Targeted Program Can Delay Onset of Drinking

Article excerpt

CHICAGO -- An intervention that allows at-risk adolescents to explore the strengths and weaknesses of their individual personalities can delay the onset of risky drinking for at least 6 months, possibly decreasing the growth of alcohol use later in the teen years.

Patricia Conrod, Ph.D., developed different programs for each of four personality types who manifest a high risk of early-onset drinking and substance abuse: sensation-seeking, negative thinking, anxiety-sensitivity, and impulsivity. The manualized program, delivered in school and consisting of two 90-minute sessions, was so effective that it prevented early-onset drinking in 50% of the sensation-seeking group and in one of every four of those who participated overall, Dr. Conrod said at the annual meeting of the Research Society for Alcoholism.

"I believe that because each intervention targeted a dominant personality trait for each adolescent, the students experienced the interventions as meaningful and relevant," Dr. Conrod said in an interview. "They told us that this is the first time that they have ever spoken about their emotions and are considering for the first time the notion that they have personal control over their emotional reactions and behavior."

Furthermore, she said, the young people found it helpful to learn that others were struggling with similar issues.

Dr. Conrod, a clinical lecturer at the Institute of Psychiatry, King's College London, first developed the program in Canada, where it proved similarly successful in a study of 300 high school students with a mean age of 16 years (J. Clin. Child Adolesc. Psychol. 2006;35:550-63). The current study examined the program's effect in younger students (mean age 14 years).

More than 2,600 students in 13 London high schools completed the Substance Use Risk Profile Scale, which assesses the four dimensions of personality that are linked to different motivations for drug use and misuse. Those who scored more than one standard deviation above the school mean on one of the personality risk subscales were randomized to either the intervention group corresponding with their personality type, or to no intervention except standard drug education.

The final study group comprised 348 students. The intervention groups received the two 90-minute in-school sessions. The manuals contained real-life experiences shared by other high-risk youth of that personality. The first session included goal-setting exercises to explore personality and ways of coping with it; psychoeducational strategies teaching students about their personality and associated problematic coping behaviors; and cognitive-behavioral exercises.

The second session involved discussion of personality-specific cognitive distortions that resulted in problematic behavior. The negative thinking group focused on challenging negative thoughts; the anxiety-sensitivity group explored catastrophic thoughts; the impulsivity group focused on aggressive thinking and acting without thought; and the sensation-seekers examined reward seeking and boredom susceptibility.

The control group received the standard drug education sessions contained in the national curriculum.

All students reported their alcohol use at baseline and at 6 and 12 months. All of the control groups except for the impulsivity group demonstrated an increase in drinking between 6 and 12 months. …