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Original Article
January 2010

Brief, Personality-Targeted Coping Skills Interventions and Survival as a Non–Drug User Over a 2-Year Period During Adolescence

Author Affiliations

Author Affiliations: Addictions Department, Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, London, United Kingdom.

Arch Gen Psychiatry. 2010;67(1):85-93. doi:10.1001/archgenpsychiatry.2009.173

Context  Selective interventions targeting personality risk are showing promise in the prevention of problematic drinking behavior, but their effect on illicit drug use has yet to be evaluated.

Objective  To investigate the efficacy of targeted coping skills interventions on illicit drug use in adolescents with personality risk factors for substance misuse.

Design  Randomized controlled trial.

Setting  Secondary schools in London, United Kingdom.

Participants  A total of 5302 students were screened to identify 2028 students aged 13 to 16 years with elevated scores on self-report measures of hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. Seven hundred thirty-two students provided parental consent to participate in this trial.

Intervention  Participants were randomly assigned to a control no-intervention condition or a 2-session group coping skills intervention targeting 1 of 4 personality profiles.

Main Outcome Measures  The trial was designed and powered to primarily evaluate the effect of the intervention on the onset, prevalence, and frequency of illicit drug use over a 2-year period.

Results  Intent-to-treat repeated-measures analyses on continuous measures of drug use revealed time × intervention effects on the number of drugs used (P < .01) and drug use frequency (P < .05), whereby the control group showed significant growth in the number of drugs used as well as more frequent drug use over the 2-year period relative to the intervention group. Survival analysis using logistic regression revealed that the intervention was associated with reduced odds of taking up the use of marijuana (β = −0.3; robust SE = 0.2; P = .09; odds ratio = 0.7; 95% confidence interval, 0.5-1.0), cocaine (β = −1.4; robust SE = 0.4; P < .001; odds ratio = 0.2; 95% confidence interval, 0.1-0.5), and other drugs (β = −0.7; robust SE = 0.3; P = .03; odds ratio = 0.5; 95% confidence interval, 0.3-0.9) over the 24-month period.

Conclusion  This study extends the evidence that brief, personality-targeted interventions can prevent the onset and escalation of substance misuse in high-risk adolescents.

Trial Registration  clinicaltrials.gov Identifier: NCT00344474