Risk Reduction for Substance Use and Trauma-Related Psychopathology in Adolescent Sexual Assault Victims: Findings From an Open Trial

Abstract

Limited attention has been paid to the development and evaluation of interventions that reduce risk for substance use, while also targeting trauma-related psychopathology among maltreated adolescents. Risk Reduction through Family Therapy (RRFT) is a multicomponent treatment that integrates principles and interventions from existing empirically supported treatments. The purpose of the current study was to evaluate the feasibility of implementation and initial efficacy of RRFT through an open pilot trial involving a small sample (N = 10) of female adolescents (aged 13—17 years) who had experienced at least one memorable sexual assault in their lifetime. Measures of substance use and substance use risk factors (e.g., family functioning), posttraumatic stress disorder (PTSD), and depression symptoms were assessed pre- and posttreatment as well as at 3-month and 6-month posttreatment follow-up assessments. Results demonstrated reductions in multiple areas, including substance use and related risk factors, PTSD, and depression symptoms, which were maintained through follow-up. Clinical implications and future directions with this line of research are discussed.

Keywords

adolescents trauma sexual assault treatment substance use PTSD depression

Get full access to this article

View all access options for this article.

References

Bronfenbrenner, U. ( 1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Carey, M.P. , Faulstich, M.E. , Gresham, F.M. , Ruggiero, L. , & Enyart, P. ( 1987). Children’s Depression Inventory: Construct and discriminant validity across clinical and nonreferred (control) populations . Journal of Consulting and Clinical Psychology, 55, 755-761.

Carrigan, M.H. , Ham, L. , Thomas, S. , & Randall, C. ( 2008). Alcohol outcome expectancies and drinking to cope with social situations. Addictive Behaviors, 33, 1162-1166.

Cohen, J.A. , Mannarino, A.P. , & Deblinger, E. ( 2006). Treating trauma and traumatic grief in children and adolescents . New York, NY: Guilford.

Cornelius, J.R. , Maisto, S.A. , Pollock, N.K. , Martin, C.S. , Salloum, I.M. , Lynch, K.G. , & Clark, D.B. ( 2002). Rapid relapse generally follows treatment for substance use disorders among adolescents. Addictive Behaviors, 28, 381-386.

Curtis, N.M. , Ronan, K.R. , & Borduin, C.M. ( 2004). Multisystemic treatment: A meta-analysis of outcome studies . Journal of Family Psychology, 18, 411-419.

Danielson, C.K. ( 2007). Risk Reduction through Family Therapy (RRFT) Treatment Manual. National Crime Victims Research & Treatment Center, Medical University of South Carolina, Charleston, SC .

Danielson, C.K. , Macdonald, A. , Amstadter, A.B. , Hanson, R.F. , de Arellano, M.A. , Saunders, B. , & Kilpatrick, D.G. (2010). Risky behaviors and depression in conjunction with-or in the absence of-lifetime history of PTSD among sexually abused adolescents. Child Maltreatment, 15, 101-107.

Guo, J. , Hill, K.G. , Hawkins, J.D. , Catalano, R.F. , & Abbott, R.D. ( 2002). A developmental analysis of sociodemographic, family, and peer effects on adolescent illicit drug initiation. Journal of the Academy of Child and Adolescent Psychiatry, 41, 838-845.

10.

Hanson, R.F. , Self-Brown, S. , Fricker-Elhai, A. , Kilpatrick, D.G. , Saunders, B.E. , & Resnick, H.S. ( 2006). Relations among parental substance use, violence exposure and mental health: The National Survey of Adolescents. Addictive Behaviors, 31, 1988-2001.

11.

Hawkins, J.D. , Catalano, R.F. , & Miller, J.Y. ( 1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64-105.

12.

Hedges, L.V. , & Olkin, I. ( 1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press.

13.

Henggeler, S.W. , Clingempeel, W.G. , Brondino, M.J. , & Pickrel, S.G. ( 2002). Four year follow-up of multisystemic therapy with substance abusing and dependent juvenile offenders. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 868-874.

14.

Kilpatrick, D. , Ruggiero, K. , Acierno, R. , Saunders, B. , Resnick, H. , & Best, C. ( 2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents . Journal of Consulting & Clinical Psychology, 71, 697-703.

15.

Kovacs, M. ( 1983). The interview schedule for children (ISC): Interrater and parent-child agreement. Unpublished manuscript, Pittsburgh, PA.

16.

Krause, E. , Kaltman, S. , Goodman, L. , & Dutton, M. ( 2008). Avoidant coping and PTSD symptoms related to domestic violence exposure: A longitudinal study. Journal of Traumatic Stress, 21, 83-90.

17.

Lewis, M. , & Petry, N. ( 2005). Contingency management treatments that reinforce completion of goal-related activities. Drug & Alcohol Dependence , 79, 267-271.

18.

Maas, C.J.M. , & Hox, J.J. ( 2004). Robustness issues in multilevel regression analysis. Statistica Neerlandica, 58, 127-137.

19.

Miller, W.R. ( 1991). Form 90: Structured assessment for drinking related behaviors . Washington, DC: Department of Health and Human Services, NIH, NIAAA.

20.

Moos, R. , & Moos, B. ( 1986). FES Manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.

21.

Nace, E. ( 1988). PTSD and substance abuse: Clinical issues. Recent Developments in Alcoholism, 6, 9-26.

22.

Raudenbush, S.W. , Bryk, A.S. , Cheong, Y.F. , Congdon, R. , & du Toit, M. ( 2004). HLM 6: Hierarchical linear & nonlinear modeling. Lincolnwood, IL: Scientific Software International .

23.

Singer, J.D. , & Willett, J.B. ( 2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York, NY: Oxford University Press.

24.

Steinberg, A.M. , Brymer, M.J. , Decker, K.B. , & Pynoos, R.S. ( 2004). The UCLA Posttraumatic Stress Disorder reaction index . Current Psychiatry Reports, 6, 96-100.

25.

Waldon, H.B. , & Turner, C.W. ( 2008). Evidence-based psychosocial treatments for adolescent substance abuse. Journal of Clinical Child & Adolescent Psychology, 37, 238-261.