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Poelen EA, Schijven EP, Otten R. The mediating role of substance use motives in the relationship between personality dimensions and alcohol and drug use in adolescents and young adults with mild intellectual disabilities. Addict Behav 2022; 126:107173. [PMID: 34776302 DOI: 10.1016/j.addbeh.2021.107173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 10/03/2021] [Accepted: 11/01/2021] [Indexed: 11/01/2022]
Abstract
Adolescents and young adults with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) are a high-risk group for developing substance use disorders. The aim of this study was to gain a better understanding of the mechanisms that underlie substance use in this particular population. We tested the mediating role of substance use motives in the relationship between personality dimensions and substance use-related outcomes. Self-reported data on substance use risk personality dimensions (i.e., sensation seeking, impulsivity, anxiety sensitivity, and negative thinking), substance use motives (i.e., social, enhancement, coping, and conformity motives), and substance use were obtained from 163 individuals with MID-BIF (mean age 18.9 years). Results show that coping motives played a main role in the associations between personality dimensions and substance use in adolescents and young adults with MID-BIF, with significant relationships between impulsivity and negative thinking and severity of alcohol use or drug use via coping motives. Moreover, findings indicated a relatively high risk for several substance use motives and associated substance use (disorder) in individuals high on impulsivity. Results show significant relationships between impulsivity and severity of alcohol use or drug use via social, enhancement, and coping motives. No mediating associations were found for conformity motives, nor did we find any mediation associations in individuals with high levels of anxiety sensitivity. These insights provide the possibility of tailoring interventions to specific motives that underlie substance use in different types of users with MID-BIF based on personality dimensions.
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Bhatt NV, Gentile JP. Co-occurring intellectual disability and substance use disorders. AIMS Public Health 2021; 8:479-484. [PMID: 34395697 PMCID: PMC8334640 DOI: 10.3934/publichealth.2021037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022] Open
Abstract
Individuals with intellectual disabilities (ID) are an expanding population that confronts multiple disadvantages from social and environmental determinants of health. Deinstitutionalization and community integration have improved the lives of individuals with ID in many ways. However, deinstitutionalization may increase their access to alcohol and drugs and the potential for developing Substance Abuse Disorders (SUD). It is estimated that 7–8 million people in the United States with an intellectual disability (ID) suffer disproportionately from substance use problems [1]. There is a lack of empirical evidence to inform prevention and treatment efforts in this population and more research needs to be done in order to address these issues.
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Affiliation(s)
- Nita V Bhatt
- Associate Director of Medical Student Education Psychiatry Wright State University Boonshoft School of Medicine Dayton, Ohio, USA
| | - Julie P Gentile
- Chair Department of Psychiatry Wright State University Boonshoft School of Medicine Dayton, Ohio, USA
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Hulsmans DHG, Otten R, Schijven EP, Poelen EAP. Exploring the role of emotional and behavioral problems in a personality-targeted prevention program for substance use in adolescents and young adults with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 109:103832. [PMID: 33360962 DOI: 10.1016/j.ridd.2020.103832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/03/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adolescents and young adults with a mild intellectual disability or borderline intellectual functioning (MID-BIF) are at risk for problematic substance use and are more likely to have emotional and behavioral problems than peers without MID-BIF. A personality-targeted prevention program called Take it Personal! effectively reduces substance use in adolescents and young adults with MID-BIF. AIMS The program's effectiveness was examined on its secondary goal: reducing emotional and behavioral problems. The potentially moderating role of these problems on the program's effectiveness with substance use was also explored. METHODS AND PROCEDURES Substance use and emotional and behavioral problems were compared between participants in Take it Personal! (n = 34) and those in the control condition (n = 32) in a quasi-experimental pre-posttest study with a three-month follow-up. Effectiveness and moderation were assessed with multilevel models. OUTCOMES AND RESULTS Take it Personal! seems to reduce rule breaking. There were no significant effects on anxiety, withdrawal, and aggression. None of the problem domains moderated the program's effectiveness on substance use frequency. CONCLUSIONS AND IMPLICATIONS Take it Personal! may effectively reduce rule breaking. Moreover, adolescent and young adults with different levels of emotional and behavioral problems benefit equally in terms of reduced substance use.
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Affiliation(s)
- Daan H G Hulsmans
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Pluryn Research & Development, Nijmegen, the Netherlands.
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Pluryn Research & Development, Nijmegen, the Netherlands; The REACH Institute, Department of Psychology, Arizona State University, Phoenix, USA
| | - Esmée P Schijven
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Pluryn Research & Development, Nijmegen, the Netherlands
| | - Evelien A P Poelen
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Pluryn Research & Development, Nijmegen, the Netherlands
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Schijven EP, Hulsmans DHG, VanDerNagel JEL, Lammers J, Otten R, Poelen EAP. The effectiveness of an indicated prevention programme for substance use in individuals with mild intellectual disabilities and borderline intellectual functioning: results of a quasi-experimental study. Addiction 2021; 116:373-381. [PMID: 32678489 PMCID: PMC7891383 DOI: 10.1111/add.15156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/20/2019] [Accepted: 06/05/2020] [Indexed: 01/30/2023]
Abstract
AIMS To assess the effectiveness of Take it personal!, a prevention programme for individuals with mild intellectual disabilities and borderline intellectual functioning (MID-BIF) and substance use (SU). The prevention programme aims to reduce SU (alcohol, cannabis and illicit drugs) among experimental to problematic substance users. DESIGN A quasi-experimental design with two arms and a 3-month follow-up. SETTING Adolescents were recruited from 14 treatment centres in the Netherlands specialized in offering intra- and extramural care for people with MID-BIF and behavioural problems. PARTICIPANTS Data were collected from 66 individuals with MID-BIF assigned either to the intervention condition (n = 34) or to the control condition (n = 32). INTERVENTIONS Take it personal! was designed to target four personality traits: sensation-seeking, impulsive behaviour, anxiety sensitivity and negative thinking. For each of these profiles, interventions were developed that were structurally the same but contained different personality-specific materials, games and exercises. The control group received care as usual. MEASUREMENTS Primary outcomes at 3-month follow-up were frequency of SU, severity of SU and binge drinking. RESULTS Results showed intervention effects for SU frequency (F(1, 50.43) = 9.27, P = 0.004) and binge drinking (F(1, 48.02) = 8.63, P = 0.005), but not for severity of SU (F(1, 42.09) = 2.20, P = 0.145). CONCLUSIONS A prevention programme to reduce substance use among experimental to problematic users with mild intellectual disabilities and borderline intellectual functioning helped participants to decrease substance use frequency and binge drinking.
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Affiliation(s)
- Esmée P. Schijven
- Research and DevelopmentPlurynNijmegenthe Netherlands
- Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
| | - Daan H. G. Hulsmans
- Research and DevelopmentPlurynNijmegenthe Netherlands
- Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
| | - Joanneke E. L. VanDerNagel
- TactusCentre for Addiction and Intellectual Disability (CAID)Deventerthe Netherlands
- Radboud University, Nijmegen Institute for Scientist‐Practitioners in AddictionNijmegenthe Netherlands
- AveleijnBornethe Netherlands
- Faculty of Electrical Engineering, Mathematics, and Computer Science, Human Media InteractionUniversity of TwenteEnschedethe Netherlands
| | - Jeroen Lammers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtthe Netherlands
| | - Roy Otten
- Research and DevelopmentPlurynNijmegenthe Netherlands
- Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
- REACH Institute, Department of PsychologyArizona State UniversityTempeAZUSA
| | - Evelien A. P. Poelen
- Research and DevelopmentPlurynNijmegenthe Netherlands
- Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
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Schijven EP, VanDerNagel JEL, Otten R, Lammers J, Poelen EAP. Take it personal! Development and modelling study of an indicated prevention programme for substance use in adolescents and young adults with mild intellectual disabilities and borderline intellectual functioning. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:307-315. [PMID: 32990417 PMCID: PMC7820965 DOI: 10.1111/jar.12808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND This paper describes the theory and development of Take it personal! an indicated prevention programme aimed at reducing substance use in individuals with mild intellectual disabilities and borderline intellectual functioning. METHOD The process of the development of Take it personal! followed the steps of the Intervention Mapping protocol. Take it personal! is based on the theory that personality traits are an important construct to understand substance use (14-30 years old). A small modelling study was conducted with six adolescents to examine the feasibility, user-friendliness and potential effectiveness of the intervention. RESULTS The results showed that the intervention has good feasibility and user-friendliness. Post-intervention evaluation of frequency, binge drinking and problematic use indicated that use was lower than at pre-intervention. CONCLUSIONS Take it Personal! can be a promising preventive intervention designed to reduce substance use in individuals in this target group. A larger scale study is needed to draw further conclusions.
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Affiliation(s)
- Esmée P. Schijven
- Research and DevelopmentPlurynNijmegenThe Netherlands
- Behavioral Science InstituteRadboud University NijmegenNijmegenThe Netherlands
| | - Joanneke E. L. VanDerNagel
- Centre for Addiction and Intellectual Disability (CAID)TactusDeventerThe Netherlands
- Nijmegen Institute for Scientist‐Practitioners in AddictionRadboud University NijmegenNijmegenThe Netherlands
- AveleijnBorneThe Netherlands
- Human Media InteractionFaculty of Electrical Engineering, Mathematics, & Computer ScienceUniversity of TwenteEnschedeThe Netherlands
| | - Roy Otten
- Research and DevelopmentPlurynNijmegenThe Netherlands
- Behavioral Science InstituteRadboud University NijmegenNijmegenThe Netherlands
- REACH InstituteArizona State UniversityTempeAZUSA
| | - Jeroen Lammers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Evelien A. P. Poelen
- Research and DevelopmentPlurynNijmegenThe Netherlands
- Behavioral Science InstituteRadboud University NijmegenNijmegenThe Netherlands
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Gosens LCF, Otten R, Didden R, Poelen EAP. Evaluating a personalized treatment for substance use disorder in people with mild intellectual disability or borderline intellectual functioning: A study protocol of a multiple baseline across individuals design. Contemp Clin Trials Commun 2020; 19:100616. [PMID: 32743120 PMCID: PMC7387771 DOI: 10.1016/j.conctc.2020.100616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/19/2020] [Accepted: 07/12/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prevalence of substance use disorder (SUD) in people with Mild Intellectual Disabilities or Borderline Intellectual Functioning (MID-BIF) is high. However, an effective personalized treatment for people with MID-BIF and SUD is lacking. This paper describes the study protocol of the effectiveness study of Take it Personal!+, a personalized treatment for people with MID-BIF and SUD. METHODS The effectiveness of Take it Personal!+ in decreasing substance use will be assessed in a non-concurrent multiple baseline across individuals design comprising ten participants with MID-BIF and SUD. The participants with MID-BIF and SUD will be randomly allocated to one of the five baseline lengths (7-11 days). Substance use, will be assessed during baseline, intervention, and post-treatment phase using a daily diary method. DISCUSSION If this study shows that Take it Personal!+ is effective in decreasing substance use, the gap in treatment for people with MID-BIF and SUD will be filled. TRIAL REGISTRATION The study is registered in the Netherlands Trial Register (Trial NL4935, registered July 2, 2019).
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Affiliation(s)
- Lotte C F Gosens
- Research and Development, Pluryn, P.O. Box 53, 6500, AB, Nijmegen, the Netherlands
- Behavioral Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands
| | - Roy Otten
- Research and Development, Pluryn, P.O. Box 53, 6500, AB, Nijmegen, the Netherlands
- Behavioral Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands
- REACH Institute, Arizona State University, Tempe, USA
| | - Robert Didden
- Behavioral Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands
- Trajectum, Zwolle, the Netherlands
| | - Evelien A P Poelen
- Research and Development, Pluryn, P.O. Box 53, 6500, AB, Nijmegen, the Netherlands
- Behavioral Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500, HE, Nijmegen, the Netherlands
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Abstract
PURPOSE OF REVIEW To provide an overview of studies on substance use and substance use disorder (SUD) in individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF). RECENT FINDINGS Many individuals with MID-BIF use tobacco, alcohol, and drugs. On average, rates of substance use and SUD are similar to or even higher than those in peers with average intelligence. Individuals with MID-BIF are overrepresented in (forensic) addiction care. Several instruments are now available for the assessment of SUD and its risk factors in this target group. Prevention and intervention programs have been shown feasible and with promising outcomes, although the evidence base is still small. Professionals in addiction care and intellectual disability care facilities show deficiencies in skills in addressing SUD in clients with MID-BIF. SUMMARY Research in this area is still in its infancy, though an increasing number of studies show promising outcomes regarding case identification, assessment, and treatment of SUD in intellectual disability. Policy and practice should be adapted to the characteristics of individuals with MID-BIF.
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Schijven EP, Didden R, Otten R, Poelen EAP. Substance use among individuals with mild intellectual disability or borderline intellectual functioning in residential care: Examining the relationship between drinking motives and substance use. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:871-878. [PMID: 30844128 PMCID: PMC6850364 DOI: 10.1111/jar.12578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 01/10/2019] [Accepted: 01/23/2019] [Indexed: 11/30/2022]
Abstract
Background This study examined the relationship between substance use motives (i.e., social, conformity, coping and enhancement) and substance use in individuals with mild intellectual disability or borderline intellectual functioning (MID‐BIF). Method Data were collected among 163 clients with MID‐BIF using interactive questionnaires with visual cues on a tablet with a web application. Results Results show that social motives were positively related to frequency of alcohol use, while conformity, coping and enhancement motives were positively related to severity of alcohol use. Results for drug use show that social motives were positively related to frequency of cannabis and hard drug use and that conformity motives were negatively related to frequency of cannabis use. Coping motives were positively related to severity of drug use. Conclusions Insight in substance use motives should be used when adapting interventions, as it could contribute to the prevention and reduction of substance use disorders in individuals with MID‐BIF.
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Affiliation(s)
- Esmée P Schijven
- Research & Development Pluryn, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - Roy Otten
- Research & Development Pluryn, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,REACH Institute, Arizona State University, Phoenix, Arizona
| | - Evelien A P Poelen
- Research & Development Pluryn, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Rzezak P, Moschetta SP, Mendonça M, Paiva MLMN, Coan AC, Guerreiro C, Valente KDR. Higher IQ in juvenile myoclonic epilepsy: Dodging cognitive obstacles and "masking" impairments. Epilepsy Behav 2018; 86:124-130. [PMID: 30017836 DOI: 10.1016/j.yebeh.2018.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/18/2022]
Abstract
Executive deficits and impulsiveness are extensively reported in juvenile myoclonic epilepsy (JME). Previous literature suggests that intelligence may mediate these deficits. In this study, we evaluated and compared the performance of adults with JME with high and low intelligence quotient (IQ) and controls on tasks for executive function (EF) and impulsive traits. We investigated the neuropsychological performance of 53 adults with JME and below average IQ (57% women; 26.9 [±7.88] years; mean IQ: 89.8 [±5.1]), 26 adults with JME and average or above average IQ (53.8% women; 28.2 [±9.33] years; mean IQ: 110.7 [±8.3]), 38 controls with below average IQ (55% women; 28.4 [±8.4] years; mean IQ: 90.1 [±5.8]), and 31 controls with average or above average IQ (61.3% women; 32.20 [±11.3] years; mean IQ: 111.6 [±10.5]) with a comprehensive battery of neuropsychological tests that measure executive/attentional function. Impulsive traits were assessed using the Cloninger et al.'s Temperament and Character Inventory (novelty seeking (NS) domain). The group with JME with higher IQ presented worse performance compared with controls with higher IQ on Controlled Oral Word Association (COWA) and Wisconsin Card Sorting Test (WCST) (errors). This group showed worse performance than controls with lower IQ on Stroop Color-Word Test (SCT) 1, Trail Making (TM) A, COWA, and WCST (errors). Patients with lower IQ showed worse performance than controls with higher IQ on Digit Span Forward (DSF), Digit Span Backward (DSB), SCT1, SCT2, SCT3, TM A, COWA, and WCST (errors and failure to maintain set). Patients with lower IQ showed worse performance than controls with lower IQ on DSF, DSB, SCT1, SCT2, SCT3, TM A, TM B, COWA, and WCST (errors and failure to maintain set). Patients from groups with low and high IQ showed higher scores than controls with higher and lower IQ on impulsivity for NS1 and NS2 (except for patients with higher IQ versus controls with lower IQ). Adults with JME and higher IQ show less evidence of EF deficits compared with those with JME and below average IQ, suggesting that a higher degree of intellectual efficiency may act as a compensatory mechanism. However, it does not minimize some aspects of impulsive traits. Patients with JME and higher cognitive reserve may create strategies to dodge their cognitive obstacles. In this context, intelligence may protect and, at the same time, "mask" impairments that could be detected earlier.
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Affiliation(s)
- Patricia Rzezak
- Laboratory of Clinical Neurophysiology, Psychiatry Department, University of São Paulo (USP) School of Medicine, São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy-Clinics Hospital, University of São Paulo (USP), Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo (USP), Brazil.
| | - Sylvie Paes Moschetta
- Laboratory of Clinical Neurophysiology, Psychiatry Department, University of São Paulo (USP) School of Medicine, São Paulo, SP, Brazil
| | - Melanie Mendonça
- Laboratory of Clinical Neurophysiology, Psychiatry Department, University of São Paulo (USP) School of Medicine, São Paulo, SP, Brazil
| | - Maria Luisa Maia Nobre Paiva
- Laboratory of Clinical Neurophysiology, Psychiatry Department, University of São Paulo (USP) School of Medicine, São Paulo, SP, Brazil
| | - Ana Carolina Coan
- Department of Neurology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Carlos Guerreiro
- Department of Neurology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Kette Dualibi Ramos Valente
- Laboratory of Clinical Neurophysiology, Psychiatry Department, University of São Paulo (USP) School of Medicine, São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy-Clinics Hospital, University of São Paulo (USP), Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo (USP), Brazil
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