Psychological Approaches to Alcohol Related Problems in Adolescence


Written by Rhiannon White | Edited by Sahng-Ah Yoo

Bridging the gap between the endless summer of childhood and the independence of adult life, adolescence may perhaps always be difficult. The ages of 11 to 15 are times of social pressures, first experiences and important decisions. But recently, with the number of units of alcohol consumed by young people increasing steadily, underage drinking has begun to pose a whole new set of problems.

Excessive alcohol is bad for you at any age. But inexperience, impulsivity and an underdeveloped brain often make the effects of alcohol far more damaging in an adolescent than they would be to an adult. Newbury-Birch, et al (2009) reviewed research into the consequences of early drinking, and found that these outcomes were almost exclusively negative. This includes both short- and long- term psychological and neurocognitive health effects, as well as acute illness and injury. Developing interventions to reduce adolescent alcohol consumption is therefore of great importance. Dr Emma Davies has been aiming to do just this, using different psychological theories as the underpinnings of a novel intervention technique.

Modelling Behaviour
The first step to changing behaviour is to understand it. Applying Ajzen’s (1991) Theory of Planned Behaviour to the particular act of drinking, there seem to be three factors that would predict alcohol consumption:

  • an adolescent’s attitude towards drinking
  • an adolescent’s perception of other people’s alcohol-related attitudes and behaviour, and
  • an adolescent’s perception of how much control they have over their drinking behaviour

The combination of these factors elicit a level of intention that has been thought to determine actual drinking behaviour. However, more recent work suggest that the relationship between intention and actual behaviour is a bit more complicated than a simple positive linear association.

Sheeren (2002) conducted a meta-analysis and showed that there might actually be a considerable gap between intentions and behaviour, with intentions able to account for only about 28% of the variance in future behaviour. In adolescence, this gap may be even greater due to the high degree of impulsivity and susceptibility to external/peer influence that characterises this age group. Adolescents may be more likely to take risks, showing reduced top-down control and inhibitory processing, which may be linked to immaturity of the prefrontal cortex (Blakemore & Robbin, 2012).

The Prototype Willingness model suggests behaviour may result from either of two pathways: the rational or spontaneous pathway. While the rational pathway involves more considered and analytical consideration of behavioural intentions, the spontaneous pathway involves images and heuristics that may lead to a particular behaviour being displayed even if it is not originally intended. Adolescents are thought to possess cognitive representation, or social images, of what a prototypical person who engages in a particular type of behaviour is like. These images are related to willingness to engage in that behaviour – for example, if adolescents view drinkers more favourably, they are more likely to engage in this behaviour themselves.

Developing an Intervention
If favourable images do increase the likelihood of a particular behaviour, creating a less favourable prototype drinker in adolescents may be a means of reducing drinking behaviour. This was addressed by Dr Davies’ Alcohol Smart Quiz, encouraging adolescents to think about the consequences of drinking.

The intervention also involved creation of an implementation plan, helping adolescents decide what they would do in a particular situation should it arise. This may reduce the adverse effects of spontaneous decision making and peer pressure on alcohol consumption.

The process of refining this intervention has involved interviews with young people and their teachers and parents, and building on the ideas put forwards. The response has so far been favourable, indicating the usefulness of basing practical intervention measures on psychological theory.


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