Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: effects on mental health and substance use outcomes in young adulthood

Abstract

Objective: This 15-year follow-up assessed the effects of a preventive intervention for divorced families, the New Beginnings Program (NBP), versus a literature control condition (LC).

Method: Mothers and their 9- to 12-year-olds (N = 240 families) participated in the trial. Young adults (YAs) reported on their mental health and substance-related disorders, mental health and substance use problems, and substance use. Mothers reported on YA's mental health and substance use problems. Disorders were assessed over the past 9 years (since previous follow-up) and 15 years (since program entry). Alcohol and marijuana use, other substance use and polydrug use, and mental health problems and substance use problems were assessed over the past month, past year, and past 6 months, respectively.

Results: YAs in NBP had a lower incidence of internalizing disorders in the past 9 years (7.55% vs. 24.4%; odds ratio [OR] = .26) and 15 years (15.52% vs. 34.62%; OR = .34) and had a slower rate of onset of internalizing symptoms associated with disorder in the past 9 years (hazard ratio [HR] = .28) and 15 years (HR = .46). NBP males had a lower number of substance-related disorders in the past 9 years (d = 0.40), less polydrug (d = 0.55) and other drug use (d = 0.61) in the past year, and fewer substance use problems (d = 0.50) in the past 6 months than LC males. NBP females used more alcohol in the past month (d = 0.44) than LC females.

Conclusions: NBP reduced the incidence of internalizing disorders for females and males and substance-related disorders and substance use for males.

Trial registration: ClinicalTrials.gov NCT01407120.

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Figures

Figure 1

Risk and Protective Factors and Change Strategies Mother Program

Figure 2

Risk and Protective Factors and Change Strategies Child Program

Figure 3

Participant Flow

Figure 4

Cumulative proportion of onset of symptoms for an internalizing disorder since program entry. LC = Literature control condition; NBP = New Beginnings Program condition. For the NBP condition, there was no onset of symptoms for new cases of internalizing disorder after 12 years from program entry and for the LC condition there was no onset of symptoms for new cases of internalizing disorder after 13 years from program entry. The shaded grey area represents time since the six-year follow-up and shows onset of new internalizing disorder during this time period.