Differential Sensitivity Markers in Youth Drug Abuse Prevention

This R34 pilot study proposes to conduct feasibility and exploratory intervention outcome
research that will lead to the development of a personalized intervention framework for early
stage adolescent drug users. The study will explore putative moderators representing two
theoretically distinct frameworks and determine whether they are suitable candidates for a
subsequent R01 study. One moderation framework is based on risk severity (RS) as reflected by
individual differences in delay discounting (DD), a form of impulsive decision making that is
positively associated with escalation to more serious levels of abuse and addiction. A second
more exploratory framework is based on differential sensitivity (DS) theory. The DS framework
stipulates that individuals, due to specific sensitivity factors, vary in their
responsiveness to environmental influence such as the influence provided by an intervention.
The study will explore DS markers associated with the reward motivational system, including
dopaminergic genes, the post-auricular physiological reflex and a high sensory-processing
sensitivity trait. An agency-university partnership will collaborate in providing services to
120 adolescents (ages 12-17) who were referred to a community counseling center because of a
recent alcohol and/or marijuana incident. Recruitment will select mild/moderate drug users.
Participants will be randomized to one of two evidence-based drug abuse interventions. The
two interventions offer the same delivery dosage but differ in terms of their mechanism of
therapeutic change (i.e., degree of environmental influence). The Teen Intervene program (TI;
Winters & Leitten, 2007) is a youth-focused intervention that uses motivational interviewing,
goal setting, and skills training to foster the internal development of responsible
decision-making with the goal of choosing attitudes and behaviors that are healthier
alternatives to drug use behaviors. The Everyday Parenting program (EP; Dishion et al., 2003;
2010) is a family focused-intervention that works with parents to provide environmental
scaffolding necessary to help teens gradually internalize decision-making skills that
reinforce and promote healthy lifestyle alternatives to drug use. The aims of this R34 are to
(1) assess feasibility of recruiting, assessing, and following-up enrolled youth in an
intervention trial, (2) assess the ability of staff to implement TI and EP with fidelity, and
(3) obtain promising data on moderator and outcome variables that will help answer the
question of "what intervention works best for which youth" in a subsequent R01 study.

Inclusion Criteria:

- Youth ages 12-17

- Substance Use referral to community partner agency

- Adolescent report of weekly-monthly use of one or more substances within the prior 6
months

Exclusion Criteria:

- Current DSM-5 diagnosis of a severe substance use disorder (i.e. substance dependence)

- Adolescent report of daily use of substance within prior 6 months

- Current or past history of psychosis (including suicidal ideation)

- Pervasive developmental disabilities