Search

Objective: This study aims to explore the mechanisms of personality-targeted intervention effects on problematic drinking, internalizing and externalizing symptoms. Method: As part of a cluster-randomized trial, 1,210 high-risk students (mean age 13.7 years) in 19 London high schools (42.6% White, 54% male) were identified using the Substance Use Risk Profile Scale. Intervention school participants were invited to participate in personality-matched interventions by trained school staff. MacKinnon's products of coefficients method was used to compare 3 complementary mechanism hypotheses, namely, whether early changes in (a) alcohol use, (b) internalizing and externalizing symptoms, or (c) personality during the 6 months postintervention accounted for intervention effects over 2 years. Results: Early intervention effects on drinking behaviors during the 6 months postintervention partially accounted for longer term intervention effects on the onset of binge drinking (95% confidence interval [CI] [-.349, -.062]) and drinking problems (95% CI [-.206, -.016]) over 2 years. Intervention effects on anxiety symptoms and conduct problems were partially mediated by early reductions in depressive symptoms (95% CI [-.013, -.001]; 95% CI [-.047, -.001]), and intervention effects on internalizing symptoms were also partially mediated by reductions in anxiety sensitivity (95% CI [-.003, 0]). Conclusions: 2-year intervention effects on problematic drinking were largely accounted for by early changes in drinking behaviors, and were not mediated by changes in mental health symptoms or personality risk factors. Early improvements in mood and anxiety sensitivity partially mediated longer term reductions in mental health problems. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of the selective personality-targeted PreVenture program in reducing cannabis and stimulant use over a 7-year period spanning adolescence and early adulthood. A cluster randomized controlled trial was conducted in 14 Australian schools. Schools were randomized to PreVenture, a brief personality-targeted selective intervention, comprising two 90-minute facilitator-led sessions delivered one week apart, or a control group (health education as usual). Only students who scored highly on one of four personality traits (anxiety sensitivity, negative thinking, impulsivity, sensation seeking) were included. Students completed online self-report questionnaires between 2012 and 2019: at baseline; post-intervention; 1-, 2-, 3-, 5.5- and 7-years post-baseline. Outcomes were past 6-months cannabis use, stimulant use (MDMA, methamphetamine or amphetamine) and cannabis-related harms. The sample comprised 438 adolescents (M age =13.4 years; SD=0.47) at baseline. Retention ranged from 51% to 79% over the 7-years. Compared to controls, the PreVenture group had significantly reduced odds of annual cannabis-related harms (OR=0.78, 95% CI=0.65–0.92). However, there were no significant group differences in the growth of cannabis use (OR=0.84, 95% CI=0.69–1.02) or stimulant use (OR=1.07, 95% CI=0.91–1.25) over the 7-year period. PreVenture was effective in slowing the growth of cannabis-related harms over time, however owing to missing data over the 7-year trial, replication trials may be warranted to better understand the impact of the PreVenture intervention on cannabis and stimulant use among young Australians. Alternative implementation strategies, such as delivering the intervention in later adolescence and/or providing booster sessions, may be beneficial. • One of the longest follow-up studies of a substance use prevention program globally. • PreVenture reduced cannabis-related harms across the transition to adulthood. • Attrition was high among young adults and replication trials are needed. [ABSTRACT FROM AUTHOR]