Talk:WikiJournal of Medicine/Resources for the Assessment and Treatment of Substance Use Disorder in Adolescents

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WikiJournal of Medicine
Open access • Publication charge free • Public peer review • Wikipedia-integrated

WikiJournal of Medicine is an open-access, free-to-publish, Wikipedia-integrated academic journal for Medical and Biomedical topics. <seo title=" WJM, WikiJMed, Wiki.J.Med., WikiJMed, Wikiversity Journal of Medicine, WikiJournal Medicine, Wikipedia Medicine, Wikipedia medical journal, WikiMed, Wikimedicine, Wikimedical, Medicine, Biomedicine, Free to publish, Open access, Open-access, Non-profit, online journal, Public peer review "/>

<meta name='citation_doi' value='10.15347/WJM/2023.001'>

Article information

Authors: Emily Pender[a][b][i] , Liana Kostak[a][b] , Kelsey Sutton[a][b] , Cody Naccarato[a][b] , Angelina Tsai[a], Tammy Chung[c] , Stacey Daughters[a] 

See author information ▼
  1. 1.0 1.1 1.2 1.3 1.4 1.5 University of North Carolina at Chapel Hill
  2. 2.0 2.1 2.2 2.3 Helping Give Away Psychological Science (HGAPS)
  3. Rutgers, The State University of New Jersey
  1. penderemilym@gmail.com

 

Plagiarism check

Pass. Report from WMF copyvios tool flagged some false positives (not regarded as plagiarism) due to common stock phrases and acronym definitions e.g. "Brief Screener for Tobacco, Alcohol, and Other Drugs (BSTAD)". T.Shafee(Evo﹠Evo)talk 23:04, 20 March 2022 (UTC)[reply]

Editorial note

Author contacted about possibility of withdrawing manuscript due to difficulty in finding reviewers but they wish to proceed and reviewers are being sought Rwatson1955 (discusscontribs) 10:22, 21 June 2022 (UTC)[reply]

Peer review 1


Review by Ken C Winters ,
These assessment comments were submitted on , and refer to this previous version of the article

This is an excellent contribution to the literature. I particularly appreciate the concise overview of the key content areas of this field (e.g., diagnosis, prevalence, comorbidity, etc.). Three considerations for the authors:

1.For the Evidence-Based Assessment table, the label would be more accurate as “Assessment measures for substance use problem severity”. It is my understanding that none in the table provide a diagnosis for SUD.

2.Would the authors consider adding the Personal Experience Screening Questionnaire-Brief (PESQ-Brief) to their table? If interested, contact me at winte001@umn.edu and I will send a pdf of it.

Source: Winters, K.C. (1992). Development of an adolescent alcohol and other drug abuse screening scale: Personal Experience Screening Questionnaire. Addictive Behaviors, 17, 479 490.

3.The excellent treatment section would be stronger if it included the role of the Screening Brief Intervention Referral to Treatment (SBIRT) model.

Response

The authors would like to thank the reviewer for the thoughtful and constructive review. The considerations have been addressed as follows:

1. The authors have renamed the mentioned table to “Assessment measures for substance use problem severity” in order to more precisely reflect the content.

2. The authors have added the PESQ-Brief to the Evidence-Based Assessment section, both the table and text, as a valuable tool to screen for adolescent alcohol and other drug abuse.

3. The authors have added mention and description of the SBIRT model to capture the important role of this treatment model. 

Peer review 2


Review by anonymous peer reviewer , Expert in assessment
These assessment comments were submitted on , and refer to this previous version of the article

The manuscript "Resources for the Assessment and Treatment of Substance Use Disorder in Adolescents" provides a nice summary of prevalence of SUD in adolescents along with descriptions of the evidence-based assessment and treatment of SUD in youth. National and local resources are offered as well.

Response

The authors have reflected your suggestions and feedback into the manuscript. Please see more detailed responses to each of your points addressed below.

Overall, I thought the article provided useful information for the public. It would benefit from better synthesis of the information; rather than listing various statistics, assessments, or interventions. If the goal is to provide a helpful resource for clinicians and lay people, greater curation of the content would also be beneficial. Additional comments follow.

Response

The authors are grateful for the helpful feedback, and have added framing to each section and updated and curated the references. Of course, if the reviewer has other specific suggestions, the authors would be happy to incorporate them as well.

Please explain why opioids are included if this is not common among youth - or leave out the sentence saying that the other 3 substances were chosen because their use is the most common.

Response

The authors appreciate this inquiry and have added additional context and sources to support the mention of opioids in this list. Opioids have been included because of the current acute crisis and concern that substance use disorder with opioids may spread to adolescents, and is thus a potential upcoming cause for consideration which should be recognized more broadly.

The last sentence of the section on the DSM is not clear.

Response

Thank you for the opportunity to clarify. The authors have revised the last sentence from “Particular substances such as alcohol, hallucinogens, and prescription painkillers were at the highest risk of this misclassification, likely due to the addition of the craving criterion in the DSM-5” to:

It is possible that the DSM-5’s addition of “craving” as a criterion may have increased the likelihood of passing the threshold to meet a Substance Use Disorder for certain substances (e.g., alcohol, hallucinogens, prescription painkillers), identifying cases which otherwise wouldn't have been captured as having a Substance Use Disorder.

It would be helpful to offer some comparison of the three classification systems described. Otherwise, it is not clear how this level of detailed information is helpful to clinicians or the public (especially RDoC).

Response

The authors are appreciative of this additional opportunity to offer insight here. To provide a more clear comparison of the three classification systems, DSM-5, ICD-11, and RDoC, we have added the following preamble at the start of the “Diagnostic Criteria” section under the heading:

While a single established method of classifying and organizing Substance Use Disorders does not exist, two major classification systems are used in psychiatry – namely the DSM-5 and ICD-11. Currently, some researchers are also pursuing other classification approaches to focus more on genetics, molecular physiology, and emerging understanding of neuroscience and behavior. The American Psychiatric Association created and updates the DSM-5 classification system, which is the most well known in the United States and in regions that rely on research done in the United States. The World Health Organization has its own International Classification of Diseases, which covers not only psychiatry, but also all other areas of medicine. It is freely available from their website in several languages, and it is the most widely used system in the world for medicine. In the United States, insurance billing and tracking of illnesses use the ICD. The Research Domain Criteria (RDoC) is an example of an alternative, research-oriented classification approach. This framework has the least immediate clinical application, but an awareness of it may be helpful for those seeking literature on newer scientific research.

Statistics describing one-year changes in SUD prevalence don't seem helpful, especially given that they are already several years old. Rather than citing many prevalence statistics, it would be more useful to summarize the information across studies. I also recommend updating this information.

Response

The authors appreciate this helpful feedback. The authors have summarized and updated the information. First, this section has been split into two subsections: (A) Substance Use Prevalence and (B) Substance Use Disorder Prevalence. Second, the authors have incorporated more comprehensive figures and tables to clearly show information and trends and make this easy for the reader to find. Third, the authors have reworked the text to better summarize information and call out key insights. Specifically:

For (A), the authors have updated the substance use prevalence statistics using Monitoring the Future’s 2022 publication (showing data through 2021). The authors have shown the most recent 10 years of data (2012-2021) in a line graph figure and have used the text to summarize and highlight insights.

For (B), the authors have updated the SUD prevalence statistics to show the most recent available data from the National Survey on Drug Use and Health (NSDUH). Since the source notes that 2020 statistics are not directly comparable to prior years due to methodology changes, the authors have included 2015-2020 in order to show 5 years of comparable rates as well as the most recent available data. The authors have shown this data in a sortable table to ensure the data is easy to find and use based on the reader’s individual needs, and have used the text to summarize the information and insights.

The section on comorbid disorders is poorly organized.

Response

The authors appreciate this feedback. We have updated the section so it is organized in the following way:

1. Within SUD, rates of other disorders, mentioned in descending order

2. Within other disorders, rates of SUD, listed in descending order

3. Rates in clinical settings (which includes treatment)

Each subheading is introduced with a brief description sentence to introduce that subheading’s theme before delving into more specific information and statistics related to each comorbidity.

It would be more informative to explain the association between each of the common comorbidities and SUD. I think readers would also be interested to read about potential mechanisms dricing these associations - e.g., are there shared biological risk factors? Does one disorder tend to lead to the other? Additionally, how do rates compare when we look at youth with SUD (i.e., how many with SUD also meet criteria for ADHD/ODD/MDD/etc) vs. how many youth with ADHD/ODD/MDD/etc meet for SUD?

Response

As mentioned above, the authors have reorganized the comorbidity section to better delineate (i) within SUD, what are the rates of common comorbidities and (ii) within common comorbidities, what is the rate of SUD. Additionally the authors agree that an examination of mechanisms driving comorbidities would be a valuable addition to the literature. The authors have added the following as a future direction:

Future research may also examine the potential mechanisms driving the relationship between SUD and common comorbidities in order to better understand shared biological, psychological, social, or other factors leading to co-occurrence.

When comparing adolescents to adults, please be sure to include the rate (e.g., prevalence, relapse, etc) for both groups.

Response

Thank you very much for this feedback. The authors agree that a systematic comparison of adolescents and adults is not in the scope of this paper and thus have not included sections comparing adolescents to adults in terms of prevalence, etc. There are a couple of places in the paper where we retained the mention of adults as related to differing social contexts and processes, as appropriate.

It would be helpful to organize the assessment table in a logical way. Perhaps by which phase (prediction, prescription, process) it would be used in. It would also be useful to not whether it is a self-report, interview, other.

Response

The authors have restructured the evidence-based assessment table based on this valuable suggestion. The sortable table begins with three columns based on the Evidence Based Assessment model (i.e., “prescription”, “prediction”, “process”), which are checked accordingly. This allows the reader to sort the table using any of those columns based on need. The table can also be sorted based on other columns to fit individual needs. The authors have also added a column on “method of assessment” to indicate whether the assessment is a self report questionnaire, interview, etc.

Related to the above content. It would be nice if the treatment section were organized by treatment target and/or intervention approach to make it easier for people to find what is relevant to their question.

Response

The authors have reorganized this section, including the addition of subheadings, reorganization of text, and addition of synthesis. The new organization is as follows:

Overview

Individual therapy

Family therapy

Pharmacotherapy

Multisystemic/multidimensional therapy

I would recommend linking only to organization main pages and then listing resources available as page-specific links are likely to break over time.

Response

The authors agree that link rot is an important consideration for this article. The authors have used the Wayback Machine to replace external links with permanent links where appropriate. Certain links (e.g., those to online questionnaires) have been preserved in order to retain the ability to complete the assessment and receive results.

Rather than listing organizations in North Carolina, I think it would be more useful to prvide readers with instructions about how those were found - what are the specific search terms people should use? how would they determine whether a program is reputable? what are key terms related to the type/level of care they might be seeking?

Response

The authors are appreciative of this excellent suggestion. We have added search strategies into the paper and have deleted the NC Triangle specific facilities and treatment programs in order to provide a more generalized search strategy. We hope to help readers maximize search engine capabilities and results.

Response

Other Notes:

In addition to the revisions mentioned above, the authors have updated the resources section to reflect the transition to the 988 Lifeline in the US.