Exploring the role of emotional and behavioral problems in a personality-targeted prevention program for substance use in adolescents and young adults with intellectual disability

Daan H.G Hulsmans,Roy Otten,Esmée P Schijven,Evelien A.P Poelen

doi:10.1016/j.ridd.2020.103832

Abstract

BackgroundAdolescents and young adults with a mild intellectual disability or borderline intellectual functioning (MID-BIF) are at risk for problematic substance use and are more likely to have emotional and behavioral problems than peers without MID-BIF. A personality-targeted prevention program called Take it Personal! effectively reduces substance use in adolescents and young adults with MID-BIF. AimsThe program’s effectiveness was examined on its secondary goal: reducing emotional and behavioral problems. The potentially moderating role of these problems on the program’s effectiveness with substance use was also explored. Methods and proceduresSubstance use and emotional and behavioral problems were compared between participants in Take it Personal! (n = 34) and those in the control condition (n = 32) in a quasi-experimental pre-posttest study with a three-month follow-up. Effectiveness and moderation were assessed with multilevel models. Outcomes and resultsTake it Personal! seems to reduce rule breaking. There were no significant effects on anxiety, withdrawal, and aggression. None of the problem domains moderated the program’s effectiveness on substance use frequency. Conclusions and implicationsTake it Personal! may effectively reduce rule breaking. Moreover, adolescent and young adults with different levels of emotional and behavioral problems benefit equally in terms of reduced substance use.

Highlights

Problematic alcohol, cannabis, and other illicit drug use among adolescents and young adults with mild intellectual disability (MID) or borderline intellectual functioning (BIF) is receiving increased attention in clinical practice and research (Carroll Chapman & Wu, 2012; Didden, VanDerNagel, Delforterie, & van Duijvenbode, 2020)
The current study aims to examine the role of internalizing and externalizing problems in Take it Personal!—a prevention program that is effective in reducing substance use frequency (Schijven, Hulsmans et al, 2020)
Bivariate correlations between the four behavior problem domains and substance use reveal that none of the problem domains correlate with substance use at baseline or follow-up (Appendix Table A1)

Summary

Introduction

Problematic alcohol, cannabis, and other illicit drug use among adolescents and young adults with mild intellectual disability (MID) or borderline intellectual functioning (BIF) is receiving increased attention in clinical practice and research (Carroll Chapman & Wu, 2012; Didden, VanDerNagel, Delforterie, & van Duijvenbode, 2020). The DSM-5 describes BIF as a condition in which a person’s limited intellectual functioning is the focus of, or has an impact on, their treatment (American Psychiatric Association, 2013) This diagnosis is typically given when IQ is roughly between 70 and 85 (Wieland & Zitman, 2016). Similar to those with MID, people with BIF often lead problematic lives, facing, for example, social and coping difficulties, and are vulnerable to the development of psychopathologies such as substance use disorder (Emerson, 2011). Adolescents and young adults with a mild intellectual disability or borderline in tellectual functioning (MID-BIF) are at risk for problematic substance use and are more likely to have emotional and behavioral problems than peers without MID-BIF. Adolescent and young adults with different levels of emotional and behavioral problems benefit in terms of reduced substance use

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