The impact of disruptive behavior disorder on substance use treatment outcome in adolescents.

The current study examined the impact of disruptive behavior disorder (DBD) on substance use outcomes in an adolescent sample. Sixty-eight adolescents and their caregivers were randomized to one of two fourteen-week, outpatient treatments: Motivational Enhancement Therapy/Cognitive Behavior Therapy (MET/CBT)+Parent Management Training+Contingency Management (CM; experimental) and MET/CBT+Parent Drug Education (attention control). This study assessed abstinence, substance use, externalizing behavior, and parenting outcomes over five assessment periods for youth with DBD (DBD(+)) and without DBD (DBD(-)). Results showed DBD(+)/experimental adolescents reported fewer days of marijuana use than DBD(+)/control adolescents. Results also showed that parents of DBD(-) adolescents in the experimental condition reported significantly better parenting outcomes compared to DBD(-)/control. Substance abuse treatment for adolescents with DBD which includes a component such as contingency management and parent training has the potential to contribute to substance use outcomes. Such treatment strategies, however, should include additional support for parents.