Motivation and substance use outcomes among adolescents in a school-based intervention

Abstract

The stages of change (Precontemplation, Contemplation, Preparation, Action, and Maintenance) have been well studied in adult populations. However, fewer studies have examined how the stages of change are related to adolescent substance use. Furthermore, there have been no studies that have examined how the stages of change relate to outcomes in a school-based intervention. To better capture adolescent motivation, we added an additional group to the Transtheoretical Model of Change, which we titled Coerced Action, to represent adolescents that made changes to their substance use despite low problem recognition (representing the internal motivation of Precontemplation and the change behaviors of the Action group). We then examined how the stages of change were related to a thorough assessment of substance use at baseline and corresponding treatment outcomes. Our sample consisted of 264 adolescents (mean age 16.1, 44.5% Caucasian, 37.5% female) who participated in an 8-week, school-based Motivational Enhancement intervention. Results indicated significant group differences across the stages of change in substance use patterns (alcohol use, negative consequences, affective dysregulation), as well as treatment outcomes (alcohol use and negative consequences). For instance, adolescents in the Action group demonstrated more negative consequences at 16 weeks follow-up than those in Precontemplation and Coerced Action, F(1, 3) = 8.23, p = .000. The Coerced Action group reported the most alcohol use at 16 weeks follow-up, although the finding was not significant when post-hoc tests were conducted. This study provides meaningful support for the assessment of motivation among adolescent substance users within school-based settings.

UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis

“…The present review did find patterns of small to moderate effects for negative and positive urgency on marijuana use and negative marijuana consequences, warranting further examination; however, data for the effects of positive and negative urgency on both marijuana use (k=1 and k=2, respectively), and negative marijuana consequences (k=3 and k=4, respectively) were limited. Thoroughly assessing other impulsivityrelated traits in research and treatment is imperative, as other studies have found that, for example, positive and negative urgency traits are more strongly related to negative substance use consequences than general use (see Stautz and Cooper, 2013 for review) and interventions targeting negative and positive urgency in adolescents significantly reduce and produce sustained effects on alcohol use and negative alcohol consequences (Serafini et al, 2016). It is likely, then, that urgency is an important factor in reducing substance use consequences, including those resulting from marijuana use in both adolescents and adults.…”

Gender differences in cannabis use disorder treatment: Change readiness and taking steps predict worse cannabis outcomes for women

“…Higher scores reflect greater recognition, less ambivalence, and taking more steps towards change. The SOCRATES is widely used in substance abuse research, including with cannabis using populations (Serafini, Shipley, & Stewart, 2016; Simons, Clarke, Simons, & Spelman, 2016), and has demonstrated reliability and validity across settings (Campbell, 1997; Long & Hollin, 2009). Self-efficacy to resist marijuana was assessed using the Self-Efficacy Questionnaire (SEQ; Stephens, Wertz, & Roffman, 1993), which consists of a total self-efficacy score and has also been validated with marijuana abusing populations (Stephens, Wertz, & Roffman, 1995).…”

The Impact of Marijuana Legalization on Adolescent Use, Consequences, and Perceived Risk

“…The only other exclusion criteria were being dis-enrolled in school between referral and the start of the intervention. Project READY has demonstrated effectiveness in reducing marijuana use and consequences up to 16 weeks postintervention in several studies (Serafini, Shipley, & Stewart, 2015;Stewart, Arlt, Felleman, Athenour, & Arger, 2015;Hall, Stewart, Arger, Athenour, & Effinger, 2014) Participants consisted of 262 students from five high schools in the greater Seattle area. Of the 262 participants, 55% were male and 36% were females.…”