Effects of parental alcohol rules on risky drinking and related problems in adolescence: Systematic review and meta-analysis

Adolescent Hazardous Drinking and Socioeconomic Status in France: Insights Into the Alcohol Harm Paradox

PURPOSE

The "alcohol harm paradox" has been evidenced among adults, but it is still largely unexplored among adolescents. We examined in a sample of French adolescents the relation between family socioeconomic status (SES), family living arrangement and parental substance use on 1 hand, and heavy episodic drinking (HED), lifetime alcohol-induced emergency room visits (A-ERV), and number of alcoholic drinks and solitary drinking during the last episode on the other hand.

METHODS

A cross-sectional nationwide survey in March 2017 involved 13,314 French adolescents aged 17-18.5 years. They completed a pen and paper questionnaire about their own and their parents' alcohol and tobacco consumption. We used risk ratios (RRs) from modified Poisson regressions to assess the relationships.

RESULTS

Adolescents from the lowest SES had reduced likelihood of reporting 1-2 or 3-5 episodes of heavy drinking compared to those from the highest SES (RR = 0.58, 95% confidence interval = [0.50; 0.66] and 0.35 [0.27; 0.45]), but no difference for six or more episodes (RR = 0.81 [0.59; 1.12]). A-ERV was more frequent among lowest SES adolescents (RR = 1.86 [1.05; 3.30]), possibly due to drinking larger quantities of alcohol and to more frequent solitary drinking in their last episode (p < .001). SES, parental substance use, and family living arrangement were independently associated with HED.

DISCUSSION

Our findings reveal an "alcohol harm paradox" in late adolescence in France. Lower SES adolescents exhibit reduced HED but were more likely to consume large quantities alone and experience A-ERV. This emphasizes the significance of considering social determinants in alcohol-related research and interventions.

The significance of information variables in polydrug use by adolescents: insights from a cross-sectional study in Tarragona (Spain)

Substance use, especially among adolescents, is a significant public health concern, with profound implications for physical and psychological development. This study aimed to evaluate the quantity and sources of information available to adolescents regarding polydrug use. A cross-sectional survey was conducted in Tarragona involving adolescents with an average age of 16.44 years. This study assessed the number of substances used (alcohol, cigarettes, and cannabis) in the past month, along with information sources related to substance use. Monitored sources (e.g., schools, parents, and mass media) and unmonitored sources (e.g., peers, siblings, internet) were distinguished. In addition, four individual and four environmental control variables were considered. Multinomial logistic regression analysis revealed that incorporating variables related to adolescents' substance use information and its sources enhanced the explanatory model, surpassing control variables. The degree of information about substance use did not significantly explain consumption patterns, but the number of information sources, both monitored and unmonitored, did. The unmonitored sources were associated with increased polydrug use. Conversely, greater reliance on supervised sources for information was linked to reduced single-substance and polydrug use. This protective effect increased with an increase in the number of substances used. In conclusion, information obtained from monitored sources acts as a deterrent to substance consumption, consistent with findings suggesting that greater health literacy among adolescents discourages substance use. Conversely, this study suggests that information from more informal sources may encourage heavier polydrug use, aligning with reports indicating that adolescents with a more comprehensive understanding of substance use consequences tend to engage in heavier drug use.

Using Non-Violent Discipline Tools: Evidence Suggesting the Importance of Attunement

Training in non-violent discipline is important to prevent violence against children and ensure that their caregivers remain a safe base for them. This paper aims to deepen understanding of non-violent discipline by exploring attunement as a mechanism in the effectiveness of non-violent discipline tools. Attunement describes the sensitive responsiveness of caregivers towards their children and has been found to be central to the formation of secure attachment bonds and development of self-regulation. It includes understanding or being "in tune with" the child's needs and signals, matching these with appropriate responses. The objective of this paper is to explore attunement in relation to non-violent discipline. Peer-reviewed systematic reviews previously included in a systematic overview of evidence on non-violent discipline options were screened for information relevant to attunement. All reviews were published in English between 1999 and 2018 and offered evidence on at least one non-violent discipline tool. Although no reviews explicitly addressed attunement, evidence was found suggesting its importance in the use and effectiveness of discipline methods. Research directly investigating attunement in discipline is needed.

Prevention of hazardous use of alcohol among high school students: a study protocol for the randomized controlled trial 'Our choice'

BACKGROUND

Adolescent hazardous alcohol use is prevalent and has serious short- and long-term consequences. The trial 'Our Choice' examines efficacy, feasibility and acceptability of prevention interventions targeting school, parent, and student levels at Danish high schools. We hypothesize that students in a structural intervention (school and parent levels) reduce hazardous alcohol use and related health behaviors compared to students in an assessment only control group 12 months post baseline; and that adding group-based Motivational Interviewing (group MI) yields further improvements. The study examines the efficacy of interventions targeting multiple levels with the aim of providing novel insights into prevention of adolescent hazardous alcohol use and related health outcomes.

METHOD

The study employs a parallel group cluster randomized controlled trial design with three conditions: (1) structural condition targeting school and parent levels, (2) structural condition combined with group MI which also targets the student level, and (3) assessment-only control condition. A participatory approach is used to adapt and develop interventions. Sixteen high schools in Denmark and about N = 3100 first-year students (15-18 years) enrolled in high school in August 2023 will be recruited. Data will be collected via online questionnaires pre-interventions (baseline), 2, 6, 9 and 12 month post baseline and analyzed with generalized linear mixed models. The primary outcome is past month high intensity drinking; secondary outcomes are alcohol use, alcohol-related consequences, well-being, tobacco, and illegal substance use. Feasibility and acceptability will be assessed via surveys (students) and interviews (high school staff) to inform future implementation.

DISCUSSION

'Our Choice' is the first trial to compare the efficacy of a structural intervention targeting school- and parent levels to an intervention targeting these levels and the student level via group MI - on hazardous drinking and related health outcomes among students. Preventing and reducing hazardous alcohol use during adolescence is crucial due to the short- and long-term negative consequences. The tested interventions can be implemented at low cost. The study has significant implications for adolescent health and well-being and has potential to inform evidence-based decisions on alcohol prevention policy, education, and health professions.

TRIAL REGISTRATION NUMBER

The trial was retrospectively registered at ClinicalTrials.gov on August 24th, 2023.

TRIAL REGISTRATION NUMBER

ID NCT06018389.

Sensation seeking, drinking motives, and going out mediate the link between eveningness and alcohol use and problems in adolescence

The present study was aimed at obtaining a more comprehensive understanding of the possible mediating factors in the morningness-eveningness → alcohol consumption relation. We explored the role of mediators such as sensation seeking, the frequency of going out in the evenings, and drinking motives. We tested the proposed mediation model via structural equation modeling based on cross-sectional research conducted among Hungarian adolescents and young adults (N = 1695, 42.5% male, Mage = 18.98, SDage = 1.89). The outcomes included the frequency of alcohol consumption and problematic drinking. Both alcohol consumption and problematic drinking were predicted in similar directions and magnitudes by sensation seeking, "going out," and coping drinking motives. However, eveningness still had a significant direct effect on alcohol consumption and problematic drinking after we controlled for sensation seeking, going out, and drinking motives. For problematic drinking, the possible role of drinking motives seems to be higher and more complex than it is for alcohol consumption. The mediators, such as sensation seeking, the amount of time spent out in the evenings, and drinking motives, can explain the eveningness → alcohol consumption relationship and should be targeted for alcohol prevention programs among evening-type adolescents.

Paternal and Maternal Problem Drinking and Lifetime Problem Drinking of Their Adult Children

Parents' alcohol use is associated with alcohol use of their adolescent offspring, but does this association extend to the adulthood of the offspring? We examined associations of paternal and maternal problem drinking with lifetime problem drinking of their adult offspring prospectively assessed in a population-based Finnish twin-family cohort (FinnTwin16). Problem drinking (Malmö-modified Michigan Alcoholism Screening Test) was self-reported separately by mothers and fathers when their children were 16. The children reported on an extended lifetime version of the same measure during their mid-twenties (21-28 years) and mid-thirties (31-37 years). 1235 sons and 1461 daughters in mid-twenties and 991 sons and 1278 daughters in mid-thirties had complete data. Correlations between fathers' and their adult children's problem drinking ranged from .12 to .18. For mothers and their adult children, these correlations ranged from .09 to .14. In multivariate models, adjustment for potential confounders had little effect on the observed associations. In this study, parental problem drinking was modestly associated with lifetime problem drinking of their adult children. This association could be detected even when the children had reached the fourth decade of life.

The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review

(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.

Culturally sensitive prevention programs for substance use among adolescents of color: A systematic review and meta-analysis of randomized controlled trials

This systematic review and meta-analysis aims to synthesize the efficacy of culturally sensitive prevention programs for substance use outcomes among U.S. adolescents of color (aged 11 to 18 years old) and explore whether the intervention effects vary by participant and intervention characteristics. Eight electronic databases and grey literature were searched for eligible randomized controlled trials through September 2022. Robust variance estimation in meta-regression was used to synthesize treatment effect size estimates and to conduct moderator analysis. After screening, 30 unique studies were included. The average treatment effect size across all substance use outcomes (including 221 effect sizes) was Hedges's g = -0.20, 95% CI = [-0.24, -0.16]. The synthesized effect sizes were statistically significant across types of substances (alcohol, cigarette, marijuana, illicit and other drugs, and unspecified substance use), racial/ethnic groups (Hispanic, Black, and Native American), and different follow-ups (0-12 months, >12 months). Very few studies reported substance use consequences as outcomes and the synthesized effect size was non-significant. Meta-regression findings suggest that the intervention effects may vary based on the type of substance. This meta-analysis found supportive evidence of culturally sensitive prevention programs' efficacy in preventing or reducing substance use among Black, Hispanic, and Native American adolescents. More substance use prevention efforts and evidence is needed for Asian American, Pacific Islander, and multiracial adolescents.

The Relationship between Parental Monitoring, Peer Pressure, and Motivations for Responsible Drinking among Italian Adolescents: The Mediating Role of Positive Alcohol Expectancies

This study investigated the associations between parental monitoring, peer pressure, and motivations for responsible drinking, while also taking the mediating role of positive alcohol expectancies into account. The participants were 579 Italian adolescents, aged 14-20 years (M = 16.39 years, SD = 1.27; 55.3% females), involved in a cross-sectional survey. They were administered online self-report questionnaires. Structural equation modeling revealed both direct and indirect positive associations between study variables. Parental monitoring was positively associated, both directly and indirectly, with adolescents' motivations for responsible drinking through the mediation of positive alcohol expectancies; peer pressure was negatively and indirectly associated with adolescents' motivations for responsible drinking, via the mediating role of positive alcohol expectancies. Findings highlighted the importance of environmental factors with regard to motivations for responsible drinking, suggesting the opportunity to implement prevention programs to improve parental monitoring and increase adolescents' skills to manage peer pressure and to develop realistic expectancies about drinking.

The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis

Placental histopathology provides insights, or "snapshots", into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption versus without abruption. Records were sourced from MEDLINE, Embase, and the CENTRAL Trials Registry from 1946 to December 2019. Studies followed the PRISMA guidelines and compared frequencies of neurodevelopmental morbidities in infants born to pregnant women with placental abruption (exposure) versus women without placental abruption (comparator). The primary endpoint was cerebral palsy. Periventricular and intraventricular (both severe and any grades of IVH) and any histopathological neuronal damage were the secondary endpoints. Study methodologic quality was assessed by the Ottawa-Newcastle scale. Estimated odds ratios (OR) and hazards ratio (HR) were derived according to study design. Data were meta-analyzed using a random effects model expressed as pooled effect sizes and 95% confidence intervals. We included eight observational studies in the review, including 1245 infants born to women with placental abruption. Results of the random effects meta-analysis show that the odds of infants born to pregnant women with placental abruption who experience cerebral palsy is higher than in infants born to pregnant women without placental abruption (OR 5.71 95% CI (1.17, 27.91); I² = 84.0%). There is no statistical difference in the odds of infants born to pregnant women with placental abruption who experience severe IVH (grade 3+) (OR 1.20 95% CI (0.46, 3.11); I² = 35.8%) and any grade of IVH (OR 1.20 95% CI (0.62, 2.32); I² = 32.3%) vs. women without placental abruption. There is no statistically significant difference in the odds of infants born to pregnant women with placental abruption who experience PVL vs. pregnant women without placental abruption (OR 6.51 95% CI (0.94, 45.16); I² = 0.0%). Despite our meta-analysis suggesting increased odds of cerebral palsy in infants born to pregnant women with placental abruption versus without abruption, this finding should be interpreted cautiously, given high heterogeneity and overall poor quality of the included studies.

Testing the specificity of environmental risk factors for developmental outcomes

Developmental theories often assume that specific environmental risks affect specific outcomes. Canonical Correlation Analysis was used to test whether 28 developmental outcomes (measured at 11-15 years) share the same early environmental risk factors (measured at 0-3 years), or whether specific outcomes are associated with specific risks. We used data from the UK Millennium Cohort Study (N = 10,376, 51% Female, 84% White) collected between 2001 and 2016. A single environment component was mostly sufficient for explaining cognition and parent-rated behavior outcomes. In contrast, adolescents' alcohol and tobacco use were specifically associated with their parents', and child-rated mental health was weakly associated with all risks. These findings suggest that with some exceptions, many different developmental outcomes share the same early environmental risk factors.

Parent/caregiver attitudes, motivations and behaviours in relation to alcohol use among offspring aged 13-18 years: a qualitative study

BACKGROUND

Parental alcohol consumption and alcohol-related behaviour play a critical role in shaping adolescent alcohol use, but comparatively little is known about the perspectives of parents regarding adolescent alcohol use from qualitative studies in England. This study aimed to explore parental views and attitudes towards alcohol use during adolescence, among their offspring and among young people in general.

METHODS

Twenty-three parents (21 mothers, 2 fathers) of children aged 13-18 years were recruited via schools, workplaces and community settings, predominantly in the West of England (n = 19) between 2017 and 2018. Data were collected via in-depth one-to-one interviews and analysed thematically, using an inductive, constructionist approach.

RESULTS

Five major themes were identified in the data: (1) the parental alcohol environment, (2) balance and acceptance, (3) influences of the parental approach, (4) boundaries and parental monitoring, and (5) wider influences shaping young people's behaviour. Overall, parents were aware of the risks and consequences of alcohol use and the wide range of influences shaping drinking behaviour, and expressed broad disapproval of alcohol use among young people. However, adolescent alcohol use was viewed as inevitable, and set within a context of a tolerant drinking culture. Many parents therefore chose a balanced and reluctantly accepting approach. This approach was determined by weighing disapproval of drinking against consistency with wider culture and parental behaviour, support for autonomy of the child, and avoidance of social sanctions. Parents' responses were also determined by a desire to protect the parent-child relationship, maintain an open, communicative and trusting relationship, and ultimately limit risk and minimise harm. Various boundaries and strategies were employed to this end, including care around role modelling, gradual introductions to alcohol, boundaried provision, clear risk reduction messaging and parental monitoring.

CONCLUSIONS

Parents employ a range of mechanisms to reduce alcohol-related risk and to balance harms of alcohol use among their offspring against adolescent behavioural norms. A downward shift in community consumption and changing socio-cultural norms could alter the accepting context in which parents are required to navigate adolescent alcohol use.

Effects of parental attitude and proactive and reactive aggression on cyberbullying and victimization among secondary school students

PURPOSE

To predict the effect of parental attitude and proactive and reactive aggression on the cyberbully, cyber victims, and cyberbully/victim among students aged 9-14 years.

METHODS

This study is a cross-sectional, correlational, and predictive study. The sample included 360 students. Data were collected with the "Adolescence Information Form," "Parental Attitude Scale," "Proactive-Reactive Aggression Scale," and "Cyberbully/Victim Questionnaire." Logistic regression analysis was used.

FINDINGS

This study was determined that proactive-reactive aggression and parental attitude predicted 30.3% of cyberbully/victim cases. Proactive aggression and Internet usage time are essential predictors of cyberbullying cases.

PRACTICE IMPLICATIONS

To protect and improve their children's health, children should be informed about cyberbullying, proactive-reactive aggression, and the duration of Internet use.

To BDZ or not to BDZ? That is the question! Is there reliable scientific evidence for or against using benzodiazepines in the aftermath of potentially traumatic events for the prevention of PTSD? A systematic review and meta-analysis

BACKGROUND

Most international guidelines suggest that benzodiazepines (BDZs) may be inefficient or iatrogenic in the aftermath of a potentially traumatic event (PTE). The goal of this study was to assess the strength of the evidence on whether the use of BDZs in the aftermath of a PTE negatively affects the incidence and severity of post-traumatic stress disorder (PTSD).

METHODS

We systematically scrutinized the ISI Web of Knowledge, MEDLINE, SCOPUS, and PTSDpubs electronic databases in addition to citation searching. We included original studies providing data about the development of PTSD in adults after BDZ administration in the aftermath of a PTE. We screened 387 abstracts and selected eight studies for the qualitative synthesis and seven for the meta-analysis. We performed two separate meta-analyses, one for randomized clinical trials (RCTs) and the other for cohort studies. Heterogeneity between studies was evaluated with Higgins I² statistic and tested using the χ². This study was registered at PROSPERO (number 127170).

RESULTS

The meta-analysis of the cohort studies showed an increased risk of PTSD in patients who received BDZs compared to those who did not (risk ratio (RR) = 1.53; 95% confidence interval (CI): 1.05-2.23) with a modest heterogeneity among studies (I² = 41.8, p = 0.143). Regarding the RCTs, the combined measure revealed a tendency toward an increased severity of the PTSD symptoms (standardized mean difference (SMD): 0.24; 95% CI: 0.32-0.79).

CONCLUSION

The studies reviewed showed a possible harmful effect of BDZs when used immediately after a PTE. However, these conclusions were based on a small number of studies of poor to moderate methodological quality.

Self-Assured and Sober: The Relationship Between Maternal Parenting Sense of Competence, Stress, and Alcohol Use

Alcohol misuse is widespread, creating serious health and parenting harms. It is important to explore the motivations behind why people drink and the modifiable factors determining severity of the behavior. While alcohol-related research has historically focused on men, the closing gender gap in alcohol consumption highlights a need for targeted research on women. Parenting stress is a commonly reported motivation for maternal drinking. Likewise, parenting stress is associated with parenting sense of competence. However, there is no research connecting parenting sense of competence with alcohol use directly, nor indirectly via moderation of the alcohol and parenting stress relationship. The current study explored these associations and investigated the potential moderation through a questionnaire completed by a sample of 406 mothers. There were significant correlations between all factors, however, parenting sense of competence was not a significant moderator of the parenting stress and alcohol use relationship. Specifically, as a mother's parenting stress increases, her confidence in the parenting role tends to decline and she is more likely to misuse alcohol. Despite this, variation in parenting sense of competence among women was not significantly correlated with one's likelihood to drink when coping with stress. Further exploration of these relationships is required, with replication of the current study following the COVID-19 pandemic.

The Role of Parental Control and Support in Declining Adolescent Drinking: A Multi-Level Study Across 30 European Countries

BACKGROUND

Adolescent drinking has declined in many high-income countries since the early 2000s. It has been suggested that changing parenting practices may have contributed to the decline. However, previous studies investigating parenting have focused on single countries and have provided conflicting evidence. This study tested the association between changes in individual- and population-level parental control and parental support and changes in past month adolescent drinking.

METHODS

A total of 271,823 adolescents aged 15-16 years, from 30 European countries between 2003 and 2015 were included in this study. Our key independent variables were adolescent reports of parental control and parental support. Our outcome measure was a dichotomous measure of any alcohol use in the 30 days before the survey, referred as past month drinking. Aggregated measures of parenting variables were used to estimate between-country and within-country effects of parenting on adolescent drinking. Data were analysed using three-level hierarchical linear probability methods.

RESULTS

At the individual-level, we found a negative association between the two parental measures, i.e. parental control (β = -0.003 and 95% CI = -0.021 to 0.017) and parental support (β = -0.008 and 95% CI = -0.010 to 0.006) and past month drinking. This suggests adolescents whose parents exert higher control and provide more support tend to drink less. At a population level, we did not find any evidence of association on between-country and within-country parenting changes and past month drinking.

CONCLUSIONS

It is unlikely that changes in parental control or support at the population-level have contributed to the decline in drinking among adolescents in 30 European countries.

Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries

PURPOSE

Adolescents' perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study.

METHODS

The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents' own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models.

RESULTS

Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents' illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents' own cigarette and alcohol use.

CONCLUSION

Perceived parental permissiveness toward the use of legal drugs predicted adolescents' use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.

The association between familial death in childhood or adolescence and subsequent substance use disorder: A systematic review and meta-analysis

BACKGROUND

Exposure to childhood adversity has been linked to long-term negative mental health consequences in adulthood.

PURPOSE

This review examined the association between exposure to the death of a family member (i.e., parent or sibling) during childhood or adolescence and the subsequent diagnosis of a substance use disorder.

METHODS

Electronic databases (Scopus, Medline (for Ovid), EMBASE, and PsychINFO) were searched for cohort and case-control studies in the English language. Studies were retained if it was demonstrable that exposure to death occurred before age 18, and that disorder was diagnosed subsequently. Sensitivity analyses were performed for the meta-analysis, and study quality assessed using the Newcastle-Ottawa Scale.

RESULTS

Nine studies, seven cohort and two case-control, were retained. Due to differential metrics (hazard ratios [HRs] versus odds/risk ratios [ORs/RRs]), only one meta-analysis was possible. Individuals experiencing familial death had 1.42 (95% CI = 0.96, 2.09) times the odds of developing a substance use disorder compared to those non-exposed. Where there was a statistically significant effect in other studies, these were mostly studies using National Registers (1.4 ≤ HR ≤ 2.51).

LIMITATIONS

Meta-analysis options were limited by the variety of study designs.

CONCLUSIONS

Evidence for a significant association between familial death and subsequent disorder appears to be an artefact of the study design. Implications of key findings. Further studies are required to better understand and estimate the association between familial death and substance use disorders. Registration and funding. The review was pre-registered (PROSPERO Reg No: CRD42020192892) and funded by the Irish Research Council (COALESCE/2019/61).

Gender differences in the supply of alcohol to adolescent daughters and sons

Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood.Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms.Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms.Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers' supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)].Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children.

Trajectories of alcohol-induced blackouts in adolescence: early risk factors and alcohol use disorder outcomes in early adulthood

BACKGROUND AND AIMS

Experience of alcohol-induced memory blackouts in adolescence may be an important risk factor for later harms. This longitudinal study (i) modelled trajectories of alcohol-related blackouts throughout adolescence, (ii) explored early-adolescent predictors of blackout trajectories and (iii) examined the association between blackout trajectories and alcohol use disorder (AUD) symptoms.

DESIGN

Longitudinal study in which data from six annual surveys of a longitudinal cohort of Australian adolescents were used to model latent class growth trajectories of blackouts, adjusting for alcohol consumption frequency and typical quantity. Regression models were used to determine whether parent, child and peer factors at baseline (mean age = 12.9) predicted profiles of blackout trajectory membership and whether blackout trajectories predicted meeting criteria for AUD in early adulthood (mean age = 19.8).

SETTING AND PARTICIPANTS

Australian adolescents (n = 1821; mean age = 13.9-18.8 years).

MEASUREMENTS

Alcohol-related blackouts, alcohol consumption frequency, typical consumption quantity and DSM-5 AUD in early adulthood were all self-reported.

FINDINGS

We identified a three-class solution: delayed alcohol initiation, rare blackouts (n = 701; 38.5%); early initiation, rare blackouts (n = 869; 47.7%); and early initiation, increasing blackouts (n = 251; 13.8%). Female sex was associated with increased risk of early initiation, increasing blackouts relative to delayed initiation, rare blackouts [relative risk ratio (RRR) = 3.90; 99.5% confidence interval (CI) = 1.96, 7.76] and relative to early initiation, rare blackouts (RRR = 2.89; 99.5% CI = 1.42, 5.87). Early initiation, rare blackouts [odds ratio (OR) = 1.96; 99.5% CI = 1.17, 3.29] and early initiation, increasing blackouts (OR = 4.93; 99.5% CI = 2.32, 10.48) were each associated with increased odds of meeting criteria for AUD in early adulthood relative to delayed initiation, rare blackouts. Early initiation, increasing blackouts was associated with increased odds of meeting criteria for AUD in early adulthood relative to early initiation, rare blackouts (OR = 2.51; 99.5% CI = 1.18, 5.38).

CONCLUSIONS

Females in Australia appear to be at higher risk of adolescent alcohol-related blackouts independent of alcohol consumption levels and age of initiation. Alcohol-related blackouts may be associated with later alcohol use disorder.

One rule for one, and a different rule for another: The case of the Parental Rules about Alcohol Questionnaire

BACKGROUND

The parental rules about alcohol questionnaire (Van der Vorst et al., 2005, 2006) uses 10 items to assess how strictly adolescents believe the rules set by their parents about drinking are. An increasing body of literature has attested to the importance of rule setting in the prevention of problematic alcohol use among adolescents. A recent study proposed a two-factor solution in place of the hypothesized unidimensional one, with factors assessing non-normative, and normative rules.

METHODS

The present study used five waves of data to examine the structure of the scale, and how well it relates to a measure of heavy episodic drinking (HED). Participants in Waves one to four {10,954-9,383} were substantively more numerous than those at wave five (N = 2,332).

RESULTS

Confirmatory Factor Analyses did not support either the ten-item hypothesized model, nor the proposed two-factor solution. Results of exploratory factor analyses all pointed to a one factor solution. Using Modification Indices, we obtained a good-fitting, five-item unidimensional model in Waves one to four. At wave five, a good fitting unidimensional model was obtained with the dropping of a further item. Scores on this shortened scale were internally consistent, correlated highly with scores on the original ten-item version, and correlated to a similar degree as the original 10-item measure, with scores on a HED measure.

CONCLUSION

Further work is required in assessing the properties of this scale across cultures and samples before definitively determining that two factors best represent parental rules.

Exploratory and confirmatory factor analysis of the parental rules toward adolescent drinking questionnaire: Two factors are better than the original one

The parental rules toward drinking questionnaire (PRQ; Van der Vorst et al., 2005) assesses strictness toward adolescent drinking situations. The aim of the current study was to address a gap in the literature on the psychometric testing and evaluation of the factor structure of the PRQ. The current sample consisted of Dutch adolescents (N = 2922) who participated in a randomized control trial with three intervention groups (parent, student, and parent + student) and a control. PRQ and frequency of alcohol use (past month and year) were measured at baseline (T1) and 12 months later (T2). Results from Exploratory and Confirmatory Factor Analyses revealed two reliable factors: (a) rules about normative drinking situations and (b) rules about non-normative drinking situations (both αs ≥ 0.88). Regression analyses conducted to examine the prospective effects of the interventions revealed that both parent conditions predicted increases in strictness toward normative drinking situations relative to the control condition, while only the parent + student condition affected the original PRQ (single factor). Further, the normative subscale predicted increases in drinking (past month and year), as did the original PRQ. Significant effects with the normative subscale indicate that rules toward these drinking situations are ones that account for the effects in the original PRQ, and that the original PRQ can mask effects. The results illustrate that the PRQ is multidimensional. The effects of the normative subscale suggest that intervention efforts should focus on preventing drinking situations that parents normally permit their adolescents to engage in.

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

Background

This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated.

Methods

The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information.

Results

During the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission.

Conclusions

Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.

Helicopter parenting and alcohol use in adolescence: A quadratic relation

Aims: Research has underscored that an excessively intrusive parental style, defined as helicopter parenting, could be a risk factor for maladaptive behaviours in youth, including alcohol use and drug consumption. However, such at-risk behaviours have also been associated with low levels of parental involvement and warmth. Thus, the relationship between parental involvement and at-risk behaviours in adolescents is not clear. The purpose of the current study was to identify the relation between helicopter parenting and alcohol use in a sample of Italian youth. Design: The participants were 402 adolescents (233 female) between the ages of 14 and 19 years (M_age= 17.20, SD = 1.66). Hierarchical multiple regression analyses were conducted to examine linear, quadratic, and exponential models and to verify which model best described the correlation. Results: The results showed a quadratic correlation between mothers’ helicopter parenting and alcohol use, whereby higher and lower levels of mothers’ helicopter parenting were associated with adolescents’ alcohol use. Conclusions: The empirical data are essential for improving our understanding of the implications and potential outcomes of helicopter parenting during adolescence.

Cerebrospinal fluid levels of monoamines among suicide attempters: A systematic review and random-effects meta-analysis

BACKGROUND

It remains unclear whether the dopaminergic and noradrenergic systems may be implied in suicide attempt risk. In addition, although the serotonergic system has been extensively studied, no formal meta-analysis has been performed to examine its association with suicide attempt.

METHODS

Using PRISMA methodology, we performed a systematic literature review and random-effects meta-analyses of the differences in cerebrospinal fluid (CSF) levels of 5-HIAA, HVA and MHPG between suicide attempters and individuals who never attempted suicide.

RESULTS

We identified 30 studies including 937 suicide attempters and 1128 non-attempters; 29 of them measured CSF levels of 5-HIAA, 22 measured CSF levels of HVA and 14 measured CSF levels of MHPG. CSF levels of 5-HIAA and HVA were significantly lower in suicide attempters than in non-attempters [SMD = -0.43 (95% CI: -0.71 to -0.15; p < 0.01) and SMD = -0.45 (95% CI: -0.72 to -0.19; p < 0.01), respectively]. We did not find a significant association between CSF MHPG levels and suicide attempt.

LIMITATIONS

Our analyses relied on a limited number of studies of good quality and most studies included small sample sizes.

CONCLUSION

Both serotonin and dopamine systems may play a role in suicide attempt risk. Our findings suggest that a silo approach to biomarkers should be phased out in favor of the study of multiple systems in parallel and in the same populations to progress in the identification of the biological components independently associated with suicide risk, with the goal of identifying new treatment targets and improving suicide risk prediction.

Parents' Initiation of Alcohol Drinking among Elementary and Kindergarten Students

Parental experience of initiation of alcohol drinking has been identified as one of the early causes of alcohol drinking in preadolescents in many countries, including Japan. This study identified the association between parental alcohol-related knowledge and the initiation of alcohol use among preadolescent students in an urban area in Japan. Self-administrated questionnaires were distributed to 420 parents of kindergarteners and elementary school students, of which 339 were filled and returned (response rate: 81%). The parents' experience in initiating alcohol drinking in their children and their knowledge about the effects of alcohol on youth were explored. The requirements for drinking prevention programs for youth were also investigated. The result showed that a significantly higher proportion of parents of elementary school students had experiences of initiating alcohol use in their children compared to parents of kindergarten children. The parents' knowledge regarding the effects of alcohol on youth showed no significant difference between the two parent groups. These data indicate that the age of children is the only factor as opposed to parents' knowledge. We also found significant differences in the requirements of prevention programs between the two parent groups. The results of this study can contribute to the design of alcohol prevention programs for these parents, which could reduce the onset of children's drinking.

Adolescents' Perceptions and Experiences of Their Responsibilities for Their Alcohol Use-A Group Interview Study

Young people often experiment with alcohol during adolescence, which is a period of their life that is characterized by increasing responsibility. Knowing how adolescents perceive responsibilities with regard to their alcohol use could prevent their alcohol consumption and help them to take responsibility for this aspect of their lives. This study describes adolescents’ perceptions and experiences of their responsibilities for alcohol use. We used a qualitative descriptive method that focused on 87 adolescents aged 14–16 years, from two schools. They took part in semi-structured interviews in 19 groups in Finland in 2017. The data were analyzed using inductive content analysis. The adolescents described alcohol as harmful, but tempting, and said that they were developing a sense of responsibility for their alcohol use. They were responsible for their own wellbeing, behaving responsibly if they drank and intervening in peers’ alcohol use. They talked about how their parents had unquestionable responsibilities to care about whether adolescents drank alcohol. Their parents’ responsibilities related to the guidance they gave, how strict they were and how they responded to adolescents using alcohol. Anonymous and intense support from authorities encouraged adolescents to learn to take responsibility. Identifying and focusing on their responsibilities could help adolescents to develop into healthy individuals and increase their awareness of the need to avoid alcohol. Parents may also need support to meet their responsibilities.

Risk and protective factors for alcohol and tobacco related disorders: An umbrella review of observational studies

The credibility of evidence of various environmental risk factors for alcohol and tobacco use disorders (AUD/TUD) needs to be graded to identify groups to target with selective prevention. A systematic umbrella review was conducted (PubMed/PsycINFO), grading credibility of meta-analyses of prospective/retrospective observational cohort studies assessing risk/protective factors for AUD/TUD, applying established quantitative criteria. Sensitivity analyses were conducted. Quality of eligible meta-analyses was assessed with AMSTAR-2. Out of 8464 unique references, 80 full text articles were scrutinized, and 12 meta-analyses, corresponding to 21 individual estimates of 12 putative risk/protective factors (n = 241,300), were included. In main analyses no association had convincing nor highly suggestive evidence for AUD/TUD. Six associations had suggestive evidence for AUD, two for TUD. Among these, in sensitivity analyses without >1000 cases criterion, convincing evidence emerged for parental alcohol supply, and impulsivity traits in college students for AUD, and attention-deficit/hyperactivity disorder for TUD. Other associations were supported by weak evidence/were not nominally significant. Few risk factors identified at-risk groups where selective preventative strategies could be developed to prevent AUD/TUD.

Gender Differences in Parental Impact on Problematic Smartphone Use among Korean Adolescents

This study aimed to examine the effective parental impact in preventing problematic smartphone use in adolescents by identifying the parent-related factors. A secondary analysis of cross-sectional data from a Korean national survey was conducted. Data from 2758 male and 2419 female adolescents, aged 10 to 19 years, were analyzed; the respondents were divided into normal and risk groups based on their standardized smartphone addiction diagnostic scale scores. Parent-related factors of smartphone addiction were analyzed using a logistic regression model. Among both male and female adolescents, mobile messenger usage, and family environment emerged as significant predictors of problematic smartphone use. In addition, for male adolescents, smartphone use frequency and parent’s awareness of content use were significant predictors. The findings indicated the importance of parental roles in preventing problematic smartphone use in adolescents. Parents should create a healthy family environment by avoiding smartphone overuse and modeling the appropriate usage of smartphones.

Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes

OBJECTIVES

Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeling dynamic changes in drinking throughout adolescence while adjusting for covariates.

METHODS

Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years).

RESULTS

We identified 4 classes: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy drinking compared with late-onset moderate drinking (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11-0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10-5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41-24.47).

CONCLUSIONS

Our study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption (late-onset, moderate drinking).

Parental Optimism and Perceived Control over Children's Initiation of Tobacco, Cannabis, and Opioid Use

Families play an important role in helping teenagers avoid using tobacco, cannabis, and opioids, but some parents may underestimate the risk of their children using those substances. This study aimed to determine parents' perceived likelihood of their child initiating tobacco, cannabis, and opioid use, as well as the control they have in preventing their child from using those substances. We surveyed 427 parents of children aged 0-18 years old using the online Amazon Mechanical Turk platform in the spring of 2019. We measured participants' perceived likelihood of their child initiating tobacco, cannabis, or opioid use before the age of 18 compared to other children, using a five-point Likert scale. This perceived likelihood was dichotomized between optimistic (less likely than average) and non-optimistic (average or more likely than average). Independent variables included parental tobacco use, perceived parental control, and perceived severity of the behavior. Participants with missing data and participants with children who had already initiated substance use were excluded from statistical analyses. Mean age of participants was 38.1 years (Standard Deviation 8.4); 67% were female. Level of parental optimism was 59% for cannabis, 77% for tobacco, and 82% for opioids. Perceived severity was significantly lower for cannabis use (71/100) than tobacco (90/100) and opioid use (92/100) (p < 0.001). Current smokers were less likely than never smokers to be optimistic about their child's risk of initiating using tobacco (Adjusted Odds Ratio (AOR): 0.18 [95% Confidence Interval (CI) 0.10-0.34]) or cannabis (AOR: 0.21 [95% CI 0.12-0.38]). Parental perceived likelihood of a child initiating substance use represents an understudied and potential target for substance use prevention.

Parent-child conversations associated with alcohol-related risk behaviours in young people (13-17 years) in the UK: a cross-sectional study

OBJECTIVE

To investigate different types of parent-child conversations associated with young people's (13-17 years) alcohol-related risk behaviours.

DESIGN

Secondary analysis of the 2016 Drinkaware Monitor Survey. This survey employed a cross-sectional design and collected data using self-completion questionnaires.

SETTING

UK-wide.

PARTICIPANTS

561 parent-child pairs were included in the analysis. The nationally representative quota sample was weighted by reference to the UK population.

METHODOLOGY

Data were analysed using purposeful selection modelling (adjusted OR (AOR), 95% CIs). RISK BEHAVIOURS: 'Whether have ever drank' and 'whether vomited as a result of alcohol'.

RESULTS

50% (277/553) of young people reported drinking a whole alcoholic drink, and 22% (60/277) of these experienced vomiting as a result. After adjusting for age and gender, the likelihood of ever having drank alcohol was significantly increased among the following young people: those whose parents believed they knew a little about how much they drink (AOR 1.80, 95% CI 1.04 to 3.13) or that some/most/all friends drink (AOR 3.82, 95% CI 2.40 to 6.08); those given gentle reminders about taking care when drinking alcohol (AOR 1.82, 95% CI 1.15 to 2.88), practical advice (AOR 2.09, 95% CI 1.20 to 3.64) or designated time, led by the parent, to instil care around alcohol through a formal sit-down (AOR 1.79, 95% CI 1.07 to 2.99). The likelihood was reduced for parents aged 40-49 years (AOR 0.52, 95% CI 0.31 to 0.89) and conversations providing information (AOR 0.53, 95% CI 0.29 to 0.98). Vomiting was significantly associated with some/most/all friends drinking alcohol (AOR 3.65, 95% CI 1.08 to 12.30), parent's beliefs about child's frequency of drinking alcohol (AOR 1.26, 95% CI 1.02 to 1.54), parental harmful/dependency drinking (AOR 3.75, 95% CI 1.13 to 12.50) and having a formal sit-down conversation (AOR 2.15, 95% CI 0.99 to 4.66).

CONCLUSIONS

We found evidence of mostly negative associations between young people's risk behaviours and different types of parent-child conversations. Conversations providing information were linked to a reduced tendency to have ever drunk alcohol. All other types of conversations were negatively associated with risk behaviours. Psychological reactance and conversation quality possibly explain these findings.

Interplay Between Sensation Seeking and Parental Rules in the Emergence of Heavy Episodic Drinking

This study examined the parallel mediational processes between sensation seeking and parental rules on alcohol, in the emergence of heavy episodic drinking (HED) in adolescents. Data were drawn from a U.K. clustered randomized control trial (control arm only, N ≈ 6,300, M_age at baseline = 12.5). Using parallel process latent growth curve analysis, stricter parental rules at baseline were found to be associated with greater declines in sensation seeking over time and a lower risk of HED at follow-up (+33 months). Higher initial levels of sensation seeking predicted a faster relaxation of parental rules and a greater risk of HED. By maintaining strict rules about alcohol, parents may promote a positive reduction in sensation seeking and a lower risk of HED.

Parental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort

BACKGROUND

Recent research has not supported the idea that parental supply of alcohol to adolescents prevents later alcohol-related harm. Yet the specific role of parental supply in shaping patterns of drinking over time remains unclear. This study investigated the role of parental supply of alcohol in patterns of drinking across adolescence, and assessed whether that role remained consistent over time.

METHOD

Using a longitudinal cohort of 1927 adolescents (mean age 12.9 years), recruited in 2010 and 2011 from schools across Australia and followed up annually until 2016, we assessed three outcomes using mixed-effect negative binomial regression: frequency of consumption, typical quantity consumed, and overall alcohol consumption in the year (frequency * quantity). Child, parental, familial, and peer confounders of adolescent alcohol consumption were measured and adjusted for in the analyses.

FINDINGS

Parental supply was associated with greater overall consumption in earlier adolescence: Grade 7-8 (incidence rate ratio [IRR]: 3.61; 95% CI: 2.55, 5.12; no supply IRR: 1.00), Grade 8-9 (IRR: 4.84; 95% CI: 3.66, 6.39; no supply IRR: 1.44) and Grade 9-10 (IRR: 8.33; 95% CI: 6.28, 11.05; no supply IRR: 4.75). Alcohol consumption continued to increase in later adolescence regardless of whether parental supply occurred.

CONCLUSIONS

Parental supply of alcohol was associated with increased alcohol consumption by their children during early adolescence. While parental supply appears to have less impact on drinking in later adolescence, there was no evidence to suggest it is protective. Parents should be advised to avoid supplying children with alcohol, particularly in early adolescence.

The relationship between parental attitudes and children's alcohol use: a systematic review and meta-analysis

AIMS

The main aim of this study was to assess the relationship between parental attitudes towards children's alcohol use and their child's alcohol use. Secondary aims included assessing the relationship between attitudes reported by parents and those perceived by children, and between perceived parental attitudes and children's alcohol use.

METHODS

Meta-analysis of studies reporting on the associations between parental attitudes towards children's alcohol use and children's self-reported alcohol use. Published, peer-reviewed cross-sectional and longitudinal studies were identified from the following databases up to April 2018: Medline, PsycINFO, EMBASE, Scopus and Web of Science. Quality assessment was performed by using guidelines developed by Hayden, Cote & Bombardier. Pooled effect sizes were calculated by using random-effects meta-analyses, if there were at least two studies that could be included per analysis. Of 7471 articles screened, 29 were included comprising data from 16 477 children and 15 229 parents.

RESULTS

Less restrictive parental attitudes towards children's alcohol use were related to higher rates of alcohol use initiation [odds ratio (OR) = 1.45, 95% confidence interval (CI) = 1.17-1.80], alcohol use frequency (OR = 1.52, 95% CI = 1.24-1.86) and drunkenness (OR = 1.58, 95% CI = 1.35-1.85) among children. Less perceived restrictive parental attitudes were related to higher alcohol use frequency (OR = 1.76, 95% CI = 1.29-2.40). Perceived parental attitudes were not clearly related to alcohol use initiation. Parent-reported attitudes and perceived parental attitudes were weakly positively correlated (r = 0.27, P = ≤ 0.001). The strength of the relationship between parental attitudes and children's alcohol use frequency attenuated with children's age. Study design, sample size, study location and levels of alcohol use frequency did not have a detectable effect on the relationship.

CONCLUSIONS

Less restrictive parental attitudes towards children's alcohol use are associated with increases in children's alcohol use onset, alcohol use frequency and drunkenness. Children's perception of less restrictive parental attitudes is associated with children's alcohol use.

Alcohol supply as a favour for a friend: Scenarios of alcohol supply to younger friends and siblings

ISSUES ADDRESSED

Adolescents under the legal purchase age primarily source their alcohol through social networks. This study assessed the provision context from the perspective of both underage recipients and their suppliers who were older peers and siblings.

METHODS

Interviewer-administered surveys were conducted with 590 risky-drinking (50 g alcohol per session, at least monthly) adolescents. Participants of legal purchase age (18- to 19-year-olds; n = 269) reported their provision to 16- to 17-year-olds under eight scenarios. Those aged 14-17 (n = 321) reported receipt of alcohol under the same scenarios plus two parental supply contexts.

RESULTS

Purchase-age participants reported supply: to an underage friend (67%), an acquaintance (44%) or a sibling (16%) to drink at the same party; to a friend (43%) or sibling (20%) to take to another party (20%) and to a stranger near a bottle shop (5%). Supply to a friend at the same party was more likely if money was exchanged (60% vs 40%; P < 0.001). Almost all (98%) 14- to 17-year-olds reported receiving alcohol from an adult (including 36% from a parent for consumption away from the parent), with a similar pattern of receipt scenarios as those reported by the 18- to 19-year-olds.

CONCLUSIONS

Provision of alcohol was more frequent with a friend than a sibling or stranger, in close environmental proximity, and if money was exchanged. SO WHAT?: As supply may be sensitive to monetary considerations, the incidence of underage receipt may be affected by community-wide pricing measures. Traditional alcohol availability regulations should be supplemented by strategies relating to the social nature of supply and demand.

Underage drinking as a natural part of growing up: a UK study of parental beliefs

Purpose

Parental beliefs about underage drinking are known to influence the drinking behaviours of their children. The purpose of this paper is to explore parental beliefs about their own child drinking alcohol and young people in general, in order to ascertain whether there is a need to target such beliefs in the design of public health interventions.

Design/methodology/approach

Parents of 11–18 year olds attending one of nine schools in the Midlands of England, UK were invited to take part. Participants completed a newly designed 40-item questionnaire measuring parental beliefs about the impact and causes of underage drinking; talking to their child about alcohol; and how much and how often they thought their child consumed alcohol.

Findings

In total, 185 parents took part in the study, reporting on their eldest child aged 18 or under. The majority of parents agreed that underage drinking is detrimental to child health and wellbeing. However, over 60 per cent believed that alcohol consumption is a “natural part of growing up”, and stronger agreement with this belief was associated with higher parental reports of alcohol consumption in their children.

Social implications

The majority of parents recognised the risks and negative effects of alcohol; however, many also believe it is a natural part of growing up. Parents may hold conflicting beliefs about underage drinking, which could impact on the drinking beliefs and behaviours of their children.

Originality/value

Public health interventions may need to counter the common parental belief that underage drinking is a normal part of growing up and therefore to be expected. Clear messages about the impact parent beliefs and behaviour have on young people drinking, to ensure parents recognise that messages are aimed at themselves, and not just “other parents” are imperative.

Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths: A Systematic Review and Meta-analysis of Longitudinal Population Studies

IMPORTANCE

Recent research has highlighted that psychotic experiences are far more prevalent than psychotic disorders and associated with the full range of mental disorders. A particularly strong association between psychotic experiences and suicidal behavior has recently been noted.

OBJECTIVE

To provide a quantitative synthesis of the literature examining the longitudinal association between psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide deaths in the general population.

DATA SOURCES

We searched PubMed, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO from their inception until September 2017 for longitudinal population studies on psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death.

STUDY SELECTION

Two authors searched for original articles that reported a prospective assessment of psychotic experiences and suicidal ideation, suicide attempts, or suicide death in general population samples, with at least 1 follow-up point.

DATA EXTRACTION AND SYNTHESIS

Two authors conducted independent data extraction. Authors of included studies were contacted for information where necessary. We assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. We calculated pooled odds ratios using a random-effects model. A secondary analysis assessed the mediating role of co-occurring psychopathology.

MAIN OUTCOMES AND MEASURES

Psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death.

RESULTS

Of a total of 2540 studies retrieved, 10 met inclusion criteria. These 10 studies reported on 84 285 participants from 12 different samples and 23 countries. Follow-up periods ranged from 1 month to 27 years. Individuals who reported psychotic experiences had an increase in the odds of future suicidal ideation (5 articles; n = 56 191; odds ratio [OR], 2.39 [95% CI,1.62-3.51]), future suicide attempt (8 articles; n = 66 967; OR, 3.15 [95% CI, 2.23-4.45]), and future suicide death (1 article; n = 15 049; OR, 4.39 [95% CI, 1.63-11.78]). Risk was increased in excess of that explained by co-occurring psychopathology: suicidal ideation (adjusted OR, 1.59 [95% CI, 1.09-2.32]) and suicide attempt (adjusted OR, 2.68 [95% CI, 1.71-4.21]).

CONCLUSIONS AND RELEVANCE

Individuals with psychotic experiences are at increased risk of suicidal ideation, suicide attempts, and suicide death. Psychotic experiences are important clinical markers of risk for future suicidal behavior.

Do maternal knowledge and paternal knowledge of children's whereabouts buffer differently against alcohol use? A longitudinal study among Finnish boys and girls

BACKGROUND

Previous research suggests that parental knowledge of the child's activities and whereabouts prevents adolescents' alcohol use. However, evidence on whether the positive effects of maternal and paternal knowledge are distinctive for boys' and girls' alcohol use is inconclusive. We examined whether perceived parental knowledge at age 13 prevents alcohol use at age 16, whether the effect of maternal and paternal knowledge was the same for both genders, and whether paternal knowledge had as strong an effect as maternal knowledge.

METHOD

Adolescents answered a school survey in 2011 (age 13) and 2014 (age 16) in Finland (N = 5742). Perceived maternal and paternal knowledge was measured separately using a Parents' Monitoring Scale. The data were analysed via moderation regression modelling using Bayesian estimation.

RESULTS

Perceived maternal and paternal knowledge at age 13 predicted boys' and girls' lower alcohol use at age 16. For those who had not used alcohol at age 13, parental knowledge protected against an increase of alcohol use at age 16. Both maternal and paternal knowledge had a shielding effect against the increase of boys' and girls' alcohol use, but maternal knowledge had a stronger shielding effect than paternal knowledge.

CONCLUSIONS

Both maternal and paternal perceived knowledge at age 13 buffers against the adverse development of alcohol use at age 16 for both genders. Underlining the importance of parent-child communication and knowledge about the child's activities should be a part of family health counselling and school health services.

Prevalence and predictors of alcohol and drug use among secondary school students in Botswana: a cross-sectional study

BACKGROUND

Alcohol and illicit drug use has been recognized as a growing problem among adolescents in Botswana. Little is known about factors affecting alcohol and drug use among Botswana's secondary school students. To aid the design and implementation of effective public health interventions, we sought to determine the prevalence of alcohol and drug use in secondary school students in urban and peri-urban areas of Botswana, and to evaluate risk and protective factors for substance use.

METHODS

We performed a 72-item cross-sectional survey of students in 17 public secondary schools in Gaborone, Lobatse, Molepolole and Mochudi, Botswana. The World Health Organization's (WHO) Alcohol Use Disorder Identification Test (AUDIT) was used to define hazardous drinking behavior. Using Jessor's Problem Behavior Theory (PBT) as our conceptual framework, we culturally-adapted items from previously validated tools to measure risk and protective factors for alcohol and drug use. Between-group differences of risk and protective factors were compared using univariate binomial and multinomial-ordinal logit analysis. Relative risks of alcohol and drug use by demographic, high risks and low protections were calculated. Multivariate ordinal-multinomial cumulative logit analysis, multivariate nominal-multinomial logit analysis, and binominal logit analysis were used to build models illustrating the relationship between risk and protective factors and student alcohol and illicit drug use. Clustered data was adjusted for in all analyses using Generalized Estimating Equations (GEE) methods.

RESULTS

Of the 1936 students surveyed, 816 (42.1%) reported alcohol use, and 434 (22.4%) met criteria for hazardous alcohol use. Illicit drug use was reported by 324 students (16.7%), with motokwane (marijuana) being the most commonly used drug. Risk factors more strongly associated with alcohol and drug use were reported alcohol availability, individual and social vulnerability factors, and poor peer modeling. Individual and social controls protections appear to mitigate risk of student alcohol and drug use.

CONCLUSIONS

Alcohol and illicit drug use is prevalent among secondary school students in Botswana. Our data suggest that interventions that reduce the availability of alcohol and drugs and that build greater support networks for adolescents may be most helpful in decreasing alcohol and drug use among secondary school students in Botswana.

[Prediction of binge drinking in young adults: a cohort study over nine years]

Prediction of binge drinking in young adults: a cohort study over nine years Abstract.

OBJECTIVE

Which person characteristics and environmental factors predict binge drinking at age 21?

METHOD

A longitudinal observational study with a nine-year follow-up. A total of 5,176 adolescents from the German states Schleswig-Holstein and Saxony-Anhalt were surveyed in 2006 with paper-pencil questionnaires (mean age 12.6 years, SD = 0.6). A follow-up assessment was conducted in the year 2015. Baseline predictors were age, gender, school type, school performance, parenting style, early experience with alcohol, alcohol use of parents, alcohol use of friends, and sensation seeking. Primary outcome in 2015 was binge drinking at least once a month (six or more alcoholic drinks during one drinking occasion).

RESULTS

A subsample of 1,087 (20.9 %) of the former students could be surveyed nine years after baseline (mean age 21.6 years, SD = 0.8). One out of four (25.4 %) reported binge drinking at least once in a month. A multiple regression model revealed three significant predictors of binge drinking: male gender, early experience with alcohol and frequency of parental alcohol use at baseline.

CONCLUSIONS

Perceived frequency of parental alcohol use might be an important risk factor for children's alcohol use in early adulthood. Parents need to reflect their role as alcohol-specific socialization agents.