Personality to Prescription Drug Misuse in Adolescents: Testing Affect Regulation, Psychological Dysregulation, and Deviance Proneness Pathways

Abstract

Background: Fifteen to 25-year-olds are the age group most likely to misuse prescription drugs. Few studies have tested theory-driven models of adolescent risk for prescription drug misuse. Moreover, rarely are distinct pathways to different forms of prescription drug misuse considered.Methods: We tested mediational paths from personality to mental health symptoms to prescription drug misuse, informed by etiological models of addiction. We specified pathways from particular personality traits to unique forms of prescription drug misuse via specific mental health symptoms. We used semi-longitudinal data collected across two waves of the Co-Venture Trial. Our sample included students from 31 Canadian high schools tested in Grade 9 (n = 3,024) and again in Grade 10 (n = 2,869; 95% retention). Personality (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) was assessed in Grade 9. Mental health symptoms (depression, anxiety, ADHD, conduct disorder) and prescription drug misuse (opioids, sedatives/tranquilizers, stimulants) were assessed at both time points.Results: Consistent with the negative affect regulation model, hopelessness was specifically associated with opioid misuse via depressive symptoms, and anxiety sensitivity was specifically associated with sedative/tranquilizer misuse via anxiety symptoms. Consistent with positive affect regulation, sensation seeking was directly associated with stimulant misuse. Consistent with the psychological dysregulation model, impulsivity was associated with stimulant misuse via ADHD symptoms. And consistent with the deviance proneness model, impulsivity was also associated with unconstrained (i.e., all three forms of) prescription drug misuse via conduct disorder symptoms.Conclusions: Screening for adolescents high in hopelessness, anxiety sensitivity, sensation seeking, or impulsivity and providing them with personality-matched cognitive-behavioral interventions may be helpful in preventing or mitigating prescription drug misuse. Our results point to the specific mental health symptoms that are important to target in each of these personality-matched interventions.

Using Narrative Vignettes to Understand the Misuse and Diversion of Stimulants Among College Students With and Without a Prescription

“…Assessment can then be followed with referral to programs that can promote self-efficacy. According to Stewart and colleagues (2021), personality-matched interventions are effective in decreasing misuse of prescription drugs among adolescents; thus, these interventions may possibly decrease misuse of prescription stimulants among college students.…”

Neuroscience-Informed Classification of Prevention Interventions in Substance Use Disorders: An RDoC-based Approach

“…In the early course of adolescence, dysregulated stress responses (resulting from biased cognitive processes, a history of trauma, or genetic factors), combined with altered hypothalamic-pituitary-adrenal axis (HPA) axis and sympathetic nervous system responses, increases the risk of SUD development (al’Absi, 2018; Chaplin et al, 2018), particularly the misuse of substances with arousal and fear-reducing properties (Stewart, et al, 2021). In addition to the role of sleep deprivation as a stressor that triggers stress reactivity, there are several studies supporting the relationship between sleep and circadian changes and substance use in adolescents (Logan et al, 2018).…”

The Impact of Normative Feedback on Undergraduates’ Prescription Drug Use Knowledge and Behavior: A Mixed Methods Study

“…52 Second, as highlighted previously, our sample was not treatment-seeking. Perhaps participants were not galvanized to change their own usage because they had little desire to change combined with various motivations to continue (eg, the value derived from using prescription drugs for the medically sanctioned treatment or self-medication of mental health/physical health concerns 53 ). A related limitation pertains to the inclusion of all participant voices in a combined qualitative group, thus limiting our ability to evaluate whether qualitative results may have differed between PDU and NMPDU subsamples.…”