针对多动症青少年的校本培训干预对酗酒和使用药物的影响。

0 PSYCHOLOGY, CLINICAL

Journal of substance use and addiction treatment Pub Date : 2024-10-02 DOI:10.1016/j.josat.2024.209523

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引用次数: 0

摘要

导言：患有注意力缺陷/多动障碍（ADHD）的青少年可能会因为学业、同伴和家庭的影响而面临酗酒和滥用药物的风险。现有的针对注意力缺陷/多动症青少年的校本干预措施能有效地针对这些风险因素，但其对酒精和药物使用的影响尚未得到探讨。我们研究了一项针对多动症青少年的循证校本干预措施对酗酒和药物使用的直接和长期影响：共有 186 名患有多动症的青少年（年龄 = 15 岁，79 % 为男孩，78 % 为白人，11 % 为西班牙裔）被随机分配到针对学习和社交技能的校本培训干预组或照常治疗对照组。对其中一部分青少年进行了跟踪调查，直至其成年（跟踪调查 5 年；n = 73）。参与者在治疗后、6 个月随访和 5 年随访时报告了他们的酒精和药物使用行为及问题：结果：控制先前使用情况和人口统计学特征的两部分障碍模型表明，在 6 个月的随访中，治疗与使用任何药物的青少年的药物使用结果改善相关（β = -0.45）。然而，在随访 5 年并报告任何酒精使用情况的青少年中，治疗与对照组相比与酒精使用问题的恶化有关（β = 0.27）。大约 22% 的干预参与者达到了危险饮酒行为的标准，而对照组的参与者只有 5%：我们发现，有混合证据表明，一项以学校为基础的干预措施对患有多动症的青少年的学业、社交和情绪功能产生了积极的影响，同时也防止了酗酒和使用药物的不良后果。这些出乎意料的结果要求我们延长随访期，以确定干预效果的持久性和下游先天性影响的可能性。还需要进行更多的研究，以确定能有效阻止特定人群使用药物风险的校本干预策略。

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Effects on alcohol and substance use of a school-based training intervention for adolescents with ADHD

Introduction

Adolescents with attention-deficit/hyperactivity disorder (ADHD) may be at risk for early, escalating patterns of alcohol and substance use via academic, peer, and familial impairment. Existing school-based interventions for youth with ADHD effectively target these risk factors, yet their effects on alcohol and substance use have not been explored. We examined the immediate and long-term alcohol and substance use outcomes of an evidence-based school-based intervention for adolescents with ADHD.

Method

A total of 186 (M_age = 15, 79% boys, 78% White, 11% Hispanic) adolescents with ADHD were randomized to either a school-based training intervention targeting academic and social skills or a treatment-as-usual control group. A subset of youth was followed into emerging adulthood (5 year follow-up; n = 73). Participants reported on their alcohol and substance use behaviors and problems at post-treatment, 6-month follow-up, and 5-year follow-up.

Results

Two-part hurdle models controlling for prior use and demographics indicated treatment was associated with improvements in substance use outcomes among youth using any substances at 6-month follow-up (β = −0.45). However, among youth reporting any alcohol use at the 5-year follow-up, treatment was associated with worse alcohol use problems relative to the control condition (β = 0.27). Approximately 22% of intervention participants met criteria for risky drinking behavior compared to 5% of participants in the control group.

Conclusion

We found mixed evidence that a school-based intervention associated with positive outcomes on academic, social, and emotional functioning for adolescents with ADHD also prevented adverse alcohol and substance use outcomes. These unexpected results serve as a call for extended follow-up periods to identify the durability of intervention benefits and potential for downstream iatrogenic effects. Additional research is needed to identify school-based intervention strategies that can effectively deter substance use risk among select populations.

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来源期刊

Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)

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