The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis

Morten Hesse; Sheila Jones; Michael Mulbjerg Pedersen; Karina Berthu Ellegaard Skov; Birgitte Thylstrup; Mads Uffe Pedersen

doi:10.1016/j.addbeh.2022.107574

The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis

Morten Hesse^*, Sheila Jones, Michael Mulbjerg Pedersen, Karina Berthu Ellegaard Skov, Birgitte Thylstrup, Mads Uffe Pedersen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

BACKGROUND: Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder.

METHODS: Clients aged 15-25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events.

RESULTS: The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; adjusted beta = -0.45, 95% CI = -0.66 to -0.25). The EP6 was associated with shorter time to criminal offending, coefficient = -0.32, 95% CI = -0.44 to -0.19; adjusted coefficient = -0.18, 95% CI = -0.30 to -0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6.

CONCLUSIONS: The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported.

Original language	English
Article number	107574
Journal	Addictive Behaviors
Volume	139
Number of pages	8
ISSN	0306-4603
DOIs	https://doi.org/10.1016/j.addbeh.2022.107574
Publication status	Published - Apr 2023

Keywords

Brief screening
Externalizing
Internalizing
Substance abuse treatment
Substance use
Young adults
Young Adult
Humans
Adolescent
Criminals
Substance-Related Disorders/epidemiology

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@article{819c0384ff474896ab5590a981ce783f,

title = "The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis",

abstract = "BACKGROUND: Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder.METHODS: Clients aged 15-25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events.RESULTS: The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; adjusted beta = -0.45, 95% CI = -0.66 to -0.25). The EP6 was associated with shorter time to criminal offending, coefficient = -0.32, 95% CI = -0.44 to -0.19; adjusted coefficient = -0.18, 95% CI = -0.30 to -0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6.CONCLUSIONS: The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported.",

keywords = "Brief screening, Externalizing, Internalizing, Substance abuse treatment, Substance use, Young adults, Young Adult, Humans, Adolescent, Criminals, Substance-Related Disorders/epidemiology",

author = "Morten Hesse and Sheila Jones and Pedersen, {Michael Mulbjerg} and Skov, {Karina Berthu Ellegaard} and Birgitte Thylstrup and Pedersen, {Mads Uffe}",

year = "2023",

month = apr,

doi = "10.1016/j.addbeh.2022.107574",

language = "English",

volume = "139",

journal = "Addictive Behaviors",

issn = "0306-4603",

publisher = "Elsevier Ltd",

}

The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis. / Hesse, Morten; Jones, Sheila; Pedersen, Michael Mulbjerg et al.
In: Addictive Behaviors, Vol. 139, 107574, 04.2023.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment

T2 - A secondary analysis

AU - Hesse, Morten

AU - Jones, Sheila

AU - Pedersen, Michael Mulbjerg

AU - Skov, Karina Berthu Ellegaard

AU - Thylstrup, Birgitte

AU - Pedersen, Mads Uffe

PY - 2023/4

Y1 - 2023/4

N2 - BACKGROUND: Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder.METHODS: Clients aged 15-25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events.RESULTS: The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; adjusted beta = -0.45, 95% CI = -0.66 to -0.25). The EP6 was associated with shorter time to criminal offending, coefficient = -0.32, 95% CI = -0.44 to -0.19; adjusted coefficient = -0.18, 95% CI = -0.30 to -0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6.CONCLUSIONS: The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported.

AB - BACKGROUND: Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder.METHODS: Clients aged 15-25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events.RESULTS: The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; adjusted beta = -0.45, 95% CI = -0.66 to -0.25). The EP6 was associated with shorter time to criminal offending, coefficient = -0.32, 95% CI = -0.44 to -0.19; adjusted coefficient = -0.18, 95% CI = -0.30 to -0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6.CONCLUSIONS: The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported.

KW - Brief screening

KW - Externalizing

KW - Internalizing

KW - Substance abuse treatment

KW - Substance use

KW - Young adults

KW - Young Adult

KW - Humans

KW - Adolescent

KW - Criminals

KW - Substance-Related Disorders/epidemiology

U2 - 10.1016/j.addbeh.2022.107574

DO - 10.1016/j.addbeh.2022.107574

M3 - Journal article

C2 - 36565530

SN - 0306-4603

VL - 139

JO - Addictive Behaviors

JF - Addictive Behaviors

M1 - 107574

ER -

The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis

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