Ridenour Ty A, O'Shea Gottfredson Nisha, Williams Jason, Shaw Daniel S, Reynolds Maureen D, Roberts Cheryl A, Spoth Richard, Garnica-Agudelo David R, Baran Idil, Belger Aysenil, Fishbein Diana H
Substance Use Prevention, Evaluation, and Research, RTI International, Research Triangle Park, NC, United States.
Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, United States.
Front Child Adolesc Psychiatry. 2025 Jun 27;4:1513607. doi: 10.3389/frcha.2025.1513607. eCollection 2025.
Over the last two decades, drug use epidemics have occurred across the world, including in countries with well-funded services for treatment and recovery, underscoring the need to bolster primary prevention. Moreover, substance use (SU) and SU disorders (SUDs) contribute to the etiology and exacerbation of many medical and psychiatric illnesses. The first step in providing selective/indicated prevention for SU/SUD is identifying high liability (overall risk). We evaluated the © (YRI) screening tool, which measures liability to SU and related behaviors, frequently before they are initiated, at ages 8-14.
Using data from five previously recruited samples of youth, psychometric analyses consisted of (1) confirmatory factor analyses comparing two latent structures, (2) non-invariance tests between sexes and purposes for using the YRI (research or screening), and (3) concurrent and predictive validity. Reports from 4,495 youths aged 8-13 were analyzed, with approximately half of the sample representing each sex, each research purpose, and a Caucasian identity.
A latent structure with one second-order factor (Overall Liability) and three first-order factors (Disinhibition, Peer Conduct Problems, and Social Contagion) best fit the observed data and was well-replicated within sexes and purposes. Partial scalar non-invariance between purposes occurred for Overall Liability involving two items. Disinhibition had partial non-invariance between sexes and purposes involving the same item. Greater non-invariance was found for Peer Conduct Problems and Social Contagion. Traditional and non-invariance-adjusted scores correlated highly, with values of 0.96 for Overall Liability, 0.99 for Disinhibition, 0.89 for Peer Conduct Problems, and 0.93 for Social Contagion. Traditional scoring provided a good to excellent area under the receiving operating characteristic curve for concurrent and 1-year SU and conduct problems. Greater YRI scores were associated with greater youth-reported depression, sensation seeking, substance use, conduct disorder behaviors, and parental problems from SU and/or legal problems, as well as less self-management and parent fortification and poorer performances in planning, problem-solving, and low-load working memory tasks. YRI scores correlated less with parent reports on youths than with youth self-reports.
In sum, YRI scores encapsulate many segments of risk for SU/SUD and related behavior problems, which is critical to accurately identify the need for and provision of selective/indicated prevention because of the manifold risk factors for, and complex etiology of, SU/SUD.
在过去二十年中，药物使用流行现象在全球范围内出现，包括在那些拥有资金充足的治疗和康复服务的国家，这凸显了加强一级预防的必要性。此外，物质使用（SU）和物质使用障碍（SUD）在许多医学和精神疾病的病因及病情加重方面都有影响。为SU/SUD提供选择性/指示性预防的第一步是确定高易感性（总体风险）。我们评估了©（YRI）筛查工具，该工具在8至14岁的青少年开始出现SU及相关行为之前，就对其SU易感性及相关行为进行测量。
使用之前招募的五个青少年样本的数据，心理测量分析包括：（1）比较两种潜在结构的验证性因素分析；（2）YRI使用目的（研究或筛查）和性别的非不变性测试；（3）同时效度和预测效度。分析了4495名8至13岁青少年的报告，样本中每种性别、每个研究目的以及白人身份的人数大致各占一半。
一个具有一个二阶因素（总体易感性）和三个一阶因素（去抑制、同伴行为问题和社会传染）的潜在结构最符合观测数据，并且在性别和目的方面都得到了很好的重复验证。在总体易感性方面，涉及两个项目的使用目的之间存在部分标量非不变性。去抑制在性别和目的之间存在涉及同一项目的部分非不变性。同伴行为问题和社会传染方面发现了更大的非不变性。传统分数和非不变性调整分数高度相关，总体易感性的相关值为0.96，去抑制为0.99，同伴行为问题为0.89，社会传染为0.93。传统评分在同时效度以及1年的SU和行为问题方面，在接受者操作特征曲线下的面积表现良好至优秀。更高的YRI分数与青少年报告的更多抑郁、寻求刺激、物质使用、品行障碍行为、SU导致的父母问题和/或法律问题相关，也与更少的自我管理和父母强化以及在计划、解决问题和低负荷工作记忆任务中的较差表现相关。YRI分数与父母对青少年的报告之间的相关性低于与青少年自我报告之间的相关性。
总之，YRI分数涵盖了SU/SUD及相关行为问题的许多风险部分，由于SU/SUD存在多种风险因素和复杂病因，这对于准确识别选择性/指示性预防的需求和提供此类预防至关重要。
