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Perrier-Ménard E, Castellanos-Ryan N, O'Leary-Barrett M, Girard A, Conrod PJ. The impact of youth internalising and externalising symptom severity on the effectiveness of brief personality-targeted interventions for substance misuse: A cluster randomised trial. Addict Behav 2017; 75:138-144. [PMID: 28734153 DOI: 10.1016/j.addbeh.2017.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/16/2017] [Accepted: 07/13/2017] [Indexed: 10/19/2022]
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Lui CK, Sterling SA, Chi FW, Lu Y, Campbell CI. Socioeconomic differences in adolescent substance abuse treatment participation and long-term outcomes. Addict Behav 2017; 68:45-51. [PMID: 28088743 DOI: 10.1016/j.addbeh.2017.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/15/2016] [Accepted: 01/04/2017] [Indexed: 11/28/2022]
Abstract
Socioeconomic status (SES) has been consistently linked to poorer access, utilization and outcomes of health care services, but this relationship has been understudied in adolescent substance abuse treatment research. This study examined SES differences in adolescent's treatment participation and long-term outcomes of abstinence and 12-step attendance over five years after treatment. Data are from 358 adolescents (ages 13-18) who were recruited at intake to substance abuse treatment between 2000 and 2002 at four Kaiser Permanente Northern California outpatient treatment programs. Follow-up interviews of adolescents and their parents were conducted at 1, 3, and 5years, with over 80% response rates across time points. Using parent SES as a proxy for adolescent SES, no socioeconomic differences were found in treatment initiation, treatment retention, or long-term abstinence from alcohol or drugs. Parent education, but not parent income, was significantly associated with 12-step attendance post-treatment such that adolescents with higher parent education were more likely to attend than those with lower parent education. Findings suggest a lack of socioeconomic disparities in substance abuse treatment participation in adolescence, but potential disparities in post-treatment 12-step attendance during the transition from adolescence to young adulthood.
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Affiliation(s)
- Camillia K Lui
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
| | - Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
| | - Yun Lu
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
| | - Cynthia I Campbell
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd Floor, Oakland, CA 94612, USA
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Crawley RD, Becan JE, Knight DK, Joe GW, Flynn PM. Predictors of Physical Altercation among Adolescents in Residential Substance Abuse Treatment. DEVIANT BEHAVIOR 2015; 36:996-1018. [PMID: 26622072 PMCID: PMC4662565 DOI: 10.1080/01639625.2014.982780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study tested the hypothesis that basic social information-processing components represented by family conflict, peer aggression, and pro-aggression cognitive scripts are related to aggression and social problems among adolescents in substance abuse treatment. The sample consisted of 547 adolescents in two community-based residential facilities. Correlation results indicated that more peer aggression is related to more pro-aggression scripts; scripts, peer aggression, and family conflict are associated with social problems; and in-treatment physical altercation involvement is predicted by higher peer aggression. Findings suggest that social information-processing components are valuable for treatment research.
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Affiliation(s)
- Rachel D. Crawley
- Corresponding Author: Rachel D. Crawley, Institute of Behavioral Research, Texas Christian University, TCU Box 298740, Fort Worth, TX 76129.
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Ekinci S, Kandemir H. Childhood trauma in the lives of substance-dependent patients: The relationship between depression, anxiety and self-esteem. Nord J Psychiatry 2015; 69:249-53. [PMID: 25434460 DOI: 10.3109/08039488.2014.981856] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND High levels of childhood traumatic experiences have been observed among substance abusers. There has been insufficient study of the effects of childhood trauma in adulthood. OBJECTIVE The aim of this study is to research the relationship between childhood trauma, self-esteem, and levels of depression and anxiety in substance-dependent (SD) people. METHOD This study took place between March 2012 and April 2013, at Balıklı Rum Hospital (Istanbul) substance dependency clinic. It included 50 patients diagnosed as substance dependent according to the criteria of DSM-IV as compared with 45 healthy controls. The Structured Clinical Interview for DSM-IV Diagnosis (SCID-I) was used to identify Axis I disorders. All other data was collected using a semi-structured socio-demographic questionnaire, the Childhood Trauma Questionnaire (CTQ), the Rosenberg Self Esteem Scale (RSES), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). FINDINGS The total scores of the SD group on the CTQ and on its Emotional Abuse/Emotional Neglect (EA/EN), Physical Abuse (PA) and Sexual Abuse (SA) subscales were statistically significant. In relation to the healthy controls, the SD group scored higher on the RSES, BDI and BAI. A correlation was observed between the total scores of SD individuals on the CTQ and their scores on the RSES, BDI and BAI. CONCLUSION This study showed high levels of childhood traumatic experiences for SD people and indicates that there may be a relationship between these experiences and their levels of self-esteem, depression and anxiety.
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Affiliation(s)
- Suat Ekinci
- Suat Ekinci, Department of Psychiatry, Balıklı Rum Foundation Hospital, Addicton Service , İstanbul , Turkey
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Hersh J, Curry JF, Becker SJ. The Influence of Comorbid Depression and Conduct Disorder on MET/CBT Treatment Outcome for Adolescent Substance Use Disorders. Int J Cogn Ther 2013; 6:325-341. [PMID: 25197427 PMCID: PMC4155521 DOI: 10.1521/ijct.2013.6.4.325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although depression and conduct disorder frequently co-occur with substance use disorders (SUDs), few studies have investigated the individual and interactive effects of these conditions on SUD treatment outcome. Data were collected from 90 adolescents aged 13-21 (M = 17.1, SD = 2.07) who received a brief evidence-based intervention for SUD. Hierarchical regressions assessed the relationship among demographic variables, depression, conduct disorder, and two substance use outcomes (frequency and problems) at two intervals (three months, six months). Results revealed that higher baseline substance use and lower socioeconomic status significantly predicted higher substance problems and frequency at three-months. At six months, higher three month substance problems and lower depressive symptoms predicted substance problems. In addition, an interaction indicated that the effect of conduct disorder on substance problems was greatest at lower levels of depression. Results are discussed in the context of previous research indicating mixed effects of depression on SUD treatment outcome.
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Affiliation(s)
| | - John F Curry
- Department of Psychology & Neuroscience, Duke University ; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center
| | - Sara J Becker
- Department of Psychiatry and Human Behavior, Brown University Medical School
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Godley SH, Hunter BD, Fernández-Artamendi S, Smith JE, Meyers RJ, Godley MD. A comparison of treatment outcomes for adolescent community reinforcement approach participants with and without co-occurring problems. J Subst Abuse Treat 2013; 46:463-71. [PMID: 24462478 DOI: 10.1016/j.jsat.2013.10.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 08/16/2013] [Accepted: 10/29/2013] [Indexed: 11/28/2022]
Abstract
This study examined the relationship between Adolescent Community Reinforcement Approach (A-CRA) participation with treatment engagement, retention, and satisfaction, and with substance use and emotional problem outcomes. Participants had substance use disorders (SUD) only or co-occurring substance use and psychiatric problems. Those with co-occurring problems reported more days of substance use and emotional problems at intake to treatment than those with SUD only. All groups received equivalent exposure to A-CRA during treatment implementation. At the 12-month follow-up, adolescents classified as externalizers (n = 468) or those with both externalizing and internalizing problems (n = 674) had significantly greater improvement in their days of abstinence and substance problems relative to adolescents with substance use disorders only (n = 666). Additionally, adolescents reporting symptoms of internalizing (n = 154), externalizing, or both externalizing and internalizing disorders had significantly greater improvements in days of emotional problems relative to adolescents with SUD only.
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Affiliation(s)
- Susan H Godley
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761.
| | | | | | | | | | - Mark D Godley
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761
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Fox CL, Towe SL, Stephens RS, Walker DD, Roffman RA. Motives for cannabis use in high-risk adolescent users. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 25:492-500. [PMID: 21688873 DOI: 10.1037/a0024331] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present investigation examined the relationships between motives for cannabis use and negative consequences associated with cannabis use following a brief intervention. The sample consisted of 205 adolescent cannabis users (66.3% male), who were recruited in high schools and randomly assigned to a brief two-session motivational enhancement therapy (MET) or an educational feedback control (EFC). Results supported the hypothesis that using cannabis to cope with negative affect would predict the number of problems and dependence symptoms related to cannabis use, after controlling for age, gender, years and frequency of cannabis use, and internalizing and externalizing behavior problems. Significant interactions between internalizing behavior problems and the coping motive showed that using to cope was associated with a higher number of cannabis dependence symptoms among adolescents reporting lower levels internalizing behavior problems. Findings support the potential utility of conducting further research to explore the coping motive as an important indicator of problematic cannabis use.
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Affiliation(s)
- Courtney L Fox
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall, Blacksburg, VA 24061, USA.
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Warden D, Riggs PD, Min SJ, Mikulich-Gilbertson SK, Tamm L, Trello-Rishel K, Winhusen T. Major depression and treatment response in adolescents with ADHD and substance use disorder. Drug Alcohol Depend 2012; 120:214-9. [PMID: 21885210 PMCID: PMC3245790 DOI: 10.1016/j.drugalcdep.2011.08.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/28/2011] [Accepted: 08/02/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) frequently co-occurs in adolescents with substance use disorders (SUDs) and attention deficit hyperactivity disorder (ADHD), but the impact of MDD on substance treatment and ADHD outcomes and implications for clinical practice are unclear. METHODS Adolescents (n=303; ages 13-18) meeting DSM-IV criteria for ADHD and SUD were randomized to osmotic release methylphenidate (OROS-MPH) or placebo and 16 weeks of cognitive behavioral therapy (CBT). Adolescents with (n=38) and without (n=265) MDD were compared on baseline demographic and clinical characteristics as well as non-nicotine substance use and ADHD treatment outcomes. RESULTS Adolescents with MDD reported more non-nicotine substance use days at baseline and continued using more throughout treatment compared to those without MDD (p<0.0001 based on timeline followback; p<0.001 based on urine drug screens). There was no difference between adolescents with and without MDD in retention or CBT sessions attended. ADHD symptom severity (based on DSM-IV ADHD rating scale) followed a slightly different course of improvement although with no difference between groups in baseline or 16-week symptom severity or 16-week symptom reduction. There was no difference in days of substance use or ADHD symptom outcomes over time in adolescents with MDD or those without MDD treated with OROS-MPH or placebo. Depressed adolescents were more often female, older, and not court ordered. CONCLUSIONS These preliminary findings suggest that compared to non-depressed adolescents with ADHD and SUD, those with co-occurring MDD have more severe substance use at baseline and throughout treatment. Such youth may require interventions targeting depression.
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Affiliation(s)
- Diane Warden
- Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9119, United States.
| | | | - Sung-Joon Min
- Department of Medicine, University of Colorado Anschutz Medical Campus
| | | | - Leanne Tamm
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center
| | | | - Theresa Winhusen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine
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Sterling S, Chi F, Campbell C, Weisner C. Three-year chemical dependency and mental health treatment outcomes among adolescents: the role of continuing care. Alcohol Clin Exp Res 2009; 33:1417-29. [PMID: 19413644 PMCID: PMC2923091 DOI: 10.1111/j.1530-0277.2009.00972.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. METHODS Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. RESULTS At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). CONCLUSIONS A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents.
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Affiliation(s)
- Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, California 94612-2403, USA.
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10
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SPOONER CATHERINE. Causes and correlates of adolescent drug abuse and implications for treatment. Drug Alcohol Rev 2009. [DOI: 10.1080/09595239996329] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Winters KC, Stinchfield RD, Latimer WW, Stone A. Internalizing and externalizing behaviors and their association with the treatment of adolescents with substance use disorder. J Subst Abuse Treat 2008; 35:269-78. [PMID: 18328664 DOI: 10.1016/j.jsat.2007.11.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 11/06/2007] [Accepted: 11/19/2007] [Indexed: 11/25/2022]
Abstract
Whereas the treatment outcome research literature for adolescent alcohol and other drug abuse has shown recent advances (R. J. Williams, S. Y. Chang, & Addiction Centre Adolescent Research Group, 2000), significant knowledge gaps remain. A. E. Kazdin (2001) recently observed that one of the key questions for the field is to identify if client characteristics meaningfully mediate or moderate treatment outcome. There is support from the adolescent clinical literature that internalizing and externalizing personality subtypes are related to the onset and course of youth substance use disorders (D. B. Clark & O. G. Bukstein, 1998). The study extends this literature by examining the association of drug use behaviors outcome and subtyped adolescents (internalizers and externalizers; n = 141) who sought treatment at a 12-Step program. The analysis also includes a community-based control group (n = 94). Specifically, we examined the association of subtype and treatment retention and short-term (Year 1) and long-term (Year 4 and Year 5.5) drug involvement outcomes. Externalizers consistently showed poorer outcomes, including poorer treatment retention and greater drug use and drug disorder symptoms at each follow-up point. The treatment implications of the study are discussed.
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Affiliation(s)
- Ken C Winters
- Department of Psychiatry, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
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Baker KD, Lubman DI, Cosgrave EM, Killackey EJ, Yuen HP, Hides L, Baksheev GN, Buckby JA, Yung AR. Impact of co-occurring substance use on 6 month outcomes for young people seeking mental health treatment. Aust N Z J Psychiatry 2007; 41:896-902. [PMID: 17924242 DOI: 10.1080/00048670701634986] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Co-occurring substance use and mental health disorders are highly prevalent among young people attending services, yet few studies have examined the effect of such comorbidity among those referred for treatment. The aim of the current study was to examine the impact of co-occurring substance use disorders (SUDs) on 6 month outcomes for young people seeking mental health treatment. METHOD One hundred and six young people (aged 15-24 years) with a non-psychotic DSM-IV Axis I disorder were assessed following referral to a specialist youth public mental health service. Participants were given a structured interview, as well as questionnaires assessing drug use, psychopathology, psychosocial functioning and self-esteem at baseline and 6 month follow up. RESULTS At baseline, 23 participants met criteria for a co-occurring SUD and 83 had a non-psychotic Axis I disorder. Both the non-SUD and the co-occurring SUD groups had high levels of psychopathology, serious impairments in functioning and moderate levels of suicidal ideation, although those with co-occurring SUD had significantly poorer levels of functioning. At 6 month follow up the co-occurring SUD group continued to experience substantial problems with symptoms and functioning whereas the non-SUD group had significant improvement in both of these domains. CONCLUSIONS The present findings are consistent with studies examining the impact of co-occurring substance use and mental health issues across different treatment settings, and reinforce recommendations that young people with co-occurring disorders require more intensive and integrated interventions. The present findings also highlight the need for routine assessment and management of substance use issues within youth mental health settings.
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Affiliation(s)
- Kathryn D Baker
- ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Parkville, Vic, Australia
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Chi FW, Sterling S, Weisner C. Adolescents with co-occurring substance use and mental conditions in a private managed care health plan: prevalence, patient characteristics, and treatment initiation and engagement. Am J Addict 2007; 15 Suppl 1:67-79. [PMID: 17182422 DOI: 10.1080/10550490601006022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
This study examined the prevalence, patient characteristics, and treatment initiation and engagement of adolescents with co-occurring substance use (SU) and serious mental health (MH) diagnoses in a private, managed care health plan. We identified 2,005 adolescents aged 12-17, who received both SU and MH diagnoses within a 1-year window between 1/1/2000 and 12/31/2002; 57% were girls. Gender variations were found in diagnoses received and point of identification. Being dually diagnosed in specialty departments (rather than Primary Care and Emergency) and receiving both diagnoses within a shorter time period were associated with treatment initiation and engagement.
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Affiliation(s)
- Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612-2403, USA.
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Dowden C, Latimer J. Providing effective substance abuse treatment for young-offender populations: what works! Child Adolesc Psychiatr Clin N Am 2006; 15:517-37, xi. [PMID: 16527669 DOI: 10.1016/j.chc.2005.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Previous research has documented a strong linkage between substance abuse and criminal activity among young offenders. Consequently, the provision of effective substance-abuse interventions for this population is of paramount importance to the criminal justice system. This article explores the literature on the treatment of substance abuse in offender and nonoffender populations. It reviews three major areas: pretreatment variables (eg, gender and psychopathology), in-treatment variables (eg, program targets, program setting, client-treatment matching), and posttreatment variables (eg, aftercare). The article concludes with a list of empirically derived guidelines for the effective development and implementation of substance-abuse treatment programs for adolescents.
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Waldron HB, Turner CW, Ozechowski TJ. Profiles of drug use behavior change for adolescents in treatment. Addict Behav 2005; 30:1775-96. [PMID: 16202539 PMCID: PMC1862602 DOI: 10.1016/j.addbeh.2005.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Revised: 06/23/2005] [Accepted: 07/01/2005] [Indexed: 11/16/2022]
Abstract
This study was designed to replicate and extend previous research on post-treatment responding by identifying trajectories of change on the basis of an empirical classification strategy and to examine predictors of those change trajectories identified. Treatment response was examined for 232 adolescents with substance use disorders who participated in one of two randomized controlled trials evaluating family and cognitive behavioral interventions in an outpatient treatment setting. Cluster analysis was used to identify, empirically, homogeneous groups of individuals who display common internally consistent patterns of change over the course of treatment.
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Affiliation(s)
- Holly Barrett Waldron
- Center for Family and Adolescent Research, Oregon Research Institute, Eugene, OR 97403, USA.
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Tomlinson KL, Brown SA, Abrantes A. Psychiatric comorbidity and substance use treatment outcomes of adolescents. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2004; 18:160-9. [PMID: 15238058 DOI: 10.1037/0893-164x.18.2.160] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Treatment outcomes of 126 adolescents (13-18 years old) with comorbid substance use disorders (SUDs) and Axis I psychiatric disorders (mood, anxiety, conduct, and attention-deficit/hyperactivity disorders) were compared to 81 SUD adolescents with no additional Axis I disorder. Participants completed structured interviews and symptom measures while participating in an adolescent treatment program and at 6 months following treatment. Results indicated that comorbid youth received more treatment during the outcome period; despite this, more comorbid SUD-Axis I disordered adolescents used substances following treatment than SUD-only youth, even after controlling for socioeconomic status and ethnicity. Among comorbid youth, internalizing disordered adolescents were less likely to use substances during the follow-up period, and externalizing disordered youth returned to substance use most rapidly after discharge from treatment.
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Spooner C, Mattick RP, Noffs W. A study of the patterns and correlates of substance use among adolescents applying for drug treatment. Aust N Z J Public Health 2000; 24:492-502. [PMID: 11109686 DOI: 10.1111/j.1467-842x.2000.tb00499.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To inform planners by providing a psychosocial and drug-use profile of adolescents who have applied for a drug-treatment program. METHOD The setting was a residential drug-treatment program in Sydney for adolescents from NSW and the ACT. The design was a descriptive study of consecutive program applicants over 18 months. Study participants were 14-18 years, 53% were male. Most assessments were telephone interviews. The instrument incorporated the Opiate Treatment Index, Adolescent Drug Abuse Diagnosis, Severity of Dependence Scale and Symptom Checklist 90-Revised (SCL-90-R). RESULTS Study participants tended to be poly-substance users, mostly using cannabis, heroin and/or alcohol. Heavy use in terms of frequency and amounts of use were reported, e.g. 50% of the sample used heroin daily and the mean number of standard drinks consumed on the last day of drinking was 18. High levels of problems in the areas of social functioning, criminal activity, psychological distress, physical health, HIV risk and substance dependence were reported. For example, most participants were unemployed and 88% had committed a crime in the previous month. Higher rates of some problems were identified among females, heroin users and benzodiazepine users. CONCLUSIONS The sample reported a high level of involvement in substance use and associated problems. The profile suggested that improvements might be difficult to achieve and to maintain. IMPLICATIONS A comprehensive, intensive, longer-term drug-treatment program to address the number and extent of substance-related problems for such adolescents is recommended.
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Affiliation(s)
- C Spooner
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney.
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