Omega-3 Supplementation to Reduce Externalizing Behavior Problems in Risk-Taking Adolescents: A Randomized, Placebo-Controlled, Double-Blind Trial

Description

Externalizing behavior problems (aggressive and antisocial behaviors) are widelyrecognized as predisposing to significant mental health problems and violence amongadolescents in secondary schools. These in turn result in enormous economic and socialcosts to schools as well as to society (Snyder & Sickmund, 1999). These costs includemental illness, crime, and violence. Similarly, violence is widely recognized as a majorpublic health problem which has also largely defied successful intervention andprevention. Because an increasing body of research is documenting health andneurobiological risk factors for aggression and violence, part of this prevention failuremay be due to intervention efforts ignoring biological contributory factors which includeimpaired neurocognitive and psychophysiological functioning. One benign biologicalintervention that may help attenuate behavior problems in children consists of omega-3supplementation of the diet, a long-chain fatty acid critical for brain structure andfunction.The overarching aim of this study is to assess whether omega-3 supplementation canreduce the base level of externalizing behavior problems in children and adolescents.Secondary but important aims are to assess whether any behavioral improvement is dueto enhanced neurocognitive and psychophysiological functioning produced by omega-3supplementation.The specific aims are as follows:1. To assess the effectiveness of omega-3 dietary supplementation in reducingexternalizing behaviors in adolescents.2. To assess whether omega-3 supplementation can enhance childhood neurocognitiveand psychophysiological functioning.3. To assess whether any such enhanced neurocognitive functioning mediates therelationship between omega-3 enhancement and reductions in externalizing behavior.Hypotheses will be tested in a placebo-controlled, double-blind, randomized trialinvolving 11 to16 year-old adolescents drawn from secondary schools in Hong Kong.Omega-3 supplementation will be in the form of a Norwegian fruit juice drink. 300adolescents will be randomly assigned into: (1) omega-3 supplemented drink, (2) placebodrink, (3) treatment-as-usual controls. Behavioral, neurocognitive, andpsychophysiological measures will be assessed at baseline (0 months), end of treatment(6 months), and 6 months post-treatment (12 months).This initial study could be the first to identify possible mechanisms of action by whichomega-3 may reduce behavior problems in children, and the first to document efficacyof omega-3 in reducing behavior problems in an East Asian population. If successful,this study could yield enormous long-term financial benefits in terms of the saved legal,medical, social, and psychological costs resulting from the long-term consequences ofadolescent behavior problems.