Targeting adolescents and helping them manage high levels of impulsivity in early adolescence could halt a cascading chain of events that lead to late-adolescence antisocial personality disorder and alcohol use disorder.
A study that followed hundreds of youths over more than six years suggests that tendencies toward impulsivity in early adolescence are associated with several adverse outcomes in later adolescence, including antisocial personality disorder and alcohol use disorder. However, by the time teenagers reach mid-adolescence, it may be too late to target impulsivity to prevent the development of these behavioural disorders.
Need to address impulsivity before it starts influencing behaviours
Previous studies have demonstrated the connection between impulsivity and various diseases, but not how it manifests. A recent study that followed hundreds of young people in Philadelphia for more than six years reveals the intricate relationship between impulsivity, alcohol use, and antisocial conduct. The findings suggest that targeting adolescents who exhibit high levels of impulsivity in early adolescence could halt a cascading chain of events that leads to late-adolescence antisocial personality disorder (APD) and alcohol use disorder (AUD).
“Kids with impulse control problems are at risk for a variety of adverse outcomes, such as drug use, acting-out behaviour, and antisocial behaviour,” said study co-author Dan Romer, research director of the Annenberg Public Policy Centre of the University of Pennsylvania. “What we’ve found is that you’ve got to start mitigating impulsivity before it starts influencing behaviours that lead to substance use and antisocial behaviour disorders. Once adolescents are on a trajectory of engaging in those behaviours, it may become more difficult to prevent disorders later in adolescence than it is to treat impulsivity itself.”
The open-access study, published this week in the Journal of Adolescent Health, was conducted by researchers from the Annenberg Public Policy Centre (APPC), the University of Amsterdam, the University of Oregon, and the Children’s Hospital of Philadelphia.
The Philadelphia Trajectory Study
The Philadelphia Trajectory Study, a six-wave study in which participants aged 10 to 12 were surveyed annually from 2004 to 2010, with a final two-year follow-up in 2012, provided the data for the study. The five years of self-reported data from waves three through six are what the current study is based on. The participants in the last wave ranged in age from 18 to 21. Data from 364 adolescents (at wave 3) from various ethnic backgrounds formed the basis of the study.
The researchers said that to the best of their knowledge, “this is the first study to investigate cascading mediating links between impulsivity, alcohol use, and antisocial behaviour across adolescence.”
Adolescent impulsivity and antisocial behaviour
The study’s findings showed that increases in impulsivity from early to mid-adolescence predicted changes in antisocial conduct and alcohol consumption. But as the participants approached mid- to late adolescence, impulsivity changes ceased to be a predictor of such behaviours. Instead, it was antisocial behaviour that foreshadowed later signs of alcoholism as well as antisocial personality problems.
“It is also important to target antisocial behaviour to interrupt the cascade that predicts both alcohol use disorder and antisocial personality disorder,” said the lead author, Ivy Defoe, an assistant professor at the University of Amsterdam and a former postdoctoral fellow at the Annenberg Public Policy Centre. “In fact, the study showed that increases in antisocial behaviour in mid- to late adolescence further predicted increases in impulsivity as well. This is consistent with labelling theory that suggests that individuals who show antisocial behaviour are subsequently labelled as ‘antisocial’ or ‘rule-breakers,’ which causes them to further exhibit attributes that are associated with such behaviour.”
Mindfulness training and family-based programs help to overcome impulsive tendencies
Identification of children and adolescents with problems that may develop into illnesses later is crucial given the crisis in adolescent mental health. One strategy to warn parents about the risks and refer kids for treatment is to screen for these problems. According to the researchers, “Intervening early is critical to further avoid the consequences of impulsivity which are more difficult to reverse once psychopathology has developed.” The researchers suggested that these interventions might include mindfulness instruction and family-based ones in which parents and other family members assist a child in overcoming negative impulsive tendencies.
Most of the participants came from low- to middle-class socioeconomic (SES) backgrounds. At each wave of the trial, the researchers discovered that socioeconomic position was a strong predictor of impulsivity. “Future research could further investigate the mechanisms by which early exposure to socioeconomic disadvantage influences heightened impulsivity during adolescence, including impacts on child executive functioning and parenting behaviours,” the researchers wrote. In addition to Defoe and Romer, the study was authored by Atika Khurana of the University of Oregon and Laura M. Betancourt and Hallam Hurt of the Children’s Hospital of Philadelphia.
Materials provided by the Annenberg Public Policy Centre of the University of Pennsylvania. Note: Content may be edited for style and length.
Ivy N. Defoe, Atika Khurana, Laura M. Betancourt, Hallam Hurt, Daniel Romer. Cascades From Early Adolescent Impulsivity to Late Adolescent Antisocial Personality Disorder and Alcohol Use Disorder. Journal of Adolescent Health, 2022; DOI: 10.1016/j.jadohealth.2022.06.007
Annenberg Public Policy Centre of the University of Pennsylvania. “Targeting impulsivity early in adolescence could prevent later behavioural disorders: Study supports early intervention to halt cascading chain.” ScienceDaily. ScienceDaily, 9 August 2022. <www.sciencedaily.com/releases/2022/08/220809194924.htm>.
Help is here:
Toll-Free Mental Health Rehabilitation Helpline Kiran (1800-599-0019)
Name of the Organisation: Indla’s Child Guidance Clinics (ICGC)
Indla’s Child Guidance Clinics (ICGC) was established in Vijayawada and then was expanded to Mumbai in 2015 followed by another branch in the same city in 2017. ICGC provides assessment, remediation, and counselling all under one roof. It offers medication, parental counselling and therapies for children and adolescents. They also conduct workshops on parenting and life skills development.
Contact: email: email@example.com
Telephone: 9820333068, 022-24380802
Name of the Organisation: Vandrevala Foundation
Vandrevala Foundation is a non-profit that partners with organizations to help communities thrive by providing education and healthcare. Vandrevala Foundation launched a mental health helpline in India in 2009 to offer free psychological counselling and crisis mediation to anyone experiencing distress due to depression, trauma, mood disorders, chronic illness, and relationship conflict.
Contact: Email: firstname.lastname@example.org
Telephone: +91 9999 666 555