Advertisement

European Child & Adolescent Psychiatry

, Volume 25, Issue 6, pp 639–648 | Cite as

Effectiveness of a brief school-based intervention on depression, anxiety, hyperactivity, and delinquency: a cluster randomized controlled trial

  • Ferry X. GoossensEmail author
  • J. Lammers
  • S. A. Onrust
  • P. J. Conrod
  • B. Orobio de Castro
  • K. Monshouwer
Original Contribution

Abstract

Problematic substance use and mental health problems often co-occur in adolescents. Effective school-based interventions that are brief and target multiple problems are promising in the field of health promotion. Preventure is a brief, school-based, selective preventive intervention, tailored to four personality profiles. Preventure has already proved effective on alcohol outcomes. Previous trials also reveal effects on several mental health outcomes, yet the evidence for these outcomes is limited. This study presents the results of the Dutch Preventure Trial, on a range of mental health outcomes. In a cluster RCT, including 699 high risk students (mean age 14 years), the intervention effects on mental health problems at 2, 6, and 12 months post intervention were tested in the total high risk population and in four specific personality groups. No significant intervention effects were found on 22 from the 24 tests. A positive intervention effect on anxiety was found in the anxiety sensitivity personality group at 12-month follow-up, and a negative intervention effect on depression was found at 12-month follow-up in the negative thinking group. In post hoc growth curve analyses these effects were not found. This study found no convincing evidence for the effectiveness of Preventure in The Netherlands on mental health problems. This finding is not in line with the results of an earlier effectiveness study in the UK. This highlights the need for more research into the knowledge transfer model of interventions, to ensure that interventions are effective in a variety of circumstances.

Keywords

Prevention Intervention Mental health Adolescents 

Notes

Compliance with ethical standards

Conflicts of interest

J.L., F.G., M.K., R.W. and R.E. declare that they have no conflict of interest. PC is the developer and licensee of Preventure.

References

  1. 1.
    De Graaf R, Bijl RV, Smit F, Vollebergh WAM, Spijker J (2002) Risk factors for 12-month comorbidity of mood, anxiety, and substance use disorders: findings from the Netherlands Mental Health Survey and Incidence Study. Am J Psychiatry 156:620–629CrossRefGoogle Scholar
  2. 2.
    Kessler RC (2004) Impact of substance abuse on the diagnosis, course, and treatment of mood disorders. The epidemiology of dual diagnosis. Biol Psychiatry 56(10):730–737CrossRefPubMedGoogle Scholar
  3. 3.
    Kendler KS, Prescott CA, Myers J, Neale MC (2003) The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry 60(9):929–937CrossRefPubMedGoogle Scholar
  4. 4.
    Conrod PJ, Stewart SH, Comeau MN, Maclean AM (2006) Efficacy of cognitive-behavioral interventions targeting personality risk factors for youth alcohol misuse. J Clin Child Adolesc Psychol 35(4):490–504CrossRefGoogle Scholar
  5. 5.
    Conrod PJ, Castellanos N, Mackie C (2008) Personality-targeted interventions delay the growth of adolescent drinking and binge drinking. J Child Psychol Psychiatry 49(2):181–190PubMedGoogle Scholar
  6. 6.
    Conrod PJ, Castellanos-Ryan N, Mackie C (2011) Long-term effects of a personality-targeted intervention to reduce alcohol use in adolescents. J Consult Clin Psychol 79(3):296–306CrossRefPubMedGoogle Scholar
  7. 7.
    O’Leary-Barrett M, Mackie CJ, Castellanos-Ryan N, Al-Khudhairy N, Conrod PJ (2010) Personality-targeted interventions delay uptake of drinking and decrease risk of alcohol-related problems when delivered by teachers. J Am Acad Child Adolesc Psychiatry 49(9):954–963CrossRefPubMedGoogle Scholar
  8. 8.
    Conrod PJ, Castellanos-Ryan N, Strang J (2010) Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence. Arch Gen Psychiatry 67(1):85–93CrossRefPubMedGoogle Scholar
  9. 9.
    Castellanos N, Conrod PJ (2006) Brief interventions targeting personality risk factors for adolescent substance misuse reduce depression, panic and risk-taking behaviours. J Mental Health 15(6):645–658CrossRefGoogle Scholar
  10. 10.
    O’Leary-Barrett M, Topper L, Al-Khudairy N, Pihl RO, Castellanos-Ryan N, Mackie CJ, Conrod PJ (2013) Two-year Impact of personality-targeted, teacher-delivered interventions on youth internalizing and externalizing problems: a cluster-randomized trial. J Am Acad Child Adolesc Psychiatry 52(9):911–920CrossRefPubMedGoogle Scholar
  11. 11.
    Comeau N, Stewart SH, Loba P (2001) The relations of trait anxiety, anxiety-sensitivity, and sensation seeking to adolescents’ motivations for alcohol, cigarette, and marijuana use. Addict Behav 26:1–24CrossRefGoogle Scholar
  12. 12.
    Cooper ML, Frone MR, Russell M, Mudar P (1995) Drinking to regulate positive and negative emotions: a motivational model of alcohol use. J Pers Soc Psychol 69:990–1005CrossRefPubMedGoogle Scholar
  13. 13.
    Blackwell E, Conrod PJ, Hansen N (2002) Negative cognitions, hopelessness, and depression related drinking motives. Abstract in alcoholism: clinical and experimental research, 26(Supplement), 27A. Poster session presented at the Scientific Meeting of the Research Society on Alcoholism, San Francisco, CAGoogle Scholar
  14. 14.
    Conrod PJ, Woicik P (2002) Validation of a four factor model of personality risk for substance abuse and examination of a brief instrument for assessing personality risk. Addict Biol 7:329–346CrossRefGoogle Scholar
  15. 15.
    Malmberg M, Overbeek G, Monshouwer K, Lammers J, Vollebergh WAM, Engels RCME (2010) Substance use risk profiles and associations with early substance use in adolescence. J Behav Med 33:474–485CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pulkkinen L, Pitkänen T (1994) A prospective study of the precursors to problem drinking in young adulthood. J Stud Alcohol 55:578–587CrossRefPubMedGoogle Scholar
  17. 17.
    Shall M, Kemeny A, Maltzman I (1992) Factors associated with alcohol use in university students. J Stud Alcohol 53:122–136CrossRefGoogle Scholar
  18. 18.
    Stewart SH, Peterson JB, Pihl RO (1995) Anxiety sensitivity and self-reported alcohol consumption rates in university women. J Anxiety Disord 9:283–292CrossRefGoogle Scholar
  19. 19.
    Joiner TE Jr (2000) A test of hopelessness theory in youth psychiatric inpatients. J Clin Child Psychol 29:167–176CrossRefPubMedGoogle Scholar
  20. 20.
    Maller RG, Reiss S (1992) Anxiety sensitivity in 1984 and panic attacks in 1987. J Anxiety Disord 6:241–247CrossRefGoogle Scholar
  21. 21.
    Moeller FG, Barratt ES, Dougherty DM, Schmitz JM, Swann AC (2001) Psychiatric aspects of impulsivity. Am J Psychiatry 158:1783–1793CrossRefPubMedGoogle Scholar
  22. 22.
    Arnett JJ (1994) Sensation seeking: a new conceptualization and a new scale. Personal Individ Differ 16:289–296CrossRefGoogle Scholar
  23. 23.
    Lammers J, Goossens F, Lokman S, Monshouwer K, Lemmers L, Conrod P, Kleinjan M (2011) Evaluating a selective prevention programme for binge drinking among young adolescents: study protocol of a randomized controlled trial. BMC Public Health 11:126. doi: 10.1186/1471-2458-11-126 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lammers J, Goossens F, Conrod P, Engels R, Wiers RW, Kleinjan M (2015) Effectiveness of a selective intervention program targeting personality risk factors for alcohol misuse among young adolescents: results of a cluster randomized controlled trial. Addiction 110:1101–1109CrossRefPubMedGoogle Scholar
  25. 25.
    Woicik PA, Stewart SH, Pihl RO, Conrod PJ (2009) The substance use risk profile scale: a scale measuring traits linked to reinforcement-specific substance use profiles. Addict Behav 34:1042–1055CrossRefPubMedGoogle Scholar
  26. 26.
    Bouma J, Ranchor AV, Sanderman R, Van Sonderen E (1995) Het meten van symptomen van depressie met de CES-D: een handleiding. [Measuring symptoms of depression with the CES-D: Manual]. Groningen: Rijksuniversiteit GroningenGoogle Scholar
  27. 27.
    Silverman WK, Fleisig W, Rabian B, Peterson RA (1991) Childhood anxiety sensitivity index. J Clin Child Psychol 20:162–168CrossRefGoogle Scholar
  28. 28.
    Van Widenfelt BM, Siebelink BM, Goedhart A, Treffers DA (2002) The Dutch childhood anxiety sensitivity index: psychometric properties and factor structure. J Clin Child Psychol 31(1):90–100CrossRefGoogle Scholar
  29. 29.
    Reiss SR, Peterson R, Gursky D, McNally R (1986) Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther 24:11–18CrossRefGoogle Scholar
  30. 30.
    Walsh TM, Stewart SH, McLaughlin E, Comeau MN (2004) Gender differences in childhood anxiety sensitivity index dimensions. J Anxiety Disord 18:695–706CrossRefPubMedGoogle Scholar
  31. 31.
    Weems CF, Hammond-Laurence K, Silverman WK, Ginsburg GS (1998) Testing the utility of the anxiety sensitivity construct in children and adolescents referred for anxiety disorders. J Clin Child Psychol 27:69–77CrossRefPubMedGoogle Scholar
  32. 32.
    Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586CrossRefPubMedGoogle Scholar
  33. 33.
    Goodman R, Scott S (1999) Comparing the strengths and difficulties questionnaire and the child behavior checklist: is small beautiful? J Abnorm Child Psychol 27(1):17–24CrossRefPubMedGoogle Scholar
  34. 34.
    Baerveldt C (1992) Schools and the prevention of petty crime: search for a missing link. J Quant Criminol 8:79–94CrossRefGoogle Scholar
  35. 35.
    Krank M, Stewart SH, Wall A-M, Woicik PB, Conrod PJ (2011) Structural, concurrent, and predictive validity of the substance use risk personality scale in early adolescence. Addict Behav 36:37–46CrossRefPubMedGoogle Scholar
  36. 36.
    Wiers RW, Ames SL, Hofmann W, Krank M, Stacey AW (2010) Impulsivity, impulsive and reflective processes and the development of alcohol use and misuse in adolescents and young adults. Front Psychol 1:144. doi: 10.3389/fpsyg.2010.00144 Epub 2010 Sep 30 CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A, Kraus L (2009) The 2007 ESPAD report. Substance use among students in 35 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN)Google Scholar
  38. 38.
    O’Malley PM, Bachman JG, Johnston LD (1983) Reliability and consistency in self-reports of drug use. Int J Addict 18:805–824CrossRefPubMedGoogle Scholar
  39. 39.
    Muthén B, Muthén L (1998–2010) Mplus user’s guide (6th ed.). Los Angeles, CA: Muthén & Muthén. www.statmodel.com
  40. 40.
    Monshouwer K, Smit F, Ruiter M, Ormel J, Verhulst FC, Vollebergh WAM, Oldehinkel AJ (2012) Identifying target groups for the prevention of depression in early adolescence: the TRAILS study. J Affect Disord 138:287–294CrossRefPubMedGoogle Scholar
  41. 41.
    Odgers CL, Moffitt TE, Broadbent JM, Dickson N, Hancox RJ, Harrington H et al (2008) Female and male antisocial trajectories: from childhood origins to adult outcomes. Dev Psychopathol 20:673–716CrossRefPubMedGoogle Scholar
  42. 42.
    Moffitt TE, Caspi A (2001) Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females. Dev Psychopathol 13:355–375CrossRefPubMedGoogle Scholar
  43. 43.
    De Boer MR, Waterlander WE, Kuijper LDJ, Steenhuis IHM, Twisk JWR (2015) Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate. In J Behav Nutr Phys Activity 12:4CrossRefGoogle Scholar
  44. 44.
    Duncan TE, Duncan SC, Strycker LA, Li F, Alpert A (1999) An introduction to latent variable growth curve modeling: concepts, issues, and applications. Erlbaum, MahwahGoogle Scholar
  45. 45.
    Bentler PM, Bonett DG (1980) Goodness-of-fit procedures for the evaluation and selection of log-linear models. Psychol Bull 88:588–606CrossRefGoogle Scholar
  46. 46.
    Schulz KF, Grimes DA (2005) Multiplicity in randomized trials I: endpoints and treatments. Lancet 365:1591–1595CrossRefPubMedGoogle Scholar
  47. 47.
    Greenberg MT (2000) Preventing mental disorders in school-age children. A review of the effectiveness of prevention programs. Prevention Research Center for the Promotion of Human Development College of Health and Human Development Pennsylvania State UniversityGoogle Scholar
  48. 48.
    Eisner M (2009) No effects in independent prevention trials: can we reject the cynical view? J Exp Criminol 5:163–183CrossRefGoogle Scholar
  49. 49.
    Flay BR, Biglan A, Boruch RF, Castro FG, Gottfredson D, Kellam S, Mocicki EK, Schinke S, Valentine JC, Ji P (2005) Standards of Evidence: criteria for efficacy, effectiveness and dissemination. Prev Sci 6:151–175CrossRefPubMedGoogle Scholar
  50. 50.
    Brener ND, Billy JO, Grady WR (2003) Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health 33:436–457CrossRefPubMedGoogle Scholar
  51. 51.
    Koning IM, Vollebergh WAM, Smit F, Verdurmen JEE, van der Eijnden RJJM, ter Bogt TFM et al (2009) Preventing heavy alcohol use in adolescents (PAS): cluster randomized trial of a parent and student intervention offered separately and simultaneously. Addiction 104:1669–1678CrossRefPubMedGoogle Scholar
  52. 52.
    Del Boca FK, Darkes J (2003) The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction 98:1–12CrossRefPubMedGoogle Scholar
  53. 53.
    Elliot SE, Mihalic S (2004) Issues in disseminating and replicating effective prevention programs. Prev Sci 5(1):47–53CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ferry X. Goossens
    • 1
    • 2
    Email author
  • J. Lammers
    • 2
  • S. A. Onrust
    • 2
  • P. J. Conrod
    • 3
  • B. Orobio de Castro
    • 4
  • K. Monshouwer
    • 2
    • 5
  1. 1.Trimbos InstituteUtrechtThe Netherlands
  2. 2.Trimbos Institute (Netherlands Institute of Mental Health and Addiction)UtrechtThe Netherlands
  3. 3.King’s College London, Department of Psychological Medicine and PsychiatryInstitute of PsychiatryLondonUK
  4. 4.Department of Developmental PsychologyUtrecht UniversityUtrechtThe Netherlands
  5. 5.Department of Interdisciplinary Social ScienceUtrecht UniversityUtrechtThe Netherlands

Personalised recommendations