Disorders - Substance Use Disorders
Haggerty, Kevin P., Skinner,
Martie L., MacKenzie, Elizabeth P., Catalano, Richard F.
This study was designed to test the efficacy of Parents Who Care (PWC), a seven-session universal prevention program
which includes parenting, youth, and family components designed to prevent substance use and other problem behaviors. Using an intent-to-treat
experimental design, this study tests the program efficacy across race within a balanced sample of European American (EA) and African American (AA)
youth and their parents (n = 331 n AA = 163; n EA = 168). Families were recruited, randomly assigned to three conditions (group-administered [PA],
self-administered with telephone support [SA], and no-treatment control) and the intervention was administered when the adolescents were in the
eighth grade. Analyses on key teen outcomes of the Parent's Who Care program at 24-month follow-up are reported here and include perceptions of drug
use harm; favorable attitudes about drug use; delinquent and violent behavior; and initiation into cigarette, alcohol, other drug use, or sexual
activity. Repeated measures mixed model regressions found no effect of the intervention on rate of change in attitudes about drug use or frequency of
delinquent or violent behavior. Regression analyses with multiple imputations for missing data detected group differences in means at 24-month
follow-up. Both program formats reduced favorable attitudes toward drug use among youth (SA d = 0.39, PA d = 0.22); and AA youth in the self-
administered intervention reported significantly less violent behavior than their control counterparts (d = 0.45). No effects were found for drug use
harm or delinquency. Finally, logistic regression predicting a combined outcome measure of initiation of alcohol, tobacco, drug use, and/or sexual
activity found AA youth in both the group- and self-administered intervention conditions significantly less likely to initiate substance use and/or
sexual activity than those in the control condition. Odds ratios indicated the chances of initiating sex or substance use were reduced by almost 70%
(OR = 0.31) for AA teens in the SA condition compared to controls, and 75% (OR = 0.25) for the AA teens in the PA compared to controls.
Prevention Science, 8(4) : 249-
60
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kemp, Rosalind, Harris, Anthony, Vurel, Erdal, Sitharthan, Thiagarajan
OBJECTIVE: Substance abuse is a
significant problem in the treatment of young people with their first psychosis. This study reports a randomized trial of a brief manualized
cognitive behavioural therapy for substance abuse in young people with psychosis. METHOD: Subjects were randomized between the study treatment and a
group treated as usual. Treatment was a four to six session brief cognitive behavioural therapy (CBT) intervention developed specifically for this
patient group - Stop Using Stuff (SUS). RESULTS: Both groups improved across the trial. However, those exposed to the active treatment improved
significantly on measures of the frequency of cannabis and alcohol abuse. CONCLUSIONS: Brief interventions in substance abuse in young people with
psychosis can help moderate substance use in this difficult to treat group.
Australasian Psychiatry, 15(6) : 490-
3
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Faggiano, Fabrizio, Richardson, Clive, Bohrn,
Karl, Galanti, M. Rosaria, EU-DapStudyGroup
BACKGROUND: The empirical evidence of effectiveness of many
school-based programs against substance abuse is rather weak. The EU-Dap study is a multicenter cluster randomized community trial (CRCT) designed to
evaluate such a program. This paper presents study design and baseline characteristics of the study population. METHODS: 170 schools from 9 centers
from seven countries (Austria, Belgium, Germany, Greece, Italy, Spain, Sweden), stratified according to average social status in the catchment area,
were randomized to either three variants of the active intervention (basic curriculum, basic with peer involvement, and basic with parent
involvement) or to a control group. The program under evaluation is based on a comprehensive social influence approach, and was delivered during the
scholar year 2004-2005 to a population of 12- to 14-year-old students attending junior high school. An anonymous questionnaire administered before
and after the intervention was used to track behavioral and attitudinal changes. RESULTS: All in all, we included in the study 143 schools and 7079
students, of which 3547 in the intervention groups and 3532 in the control group. At baseline, 34.9% of students had smoked cigarettes, 24.7% had
been drunk, and 8.9% had used cannabis at least once in life. DISCUSSION: EU-Dap is the first European multicenter randomized study to evaluate the
effectiveness of a school program targeting tobacco, alcohol and drug use. The baseline assessment showed high prevalence and wide geographical
variations of substance use.
Preventive Medicine, 44(2) : 170-
3
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Collins, D. Johnson, K., Becker, B. J.
This article reports results of a meta-analysis of the effects of a set of community coalitions that implemented science-based
substance use prevention interventions as part of a State Incentive Grant (SIG) in Kentucky. The analysis included assessment of direct effects on
prevalence of substance use among adolescents as well as assessment of what \"risk\" and \"protective\" factors mediated the coalition effects. In
addition, we tested whether multiple science-based prevention interventions enhanced the effects of coalitions on youth substance use. Short-term
results (using 8th-grade data) showed no significant decreases in six prevalence of substance use outcomes -- and, in fact, a significant though
small increase in prevalence of use of one substance (inhalants). Sustained results (using 10th-grade data), however, showed significant, though
small decreases in three of six substance use outcomes -- past month prevalence of cigarette use, alcohol use, and binge drinking. We found evidence
that the sustained effects on these three prevalence outcomes were mediated by two posited risk factors: friends' drug use and perceived
availability of drugs. Finally, we found that the number of science-based prevention interventions implemented in schools within the coalitions did
not moderate the effects of the coalitions on the prevalence of drug use. Study limitations are noted.
Substance Use & Misuse, 42(6) : 985-1007
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)
Connell, Arin M., Dishion, Thomas J., Yasui, Miwa, Kavanagh, Kathryn
This study used
Complier Average Causal Effect analysis (CACE; see G. Imbens & D. Rubin, 1997) to examine the impact of an adaptive approach to family intervention
in the public schools on rates of substance use and antisocial behavior among students ages 11-17. Students were randomly assigned to a family-
centered intervention (N = 998) in 6th grade and offered a multilevel intervention that included (a) a universal classroom-based intervention, (b)
the Family Check-Up (selected; T. J. Dishion & K. Kavanagh, 2003), and (c) family management treatment (indicated). All services were voluntary, and
approximately 25% of the families engaged in the selected and indicated levels. Participation in the Family Check-Up was predicted by 6th-grade
teacher ratings of risk, youth reports of family conflict, and the absence of biological fathers from the youths' primary home. Relative to
randomized matched controls, adolescents whose parents engaged in the Family Check-Up exhibited less growth in alcohol, tobacco, and marijuana use
and problem behavior during ages 11 through 17, along with decreased risk for substance use diagnoses and police records of arrests by age 18.
Journal of Consulting & Clinical Psychology, 75(4) : 568-79
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Valente, Thomas W., Ritt-Olson, Anamara, Stacy, Alan, Unger, Jennifer B., Okamoto, Janet, Sussman, Steve
OBJECTIVE: To test whether a social
network tailored substance abuse prevention program can reduce substance use among high-risk adolescents without creating deviancy training
(iatrogenic effects). METHODS: A classroom randomized controlled trial comparing control classes with those receiving an evidence-based substance use
prevention program [Towards No Drug Abuse (TND)] and TND Network, a peer-led interactive version of TND. Students (n = 541, mean age 16.3 years) in
75 classes from 14 alternative high schools completed surveys before and approximately 1 year after curriculum delivery. Past-month use of tobacco,
alcohol, marijuana and cocaine were assessed. RESULTS: Overall, TND Network was effective in reducing substance use. However, the program effect
interacted with peer influence and was effective mainly for students who had peer networks that did not use substances. Students with classroom
friends who use substances were more likely to increase their use. CONCLUSIONS: A peer-led interactive substance abuse prevention program can
accelerate peer influences. For students with a peer environment that supports non-use, the program was effective and reduced substance use. For
students with a peer environment that supports substance use, an interactive program may have deleterious effects.
Addiction, 102(11) : 1804-15
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Spoth, Richard, Redmond, Cleve, Shin, Chungyeol, Greenberg, Mark, Clair, Scott, Feinberg,
Mark
BACKGROUND: The study's objective was to examine the effects of \"real-world,\" community-based
implementation of universal preventive interventions selected from a menu, including effects specific to higher- and lower-risk subsamples. DESIGN:
School districts were selected based on size and location, and then randomly assigned to a control condition or to an experimental condition in a
cohort sequential design. SETTING/PARTICIPANTS: The study included 28 public school districts in Iowa and Pennsylvania that were located in rural
towns and small cities, ranging in size from 6975 to 44,510. Sixth and seventh graders in these school districts participated in the study.
INTERVENTION: Community teams were mobilized; each team implemented one of three evidence-based, family-focused interventions (5 to 12 sessions) and
one of three evidence-based school interventions (11 to 15 sessions), for 6th and 7th graders, respectively. Observations showed that interventions
were implemented with fidelity. MAIN OUTCOME MEASURES: Outcomes included student reports of past month, past year, and lifetime use of alcohol,
cigarettes, marijuana, methamphetamines, ecstasy, and inhalants, as well as indices of gateway and illicit substance initiation, at pretest and at a
follow-up assessment 18 months later. RESULTS: Intent-to-treat analyses demonstrated significant effects on substance initiation (marijuana,
inhalants, methamphetamines, ecstasy, gateway index, illicit-use index), as well as past-year use of marijuana and inhalants, with positive trends
for all substances measured. For three outcomes, intervention effects were stronger for higher-risk students than lower-risk students. CONCLUSIONS:
Community-based implementation of brief universal interventions designed for general populations has potential for public health impact by reducing
substance use among adolescents.
American Journal of Preventive Medicine, 32(5) : 395-
402
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions
Slesnick, Natasha, Prestopnik, Jillian L., Meyers, Robert J., Glassman, Michael
Comprehensive intervention for homeless, street living youth that addresses substance use, social stability, physical
and mental health issues has received very little attention. In this study, street living youth aged 14-22 were recruited from a drop-in center and
randomly assigned to the Community Reinforcement Approach (CRA) or treatment as usual (TAU) through a drop-in center. Findings showed that youth
assigned to CRA, compared to TAU, reported significantly reduced substance use (37% vs. 17% reduction), depression (40% vs. 23%) and increased social
stability (58% vs. 13%). Youth in both conditions improved in many other behavioral domains including substance use, internalizing and externalizing
problems, and emotion and task oriented coping. This study indicates that homeless youth can be engaged into treatment and respond favorably to
intervention efforts. However, more treatment development research is needed to address the barriers associated with serving these youth.
Addictive
Behaviors, 32(6) : 1237-51
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Spoth, Richard, Shin, Chungyeol, Guyll, Max, Redmond, Cleve, Azevedo, Kari
This study extends earlier investigation of family risk-related moderation of two brief, family-focused preventive interventions. It
examines effects on the trajectories of substance initiation over a period of six years after a pretest assessment, evaluating whether effects were
comparable across higher- and lower-risk subgroups. The two interventions, designed for general-population families of adolescents, were the seven-
session Iowa Strengthening Families Program (ISFP) and the five-session Preparing for the Drug Free Years program (PDFY). Thirty-three rural public
schools were randomly assigned to either the ISFP, the PDFY, or a minimal contact control condition. Curvilinear growth curve analyses were used to
evaluate the universality of intervention effectiveness by testing for risk moderation of intervention effects on school-level substance use
trajectories of initiation of alcohol and illicit substance use. Results were most consistent with the interpretation that both interventions
provided comparable benefits for both outcome measures, regardless of family risk status. Findings are discussed in terms of their implications for
implementing universal preventive interventions in general populations.
Prevention Science, 7(2) : 209-
24
- Year: 2006
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Smith, Douglas C., Hall, James A., Williams,
Julie K, An, Hyonggin, Gotman, Nathan
Due to the continuing prevalence of adolescent substance abuse, promising treatment models need to be developed and
evaluated. Thus, the purpose of this study was to evaluate the efficacy of two promising models, Strengths Oriented Family Therapy (SOFT) and The
Seven Challenges(R) (7C). Adolescents who qualified for outpatient treatment and agreed to participate in our study were randomly assigned to one of
the two treatments and assessed at 3 and 6-months following baseline. Using a two-part, random-effects model, we examined the odds of achieving
abstinence or full symptom remission between treatments and over time. For those not achieving full abstinence or full problem remission, we
investigated whether frequency of use or symptom severity were reduced at follow-up. Participants in both SOFT and 7C demonstrated significant
reductions in substance use and related problems, but treatments did not differ at 3 and 6 months following baseline. Overall, treatment services
were delivered as planned. Both SOFT and 7C were efficacious with adolescents who abuse substances, as participants in both conditions were
significantly more likely to be in symptom remission or abstinent at follow-up interviews versus at baseline. Replication studies are needed that
address this study's limitations.
American Journal
on Addictions, 15 Suppl 1 : 131-6
- Year: 2006
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Family therapy, Other Psychological Interventions, Case management, Other service delivery and improvement
interventions
Slater, Michael D., Kelly, Kathleen J., Edwards, Ruth W., Thurman, Pamela J., Plested, Barbara A., Keefe, Thomas J., Lawrence,
Frank R., et-al
This study tests the impact of an in-school
mediated communication campaign based on social marketing principles, in combination with a participatory, community-based media effort, on
marijuana, alcohol and tobacco uptake among middle-school students. Eight media treatment and eight control communities throughout the US were
randomly assigned to condition. Within both media treatment and media control communities, one school received a research-based prevention curriculum
and one school did not, resulting in a crossed, split-plot design. Four waves of longitudinal data were collected over 2 years in each school and
were analyzed using generalized linear mixed models to account for clustering effects. Youth in intervention communities (N = 4216) showed fewer
users at final post-test for marijuana [odds ratio (OR) = 0.50, P = 0.019], alcohol (OR = 0.40, P = 0.009) and cigarettes (OR = 0.49, P = 0.039),
one-tailed. Growth trajectory results were significant for marijuana (P = 0.040), marginal for alcohol (P = 0.051) and non-significant for cigarettes
(P = 0.114). Results suggest that an appropriately designed in-school and community-based media effort can reduce youth substance uptake.
Effectiveness does not depend on the presence of an in-school prevention curriculum. (PsycINFO Database Record (c) 2007 APA, all rights reserved)
(journal abstract).
Health Education Research, 21(1) : 157-167
- Year: 2006
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
White, Helene R., Morgan, Thomas J., Pugh, Lisa A., Celinska, Katarzyna, Labouvie, Erich W., Pandina, Robert
J.
OBJECTIVE: This study evaluated two brief personal feedback
substance-use interventions for students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students (ADAPS): (1) a
brief motivational interview (BMI) intervention and (2) a written feedback-only (WF) intervention. A key question addressed by this study was whether
there is a need for face-to-face feedback in the context of motivational interviewing to affect changes in substance-use behaviors or whether a
written personal feedback profile is enough of an intervention to motivate students to change their substance use. METHOD: The sample consisted of
222 students who were mandated to ADAPS, were eligible for the study, and completed the 3-month follow-up assessment. Eligible students completed a
baseline assessment from which a personal feedback profile was created. They were then randomly assigned to the BMI or WF condition. Students were
followed 3 months later. RESULTS: Students in both interventions reduced their alcohol consumption, prevalence of cigarette and marijuana use, and
problems related to alcohol and drug use between baseline and follow-up. There were no differences between the two intervention conditions in terms
of any substance-use outcomes. CONCLUSIONS: The results suggest that, under these circumstances and with these students, assessment and WF students
changed similarly to those who had an assessment and WF within the context of a BMI. Given the fact that the former is less costly in terms of time
and personnel, written profiles may be found to be a cost-effective means of reducing alcohol and drug use and related problems among low- to
moderate-risk mandated college students. More research is needed with mandated students to determine the efficacy of feedback interventions and to
isolate the effects of interventions from the effects of being caught and being reprimanded to treatment.
Journal of Studies on Alcohol, 67(2) : 309-17
- Year: 2006
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback