In an Australian first more than 3,000 Year 8 school children have been enrolled in a drug and alcohol prevention trial which aims to reduce the development of substance use problems in young people by targeting at-risk personality types.
An increasing body of research evidence suggest that young people with specific personality types are more at risk of developing drug and alcohol problems than their peers. Around 40 per cent of Year 8 students are believed to exhibit one of four personality traits which put them at risk of future drug and alcohol problems: sensation seeking; impulsivity; anxiety sensitivity and negative thinking.
A study of British school children published this month in JAMA Psychiatry found that personality targeted interventions not only reduced and postponed alcohol problems in the at-risk group, they also delayed alcohol use in non at-risk students by reducing drinking within their social network.*
In order to test the effectiveness in Australia of personality-targeted interventions and “universal interventions” – that is, interventions delivered to all children regardless of whether they are deemed at risk – researchers from the National Drug and Alcohol Research Centre at the University of New South Wales (Prof Teesson, Dr Newton) and University of Montreal (Prof Conrod) have randomly assigned participating schools in Victoria and New South Wales to four groups receiving either:
universal online prevention delivered to all students, regardless of personality risk;
a combination of both;
no interventions aside from what is routinely offered in schools.
The study is of one of several being conducted by a new $2.5 million National Health and Medical Research Council (NHMRC) Centre for Research Excellence (CRE) in Mental Health and Substance Use, which is being launched on January 31 at the University of New South Wales by the Australian Minister for Health Tanya Plibersek and Australian Minister for Mental Health and Ageing Mark Butler.
All students will take a baseline survey and those in the targeted intervention and combined intervention groups who screen positive for one of four specific personality types will be invited to attend two 90 minute early intervention workshops. These workshops are designed to increase awareness of, and coping mechanisms for, specific personality traits which may lead the students to develop later problems with drug and alcohol.
Chief investigator of the schools trial and director of the new CRE, Professor Maree Teesson, said the top 10 causes of disability in young Australians (15-24 years) are dominated by mental and substance use disorders.
“We know that co-occurrence of mental health problems and drug and alcohol problems are extremely common,” she said. “Around 50 per cent of people with a drug and alcohol use disorder are also struggling with at least one other current mental illness. This type of comorbidity is very complex and can be hard to shift. Current prevention and treatment models tend to place mental health and substance use in separate silos. Our research is designed to evaluate the effectiveness of interventions and treatments which target the problems together.
“What is exciting about the schools study and others at the new CRE is that we are focussing our research on early interventions designed to avert problems before they become entrenched. We know from our previous studies that education and prevention programs which are relevant to young people do work. However this is the first time in Australia that we have evaluated the benefits of providing targeted programs for at-risk individuals.”
Dr Nicola Newton, who heads the prevention program at the new Centre, says “Drug and alcohol problems cost our community dearly; not only financially, but in the functioning and future life options of our young people. Our early intervention research is aimed at giving young people the tools to best manage personality traits which make them vulnerable and to help them to make the right decisions in any given situation.
“Results from the UK study suggest targeted programs may also help those who are not among the ‘at risk’ personality types by reducing the use of drugs and alcohol within their social network and thereby creating an ‘immunity effect’.”
The chief investigator of the UK targeted prevention trials, Dr Patricia Conrod, is collaborating with Prof Teesson and Dr Newton on their Australian research.
* Conrod PJ, O’Leary-Barrett M, Newton N, et al. Effectiveness of a Selective, Personality-Targeted Prevention Program for Adolescent Alcohol Use and Misuse: A Cluster Randomized Controlled Trial. JAMA Psychiatry. 2013;():1-9. doi:10.1001/jamapsychiatry.2013.651.
ABOUT THE NHMRC CENTRE OF RESEARCH EXCELLENCE IN MENTAL HEALTH AND SUBSTANCE USE
The National Drug and Alcohol Research Centre at the University of New South Wales will lead a new Centre of Research Excellence (CRE) targeting co-occurring mental illness and drug and alcohol use disorders – debilitating conditions which affect more than 300,000 Australians every year. This CRE will focus on prevention and treatment.
The world first Centre of Research Excellence in Mental Health and Substance Use: Translating Innovative Prevention and Treatment will receive $2.5 million in NHMRC funding over the next five years. It will be led by NDARC’s Professor Maree Teesson in collaboration with researchers from the University of Newcastle, University of Sydney, University of Macquarie and University of Queensland. International collaborators include the University of Birmingham in the UK, North-western University Medical School, USA and the Medical University of South Carolina, USA.
Why is the CRE so important?
Mental and substance use disorders account for more years of life lost due to disability than any other disorders (24% of burden) and are second only to cardiovascular disease and cancer as leading causes of disease burden. In young Australians (aged 15-24) the top 10 causes of burden of disease are dominated by mental and substance use disorders. Comorbidity is common, with 25-50% of people experiencing more than one disorder. Once both mental and substance use disorders have been established, each condition serves to maintain or exacerbate the other. Average life expectancy is 20-30 years shorter among people with mental or substance use disorders compared to those without such problems, with the last 10 years of life spent living with chronic illnesses. Yet the prevention and treatment evidence base is weak, limited by traditional single disorder models and treatment silos.
What is it aiming to achieve?
The CRE aims to break down single disorder silos by generating significant new research on the prevention, treatment and epidemiology of comorbid mental health and substance use disorders. An integral component of this CRE is the translation of research findings into educational curricula, training programs, clinical resources, as well as resources for the general public.
How will these achievements make a difference?
This CRE is an example of strong Australian leadership. It will establish the largest concentration of internationally recognised comorbidity researchers worldwide, creating the potential for major gains in prevention and treatment. The CRE will provide the opportunity for researchers currently working in diagnostic silos (addiction, depression, anxiety and psychosis) to share skills, innovations in treatment and research approaches, synergise data collection and establish collaborative databases.
WHAT: Launch of the NHMRC Centre of Research Excellence in Mental Health and Substance Use and the NHMRC Centre for Research Excellence in Suicide Prevention.
WHEN: 31 January 2013
TIME: 10:15am for 10:30am
WHERE: Lowy Cancer Research Centre, University of New South Wales Level 4 Building C25, Gate 9 High St, Randwick.
SPEAKING: The Hon. Minister Tanya Plibersek, Minister for Health; The Hon Mark Butler, Minister for Mental Health and Ageing; Professor Maree Teesson, National Drug and Alcohol Research Centre; Professor Helen Christensen, Black Dog Institute.
Interviews will be available with speakers as well as consumers with first-hand experience of the issues.