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Dabbagh R, Alsulimani A, Alshamrani S, Abuhaimed A, Alzaid W, Aldofyan M, Alqahtani S, Alsharqi A, Rawson R. Prescription opioid misuse in relation to addiction susceptibility among women at a Saudi university. Saudi Pharm J 2023; 31:101764. [PMID: 37693733 PMCID: PMC10491761 DOI: 10.1016/j.jsps.2023.101764] [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: 05/08/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives The trends of prescription opioid misuse are understudied in Arab populations, let alone among university students. Additionally, little is known about the psychological traits that increase susceptibility for such behaviors in this region. Thus, this study aimed to assess the prevalence of prescription opioid misuse and its association with addiction susceptibility, as measured by the Substance Abuse Risk Profile Scale (SURPS). Methods We sampled university students from King Saud University's women's campus. Data on prescription opioid misuse, SURPS traits, and demographic characteristics were collected using an electronic self-administered survey. Results Lifetime prescription opioid misuse was 48.5%, while past-month misuse was 28.9%. On average, SURPS subscale scores for impulsivity (mean = 11.6; SD = 2.8) hopelessness (mean = 12.3; SD = 3.5), sensation seeking (mean = 16.4; SD = 3.8), and anxiety sensitivity (mean = 14.6; SD = 2.6). Anxiety sensitivity composite scores significantly differed between students reporting misuse and those who did not. Moreover, the odds for prescription opioid misuse increased by 7% for every 1 unit increase in anxiety sensitivity (AOR = 1.07; 95% CI = 1.00, 1.14), when controlling for other SURPS measures and student characteristics. Conclusion The prevalence of prescription opioid misuse in our study is higher than what is reported in global student populations. This may reflect unmonitored availability of controlled substances and unsupervised medical prescriptions. Additionally, high levels of anxiety sensitivity may be driving such misuse. Further surveillance of prescription drug misuse among university students and motivators for such behavior is needed for planning prevention and control interventions.
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Affiliation(s)
- Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Wejdan Alzaid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Samar Alqahtani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Richard Rawson
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, United States
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2
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Kim AJ, Sherry SB, Nealis LJ, Mushquash A, Lee-Baggley D, Stewart SH. Do symptoms of depression and anxiety contribute to heavy episodic drinking? A 3-wave longitudinal study of adult community members. Addict Behav 2022; 130:107295. [PMID: 35231843 DOI: 10.1016/j.addbeh.2022.107295] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/29/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
Heavy episodic drinking (or binge drinking) is a significant public health concern. Self-medication using alcohol is often thought to explain the co-occurrence of heavy episodic drinking with depression and anxiety. Yet, there is little longitudinal work examining both depressive and anxiety symptoms and how they are independently related to heavy episodic drinking in adult community samples. To this end, we invited adult community members (N = 102) to come to the lab to complete validated measures of depressive symptoms (composite of CES-D-SF, SCL-90-D, and DASS-21-D), anxiety symptoms (DASS-21-A), and heavy episodic drinking (composite of frequency, severity, and perceptions) at baseline, and again three and six months later. Using a three-wave cross-lagged panel model, we tested reciprocal relations between heavy episodic drinking and each internalizing symptom. We found strong temporal stability in our study variables. Depressive symptoms were associated with increases in heavy episodic drinking, and anxiety symptoms were associated with decreases in heavy episodic drinking. In contrast, heavy episodic drinking did not predict either internalizing symptom over time. Results are consistent with the notion that individuals with greater depressive symptoms use alcohol to self-medicate, and that anxiety symptoms (particularly autonomic arousal) may be potentially protective against future heavy episodic drinking.
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Affiliation(s)
- Andy J Kim
- Department of Psychology and Neuroscience, Dalhousie University, B3H 4R2, Canada.
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, B3H 4R2, Canada; Department of Psychiatry, Dalhousie University, B3H 2E2, Canada.
| | - Logan J Nealis
- Department of Psychology and Neuroscience, Dalhousie University, B3H 4R2, Canada.
| | | | - Dayna Lee-Baggley
- Department of Psychology and Neuroscience, Dalhousie University, B3H 4R2, Canada.
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, B3H 4R2, Canada; Department of Psychiatry, Dalhousie University, B3H 2E2, Canada.
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3
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Hilton BT, Yusufov M, Rosellini AJ, Taghian NR, Weiss RD, Griffin ML, McHugh RK. Psychometric properties of the Anxiety Sensitivity Index-3 in adults with substance use disorders. J Subst Abuse Treat 2021; 132:108507. [PMID: 34214925 DOI: 10.1016/j.jsat.2021.108507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022]
Abstract
Anxiety sensitivity, or the fear of anxiety-related sensations, has demonstrated relevance to a broad range of psychiatric conditions, including substance use disorders (SUDs). Anxiety sensitivity is typically measured through self-report instruments, most commonly the Anxiety Sensitivity Index-3 (ASI-3). Despite the widespread use of the ASI-3 in studies of SUDs, little is known about its psychometric properties within this population. Patients on an inpatient detoxification unit seeking treatment for SUDs (N = 1248) completed a battery of self-report measures, including the ASI-3. Psychometric properties of the ASI-3 were examined. An exploratory factor analysis with half of the sample (n = 624) supported a 3-factor structure corresponding to the ASI-3 subscales (Social Concerns, Cognitive Concerns, Physical Concerns). Confirmatory factor analysis was used to validate this 3-dimensional structure in a separate subsample (n = 624), resulting in adequate fit when testing a second-order hierarchical model. Internal consistency and convergent and discriminant validity results also supported the use of the ASI-3 in people with SUDs. Despite its widespread use in SUD research, this is the first psychometric investigation of the ASI-3 among individuals seeking treatment for SUDs.
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Affiliation(s)
- Blake T Hilton
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America.
| | - Miryam Yusufov
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, 450 Brookline Avenue, JF 707, Boston, MA 02215, United States of America
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Boston, MA 02215, United States of America
| | - Nadine R Taghian
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America
| | - Roger D Weiss
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - Margaret L Griffin
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - R Kathryn McHugh
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
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4
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Stewart SH, Chinneck A, Thompson K, Afzali MH, Nogueira-Arjona R, Mahu IT, Conrod PJ. Personality to Prescription Drug Misuse in Adolescents: Testing Affect Regulation, Psychological Dysregulation, and Deviance Proneness Pathways. Front Psychiatry 2021; 12:640766. [PMID: 33986700 PMCID: PMC8110923 DOI: 10.3389/fpsyt.2021.640766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Fifteen to 25-year-olds are the age group most likely to misuse prescription drugs. Few studies have tested theory-driven models of adolescent risk for prescription drug misuse. Moreover, rarely are distinct pathways to different forms of prescription drug misuse considered. Methods: We tested mediational paths from personality to mental health symptoms to prescription drug misuse, informed by etiological models of addiction. We specified pathways from particular personality traits to unique forms of prescription drug misuse via specific mental health symptoms. We used semi-longitudinal data collected across two waves of the Co-Venture Trial. Our sample included students from 31 Canadian high schools tested in Grade 9 (n = 3,024) and again in Grade 10 (n = 2,869; 95% retention). Personality (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) was assessed in Grade 9. Mental health symptoms (depression, anxiety, ADHD, conduct disorder) and prescription drug misuse (opioids, sedatives/tranquilizers, stimulants) were assessed at both time points. Results: Consistent with the negative affect regulation model, hopelessness was specifically associated with opioid misuse via depressive symptoms, and anxiety sensitivity was specifically associated with sedative/tranquilizer misuse via anxiety symptoms. Consistent with positive affect regulation, sensation seeking was directly associated with stimulant misuse. Consistent with the psychological dysregulation model, impulsivity was associated with stimulant misuse via ADHD symptoms. And consistent with the deviance proneness model, impulsivity was also associated with unconstrained (i.e., all three forms of) prescription drug misuse via conduct disorder symptoms. Conclusions: Screening for adolescents high in hopelessness, anxiety sensitivity, sensation seeking, or impulsivity and providing them with personality-matched cognitive-behavioral interventions may be helpful in preventing or mitigating prescription drug misuse. Our results point to the specific mental health symptoms that are important to target in each of these personality-matched interventions.
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Affiliation(s)
- Sherry H. Stewart
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Annie Chinneck
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | | | | | - Ioan T. Mahu
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
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Guillot CR, Blackledge SM, Douglas ME, Cloutier RM, Liautaud MM, Pang RD, Kirkpatrick MG, Leventhal AM. Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents. Behav Med 2020; 46:161-169. [PMID: 31039083 PMCID: PMC6821558 DOI: 10.1080/08964289.2019.1573797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, University of North Texas, Denton, TX,Corresponding author: Casey Guillot, PhD, University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX 76203-5017; Tel: 1-940-369-8426; Fax: 1-940-565-4682;
| | - Sabrina M. Blackledge
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | | | - Madalyn M. Liautaud
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | | | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Department of Psychology, University of California, Los Angeles, CA
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6
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Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies. Addiction 2019; 114:968-982. [PMID: 30891835 PMCID: PMC6563455 DOI: 10.1111/add.14575] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings. DESIGN AND SETTING We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later. PARTICIPANTS Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years. MEASUREMENTS Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders). FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87). CONCLUSIONS Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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7
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Lassi G, Taylor AE, Mahedy L, Heron J, Eisen T, Munafò MR. Locus of control is associated with tobacco and alcohol consumption in young adults of the Avon Longitudinal Study of Parents and Children. ROYAL SOCIETY OPEN SCIENCE 2019; 6:181133. [PMID: 31031995 PMCID: PMC6458410 DOI: 10.1098/rsos.181133] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
Individuals appraise events as a consequence of their own actions (i.e. internal locus of control, LoC) or as the outcome of chance or others' will (i.e. external LoC). We hypothesized that having a more external LoC would be associated with higher risk of tobacco and alcohol use. Few studies have examined this association using large prospective data. We evaluated within the Avon Longitudinal Study of Parents and Children (ALSPAC) the associations between LoC at 16 and tobacco and alcohol consumption at 17 and 21 years using logistic regression. A more external LoC at age 16 (N = 4656) was associated with higher odds of being a weekly smoker at age 17 (OR 1.18, 95% CI 1.10-1.25) and 21 (OR 1.14, 95% CI 1.07-1.21) and with dependence measured using the Fagerström Test of Nicotine Dependence at age 17 (OR 1.26, 95% CI 1.05-1.51) and 21 (OR 1.25, 95% CI 1.05-1.49). Individuals with external LoC at age 16 were more likely to be hazardous drinkers according to the Alcohol Use Disorders Identification Test at age 17 (OR 1.09, 95% CI 1.04-1.15) but not at 21 (OR 1.01, 95% CI 0.96-1.06). Having a more external LoC at age 16 is associated with increased tobacco consumption at age 17 and 21 and alcohol consumption at 17 years. LoC may represent an intervention target for preventing substance use and dependence.
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Affiliation(s)
- G. Lassi
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
- Centre for Genomics Research, Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - A. E. Taylor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - L. Mahedy
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - J. Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - T. Eisen
- Oncology Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - M. R. Munafò
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
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Vassileva J, Conrod PJ. Impulsivities and addictions: a multidimensional integrative framework informing assessment and interventions for substance use disorders. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180137. [PMID: 30966920 PMCID: PMC6335463 DOI: 10.1098/rstb.2018.0137] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2018] [Indexed: 12/18/2022] Open
Abstract
Impulse control is becoming a critical survival skill for the twenty-first century. Impulsivity is implicated in virtually all externalizing behaviours and disorders, and figures prominently in the aetiology and long-term sequelae of substance use disorders (SUDs). Despite its robust clinical and predictive validity, the study of impulsivity is complicated by its multidimensional nature, characterized by a variety of trait-like personality dimensions, as well as by more state-dependent neurocognitive dimensions, with variable convergence across measures. This review provides a hierarchical framework for linking self-report and neurocognitive measures to latent constructs of impulsivity and, in turn, to different psychopathology vulnerabilities, including substance-specific addictions and comorbidities. Impulsivity dimensions are presented as novel behavioural targets for prevention and intervention. Novel treatment approaches addressing domains of impulsivity are reviewed and recommendations for future directions in research and clinical interventions for SUDs are offered. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.
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Affiliation(s)
- Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia J. Conrod
- Department of Psychiatry, University of Montreal, Montreal, Canada
- Centre de Recherche, CHU Ste Justine, Montreal, Canada
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Mathews BL, Koehn AJ, Abtahi MM, Kerns KA. Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review. Clin Child Fam Psychol Rev 2017; 19:162-84. [PMID: 27072682 DOI: 10.1007/s10567-016-0204-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others' emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N's ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = -0.15) and understanding emotions (r = -0.20), less aware of (r = -0.28) and less accepting of their own emotions (r = -0.49), and report less emotional self-efficacy (r = -0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children's age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.
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Affiliation(s)
| | - Amanda J Koehn
- Kent State University, 600 Hilltop Dr., Kent Hall, Kent, OH, 4424, USA
| | | | - Kathryn A Kerns
- Kent State University, 600 Hilltop Dr., Kent Hall, Kent, OH, 4424, USA
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10
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Adan A, Forero DA, Navarro JF. Personality Traits Related to Binge Drinking: A Systematic Review. Front Psychiatry 2017; 8:134. [PMID: 28804465 PMCID: PMC5532381 DOI: 10.3389/fpsyt.2017.00134] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/12/2017] [Indexed: 12/17/2022] Open
Abstract
The pattern of alcohol consumption in the form of binge drinking (BD) or heavy episodic drinking has increased notably worldwide in recent years, especially among adolescent and young people, being currently recognized as a global health problem. Although only a minority of binge drinkers will develop a substance use disorder, BD may have negative personal and social consequences in the short and medium term. The objective of this article is to review the findings on personality traits related to binge drinkers and to emphasize the aspects that should be examined in order to make progress in this area. The main characteristics of personality related to the practice of BD, regardless of the theoretical model used, are high Impulsivity and high Sensation seeking, as well as Anxiety sensitivity, Neuroticism (Hopelessness), Extraversion and low Conscientiousness. The data obtained may have theoretical implications to elucidate the endophenotype of BD, but they are especially useful for their preventive applications. Integration into prevention programs of emotional self-control skills, decision-making, social skills, and strategies to manage negative emotions will minimize the risk factors or consequences of BD associated with personality and will improve their effectiveness. In the future, it is necessary to harmonize a common measurement instrument for the assessment of personality, develop longitudinal studies with large samples that also integrate biological and neurocognitive measurements, and determine the reciprocal relationship between personality and BD together with its modulating variables, as well as the possible cultural differences.
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Affiliation(s)
- Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Diego A Forero
- Laboratory of Neuropsychiatric Genetics, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
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11
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Hides L, Wilson H, Quinn C, Sanders D. QuikFix: enhanced motivational interviewing interventions for youth substance use. ADVANCES IN DUAL DIAGNOSIS 2016. [DOI: 10.1108/add-03-2016-0008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper explores the background principles, theories, and components of the QuikFix intervention for primary and comorbid substance use in young people.
Design/methodology/approach
QuikFix is a brief Motivational Interviewing (MI) intervention utilising cognitive-behavioural coping skills training to reduce vulnerability to substance use and comorbid mental health problems in young people. It is delivered in two to three brief sessions including an assessment. A new version, QuikFix PI (Personality Intervention) which incorporates coping skills training targeting, sensation seeking, impulsive, depressive and anxiety personality styles that may underlie primary and comorbid substance use problems is presented.
Findings
The original QuikFix intervention has demonstrated efficacy in young alcohol and cannabis users with comorbid depression and anxiety symptoms. The efficacy of the new personality targeted version of QuikFix is currently being tested in a large randomized controlled trial among young people with alcohol related injuries/illnesses. Future research is required to determine the efficacy of QuikFix PI in comorbid populations including those with behavioural disorders.
Practical implications
QuikFix interventions can be delivered via telephone or face-to-face in clinical settings for clients with primary substance use and comorbid depression and anxiety symptoms.
Originality/value
This paper describes a novel two to three session manualised personality targeted substance use intervention. The full original QuikFix treatment manual is available online (Hides and Carroll 2010).
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12
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Wolitzky-Taylor K, McBeth J, Guillot CR, Stone MD, Kirkpatrick MG, Zvolensky MJ, Buckner JD, Leventhal AM. Transdiagnostic processes linking anxiety symptoms and substance use problems among adolescents. J Addict Dis 2016; 35:266-277. [PMID: 27431313 DOI: 10.1080/10550887.2016.1207969] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Numerous anxiety syndromes co-occur with substance use problems in adolescents, though the mechanisms underlying these comorbidities are not well understood. There are 3 transdiagnostic processes-anxiety sensitivity (fear of anxiety-related sensations), distress tolerance (capacity to withstand emotional distress), and negative urgency (propensity to respond impulsively to negative emotion)-that have been implicated in various anxiety and substance use problems. To examine whether anxiety sensitivity, distress tolerance, and negative urgency statistically mediated relations between symptoms of 3 different anxiety disorders (social anxiety, generalized anxiety, and panic disorders) and alcohol and cannabis use problems, cross-sectional analysis of high school students in Los Angeles (N = 3002) was assessed via paper and pencil questionnaires. When mediators were entered simultaneously, negative urgency accounted for a significant 33 to 85% of the covariance between anxiety symptomatology and substance use problems over and above the other trandiagnostic processes. This pattern was consistent across all 3 anxiety syndromes and both alcohol and cannabis problems. Anxiety sensitivity and distress tolerance did not account for positive associations between anxiety symptoms and substance use problems. Negative urgency may be an important mechanism underlying the relationship between various types of anxiety and substance use problems in adolescence, and thus represents a possible target for preventive interventions targeting adolescent anxiety and substance use.
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Affiliation(s)
| | - Julia McBeth
- b University of Southern California , Los Angeles , California , USA
| | - Casey R Guillot
- b University of Southern California , Los Angeles , California , USA
| | - Matthew D Stone
- b University of Southern California , Los Angeles , California , USA
| | | | | | - Julia D Buckner
- d Louisiana State University , Baton Rouge , Louisiana , USA
| | - Adam M Leventhal
- b University of Southern California , Los Angeles , California , USA
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13
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Wang SH, Ding Y, Zhao W, Huang YH, Perkins R, Zou W, Chen JJ. Text mining for identifying topics in the literatures about adolescent substance use and depression. BMC Public Health 2016; 16:279. [PMID: 26993983 PMCID: PMC4799597 DOI: 10.1186/s12889-016-2932-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 03/07/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Both adolescent substance use and adolescent depression are major public health problems, and have the tendency to co-occur. Thousands of articles on adolescent substance use or depression have been published. It is labor intensive and time consuming to extract huge amounts of information from the cumulated collections. Topic modeling offers a computational tool to find relevant topics by capturing meaningful structure among collections of documents. METHODS In this study, a total of 17,723 abstracts from PubMed published from 2000 to 2014 on adolescent substance use and depression were downloaded as objects, and Latent Dirichlet allocation (LDA) was applied to perform text mining on the dataset. Word clouds were used to visually display the content of topics and demonstrate the distribution of vocabularies over each topic. RESULTS The LDA topics recaptured the search keywords in PubMed, and further discovered relevant issues, such as intervention program, association links between adolescent substance use and adolescent depression, such as sexual experience and violence, and risk factors of adolescent substance use, such as family factors and peer networks. Using trend analysis to explore the dynamics of proportion of topics, we found that brain research was assessed as a hot issue by the coefficient of the trend test. CONCLUSIONS Topic modeling has the ability to segregate a large collection of articles into distinct themes, and it could be used as a tool to understand the literature, not only by recapturing known facts but also by discovering other relevant topics.
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Affiliation(s)
- Shi-Heng Wang
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA.,Graduate Institute of Biostatistics, China Medical University, No. 91, Xueshi Rd, Taichung City, 40402, Taiwan
| | - Yijun Ding
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA
| | - Weizhong Zhao
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA
| | - Yung-Hsiang Huang
- National Applied Research Laboratories, National Center for High-Performance Computing, No. 7, R&D 6th Rd., Hsinchu Science Park, Hsinchu City, 30076, Taiwan
| | - Roger Perkins
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA
| | - Wen Zou
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA.
| | - James J Chen
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, 3900 NCTR Road, HFT-20, Jefferson, AR, 72079, USA.
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14
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Conrod PJ, Nikolaou K. Annual Research Review: On the developmental neuropsychology of substance use disorders. J Child Psychol Psychiatry 2016; 57:371-94. [PMID: 26889898 DOI: 10.1111/jcpp.12516] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Adolescence represents a period of development during which critical biological, as well as social and cognitive, changes occur that are necessary for the transition into adulthood. A number of researchers have suggested that the pattern of normative brain changes that occurs during this period not only predisposes adolescents to engage in risk behaviours, such as experimentation with drugs, but that they additionally make the adolescent brain more vulnerable to the direct pharmacological impact of substances of abuse. The neural circuits that we examine in this review involve cortico-basal-ganglia/limbic networks implicated in the processing of rewards, emotion regulation, and the control of behaviour, emotion and cognition. FINDINGS AND CONCLUSIONS We identify certain neurocognitive and personality/comorbidity-based risk factors for the onset of substance misuse during adolescence, and summarise the evidence suggesting that these risk factors may be further impacted by the direct effect of drugs on the underlying neural circuits implicated in substance misuse vulnerability.
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Affiliation(s)
- Patricia J Conrod
- Faculty of Medicine, Department of Psychiatry, Université de Montréal, Montréal, Canada.,Centre de recherche CHU Sainte-Justine, Montréal, Canada.,Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Kyriaki Nikolaou
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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15
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Newton NC, Barrett EL, Castellanos-Ryan N, Kelly E, Champion KE, Stapinski L, Conrod PJ, Slade T, Nair N, Teesson M. The validity of the Substance Use Risk Profile Scale (SURPS) among Australian adolescents. Addict Behav 2016; 53:23-30. [PMID: 26441044 DOI: 10.1016/j.addbeh.2015.09.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 10/23/2022]
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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16
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Jurk S, Kuitunen-Paul S, Kroemer NB, Artiges E, Banaschewski T, Bokde ALW, Büchel C, Conrod P, Fauth-Bühler 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. Personality and Substance Use: Psychometric Evaluation 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. [DOI: 10.1111/acer.12886] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 08/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah Jurk
- Department of Psychiatry and Neuroimaging Center; Technische Universität Dresden; Dresden Germany
| | - Sören Kuitunen-Paul
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Neuroimaging Center; Technische Universität Dresden; Dresden Germany
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale; INSERM CEA Unit 1000 “Imaging & Psychiatry”; University Paris Sud; Orsay France
- Department of Psychiatry; Orsay Hospital; Orsay France
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Arun L. W. Bokde
- Trinity College Institute of Neuroscience and Discipline of Psychiatry; School of Medicine; Trinity College Dublin; Dublin Ireland
| | | | - Patricia Conrod
- Institute of Psychiatry; King's College London; London United Kingdom
- Department of Psychiatry; Université de Montréal; CHU Ste Justine Hospital; Montreal Quebec Canada
| | - Mira Fauth-Bühler
- Department of Addictive Behaviour and Addiction Medicine; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Vincent Frouin
- Neurospin; Commissariat à l'Energie Atomique et aux Energies Alternatives; Paris France
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Hugh Garavan
- Institute of Neuroscience; Trinity College Dublin; Dublin Ireland
- Departments of Psychiatry and Psychology; University of Vermont; Burlington Vermont
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy; Campus Charité Mitte, Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Karl F. Mann
- Department of Addictive Behaviour and Addiction Medicine; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Tomáš Paus
- Rotman Research Institute; University of Toronto; Toronto Ontario Canada
- School of Psychology; University of Nottingham; Nottingham United Kingdom
- Montreal Neurological Institute; McGill University; Montreal Quebec Canada
| | - Zdenka Pausova
- The Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Gunter Schumann
- Institute of Psychiatry; King's College London; London United Kingdom
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre; London United Kingdom
| | - Maren Struve
- Department of Cognitive and Clinical Neuroscience; Central Institute of Mental Health; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging Center; Technische Universität Dresden; Dresden Germany
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Richmond AD, Laursen B, Kerr M, Stattin H. Depressive Symptoms Anticipate Changes in the Frequency of Alcohol Intoxication Among Low-Accepted Adolescents. J Stud Alcohol Drugs 2015; 76:585-93. [PMID: 26098034 PMCID: PMC4495076 DOI: 10.15288/jsad.2015.76.585] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 02/16/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There is strong evidence that depression anticipates later drinking problems among adults. These associations have not been consistently documented during adolescence, perhaps because little attention has been given to individual differences in peer relationships, which are the primary setting for adolescent alcohol consumption. This study investigated associations between depressive affect and alcohol misuse as moderated by peer group acceptance. METHOD A community sample of 1,048 Swedish youth provided self-reports of depressive symptoms and intoxication frequency at annual intervals across the middle school years (seventh grade: M = 13.21 years old; eighth grade: M = 14.27 years old; ninth grade: M = 15.26 years old). Peer nominations provided a measure of individual acceptance. RESULTS Growth curve analyses revealed differences in the extent to which initial levels of depressive symptoms predicted the slope of increase in intoxication frequency. Higher levels of depressive symptoms at the outset anticipated sharp increases in intoxication frequency from seventh to ninth grades for low-accepted youth but not for average- or high-accepted youth. CONCLUSIONS poor peer relations and depressive affect are vulnerabilities that set the stage for escalating adolescent alcohol misuse. Across the middle school years, when most youth have their first experiences with alcohol, peer difficulties exacerbated the tendency of depressed youth to drink to excess.
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Affiliation(s)
- Ashley D. Richmond
- Department of Psychology, Florida Atlantic University, Fort Lauderdale, Florida
| | - Brett Laursen
- Department of Psychology, Florida Atlantic University, Fort Lauderdale, Florida
| | - Margaret Kerr
- Center for Developmental Research, Örebro University, Örebro, Sweden
| | - Håkan Stattin
- Center for Developmental Research, Örebro University, Örebro, Sweden
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Personality and substance use in Japanese adolescents: The Japanese version of Substance Use Risk Profile Scale. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.11.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hides L, Kavanagh DJ, Daglish M, Cotton S, Connor JP, Barendregt JJ, Young RM, Sanders D, White A, Mergard L. The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care. BMC Emerg Med 2014; 14:19. [PMID: 25103779 PMCID: PMC4136406 DOI: 10.1186/1471-227x-14-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 07/23/2014] [Indexed: 12/02/2022] Open
Abstract
Background Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.
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Affiliation(s)
- Leanne Hides
- Center for Youth Substance Abuse Research (CYSAR), School for Psychology & Counselling, Institute of Health & Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Ave, Brisbane, Queensland, 4059, Australia.
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Interaction matters: quantifying conduct problem × depressive symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample. Dev Psychopathol 2014; 25:1029-43. [PMID: 24229547 DOI: 10.1017/s0954579413000357] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Substance use is a major contributor to morbidity and mortality among American adolescents. Conduct problems and depressive symptoms have each been found to be associated with adolescent substance use. Although they are highly comorbid, the role of the interaction of conduct problems and depressive symptoms in substance use is not clear. In national samples of 8th-, 10th-, and 12th-grade students from the Monitoring the Future study, latent moderated structural equation modeling was used to estimate the association of conduct problems, depressive symptoms, and their interaction to the use of alcohol (including binge drinking), cigarettes, and marijuana. Moderation by age and sex was tested. The interaction of conduct problems with depressive symptoms was a strong predictor of substance use, particularly among younger adolescents. With few exceptions, adolescents with high levels of both conduct problems and depressive symptoms used substances most frequently. Conduct problems were a strong positive predictor of substance use, and depressive symptoms were a weak positive predictor. Whereas conduct problems are often thought to be a primary predictor of substance use, this study revealed that depressive symptoms potentiate the relation of conduct problems to substance use. Therefore, substance use prevention efforts should target both depressive symptoms and conduct problems.
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21
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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 internalizing and externalizing problems: a cluster-randomized trial. J Am Acad Child Adolesc Psychiatry 2013; 52:911-20. [PMID: 23972693 DOI: 10.1016/j.jaac.2013.05.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 04/01/2013] [Accepted: 06/07/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and externalizing symptoms in an adolescent U.K. sample. METHOD This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents). Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month intervals. RESULTS Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p < .05) over 2 years in the full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96), and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms. CONCLUSIONS Brief, personality-targeted interventions delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity. Clinical trial registration information-Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky Behaviors as Delivered by Educational Professionals.
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Gea A, Beunza JJ, Estruch R, Sánchez-Villegas A, Salas-Salvadó J, Buil-Cosiales P, Gómez-Gracia E, Covas MI, Corella D, Fiol M, Arós F, Lapetra J, Lamuela-Raventós RM, Wärnberg J, Pintó X, Serra-Majem L, Martínez-González MA. Alcohol intake, wine consumption and the development of depression: the PREDIMED study. BMC Med 2013; 11:192. [PMID: 23988010 PMCID: PMC3765610 DOI: 10.1186/1741-7015-11-192] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 07/26/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Alcoholic beverages are widely consumed. Depression, the most prevalent mental disorder worldwide, has been related to alcohol intake. We aimed to prospectively assess the association between alcohol intake and incident depression using repeated measurements of alcohol intake. METHODS We followed-up 5,505 high-risk men and women (55 to 80 y) of the PREDIMED Trial for up to seven years. Participants were initially free of depression or a history of depression, and did not have any history of alcohol-related problems. A 137-item validated food frequency questionnaire administered by a dietician was repeated annually to assess alcohol intake. Participants were classified as incident cases of depression when they reported a new clinical diagnosis of depression, and/or initiated the use of antidepressant drugs. Cox regression analyses were fitted over 23,655 person-years. RESULTS Moderate alcohol intake within the range of 5 to 15 g/day was significantly associated with lower risk of incident depression (hazard ratio (HR) and 95% confidence interval (95% CI) = 0.72 (0.53 to 0.98) versus abstainers). Specifically, wine consumption in the range of two to seven drinks/week was significantly associated with lower rates of depression (HR (95% CI) = 0.68 (0.47 to 0.98)). CONCLUSIONS Moderate consumption of wine may reduce the incidence of depression, while heavy drinkers seem to be at higher risk.
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Affiliation(s)
- Alfredo Gea
- Department of Preventive Medicine and Public Health, Medical School-Clinica Universidad de Navarra, Pamplona, Spain
| | - Juan J Beunza
- School of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Almudena Sánchez-Villegas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Human Nutrition Unit, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | | | - Enrique Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - María-Isabel Covas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Lipids and Cardiovascular Epidemiology Research Unit, Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Miquel Fiol
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, Araba University Hospital, Vitoria, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, Centro de Salud San Pablo, Sevilla, Spain
| | - Rosa-María Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Nutrition and Food Science Department– XaRTA, INSA, University of Barcelona, Barcelona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Internal Medicine Service, Hospital of Bellvitge, Hospitalet de Llobregat, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, Medical School-Clinica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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Ortin A, Lake AM, Kleinman M, Gould MS. Sensation seeking as risk factor for suicidal ideation and suicide attempts in adolescence. J Affect Disord 2012; 143:214-22. [PMID: 22921521 PMCID: PMC3501599 DOI: 10.1016/j.jad.2012.05.058] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/16/2012] [Accepted: 05/30/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND High sensation seeking in adolescence is associated with engagement in risk-taking behaviors, especially substance use. Although depressed adolescents are prone to increased risk-taking, and suicidal behavior can be considered within the spectrum of risk-taking behaviors, the relationships between sensation seeking, depression, and suicidal behavior have not been explored. METHODS A self-report questionnaire assessing sensation seeking, depression, substance use problems, and suicidal ideation and suicide attempts was completed by 9th- through 12th-grade students (n=2189) in six New York State high-schools from 2002 through 2004. Logistic regression analyses were conducted to examine main and interaction effects between sensation seeking and the four clinical variables. RESULTS High sensation seeking was positively associated with depressive symptoms and substance use problems. The main effects of sensation seeking on suicidal ideation and suicide attempts remained significant after controlling for depression and substance use. The association between sensation seeking and suicide attempts was moderated by substance use problems. LIMITATIONS The schools were suburban and predominantly white, limiting the generalizability of the results. Other mental disorders with potential implications for sensation seeking and for suicidal behavior, such as bipolar disorders, were not assessed. CONCLUSIONS The finding that sensation seeking makes an independent contribution to the risk of suicidal ideation and attempts is consistent with findings in literature on novelty seeking and impulsivity. The associations between sensation seeking, depressive symptoms and suicidal behavior may be compatible with the presence of an underlying temperamental dysregulation. Screening for sensation seeking may contribute to the reduction of adolescent suicide risk.
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Affiliation(s)
- Ana Ortin
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032, USA
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Murphy A, Taylor E, Elliott R. The detrimental effects of emotional process dysregulation on decision-making in substance dependence. Front Integr Neurosci 2012; 6:101. [PMID: 23162443 PMCID: PMC3491319 DOI: 10.3389/fnint.2012.00101] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 10/19/2012] [Indexed: 01/04/2023] Open
Abstract
Substance dependence is complex and multifactorial, with many distinct pathways involved in both the development and subsequent maintenance of addictive behaviors. Various cognitive mechanisms have been implicated, including impulsivity, compulsivity, and impaired decision-making. These mechanisms are modulated by emotional processes, resulting in increased likelihood of initial drug use, sustained substance dependence, and increased relapse during periods of abstinence. Emotional traits, such as sensation-seeking, are risk factors for substance use, and chronic drug use can result in further emotional dysregulation via effects on reward, motivation, and stress systems. We will explore theories of hyper and hypo sensitivity of the brain reward systems that may underpin motivational abnormalities and anhedonia. Disturbances in these systems contribute to the biasing of emotional processing toward cues related to drug use at the expense of natural rewards, which serves to maintain addictive behavior, via enhanced drug craving. We will additionally focus on the sensitization of the brain stress systems that result in negative affect states that continue into protracted abstinence that is may lead to compulsive drug-taking. We will explore how these emotional dysregulations impact upon decision-making controlled by goal-directed and habitual action selections systems, and, in combination with a failure of prefrontal inhibitory control, mediate maladaptive decision-making observed in substance dependent individuals such that they continue drug use in spite of negative consequences. An understanding of the emotional impacts on cognition in substance dependent individuals may guide the development of more effective therapeutic interventions.
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Affiliation(s)
- Anna Murphy
- Neuroscience and Psychiatry Unit, University of ManchesterManchester, UK
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Gea A, Martinez-Gonzalez MA, Toledo E, Sanchez-Villegas A, Bes-Rastrollo M, Nuñez-Cordoba JM, Sayon-Orea C, Beunza JJ. A longitudinal assessment of alcohol intake and incident depression: the SUN project. BMC Public Health 2012; 12:954. [PMID: 23134690 PMCID: PMC3526561 DOI: 10.1186/1471-2458-12-954] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 10/27/2012] [Indexed: 01/30/2023] Open
Abstract
Background Longitudinal studies assessing the long-term association between alcohol intake and depression are scarce. The type of beverage may also be important. Therefore we aimed to prospectively evaluate the influence of alcohol intake on incident depression in a Mediterranean cohort. Methods We assessed 13,619 university graduates (mean age: 38 years, 42% men) participating in a Spanish prospective epidemiological cohort (the SUN Project), initially free of depression. They were recruited between 1999–2008 and biennially followed-up during 2001–2010. At baseline, a 136-item validated food–frequency questionnaire was used to assess alcohol intake. Wine was the preferred beverage. Participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression and restricted cubic splines analyses were performed over 82,926 person-years. Results Only among women, an U-shaped relationship between total alcohol intake and depression risk was found (P=0.01). Moderate alcohol intake (5–15 g/day) was associated with lower risk (Hazard Ratio: 0.62; 95% Confidence Interval: 0.43-0.89). No association was apparent for higher intakes of alcohol or for any specific type of alcoholic beverage. Conclusions Moderate alcohol intake might protect against depression among women. Further confirmatory studies are needed.
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Affiliation(s)
- Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain
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Hanna KM. A framework for the youth with type 1 diabetes during the emerging adulthood transition. Nurs Outlook 2012; 60:401-10. [PMID: 22226223 PMCID: PMC3324668 DOI: 10.1016/j.outlook.2011.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 10/03/2011] [Accepted: 10/30/2011] [Indexed: 10/14/2022]
Abstract
Emerging adulthood, a developmental period from late adolescence to the late twenties, is a critical transition for youths with type 1 diabetes. This article proposes a framework for emerging adults with diabetes during this transitional time, integrating theoretical writings on transitions and emerging adulthood with empirical findings from younger adolescents with diabetes, about whom more is known. Key health, developmental, and behavioral outcomes are proposed, as well as key influential personal and environmental characteristics. Influential transitional events for this age group are also discussed relative to these outcomes and to personal and environmental characteristics. This framework provides a guide for longitudinal studies on the transition to young adulthood among emerging adults with type 1 diabetes. Identifying key times and influential factors will provide information for designing future effective interventions to improve glycemic control and quality of life for these youths as they transition to adulthood.
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Affiliation(s)
- Kathleen M Hanna
- Indiana University School of Nursing, Indianapolis, IN 46202, USA.
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Castellanos-Ryan N, O'Leary-Barrett M, Sully L, Conrod P. Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale. Alcohol Clin Exp Res 2012; 37 Suppl 1:E281-90. [PMID: 22974180 DOI: 10.1111/j.1530-0277.2012.01931.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 06/12/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND This study assessed the validity, sensitivity, and specificity of the Substance Use Risk Profile Scale (SURPS), a measure of personality risk factors for substance use and other behavioral problems in adolescence. METHODS The concurrent and predictive validity of the SURPS was tested in a sample of 1,162 adolescents (mean age: 13.7 years) using linear and logistic regressions, while its sensitivity and specificity were examined using the receiver operating characteristics curve analyses. RESULTS Concurrent and predictive validity tests showed that all 4 brief scales-hopelessness (H), anxiety sensitivity (AS), impulsivity (IMP), and sensation seeking (SS)-were related, in theoretically expected ways, to measures of substance use and other behavioral and emotional problems. Results also showed that when using the 4 SURPS subscales to identify adolescents "at risk," one can identify a high number of those who developed problems (high sensitivity scores ranging from 72 to 91%). And, as predicted, because each scale is related to specific substance and mental health problems, good specificity was obtained when using the individual personality subscales (e.g., most adolescents identified at high risk by the IMP scale developed conduct or drug use problems within the next 18 months [a high specificity score of 70 to 80%]). CONCLUSIONS The SURPS is a valuable tool for identifying adolescents at high risk for substance misuse and other emotional and behavioral problems. Implications of findings for the use of this measure in future research and prevention interventions are discussed.
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Hopley AAB, Brunelle C. Personality mediators of psychopathy and substance dependence in male offenders. Addict Behav 2012; 37:947-55. [PMID: 22543034 DOI: 10.1016/j.addbeh.2012.03.031] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 02/02/2012] [Accepted: 03/27/2012] [Indexed: 11/16/2022]
Abstract
Psychopathy and substance dependence (SUD) is highly prevalent in incarcerated populations and tends to co-occur in the same individuals. The factors underlying this relationship are not clearly understood. The primary purpose of this study was to investigate whether two personality models mediate the relationship between psychopathy and substance misuse in male offenders. Ninety-two inmates in provincial correctional centers in New Brunswick completed questionnaires, including the Sensitivity to Reward Sensitivity to Punishment Questionnaire to measure behavioral activation and behavioral inhibition, the Substance Use Risk Profile Scale to measure anxiety sensitivity, introversion/hopelessness, sensation seeking and impulsivity, and the Psychopathic Personality Inventory-Revised to assess psychopathy levels. Results revealed that high impulsivity indirectly mediated the relationship between psychopathy and stimulant dependence. In addition, low anxiety sensitivity indirectly mediated the relationship between psychopathy and opioid dependence. Finally, impulsivity indirectly and inconsistently mediated the relationship between psychopathy and alcohol dependence. These results suggest that individuals with psychopathic traits are at increased risk of misusing certain drugs due to underlying personality-based differences.
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Affiliation(s)
- Anthony A B Hopley
- Department of Psychology, University of New Brunswick, Fredericton Campus, 38 Dineen Drive, Fredericton, NB, Canada.
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Castellanos-Ryan N, Conrod PJ. Personality correlates of the common and unique variance across conduct disorder and substance misuse symptoms in adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 39:563-76. [PMID: 21181434 DOI: 10.1007/s10802-010-9481-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Externalising behaviours such as substance misuse (SM) and conduct disorder (CD) symptoms highly co-occur in adolescence. While disinhibited personality traits have been consistently linked to externalising behaviours there is evidence that these traits may relate differentially to SM and CD. The current study aimed to assess whether this was the case, after examining the nature of the relationship between SM and CD symptoms in an adolescent sample (N = 392), using structural equation modelling. Similar to those found in adults (Krueger et al. Journal of Abnormal Psychology 116: 645-666, 2007), results showed that CD and SM symptoms were organized hierarchically, with symptoms explaining a single broad, coherent construct of externalising behaviour, but also explaining specific factors of SM and CD that vary independently from the general externalising factor. Furthermore, disinhibited personality traits related differentially to these factors, with results showing that, even controlling for inhibited personality traits, impulsivity was associated with CD and the common variance shared by CD and SM, while sensation seeking was specifically associated with SM only. Hopelessness was also associated with the common variance shared by SM and CD. Results confirm impulsivity, hopelessness and sensation seeking as key correlates of externalising behaviour problems in adolescence, identifying them as clear targets for intervention and prevention strategies.
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Affiliation(s)
- Natalie Castellanos-Ryan
- Centre de recherche du CHU Ste-Justine, Université de Montréal, 3175 Côte Sainte-Catherine, Montréal, Canada.
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