Substance use treatment outcomes for youth: integrating personal and environmental predictors.

This investigation examined personal and environmental predictors of substance treatment outcomes in youth. A 424 adolescents (M=15.9 years, S.D.=1.3) completed comprehensive assessments, including substance use, environmental factors (e.g., family history, social supports), and person-centered variables (e.g., Axis I diagnosis, motivation, self-esteem), at study intake and throughout the year following inpatient treatment. Youth treatment outcomes were assessed by relapse status (abstaining, minor relapse, major relapse) and DSM-IV dependence symptoms at 1 year. Relapse status was predicted by demographic (age), environmental (social supports), and person-centered factors (diagnosis) while dependence symptoms were best predicted by substance use variables alone. Consideration of the general and specific nature of risk and protection within the adolescent developmental context were explored.

[1]  M. Goldman,et al.  Alcohol-related expectancies versus demographic/background variables in the prediction of adolescent drinking. , 1983, Journal of consulting and clinical psychology.

[2]  K. Winters,et al.  Adolescent substance abuse treatment outcome: the role of substance abuse problem severity, psychosocial, and treatment factors. , 2000, Journal of consulting and clinical psychology.

[3]  S. Brown,et al.  Adolescent Alcohol and Drug Treatment Outcome , 1990 .

[4]  Christy K. Scott,et al.  Factors influencing initial and longer-term responses to substance abuse treatment: a path analysis , 2003 .

[5]  S. Brown,et al.  The impact of social support and self-esteem on adolescent substance abuse treatment outcome. , 1991, Journal of substance abuse.

[6]  R. Watson Drug and Alcohol Abuse Prevention , 1990, Drug and Alcohol Abuse Reviews.

[7]  A. S. Friedman,et al.  Family and client characteristics as predictors of outpatient treatment outcome for adolescent drug abusers. , 1995, Journal of substance abuse.

[8]  R. Jessor,et al.  Adolescent problem drinking. Psychosocial correlates in a national sample study. , 1978, Journal of studies on alcohol.

[9]  August B. Hollingshead,et al.  Two Factor Index of Social Position , 1957 .

[10]  Phillip K Wood,et al.  Personality and the predisposition to engage in risky or problem behaviors during adolescence. , 2003, Journal of personality and social psychology.

[11]  B. Piko,et al.  Perceived Social Support from Parents and Peers: Which Is the Stronger Predictor of Adolescent Substance Use? , 2000, Substance use & misuse.

[12]  D. Cicchetti A developmental psychopathology perspective on drug abuse. , 1999 .

[13]  M. Schuckit,et al.  Conduct disorder among adolescent alcohol and drug abusers. , 1996, Journal of studies on alcohol.

[14]  T. Wills,et al.  Role of parent support and peer support in adolescent substance use: a test of mediated effects. , 2004, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[15]  B T Jones,et al.  A review of expectancy theory and alcohol consumption. , 2001, Addiction.

[16]  M. Hamilton The assessment of anxiety states by rating. , 1959, The British journal of medical psychology.

[17]  L. Chassin,et al.  Trajectories of alcohol and drug use and dependence from adolescence to adulthood: the effects of familial alcoholism and personality. , 2004, Journal of abnormal psychology.

[18]  D. Brewer,et al.  Evaluation of the effectiveness of adolescent drug abuse treatment, assessment of risks for relapse, and promising approaches for relapse prevention. , 1990, The International journal of the addictions.

[19]  S. Brown Measuring youth outcomes from alcohol and drug treatment. , 2004, Addiction.

[20]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[21]  H. Stern,et al.  The use of multiple imputation for the analysis of missing data. , 2001, Psychological methods.

[22]  I. Sarason,et al.  Assessing Social Support: The Social Support Questionnaire. , 1983 .

[23]  M. Goldman,et al.  Expectancy for social facilitation from drinking: the divergent paths of high-expectancy and low-expectancy adolescents. , 1995, Journal of abnormal psychology.

[24]  N. Jainchill,et al.  Ethnic differences in psychiatric disorders among adolescent substance abusers in treatment , 1997 .

[25]  J. Schafer,et al.  Missing data: our view of the state of the art. , 2002, Psychological methods.

[26]  A. Abrantes,et al.  Psychiatric comorbidity and substance use treatment outcomes of adolescents. , 2004, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[27]  J. Nurnberger,et al.  Clinical relevance of the distinction between alcohol dependence with and without a physiological component. , 1998, The American journal of psychiatry.

[28]  D. Cahalan,et al.  Comparison of abstainers and heavy drinkers in a national survey. , 1968, Psychiatric research reports.

[29]  B. McCrady To have but one true friend: implications for practice of research on alcohol use disorders and social network. , 2004, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[30]  S. Tapert,et al.  Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR): a measure of adolescent alcohol and drug involvement. , 1998, Journal of studies on alcohol.

[31]  M. Goldman,et al.  The Alcohol Expectancy Questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies. , 1987, Journal of studies on alcohol.

[32]  P. Bentler,et al.  Cognitive motivation and drug use: a 9-year longitudinal study. , 1991, Journal of abnormal psychology.

[33]  K. Kobak,et al.  Reliability and Validity of the Hamilton Depression Inventory: A Paper-and-Pencil Version of the Hamilton Depression Rating Scale Clinical Interview , 1995 .

[34]  A. Leshner Introduction to the special issue: The National Institute on Drug Abuse's (NIDA's) Drug Abuse Treatment Outcome Study (DATOS). , 1997 .

[35]  M. Leff Drug Abuse: Origins and Interventions , 2002 .

[36]  S. Brown,et al.  Characteristics of relapse following adolescent substance abuse treatment. , 1989, Addictive behaviors.

[37]  Sandra A. Brown,et al.  Correlates of success following treatment for adolescent substance abuse , 1994 .

[38]  R. Hough,et al.  Adolescent alcohol and drug abuse and health. , 1999, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[39]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[40]  D. Shaffer,et al.  NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[41]  D L Newman,et al.  Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort. , 1996, Archives of general psychiatry.

[42]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[43]  M. Goldman,et al.  Expectancy challenge and drinking reduction: process and structure in the alcohol expectancy network. , 1998, Experimental and clinical psychopharmacology.

[44]  C. Berthiaume,et al.  Diagnostic Interview Schedule for Children (DISC-2.25) in Quebec: reliability findings in light of the MECA study. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[45]  T. Simpson,et al.  Dual diagnosis: impact of family history. , 2005, The American journal on addictions.

[46]  H. Boshuizen,et al.  Multiple imputation of missing blood pressure covariates in survival analysis. , 1999, Statistics in medicine.

[47]  C. R. Cloninger,et al.  Measurement of temperament and character in mood disorders: a model of fundamental states as personality types. , 1998, Journal of affective disorders.

[48]  S. Brown,et al.  Utilizing expectancies in alcoholism treatment. , 1988 .

[49]  M. Davies,et al.  The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): III. Concurrent criterion validity. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[50]  F. J. Evans,et al.  New Data from the Addiction Severity Index Reliability and Validity in Three Centers , 1985, The Journal of nervous and mental disease.

[51]  E. Labouvie,et al.  Relation of personality to alcohol and drug use in adolescence. , 1986, Journal of consulting and clinical psychology.