Substance refusal skills in a population of adolescents diagnosed with conduct disorder and substance abuse

The present study examined substance refusal skills of 44 conduct-disordere d male adolescents. Fifty percent of these adolescents were dually diagnose d with substance abuse/dependence. Substance refusal skills were assessed u tilizing a role-play test that consisted of four interpersonal scenarios in which a confederate prompted youths to engage in illicit drug and alcohol activity. The test demonstrated adequate interrater agreement and validity. Overall skill in refusing alcohol was positively related to adolescents' p erceptions of belonging and attention, and overall skill in refusing illici t drugs was positively related to school performance and social competence. Contrary to expectations, substance refusal skills of dually diagnosed ado lescents were comparable to their non-substance-abusing counterparts. Clini cal implications of this study are discussed. (C) 1998 Elsevier Science Ltd .