56 Chapter 3 VanDerNagel, 2019). However, substance use is seldom an isolated problem— numerous adverse psychological, physiological, legal, and social consequences have been associated with substance use in people with a mild intellectual disability (Taggart et al., 2007). Problematic substance use relates to a range of emotional and behavioral problems. Emotional problems (often termed internalizing problems) include anxiety, depression and associated symptoms and behaviors. Behavioral problems (or externalizing problems) includes a range of difficulties associated with e.g. attention, hyperactivity, conduct problems, aggression or antisocial behavior (Hannigan et al., 2017). Emotional problems are mostly harmful to oneself, whereas behavioral problems are generally also disruptive to others. Both constructs can reciprocally reinforce each other and lead to increases in the other (Lee & Bukowski, 2012). Frequent rule-breaking and aggression are examples of behavioral problems that cooccur with problematic substance use, while persistent internalizing problems such as depressed, anxious or withdrawn emotions and behaviors also have well-documented associations with substance use (e.g., Colder et al., 2013). Associations between substance use and emotional and behavioral problems have also been found in people with a mild intellectual disability (Didden et al., 2009). The high risk of triple diagnosis (i.e., a mild intellectual disability, substance use disorder and another comorbid mental disorder) in adolescents and young adults with a mild intellectual disability reveals the considerable interrelatedness between problematic substance use and other behavioral problems (Didden, 2017). Consequently, effective prevention programs for problematic substance use should have an additional impact on related emotional and behavioral problems. Extensive research documents that personality significantly correlates with problematic substance use and a wide range of emotional and behavioral problems (Krueger et al., 2001; Zilberman et al., 2018). Woicik et al. (2009) distinguished four higher order personality profiles that are associated with an increased risk for problematic substance use: anxiety sensitivity (AS), negative thinking (NT), impulsivity (IMP), and sensation seeking (SS). Targeting these high-risk personality profiles in intervention efforts has shown effectiveness in reducing substance use in adolescents without a mild intellectual disability (Lammers et al., 2017; Mahu et al., 2015). Schijven et al. (2020b) adapted this personality targeted approach to the needs of alcohol and/or drug using adolescents and young adults with a mild intellectual disability and comorbid emotional and behavioral problems in an indicated prevention program called Take it Personal! This program is aimed at reducing problematic substance use and, as a secondary aim, attempts to reduce related emotional and behavioral
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