A Review of Personality-Targeted Interventions for Prevention of Substance Misuse and Related Harm in Community Samples of Adolescents

Hanie Edalati, Patricia J Conrod, Hanie Edalati, Patricia J Conrod

Abstract

Several school-based prevention programmes have been developed and used to prevent, delay, or reduce substance misuse, and related problems among community samples of adolescents. However, findings indicate that many of these interventions are associated with null, small, or mixed effects in reducing adolescent substance misuse, in particular for those mostly at risk of transitioning to substance use disorders. These findings highlight the need to shift the focus of substance use prevention efforts toward intervention strategies which directly target high-risk adolescents. The Preventure programme was designed to target four personality risk factors for substance misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. This article reviews findings from the previous trials of personality-targeted interventions (i.e., Preventure programme) with adolescents and discuss the promises and benefits of these interventions for targeting community samples of high-risk adolescents at school level for reducing substance misuse and related mental health problems. Findings indicated that this programme has been successful in reducing the rates of alcohol and illicit drug use and substance-related harms by ~50% in high-risk adolescents with the effects last for up to 3 years. These interventions were also associated with a 25% reduction in likelihood of transitioning to mental health problems, such as anxiety, depression, suicidal ideation, and conduct problems. The programme is particularly beneficial for youth with more significant risk profiles, such as youth reporting clinically significant levels of externalizing problems, and victimized adolescents. A key strength of the Preventure programme is that it is embedded in the community and provides substance use intervention at school level to the general samples of high-risk adolescents who might not otherwise have access to those programmes.

Keywords: cluster randomized trial; community-based targeted prevention; high-risk adolescents; mental health; school-based substance use prevention programme; substance use outcomes.

References

    1. Cuijpers P. Effective ingredients of school-based drug prevention programs. A systematic review. Addict Behav. (2002) 27:1009–23. 10.1016/S0306-4603(02)00295-2
    1. Foxcroft DR, Tsertsvadze A. Universal family-based prevention programs for alcohol misuse in young people. Cochrane Database Syst Rev. (2011) 9:CD009308 10.1002/14651858.CD009308
    1. Tobler N, Roona M, Ochshorn P, Marshall D, Streke A, Stackpole K. School-based adolescent drug prevention programs: 1998 meta-analysis. J Primary Prev. (2000) 20:275–336. 10.1023/A:1021314704811
    1. Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet (2009) 373:2234–46. 10.1016/S0140-6736(09)60744-3
    1. Foxcroft DR, Ireland D, Lister-Sharp DJ, Lowe G, Breen R. Longer-term primary prevention for alcohol misuse in young people: a systematic review. Addiction (2003) 98:397–411. 10.1046/j.1360-0443.2003.00355.x
    1. Das JK, Salam RA, Arshad A, Finkelstein Y, Bhutta ZA. Interventions for adolescent substance abuse: an overview of systematic reviews. J Adolesc Health (2016) 59:S61–75. 10.1016/j.jadohealth.2016.06.021
    1. Carney T, Myers BJ, Louw J, Okwundu CI. Brief school-based interventions and behavioural outcomes for substance-using adolescents. Cochrane Database Syst Rev. (2016) CD008969 10.1002/14651858.CD008969.pub3
    1. Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. Cochrane Database Syst Rev. (2013) CD001293 10.1002/14651858.CD001293.pub3
    1. Strom HK, Adolfsen F, Fossum S, Kaiser S, Martinussen M. Effectiveness of school-based preventive interventions on adolescent alcohol use: a meta-analysis of randomized controlled trials. Subst Abuse Treat Prev Policy (2014) 9:48. 10.1186/1747-597X-9-48
    1. Wiehe SE, Garrison MM, Christakis DA, Ebel BE, Rivara FP. A systematic review of school-based smoking prevention trials with long-term follow-up. J Adolesc Health (2005) 36:162–9. 10.1016/j.jadohealth.2004.12.003
    1. Kellam SG, Mackenzie ACL, Brown CH, Poduska JM, Wang W, Petras H, et al. . The good behavior game and the future of prevention and treatment. Addict Sci Clin Pract. (2011) 6:73–84.
    1. Isensee B, Hanewinkel R. Meta-analysis on the effects of the smoke-free class competition on smoking prevention in adolescents. Eur Addict Res. (2012) 18:110–5. 10.1159/000335085
    1. Hennessy EA, Tanner-Smith EE. Effectiveness of brief school-based interventions for adolescents: a meta-analysis of alcohol use prevention programs. Prev Sci. (2015) 16:463–74. 10.1007/s11121-014-0512-0
    1. Faggiano F, Minozzi S, Versino E, Buscemi D. Universal school-based prevention for illicit drug use. Cochrane Database Syst Rev. (2014) 12:CD003020 10.1002/14651858.CD003020.pub3
    1. Porath-Waller AJ, Beasley E, Beirness DJ. A meta-analytic review of school-based prevention for cannabis use. Health Educ Behav. (2010) 37:709–23. 10.1177/1090198110361315
    1. Lemstra M, Bennett N, Nannapaneni U, Neudorf C, Warren L, Kershaw T, et al. A systematic review of school-based marijuana and alcohol prevention programs targeting adolescents aged 10–15. Addict. Res. Theory (2010) 18:84–96. 10.3109/16066350802673224
    1. Botvin GJ, Baker E, Dusenbury L, Tortu S, Botvin EM. Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: results of a 3-year study. J Consult Clin Psychol. (1990) 58:437–46. 10.1037/0022-006X.58.4.437
    1. Ellickson P, Bell R. Prospects for Preventing Drug Use Among Young Adolescents. Santa Monica, CA: RAND Corporation; (1990).
    1. Gottfredson DC, Wilson DB. Characteristics of effective school-based substance abuse prevention. Prev Sci. (2003) 4:27–38. 10.1023/A:1021782710278
    1. Ennett ST, Haws S, Ringwalt CL, Vincus AA, Hanley S, Bowling JM, et al. . Evidence-based practice in school substance use prevention: fidelity of implementation under real-world conditions. Health Educ Res. (2011) 26:361–71. 10.1093/her/cyr013
    1. Sloboda Z, Stephens RC, Stephens PC, Grey SF, Teasdale B, Hawthorne RD, et al. . The adolescent substance abuse prevention study: a randomized field trial of a universal substance abuse prevention program. Drug Alcohol Depend. (2009) 102:1–10. 10.1016/j.drugalcdep.2009.01.015
    1. Center for Behavioral Health Statistics and Quality Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50) (2015). Available online at:
    1. National Advisory Committee on Prescription Drug Misuse. First do no Harm: Responding to Canada's Prescription Drug Crisis. Ottawa, ON: Canadian Centre on Substance Abuse; (2013).
    1. Conrod PJ, Nikolaou K. Annual research review: on the developmental neuropsychology of substance use disorders. J Child Psychol Psychiatry (2016) 57:371–94. 10.1111/jcpp.12516
    1. Dishion TJ, Andrews DW. Preventing escalation in problem behaviors with high-risk young adolescents: immediate and 1-year outcomes. J Consult Clin Psychol. (1995) 63:538–48.
    1. Harrington NG, Donohew L. Jump start: a targeted substance abuse prevention program. Health Educ Behav. (1997) 24:568–86. 10.1177/109019819702400505
    1. Conrod PJ. Personality-targeted interventions for substance use and misuse. Curr Addict Rep. (2016) 3:426–36. 10.1007/s40429-016-0127-6
    1. Edalati H, Conrod PJ. A review to identify gaps in research and service delivery for substance use prevention among at-risk adolescents involved in child welfare system: the promises of targeted interventions. Int J Child Adolesc Resilience (2017) 5:20–39.
    1. Edalati H, Perrier-Menard E, Castellanos-Ryan N, O'Leary-Barrett M, Girard A, Conrod P. Moderating effects of socioeconomic status, victimization and psychiatric disorders on personality-targeted interventions for adolescent alcohol abuse. Alcohol Clin Exp Res. (2017) 14:338A.
    1. Castellanos-Ryan N, O'Leary-Barrett M, Sully L, Conrod PJ. 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. (2013) 37 (Suppl. 1):E281–90. 10.1111/j.1530-0277.2012.01931.x
    1. Castellanos-Ryan N, Conrod PJ. Personality correlates of the common and unique variance across conduct disorder and substance misuse symptoms in adolescence. J Abnorm Child Psychol. (2011) 39:563–76. 10.1007/s10802-010-9481-3
    1. Whelan R, Watts R, Orr CA, Althoff RR, Artiges E, Banaschewski T, et al. . Neuropsychosocial profiles of current and future adolescent alcohol misusers. Nature (2014) 512:185–9. 10.1038/nature1340
    1. Castellanos-Ryan N, Conrod P. Personality and substance misuse: evidence for a four-factor model of vulnerability. New York, NY: Springer Science + Business Media; (2012). p. 47–62.
    1. Comeau N, Stewart SH, Loba P. The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents' motivations for alcohol, cigarette, and marijuana use. Addict Behav. (2001) 26:803–25. 10.1016/S0306-4603(01)00238-6
    1. Mushquash C, Stewart S, Mushquash A, Comeau M, McGrath P. Personality traits and drinking motives predict alcohol misuse among canadian aboriginal youth. Int J Mental Health Addict. (2014) 12:270–82. 10.1007/s11469-013-9451-4
    1. Hudson A, Wekerle C, Stewart SH. Associations between personality and drinking motives in adolescents involved in the child welfare system. Personality and Individual Differences. (2015) 81:84–9. 10.1016/j.paid.2014.12.008
    1. Woicik PA, Stewart SH, Pihl RO, Conrod PJ. The substance use risk profile scale: a scale measuring traits linked to reinforcement-specific substance use profiles. Addict Behav. (2009) 34:1042–55. 10.1016/j.addbeh.2009.07.001
    1. O'Leary-Barrett M, Castellanos-Ryan N, Pihl RO, Conrod PJ. Mechanisms of personality-targeted intervention effects on adolescent alcohol misuse, internalizing and externalizing symptoms. J Consult Clin Psychol. (2016) 84:438–52. 10.1037/ccp0000082
    1. O'Leary-Barrett M, Mackie CJ, Castellanos-Ryan N, Al-Khudhairy N, Conrod PJ. Personality-targeted interventions delay uptake of drinking and decrease risk of alcohol-related problems when delivered by teachers. J Am Acad Child Adolesc Psychiatry (2010) 49:954,963.e1. 10.1016/j.jaac.2010.04.011
    1. Castellanos N, Conrod P. Brief interventions targeting personality risk factors for adolescent substance misuse reduce depression, panic and risk-taking behaviours. J Mental Health (2006) 15:645–58. 10.1080/09638230600998912
    1. Newton NC, Conrod PJ, Slade T, Carragher N, Champion KE, Barrett EL, et al. . The long-term effectiveness of a selective, personality-targeted prevention program in reducing alcohol use and related harms: a cluster randomized controlled trial. J Child Psychol Psychiatry (2016) 57:1056–65. 10.1111/jcpp.12558
    1. O'Leary-Barrett M, Pihl RO, Conrod PJ. Process variables predicting changes in adolescent alcohol consumption and mental health symptoms following personality-targeted interventions. Addict Behav. (2017) 75:47–58. 10.1016/j.addbeh.2017.06.022
    1. Faggiano F, Vigna-Taglianti F, Burkhart G, Bohrn K, Cuomo L, Gregori D, et al. . The effectiveness of a school-based substance abuse prevention program: 18-month follow-up of the EU-dap cluster randomized controlled trial. Drug Alcohol Depend. (2010) 108:56–64. 10.1016/j.drugalcdep.2009.11.018
    1. Lammers J, Goossens F, Conrod P, Engels R, Wiers RW, Kleinjan M. Effectiveness of a selective intervention program targeting personality risk factors for alcohol misuse among young adolescents: results of a cluster randomized controlled trial. Addiction (2015) 110:1101–9. 10.1111/add.12952
    1. Conrod PJ, Stewart SH, Comeau N, Maclean AM. Efficacy of cognitive-behavioral interventions targeting personality risk factors for youth alcohol misuse. J Clin Child Adolesc Psychol. (2006) 35:550–63. 10.1207/s15374424jccp3504_6
    1. Conrod PJ, Castellanos-Ryan N, Mackie C. Long-term effects of a personality-targeted intervention to reduce alcohol use in adolescents. J Consult Clin Psychol. (2011) 79:296–306. 10.1037/a0022997
    1. Conrod PJ, Castellanos N, Mackie C. Personality-targeted interventions delay the growth of adolescent drinking and binge drinking. J Child Psychol Psychiatry (2008) 49:181–90. 10.1111/j.1469-7610.2007.01826.x
    1. Conrod PJ, Castellanos-Ryan N, Strang J. Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence. Arch Gen Psychiatry (2010) 67:85–93. 10.1001/archgenpsychiatry.2009.173
    1. Conrod PJ, O'Leary-Barrett M, Newton N, Topper L, Castellanos-Ryan N, Mackie C, et al. . Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: a cluster randomized controlled trial. JAMA Psychiatry (2013) 70:334–42. 10.1001/jamapsychiatry.2013.651
    1. Mahu IT, Doucet C, O'Leary-Barrett M, Conrod PJ. Can cannabis use be prevented by targeting personality risk in schools? Twenty-four-month outcome of the adventure trial on cannabis use: a cluster-randomized controlled trial. Addiction (2015) 110:1625–33. 10.1111/add.12991
    1. Adair C. Concurrent Substance Use and Mental Disorders in Adolescents. A Review of the Literature on Current Science and Practice. The Alberta Centre for Child Family and Community Research (2009). Available online at:
    1. Beck AT, Young JE. Depression. In: Barlow D, editor. Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual. New York, NY: The Guilford Press; (1985). p. 206–44.
    1. Barlow D. Clinical Handbook Of Psychological Disorders: A Step- by- Step Treatment Manual. New York, NY: Guilford; (1985).
    1. Barlow D, Craske M. Mastery of Your Anxiety and Panic. Albany, NY: Graywind; (1988).
    1. Kendall P, Braswell L. Cognitive-behavioral Therapy for Impulsive Children. New York, NY: Guilford Press; (1985).
    1. O'Leary-Barrett M, Topper L, Al-Khudhairy N, Pihl RO, Castellanos-Ryan N, Mackie CJ, et al. . 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. 10.1016/j.jaac.2013.05.020
    1. Newton N, Stapinski L, Slade T, Conrod P, Barrett E, Chapman C, et al. Pathways to prevention: the effectiveness of universal and selective prevention for alcohol use and related harms. In: 30th National Drug & Alcohol Research Centre (NDARC) Annual Research Symposium (2017).
    1. Perrier-Menard 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) 75:138–44. 10.1016/j.addbeh.2017.07.015
    1. Hong JS, Davis JP, Sterzing PR, Yoon J, Choi S, Smith DC. A conceptual framework for understanding the association between school bullying victimization and substance misuse. Am J Orthopsychiatry (2014) 84:696–710. 10.1037/ort0000036
    1. Maniglio R. Bullying and other forms of peer victimization in adolescence and alcohol use. Trauma Violence Abuse (2017) 18:457–73. 10.1177/1524838016631127
    1. Hanson MD, Chen E. Socioeconomic status and health behaviors in adolescence: a review of the literature. J Behav Med. (2007) 30:263–85. 10.1007/s10865-007-9098-3
    1. Lammers J, Goossens F, Conrod P, Engels R, Wiers RW, Kleinjan M. Effectiveness of a selective alcohol prevention program targeting personality risk factors: results of interaction analyses. Addict Behav. (2017) 71:82–8. 10.1016/j.addbeh.2017.02.030
    1. Topper LR, Castellanos-Ryan N, Mackie C, Conrod PJ. Adolescent bullying victimisation and alcohol-related problem behaviour mediated by coping drinking motives over a 12 month period. Addict Behav. (2011) 36:6–13. 10.1016/j.addbeh.2010.08.016
    1. Zarate-Garza PP, Biggs BK, Croarkin P, Morath B, Leffler J, Cuellar-Barboza A, et al. . How well do we understand the long-term health implications of childhood bullying? Harv Rev Psychiatry (2017) 25:89–95. 10.1097/HRP.0000000000000137
    1. Teesson M, Newton NC, Slade T, Carragher N, Barrett EL, Champion KE, et al. . Combined universal and selective prevention for adolescent alcohol use: a cluster randomized controlled trial. Psychol Med. (2017) 47:1761–70. 10.1017/S0033291717000198
    1. Poulin F, Dishion TJ, Burraston B. 3-year iatrogenic effects associated with aggregating high-risk adolescents in cognitive-behavioral preventive interventions. Appl Dev Sci. (2001) 5:214–24. 10.1207/S1532480XADS0504_03
    1. Werch CE, Owen DM. Iatrogenic effects of alcohol and drug prevention programs. J Stud Alcohol. (2002) 63:581–90. 10.15288/jsa.2002.63.581

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