Disorders - Substance Use Disorders
Brody, G. H., Chen, Y. F., Kogan, S. M., Yu, T., Molgaard, V. K., DiClemente, R. J., Wingood, G. M.
OBJECTIVES: The present research addressed the following important
question in pediatricmedicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T)
program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months?
METHODS: Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention
condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a
caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem
behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment).
RESULTS: Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and
depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment.
CONCLUSIONS: This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use
problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to
public health agencies, schools, churches, boys' and girls' clubs, and other community organizations. Copyright (copyright) 2012 by the American
Academy of Pediatrics.
Pediatrics, 129(1) : 108-
115
- Year: 2012
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Brody, G. H., Yu,
T., Chen, Y. F., Kogan, S. M., Smith, K.
Objective: This report
addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of
substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. Method: African
American youths (M age, pretest = 17.7 years) were assigned randomly to the AIM (n = 174) or control (n = 173) group. Past 3-month alcohol use, past
6-month substance use problems, risk taking, and susceptibility cognitions were assessed at pretest and at 6.4, 16.6, and 27.5 months after pretest.
Pretest assessments of parent-child conflict, affiliations with substance-using companions, and perceived racial discrimination were used to
construct a contextual risk factor index. Results: A protective stabilizing hypothesis was supported; the long-term efficacy of AIM in preventing
escalation of alcohol use and substance use problems was greater for youths with higher pretest contextual risk scores. Consistent with a mediation-
moderation hypothesis, AIM-induced reductions over time in risk taking and susceptibility cognitions were responsible for the AIM null contextual
risk prevention effects on alcohol use and substance use problems. Conclusions: Training in developmentally appropriate protective parenting
processes and self-regulatory skills during the transition from adolescence to emerging adulthood for rural African Americans may contribute to a
self-sustaining decreased interest in alcohol use and a lower likelihood of developing substance use problems. (copyright) 2011 American
Psychological Association.
Journal of Consulting & Clinical Psychology, 80(1) : 17-
28
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Broning, S., Kumpfer, K., Kruse,
K., Sack, P. M., Schaunig-Busch, I., Ruths, S., Moesgen, D., et-al
Children from substance-affected families
show an elevated risk for developing own substance-related or other mental disorders. Therefore, they are an important target group for preventive
efforts. So far, such programs for children of substance-involved parents have not been reviewed together. We conducted a comprehensive systematic
review to identify and summarize evaluations of selective preventive interventions in childhood and adolescence targeted at this specific group. From
the overall search result of 375 articles, 339 were excluded, 36 full texts were reviewed. From these, nine eligible programs documented in 13
studies were identified comprising four school-based interventions (study 1-6), one community-based intervention (study 7-8), and four family-based
interventions (study 9-13). Studies' levels of evidence were rated in accordance with the Scottish Intercollegiate Guidelines Network (SIGN)
methodology, and their quality was ranked according to a score adapted from the area of meta-analytic family therapy research and consisting of 15
study design quality criteria. Studies varied in program format, structure, content, and participants. They also varied in outcome measures, results,
and study design quality. We found seven RCT's, two well designed controlled or quasi-experimental studies, three well-designed descriptive studies,
and one qualitative study. There was preliminary evidence for the effectiveness of the programs, especially when their duration was longer than ten
weeks and when they involved children's, parenting, and family skills training components. Outcomes proximal to the intervention, such as program-
related knowledge, coping-skills, and family relations, showed better results than more distal outcomes such as self-worth and substance use
initiation, the latter due to the comparably young age of participants and sparse longitudinal data. However, because of the small overall number of
studies found, all conclusions must remain tentative. More evaluations are needed and their quality must be improved. New research should focus on
the differential impact of program components and delivery mechanisms. It should also explore long-term effects on children substance use,
delinquency, mental health, physical health and school performance. To broaden the field, new approaches to prevention should be tested in diverse
cultural and contextual settings.
Substance
Abuse Treatment, Prevention & Policy, 7 : 23
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Baldwin, S. A., Christian, S., Berkeljon, A., Shadish, W. R.
This meta-analysis summarizes results from k=24
studies comparing either Brief Strategic Family Therapy, Functional Family Therapy, Multidimensional Family Therapy, or Multisystemic Therapy to
either treatment-as-usual, an alternative therapy, or a control group in the treatment of adolescent substance abuse and delinquency. Additionally,
the authors reviewed and applied three advanced meta-analysis methods including influence analysis, multivariate meta-analysis, and publication bias
analyses. The results suggested that as a group the four family therapies had statistically significant, but modest effects as compared to
treatment-as-usual (d=0.21; k=11) and as compared to alternative therapies (d=0.26; k=11). The effect of family therapy compared to control was
larger (d=0.70; k=4) but was not statistically significant probably because of low power. There was insufficient evidence to determine whether the
various models differed in their effectiveness relative to each other. Influence analyses suggested that three studies had a large effect on
aggregate effect sizes and heterogeneity statistics. Moderator and multivariate analyses were largely underpowered but will be useful as this
literature grows. (copyright) 2011 American Association for Marriage and Family Therapy.
Journal of Marital & Family Therapy, 38(1) : 281-
304
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Barnett, E., Sussman, S., Smith, C., Rohrbach, L.
A., Spruijt-Metz, D.
Motivational Interviewing (MI) is a widely-used approach for addressing adolescent substance use. Recent meta-analytic
findings show small but consistent effect sizes. However, differences in intervention format and intervention design, as well as possible mediators
of change, have never been reviewed. This review of the literature summarizes the most up-to-date MI interventions with adolescents, looks at
differences between intervention format and design, and discusses possible theory-based mechanisms of change. Of the 39 studies included in this
review, 67% reported statistically significant improved substance use outcomes. Chi square results show no significant difference between
interventions using feedback or not, or interventions combined with other treatment versus MI alone. The need for systematic investigation in
theory-based mechanisms of change is presented. (copyright) 2012 Elsevier Ltd.
Addictive
Behaviors, 37(12) : 1325-1334
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Cordova, David, Huang, Shi, Pantin, Hilda, Prado, Guillermo
To examine whether the intervention effects of Familias Unidas, compared to community practice, on Hispanic
adolescent alcohol and drug use varies by nativity status (i.e., U.S.-born and foreign-born). A total of 213 eighth grade Hispanic adolescents with
behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants
were assessed at baseline and at 6, 18, and 30 months post baseline. Results showed that, the effects of Familias Unidas on alcohol use was moderated
by nativity status. Specifically, Familias Unidas was efficacious in preventing/reducing alcohol use for U.S.-born youth, but not foreign-born. No
moderating effects were found for drug use. These findings suggest that prevention interventions may be more efficacious in preventing/reducing
alcohol use among certain Hispanic adolescent subgroups. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Psychology of Addictive Behaviors, 26(3) : 655-
660
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Carney, T., Myers, B.
Information on the impact of available interventions that
address adolescent substance use and delinquency can inform investment choices. This article aims to identify and evaluate early interventions that
target adolescent substance use as a primary outcome, and criminal or delinquent behaviours as a secondary outcome. A systematic review of early
interventions for adolescent substance use and behavioural outcomes was conducted. We identified nine studies using specific search strategies. All
but one of the studies reported the use of brief intervention strategies. Only seven studies contained information which allowed for the calculation
of an effect size, and were therefore included in the meta-analysis. The overall effect size for all outcomes combined was small but significant (g =
0.25, p < 0.001). The overall outcome for substance use was also small but significant (g = 0.24, p < 0.001). For studies with behavioural outcomes,
the overall effect size reached significance (g = 0.28, p < 0.001). In general, subgroup analysis showed that individual interventions with more than
one session had a stronger effect on the outcomes of interest. Early interventions for adolescent substance use do hold benefits for reducing
substance use and associated behavioural outcomes. Interventions are most promising if delivered in an individual format and over multiple sessions.
One intervention in particular had large effect sizes. As all the interventions were tested in developed countries, further testing is needed in low-
and middle-income countries where there is a lack of research on evidence-based interventions for adolescent risk behaviours. Additional
recommendations for policy and practice are provided in this paper.
Substance Abuse Treatment, Prevention &
Policy, 7 : 25
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Evers, Kerry E., Paiva, Andrea L., Johnson, Janet L., Cummins, Carol O., Prochaska, James O., Prochaska, Janice M., Padula,
Julie, et-al
Background: Early use of alcohol, tobacco, and other drugs threatens the physical and mental well-being of
students and continued use negatively affects many areas of development. An internet-based, tailored intervention based on the Transtheoretical Model
of Behavior Change was delivered to middle school students to reduce alcohol, tobacco, and other drug use. This internet-based approach requires very
little faculty and staff time, which is efficient given curricular demands.; Methods: Twenty-two middle schools in the United States were matched and
randomly assigned to either the intervention or control conditions (N=1590 students who had ever used substances). Participants received one pre-test
assessment, three thirty-minute intervention sessions over three months, and two post-test assessments (3 and 14 months after pre-test,
respectively).; Results: Random effects logistic models showed significant treatment effects for the intervention group when compared to the control
group at the 3-month post-test.; Conclusions: This program has the potential to be applied as stand-alone practice or as part of more intensive
interventions to promote substance use cessation.; Copyright © 2012 Elsevier Ltd. All rights reserved.
Addictive Behaviors, 37(9) : 1009-
1018
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Branson, C. E., Barbuti, A. M., Clemmey, P., Herman, L., Bhutia, P.
Numerous studies demonstrate the efficacy of contingency management (CM) for improving patient outcomes, yet it is rarely used in
treatment settings due to the high cost of implementation. This quasi-experimental study (N = 52) examined the effect of a low-cost \"Fishbowl\" CM
intervention on attendance/retention in an early intervention adolescent substance abuse program. The CM group attended significantly more sessions
compared to the control group. Furthermore, the CM intervention costs $3.27 per patient per session. Our findings support the use of low-cost CM to
improve adolescent attendance in clinical settings. Copyright (copyright) American Academy of Addiction Psychiatry.
American Journal on Addictions, 21(2) : 126-
129
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Contingency
management
Bartle-Haring,
Suzanne, Slesnick, Natasha, Collins, Jennifer, Erdem, Gizem, Buettner, Cynthia
Background: Despite the intuitive appeal and popularity
of mentoring programs, mentoring has shown only limited success for positively impacting children's psychosocial functioning. Furthermore, we were
not able to identify a study that examined the potential utility of mentoring for homeless adolescents.; Objective: The purpose of this pilot study
was to examine the impact of mentoring among a group of homeless adolescents who were also receiving substance abuse treatment.; Methods: This pilot
study examined the impact of mentoring among homeless adolescents (n = 90) between the ages of 14 and 20 years who also received substance abuse
treatment. A longitudinal design was used in which adolescents were assessed at baseline, 3 months, and following the completion of treatment at 6
months postbaseline.; Results: Findings showed that adolescents with a history of physical or sexual abuse attended more mentoring sessions. Also,
mentoring in addition to treatment was associated with a decrease in problem consequences associated with substance use. However, more mentoring with
fewer treatment sessions was associated with an increase in internalizing behaviors. Only these two outcomes were associated with mentoring.
Conclusions and; Scientific Significance: While not providing resounding support for mentoring, this study suggests that examining the mentor/mentee
relationship may be a fruitful line of future research given that significant variability among the mentor/mentee pairs was noted for some outcomes
of interest.;
The American Journal of Drug & Alcohol Abuse, 38(4) : 350-358
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Gabrhelik, Roman, Duncan, Alexandra, Miovsky, Michal, Furr-Holden, C. Debra M., Stastna, Lenka, Jurystova, Lucie
Background: The Czech Unplugged Study, inspired by the European Drug Addiction Prevention
Trial, is a prospective, school-based, randomized controlled prevention trial designed to reduce the risk of alcohol, tobacco, inhalant, and illegal
drug use in 6th graders in the Czech Republic. The intervention uses the comprehensive social influence model to affect alcohol and drug using norms
among primary school students. Methods: Descriptive statistics and chi-square analyses were used to assess differences between the experimental and
control groups on demographic characteristics and study outcomes. Multilevel techniques were used to take the hierarchical structure of the data into
account. Prevalence odds ratios using the Bonferroni correction were calculated to assess the differences between the experimental (N = 914) and
control (N = 839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. Results: Multilevel analysis using the
Bonferroni correction showed statistically significant intervention effects at the final follow-up for any smoking (OR = 0.75, 99.2% CI 0.65 - 0.87),
daily smoking (OR = 0.62, 99.2% CI 0.48 - 0.79), heavy smoking (OR = 0.48, 99.2% CI 0.28 - 0.81), any cannabis use (OR = 0.57 99.2% CI 0.42 - 0.77),
frequent cannabis use (OR = 0.57, 99.2% CI 0.36 - 0.89), and any drug use (OR = 0.78, 99.2% CI 0.65 - 0.94). Conclusions: This study adds new
evidence on the effectiveness of the Unplugged school-based prevention program for primary school students in the Czech Republic. (PsycINFO Database
Record (c) 2012 APA, all rights reserved) (journal abstract)
Drug & Alcohol Dependence, 124(1-2) : 79-
87
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Garner, B. R., Godley, S. H., Dennis, M. L., Hunter, B. D., Bair, C. M. L., Godley, M. D.
Objective: To test whether pay for performance (P4P) is
an effective method to improve adolescent substance use disorder treatment implementation and efficacy. Design : Cluster randomized trial. Setting:
Community-based treatment organizations. Participants: Twenty-nine community-based treatment organizations, 105 therapists, and 986 adolescent
patients (953 with complete data). Intervention: Community-based treatment organizations were assigned to 1 of the following conditions: the
implementation-as-usual (IAU) control condition or the P4P experimental condition. In addition to delivering the same evidence-based treatment (ie,
using the Adolescent Community Reinforcement Approach [A-CRA]), each organization received standardized levels of funding, training, and coaching
from the treatment developers. Therapists in the P4P condition received US $50 for each month that they demonstrated competence in treatment delivery
(ie, A-CRA competence) and US $200 for each patient who received a specified number of treatment procedures and sessions (ie, target A-CRA) that has
been found to be associated with significantly improved patient outcomes. Main Outcome Measures : Outcomes included ACRA competence (ie, a
therapist-level implementation measure), target A-CRA (ie, a patient-level implementation measure), and remission status (ie, a patientlevel
treatment effectiveness measure). Results: Relative to therapists in the IAU control condition, therapists in the P4P condition were significantly
more likely to demonstrate A-CRA competence (24.0% vs 8.9%; event rate ratio, 2.24; 95% CI, 1.12- 4.48; P =.02). Relative to patients in the IAU
control condition, patients in the P4P condition were significantly more likely to receive target A-CRA (17.3% vs 2.5%; odds ratio, 5.19; 95% CI,
1.53-17.62; P =.01). However, no significant differences were found between conditions with regard to patients' end-of-treatment remission status.
Conclusion: Pay for performance can be an effective method of improving treatment implementation. (copyright)2012 American Medical Association. All
rights reserved.
Archives of
Pediatrics & Adolescent Medicine, 166(10) : 938-944
- Year: 2012
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions