66 Chapter 3 4. Discussion This study examined the role of emotional and behavioral problems in Take it Personal!—a personality targeting prevention program for adolescents and young adults with a mild intellectual disability that has demonstrated effectiveness in reducing substance use frequency (Schijven et al., 2020a). Whereas decreasing substance use frequency was the primary aim of the program, the secondary aim was reducing related behavioral and emotional problems (Schijven et al., 2015). The current study first assessed effectiveness on anxious, withdrawn, rule-breaking, and aggressive problems. Our hypothesis that Take it Personal! would show concurrent effectiveness on emotional and behavioral problems could partially be confirmed. Anxious, withdrawn and aggressive problems did not show a stronger decrease for the adolescents and young adults who followed the program compared to the adolescents and young adults in the control condition. Rulebreaking problems decreased significantly more in those who followed Take it Personal!, but the effect size of this effect was small. Second, the moderating role of anxious, withdrawn, rule-breaking, and aggressive problems on the program’s primary effect on the frequency of substance use was explored. None of the four behavioral and emotional problem domains moderated this effect, indicating that the program was effective in reducing substance use frequency, regardless of how anxious, withdrawn, rule-breaking, or aggressive the adolescents and young adults were at baseline. The effectiveness of Take it Personal! was not limited to its primary goal reducing substance use (described in Schijven et al., 2020b), as also rule-breaking problems decreased significantly more for adolescents and young adults who followed Take it Personal! compared to those in the control condition. This is in line with findings of O’Leary-Barrett et al. (2013), who found concurrent effectiveness on alcohol use and conduct problems in a personality-based prevention program for alcohol using youth without a mild intellectual disability. On the other hand, our null-results on anxious and withdrawn problems contrast the effects that O’Leary-Barret et al. (2013) found on internalizing symptoms. This discrepancy is most likely explained by our predominantly rule-breaking sample. The vast majority of participants’ scores of anxious, withdrawn, and aggressive problems were in the normal range (89%, 77%, 91% respectively). In contrast, 35% of the participants were in the normal range for rule-breaking. It is therefore possible that most of the personal ‘changing plans’ that each participant edited during Take it Personal! contained personal goals related to reducing rule-breaking problems. This would explain why, with a small sample of adolescents and young adults that—compared to the other problem domains—scored relatively high on
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