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S ubstance U se R isk P rofile S cale: Psychometric Evaluation in First Nation Adolescents Sherry H. Stewart, Ph.D. Dalhousie University CIHR Investigator

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S ubstance U se R isk P rofile S cale: Psychometric Evaluation in First Nation Adolescents Sherry H. Stewart, Ph.D. Dalhousie University CIHR Investigator. Collaborators. Patricia J. Conrod, Ph.D. Institute of Psychiatry, London, UK

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SubstanceUseRiskProfileScale:Psychometric Evaluation in First Nation AdolescentsSherry H. Stewart, Ph.D.Dalhousie UniversityCIHR Investigator

collaborators
Collaborators
  • Patricia J. Conrod, Ph.D.Institute of Psychiatry, London, UK
  • M. Nancy Comeau, Ph.D. Department of Psychology, Dalhousie University
  • Kaitlin English Department of Psychology, Dalhousie University
funding
Funding
  • Canadian Institutes of Health Research (CIHR) NET
  • Royal Canadian Mounted Police Foundation
substance related disorders some important facts
Substance-Related Disorders: Some Important Facts
  • Prevalent and costly
  • Moderately responsive to treatment
  • Heterogeneous in nature
  • Highly co-morbid with other mental disorders
conrod et al s 2000 motivational model of substance abuse risk
Conrod et al.’s (2000) Motivational Model of Substance Abuse Risk

Differences in functioning of four theorized brain motivational systems:

    • specific “vulnerability profiles”
    • susceptibility to patterns of personality and co-morbid psychopathology
    • differential sensitivity to certain types of drug reinforcement
  • Subtypes of substance abusers can be differentiated based on their degree of susceptibility to seek out specific drug reinforcement effects
reinforcing effects of drugs of abuse
Reinforcing effects of Drugs of Abuse

Negative Reinforcement

anxiety reducing (anxiolytic)

pain reducing (analgesic)

Positive Reinforcement

psycho-stimulant

personality risk factors for drug abuse
Personality Risk Factors for Drug Abuse
  • Anxiety Sensitivity
  • Hopelessness
  • Sensation Seeking
  • Impulsivity
anxiety sensitivity reiss peterson gursky mcnally 1986
Anxiety Sensitivity(Reiss, Peterson, Gursky, & McNally, 1986)
  • increased risk for anxiety disorders, including panic(Maller & Reiss, 1992; Schmidt, Lerew, & Jackson, 1997)
  • greater benzodiazepine use/abuse(Bruce, Speigel, Gregg, & Nuzzarello, 1992)
  • increased rates of alcohol consumption(Stewart, Peterson, & Pihl, 1995; Stewart, Zvolensky, & Eifert, 2001)
  • drinking to cope with negative emotions(Conrod, Pihl, & Vassileva, 1998; Stewart, Karp, Pihl, & Peterson, 1997)
  • sensitivity to the anxiolytic effects of alcohol(Conrod, Pihl, & Vassileva, 1998; MacDonald, Baker, Stewart, & Skinner, 2000; MacDonald, Stewart, Hutson, Loughlin, & Rhyno, 2001; Stewart & Pihl, 1994)
  • AS individuals particularly appreciate anxiolytic effects of alcohol & benzodiazepines(Stewart & Kushner, 2001)
hopelessness
Hopelessness
  • Depression predictive of the eventual development of alcohol problems, particularly for women(Hartka et al., 1991; Helzer & Pryzbeck, 1988).
  • Hopelessness associated with depression and with depression-specific coping motives for alcohol use (Blackwell et al., RSA presentation)
  • Alcohol and narcotics alleviate pain and hurt and suppress the inhibitory effects of punishment on previously-rewarded behavior(Gray, 1987).
  • Hopeless individuals may particularly appreciate the analgesic properties of alcohol and the opiates
sensation seeking
Sensation Seeking
  • Psychomotor stimulant theory of addiction: drugs’ addictive properties due to ability to increase dopamine in incentive reward system(Fibiger & Phillips, 1988; Wise & Bozarth, 1987)
  • Sensation seeking linked to dopamine-related biochemical mechanisms related to functioning of incentive reward system(Depue & Collins, 1999)
  • Sensation seekers show elevated drinking levels and drink to experience euphoric/intoxicating effects(Comeau, Stewart, & Loba, 2001; Conrod, Peterson, & Pihl, 1997; Ohannessian & Hesselbrock, 1994; Stewart & Devine, 2000)
  • Sensitivity to incentive motivation and psycho-stimulant properties of alcohol may be associated with propensity toward uncomplicated alcohol abuse
impulsivity
Impulsivity
  • Linked to elevated risk for early onset alcohol and drug problems(Pulkkinen & Pitkänen, 1994)
  • Represents a separate mediator of familial risk for alcoholism(Sher, 1993; Hill, 1994)
  • Deficits in executive cognitive functions(Harden & Pihl, 1995)
  • Lack of ability to delay behavioral response when faced with immediate reinforcement (Spoont, 1992)
  • Risk factor for abuse of immediately reinforcing drugs due to self-regulation deficit (Pihl & Peterson, 1995)
utility of model
Utility of model
  • Useful in predicting drug of choice and co-morbid psychopathology in substance abusers (Conrod et al., 2000a)
  • Useful in treatment matching with substance abusers (Conrod et al., 2000b)
  • Useful in school-based early interventions for alcohol abuse in adolescents (Stewart et al., in press)
measurement issues
Measurement Issues
  • Original measurement tool cumbersome; not realistic for use in practice
  • Woicik et al. developed brief version of original battery designed to more efficiently tap four personality constructs
  • Original measure called Drug Abuse Subtyping Scale (DASS)
  • Revised shortened 23-item version called the Substance Use Risk Profile Scale (SURPS)
  • Validated in substance abusers and adolescents/young adults from majority culture
s ubstance u se r isk p rofile s cale
Substance Use Risk Profile Scale

1. I am content.*

2. I often don\'t think things through before I speak.

3. I would like to skydive.

4. I am happy.*

5. I often involve myself in situations that I later regret being involved in.

6. I enjoy new and exciting experiences even if they are unconventional.

7. I have faith that my future holds great promise.*

8. It\'s frightening to feel dizzy or faint.

9. I like doing things that frighten me a little.

10. It frightens me when I feel my heart beat change.

11. I usually act without stopping to think.

12. I would like to learn how to drive a motorcycle.

13. I feel proud of my accomplishments.*

14. I get scared when I\'m too nervous.

15. Generally, I am an impulsive person.

16. I am interested in experience for its own sake even if it is illegal.

17. I feel that I\'m a failure.

18. I get scared when I experience unusual body sensations.

19. I would enjoy hiking long distances in wild and uninhabited territory.

20. I feel pleasant.*

21. It scares me when I\'m unable to focus on a task.

22. I feel I have to be manipulative to get what I want.

23. I am very enthusiastic about my future.*

Asterisk (*) indicates reverse keyed item.

surps anxiety sensitivity scale
SURPS Anxiety Sensitivity Scale

1. I am content.*

2. I often don\'t think things through before I speak.

3. I would like to skydive.

4. I am happy.*

5. I often involve myself in situations that I later regret being involved in.

6. I enjoy new and exciting experiences even if they are unconventional.

7. I have faith that my future holds great promise.*

8. It\'s frightening to feel dizzy or faint.

9. I like doing things that frighten me a little.

10. It frightens me when I feel my heart beat change.

11. I usually act without stopping to think.

12. I would like to learn how to drive a motorcycle.

13. I feel proud of my accomplishments.*

14. I get scared when I\'m too nervous.

15. Generally, I am an impulsive person.

16. I am interested in experience for its own sake even if it is illegal.

17. I feel that I\'m a failure.

18. I get scared when I experience unusual body sensations.

19. I would enjoy hiking long distances in wild and uninhabited territory.

20. I feel pleasant.*

21. It scares me when I\'m unable to focus on a task.

22. I feel I have to be manipulative to get what I want.

23. I am very enthusiastic about my future.*

Asterisk (*) indicates reverse keyed item.

surps hopelessness scale
SURPS Hopelessness Scale

1. I am content.*

2. I often don\'t think things through before I speak.

3. I would like to skydive.

4. I am happy.*

5. I often involve myself in situations that I later regret being involved in.

6. I enjoy new and exciting experiences even if they are unconventional.

7. I have faith that my future holds great promise.*

8. It\'s frightening to feel dizzy or faint.

9. I like doing things that frighten me a little.

10. It frightens me when I feel my heart beat change.

11. I usually act without stopping to think.

12. I would like to learn how to drive a motorcycle.

13. I feel proud of my accomplishments.*

14. I get scared when I\'m too nervous.

15. Generally, I am an impulsive person.

16. I am interested in experience for its own sake even if it is illegal.

17. I feel that I\'m a failure.

18. I get scared when I experience unusual body sensations.

19. I would enjoy hiking long distances in wild and uninhabited territory.

20. I feel pleasant.*

21. It scares me when I\'m unable to focus on a task.

22. I feel I have to be manipulative to get what I want.

23. I am very enthusiastic about my future.*

Asterisk (*) indicates reverse keyed item.

surps sensation seeking scale
SURPS SensationSeeking Scale

1. I am content.*

2. I often don\'t think things through before I speak.

3. I would like to skydive.

4. I am happy.*

5. I often involve myself in situations that I later regret being involved in.

6. I enjoy new and exciting experiences even if they are unconventional.

7. I have faith that my future holds great promise.*

8. It\'s frightening to feel dizzy or faint.

9. I like doing things that frighten me a little.

10. It frightens me when I feel my heart beat change.

11. I usually act without stopping to think.

12. I would like to learn how to drive a motorcycle.

13. I feel proud of my accomplishments.*

14. I get scared when I\'m too nervous.

15. Generally, I am an impulsive person.

16. I am interested in experience for its own sake even if it is illegal.

17. I feel that I\'m a failure.

18. I get scared when I experience unusual body sensations.

19. I would enjoy hiking long distances in wild and uninhabited territory.

20. I feel pleasant.*

21. It scares me when I\'m unable to focus on a task.

22. I feel I have to be manipulative to get what I want.

23. I am very enthusiastic about my future.*

Asterisk (*) indicates reverse keyed item.

surps impulsivity scale
SURPS Impulsivity Scale

1. I am content.*

2. I often don\'t think things through before I speak.

3. I would like to skydive.

4. I am happy.*

5. I often involve myself in situations that I later regret being involved in.

6. I enjoy new and exciting experiences even if they are unconventional.

7. I have faith that my future holds great promise.*

8. It\'s frightening to feel dizzy or faint.

9. I like doing things that frighten me a little.

10. It frightens me when I feel my heart beat change.

11. I usually act without stopping to think.

12. I would like to learn how to drive a motorcycle.

13. I feel proud of my accomplishments.*

14. I get scared when I\'m too nervous.

15. Generally, I am an impulsive person.

16. I am interested in experience for its own sake even if it is illegal.

17. I feel that I\'m a failure.

18. I get scared when I experience unusual body sensations.

19. I would enjoy hiking long distances in wild and uninhabited territory.

20. I feel pleasant.*

21. It scares me when I\'m unable to focus on a task.

22. I feel I have to be manipulative to get what I want.

23. I am very enthusiastic about my future.*

Asterisk (*) indicates reverse keyed item.

substance abuse in first nation communities
Substance Abuse in First Nation Communities
  • Alcohol abuse and other substance abuse an enormous problem for First Nation communities and peoples
  • Substance abuse the most common problem contributing to mental health service use in study of Cree males in James Bay Quebec (Lavallee et al., 1991)
  • High rates of alcohol abuse contribute to the extremely high rates of suicide in many First Nations communities (Malchy et al., 1997; Wilkie et al., 1998)
first step in project
First Step in Project
  • Examine psychometric properties of SURPS in First Nation youth
  • Specifically, examine the following properties:
    • Factorial validity
    • Reliability
    • Construct Validity
    • Criterion-Related Validity
      • Risky drinking motives, alcohol problems, reckless behavior
sample characteristics
Sample Characteristics
  • N = 164 First Nation adolescents
  • 2 Mi’kmaq communities in N.S.
  • 3 schools
  • Age Range = 14-18 yrs (mean = 16.3)
  • 85 girls; 79 boys
  • Grade Range = Gr. 8-12 (mean = 10.1)
measures
Measures
  • SURPS (Woicik et al., in preparation)
  • Demographics (age, gender, grade)
  • CASI, STAIT-C, AISS-I, BSI-DEP
  • DMQ-R: Coping, Conformity, Enhancement, and Social Motives
  • RAPI (alcohol problems)
  • RBQ (reckless behavior)
factorial validity
Factorial Validity
  • Performed principal components analysis
  • Varimax rotation
  • # factors determined by examination of scree plot
  • Four-factor solution explained 44% variance in SURPS item scores
surps problem items
SURPS – Problem Items

3. I would like to skydive. (SS-hyperplane)

5. I often involve myself in situations that I later regret being involved in. (IMP-hyperplane)

16. I am interested in experience for its own sake even if it is illegal. (SS but loads as IMP)

17. I feel that I\'m a failure. (HOP-hyperplane)

19. I would enjoy hiking long distances in wild and uninhabited territory.(SS-hyperplane)

reliability
Reliability
  • Anxiety Sensitivity Scale
    • 5 items
    • α = .65
  • Hopelessness Scale
    • 7 items
    • α = .76
  • Sensation Seeking Scale
    • 6 items
    • α = .62
  • Impulsivity Scale
    • 5 items
    • α = .61
  • Acceptable internal consistency for short scales
construct validity
Construct Validity
  • SURPS AS
    • With CASI (N = 164): r = .57, p < .001
    • With STAIC-T (N = 164): r = .28, p < .001
  • SURPS HOP
    • With BSI-DEP (N = 162): r = .30, p < .001
  • SURPS SS
    • With AISS-I (N = 164): r = .36, p < .001
criterion related validity
Criterion-Related Validity
  • Set of analyses examining incremental validity of block of SURPS personality variables in predicting risky drinking motives, alcohol problems, and other reckless behavior, over-and-above demographic variables
  • Block of demographic variables = age, gender, grade
criterion related validity risky drinking motives
Criterion-Related Validity: Risky Drinking Motives
  • Criterion variable = DMQ-R Conformity
  • Block of SURPS variables significantly increased prediction of conformity motives above demographics
    • ΔF (4, 88) = 2.68, p < .05 (10.3% additional variance explained by SURPS variables)
  • Final Model significant
    • F (7, 88) = 2.33, p < .05 (demographics and personality variables together predict 15.7% variance in conformity motives scores)
criterion related validity risky drinking motives37
Criterion-Related Validity: Risky Drinking Motives
  • Criterion variable = DMQ-R Coping
  • Block of SURPS variables significantly increased prediction of coping motives above demographics
    • ΔF (4, 88) = 3.13, p < .05 (11.8% additional variance explained by SURPS variables)
  • Final Model significant
    • F (7, 88) = 2.62, p < .05 (demographics and personality variables together predict 17.3% variance in conformity motives scores)
criterion related validity risky drinking motives39
Criterion-Related Validity: Risky Drinking Motives
  • Criterion variable = DMQ-R Enhancement
  • Block of SURPS variables significantly increased prediction of enhancement motives above demographics
    • ΔF (4, 88) = 3.13, p < .05 (12.3% additional variance explained by SURPS variables)
  • Final Model not significant
    • F (7, 88) = 2.02, p > .05
  • Therefore considered SURPS only model
criterion related validity risky drinking motives41
Criterion-Related Validity: Risky Drinking Motives
  • Criterion variable = DMQ-R Social
  • Block of SURPS variables did not significantly increase prediction of social motives above demographics
    • ΔF (4, 88) = 1.68, p > .05
criterion related validity alcohol problems
Criterion-Related Validity: Alcohol Problems
  • Criterion variable = RAPI Total
  • Block of SURPS variables significantly increased prediction of alcohol problems above demographics
    • ΔF (4, 94) = 8.76, p < .001 (26.6% additional variance explained by SURPS variables)
  • Final Model significant
    • F (7, 94) = 5.41, p < .001 (demographics and personality variables together predict 28.7% variance in RAPI scores)
concurrent validity other reckless behavior
Concurrent Validity: Other Reckless Behavior
  • Criterion variable = RBQ Total
  • Block of SURPS variables significantly increased prediction of reckless behavior above demographics
    • ΔF (4, 156) = 10.89, p < .001 (21.0% additional variance explained by SURPS variables)
  • Final Model significant
    • F (7, 156) = 7.42, p < .001 (demographics and personality variables together predict 25.0% variance in RBQ scores)
summary of findings
Summary of Findings

Factorial validity

  • Findings encouraging
  • Four factors emerged clearly relating to the hypothesized personality factors
  • Some items may need revision to improve psychometric properties in this cultural and age group
summary of findings48
Summary of Findings

Anxiety Sensitivity

  • Good construct validity (CASI, STAIC-T)
  • Acceptable internal consistency
  • Predicted conformity-motivated drinking but not coping-motivated drinking (cf. Comeau et al., 2001)
  • Unexpectedly, predicted cocaine use
  • Did not predict alcohol problems on RAPI
summary of findings49
Summary of Findings

Hopelessness

  • Adequate construct validity (BSI-DEP)
  • Good internal consistency
  • Predicted conformity- and coping-motivated drinking
  • Predicted alcohol problems on RAPI
  • Predicted reckless behavior, particularly use of cocaine and other illegal drugs
summary of findings50
Summary of Findings

Sensation Seeking

  • Adequate construct validity (AISS-I)
  • Acceptable internal consistency
  • Predicted enhancement-motivated drinking, but only marginally
  • Predicted alcohol problems on RAPI
  • Predicted reckless behavior, particularly sexual risk taking, property damage, shoplifting, speeding, and marijuana use
  • Not associated with use of cocaine or other illegal drugs
summary of findings51
Summary of Findings

Impulsivity

  • Construct validity remains unknown
  • Acceptable internal consistency
  • Predicted coping-motivated drinking, but only marginally
  • Predicted alcohol problems on RAPI
  • Predicted reckless behavior, particularly sexual risk taking, property damage, shoplifting, marijuana use, cocaine use, and use of other illegal drugs
  • Not associated with speeding
conclusions
Conclusions
  • SURPS appears a promising measure for tapping personality variables related to substance abuse risk and other problem behaviors in First Nations youth
  • Should prove useful instrument for selecting high-risk youth to participate in personality-matched early interventions for substance abuse modified for use in First Nations culture
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