Childhood intervention can stop ‘deaths of despair’

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The death rate among young adults in the US is increasing in part from “deaths of desperation” – preventable deaths from suicide, drug overdose, and alcohol-related liver disease. An intense intervention program for children called Fast Track could help reduce these deaths by reducing risky behaviors in adolescence and young adulthood. This is the result of new research from Duke University and the behavioral prevention research group.

“To lessen the death of desperation, we must prevent the hopelessness and destructive behavior that often lead to these deaths,” said study co-author Kenneth A. Dodge, William McDougall Distinguished Professor of Public Policy Studies at the Sanford School of Public Policy at Duke. Dodge is a member of the Behavioral Problem Prevention Research Group that created the Fast Track program.

“We knew the Fast Track Intervention was effective in reducing childhood aggression and criminal arrest in early adulthood,” said Dodge. “This latest study shows that this early intervention also has positive effects in increasing hope and reducing behavior in despair.”

Factors that contribute to death from despair include hopelessness, cynicism, poor interpersonal skills, and conflict and failure in social relationships. Many of these factors date from childhood and are ripe for preventive intervention, Dodge said.

“We developed the Fast Track Program to increase emotional awareness and interpersonal skills in children who are at high risk of peer conflict, antisocial and delinquent behavior, and life course,” said Dodge. “The intervention started when the children were in first grade and lasted 10 years. Participants are now in their mid to late thirties.”

Participants came from high-risk elementary schools in Durham, North Carolina; Nashville, Tennessee; rural Pennsylvania and Seattle, Washington. From the first grade onwards, students were randomly selected to either receive Fast Track or to be followed as a control group.

The results show a lower rate of “behaviors of desperation” in young adulthood for fast-track participants than for the control group.

In young people aged 15 to 25, the fast-track intervention was associated with significantly fewer thoughts or thoughts of suicide. Within the control group, 24.3 percent reported suicidal thoughts, compared to just 16.3 percent of the Fast Track participants – a difference of 45.1 percent.

The rate of dangerous drinks was also lower among young people participating in Fast Track. Among study participants aged 15 to 25, 14.9 percent of the control group reported dangerous drinking, compared with 8.9 percent of the Fast Track participants – a difference of 45.3 percent.

In addition, opioid use was significantly lower in fast track participants. Within the control group, 4.1 percent said they used opioids at least once a week. Among former Fast Track participants, 1.7 percent used opioids at least weekly – a difference of 61.2 percent.

“Our results suggest that prevention programs designed to facilitate the acquisition of social and behavioral skills in children with behavioral problems could reverse the alarming increase in desperate illnesses in early and middle age,” the study said.

“The breadth and extent of the positive effects are a clear argument for the value of early holistic, developmental psychological interventions in which the child, family and school reduce preventable self-inflicted mortality.”

Working with aggressive children prevents some from becoming violent, criminal adults

More information:
Jennifer W. Godwin et al., Effects of Fast Track Intervention on Despair Behavior in Adolescence and Young Adulthood, Proceedings of the National Academy of Sciences (2020). DOI: 10.1073 / pnas.2016234117 Provided by Duke University School of Nursing

Quote: Childhood Interventions Can Prevent the Death of Despair (2020, December 17), accessed December 17, 2020 at

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