Multidimensional Predictors of Treatment Outcome in Usual Care for Adolescent Conduct Problems and Substance Use.
Multidimensional Predictors of Treatment Outcome in Usual Care for Adolescent Conduct Problems and Substance Use.
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DOI：
10.1007/s10488-016-0724-7
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Schmidt AT
中科院分区：
文献类型：
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作者：
Hogue A;Henderson CE;Schmidt AT
本研究调查了基线客户端的特征，预测长期治疗结果的青少年从学校和社区的来源，并参加了日常护理的行为和物质使用问题。对多个人口统计学（年龄、性别、种族/民族）、临床（基线症状严重程度、合并症、家庭不和）和发育性精神病理学（行为失调、抑郁、同伴犯罪）特征的预测效应进行了研究。参与者是205名来自不同背景（59%西班牙裔美国人，21%非洲裔美国人，15%多种族，6%其他）的青少年（52%男性，平均年龄15.7岁），居住在一个大的内城地区。正如预期的那样，所有三个预测类别的特征都与一年随访时外化问题、违法行为和物质使用变化的各个方面有关。基线症状严重程度的预测作用最强：严重程度越高的青年临床获益越大。同时发生的发展性精神病理学特征水平越高，同样预测的结果越好。探索性分析表明，随着时间的推移，在发展的精神病理学特征（同伴犯罪，抑郁症）的变化与犯罪行为和物质使用的变化。服务多问题青少年和定制治疗计划在常规护理的影响进行了讨论。
This study investigated baseline client characteristics that predicted long-term treatment outcomes among adolescents referred from school and community sources and enrolled in usual care for conduct and substance use problems. Predictor effects for multiple demographic (age, sex, race/ethnicity), clinical (baseline symptom severity, comorbidity, family discord), and developmental psychopathology (behavioral dysregulation, depression, peer delinquency) characteristics were examined. Participants were 205 adolescents (52% male; mean age 15.7 years) from diverse backgrounds (59% Hispanic American, 21% African American, 15% multiracial, 6% other) residing in a large inner-city area. As expected, characteristics from all three predictor categories were related to various aspects of change in externalizing problems, delinquent acts, and substance use at one-year follow-up. The strongest predictive effect was found for baseline symptom severity: Youth with greater severity showed greater clinical gains. Higher levels of co-occurring developmental psychopathology characteristics likewise predicted better outcomes. Exploratory analyses showed that change over time in developmental psychopathology characteristics (peer delinquency, depression) was related to change in delinquent acts and substance use. Implications for serving multiproblem adolescents and tailoring treatment plans in routine care are discussed.