Trajectories of adolescent alcohol use after brief treatment in an Emergency Department

Abstract

Objective The primary aim of this study was to identify distinct classes of trajectories of adolescent substance use following a brief motivational interviewing (MI) intervention in an Emergency Department (ED). The secondary aim was to identify predictors of class membership. Methods Latent growth mixture modeling was used with 177 adolescents who participated in two randomized clinical trials evaluating MI for an alcohol-related event. Results Three classes were identified: (1) moderate use, decreasers consisting of 56.8% of participants; (2) heavy use, decreasers, consisting of 10.5% of participants, and (3) heavy use sustainers, consisting of 32.7% of participants. Hispanic ethnicity, parental monitoring, and days of high-volume drinking were significant predictors of class membership. Hispanic ethnic status and high levels of parental monitoring were associated with decreased likelihood of belonging to either of the two heavy use classes. More frequent high-volume drinking at baseline was associated with increased likelihood of belonging to the heavy use, sustainer class, and decreased likelihood of belonging to the heavy use, decreaser class. Across all three classes, being female and having frequent high-volume drinking at baseline were associated with worse response to the intervention. Conclusions These findings have important implications for identifying adolescents who may benefit from different or additional intervention, and for anticipating and informing families of adolescents’ potential drinking course following treatment.

Do therapist behaviors differ with Hispanic youth? A brief look at within-session therapist behaviors and youth treatment response.

“…Yet, only a few have examined adolescent addiction treatment mechanisms and outcomes for Hispanic youth (e.g., Becker et al, 2012; Clair et al, 2013). This is important because while some argue that MI is ideally suited for Hispanic youth, it is equally possible that the approach of MI may be a poor fit (Feldstein Ewing, Wray, Mead, & Adams, 2012).…”

Prevalence and Correlates of Depression and Drinking Behaviors Among Adolescents and Emerging Adults in a Suburban Emergency Department

“…For instance, in a case-control study examining depression and alcohol use among adolescents recruited from either an urban ED or community site, adolescents receiving ED services were significantly more likely to report both increased alcohol use disorders and major depression as compared to the community sample (Kelly et al, 2003). In another study, Becker et al (2012) examined the impact of depression on drinking trajectories after receiving urban ED services and found that baseline depressive symptoms significantly impacted drinking frequency over the following 12 months. Additionally, studies examining higher-risk subgroups of ED patients (e.g.…”

Trajectories of Adolescent Alcohol Use in the Year Following a Brief Alcohol Intervention

“…Less is known about the drinking trajectories of adolescents immediately following the receipt of alcohol interventions, and even less is known about adolescents receiving brief interventions. In fact, to date, only one study has examined the drinking trajectories of adolescents after they received a brief, evidence-based intervention (Becker et al, 2012), and only two have examined the trajectories of adolescents on a month-by-month basis over the course of 1 year following alcohol or other drug treatment (Chung et al, 2004(Chung et al, , 2005. In the Becker et al (2012) study, data from 3-, 6-, and 12-month follow-up interviews were examined, and three classes of response were identified: moderate users who decreased use over time, heavy users who decreased use, and heavy users who sustained use following a brief intervention in an emergency department.…”

“…Rigorous Timeline Followback (TLFB) methods were used to obtain daily estimates of alcohol use behaviors, which were then aggregated at the monthly level to examine trajectories. Monthly data, gathered using TLFB methods, provide for a much more granular and thorough examination than previous longitudinal work (e.g., Becker et al, 2012). This granularity provides for the identification of potential targets of intervention in future work.…”