Identifying Targets for School-Based Prevention Programs: A Gene by Intervention Interaction with Impulsive Behaviors

Introduction. A variety of school-based preventive interventions have been developed to address behavioral and mental health problems, however there have been few long-term follow-ups to randomized controlled trials, and none have examined potential genetic factors that may explain some of the variability in the intervention impacts. With a more complete explanation of the variation in intervention impacts, we may be able to identify targets for prevention programs.  We are particularly interested in a family focused intervention as well as widely used classroom-based intervention, called the Good Behavior Game (GBG; Barrish, Saunders, & Wolfe, 1969) which was combined with academic enhancements. The two programs were contrasted with a control condition through a randomized controlled trial (RCT). We examine the extent to which the longitudinal effects of the school-based interventions were moderated by brain derived neurotrophic factor (BDNF) gene, which codes for a protein related to reward pathways and dopaminergic functioning, and has been liked with impulsivity.

Methods. A RCT tested the long-term impacts of the school-based prevention program on behavioral and mental health outcomes through age 24. The sample included 678 urban, primarily African American children who were in first grade classrooms randomized to one of three conditions:  classroom-centered (CC) intervention, which combined the GBG with an enhanced academic curriculum; Family School Partnership (FSP), focused on promoting parental involvement in educational activities and behavior management strategies; or a control condition. Teacher ratings of youth’s impulsive behavior were obtained at baseline and in grades 6-12 via the Teacher Observation of Classroom Adaptation-Revised. SNPs from the BDNF gene were extracted from the genome wide data at ages 19-24. Longitudinal latent trait-state error models indicated a significant interaction between a particular profile of the BDNF haplotype (46% of sample) and CC intervention on impulsivity (β = -.53, p < .01).  A similar interaction was observed for the BDNF haplotype and the FSP intervention on impulsivity (β = -.56, p < .01).

Conclusion. The results illustrate how impacts of preventive interventions in early elementary school on late adolescent outcomes of impulsivity can be modified by genetic factors, such as BDNF. Additionally, the results of this study add support to the development of personalized prevention programs aimed at reducing impulsive behaviors in at-risk youth.