The validity of the Substance Use Risk Profile Scale (SURPS) among Australian adolescents
Introduction
Each year, a significant proportion of adolescents put themselves at risk of harms related to alcohol or illicit drug use worldwide (World Health Organisation, 2011). In Australia, 51% of adolescents aged 12–17 report consuming alcohol in the past year, 12.7% report using cannabis and 6.5% report using an illicit drug other than cannabis (White & Bariola, 2012). The high prevalence of substance use among adolescents is particularly concerning, given that early onset of use has been associated with a range of consequences, including the development of substance use and mental health disorders, poor school performance, and juvenile offending (Patton et al., 2007, Grant et al., 2006, Behrendt et al., 2009). These disabling consequences can persist into adulthood, and are associated with considerable burden and costs to society (Collins & Lapsley, 2008).
To alleviate these problems, effective prevention is essential. In recent years we have seen an emergence of successful prevention programs to reduce substance use and associated harms (Fabrizio et al., 2014, Teesson et al., 2012, Foxcroft and Tsertsvadze, 2012, Conrod et al., 2013, Newton et al., 2010, Newton et al., 2009, Conrod et al., 2010). These span from universal programs, delivered to a whole population regardless of level of risk, to selective programs, targeted to those most at risk of developing substance use problems (Foxcroft, 2014). An integral component of selective prevention programs is the identification of individuals at increased risk. One area of risk shown to be particularly predictive of substance misuse is personality (Conrod et al., 2010, Woicik et al., 2009, Whelan et al., 2012, Mackie et al., 2011, Conrod et al., 2008a, Castellanos and Conrod, 2006, Peeters et al., 2014, Jaffee and D'Zurilla, 2009). Four personality profiles have been identified in this respect; the internalising profiles of Anxiety Sensitivity and Hopelessness, and the externalising profiles of Sensation Seeking and Impulsivity. Each of these profiles is associated with specific patterns of substance misuse, motivations for use, and vulnerabilities to comorbid psychopathology (Woicik et al., 2009, Castellanos-Ryan et al., 2013a, Cooper et al., 1995, Conrod et al., 2000a, Comeau et al., 2001). Anxiety sensitivity is described as a fear of anxiety-related physical sensations (Reiss, Peterson, Gursky, & McNally, 1986) and has been shown to be associated with coping motives for substance use, high levels of drinking problems, other drug use, and anxiety and panic symptoms among adults (Conrod et al., 2000a, Stewart and Kushner, 2001, Conrod et al., 1998, Zvolensky et al., 2009, Stewart et al., 2001). Anxiety sensitivity has been associated with lower levels of substance use among young adolescents (Krank et al., 2011), indicating it may be protective in early adolescence, but become a risk factor for substance misuse at later stages of development (Krank et al., 2011). Hopelessness, on the other hand, has been shown to be associated with early onset of alcohol use, motivations to drink to reduce negative affect, and symptoms of depression in adulthood (Conrod et al., 2010, Woicik et al., 2009, Conrod and Woicik, 2002). Hopelessness refers to a tendency towards low mood, worthlessness and negative beliefs about oneself, the world and the future (Castellanos-Ryan and Conrod, 2006, Conrod et al., 2000b). The two externalising profiles, Impulsivity and Sensation Seeking, have been linked to substance use and other high risk, anti-social behaviours (Woicik et al., 2009, Conrod et al., 2008b, Castellanos-Ryan et al., 2011, Krueger et al., 2002). Impulsivity is associated with rapid decision making and action and poor response inhibition (Conrod et al., 2010, Castellanos-Ryan et al., 2011, Krueger et al., 2002, Baumeister and Vohs, 2004) whereas sensation seeking is associated with an elevated need for stimulation and intolerance to boredom (Woicik et al., 2009, Arnett, 1994).
Based on this research, the Substance Use Risk Profile Scale (SURPS) was developed to assess variability on the four personality profiles (Woicik et al., 2009). This 23-item self-report scale has shown to be easily administered in large adolescent samples. The SURPS items measure personality and not substance use, therefore enabling the identification of adolescents at risk for substance use and related problems prior to the onset of use. This unique feature of the SURPS is of particular relevance to selective prevention programs. Importantly, the psychometric properties of the SURPS have been established and replicated, with studies demonstrating good test–retest reliability, internal consistency, and concurrent and predictive validity among adolescents and young adults (Woicik et al., 2009, Castellanos-Ryan et al., 2013a, Krank et al., 2011, Lammers et al., 2013, Malmber et al., 2010). A recent longitudinal study in the UK examined the sensitivity and specificity of the SURPS and demonstrated that all four profile scales were related to substance use and the development of profile-specific behavioural and emotional problems (Castellanos-Ryan et al., 2013a).
Taken together, these previous studies indicate that the SURPS can be a reliable tool for identifying high-risk personality profiles among adolescents with the aim of implementing selective programs to prevent substance misuse and other emotional and behavioural problems. In addition, the SURPS has demonstrated high cross-cultural validity, as evidenced by research carried out in the UK (Castellanos-Ryan et al., 2013a), The Netherlands (Lammers et al., 2013, Malmber et al., 2010), Canada (English and French versions) (Krank et al., 2011, Castonguay-Jolin et al., 2013), Mexico (Robles-Garcia et al., 2014), China (Siu, 2011), Sri Lanka (Ismail, De Senevirante, Newcombe, & Wanigarante, 2009), and Japan (Omiya, Kobori, Tomoto, Igarashi, & Iyo, 2015). Given the prevalence of substance use and the need for effective prevention among adolescents in Australia, the next important step is to examine the psychometric properties of the SURPS in an Australian adolescent sample.
The aims of this study are to: 1) examine the concurrent and predictive validity of the SURPS in relation to substance use and other emotional and behavioural problems among Australian adolescents; 2) report SURPS subscale scores in an Australian sample; and 3) compare the findings to a previously studied UK sample. Comparisons with the UK are of particular interest due to the similar drinking cultures and same legal purchase age of alcohol in Australia and UK (World Health Organisation, 2014). In addition to these broad aims, we propose a number of hypotheses in line with previous research (Castellanos-Ryan, O'Leary-Barrett, Sully, & Conrod, 2013b): i) Hopelessness will be associated with substance use, drinking problems, and depression symptoms; (ii) Anxiety sensitivity will not be associated with increased substance use at this age, but will be associated with emotional problems; (iii) Impulsivity will be associated with substance use, as well as hyperactivity and conduct problems; and (iv) Sensation Seeking will be related to substance use and hyperactivity. This will be the first study to examine these relationships in Australia.
Section snippets
Participants and procedure
The sample was derived from the Climate and Preventure (CAP) study, a cluster randomised controlled trial designed to prevent substance use and related harms. The study was conducted in 27 schools in Sydney and Melbourne, Australia between 2012 and 2015. A detailed description of the study participants and procedure is published elsewhere (Newton, Teesson, Barrett, Slade, & Conrod, 2012). The present study focuses on baseline and 24 month follow-up data from the seven control schools, to avoid
Sample characteristics
At baseline, 67% (n = 351) of the sample were female and participants' ages ranged from 12 to 15 years, with a mean age of 13.38 years (SD = 0.43). The majority of students were born in Australia (89%). The UK sample, with which we make comparisons in the following analyses, had a total of 1057 adolescents (42% female) with a mean age of 13.66 years (SD = 0.32) and a variety of ethnic backgrounds (43% White British) (Castellanos-Ryan et al., 2013b).
Attrition
Eighty four percent of students completed surveys 24
Discussion
This study examined the validity of the SURPS, a measure of personality risk factors for substance use, in predicting substance use, emotional and behavioural problems in a longitudinal sample of Australian adolescents. Results replicated previous research showing that the SURPS is effective in making meaningful predictions of substance use and other emotional and behavioural problems among adolescents (Castellanos-Ryan et al., 2013a, Krank et al., 2011). It compared these findings to a UK
Role of funding sources
This research was funded by the National Health and Medical Research Council (NHMRC; APP1004744). NHMRC had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.
Contributors
NN, PC, TS and MT designed the study and wrote the protocol. KC, EB, EK, NN and LS collected data for the study and NCR conducted the statistical analysis. NN wrote the first draft of the manuscript and all authors contributed to and approved the final version of the manuscript.
Conflict of interest
All authors declare that they have no conflicts of interest.
Acknowledgements
The authors would like to acknowledge the schools, students, teachers and health professionals who participated in this research. The research team also acknowledges the assistance of the NSW Department of Education and Communities for access to its schools (SERAP 2011201). This research was funded by the National Health and Medical Research Council (APP1004744).
References (70)
- et al.
Transitions from first substance use to substance use disorders in adolescence: Is early onset associated with a rapid escalation?
Drug Alcohol Depen.
(2009) - et al.
The substance use risk profile scale: A scale measuring traits linked to reinforcement-specific substance use profiles
Addictive Behaviors
(2009) - et al.
Personality, problem solving, and adolescent substance use
Behavior Therapy.
(2009) - et al.
The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents' motivations for alcohol, cigarette, and marijuana use
Addictive Behaviors
(2001) - et al.
Introduction to the special issue on “anxiety sensitivity and addictive behaviors”
Addictive Behaviors
(2001) - et al.
Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks
Behaviour Research and Therapy
(2001) - et al.
Structural, concurrent, and predictive validity of the Substacne Use Risk Profile Scale in early adolescence
Addictive Behaviors
(2011) Sensation seeking: A new conceptualization and a new scale
Personality and Individual Differences
(1994)- et al.
Mediational relations of substance use risk profiles, alcohol-related outcomes, and drinking motives among young adolescents in the Netherlands
Drug and Alcohol Dependence
(2013) - et al.
The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties
Journal of the American Academy of Child & Adolescent Psychiatry
(2005)
Psychometric properties of the strengths and difficulties questionnaire
Journal of the American Academy of Child & Adolescent Psychiatry
Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature
The Journal of Adolescent Health
Global Status Reporton Alcohol and Health
Australian Secondary School Students' Use of Tobacco, Alcohol, and Over-thecounter and Illicit Substances in 2011
Trajectories of Adolescent Alcohol and Cannabis Use into Young Adulthood
Adolescent alcohol use is a risk factor for adult alcohol and drug dependence: Evidence from a twin design
Psychological Medicine
Universal school-based prevention for illicit drug use
Cochrane Database of Systematic Reviews.
Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews
Perspectives in Public Health
Internet-based prevention for alcohol and cannabis use: Final results of the climate schools course
Addiction
CLIMATE schools alcohol module: Cross-validation of a school-based prevention programme for alcohol misuse
Australian and New Zealand Journal of Psychiatry.
Brief, personality-targeted coping skills interventions prolong survival as a non-drug user over a two-year period during adolescence
Archives of General Psychiatry
Can prevention classification be improved by considering the function of prevention?
Prevention Science
Adolescent impulsivity phenotypes characterized by distinct brain networks
Nature Neuroscience
Personality moderates the longitudinal relationship between psychological symptoms and alcohol use in adolescents
Alcoholism-Clinical and Experimental Research
Personality-targeted interventions delay the growth of adolescent drinking and binge drinking
Journal of Child Psychology and Psychiatry
Brief interventions targeting personality risk factors for adolescent substance misuse reduce depression, panic and risk taking behaviours
Journal of Mental health.
Personality and the prediction of high-risk trajectories of alcohol use during adolescence
Journal of studies on alcohol and drugs.
Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional and behavioral problems: 18-month predictive vailidity of the Substance Use Risk Profile Scale
Alcoholism: Clinical and Experimental Research
Validation of a system of classifying female substance abusers on the basis of personality and motivational risk factors for substance abuse
Psychology of Addictive Behaviors
Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes
Alcoholism: Clinical and Experimental Research
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