Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents.
Keywords
Substance use, Prevention, Environmental sensitivity, R i s k s e v e r i t y, D i ff e r e n t i a l s u s c e p t i b i l i t y, PersonalizationAlcohol and other drug use among adolescents is a serious public health concern in the USA. For example, by late adolescence, over 78 % of teens will have experimented with alcohol, over 47 % will be engaged in regular drinking habits, and over 14 % will have met criteria for lifetime abuse [1]. Despite herculean efforts over the previous five decades to stem the rising tide of substance use, treatment approaches (largely based on behavioral parent training and cognitive behavioral therapy principles) have been modest at best; there is considerable variability in outcomes, and no one model works similarly for all youth [2]. Even among those who experience initial success following treatment, relapse rates are high [3].