Anthony Spirito's current research interests focus on developing and testing treatments for adolescent substance use and adolescent depression/suicidal behavior.

Dr. Spirito has been conducting research in adolescent suicidality and depression for 25 years. Working with a postdoctoral fellow, he published the first randomized trial of individual therapy with adolescents who attempt suicide. He also conducted an intervention trial designed to improve treatment attendance in this population. He was also site CBT supervisor for a large multisite study, "The Treatment of Resistant Depression in Adolescence". He conducted three treatment development studies to determine if new approaches will increase the efficacy of depression treatments for adolescents. The first trial examined whether concurrently treating the depressed parent of a depressed teen will improve outcomes for the adolescent. The second study examined whether the addition of an exercise component to a CBT protocol will improve depression outcomes in overweight adolescents treated with CBT. And the third trial tested an integrated approach for treating conduct problems in depressed adolescents.  He recently completed a large RCT testing a combined parent/adolescent treatment protocol for adolescents with Major Depression and at least one other risk factor:  a prior suicide attempt, susbtance abuse, and/or nonsuicidal self injury. 

With respect to alcohol and substance use treatment research, he has used individual motivational interventions with adolescents who presented to the Emergency Department (ED) with an alcohol-related admission. In an extension of the original work, he broadened the scope of the brief intervention to include a parent motivational intervention. He recently completed a study using this parent motivational approach, the Family Check-Up, with families who have teenage siblings in which one has been identified after an alcohol-related incident. He recently completed a study using both an individual adolescent motivational interview and the Family Check-up to address marijuana, sexual risk behavior, and school attendance in high school students who are truant from school. He also recently completed two prevention studies: One that modified the Family Check-Up for a protocol designed to prevent the onset of substance use in middle schoolers receiving mental health treatment while the other tested an alcohol prevention program with middle schoolers being treated in the ED for an injury. He also recently completed a 16 site alcohol screening study in Pediatric Emergency Departments. 

With respect to combined treatments for depression, suicidality, and alcohol/drug use, he collaborated on a study of an integrated CBT protocol for adolescents with alcohol use disorders, MDD, and suicidality. He also transported this integrated protocol to the community to test whether the protocol is effective when delivered by licensed mental health counselors in a community mental health clinic. A larger RCT with this population was recently completed.

He is currently conducting brief interventions for suicidal and substance using adolescents in the juvenile justice system. 

Ongoing PI studies

1R34DA042247-01A1   Spirito/Hernandez (Multiple PIs)                 04/15/17 – 02/29/20                

NIDA                                                                             

Computer-Assisted Brief Intervention Protocol for Marijuana Using Juvenile Offenders                                                            

This R34 investigation is designed to determine whether it is feasible to provide a computer-based intervention for marijuana using juvenile offenders and if feasible, is there an indication it will reduce marijuana use in these youth.

R34MH114307           Spirito/Kemp (Multiple PIs)          07/01/2018 – 06/30/2020                       

NIMH                                                                                                                   

Screening and Brief Intervention for Suicidality and Nonsuicidal Self-Injury Among Youth in the Juvenile Justice System

This study will examine the feasibility of a training program designed to teach non-mental health juvenile justice staff how to conduct safety planning with youth in the juvenile justice system who are at risk for suicide and hurting themselves.

R01DA045396     (Spirito)                                                     07/01/2018 – 06/30/2023        

NIDA                                                                           

Brief Individual and Parent Interventions for Marijuana Misuse in Truant Adolescents

The goal of this application is to find out if a brief, motivation-building approach with parents and teens who have been involved in the juvenile justice system results in better outcomes for marijuana use and truancy than standard educational information.

 

R34MH115457           Spirito (PI)                                                                                            07/01/18 – 06/30/21

NIMH

Reducing the Duration of Untreated Illness Among Youth in Juvenile Justice with Psychosis-Spectrum Disorders

This study will examine the feasibility of identifying youth in the juvenile justice system with thought disturbances and referring them to a specialized state program serving youth with these thinking problems.

 

R21MH115514           Spirito/ Boekamp (MPIs)                                                                     07/01/18 – 06/30/20

NIMH

Suicidal Thoughts and Behaviors in Young Children: Cognitive, Behavioral and Affective Risk Factors

This study will examine the thoughts, actions and feelings of very young children, 4 to 7 years old, admitted to a psychiatric day treatment program, who make comments to their parents about wanting to die or kill themselves.

Recent substance use publications include:

 

Spirito, A, Hernandez, L, Marceau, K, Cancilliere, MK, Barnett N, Graves, Rodriguez, A, & Knopik, V (2017). Effects of a brief, parent-focused intervention for substance using adolescents and their sibling.  Journal of Substance Abuse Treatment,77, 156 – 165.  PMC5420332

Spirito, A., Hernandez, L., Cancilliere, M. K., Graves, H., Rodriguez, AM, Operario, D, Jones, R, & Barnett, N. (in press) Parent and adolescent motivational enhancement intervention for substance using, truant adolescents: A pilot randomized trial Journal of Clinical Child and Adolescent Psychology PMC in process

Spirito, A; Bromberg, J; Casper, C.; Chun, T; Mello, M; Dean, J.M; Linakis, J (2016).  Reliability and Validity of a Two-Question Alcohol Screen in the Pediatric Emergency Department. Pediatrics, 138(6).  PMC5127060

Becker, S, Jones, R, Hernandez, L, Graves, H, & Spirito, A. (in press). Moderators of Brief Motivation-

Enhancing Treatments for Alcohol-Positive Adolescents Presenting to the Emergency Department. Journal of

Substance Abuse Treatment PMC in process

ED Research with Substance Abusing Adolescents 

       Dr. Spirito has examined characteristics of adolescents who receive treatment in the ED for an alcohol-related incident.  He is currently MPI on a multisite screening study testing the predictive validity of the two question NIAAA screen for youth alcohol abuse.

 

Barnett, M.P., Spirito, A., Colby, S.M., Vallee, J.A., Woolard, R., Lewander, W., & Monti, P.M. (1998) Detection of alcohol use in adolescent patients in the Emergency Department. Academic Emergency Medicine, 5, 607-612.

 

Fairlie, A.M., Chun, T.H., Hernandez, L., Sindelar-Manning, H., Eaton, C.A., Lewander, W., & Spirito, A. (2010). Alcohol use history differentiates adolescents treated in the Emergency Department following an alcohol-related incident.  Pediatric Emergency Care, 26, 417-423  PMC3708259

 

Chun, T.H., Spirito, A., Hernandez, L, Fairlie, A.M., Sindelar-Manning, H., Eaton, C.A., & Lewander W.J. (2010). The significance of marijuana use among alcohol-using adolescent Emergency Department patients.  Academic Emergency Medicine, 17, 63-71.  PMC 3049922

 

Becker, S. J.,Spirito, A., Hernandez, L., Barnett, N. P., Eaton, C. A., Lewander, W.,Rohsenow, D. J., & Monti, P. M. (2012). Trajectories of adolescent alcohol use after brief treatment in an emergency department. Drug and Alcohol Dependence, 125, 103 – 109.   PMC3419330

 

Brief Interventions for Adolescent Substance Use in the ED

      Dr. Spirito has been conducting alcohol and substance use treatment research for 15 years. Most have been brief interventions with adolescents and their parents. He has used individual motivational interventions with adolescents who presented to the ED with an alcohol-related admission. In an extension of the original work, he broadened the scope of the brief intervention to include a parent motivational intervention. He recently completed testing an alcohol prevention program with middle school students being treated in the ED for an injury that involved providing brief advice to parents

 

Monti, P., Colby, S., Barnett, N., Spirito, A., Rohsenow, D., Myers, M., Woolard, R., Lewander, W. (1999).  Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. Journal of Consulting and Clinical Psychology, 67, 989-994.

 

Spirito, A., Monti, P., Barnett, N., Colby, S., Sindelar, H., Rohsenow, D.,Lewander, W, Myers, M. (2004). A randomized clinical trial of a brief motivational intervention for alcohol positive adolescents treated in an emergency department. Journal of Pediatrics, 145, 396-402. PMID: 15343198

 

Spirito, A., Sindelar-Manning, H., Colby, S., Barnett, W., Lewander, W., Rohsenow,D., & Monti, P. (2011). Individual and family motivational interventions for alcohol-positive adolescents treated in an Emergency Department: Results of a Randomized Clinical Trial. Archives of Pediatric and Adolescent Medicine, 165, 269-274.  PMC3690344

 

Linakis JG, Bromberg J, Baird JR, Nirenberg T, Chun TH, Mello MJ, Jackson KM, Spirito A (2013). Feasibility and acceptability of a pediatric emergency department (PED) alcohol prevention intervention for young adolescents. Pediatric Emergency Care, 29(11):1180-1188. PMID: 24168879 PMCID in process

 

Substance Use Intervention and Prevention Studies

      Dr. Spirito just completed a study using a parent motivational approach, the Family Check-Up, as well as an individual MI, with families who have teenage siblings in which one has been identified after an alcohol-related incident. He also recently used both an individual adolescent motivational interview and the Family Check-up to address marijuana, sexual risk behavior, and school attendance in high school students who are truant from school. Manuscripts from these two studies are currently under review. He has also modified the Family Check-Up for a protocol designed to prevent the onset of substance use in middle schoolers receiving mental health treatment.

 

Spirito, A., Hernandez, L., Cancilliere, M. K., Graves, H., Knopik, V., Barnett, N. (in press).Improving parenting and parent-teen communication to delay or prevent the onset of alcohol and drug use in young adolescents with emotional/behavioral disorders: A pilot trial.  Journal of Child and Adolescent Substance Abuse  PMCID in process

 

Adolescents with co-occurring mental health and substance use problems

      Dr. Spirito and colleagues have been examining the characteristics of adolescents with comorbid substance use, depression, and suicidality. 

 

Esposito, C., & Spirito, A. (2004).  Adolescent substance use and suicidal behavior: A review with implications for treatment research.  Alcoholism: Clinical and Experimental Research, 28, 775-785

 

Becker, S. J., Nargiso, J., Wolff, J., Uhl, J., Simon, V., Spirito, A., & Prinstein, M. (2012). Temporal relationship between substance use and delinquent behavior among young psychiatrically hospitalized adolescents. Journal of Substance Abuse Treatment, 43, 251- 259  PMC 3368082

 

Esposito, C., Spirito, A., Rizzo, C., McGeary, J., & Knopik, V (2009). Associations of the DRD2 Taq A polymorphism with impulsivity and substance use. Pharmacology, Biochemistry, and Behavior, 93, 306-312 (NIHMS 106960).   PMC 2706288

 

Liu, R., Case, Br., & Spirito, A., (in press).  Injection drug use is associated with suicide attempts but not ideation or plans in a sample of adolescents with depressive symptoms. Journal of Psychiatric Research  PMCID in process

 

Treatment of Adolescents with Comorbid Mental Health and Substance Use Disorders

       Dr. Spirito and colleagues were one of the first groups to develop an integrated CBT protocol for adolescents with alcohol use disorders, MDD, and suicidality.  He is now testing the comparative efficacy of this protocol versus standard care in a community clinic. He is also testing this same protocol in an efficacy trial comparing the intensive treatment protocol versus standard care.

 

Esposito-Smythers, C., LaChance, H., & Spirito, A. (2006).  Cognitive-behavioral treatment for suicidal alcohol abusing adolescents:  Development and pilot testing.  American Journal on Addictions, 15, 126-130

 

Esposito-Smythers, C. Spirito, A., Hunt,J., Kahler, C., & Monti, P. (2011) Treatment of co-occurring substance abuse and suicidality among adolescents: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 79, 728-739. PMC3226923

 

Esposito-Smythers, C.,Walsh, A.,Spirito,A., Rizzo, C., Goldston, D., & Kaminer, Y. (2012).  Working with the  

suicidal client who also abuses substances.  Cognitive  and Behavioral Practice,19, 245-255. PMC3510478

 

Goldstein, B.I., Shamseddeen, W., Spirito, A., Emslie, G. Clarke, G., Wagner, K.D., Arsarnow, J.R., Vitiello,     B., Ryan, N., Birmaher, B., Mayes T., Onorato, M., Zelazny, J., Brent, D.A. (2009). Substance use and the treatment of resistant depression in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 1182-1192.  PMC2895963

 

List of Published Work in MyBibliography:

http://www.ncbi.nlm.nih.gov/sites/myncbi/1ty9vmCbzVDkd/bibliography/47998047/public/?sort=date&direction=ascending

Outstanding Teaching Award in Clinical Psychology, Department of Psychiatry Brown Medical School, 1997-1998
Research Mentor Award, Department of Psychiatry, Brown Medical School, 2001.
President, Society of Pediatric Psychology, 2002.
Martin P. Levin Mentorship Award, Society of Pediatric Psychology, 2005.
President, Section on Clinical Emergencies and Crises, Society of Clinical Psychology, American Psychological Association, 2009
President, Society of Clinical Child and Adolescent Psychology, American Psychological Association , 2010
Faculty Mentor Award, Department of Psychiatry, Brown University,2010
Research Mentor Award, Center for Alcohol and Addiction Studies, Brown University, 2010

Distinguished Career Award, Society of Clinical Child and Adolescent Psychology, 2015

Dean’s Award for Faculty Research Mentoring in the Division of Biology and Medicine, 2018  

American Psychological Association (APA)
Society of Clinical Child and Adolescent Psychology, APA
Society of Pediatric Psychology, APA
Society of Clinical Psychology, APA
Association for Behavioral and Cognitive Therapies
American Association of Suicidology