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
Anthony Spirito's current research interests focus on developing and testing new 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 recently completed 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 currently has 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 is also involved in 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 is now transporting this integrated protocol to the community and testing whether the protocol is effective when delivered by licensed mental health counselors in a community mental health clinic.
Ongoing PI studies
1R01AA020705-01A1 Spirito (PI) 4/20/12 03/31/17
Adolescents with Major Depression and AUD: Community-based Integrated Treatment
The purpose of this application is to conduct an RCT comparing integrated CBT- I for adolescents with MDD and AUD to standard care. Both the integrated CBT-I and SC condition will be delivered by licensed mental health counselors at a community mental health clinic that uses an Intensive Outpatient Program model.
1 R01 AA021900-01 A. Spirito, Ph.D/J. Linakas, M.D. (Multiple PI's) 9/1/12 8/31/17
Teen Alcohol Screening in the Pediatric Emergency Care Applied Research Network
The purpose of this grant is to validate the NIAAA two-question screen with 12-17 year olds in 15 U.S. pediatric emergency departments (PED), by determining the concurrent, convergent, discriminant, and predictive validity of the two-question screen regarding alcohol misuse.
1R01 MH 099703-01 A.Spirito/C. Esposito-Smythers (Mulitple PIs) 9/1/12 08/31/16
Intensive Outpatient Risk Protocol with High Risk Suicidal Teens
The purpose of this application is to conduct a two group randomized controlled trial to test the primary aim that an intensive protocol designed to treat depressed, suicidal adolescents with an additional complicating risk factor will produce better treatment outcomes compared to standard care at the end of the active treatment (6 months), end of maintenance treatment (12 months) and at the final follow-up point (18 months).
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
Becker, Sara Assistant Professor of Behavioral and Social Sciences (Research), Assistant Professor of Psychiatry and Human Behavior (Research)
Dickstein, Daniel Associate Professor of Psychiatry and Human Behavior, Associate Professor of Pediatrics, Associate Professor of Diagnostic Imaging
Hernandez, Lynn Assistant Professor of Behavioral and Social Sciences (Research), Assistant Professor of Psychiatry and Human Behavior (Research)
Wolff, Jennifer Assistant Professor of Psychiatry and Human Behavior (Research)
Yen, Shirley Associate Professor of Psychiatry and Human Behavior (Research)
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