A network analysis of alcohol-related harms: an exploratory study in United Kingdom adolescents

Background: This study applied a network analysis approach to the study of individual self-reported alcohol-related harms (ARHs) across four waves of data.

Methods: Data were from a large clustered randomised control trial (N = 12,738) involving 105 schools. Data were collected at 4 time points over 4 academic years (mean age 12.5 [Time 0], 13.5 [T1], 14.5 [T2], and 15.3 years [Time 3]). Data were gathered on the experience of 16 separate ARHs experienced during the previous six months, and these were dichotomised (yes/no). We estimated cross-lagged panel networks for the 16 ARHs, capturing both the auto-regressive relationships (a harm predicting itself at follow up) and the cross-lagged relationships (a harm predicting another harm at follow-up) across the study (T0 → T1; T1 → T2; T2 →T3).

Results: Exposure to all ARHs increased with age. However, the most serious ARHs (e.g., getting in trouble with the police because of your drinking) remained relatively rare, even at age 15. Actively planning to get drunk, coupled with an inability to control levels of intoxication (drinking more than planned) appeared central to each network, facilitating the emergence of all other ARHs. While the prevalence of ARHs increased with age, network complexity declined, and networks becoming more stable.

Conclusions: Interventions aimed at improving the capacity to self-regulate alcohol consumption, and actively challenging the planning of drunken episodes, may be pivotal in reducing the emergence of both acute and chronic ARHs in adolescence.