Is integrated motivational interviewing and cognitive behavioural therapy (CBT) an effective addition to standard care for people with psychosis and
a comorbid substance use problem?
Not exact matches
Comorbid mental health symptoms were common: 28 % of youth reported significant externalizing symptoms or conduct
problems (eg, disobedient, stealing, aggression), 60 22 % screened positive for posttraumatic stress disorder, 61 25 % endorsed 1 or more indicators of problematic
substance use, 62 27 % reported suicidal ideation, 60 and 13 % reported suicide attempts or deliberate self - harm (defined as some suicidal ideation plus some suicide attempt or deliberate self - harm during the previous 6 months on the Youth Self Report).60 About 22 % reported specialty mental health care and psychotherapy / counseling in the past 6 months, and 16 % reported medication treatment in the past 6 months.
Although smoking, alcohol and illicit drug
use might as behaviors have very different individual effects, they can be combined into a single category insofar as previous studies suggest that the
use of these three
substances is correlated or
comorbid (e.g., Farrell et al. 1992; Lynskaey et al. 1998) and also, because they comprise a general type of deviant behavior often associated with externalizing behavior
problems (e.g., Timmermans et al. 2008).
The externalizing pathway highlights the underlying neurological systems of increased reward sensitivity and reactivity combined with decreased effortful control and regulation that are imbalanced and competing during adolescence (i.e., dual systems model), which further contributes to adolescence being a high - risk period for the onset of
substance use and
comorbid behavior
problems [80, 81].
We chose this validated measure of externalizing behavior, as opposed to other broader measures, as it takes into account those specific externalizing traits commonly
comorbid with SUD (see Introduction, A Focus on Youths with Child / Adolescent - Onset
Substance Use Problems).
For example, compared to their peers, adolescents with ADHD experience higher rates of family conflict (Deault 2010), peer
problems (Gardner and Gerdes 2013), academic failure (DuPaul and Langberg 2014),
comorbid mental health
problems (Larson et al. 2011),
substance use (Lee et al. 2011), and driving citations / crashes (Barkley et al. 1996).