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3. Selective personality‐targeted prevention of suicidal ideation in young adolescents: post hocanalysis of data collected in a cluster randomised controlled trial

Author

Grummitt, Lucinda R, Debenham, Jennifer, Kelly, Erin, Barrett, Emma L, Champion, Katrina, Conrod, Patricia, Teesson, Maree, and Newton, Nicola

Abstract

To assess the efficacy of a selective, personality‐targeted intervention for reducing suicidal ideation in adolescents. Post hocanalysis of survey data collected in the Climate and Preventure (CAP) study, a cluster randomised controlled trial that compared strategies for reducing alcohol misuse by adolescents, 2012–2015. Year 8 students at 16 New South Wales non‐government schools and one Victorian non‐government school. Preventure, a selective, personality‐targeted intervention designed to help adolescents with personality risk factors for alcohol misuse, comprising two 90‐minute sessions, one week apart. For our post hocanalysis, we combined data from the two CAP trial groups in which Preventure was offered (the Preventure and the Preventure/Climate Schools [a non‐selective prevention strategy] groups) as the intervention group; and data from the two groups in which Preventure was not offered (usual health education only [control] and Climate Schools groups) as the control group. Difference between post hoccontrol and intervention groups in the change in proportions of students reporting suicidal ideation during the preceding six months (single item of Brief Symptom Inventory depression subscale) over three years. A total of 1636 students (mean age at baseline, 13.3 years; standard deviation, 0.5 years) were included in our analysis, of whom 1087 (66%) completed the suicidal ideation item in the three‐year follow‐up assessment. The post hoccontrol group included 755 students (nine schools), the intervention group 881 students (eight schools). After adjusting for nesting of students in schools and sex, reporting of suicidal ideation by students who had received Preventure had declined over three years, compared with the control group (per year: adjusted odds ratio, 0.80; 95% CI, 0.66–0.97). Personality‐targeted selective prevention during early secondary school can have a lasting impact on suicidal ideation during adolescence. Australian and New Zealand Clinical Trials Registry, ACTRN12612000026820 (prospective).

Published
2022
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4. Identifying Targets for Substance Use Prevention in Young People Exposed to Childhood Adversity: Protocol for a Systematic Review

Author

Grummitt, Lucinda Rachel, Kelly, Erin Veronica, Barrett, Emma Louise, Keyes, Katherine M, and Newton, Nicola Clare

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundAdverse childhood experiences are prevalent robust risk factors for the development of substance use problems. However, less is known about the causal mechanisms that explain these relationships. While directly preventing adverse childhood experiences is ideal, it is not always possible. In such cases, the mechanisms themselves may be amenable to intervention, allowing for the effective prevention of problematic substance use among children exposed to adversity. Identifying such mechanisms is therefore a critical step for efforts aiming to reduce the high individual and societal burdens associated with substance use globally. ObjectiveThis study aims to systematically identify and synthesize evidence on the modifiable mediators and moderators of the relationship between adverse childhood experiences and substance use outcomes in young people (age 10-24 years). MethodsA systematic review will be conducted using PubMed, MEDLINE, PsycINFO, Web of Science, and CINAHL databases to determine the modifiable mediators and moderators of the relationship between adverse childhood experiences and substance use in young people. Data from the review will be qualitatively synthesized, unless we identify a sufficient number of studies (at least five) that examine the same type of adversity (eg, physical or sexual abuse) and the same mediator/moderator, in which case a quantitative synthesis (meta-analysis) will be conducted. If a quantitative synthesis is warranted, standardized effect estimates of the indirect (mediated) effect between adverse childhood experiences and substance use outcomes will be combined using a random-effects meta-analysis. Mediators/moderators will be grouped according to a socioecological perspective, using the four levels of individual, interpersonal, community, and public policy/culture. ResultsElectronic searches were completed in August 2019. A total of 4004 studies were included for screening after removing duplicates. After evaluating titles and abstracts against eligibility criteria, a further 3590 studies were excluded, leaving 415 studies for full-text screening. The results of the review are expected to be available by December 2020. ConclusionsThe mechanisms linking adverse childhood experiences and substance use outcomes in young people are vital targets for substance use prevention efforts. This review will provide evidence to inform the development of prevention strategies in order to interrupt the negative life trajectory that can begin with childhood adversity. Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42020148773; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020148773 International Registered Report Identifier (IRRID)DERR1-10.2196/22368

Published
2020
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