Clinical Variations of Adolescent Substance Abuse: An Empirically Based Typology

Rowe, Cynthia L.; Liddle, Howard A.; Caruso, John C.; Dakof, Gayle A.

doi:10.1300/j029v14n02_02

Cited by 8 publications

(5 citation statements)

References 42 publications

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“…Second, descriptive profiles of modifiable psychosocial characteristics (e.g., alcohol-sex outcome expectancies, condom use self-efficacy) and sexual risk behaviors were constructed across cluster membership to improve current understanding of relations between patterns of psychiatric symptoms and proximal risk and protective factors for HIV/STI exposure. The use of cluster analysis with the current sample resulted in the documentation of significant heterogeneity in psy-chiatric symptoms, similar to previous studies employing this analytic strategy with samples of multiproblem youth (e.g., Houck et al, 2006;Potter & Jenson, 2003;Rowe, Liddle, Caruso, & Dakof, 2004;Stewart & Trupin, 2003). In addition, significant relations between multivariate patterns of psychiatric symptoms and participation in specific indices of SRB replicate findings in other community and clinical samples of stigmatized adolescents and adults (e.g., Brown et al, 1997;McClelland, Teplin, Abram, & Jacobs, 2002;Rothenberg et al, 2007;Tubman et al, 2003).…”

Section: Discussionsupporting

confidence: 79%

Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

Oshri¹,

Tubman²,

Wagner³

et al. 2008

American Journal of Orthopsychiatry

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The purpose of the current study was to classify adolescents receiving outpatient treatment for alcohol or other drug (AOD) problems via self-reports of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. American Psychiatric Association, 1994) psychiatric symptoms, and to identify group differences in measures of proximal risk factors for sexual risk behaviors (SRBs) and self-reported SRBs. Structured interviews were administered to 300 adolescent clients (202 males, 98 females; M = 16.22 years; SD = 1.13) receiving treatment services as part of a larger National Institute on Alcohol Abuse and Alcoholism (NIAAA)-funded randomized clinical trial. Ward's method cluster analysis (Ward, 1963) was used to classify adolescents into distinct groups based on psychiatric symptom profiles. A multivariate analysis of variance was used to identify significant between-cluster differences in self-reported SRBs and proximal risk factors for SRB. Substantial heterogeneity in patterns of psychiatric symptoms was documented in this treatment sample. Membership in certain psychiatric symptom clusters was associated with several self-reported SRBs and correlated proximal risk factors. Among youth receiving AOD treatment, interventions to promote HIV/STI risk reduction may need adaptation for those with differing psychiatric profiles.

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Section: Discussionsupporting

confidence: 79%

Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

Oshri¹,

Tubman²,

Wagner³

et al. 2008

American Journal of Orthopsychiatry

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“…Past typologies have generally found three or four cannabis users categories ( 5 – 8 ). However, some of these often relied on clinical samples ( 40 ) or adult population ( 5 ), whereas the current study examines a normative population of adolescents. As in other typologies, we found early and late onset classes.…”

Section: Discussionmentioning

confidence: 99%

“…Four groups were identified: Non-problematic (59.2%); primary alcohol use disorders (14.4%); delinquent cannabis/alcohol DSM-IV-abuse (17.9%); and CUD with multiple problems (8.5%). Another cross-sectional study used cluster analysis on a clinical sample of mostly juvenile justice involved adolescents who sought drug abuse treatment ( 40 ). They identified three groups based on individual and family risk factors, associated problems, and severity of substance use: Juvenile Justice Involved Substance Abusers (41%, lowest level of risk but highest juvenile justice involvement); Comorbid Substance Abusers (33%, greatest family risk and individual psychopathology); and Heavy Substance Abusers (26%, serious substance abuse and peer substance use).…”

Section: Introductionmentioning

confidence: 99%

“…First, the variety of designs used in these studies complicates comparisons between them. Second, few studies have examined subgroups of cannabis users (or heterogeneity in cannabis use) and many of the classification efforts were limited to clinical samples ( 40 ). Finally, cannabis use severity and important risk factors, such as peer deviancy, parental monitoring, and school bonding, have typically been omitted in previous typologies.…”

Section: Introductionmentioning

confidence: 99%

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Latent Classes of Substance Use in Adolescent Cannabis Users: Predictors and Subsequent Substance-Related Harm

2014

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Cannabis use is highly prevalent in late adolescence, but not all users experience significant negative consequences. Little information is available to identify the substance use patterns and risk factors of users who are at greater risk of experiencing negative consequences. In this prospective study, we aimed to empirically identify latent classes of substance use in adolescent cannabis users and to examine how these classes relate to antecedent psychosocial predictors and subsequent substance-related outcomes. The sample was recruited from 68 high schools in Quebec and consisted of 1618 participants who reported using cannabis in grade 10. We used latent class analysis to empirically identify classes of users based on the age of onset, frequency, and typical quantity of cannabis and other substance use, as well as substance mixing behaviors. We then compared classes in terms of (a) sociodemographic and psychosocial predictors in grades 7–8 and (b) substance-related consequences in grade 11. Four distinct classes were identified: Late-Light Users (28%); Late-Heavy + Polydrug Users (14%); Early-Moderate Users (33%); Early-Heavy + Polydrug Users (26%). Late-Light Users reported the lowest levels of substance use, while Early-Heavy + Polydrug Users reported the highest levels. Intermediate levels of substance use were found in the other two classes. Sex, age, delinquency, peer delinquency, school bonding, parental monitoring, and parental conflict all helped to differentiate classes. Class membership predicted substance-related harm, with greater consequences in early- and late-onset heavy using classes. In light of results, in addition to age and sex, screening and intervention for risky cannabis use among adolescents should focus on school bonding in order to target the most risky late-onset adolescents and on peer delinquency in order to target the most risky early-onset ones.

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“…As the previous statement suggests, use severity is commonly captured by continuous measures of the frequency and amount of substance use, with higher values indicating greater severity (see for example the National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration, 2005; and the Monitoring the Future survey, Johnston et al, 2005). However, experimental adolescent users are also distinguished from more severe users in that they have fewer chronic problems and fewer risk factors, such as less access to drugs and less or no family dysfunction, and their problem behavior is short term-that is, it tends not to persist into adulthood (Rowe et al, 2004;Eggert et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Promoting Reduced and Discontinued Substance Use among Adolescent Substance Users: Effectiveness of a Universal Prevention Program

et al. 2006

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Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin' it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N= 1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N = 1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed.

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Clinical Variations of Adolescent Substance Abuse: An Empirically Based Typology

Cited by 8 publications

References 42 publications

Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

Psychiatric symptom patterns, proximal risk factors, and sexual risk behaviors among youth in outpatient substance abuse treatment.

Latent Classes of Substance Use in Adolescent Cannabis Users: Predictors and Subsequent Substance-Related Harm

Promoting Reduced and Discontinued Substance Use among Adolescent Substance Users: Effectiveness of a Universal Prevention Program

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