Does Adolescents' Readiness to Change Substance Use Behavior Differ Depending on Profile of Psychiatric Comorbidity?

Abstract

ABSTRACT Objectives: Certain psychiatric diagnoses, such as conduct disorder, typically predict more chronic course of substance use in adolescents. Little is known, however, regarding the extent to which an adolescent's profile of psychiatric comorbidity is associated with differences in readiness to change substance use behavior following admission to outpatient treatment. Methods: Adolescents (N = 169, 14–18 years old) recruited from addictions treatment completed a comprehensive assessment of substance use and other psychiatric disorders, and measures of readiness to change substance use. Latent class analysis was used to identify distinct profiles of comorbid psychopathology, which were then related to measures of readiness to change. Results: The most prevalent psychiatric disorders were conduct disorder (47%), major depression (29%), attention deficit-hyperactivity disorder (17%), and oppositional defiant disorder (11%). Latent class analysis identified 6 distinct profiles of psychiatric comorbidity. All profiles included conduct disorder symptoms, with varying severity. The most prevalent class consisted of teens primarily with conduct problems only (23%). Adolescents with low severity externalizing problems (15%) tended to have relatively high readiness to change alcohol use compared to other comorbidity profiles. Conclusions: Results indicate heterogeneity among youth presenting to addictions treatment, particularly with regard to profile of co-occurring psychiatric symptoms and readiness to change substance use. Youth with overall low severity of externalizing behaviors reported higher readiness to change alcohol use relative to teens with other comorbidity profiles, highlighting the potential importance of enhancing and maintaining teens' readiness to change substance use behavior during treatment, specifically in relation to the adolescent's profile of psychiatric comorbidity.