Using sensation seeking to target adolescents for substance use interventions

Addiction. 2010 Mar;105(3):506-14. doi: 10.1111/j.1360-0443.2009.02782.x.


Aims: This study examines the predictive validity of sensation seeking as a predictor of adolescent substance use, in order to optimize targeting for substance use prevention programs.

Design: Longitudinal study.

Setting: Random-digit dial telephone survey. Participants A total of 6522 US adolescents aged 10-14 years at baseline, resurveyed at 8-month intervals for three subsequent waves.

Measurements: Two outcomes were assessed-onset of binge drinking (more than five drinks in a short time) and established smoking (>100 cigarettes life-time). Sensation seeking level was assessed at baseline. Logistic regression was used to predict onset of substance use at any follow-up wave as a function of sensation seeking. The receiver operating characteristics curve was used to illustrate how well sensation seeking predicted substance use as a function of different cut-off points for defining high sensation seeking, and area under the receiver operating characteristics curve (AROC) was the metric of predictive validity.

Findings: Of 5834 participants with one or more follow-up assessments, 5634 reported no binge drinking and 5802 were not established smokers at baseline, of whom 717 (12.7% of 5634) reported binge drinking and 144 (2.5% of 5802) reported established smoking at one or more follow-up interviews. Sensation seeking predicted binge drinking moderately well [AROC = 0.71 (95% confidence interval 0.69, 0.73)] and was a significantly better predictor of established smoking onset [AROC = 0.80 (0.76, 0.83)]. For binge drinking, predictive validity was significantly lower in blacks; for established smoking it was significantly higher for Hispanics. Implications for two targeting interventions are discussed.

Conclusions: Sensation seeking works moderately well at identifying adolescents at risk for onset of binge drinking and established smoking. This study offers a guide for determining the appropriate targeting cut-off value, based on intervention efficacy, costs and risks.

Keywords: Smoking; adolescent; binge drinking; false positive rate; longitudinal; predictive validity; receiver operating characteristic curve; sensation seeking; sensitivity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Alcoholic Intoxication / prevention & control*
  • Alcoholic Intoxication / psychology
  • Child
  • Epidemiologic Methods
  • Ethanol / poisoning
  • Ethnicity
  • Exploratory Behavior
  • Female
  • Humans
  • Male
  • Risk Factors
  • Smoking / psychology
  • Smoking Prevention*
  • Substance-Related Disorders / prevention & control*
  • Substance-Related Disorders / psychology


  • Ethanol