Association between cumulating substances use and cumulating several school, violence and mental health difficulties in early adolescents

Childhood maltreatment as a predictor of substance use/misuse among youth: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to comprehensively describe whether experiencing a variety of childhood maltreatment types predicts a variety of substance use/misuse types among youth, beyond the narrow scope covered in previous systematic reviews on similar topics. A literature search was conducted in June, 2022 using PubMed, PsycInfo, and Embase. 58 studies (total participant n=170,749) were included. These studies were primarily organized by substance type outcomes including alcohol (n=43), cannabis (n=25), unspecified substances (n=25), and other specific substances (n=10). Results were further stratified by maltreatment type. For specific maltreatment and substance type combinations, the majority of studies indicated that childhood maltreatment was a significant predictor of substance use/misuse in youth. Of the 10 meta-analyses we conducted, significant associations were found for the majority (9/10) of maltreatment and substance type combinations. For instance, unspecified childhood maltreatment increased the probability of youth alcohol use by about four times, which was the highest relative risk found. In conclusion, this study shows that childhood maltreatment is a predictor of youth substance use/misuse.

Substance Use Among Middle School Adolescents: Association with Family Members' and Peers' Substance Use and the Mediating Role of School and Mental Difficulties

OBJECTIVE

We assessed the associations of substance (alcohol, tobacco, cannabis, and other illicit drugs) use of adolescents with that of their family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers, and the mediating role of school and mental difficulties (SMDs) which remained insufficiently addressed.

METHODS

This cross-sectional population-based study included 1,559 middle-school adolescents in France (mean age = 13.5 ± 1.3, 778 boys, 781 girls). They completed a questionnaire including socioeconomic features (nationality, family structure and parents' education, occupation, and income), substance use, cumulative number of substance use of family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers (noted familySUcn and peerSUcn), SMDs (grade repetition, suffered physical/verbal violence, sexual abuse, lack of family/peer support, depressive symptoms, suicide attempt, and age at onset). Data were analyzed using logistic regression models and Kaplan-Meier estimates.

RESULTS

Most adolescents had familySUcn 1-2, 3-5, and ≥ 6 (39.1%, 23.0%, and 4.5%, respectively) and peerSUcn 1-2 and ≥ 3 (36.1% and 13.0%, respectively). Strong dose-effect associations were found between all substance use and familySUcn and peerSUcn (odds ratio adjusted for sex, age, and socioeconomic features reaching 13.44 and 9.90, respectively, most with p < .001). SMDs explained more the associations of all substance use with familySUcn than with peerSUcn (contributions reaching 69% and 34%, respectively). The proportion of subjects without each substance use decreased with age more quickly among the adolescents with higher familySUcn or peerSUcn.

CONCLUSIONS

Early prevention reducing familySUcn, peerSUcn and SMDs among adolescents and their families may reduce efficiently initiation and regular use of substances during adolescents' life course.

Associations between excessive screen time and school and out-of-school injuries among adolescents: A population-based study

Most adolescents spend excessive screen time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) which may impact the occurring of various types of school and out-of-school injuries. We assessed their associations and potential confounding factors among 1559 middle-school students from north-eastern France (mean age=13.5 ± 1.3). Participants completed a questionnaire including socioeconomic features, daily screen time for various screen-based activities (coded 1=<2, 2 = 2-4, 3=≥5 h; daily-total-screen time level (TDST) was defined as their sum, categorized into <7/7-11/≥12), various injury types during the school-year, behavior and health difficulties (BHDs; alcohol/tobacco/cannabis/other illicit drugs use, suffered physical/verbal violence, sexual abuse, poor family-peer support, sleep difficulty, depressive symptoms, suicide attempt, and time at onset). Most subjects had TDST≥7 (82.3 %). There were dose-effect associations of TDST with school-physical/sports training, school-free-time, out-of-school-sports, and single/repeated injuries (sex-age-adjusted odds ratio reaching 4.45). BHDs explained up to 39 % of these associations. The frequency of subjects without various BHDs decreased with age since age 10 more quickly among the participants with both TDST≥7 and injury than among the others. Our findings may inform health care providers, parents, schools, and public policy that reducing elevated screen time is efficient to prevent injuries and BHDs among adolescents.

Associations between School-Behavior-Health Difficulties and Subsequent Injuries among Younger Adolescents: A Population-based Study

Objective: School-behavior-health difficulties (SBHDs) may alter physical/mental capabilities and consequently increase injury risk during daily activities. This study assessed the associations of potential SBHDs and their cumulative number (SBHDcn) with various injury types among younger adolescents. Methods: The study population included 1,559 middle-school adolescents in France (10-18 years, 98% under 16,778 boys and 781 girls). They completed a questionnaire at school-year end collecting socioeconomic features (nationality, family structure, parents' education/occupation/income), school/out-of-school injuries during the school-year (dependent variables), and SBHDs starting before the school-year (low academic performance, alcohol/tobacco/cannabis/other-illicit-drugs use, physical/verbal violence, sexual abuse, perpetrated violence, poor social support, poor general health status, sleep difficulty, depressive symptoms, and suicide attempt). Data were analyzed using logistic regression models and Kaplan-Meier estimates. Results: Injuries were frequent during school-physical/sports-training (10.9%), other-school-training (4.7%), school-free-time (7.4%), out-of-school-sports-activity (16.5%), and traffic (2.2%). Single injury (one injury all injury types combined) and ≥2 injury types affected 23.3 and 7.9% of subjects, respectively. The proportion of adolescents without SBHDs decreased with age more quickly among those with each injury type than among those without injury. Various SBHDs were associated with most injury types, single injury, and ≥2 injury types (sex-age-adjusted odds/relative-risk ratios reaching 11, p < .001). A dose-effect association was found between SBHDcn 1-2/3-5/≥6 and both single injury and ≥2 injury types (sex-age adjusted relative risk ratios reaching 12.66, p < .001, vs. SBHDcn = 0). Socioeconomic features had a moderate confounding role in these associations. Conclusions: SBHDs strongly predict injuries among adolescents. Our findings may inform healthcare providers about their prominent role in detecting/reducing SBHDs and injuries.

Association of School Health Relationship Difficulties with Lack of Regular Physical Activity in Younger Adolescents: A Population Based Study

Objective: Lack of regular physical activity (LPA) and the number of days/week with physical activity >60 minutes/day (Ndw) may be associated with school-health-relational difficulties (SHRDs) during the life-course. This study assessed their associations and the confounding role of socioeconomic features (nationality, family structure, parents' education/occupation/income) among younger adolescents. Methods: This cross-sectional population-based study included 1,559 middle-school adolescents from north-eastern France (10-18 years, 98% under 16 years, 778 boys and 781 girls). They completed over one-hour teaching period a questionnaire collecting last-12-month LPA and last-7-day Ndw (dependent variables), and risk factors including socioeconomic features, SHRDs (previous grade repetitions, last-12-month poor general health status/physical health/psychological health/social-relationships, depressive symptoms (and age at onset and duration from onset); cumulated number noted SHRDcn). Data were analyzed using logistic/linear regression models. Results: LPA was common (32.5%) and associated with all SHRDs (sex-age-adjusted odds ratio saOR reaching 1.99, p < .001) and depressive-symptoms duration (saOR 1.63 (p < .05) and 2.11 (p < .001) for 1-2 and ≥3 years, respectively, vs. no depressive symptoms). A dose-effect association was found between SHRDcn and LPA (24.0, 33.7, 45.6, and 53.5%; saOR 1.59, 2.58, and 3.43; for SHRDcn 1-2, 3-4, and ≥5 respectively, vs. SHRDcn = 0, p < .001). Ndw was similarly associated with all SHRDs and SHRDcn (sex-age-adjusted regression coefficient reaching -1.10 day/week, p < .001). These results were robust when controlling for socioeconomic features (18% Collapse

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MESH Headings

• Male
• Female
• Humans
• Adolescent
• Child, Preschool
• Infant, Newborn
• Socioeconomic Factors
• Cross-Sectional Studies
• France/epidemiology
• Surveys and Questionnaires
• Exercise

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Association between untreated low back pain and injury proneness and confounding role of behavioral-health difficulties among younger adolescents: a population-based study

PURPOSE

Low back pain (LPB) is mostly left untreated (LBP_untreated) and may increase the injury risk due to associated behavioral-health difficulties (BHDs) among adolescents. This study assessed the association between LBP_untreated (vs. treated LBP (LBP_treated)) and injuries and the mediating role of BHDs among younger adolescents (10-16 years).

METHODS

This population-based study compared 328 adolescents with LBP_untreated (mean age = 13.7 ± 1.3) with 291 with LBP_treated (mean age = 13.3 ± 1.2) from north-eastern France. They completed a questionnaire collecting, at school-year end, socioeconomic features, LBP_treated/LBP_untreated, BHDs (alcohol/tobacco use, excessive screen-time, poor social support, poor physical health, depressive symptoms, and pain limiting activities), and injuries during the current school-year. Data were analyzed using multinomial logistic regression models and Kaplan-Meier estimates.

RESULTS

The proportion of subjects without alcohol/tobacco use or depressive symptoms decreased with time more quickly since age 10 among the adolescents with LBP_untreated than among those with LBP_treated. Hence, most LBP early started and the subjects with LBP_untreated had a higher risk of single injury (sex-age-class-level-socioeconomic-features-adjusted relative risk ratio RR = 1.63, p < 0.05, vs. LBP_treated) and a much higher risk of ≥ 2 injuries (RR = 2.60, p < 0.001). BHDs played a strong mediating role in the association between LBP_untreated and ≥ 2 injuries (contribution = 48%) but a modest mediating role in that between LBP_untreated and single injury (contribution = 10%) (pseudo R² = 7.6%).

CONCLUSION

LBP_untreated is common and associated with injuries partly due to BHDs (which may alter physical/mental capabilities, risk perception/awareness, and vigilance) among younger adolescents. Our results may inform healthcare providers that they can detect/treat LBP and BHDs to prevent their aggravation and injuries.

Psychiatric Symptomatology is Associated with Polydrug Use and School Violence in Early Adolescence

This study investigated the association between psychiatric symptoms and polydrug use, school violence, and sociodemographic factors among Brazilian early adolescents. Using the baseline data collection from the effectiveness evaluation of PROERD, a school-based drug use prevention program, implemented in 30 public schools in São Paulo (n = 2316, M age = 12.3 years, 48.5% girls), multinomial logistic regressions were performed using Strengths and Difficulties Questionnaire (SDQ) subscales as response variables, and polydrug use, school violence, and sociodemographic characteristics as explanatory variables. In most SDQ subscales, girls and older students were more likely to have psychiatric symptoms. A positive association was identified between polydrug use and psychiatric symptoms. It was found that those who suffered and perpetrated physical violence had a greater likelihood of presenting psychiatric symptoms. Preventive interventions should consider the greater vulnerability related to the mental health of girls, older students, and those who suffer and perpetrate physical violence at school.

An Explanatory Model of Violent Behavior, Self-Concept, and Alcohol, Tobacco, and Cannabis Consumption in Secondary Education Students

Background

Current scientific evidence establishes that regular physical activity engagement provides numerous physical and mental benefits. Thus, the present research aims at examining the relationships between violent behavior, self-concept, and consumption of alcohol, tobacco, and cannabis. Specifically, two objectives were defined: (a) analyze and establish the relationships between violent behaviors, the different dimensions of self-concept, and the consumption of alcohol, tobacco, and cannabis as a function of physical activity engagement, (b) define and examine a proposed explanatory model, and (c) analyze the effect of self-concept on alcohol and tobacco consumption and physical activity engagement based on the explanatory model developed.

Methods

For this purpose, a nonexperimental (ex post facto), descriptive, and cross-sectional study was conducted. For data collection, a sociodemographic questionnaire was administered alongside the Self-Concept Form 5 and the School Victimization Scale.

Results

It was shown that individuals engaging in more than three hours of physical exercise per week scored more highly on the social, family, physical, and emotional aspects of self-concept, whilst those who do not meet this criterion scored more highly on the academic aspect and on physical and verbal victimization.

Conclusions

The present research concludes that engagement in more than 3 hours of physical activity per week led to benefits in a number of domains of self-concept whilst, at the same time, increasing levels of violence.

Associations between school difficulties and family type and the role of socioeconomic, behavior and health-related difficulties in early adolescents: a population-based study

OBJECTIVES

Nowadays many early adolescents are living in non-intact families (parents divorced/separated, reconstructed families or single parents) and have many school difficulties (learning difficulty, skipping school, school absence due to family problems, grade repetition, low school performance, and school dropout ideation). This study assessed the associations between school difficulties and family type which remain little addressed and the confounding role of socioeconomic adversities and behavior, social support and health-related difficulties (BSSHDs).

METHODS

The study population included 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed at the end of school-year a questionnaire gathering socioeconomic adversities, school difficulties and BSSHDs (being obese, substances use, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt; cumulated number noted BSSHD_CM). Data was analyzed using logistic regression models.

RESULTS

The adolescents with parents divorced/separated, reconstructed families or single parents had a much higher risk for various school difficulties than those in intact families (sex-age-adjusted odds ratios 1.60-4.70, mostly with p < 0.001). These risks were robust and remained significant (often with p < 0.01/0.001) after adjustment for socioeconomic adversities and BSSHD_CM. The contributions of socioeconomic adversities plus BSSHD_CM to the risks were mostly elevated (>40%, reaching 65%) while those of socioeconomic adversities alone were mostly moderate (<30%, but reaching 52%).

CONCLUSIONS

Family type plays a strong role in school difficulties among early adolescents, mainly due to socioeconomic adversities and BSSHD_CM. Our results may help primary care providers identify at-risk adolescents and their problems and establish timely prevention and care.HighlightsLearning difficulty, school absence, grade repetition, low academic performance, and school dropout ideation are common in early adolescents.The adolescents with parents divorced/separated, reconstructed families or single parents have up to 4.7-time higher risk for these school difficulties than those in intact families.These risks are robust after adjustment for socioeconomic, behavior and health-related difficulties which explain up to 65% of the risks.School-difficulty prevention should consider family features and include early monitoring behavior and health-related difficulties in adolescents.

Cannabis smoking increases the risk of suicide ideation and suicide attempt in young individuals of 11-21 years: A systematic review and meta-analysis

BACKGROUND

Cannabis is the most frequently consumed drug around the world. Its use has been associated with increased suicide behaviors; nonetheless, the association of cannabis smoking and suicide behaviors in adolescents has not yet been established. The aim of this systematic review and meta-analysis was to evaluate the risk of suicide attempt, suicidal ideation or suicide planning in individuals of 11-21 years of age who smoke cannabis.

METHODS

We performed an online searched using PubMed, EBSCO and Science Direct databases, up to July 2021. We calculated odds ratio with 95% confidence intervals to evaluate the association between suicide attempt, suicidal ideation or suicide planning and cannabis smoking in individuals of 11-21 years of age.

RESULTS

Twenty studies reported suicide attempts in 34,859 young individuals, suicidal ideation in 26, 937 individuals, and suicide planning in 9054 young individuals. We found an increased risk of suicide attempt in cannabis smokers than in non-cannabis users (OR: 2.33; 95% CI: 1.78-3.05; Z p value; <0.0001; I² = 97.12%), as well as a significant association between cannabis smoking and suicidal ideation (OR: 2.04; 95%CI: 1.64-2.53; Z p value: <0.001; I²: 94.88) and suicide planning (OR: 1.674; 95% CI: 1.554-1.804; Z p value: 0.000; I²: 92.609). Subgroup analyses showed that American teens have an increased risk of suicidal ideation; the meta-regression analysis revealed that age was negatively associated with the risk of suicide attempt.

CONCLUSIONS

This meta-analysis shows that cannabis smoking increased the risk of suicide attempt, suicidal ideation and suicide planning in young individuals of 11-21 years of age. The high risk of suicide behaviors could vary depending on the population studied; therefore, more studies are necessary to corroborate the risk of presenting suicide behaviors in individuals of 11-21 years of age who smoke cannabis.

Association between screen time and cumulating school, behavior, and mental health difficulties in early adolescents: A population-based study

Early adolescents may daily spend excessive screen-time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) while its association with cumulating several school-behavior-mental-health difficulties (SBMDs) (poor-academic-performance, being obese, alcohol/tobacco/cannabis/other-illicit-drugs use, suffered violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt) is poorly addressed. We investigated this association among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, daily screen-time for various screen-based activities (coded 1=<2/2=2-4/3=≥5 h; daily-total-screen-time level DSA_total was defined as their sum and categorized into 4 levels: 6-7/8-9/10-12/≥13), various SBMDs and the time of their onset during the life course (their cumulated number SBMD_score was categorized into 5 levels: 0/1/2/3-4/≥5). Logistic regression modeling showed that the DSA_total was strongly associated with all SBMDs (gender-age-adjusted odds ratio reaching 8.28, p < 0.001) and SBMD_score (gender-age-adjusted relative risk reaching 11.60, p < 0.001, pseudo R² = 0.039). These associations remained strongly significant when controlling for socioeconomic adversities (contributions 20-38%). The proportion of subjects without each SBMD steadily decreased with age according to DSA_total levels. These findings help to understand the impacts of high DSA_total on SBMDs in early adolescents and identify at-risk adolescents for prevention and care.

Spatial density of adolescents aged 14 years old, victims of dental: A longitudinal study

BACKGROUND/AIM

Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period.

MATERIAL AND METHODS

This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map.

RESULTS

Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years.

CONCLUSION

The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.