Pregnancy and child

Tests can predict teens most likely to binge drink

“A single glass of wine or beer at the age of 14 can help a young teenager along the path to binge drinking,” the Daily Mail warns.

But having a single drink does not mean a child is bound to become a “binge boozer”. That is just one of around 40 factors researchers have identified which they claim can be used to predict whether a teenager will grow up to become a binge drinker.

These factors include life events, personality traits and differences in brain structure – such as increased activity in areas of the brain associated with reward-seeking.

It is difficult to see what practical implications this research will have in preventing teenage drinking, due to the cost of brain scans. A single functional MRI brain scan, as used in the study, can cost around £300 to £400 to carry out and then interpret.

As BBC News reports “A simplified version of the test … is more likely to be used”.

Children and their parents and carers are advised that an alcohol-free childhood is the healthiest and best option. Aside from the short and long-term risks of alcohol abuse, alcohol may disrupt the normal development of the teenage brain.

Where did the story come from?

The study was carried out by researchers from a number of academic institutions in Europe and North America, including the University of Nottingham and the Medical Research Council in the UK. It was funded by a number of different sources, including the European Union and the National Institute for Health Research.

The study was published in the peer-reviewed journal Nature.

Although drinking from an early age is not advised, the Daily Mail’s headline was rather alarmist. It is certainly not the case that drinking a single glass of wine at the age of 14 will condemn a teenager to a life of binge drinking. The research identified a range of factors which might put young people at risk.

BBC News coverage of the study was rather more measured and usefully quotes from both the researchers involved in the study as well as independent experts.

What kind of research was this?

This was a longitudinal study of 692 adolescents aged 14 from across Europe which aimed to create a model which could identify individuals at risk of future alcohol misuse.

It looked at a range of data including brain images, personality, life experiences and genetic information, to construct models of adolescent binge drinking.

The study follows on from a previous study by the same group, in which they investigated the associations between brain networks and high risk behaviours such as drug and alcohol misuse. The latest study aimed to predict who went on to drink heavily at age 16.

The researchers say that alcohol misuse is common among adolescents and is a strong risk factor for adult alcohol dependence. Identifying risk factors is important but previous studies have typically focused on just one type of risk factor. Personality, life events such as parental divorce, and certain genes and brain structure may all play a role.

What did the research involve?

The researchers used data from the IMAGEN project, a longitudinal study of adolescent development which followed 692 adolescents aged 14 from across Europe.

To construct and test their model, they looked at a whole range of information which had been collected on the children, including:

  • brain imaging and activity – including looking at the volume of the brains and also how the brain responds to reward
  • personality, using validated measures – including traits such as neuroticism, extravagance, and conscientiousness
  • cognitive ability, using validated intelligence scales
  • life experience including family history and stressful life events, gathered using a validated questionnaire
  • factors such as age, sex, age at puberty and socio economic status
  • the presence of 15 “candidate genes” which are thought to predispose to alcohol misuse, identified through blood tests

They used the data to construct a model of current and future adolescent alcohol misuse and to predict which individuals would become binge drinkers by the age of 16. They then tested their model on a new, separate group of teenagers, to test its reliability.

What were the basic results?

The researchers found that life experiences, neurobiological differences and personality are all important risk factors for binge drinking.

Personality measures associated with binge drinking included a “novelty seeking” trait – in other words, behaviour of searching for and feeling rewarded by novel experiences.

They found that their method predicted with about 70% accuracy (confidence interval [CI] 66-83%) which 14-year-olds are likely to binge drink at age 16.

How did the researchers interpret the results?

They conclude that vulnerability to binge drinking can be accurately predicted by a test looking at teenagers’ life experience, personality traits and brain structure and function. They point out that there are multiple factors involved in adolescent alcohol misuse – and that the influence of any one factor is “modest”.

The risk profile could help develop targeted interventions to those at risk.

Conclusion

This research on a model for identifying those at risk of turning into binge drinkers included a wide range of potential risk factors. How such a detailed test might be used in practice is uncertain.

Limitations of this study include the facts that:

  • it was reliant on the 14-year-olds accurately reporting how much alcohol they drank
  • some of the analysis was restricted to subsets of the 692 participants (115 “binge drinkers” and 150 “controls”)

There is also the practical limitation that access to brain scanning devices, such as MRI scanners, are limited. You also have to pay the wages of people who are able to interpret the scans correctly, making them an expensive diagnostic technique. It could be the case that a “streamlined” version of the testing protocol, just focusing on personality traits and life experiences, may be used in the future.

There is already evidence that drinking frequently at a young age is linked to an increased risk of developing alcohol dependence in young adulthood. So an alcohol-free childhood is the healthiest and best option.

However, if children drink alcohol, it should not be until at least the age of 15 years.


NHS Attribution