ABSTRACT

Objective: This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information on “for whom” a specific treatment may work best.

Method: We used Google Scholar, PubMed, PsycInfo, and manual search of relevant reference lists to identify eligible peer-reviewed publications from January 2005 to December 2019.

Results: We summarize 21 published studies (including meta-analyses, randomized clinical trials, and correlational work) testing moderators and/or predictors of adolescent SUD treatment outcomes. Conclusions are, thus, limited by the relatively small number of studies. Results suggest that, for adolescents with co-occurring externalizing pathology or those higher in SUD severity, more intensive treatment appears to be more effective. Other findings were often inconsistent (e.g., examining sex or race/ethnicity as a moderator) between studies, making it challenging to provide clear recommendations for personalizing SUD treatment choice.

Conclusions: Future research may need to shift focus from exploring often unchangeable moderators (e.g., race/ethnicity) to factors that are potentially modifiable with treatment. Additionally, testing models that include mediators of treatment effects—that is, factors that help to explain “how” treatment works—along with moderators (moderated-mediation) may provide the most benefit in understanding both “for whom” and “how” to tailor SUD treatment to optimally meet an adolescent’s personal needs.

摘要

目的：这篇简短的综述涵盖了关于青少年物质使用障碍 (SUD) 治疗调节剂的文献现状。这些版主提供有关特定治疗可能对“谁”最有效的信息。

方法：我们使用 Google Scholar、PubMed、PsycInfo 和手动搜索相关参考列表来确定 2005 年 1 月至 2019 年 12 月期间符合条件的同行评审出版物。

结果：我们总结了 21 项已发表的研究（包括荟萃分析、随机临床试验和相关工作）测试青少年 SUD 治疗结果的调节因子和/或预测因子。因此，结论受到研究数量相对较少的限制。结果表明，对于同时发生外化病理或 SUD 严重程度较高的青少年，更强化的治疗似乎更有效。研究之间的其他发现通常不一致（例如，将性别或种族/民族作为调节因素进行检查），这使得为个性化 SUD 治疗选择提供明确的建议具有挑战性。

结论：未来的研究可能需要将重点从探索通常不可改变的调节因素（例如，种族/民族）转移到可能通过治疗改变的因素。此外，包含治疗效果中介因素的测试模型 - 即有助于解释“如何”治疗起作用的因素 - 以及调节因素（适度中介）可能在理解“为谁”和“如何”方面提供最大的好处定制 SUD 治疗以最佳地满足青少年的个人需求。