title: Matching adolescents with a cannabis use disorder to multidimensional family therapy or cognitive behavioral therapy: treatment effect moderators in a randomized controlled trial.
abstract: BACKGROUND
  In a recent randomized controlled trial (Hendriks et al., 2011), multidimensional family therapy (MDFT) and cognitive behavioral therapy (CBT) were equally effective in reducing cannabis use in adolescents (13-18 years old) with a cannabis use disorder (n=109). In a secondary analysis of the trial data, we investigated which pretreatment patient characteristics differentially predicted treatment effect in MDFT and CBT, in order to generate hypotheses for future patient-treatment matching.
  
  
  METHODS
  The predictive value of twenty patient characteristics, in the area of demographic background, substance use, substance-related problems, delinquency, treatment history, psychopathology, family functioning and school or work related problems, was investigated in bivariate and subsequent multivariate linear regression analyses, with baseline to month 12 reductions in cannabis use days and smoked joints as dependent variables.
  
  
  RESULTS
  Older adolescents (17-18 years old) benefited considerably more from CBT, and younger adolescents considerably more from MDFT (p<0.01). Similarly, adolescents with a past year conduct or oppositional defiant disorder, and those with internalizing problems achieved considerably better results in MDFT, while those without these coexisting psychiatric problems benefited much more from CBT (p<0.01, and p=0.02, respectively).
  
  
  CONCLUSIONS
  The current study strongly suggests that age, disruptive behavior disorders and internalizing problems are important treatment effect moderators of MDFT and CBT in adolescents with a cannabis use disorder. If replicated, this finding suggests directions for future patient-treatment matching in adolescent substance abuse treatment.
authors.affiliation: Parnassia Addiction Research Centre, Brijder Addiction Treatment, Parnassia Bavo Group, PO-Box 53002, 2505 AA, The Hague, The Netherlands. vincent.hendriks@brijder.nl
authors.forename: Vincent
authors.initials: V
authors.lastname: Hendriks
authors.forename: Evelien
authors.initials: E
authors.lastname: van der Schee
authors.forename: Peter
authors.initials: P
authors.lastname: Blanken
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003415:Crime; D003627:Data Interpretation, Statistical; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family; D005196:Family Therapy; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology / Q000628:therapy*; D001523:Mental Disorders / Q000150:complications; D015233:Models, Statistical; D009426:Netherlands; D011237:Predictive Value of Tests; D012959:Socioeconomic Factors; D016896:Treatment Outcome