以人格特征为靶点技能培训为主导的青春前期青少年ATOD使用的预防干预研究

According to the most recent national survey data, the number of drug use had increased, with about 178 thousand being adolescents. For many, initiation of cigarette smoking, drinking, or drug-taking may lead to patterns of use which result in both psychological and physical dependence. Unfortunately, many intervention programs appear less effective for adolescents who began using alcohol, tobacco, or other drugs (ATOD) at an early age and few prevention programs target elementary-aged youths, and even fewer have specifically addressed the needs of a higher-risk population. .Theories and researches supported the influence of a variety of interpersonal factors (social pressures), intrapersonal factors (personality traits). Four particular personality risk factors for adolescent substance misuse-Hopelessness (H), Anxiety Sensitivity (AS), Impulsivity (IMP), and Sensation Seeking (SS)-which are also linked to risk for specific patterns of psychopathology have been shown to differentially predict susceptibility to binge drinking, problem drinking symptoms, illicit substance use. And a variety of theory-based school-based drug prevention programs have been tested that the most effective components are to teach skills to help young people refuse drug offers, resist pro-drug influences, correct misperceptions that drug use is normative, and enhance social and personal competence skills. With this in mind, the intervention approach to ATOD use prevention is based on a person-environment interactionist. The prevention programs have been categorized as universal and selective.Universal programs were multifaceted school-based programs and focus on health-education, cognition-behavior skills for elementary school-age children, parents and teachers. Selective prevention programs targeted specifically children that appear to be more vulnerable to use drugs before entering adolescence on personality factors (SS, AS, H, IMP) which exhibit a high risk for future ATOD use. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies. Manuals contained psychoeducational information on the target personality risk factor and how it is associated with maladaptive coping, as well as exercises targeting maladaptive cognitions and behaviors specific to each personality type..Participants received either an universal intervention programs or no intervention. Students with elevated scores on one of four personality (SS, AS, H, IMP) risk factor?were assigned randomly to participate in the selective programs. Outcome data were collected pretest, post-test, 6 and 12-month follow-up. Evaluation research has demonstrated whether this prevention approach is effective by ATOD expectations, ATOD intentions, ATOD experiment，refusal skills, refusal efficacy , current ATOD use, ATOD us onset and implementation translatability and feasibility.

截至2011年11月7日，我国经公安机关查获并登记在册的青少年吸毒人数已达178万。青少年成为毒品滥用主体已然构成新时期毒情的主要特点。完善青少年药物滥用预防教育在遏制药物滥用不断蔓延的趋势中有着举足轻重的地位。.本项目全面考虑青少年使用ATOD（alcohol, tobacco, and other drugs, ATOD）影响因素的群体背景, 从外在因素（社会环境因素）和内在因素（人格特征）两个方面综合考察其对青少年ATOD使用的影响方式（直接或间接）、影响途径和影响权重，以全面、深入地探讨青少年ATOD使用行为机制。同时，以学校为平台，开展以人格特征为靶点以技能培训为主导的青少年ATOD预防一级干预模式。该干预模式希望从双向策略（全人群干预和高危干预）、三个渠道（个人、家庭和学校），降低ATOD使用的内外在危险因素，增加保护因素，从而促进青少年的认知、行为、心理的健康发展。

青少年ATOD使用及其预防干预是国内众多研究的热点。研究较少涉足青春前期青少年，更少开展高危人群针对性的干预措施。本项目全面考虑青少年使用ATOD影响因素的群体背景, 从外在因素（社会环境因素）和内在因素（人格特征）两个方面，深入地探讨青少年ATOD 使用行为机制。首先，我们将物质使用风险评估量表（Substance Use Risk Profile Scale，SURPS）引入本项目，SURPS是探究非法药物使用相关人格特征（绝望、焦虑敏感、冲动和感觉寻求）的有效测量工具，人格特征的量化评价，可了解其非法药物使用相关的心理发展状况，预测其不良行为的发生，为预防和干预青少年不良行为提供指导依据。修订后的SURPS量表的信、效度均可接受，适用于我国青少年物质使用相关个体特征因素的风险评估；第二，为了有效提高青少年拒毒的能力，通过建立Logistic回归方程、Poisson回归方程、析因分析等，全面评估青少年面对四种情景ATOD供给所采用的拒绝方式、抵御技能的影响因素和因素间的相互作用。第三，探索有效的干预模式，采用全人群干预和高危干预双向策略，以个体特征为靶点，重点培养青少年防毒、拒毒的行为技能。干预措施显现一定效果。还需后期跟踪随访，强化干预效果。