Screening for Signs of Vulnerability To Addiction In Adolescence - The BASUS Project - Chris Richardson

Screening for signs of vulnerability to addiction in adolescence: Results from the British Columbia Adolescent Substance Use Survey (BASUS) Dr. Chris G. Richardson ([email protected])

2013 Lost in Translation 2013: Exploring the Early Origins of Addiction

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Chris G Richardson, PhD

Centre for Health Evalua9on and Outcome Sciences, Providence Health Care School of Popula9on and Public Health, University of Bri9sh Columbia

[email protected]

Screening for signs of vulnerability to addic4on in adolescence: Results from the Bri4sh Columbia Adolescent

Substance Use Survey (BASUS)

CHÉOS Centre for Health Evalua4on and Outcome Sciences



A Public Health Perspec4ve

‘Medical care is vital

to all of us some of

the 9me, but Public

Health is vital to all

of us all of the 9me’ C. EvereG Koop, MD, former U.S.

Surgeon General



Leyton M., Cox S. Impulsivity and Substance Use Disorders. Canadian Centre on Substance abuse. (2009). Substance abuse in Canada: Concurrent disorders. OGawa, ON: Canadian Centre on Substance Abuse.

VEAR Model of Addic4on



Adolescence Enhanced mo9va9onal drives for novel experiences Rela9vely immature inhibitory control system

Impulsivity, risk taking, & sensa4on seeking

Enter a social environment with new norms, psychosocial challenges and increased poten9al for substance use

Evidence indica9ng that the pharmacological-‐mo9va9onal effects of addic9ve drugs may be accelerated at this 9me

Period of bio-‐psycho-‐social vulnerability



Social Neuroscience: A Duel Systems Model Sensa4on Seeking and Impulsivity

Subcor4cal socioemo4onal system Ventral striatum, amygdala Responsive to affec9ve cues, novelty and rewards More sensi9ve/maturing in early adolescence

Cogni4ve control system Prefrontal cortex Impulse control, emo9on regula9on and decision making

Individual differences in the developmental imbalance between these two systems



12-‐13 yrs

13-‐14 yrs

15-‐17 yrs 18-‐19 yrs



Bri4sh Columbia Adolescent Substance Use Survey (BASUS)

•  Hybrid model combining in-‐school recruitment with online survey •  Allows for complex skip logic paGerns, random assignment etc. •  Email, Facebook, text messaging, mail and in-‐school reminders •  Responses are saved con9nuously (selec9ve emails to complete) •  Data can be downloaded and analyzed at any 9me •  Started in Grade 8 and surveyed every fall and spring •  Over 3000 students in 72 Secondary Schools in B.C. •  Just finished collec9ng Wave 7 :

•  Incomplete surveys ranged from 6-‐16% •  Return rates at 50%







Core Content in BASUS •  Substance use inten9ons and use •  Substance use expectancies, mo9ves for using •  Peer and parent use of substances •  Resilience, self-‐esteem, spirituality, health status, pubertal status •  Childhood violence and neglect, stressful life events, aGachment style, coping style, internet use

Par4cularly interested in substance use and emerging: •  Sensa9on Seeking, Impulsivity, Hopelessness, Anxiety Sensi9vity (SURPS & BSS)

•  Depression (SURPS & CES-‐D) •  Delay discoun4ng Substance use? •  Compulsive internet use?



Preliminary BASUS Results: Substance Use

Initiation of Substance Use

2008: Adolescent Health Survey*

(n=29440)

2012: BASUS (n=3170)

Tobacco -‐ Percentage of students who have tried smoking

26 19

Alcohol – Percentage of students who have tried more than a sip

58 63

Alcohol – Percentage of students who reported binge drinking

24

36

Marijuana – Percentage of students who have tried marijuana

30 28

* Source: McCreary Centre Society: 2008 Adolescent Health Survey



Delay Discoun4ng Imagine you bought a loGery 9cket and were told that you had won $100, but you won't get the money for 1 year. Now imagine that someone wants to buy the 9cket from you today, but doesn't want to pay you $100 for it. How much of the $100 would you give up in order to get the money right away (instead of in 1 year)? For example, some people would give up $20, and take $80 today instead of $100 in 1 year. So, how many dollars of the $100 would you give up to get the money right away? Now, imagine the same situa9on, but this 9me the $100 you have won will be paid out to you in 1 month (not 1 year). How many dollars of the $100 would you give up to get the money today instead of in 1 month? Now, imagine the same situa9on, but this 9me the $100 you have won will be paid out to you in 1 week (not 1 year or 1 month). How many dollars of the $100 would you give up to get the money today instead of in 1 week?



Delay Discoun4ng: Wave 7



Binge Drinking Tobacco Marijuana Sig.

Exp(B)

95% C.I.for EXP(B) Sig.

Exp(B)

95% C.I.for EXP(B) Sig.

Exp(B)

95% C.I.for EXP(B) Lower Upper Lower Upper Lower Upper

Ethnicity Caucasian (Ref) .00 .00 .000 Aboriginal .27 1.28 .83 1.98 .01 1.88 1.16 3.08 .01 1.97 1.26 3.08 Asian .00 .34 .24 .47 .00 .42 .27 .66 .01 .35 .24 .52 Other .11 .49 .21 1.16 .73 .82 .28 2.46 .67 .83 .34 2.01 Female .97 .99 .75 1.32 .70 1.08 .75 1.55 .85 .97 .71 1.33 Mothers Edu. University (Ref) .71 .24 .83 No high school .68 .87 .46 1.67 .17 1.68 .81 3.51 .86 .94 .44 1.97

High school .33 .83 .58 1.20 .36 .80 .49 1.30 .53 .88 .58 1.33 College/Trade .85 1.03 .75 1.43 .41 .84 .55 1.28 .67 1.08 .76 1.55 Age .09 1.21 .97 1.50 .02 1.39 1.06 1.82 .01 1.39 1.08 1.79 Area Under Curve Q1 (Ref) .00 .02 .01 Q2 .04 1.55 1.03 2.32 .06 1.72 .99 3.00 .01 2.18 1.37 3.47 Q3 .00 2.17 1.51 3.11 .01 2.08 1.28 3.38 .01 2.53 1.67 3.84 Q4 .04 1.48 1.02 2.14 .01 1.96 1.20 3.22 .01 2.11 1.37 3.24

Delay Discoun4ng and Substance Use



Addic4on and Internet Use

Source: Merkeek, G.J., Van Den Eijnden, R. J., Vermulst, A. A., and Garretsen, H. F. (2009). The Compulsive Internet Use Scale (CIUS): some psychometric proper9es. Cyberpsychology, Behavior, and Social Networking, 12(1):1-‐6



Compulsive Internet Use Do you find it difficult to stop using the internet when you are online?

Do you con4nue to use the internet despite your inten4on to stop?

Do others (for example parents, other family, friends) say you should use the internet less?

Do you prefer to use the internet instead of spending 4me with others (for example parents, other family, friends)?

Are you short of sleep because of the internet?

Do you think about the internet, even when not online?

Do you look forward to your next internet session?

Do you think you should use the internet less oqen?

Have you unsuccessfully tried to spend less 4me on the internet?

Do you rush through your (home) work in order to go on the internet?

Do you neglect your daily obliga4ons (work, school, or family life) because you prefer to go on the internet?

Do you go on the internet when you are feeling down?

Do you use the internet to escape from your sorrows or get relief from nega4ve feelings?

Do you feel restless, frustrated, or irritated when you cannot use the internet?

Never, Seldom, Some9mes, Oqen, Very Oqen Merkeek, G.J., Van Den Eijnden, R. J., Vermulst, A. A., and Garretsen, H. F. (2009). The Compulsive Internet Use Scale (CIUS): some psychometric proper9es. Cyberpsychology, Behavior, and Social Networking, 12(1):1-‐6



Compulsive Internet Use Male Female



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Amazing Team Members

Inves9gators: Dr. P Ratner, Dr. J Johnson & Dr. K Prkachin

Project Manager: Lara Russell Database Manager: Jasmina Memetovic Database Support: Isabel Zhitong Zhu

Digital Media: Ladan Hamadani

CHÉOS Centre for Health Evalua4on and Outcome Sciences

Health & Medicine

Screening for Signs of Vulnerability To Addiction In Adolescence - The BASUS Project - Chris Richardson