Validation of the Automatic Balloon Analogue Risk Task in Adolescents of Peri-rural Uganda

Background: Risk-taking behaviors are a known source of vulnerability for people of all ages, but they are known to disproportionately affect young people, especially adolescents. To investigate this, psychologists have developed the Balloon Analogue Risk Task (BART), one of the most widely used measures of risk-taking in adolescents. The Bart is an internally consistent measure that has also been found to relate to real-world risk-taking, as well as mental health outcomes. Problematically, this has almost exclusively been studied in WEIRD (Western, Educated, Industrialized, Rich, Democratic) participants. The current study aims to validate the Bart and investigate these associations in adolescents of peri-rural Uganda. Methods: A total of 310 adolescents, aged 15-19 years (mean age = 17.01), from peri-rural Uganda participated in the study. The BART was used to measure risk-taking behavior, and participants completed self-report questionnaires assessing real-world risky behaviors and mental health. After addressing the Bart’s internal consistency and response processes, we tested for the association between risk taking in the Bart and both, real world risky behavior and mental health outcomes, using a combination of factor analytic and regression analyses. Findings: Split-half reliability analyses showed that Bart had good internal consistency, and response processes were in line with what is known from WEIRD samples. Also, in line with WEIRD samples, on average participants took less risk than is optimal in the BAR, suggestion they are risk averse. Despite an adequate sample size, we observed no significant associations between Bart and real-world risky behaviors. However, we found that the Bart was oppositely associated with two independent latent factors of mental health: adolescents who took more risks in the Bart were those with greater emotional well-being and less anxiety. Conclusions: These findings suggest that the Bart is a valid measure of risk-taking in peri-rural Uganda, and they provide new important insights into the relationship between risk-taking and mental health during adolescence.