Outcomes of reducing stigma towards alcohol misuse during adolescence: results of a randomized controlled trial of the MAKINGtheLINK intervention

Springer Science and Business Media LLC - Tập 14 - Trang 1-8 - 2020
Ali Cheetham1,2, Emma Sandral1,2, Dan I. Lubman1,2
1Turning Point, Eastern Health, Richmond, Australia
2Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, Australia

Tóm tắt

While it is well-recognized that the stigma associated with alcohol use problems can prevent or delay help-seeking, there is limited research examining stigmatising attitudes towards alcohol misuse, or their consequences, during adolescence. The current study examined the results of a school-based intervention on adolescents’ stigmatising attitudes towards alcohol misuse among their peers, and how changes in attitudes influenced intentions to encourage help-seeking, as well as participants’ personal use and misuse of alcohol. Participants (n = 463) were a subset of a larger sample participating in a randomized controlled trial of the MAKINGtheLINK intervention. Of the included participants, 287 (62%) were allocated to the intervention group and 176 (38%) to the control group. Assessments were conducted at baseline and 6-weeks, 6-months, and 12-months post-baseline. At each assessment, participants were presented with a vignette describing a peer experiencing alcohol misuse and completed the General Help Seeking Questionnaire as well as a 10-item scale measuring stigmatising attitudes. Alcohol use was also assessed. The intervention was associated with a greater reduction in ‘weak-not-sick’ attitudes over time, which in turn predicted stronger intentions to encourage help-seeking from family members and formal help sources at the 12-month follow-up. Perceptions of dangerousness did not change significantly as a result of the intervention, however overall perceptions of dangerousness demonstrated a trend towards encouraging help-seeking from formal sources. Changes in stigma were not associated with past-year alcohol use or problems. School-based interventions such as MAKINGtheLINK can decrease some stigmatising attitudes towards alcohol misuse during adolescence, and increase adolescents’ intentions to encourage help-seeking from both formal and informal help sources. However, results varied depending on both the dimension of stigma examined and the type of help source, highlighting a complex relationship between stigma, intentions, and sources of help that requires further investigation. Importantly, reducing stigma did not appear to result in negative effects due to greater acceptance of drinking (e.g., heavier alcohol use), supporting continued efforts to reduce alcohol-related stigma during adolescence. Trial registration: Registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (ACTRN12613000235707)

Tài liệu tham khảo

Schomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC. The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol. 2011;46(2):105–12. Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry. 2010;167(11):1321–30. Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16–20. Rüsch N, Angermeyer MC, Corrigan PW. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry. 2005;20(8):529–39. Livingston JD, Milne T, Fang ML, Amari E. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction. 2012;107(1):39–50. Corrigan PW, Lurie BD, Goldman HH, Slopen N, Medasani K, Phelan S. How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatric Serv. 2005;56(5):544–50. Cheetham A, Jorm AF, Wilson C, Berridge BJ, Blee F, Lubman D. Stigmatising attitudes towards depression and alcohol misuse in young people: relationships with help-seeking and behavior. Adolescent Psychiatry. 2019;9(1):24–32. Secker J, Armstrong C, Hill M. Young people’s understanding of mental illness. Health Educ Res. 1999;14(6):729–39. Rickwood D, Deane FP, Wilson CJ, Ciarrochi J. Young people’s help-seeking for mental health problems. Australian e-J Adv Mental Health. 2005;4(3):218–51. Rickwood D, White A, Eckersley R. Overview of current trends in mental health problems for Australia’s youth and adolescents. Clin Psychol. 2007;11(3):72–8. White V, Smith G. Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substance in 2008. Melbourne: Cancer Control Research Institute; 2009. Schachter HM, Girardi A, Ly M, Lacroix D, Lumb AB, van Berkom J, et al. Effects of school-based interventions on mental health stigmatization: a systematic review. Child Adolesc Psychiatry Mental Health. 2008;2(1):1. Lubman D, Cheetham A, Jorm AF, Berridge BJ, Wilson C, Blee F, et al. Australian adolescents’ beliefs and help-seeking intentions towards peers experiencing symptoms of depression and alcohol misuse. BMC Public Health. 2017;17(1):658. Lubman DI, Cheetham A, Sandral E, Wolfe R, Martin C, Blee F, et al. Twelve-month outcomes of MAKINGtheLINK: a cluster randomized controlled trial of a school-based program to facilitate help-seeking for substance use and mental health problems. EClinicalMedicine. 2020;18:100225. Cheetham A, Jorm AF, Wilson C, Berridge BJ, Blee F, Lubman DI. Stigmatising attitudes towards depression and alcohol misuse in young people: relationships with help-seeking intentions and behavior. Adolesc Psychiatry. 2019;9(1):24–32. Yap MBH, Reavley NJ, Jorm AF. Associations between stigma and help-seeking intentions and beliefs: findings from an Australian national survey of young people. Psychiatry Res. 2013;210(3):1154–60. Yap MBH, Wright A, Jorm AF. First aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth. Psychiatry Res. 2011;188(1):123–8. Adlaf EM, Hamilton HA, Wu F, Noh S. Adolescent stigma towards drug addiction: effects of age and drug use behaviour. Addict Behav. 2009;34(4):360–4. Lubman DI, Berridge BJ, Blee F, Jorm AF, Allen NB, McKay-Brown L, et al. A school-based health promotion program to increase help-seeking for substance use and mental health problems: study protocol for a randomised controlled trial. Trials. 2016;17:393. Barnes G. Report on the generation of the 2010 index of community socio-educational advantage (ICSEA). http://www.acaraeduau/verve/_resources/2010_Index_of_Community_Socio-Educational_Advantage_Generation_Reportpdf.Accessed 2011 3. Fisher JD, Fisher WA. The Information-Motivation-Behavioural Skills Model. In: DiClemente J, Kegler C, editors. Emerging theories in health promotion practice and research. 2nd ed. CA: Wiley; 2009. Webb T, Sheeran P. Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychol Bull. 2006;132(2):249–68. Yap MB, Wright A, Jorm AF. The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help. Soc Psychiatry Psychiatr Epidemiol. 2011;46(12):1257–65. Yap MBH, Jorm AF. The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth. J Affect Disord. 2011;134(1):473–7. Jorm AF, Wright A. Influences on young people’s stigmatising attitudes towards peers with mental disorders: national survey of young Australians and their parents. Br J Psychiatry. 2008;192(2):144–9. Yap MB, Mackinnon A, Reavley N, Jorm AF. The measurement properties of stigmatizing attitudes towards mental disorders: results from two community surveys. Int J Methods Psychiatric Res. 2014;23(1):49–61. Prior M, Sanson A, Smart D, Oberklaid F. Pathways from infancy to adolescence: Australian temperament project 1983–2000. Melbourne: Australian Institute of Family Studies; 2000. Mason A, Toumbourou JW, Herrenkohl TI, Hemphill SA, Catalano RF, Patton GC. Early-age alcohol use and later alcohol problems in adolescents: individual and peer mediators in a bi-national study. Psychol Addict Behav. 2011;25:625–33. Lubman DI, Hides L, Yucel M, Toumbourou JW. Intervening early to reduce developmentally harmful substance use among youth populations. Med J Aust. 2007;187(7):S22–5. Velleman RD, Templeton LJ, Copello AG. The role of the family in preventing and intervening with substance use and misuse: a comprehensive review of family interventions, with a focus on young people. Drug Alcohol Rev. 2005;24(2):93–109. Jorm AF, Wright A, Morgan AJ. Beliefs about appropriate first aid for young people with mental disorders: findings from an Australian national survey of youth and parents. Early Intervent Psychiatry. 2007;1(1):61–70. Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2012;34(4):520–47. Kulesza M, Larimer ME, Rao D. Substance use related stigma: what we know and the way forward. J Addict Behav Ther Rehabil. 2013;2(2):782. Wilson CJ, Deane FP, Ciarrochi J, Rickwood D. Measuring help-seeking intentions: properties of the general help-seeking questionnaire. Canadian J Couns. 2005;39(1):15–28.