Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2020

Open Access 01-12-2020 | Research article

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

Authors: Ali Cheetham, Emma Sandral, Dan I. Lubman

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2020

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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)
Literature
1.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
2.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
3.
go back to reference Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16–20.PubMedPubMedCentral Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002;1(1):16–20.PubMedPubMedCentral
4.
go back to reference Rüsch N, Angermeyer MC, Corrigan PW. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry. 2005;20(8):529–39.PubMedCrossRef Rüsch N, Angermeyer MC, Corrigan PW. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry. 2005;20(8):529–39.PubMedCrossRef
5.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
6.
go back to reference 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.CrossRef 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.CrossRef
7.
go back to reference 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.CrossRef 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.CrossRef
8.
go back to reference Secker J, Armstrong C, Hill M. Young people’s understanding of mental illness. Health Educ Res. 1999;14(6):729–39.PubMedCrossRef Secker J, Armstrong C, Hill M. Young people’s understanding of mental illness. Health Educ Res. 1999;14(6):729–39.PubMedCrossRef
9.
go back to reference 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.CrossRef 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.CrossRef
10.
go back to reference 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.CrossRef 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.CrossRef
11.
go back to reference 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. 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.
12.
go back to reference 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.CrossRef 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.CrossRef
13.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
14.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
15.
go back to reference 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.CrossRef 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.CrossRef
16.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
17.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
18.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
19.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
21.
go back to reference 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. 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.
22.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
23.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
24.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
25.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
26.
go back to reference 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.CrossRef 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.CrossRef
27.
go back to reference 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. 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.
28.
go back to reference 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
29.
go back to reference 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.PubMed 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.PubMed
30.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
31.
go back to reference 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.CrossRef 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.CrossRef
32.
go back to reference Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2012;34(4):520–47.PubMedCrossRef Dalky HF. Mental illness stigma reduction interventions: review of intervention trials. West J Nurs Res. 2012;34(4):520–47.PubMedCrossRef
34.
go back to reference 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. 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.
Metadata
Title
Outcomes of reducing stigma towards alcohol misuse during adolescence: results of a randomized controlled trial of the MAKINGtheLINK intervention
Authors
Ali Cheetham
Emma Sandral
Dan I. Lubman
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2020
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-020-00317-7

Other articles of this Issue 1/2020

Child and Adolescent Psychiatry and Mental Health 1/2020 Go to the issue