Mechanisms of personality-targeted intervention effects on adolescent alcohol misuse, internalising and externalising symptoms

Objective: This study aims to explore the mechanisms of personality-targeted intervention effects on problematic drinking, internalising and externalising symptoms. Method: As part of a cluster-randomised trial, 1210 high-risk students (mean age 13.7 years) in 19 London high schools (42.6% white, 54% male) were identified using the Substance Use Risk Profile Scale. Intervention school participants were invited to participate in personality-matched interventions by trained school staff. MacKinnon’s products of coefficients method was used to compare three complementary mechanism hypotheses, namely, whether early changes in i) alcohol use, ii) internalising and externalising symptoms or iii) personality during the 6 months post-intervention accounted for intervention effects over 2 years. Results: Early intervention effects on drinking behaviours during the 6 months postintervention partially accounted for longer term intervention effects on the onset of binge drinking (95% CI -.349 to -.062) and drinking problems (95% CI -.206 to -.016) over 2 years. Intervention effects on anxiety symptoms and conduct problems were partially mediated by early reductions in depressive symptoms (95% CI -.013 to -.001; 95% CI - .047 to -.001), and intervention effects on internalising symptoms were also partially mediated by reductions in anxiety sensitivity (95% CI -.003 to 0). Conclusions: 2 year intervention effects on problematic drinking were largely accounted for by early changes in drinking behaviours, and were not mediated by changes in mental health symptoms or personality risk factors. Early improvements in mood and anxiety sensitivity partially mediated longer term reductions in mental health problems

The impact of youth internalising and externalising symptom severity on the effectiveness of brief personality-targeted interventions for substance misuse : a cluster randomised trial

Highlights : Personality-targeted interventions reduce binge drinking in high-risk youth ; Youth with high (vs. low) externalising symptoms benefitted more from the intervention ; Personality-targeted interventions may effectively treat dually diagnosed youth ; The presence of high internalising symptoms didn't moderate intervention effects

The structure of psychopathology in adolescence and its common personality and cognitive correlates

The traditional view that mental disorders are distinct, categorical disorders has been challenged by evidence that disorders are highly comorbid and exist on a continuum (e.g., Caspi et al., 2014; Tackett et al., 2013). The first objective of this study was to use structural equation modeling to model the structure of psychopathology in an adolescent community-based sample (N = 2,144) including conduct disorder, attention-deficit/hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), obsessive-compulsive disorder, eating disorders, substance use, anxiety, depression, phobias, and other emotional symptoms, assessed at 16 years. The second objective was to identify common personality and cognitive correlates of psychopathology, assessed at 14 years. Results showed that psychopathology at 16 years fit 2 bifactor models equally well: (a) a bifactor model, reflecting a general psychopathology factor, as well as specific externalizing (representing mainly substance misuse and low ADHD) and internalizing factors; and (b) a bifactor model with a general psychopathology factor and 3 specific externalizing (representing mainly ADHD and ODD), substance use and internalizing factors. The general psychopathology factor was related to high disinhibition/impulsivity, low agreeableness, high neuroticism and hopelessness, high delay-discounting, poor response inhibition and low performance IQ. Substance use was specifically related to high novelty-seeking, sensation-seeking, extraversion, high verbal IQ, and risk-taking. Internalizing psychopathology was specifically related to high neuroticism, hopelessness and anxiety-sensitivity, low novelty-seeking and extraversion, and an attentional bias toward negatively valenced verbal stimuli. Findings reveal several nonspecific or transdiagnostic personality and cognitive factors that may be targeted in new interventions to potentially prevent the development of multiple psychopathologies

Personality, attentional biases towards emotional faces and symptoms of mental disorders in an adolescent sample

Objective To investigate the role of personality factors and attentional biases towards emotional faces, in establishing concurrent and prospective risk for mental disorder diagnosis in adolescence. Method Data were obtained as part of the IMAGEN study, conducted across 8 European sites, with a community sample of 2257 adolescents. At 14 years, participants completed an emotional variant of the dot-probe task, as well two personality measures, namely the Substance Use Risk Profile Scale and the revised NEO Personality Inventory. At 14 and 16 years, participants and their parents were interviewed to determine symptoms of mental disorders. Results Personality traits were general and specific risk indicators for mental disorders at 14 years. Increased specificity was obtained when investigating the likelihood of mental disorders over a 2-year period, with the Substance Use Risk Profile Scale showing incremental validity over the NEO Personality Inventory. Attentional biases to emotional faces did not characterise or predict mental disorders examined in the current sample. Discussion Personality traits can indicate concurrent and prospective risk for mental disorders in a community youth sample, and identify at-risk youth beyond the impact of baseline symptoms. This study does not support the hypothesis that attentional biases mediate the relationship between personality and psychopathology in a community sample. Task and sample characteristics that contribute to differing results among studies are discussed

Two-Year Impact of Personality-Targeted, Teacher-Delivered Interventions on Youth Internalizing and Externalizing Problems: A Cluster-Randomized Trial

ObjectiveTo assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and externalizing symptoms in an adolescent U.K. sample.MethodThis cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents). Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month intervals.ResultsInterventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p < .05) over 2 years in the full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58–0.96), and conduct problems (OR = 0.79, CI = 0.65–0.96), and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59–1.05). Evaluating a priori personality-specific hypotheses revealed strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity–specific effects on severe anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms.ConclusionsBrief, personality-targeted interventions delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity

Pearson’s <i>r</i> correlation values between emotional biases, personality traits and mental health symptoms at 14 years.

<p>Note. *<i>p</i><.0004 (significance level adjusted for multiple comparisons using the Bonferroni test)</p><p>DAWBA = Development and Well-Being Assessment, GAD = Generalised Anxiety Disorder; MDD = Major Depressive Disorder; ADHD = Attention-Deficit/Hyperactivity Disorder, ODD = Oppositional Defiant Disorder; CD = Conduct Disorder, SURPS = Substance Use and Risk Profile Scale, H = Hopelessness, AS = Anxiety-Sensitivity; IMP = Impulsivity, SS = Sensation-Seeking, NEO-FFI = NEO Five-Factor Inventory; Neur = Neuroticism, Extr = Extraversion, Open = Openness, Agree = Agreeableness, Cons = Conscientiousness</p><p>Pearson’s <i>r</i> correlation values between emotional biases, personality traits and mental health symptoms at 14 years.</p

Hierarchical linear regressions predicting symptom severity at 16 years, accounting for site as cluster.

<p>Note. β = Standardised beta; SE = Standard Error</p><p>***<i>p</i>≤.001</p><p>**<i>p</i> ≤ .01</p><p>*<i>p</i> < .05</p><p>GAD = Generalised Anxiety Disorder; MDD = Major Depressive Disorder; ADHD = Attention-Deficit/Hyperactivity Disorder, ODD = Oppositional Defiant Disorder; CD = Conduct Disorder, H = Hopelessness, AS = Anxiety-Sensitivity; IMP = Impulsivity, SS = Sensation-Seeking, Neur = Neuroticism, Extr = Extraversion, Open = Openness, Agree = Agreeableness, Cons = Conscientiousness</p><p>† Results remained unchanged when personality was removed from the model.</p><p>Hierarchical linear regressions predicting symptom severity at 16 years, accounting for site as cluster.</p