Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity

Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings.

Family and peer influences on tobacco use among adolescents with psychiatric disorders

The purpose of this study was to examine family and peer influences on smoking behaviors among 239 (191 smokers; 48 nonsmokers) psychiatrically hospitalized adolescents. Participants were queried using scales to measure parental supervision and monitoring, parenting style, adolescent-parent communication, family conflict and relations with parents, and the importance placed on life goals. The results of this study are consistent with previous findings from general population studies. Psychiatrically hospitalized adolescents' smoking status were also correlated with their siblings', peers', and girlfriends'/boyfriends' smoking status. In addition, we found that parental monitoring, closeness to parents, and ambitious life goals were protective factors against smoking. As a result, peer and family influences strongly impact the initiation and maintenance of adolescent smoking and should be considered when designing smoking cessation interventions for adolescents with psychiatric disorders.