Mental health approach works better than information at preventing problem drinking in teenagers

BMJ 2013; 346 doi: (Published 24 January 2013) Cite this as: BMJ 2013;346:f519
  1. Matthew Limb
  1. 1London

Schools can prevent teenagers’ misuse of alcohol and deliver “substantial savings” for society through a mental health approach that targets support at pupils with “high risk” personalities, say researchers.

Their study showed that cognitive behavioural group workshops led by trained staff improved pupils’ ability to cope with traits such as anxiety and impulsiveness and reduce the likelihood of problem drinking.1

The lead researcher, Patricia Conrod, of King’s College London’s Institute of Psychiatry, said that the mental health approach was “more successful in reducing drinking behaviour than giving teenagers general information on the dangers of alcohol.”

The randomised controlled trial, called the Adventure Trial, was carried out jointly by King’s College, the University of Montreal, and Sainte-Justine University Hospital Centre, Canada.

It was commissioned by the UK charity Action on Addiction, and its findings were published online by JAMA Psychiatry on Wednesday 23 January.

In total, 21 London secondary schools took part between 2007 and 2011. They were randomly allocated to receive either the personality targeted programme delivered by trained school staff or the control intervention, the UK statutory drug and education curriculum.

A total of 2548 pupils (average age 13.8 years in 2007) were assessed as being at high or low risk of developing future alcohol dependency. Those classed as at high risk fitted one of four personality risk profiles: anxious, hopeless, impulsive, or sensation seeking.

In the 11 schools that received the intervention 709 high risk pupils were invited to attend two 90 minute group workshops offering cognitive behavioural strategies geared to their particular personality profiles.

Conrod said that the workshops helped the teenagers to “better manage their personality traits and individual tendencies,” build resilience, improve decision making, and be less likely to turn to alcohol to cope.

All students were monitored for their drinking behaviour over two years.

The researchers said that the programme’s targeted effects were seen in “all drinking outcomes and for the duration of the follow-up period.”

The study reported a 29% reduced odds of drinking, 43% reduced odds of binge drinking, and 29% reduced odds of problem drinking among the high risk pupils in the intervention schools relative to the high risk students in control schools.

The intervention was also found to “delay the natural progression to more risky drinking behaviour, such as frequency of binge drinking, greater quantity of drinking and severity of problem drinking in these students.”

Conrod said that the intervention could also benefit the wider community, as high risk young people tended to be the earlier users of alcohol. Some signs in the study of a mild “herd effect” needed further investigation, she added.

“This intervention could be widely administered to schools. It remains relatively inexpensive to roll out,” she said.


Cite this as: BMJ 2013;346:f519


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