• By Dartington SRU
  • Posted on Monday 24th November, 2014

Measuring “sense of coherence” – a new tool for predicting risky health behaviours?

The ability to identify young people prone to risky health and sexual behaviours could help reduce the likelihood of negative life outcomes, and ultimately costs for public health services. A recent study of teenage girls in the UK revealed that those who saw their world as chaotic and uncontrollable were more likely to be involved with alcohol, drugs, and risky sex.

People with a low “sense of coherence” often feel that the world is meaningless. They don’t believe they can cope with what life throws at them. They are likely to say they don’t really care about what goes on around them, and that they have been let down by people they trusted.

Those with a lower sense of coherence and more pessimistic views of the world may be more prone to using poor coping strategies, such as drinking or smoking, as a way of release. By contrast, those who score high on measures of sense of coherence are more likely to feel they can meet life’s demands and are less prone to stress and tension.

Perhaps a strong sense of coherence can promote good health and build resilience. If so, programmes that help young people see meaning in their lives and build confidence in their own abilities might help them steer clear of risky health behaviours.

A recent survey of about 200 teenage girls in the UK revealed a significant link between risky health behaviours and a sense of coherence. Those with a stronger and more positive sense of coherence were less likely to engage in risky health behaviours. There has previously been little research into SOC as a marker of risky health behaviour, so this finding is novel and exciting, with implications for future research and intervention.

The sample consisted of adolescent girls who had completed the UK Teens and Toddlers programme, which aims to foster a sense of coherence. In this programme, teenage girls who have been identified as being at risk of becoming a teenage parent or NEET (not in employment, education or training) are paired with a preschool child to interact with and mentor.

The logic of the programme is that, through combining experiential learning and education, the girls develop life skills and their self-belief, and consequently build their aspirations to remain in education and employment.

Participants who had previously been in the programme were asked to complete questionnaires that measured their involvement in risky health behaviours (RHB) and their sense of coherence (SOC). In formal terms, a sense of coherence is defined as “the extent to which one has a pervasive, enduring though dynamic, feeling of confidence that one’s environment is predictable and that things will work out as well as can reasonably be expected.”

The correlation between RHB and SOC was moderate (about -0.4), showing that, on average, girls who reported more risky behaviour also reported a lower sense of coherence.

This study has shed some light on the uncertain world of risky health behaviours in adolescence, providing evidence that this sort of behaviour may be linked to one’s sense of coherence. This suggests that measuring an individual’s sense of coherence could have predictive value for identifying teenagers who are more prone to risky behaviour such as early sexual activity and misusing substances.

The main limitation with the current study was that the participants completed the measures at a single time point. Therefore, there is no way of monitoring the relationship between sense of coherence and risky health behaviour over time, or whether the Teens and Toddlers programme influenced this relationship.

It is also possible that the causal relationship runs the opposite direction: engaging in risky health behaviours could decrease one’s sense of coherence. For instance, heavy use of drugs and alcohol could create situations that are unpredictable or out of control, and also damage one’s ability to respond to challenges with healthy coping strategies.

Despite significant limitations, this study provides some important insights with implications for future research and intervention. It appears that a low sense of coherence is associated with increased likelihood of risky behaviour. Therefore, by targeting and improving teenagers’ sense of coherence, through youth development programmes such as Teens and Toddlers, we can plausibly reduce risky health behaviours and the adverse life outcomes that arise as a result.


Humphrey, K., & McDowell, A. (2013). Sense of coherence as a predictor of risky health behaviours amongst teenage girls on a targeted youth development programmeme. Journal of Public Mental Health, 12(3), 146-152. DOI 10.1108/JPMH-10-2012-0009

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