Interventions in school years can prevent "deaths of despair"

While most of these deaths are driven by external factors, interventions can still help prevent them.

Interventions in school years can prevent "deaths of despair"
Credit: Daniel Reche from Pexels
  • A decades-long study suggests childhood interventions are effective against deaths of despair.
  • The students who had interventions went on to drink less, engage in less risky behavior, and reported less self-harm.
  • The findings suggest that similar programs have the potential to save countless lives.

The increase in the number of deaths of despair over the past few years has been catastrophic to some communities and demographics. Among Americans aged 25 to 44, suicide has become the second leading cause of death, liver disease has risen to sixth alongside dangerous drinking habits, and the number of opioid overdoses continues to increase.

There are several factors behind these statistics. The decline of economic opportunity for large swaths of American society, the well-recorded pushing of opioid painkillers on people who didn't need them, and genetic predispositions towards certain behaviors are among them. However, many studies have shown that there are a number of quite malleable elements that can be the subject of intervention in addition to these external or genetic factors.

A recent study published in the Proceedings of the National Academy of Sciences followed two decades of interventions with at-risk children and recorded their outcomes compared to peers left to their own devices. The findings may offer a partial solution to the crisis.

The road to despair often begins in childhood

Studies have found that there are "behaviors of despair," such as a tendency towards suicidal ideation or substance abuse, which can lead to deaths of despair later. These behaviors are predicted by other factors, such as impulsivity or a lack of healthy stress coping mechanisms. In principle, these factors can be addressed by intervention programs. If these behaviors are controlled or prevented at the source, then the later deaths can be prevented as well.

Since many of these factors arise in childhood, the researchers started there with a program that aims to give children the skills needed to avoid developing behaviors of despair in the first place.

The program they used, Fast Track (FT), is an intervention program centered around the idea that multiple factors can leave a child without the social skills, academic preparedness, or ability to regulate the behavior that can help prevent them from having issues later in school and as young adults.

Starting with at-risk children in kindergarten in 1991, the researchers identified children in participating schools that scored high on a diagnostic for aggressive behavior in the classroom. These children and their parents were sorted into control and experimental groups. Those in the experimental group got the whole package of interventions. These focused on building the student's social skills, reducing their impulsivity, helping the parents form a more positive relationship with their child, and in-school interventions to help the student succeed.

Check-ins and tests followed over the subsequent years, in hopes of determining the success of the interventions.

The results were dramatic. There was an immediate reduction in aggressive or disruptive behaviors at home and school. While these benefits seemed to decline as the children reached middle school, they returned as they reached high school.

Later on, when the students began to report their drug and alcohol use, those who had interventions engaged in hazardous drinking 46 percent less than their peers who had not. Their weekly opioid use was 61 percent lower, and they were much less likely to report suicidal tendencies. These benefits existed for students of all demographic groups.

The children who were in the study are now in their 30s. With any luck, they will do better than many of their peers.

What can we take away from this? That a long-term, holistic program aimed at giving students the skills they need to succeed may help prevent many of the behaviors of despair, which can lead to adverse life outcomes. The authors argue that the program's long-term nature, up to 10 years in some cases, was vital to its success. Additionally, they say that the program's multifaceted approach, especially when focusing on interpersonal relationships, allowed it to help the students overcome challenges that could have driven them to drug use or self-harm:

"...our findings suggest that prevention programs aimed at facilitating the solid acquisition of key social, behavioral, and academic skills in children at risk for conduct problems could be one way to reverse the alarming rise in early and midlife mortality due to deaths of despair."

The findings are not nationally representative, though they include results for a diverse group of students from across the country. While the authors maintain that the results are generally applicable, it remains possible that some detail could arise in a more comprehensive study that was not seen here. The study could not control genetic predispositions to despair, perhaps causing the results to skew one way or the other.

Despite these limitations, the study's basic findings are likely generally applicable. Additionally, it supports previous studies that suggest that these interventions' focus should be on helping the children acquire specific academic, social, and behavioral skills.

While teaching at-risk students social skills and helping them in school won't end the crisis we find ourselves in by itself, this study offers us a powerful tool for saving lives. Let us hope that it will be used alongside more comprehensive efforts to make life better for everyone.

If you are having suicidal thoughts, help is available. The Suicide Hotline can be reached at 1-800-273-8255.

A landslide is imminent and so is its tsunami

An open letter predicts that a massive wall of rock is about to plunge into Barry Arm Fjord in Alaska.

Image source: Christian Zimmerman/USGS/Big Think
Surprising Science
  • A remote area visited by tourists and cruises, and home to fishing villages, is about to be visited by a devastating tsunami.
  • A wall of rock exposed by a receding glacier is about crash into the waters below.
  • Glaciers hold such areas together — and when they're gone, bad stuff can be left behind.

The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.

Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .

"It could happen anytime, but the risk just goes way up as this glacier recedes," says hydrologist Anna Liljedahl of Woods Hole, one of the signatories to the letter.

The Barry Arm Fjord

Camping on the fjord's Black Sand Beach

Image source: Matt Zimmerman

The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.

Not Alaska’s first watery rodeo, but likely the biggest

Image source: whrc.org

There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.

The Barry Arm event will be larger than either of these by far.

"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."

Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.

What the letter predicts for Barry Arm Fjord

Moving slowly at first...

Image source: whrc.org

"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."

The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.

Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.

Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.

While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.

Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."

How do you prepare for something like this?

Image source: whrc.org

The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:

"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."

In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.

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