Personality-targeted web-based prevention of common mental disorders in adolescents

One in ten adolescents in the UK suffers from a diagnosable mental disorder and a similar proportion shows symptoms below clinical threshold. The most prevalent problems in this age group are depression, anxiety, substance misuse and disordered eating, which have their first or peak onset during adolescence. These mental disorders can cause disruption to the development of adolescent and have far-reaching effects, whose full personal and socio-economic impact often only becomes apparent at a later stage in life.

There is considerable overlap between these common mental disorders with regard to symptoms, underlying causes and contributing factors. For example, these common mental disorders are associated with shared personality factor, such as an anxious personality, high perfectionism, impulsivity and/or low self-esteem. Several school-based interventions aiming to prevent the onset of mental disorders exist. However, our recent analysis and review of these interventions for this age group found that most of them address only single disorders and are only designed for individuals already expressing symptoms of mental ill-health. This traditional approach does not address the overlap in risk factors or psychopathology and thus is inefficient with regard to time, effort and cost. In addition, targeting only children and adolescents who show symptoms can be experienced as stigmatising and pathologising.

In this early phase study, we are aiming to develop and evaluate the feasibility of a school-based intervention targeting shared personality risk factors of common mental disorders. The intervention will be based on an existing intervention, which we have developed for undergraduate university students, which has demonstrated efficacy in a large study. the intervention will be delivered in the classroom as well as through the internet. This mixed approach will allow for the intervention to be delivered to all children in a class or year group without stigmatising individuals and also allow for a degree of personalising the content of the intervention for each user in order to optimally support them with their mental health needs.

This early phase study aims to investigate the feasibility of a personality-targeted web-based prevention programme targeting common mental disorders in adolescents. One in ten adolescents in the UK suffers from a diagnosable mental disorder and a similar proportion shows symptoms below clinical threshold. The most prevalent problems in this age group are depression, anxiety, substance misuse and disordered eating, which have their first or peak onset during adolescence. There is considerable overlap between these disorders with regard to aetiology and symptomatology. These disorders have shared personality risk factors, such as trait anxiety, high perfectionism, impulsivity and/or low self-esteem, and one in four adolescents with one of these disorders also fulfils criteria for a second or third disorder.
Several school-based primary prevention interventions for mental health exist. However, our recent review of interventions for this age group found that most of these interventions address only single disorders and are only designed for individuals already expressing symptoms of mental ill-health. This approach has significant drawbacks: 1) targeted interventions potentially stigmatise those taking part, 2) focussing on single disorders does not address the overlap in risk factors or psychopathology, and 3) it is inefficient.
The intervention in this project is based on an intervention developed for university students, which demonstrated efficacy in a large randomised controlled trial (RCT). In this study, we will adapt and refine the intervention for the use in adolescents, and ascertain the feasibility of investigating the intervention as a public health initiative in schools. The intervention will target the shared personality risk factors underlying common mental health problems and will combine classroom-based and web-based delivery. This will allow for the intervention to be delivered universally and for the intervention content to be personalised.