profiles. In the first session, participants are guided
in a goal setting exercise, designed to enhance motivation to
428 Curr Addict Rep (2016) 3:426–436
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change behaviour. Psycho-educational strategies are then used
to teach participants about the target personality variable and
associated problematic coping behaviours like avoidance, inter-
personal dependence, aggression, risky behaviours and sub-
stance misuse. They are then introduced to the CBT model
and guided in breaking down a personal experience according
to the physical, cognitive and behavioural components of an
emotional response. In the subsequent sessions, participants
are encouraged to identify and challenge personality-specific
cognitive distortions that lead to problematic behaviours.
The main difference between the personality-targeted ap-
proach and other brief intervention strategies (e.g. brief moti-
vational interviewing; [53]) is that each component is intro-
duced and discussed in personality-specific ways. For exam-
ple, the IMP intervention will discuss drug and alcohol expec-
tancies as they pertain to IMP, as well as promote the devel-
opment of cognitive behavioural skills that are most relevant
to cognitive control and response inhibition, whereas the AS
intervention will challenge expectancies related to the positive
nature of anxiolytic substances, while also helping high-risk
youth learn to challenge their catastrophic reactions to intero-
ceptive cues and reduce avoidance behaviours in response to
such cues. The cognitive–behavioural strategies that are used
in the personality-targeted approach are closely based on the
evidence-based strategies that would be used in CBT interven-
tions for major psychiatric disorders to which each of these
personality profiles is most relevant, for example, CBT for
depression in the case of HOP (e.g. [54]), CBT for panic
disorder in the case of AS (e.g. [55,56]) or CBT for ADHD
in the case of IMP (e.g. [57]).
The one intervention for which very little evidence-based
strategies were available at the time of developing the
Preventure Programme was the intervention targeting SS.
Our research has shown that one of the most important dis-
tinctions between SS and IMP is that SS does not appear to be
related to risk for the other forms of non-addictive psychopa-
thology. Therefore, sensation seekers tend not to be seen in
general psychology or psychiatry clinics: As a consequence,
other than interventions for substance use disorders, few CBT
intervention strategies have been developed to help sensation
seekers moderate the cognitive and behavioural tendencies
that contribute to their difficulties in life.
As outlined above, research on the cognitive and neural
characteristics of SS consistently indicates a sensitivity to re-
ward, whereby such individuals demonstrate more disinhibi-
tion from incentive reward but might also demonstrate abnor-
mal subcortical (e.g. limbic) activation patterns to reward that
would also leave an individual feeling less subjective reward
from conditions where rewardis less immediate or ambiguous
[58]. By contrast, high doses of substances appear to be more
stimulating for sensation seekers than for non-sensation
seekers. These findings have informed the focus of our SS
intervention, in which cognitive behavioural exercises are
used to help sensation seekers identify situations in which
their tendency to ‘chase the fun’leads to unwanted conse-
quences for them. Youth are guided in discussing how using
substances (used-remove) to cope with the need for stimula-
tion can be problematic. They are then assisted in exploring
substance-unrelated strategies for managing their need for
stimulation or their tendency to becomeundercontrolled under
highly incentive rewarding situations.
The programme does not focus on substance use but rather
on risky personality-based ways of coping that may lead to
substance misuse or other risky behaviour, such as aggressive
thinking, interpersonal dependence and avoidance. Therefore,
only one page of the 35-page treatment manual [59]directly
refers to substance use as a risky coping strategy, and an ad-
ditional couple of scenarios might describe substance use by
secondary characters mentioned in high-risk scenarios.
Delivery Format
When applied to the school setting, interventions are only two
90-min group sessions facilitated by a trained facilitator and
co-facilitator, with a minimum of 1 week between sessions
[60,61,62•,63•]. Youth with similar personality profiles are
grouped together to complete personality-specific interven-
tions targeting their most salient personality profile. In more
clinically oriented settings, such as psychiatry clinics or spe-
cial education institutions, where youth might suffer from
more severe learning difficulties or psychiatric comorbidity,
interventions can be broken down into multiple briefer inter-
vention sessions, which can be delivered in a group or indi-
vidual format, depending on the individual needs ofthe client.
In addition, a very novel treatment delivery approach [44,64]
recruited participants living with anxiety disorders from the
community and simply mailed treatment manuals to their
homes. Intervention sessions were conducted individually
with the assistance of a coach who is available to participants
by telephone or email.
Developmental and Cultural Adaptations
of Personality-Targeted Interventions
Programmes that are sensitive to the developmental needs,
cultural values and attitudes of a target group are more effec-
tive and reported by adolescents to be more relevant [65,66].
Therefore, for every new implementation of the Preventure
Programme, a preliminary process of developmental and cul-
tural adaptation of intervention materials is recommended.
First, it is recommended that the SURPS be translated, back-
translatedand then evaluated for internal consistency. It is also
recommended that the scale be administered to a representa-
tive sample of target participants in the new context to confirm
that personality factors are indeed related to substance use and
misuse in that context. For example, when adapting the
Curr Addict Rep (2016) 3:426–436 429
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programme for youth living in First Nations Communities in
Canada, it was not at all clear whether personality factors
played a similar role in their substance use, as had been pre-
viously demonstrated for youth attending mainstream schools
in Canada, as reported in [23]. This research showed that the
personality model was highly relevant to substance use in First
Nations youth [67]. Similar cultural adaptations of the scale
have been published in advance of programme adaptation
(e.g. [68,69]).
Additional validation procedures can include qualitative
interviews with high-risk youth identified using the SURPS,
such as described by Barrett et al. [70], and procedures that
include even more community engagement, such as described
by Mushquash et al. [71,72]. In both adaptations, a mixed-
method approach was used in which quantitative surveys such
as the Drinking Motives Questionnaire are used to confirm
different motivational profiles in high-risk youth and qualita-
tive surveys and interviews with high-risk youth are used to
collect detailed information on where drinking and drug use
situations occur in young people’s lives and other local inter-
ests and pastime activities for youth. Conducting structured
qualitative interviews with youth who reported substance use
and elevated personality risk is also recommended to help
identify local terms used to describe substance-related activi-
ties and the physical and emotional states relevant to each
personality dimension. For example, when adapting the
Preventure Programme to French Canadian youth, it became
evident that the term ‘Drinking to get high’did not have a
direct translation in French but rather translated to a more
ambiguous term, “Pour le ‘Feeling”’. While it was important
to maintain the local term for feeling intoxicated, it was also
important to add additional material to some of the scenarios
to allow for motivational differentiation across drinking situ-
ations (e.g. to distinguish drinking for anxiety management vs.
for enhancement motives). All this qualitative information is
then directly used to create relevant high-risk scenarios that
are included in manuals and which are read aloud during in-
tervention sessions to help young people better understand a
particular cognitive behavioural process or high-risk situation.
Another important step in some adaptations has been to
have local educational and/or psychological professionals re-
view intervention materials and provide detailed feedback on
the developmental appropriateness of the content for a partic-
ular age group or clinical population. This was particularly
relevant when adapting the Preventure Programme for youth
in London, UK and Montreal, in which the goal of the study
was to test the impact to the programme for younger cohorts
than in previous trials in order to demonstrate prevention of
substance use onset. The recent Montreal and Australian ad-
aptations [51] were also reviewed by experienced editors of
children’s literature to be sure that the intervention material,
particularly the scenarios, is written in a way that is engaging
for readers of that age.
Finally, it is also recommended that new adaptations are
first piloted with high-risk youth, who are then asked about
their experiences with the intervention. According to one
qualitative evaluation of adolescents’reactions to interven-
tions, they report that, for them, the most important compo-
nents of the intervention are learning cognitive–behavioural
strategies and that such skill development during personality-
targeted interventions was key to positive behavioural change
[73•]. Importantly, youth-generated information regarding
their intervention experiences independently accounted for
12–25 % of the variance in change in alcohol use and mental
health symptoms over 12 months. By contrast, very little var-
iance in substance use outcomes could be predicted using
investigator-selected quantitative measures of cognitive–be-
havioural processes, suggesting that mixed-method ap-
proaches, particularly those that allow for youth perspectives
to be communicated, are extremely important in the adapta-
tion process.
Training Educational and Health Professionals to Deliver
Personality-Targeted Interventions
In a study of effectiveness of the Preventure Programme under
real-world conditions, O’Leary-Barrett and her colleagues
[74] described a procedure by which educational professionals
were trained to implement the programme through a struc-
tured training protocol involving a 3-day workshop and two
supervised practical sessions in which trainees delivered a
two-session intervention to high-risk youth. Preventure
trainers offered supervision and standardised feedback using
a scale that was developed to evaluate adherence to 12 core
treatment components of the personality-targeted intervention
programme, such as goal setting and identifying and challeng-
ing automatic thoughts [73•]. The Cognitive Therapy Scale—
Revised [75] and the Motivational Interviewing Treatment
Integrity 3.0 [76] were also used to provide trainees with feed-
back on the quality of their therapy-specific skills. In this trial
and subsequent trials, each trial facilitator must reach suffi-
cient levels of programme delivery before running
personality-targeted interventions with trial participants. This
procedure is now used rather systematically to disseminate the
programme to different communities around the world and
has proven to be effective, not only in transferring skills to
new clinical teams [74], but also leading to behavioural chang-
es in young people [77], particularly if treatment fidelity is
measured during programme implementation [51].
A Review of the Evidence on Personality-Targeted
Interventions for Substance Misuse
Whether it involves the delivery of the full Preventure
Programme or personality-specific interventions, the
personality-targeted approach has now been evaluated in eight
430 Curr Addict Rep (2016) 3:426–436
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randomised trials, with two additional trials in progress.
Published trials are summarised in Table 1and include
standardised effect size estimates for primary outcomes: alco-
hol use, binge drinking, problem drinking and illicit or pre-
scription drug use. Where possible, results of quantity and
frequency outcomes are also included. While this does not
include a systematic review and formal meta-analysis, the
trials summarised in this table include all published trials of
personality-targeted interventions to date. These trials typical-
ly target individuals who are considered at high risk of
misusing substances prior to the onset, use or problem use of
substances. Therefore, many of the trials are conducted with
Tabl e 1 Summary of eight randomized trials of personality-targeted interventions for substance misuse and standardized effect sizes (Cohen’sd
equivalent)
Trial Personality traits
targeted
Population targeted Behavioural outcomes targeted Effect sizes all reported
as Cohen’sd
1. Montreal Prescription
Drug and Alcohol
Dependence Trial
[22]
IMP/SS, AS, HOP Alcohol and/or prescription
drug- dependent women
Int: n=78
Ctr: n=45
Alcohol use
Alcohol QF
Dependence symptoms
Remission
prescription drug use
0.47 (0.10 to 0.84)*
0.02 (−0.35 to 0.39)
0.47 (0.10 to 0.84)*
0.46 (0.10 to 0.83)*
0.58 (0.03 to 1.13)*
2. Canadian Preventure
Trial [60]
AS, SS, HOP HR secondary students
(drinkers)
Int: N=166
Ctr: n=131
Alcohol use (4 months)
Binge drinking (4 months)
Drinking problems (4 months)
0.20 (−0.02 to 0.43)
0.37 (0.14 to 0.60)*
0.32 (0.09 to 0.55)*
3. College AS Trial
a
[78]
AS College students
Int: n=51
Ctr: n=56
Drinking frequency
Binge drinking
Drinking problems
00 (ns)
Not reported
0.37 (−0.02 to 0.75)
4. UK Preventure Trial
b
[61,62•,81]
AS, IMP, HOP, SS HR secondary students
Int: n=190
Ctr: n=157
Alcohol use (6 months)
Binge drinking (6 months)
Drinking problems (6 months)
Drinking problems (2 years)
Drug use frequency (2 years)
Cannabis use (2 years)
Cocaine use (2 years)
0.22 (0.00 to 0.43)*
0.21 (0.00 to 0.42)*
0.35 (0.00 to 0.42)*
0.33 (0.12 to 0.54)*
0.25 (0.10 to 0.40)*
0.16 (0.04 to 0.34)*
d
0.80 (0.94 to 1.17)*
d
5. Dutch Preventure
c
Trial [77]
AS, IMP, HOP, SS HR secondary students
(drinkers)
Int: n=343
Ctr: n=356
Alcohol use (12 months)
Binge drinking (12 months)
Drinking problems (12 months)
0.02
0.33 (0.17 to 0.47)*
00 (ns)
6. Adventure Trial
c
[24,
63•]
AS, IMP, HOP, SS HR secondary students
Int: n=558
Ctr: n=437
Alcohol use (2 years)
Drinking Q (2 years)
Binge drinking (2 years)
Binge drinking-freq (2 years)
Binge drinking-growth (2 years)
Drinking problems (2 years)
Cannabis use (2 years)
0.68 (0.55 to 0.81)*
0.36 (0.23 to 0.49)*
0.88 (0.75 to 1.0)*
0.38 (0.25 to 0.50)*
2.07 (1.91 to 2.22)*
1.02 (0.88 to 1.16)*
0.06 (−0.06 to 0.18)
d
7. Australian CAP
c
Study [51]
AS, IMP, HOP, SS HR secondary students
Int: n=202
Ctr: n=291
Alcohol use (3 years)
Binge drinking (3 years)
Drinking problems (3 years)
0.47 (0.29 to 0.65)*
0.65 (0.46 to 0.84)*
0.54 (0.35 to 0.72)*
8. CBT for High AS
[64]
AS Community-recruited
adults
Alcohol use
Binge drinking
Drinking problems (phys)
Drinking problems (interper)
Not reported
Not reported
0.64
0.48
All effect sizes are presented as dand calculated from standardized betas or from means and standard deviations as presented in published manuscripts.
All effect sizes (d) were calculated using the procedure and effect size calculator described by Wilson (Practical Meta-Analysis Effect Size Calculator,
David B. Wilson, Ph.D., George Mason University; http://www.campbellcollaboration.org/escalc/html/EffectSizeCalculator-SMD16.php)
IMP impulsivity, SS sensation seeking, AS anxiety sensitivity, HOP hopelessness, Int intervention, Ctr control, QF quantity and frequency, Qquantity,
CAP Climate Schools and Preventure, CBT cognitive behavioural therapy, Phys physical, interper interpersonal
a
Calculated based p= 0.06, as no other information was available, using the effect size calculator above
b
Effect size (d) calculated on the basis of reported means and standard deviations
c
Effect size (d) calculated on the basis of reported beta and standard error from latent growth models
d
We report effect sizes for analyses in which those lost to follow-up are assigned substance use as these are the only results reported in Conrod’sstudy
[62•] and allow for better comparisons across studies
Curr Addict Rep (2016) 3:426–436 431
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secondary school students who have been invited to partici-
pate in interventions because they scored one standard devia-
tion above the mean on one of the SURPS measures. Some
such trials also specified drinking onset as an additional eligi-
bility criterion (e.g. [60,77]). Two trials differ in that they
target adults recruited from the community living with mental
health problems, such as substance dependence [22]oranxi-
ety disorders [44]. The school-based studies delivered inter-
ventions in group format, while the adult studies delivered
interventions in an individual format. Finally, studies also vary
in terms of duration of follow-up from 4 months to 3 years.
What is striking about these results is the rather consistent
moderate effects reported on most outcomes. For every study,
Table 1systematically reports on alcohol outcomes such as
drinking (use or frequency), binge drinking (use or frequency)
and alcohol problems (presence or severity). The average ef-
fect size across all studies and all outcomes is d=0.47.Fora
small number of studies, one or two of these outcomes are not
reported. Assuming that they are not reported because they did
not yield significant effects, we assign a d= 0 to missing effect
sizes and still yield an average effect size of d=0.43acrossall
studies and measures (0.26 for alcohol use; 0.35 for binge
drinking (including two unreported studies) and 0.46 for prob-
lem drinking). Three studies report illicit drug use outcomes,
and the average of these reported outcomes is a d=0.37.
Results across studies need to be interpreted in the context
of possible limitations to generalizability. All studies relied on
self-report to assess substance use outcomes, which might be
susceptible to bias. However, all studies carefully describe a
procedure for assuring confidentiality to participants and no
consequences for reporting substance use. Some studies con-
trolled for cluster-level effects (e.g. school), but not all. Only
two studies included an active control intervention as a com-
parison group [22,78]. None of these studies were able to
mask intervention condition to participants or therapists but
most described a procedure in which assessment of outcomes
was conducted by experimenters blind to treatment condition.
Despite these methodological differences across studies,
results indicate a consistent, moderate effect of brief,
personality-targeted cognitive behavioural interventions on a
number of substance use outcomes. They also indicate that the
personality-targeted approach can be delivered in a variety of
different settings and formats. There is also an emerging liter-
ature (not included in Table 1) showing that personality-
targeted interventions also impact on mental health outcomes.
Studies 3, 4, 5, 6 and 8 in Table 1also report mental health
outcomes in the following secondary analyses [44,74,
78–80], and while there is some variability in results reported
and measures used, significant effects are reported on depres-
sion, anxiety and conduct symptoms in four of five studies.
Some additional secondary analyses report differential out-
comes for personality subgroups or higher-risk individuals.
Specifically, some researchers [24,60,61,77,81] report
outcomes for specific personality risk groups, and findings
are remarkably consistent across studies. SS youth appear at
greater risk for early-onset drinking, binge drinking and can-
nabis use, and the intervention is particularly effective in
delaying such use for these higher-risk youth; large effect sizes
are reported. By contrast, the AS intervention was shown to be
particularly effective in promoting abstinence from alcohol
and alcohol-related problems, with AS-focused trials showing
that alcohol outcomes are mediated by the effect of the AS on
self-medication motives for drinking [44,64].
Conclusion
The personality-targeted approach has many advantages over
more traditional CBT intervention approaches. First, in line
with a more dimensional approach to understanding risk for
psychopathology, interventions can be delivered following
brief personality assessment, and their delivery is rarely de-
layed for the purpose of diagnostic clarity, which is often the
case in clinical practice. Furthermore, because they target
traits that are associated with risk for substance use, they can
be helpful in the context of prevention but also appear to be
equally helpful when targeting substance use problems that
have already had their onset. Finally, the traits targeted in the
personality-based approach are also relevant to non-addictive
psychopathology and therefore have potential to be dually
effective in reducing substance use and mental health con-
cerns among individuals with concurrent disorders. Indeed,
emerging results are showing that the personality-targeted ap-
proach holds promise for concurrent disorders [44,64,82].
Nevertheless, the research on personality-targeted interven-
tions remains rather limited, relative to the potential applica-
tions of the approach. Despite studies showing that the SURPS
personality dimensions are relevant to substance use in patients
receiving treatment in general psychiatry, substance use or fo-
rensic settings [26,32,68,83], personality-targeted interven-
tions have yet to be tested in clinical settings with substance-
dependent adults reporting concurrent mental health problems
or with incarcerated individuals at risk of returning to substance
use upon release from prison or following sentencing (e.g. for
driving under the influence). Similarly, the SURPS dimensions
have been shown to be highly relevant to smoking behaviour
[30,84], yet none of the published trials on personality-targeted
interventions report smoking outcomes. The SURPS dimen-
sions have also been shown to be implicated in other health
behaviours, such as eating, drug injecting, sexual behaviours
and risky driving (e.g. [85]), which suggests that the potential
benefits of the personality-targeted approach are far reaching
and might eventually provide solutions to a number of health
problems facing society. Finally, the personality-targeted ap-
proach has been applied to the school setting for the purpose
of preventing substance use in high-risk youth, but there are a
number of other contexts that might prove to be opportunities
432 Curr Addict Rep (2016) 3:426–436
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
for targeted prevention. For example, young people enlisted in
the military, which has a long history of personality testing,
might benefit from personality-targeted interventions prior to
being exposed to service-related stressors known to increase
risk for mental health problems and addiction. Similarly, preg-
nant women with a history of substance use or mental health
concerns might also benefit from a prevention programme that
focuses on their personality and coping strategies, rather than
focusing directly on perinatal substance use, which remains a
major taboo for pregnant women but continues to affect a sig-
nificant number of newborns globally. The personality-targeted
approach has a number of advantages over traditional sub-
stance use interventions because it does not necessarily refer
to substance use and might therefore be less stigmatizing or
threatening for such populations.
In conclusion, personality-targeted interventions for sub-
stance misuse have been applied and evaluated in a number
of different contexts. A number of randomised trials indicate
efficacy and effectiveness of a personality-targeted approach
when applied to the school (secondary and undergraduate) and
community context. Studies suggest, on average, moderate
effect sizes on alcohol and illicit substance use outcomes, up
to 3 years post-intervention. Studies also indicate promising
results for non-addictive, mental health outcomes. More re-
search is needed to understand the active ingredients of the
personality-targeted approach, the most optimal delivery con-
ditions and its potential to address other health behaviours.
Acknowledgments Research Grant from the Canadian Institutes of
Health Research, MOP 114887 and a Senior Research Fellowship from
Fondation de Recherche du Quebec en Sante (FRQ-S), Chercheur
Boursier, Senior.
Compliance with Ethical Standards
Conflict of Interest Dr. Patricia J. Conrod declares that she has no
conflict of interest.
Human and Animal Rights and Informed Consent This article does
not contain any studies with human or animal subjects performed by any
of the authors.
References
Papers of particular interest, published recently, have been
highlighted as:
•Of importance
1. Health Canada. Canadian Alcohol and Drug Use Monitoring
Survey (CADUMS). 2011.
2. First do no harm: responding to Canada’s prescription drug crisis.
Ottawa, Canada: Canadian Centre on Substance Abuse. Retrieved
from http://www.ccsa.ca/resource%20library/canadastrategy-
prescription-drug-misuse-report-en.pdf, 2013.
3. Substance Abuse and Mental Health Services Administration
(SAMHSA). Results from the 2014 National Survey on Drug Use
and Health: Summary of National Findings. Rockville, MD: 2015.
4.•Conrod PJ, Nikolaou K. Annual research review: on the develop-
mental neuropsychology of substance use disorders. J Child
Psychol Psychiatry. 2016;57:371–94. This article provides a re-
view of the literature linking personality and cognitive factors
to risk for substance misuse and recommends a comprehensive
intervention strategy for managing risk among high risk indi-
vidual from a developmental perspective.
5.•Castellanos-Ryan N, O’Leary-Barrett M, Sully L, Conrod P.
Sensitivity and specificity of a brief personality screening instru-
ment in predicting future substance use, emotional, and behavioral
problems: 18-month predictive validity of the substance use risk
profile scale. Alcohol Clin Exp Res. 2013;37:E281–E90. This ar-
ticle is important because it rigorously tests the sensitivity of the
SURPS measure in detecting future substance misuse and men-
tal health symptoms and provides norms and practical recom-
mendations for selecting high risk youth for selective
personality-targeted interventions.
6. World Health Organization. Global status report on alcohol and
health. Geneva: Author; 2011.
7. The 2004 Canadian campus survey. Toronto, Canada: Centre for
Addiction and Mental Health, 2005.
8. Mushquash AR, Stewart SH, Sherry SB, Mackinnon SP, Antony
MM, Sherry DL. Heavy episodic drinking among dating partners: a
longitudinal actor–partner interdependence model. Psychol Addict
Behav. 2013;27:178.
9. Wechsler H, Lee JE, Kuo M, Seibring M, Nelson TF, Lee H. Trends
in college binge drinking during a period of increased prevention
efforts: findings from 4 Harvard School of Public Health College
alcohol study surveys: 1993–2001. J Am Coll Heal. 2002;50:203–
17.
10. Lancet T. Calling time on young people’s alcohol consumption. The
Lancet. 2008;371:871.
11. McAllister I, editor. Alcohol consumption among adolescents and
young adults. Melbourne: Distilled Spirits Industries Council of
Australia; 2003.
12. Hingson R, White A. New research findings since the 2007 surgeon
general’s call to action to prevent and reduce underage drinking: a
review. Journal of studies on alcohol and drugs. 2014;75:158–69.
13. Room R, Babor T, Rehm J. Alcohol and public health. Lancet.
2005;365:519–30.
14. Thombs DL, Olds RS, Bondy SJ, Winchell J, Baliunas D, Rehm J.
Undergraduate drinking and academic performance: a prospective
investigation with objective measures. Journalof studies on alcohol
and drugs. 2009;70:776–85.
15. Vergés A, Littlefield AK, Sher KJ. Did lifetime rates ofalcohol use
disorders increase by 67 % in 10 years? A comparison of NLAES
and NESARC Journal of abnormal psychology. 2011;120:868.
16. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. Audit.
The Alcohol Use Disorders Identification Test (AUDIT): guidelines
for use in primary care. 2001.
17. McCabe SE, West BT, Morales M, Cranford JA, Boyd CJ. Does
early onset of non-medical use of prescription drugs predict subse-
quent prescription drug abuse and dependence? Results from a na-
tional study. Addiction. 2007;102:1920–30.
18. Muhuri PK, Gfroerer JC, Davies MC. Associations of nonmedical
pain reliever use and initiation of heroin use in the United States.
CBHSQ Data Review. 2013;17.
19. Wide-ranging online data for epidemiologic research (WONDER).
Atlanta: National Center for Health Statistics, 2016.
Curr Addict Rep (2016) 3:426–436 433
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
20. McLarnon ME, Barrett SP, Monaghan TL, Stewart SH. Prescription
drug misuse across the lifespan: a developmental perspective. Drug
Abuse Addict Med Illn. 2012:213–30.
21. Barrett SP, Darredeau C, Pihl RO. Patterns of simultaneous
polysubstance use in drug using university students. Hum
Psychopharmacol Clin Exp. 2006;21:255–63.
22. Conrod PJ, Pihl RO, Stewart SH, Dongier M. Validation of a sys-
tem of classifying female substance abusers on the basis of person-
ality and motivational risk factors for substance abuse. Psychol
Addict Behav. 2000;14:243.
23. Woicik PA, Stewart SH, Pihl RO, Conrod PJ. The substance use
risk profile scale: a scale measuring traits linked to reinforcement-
specific substance use profiles. Addict Behav. 2009;34:1042–55.
24. Mahu IT, Doucet C, O’Leary-Barrett M, Conrod PJ. Can cannabis
use be prevented by targeting personality risk in schools? Twenty-
four-month outcome of the adventure trial on cannabis use: a
cluster-randomized controlled trial. Addiction. 2015;110:1625–33.
25. Stewart SH, Karp J, Pihl RO, Peterson RA. Anxiety sensitivity and
self-reported reasons for drug use. J Subst Abus. 1997;9:223–40.
26. Hecimovic K, Barrett SP, Darredeau C, Stewart SH. Cannabis use
motives and personality risk factors. Addict Behav. 2014;39:729–
32.
27. Comeau N, Stewart SH, Loba P. The relations of trait anxiety, anx-
iety sensitivity, and sensation seeking to adolescents’motivations
for alcohol, cigarette, and marijuana use. Addict Behav. 2001;26:
803–25.
28. Castellanos-Ryan N, Struve M, Whelan R, Banaschewski T, Barker
GJ, Bokde AL, Bromberg U, Buchel C, Flor H, Fauth-Buhler M,
Frouin V, Gallinat J, Gowland P, Heinz A, Lawrence C, Martinot
JL, Nees F, Paus T, Pausova Z, Rietschel M, Robbins TW, Smolka
MN, Schumann G, Garavan H, Conrod PJ, Consortium I. Neural
and cognitive correlatesof the common and specific variance across
externalizing problems in young adolescence. Am J Psychiatry.
2014;171:1310–9.
29. Whelan R, Conrod PJ, Poline JB, Lourdusamy A, Banaschewski T,
Barker GJ, Bellgrove MA, Buchel C, Byrne M, Cummins TD,
Fauth-Buhler M, Flor H, Gallinat J, Heinz A, Ittermann B, Mann
K, Martinot JL, Lalor EC, Lathrop M, Loth E, Nees F, Paus T,
Rietschel M, Smolka MN, Spanagel R, Stephens DN, Struve M,
Thyreau B, Vollstaedt-Klein S, Robbins TW, Schumann G,
Garavan H, Consortium I. Adolescent impulsivity phenotypes char-
acterized bydistinct brain networks. Nat Neurosci. 2012;15:920–5.
30. Castellanos-Ryan N, Rubia K, Conrod PJ. Response inhibition and
reward response bias mediate the predictive relationships between
impulsivity and sensation seeking and common and unique vari-
ance in conduct disorder and substance misuse. Alcohol Clin Exp
Res. 2011;35:140–55.
31. Castellanos-Ryan N, Brière FN, O’Leary-Barrett M, Banaschewski
T,BokdeA,BrombergU,BüchelC,FlorH,FrouinV,GallinatJ,
Garavan H, Martinot JL, Nees F, Paus T, Pausova Z, Rietschel M,
Smolka MN, Robbins TW, Whelan R, Schumann G, Conrod PJ,
Consortium aTI. The structure of psychopathology in adolescence
and its common personality and cognitive correlates. J Abnorm
Psychol, in press. 2016.
32. Brunelle C, Assaad JM, Barrett SP, Ávila C, Conrod PJ, Tremblay
RE, Pihl RO. Heightened heart rate response to alcohol intoxication
is associated with a reward-seeking personality profile. Alcohol
Clin Exp Res. 2004;28:394–401.
33. Conrod PJ, Pihl RO, Vassileva J. Differential sensitivity to alcohol
reinforcement in groups of men at risk for distinct alcoholism sub-
types. Alcohol Clin Exp Res. 1998;22:585–97.
34. Leyton M, Boileau I, Benkelfat C, Diksic M, Baker G, Dagher A.
Amphetamine-induced increases in extracellular dopamine, drug
wanting, and novelty seeking: a PET/[11C] raclopride study in
healthy men. Neuropsychopharmacology. 2002;27:1027–35.
35. Allan NP, Felton JW, Lejuez CW, MacPherson L, Schmidt NB.
Longitudinal investigation of anxiety sensitivity growth trajectories
and relations with anxiety and depression symptoms in adoles-
cence. Dev Psychopathol. 2016;28:459–69.
36. Domschke K, Stevens S, Pfleiderer B, Gerlach AL. Interoceptive sen-
sitivity in anxiety and anxiety disorders: an overview and integration of
neurobiological findings. Clin Psychol Rev. 2010;30:1–11.
37. O’Leary-Barrett M, Pihl RO, Artiges E, Banaschewski T, Bokde
AL, Buchel C,Flor H, Frouin V, Garavan H, Heinz A, Ittermann B,
Mann K, Paillere-Martinot ML, Nees F, Paus T, Pausova Z, Poustka
L, Rietschel M, Robbins TW, Smolka MN, Strohle A, Schumann
G, Conrod PJ, Consortium I. Personality, attentional biases towards
emotional faces and symptoms of mental disorders in an adolescent
sample. PLoS One. 2015;10:e0128271.
38. Werch CE, Pappas DM, Castellon-Vogel EA. Drug use prevention
efforts at colleges and universities in the United States. Subst Use
Misuse. 1996;31:65–80.
39. Licciardone JC. Outcomes of a federally funded program for alco-
hol and other drug prevention in higher education. Am J Drug
Alcohol Abuse. 2003;29:803–27.
40. Larimer ME, Kilmer JR, Lee CM. College student drug prevention:
a review of individually-oriented prevention strategies. J Drug
Issues. 2005;35:431–56.
41. Stewart S, Conrod P, Latvala A, Wiers R, White H. Prevention of
alcohol use and misuse in youth: a comparison of North American
and European approaches. Underage drinking: a report on drinking in
the second decade of life in Europe and North America. 2013:147–209.
42. Larimer ME, Cronce JM. Identification, prevention and treatment: a
review of individual-focused strategies to reduce problematic alco-
hol consumption by college students. J Stud Alcohol Suppl. 2002:
148–63.
43. Newton NC, Teesson M, Barrett EL, Slade T, Conrod PJ. The CAP
study, evaluation of integrated universal and selective prevention
strategies for youth alcohol misuse: study protocol of a cluster ran-
domized controlled trial. BMC Psychiatry. 2012;12:118.
44. Olthuis JV, Watt MC, Mackinnon SP, Stewart SH. Telephone-
delivered cognitive behavioral therapy for high anxiety sensitivity:
a randomized controlled trial. J Consult Clin Psychol. 2014;82:
1005–22.
45. National Institute on Alcohol Abuse and Alcoholism. A call to
action: changing the culture of drinking at US colleges. 2002.
46. McCambridge J, Strang J. The efficacy of single-session motiva-
tional interviewing in reducing drug consumption and perceptions
of drug-related risk and harm among young people: results from a
multi-site cluster randomized trial. Addiction. 2004;99:39–52.
47. Jurk S, Kuitunen-Paul S, Kroemer NB, Artiges E, Banaschewski T,
Bokde AL, Buchel C, Conrod P, Fauth-Buhler M, Flor H, Frouin V,
Gallinat J, Garavan H, Heinz A, Mann KF, Nees F, Paus T, Pausova
Z, Poustka L, Rietschel M, Schumann G, Struve M, Smolka MN.
Consortium I. Personality and substance use: psychometric evalu-
ation and validation of the Substance Use Risk Profile Scale
(SURPS) in English, Irish, French, and German adolescents.
Alcohol Clin Exp Res. 2015;39:2234–48.
48. Robles-Garcia R, Fresan A, Castellanos-Ryan N, Conrod P, Gomez
D, de Quevedo YDME, Rafful C, Real T, Vasquez L, Medina-Mora
ME. Spanish version of the Substance Use Risk Profile Scale: factor
structure, reliability, and validity in Mexican adolescents.
Psychiatry Res. 2014;220:1113–7.
49. Omiya S, Kobori O, Tomoto A, Igarashi Y, Iyo M. Substance use
risk personality trait for adolescents. Nihon Arukoru Yakubutsu
Igakkai zasshi- Japanese Journal of Alcohol Studies & Drug
Dependence. 2012;47:287–97.
50. Krank M, Stewart SH, O’Connor R, Woicik PB, Wall AM, Conrod
PJ. Structural, concurrent, and predictive validity of the Substance
Use Risk Profile Scale in early adolescence. Addict Behav.
2011;36:37–46.
434 Curr Addict Rep (2016) 3:426–436
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
51. Newton NC, Conrod PJ, Slade T, Carragher N, Champion KE,
Barrett EL, Kelly EV, Nair NK, Stapinski L, Teesson M. The
long-term effectiveness of a selective, personality-targeted preven-
tion program in reducing alcohol use and related harms: a cluster
randomized controlled trial. J Child Psychol Psychiatry. 2016;57:
1056–65.
52. Newton NC, O’Leary-Barrett M, Conrod PJ. Adolescent substance
misuse: neurobiology and evidence-based interventions. Curr Top
Behav Neurosci. 2013;13:685–708.
53. Carroll KM, Connors GJ, Cooney NL, DiClemente CC, Donovan
DM, Kadden RR, Longabaugh RL, Rounsaville BJ, Wirtz PW,
Zweben A. Internal validity of Project MATCH treatments: discrim-
inability and integrity. J Consult Clin Psychol. 1998;66:290.
54. Beck AT, Young JE. Depression. In: Barlow DH, editor. The clin-
ical handbook of psychological disorders. New York: Guilford
Press; 1985.
55. Barlow DH. Clinical handbook of psychological disorders: a step-
by-step treatment manual. New York: Guilford; 1985.
56. Barlow DH, Craske M. Mastery of your anxiety and panic. Albany:
Graywind; 1988.
57. Kendall P, Braswell L. Cognitive-behavioral therapy for impulsive
children. New York: Guilford Press; 1985.
58. Schneider S, Peters J, Bromberg U, Brassen S, Miedl SF,
Banaschewski T, Barker GJ, Conrod P, Flor H, Garavan H, Heinz
A, Ittermann B, Lathrop M, Loth E, Mann K, Martinot JL, Nees F,
Paus T, Rietschel M, Robbins TW, Smolka MN, Spanagel R,
Strohle A, Struve M, Schumann G, Buchel C, Consortium I. Risk
taking and the adolescent reward system: a potential common link
to substance abuse. Am J Psychiatry. 2012;169:39–46.
59. Conrod P, Stewart S. Preventure: learning to deal with sensation
seeking. Montreal, Canada. 2012.
60. Conrod P, Stewart S, Comeau M, Maclean M. Preventative efficacy
of cognitive behavioral strategies matched to the motivational bases
of alcohol misuse in at-risk youth. Alcohol Clin Exp Res. 2004.
61. Conrod PJ, Castellanos-Ryan N, Mackie C. Long-term effects of a
personality-targeted intervention to reduce alcohol use in adoles-
cents. J Consult Clin Psychol. 2011;79:296.
62.•Conrod PJ, Castellanos-Ryan N, Strang J. Brief, personality-
targeted coping skills interventions and survival as a non–drug user
over a 2-year period during adolescence. Arch Gen Psychiatry.
2010;67:85–93. This article demonstrates the efficacy of
personality-targeted interventions in preventing uptake of illicit
substance misuse in youth at risk.
63.•Conrod PJ, O’Leary-Barrett M, Newton N, Topper L, Castellanos-
Ryan N, Mackie C, Girard A. Effectiveness of a selective,
personality-targeted prevention program for adolescent alcohol
use and misuse: a cluster randomized controlled trial. JAMA psy-
chiatry. 2013;70:334–42. This article provides a rigorous test of
the effectiveness of personality-targeted interventions for alco-
hol misuse under real-world conditions, in which school
teachers across a variety of boroughs in London, United
Kingdom, were trained to deliver the Preventure Programme
to high risk high school students.
64. Olthuis JV, Watt MC, Mackinnon SP, Stewart SH. CBT for high
anxiety sensitivity: alcohol outcomes. Addict Behav. 2015;46:19–
24.
65. Comeau M, Stewart S, Mushquash C, Wojcik D, Bartlett C,
Marshall M, Young J, Stevens D. Community collaboration in de-
veloping a culturally relevant alcohol abuse early intervention pro-
gram for First Nation youth. Ontario Association of Children’sAid
Societies Journal. 2005;49:39–46.
66. Midford R, Munro G, McBride N, SnowP, Ladzinski U. Principles
that underpin effective school-based drug education. J Drug Educ.
2002;32:363–86.
67. Mushquash CJ, Stewart SH, Mushquash AR, Comeau MN,
McGrath PJ. Personality traits and drinking motives predict alcohol
misuse among Canadian aboriginal youth. Int J Ment Heal Addict.
2014;12:270–82.
68. Castonguay-Jolin L, Perrier-Menard E, Castellanos-Ryan N, Parent
S, Vitaro F, Tremblay RE, Garel P, Seguin JR, Conrod PJ. [SURPS
French version validation in a Quebec adolescent population]. Can
J Psychiatr. 2013;58:538–45.
69. Newton NC, Conrod PJ, Rodriguez DM, Teesson M. A pilot study
of an online universal school-based intervention to prevent alcohol
and cannabis use in the UK. BMJ Open. 2014;4:e004750.
70. Barrett EL, Newton NC, Teesson M, Slade T, Conrod PJ. Adapting
the personality-targeted Preventure program to prevent substance
use and associated harms among high-risk Australian adolescents.
Early Interv Psychiatry. 2015;9:308–15.
71. Mushquash CJ, Comeau MN, McLeod BD, Stewart SH. A four-
stage method for developing early interventions for alcohol among
aboriginal adolescents. Int J Ment Heal Addict. 2010;8:296–309.
72. Mushquash CJ, Comeau N, Stewart SH. An alcohol abuse early
intervention approach with Mi’kmaq adolescents. First Peoples
Child & Family Review. 2007;3:17–26.
73.•O’Leary-Barrett M, Castellanos-Ryan N, Pihl RO, Conrod PJ.
Mechanisms of personality-targeted intervention effects on adoles-
cent alcohol misuse, internalizing and externalizing symptoms.
Presented at the 67th Annual Meeting of the American
Academy of Child and Adolescent Psychiatry, New York, NY,
October 26-30, 2016.This article reports mental health out-
comes following delivery of personality-targeted interventions
to high risk adolescents in the school context and shows signif-
icant preventative effects on depression, anxiety and conduct
disorder symptoms.
74. O’Leary-Barrett M, Mackie CJ, Castellanos-Ryan N, Al-Khudhairy
N, Conrod PJ. Personality-targeted interventions delay uptake of
drinking and decrease risk of alcohol-related problems when deliv-
ered by teachers. Journal of the American Academy of Child &
Adolescent Psychiatry. 2010;49:954–63. e1.
75. Blackburn I-M, James IA, Milne DL, Reichelt FK, Garland A,
Baker C, Standart S, Claydon A. Cognitive therapy scale—revised
(CTS-R). Newcastle-upon-Tyne: Newcastle Cognitive and
Behavioural Therapies Centre; 2001.
76. Moyers T, Martin T, Manuel J, Miller W, Ernst D. Revised global
scales: Motivational Interviewing Treatment Integrity 3.1. 1 (MITI
3.1. 1). Unpublished manuscript, University of New Mexico,
Albuquerque, NM. 2010.
77. Lammers J, Goossens F, Conrod P, Engels R, Wiers RW, Kleinjan
M. Effectiveness of a selective intervention program targeting per-
sonality risk factors for alcohol misuse among young adolescents:
results of a cluster randomized controlled trial. Addiction.
2015;110:1101–9.
78. Watt M, Stewart S, Birch C,Bernier D. Brief CBT for high anxiety
sensitivity decreases drinking problems, relief alcohol outcome ex-
pectancies, and conformity drinking motives: evidence from a ran-
domized controlled trial. J Ment Health. 2006;15:683–95.
79. Castellanos C, Conrod P. Efficacy of brief personality-targeted cog-
nitive behavioural interventions in reducing and preventing adoles-
cent emotional and behavioural problems. J Ment Health. 2006.
80. Goossens FX, Lammers J, Onrust S, Conrod P, de Castro BO,
Monshouwer K. Effectiveness of a brief school-based intervention
on depression, anxiety, hyperactivity, and delinquency: a cluster
randomized controlled trial. European child & adolescent psychia-
try. 2016;25:639–48.
81. Conrod PJ, Castellanos N, Mackie C. Personality-targeted interven-
tions delay the growth of adolescent drinking and binge drinking. J
Child Psychol Psychiatry. 2008;49:181–90.
82. O’Leary-Barrett M, Topper L, Al-Khudhairy N, Pihl RO,
Castellanos-Ryan N, Mackie CJ, Conrod PJ. Two-year impact of
personality-targeted, teacher-delivered interventions on youth in-
ternalizing and externalizing problems: a cluster-randomized trial.
Curr Addict Rep (2016) 3:426–436 435
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Journal of the American Academy of Child & Adolescent
Psychiatry. 2013;52:911–20.
83. Schlauch RC, Crane CA, Houston RJ, Molnar DS, Schlienz NJ,
Lang AR. Psychometric Evaluation of the Substance Use Risk
Profile Scale (SURPS) in an inpatient sample of substance users
using cue-reactivity methodology. J Psychopathol Behav Assess.
2015;37:231–46.
84. Memetovic J, Ratner PA, Gotay C, Richardson CG. Examining the
relationship between personality and affect-related attributes and
adolescents’intentions to try smoking using the Substance Use
Risk Profile Scale. Addict Behav. 2016;56:36–40.
85. Kazemi DM, Levine MJ, Dmochowski J, Van Horn KR, Qi L.
Health behaviors of mandated and voluntary students in a motiva-
tional intervention program. Preventive medicine reports. 2015;2:
423–8.
436 Curr Addict Rep (2016) 3:426–436
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