Depression, Suicidal Ideation, and Substance Use Among Continuation High School Students

Prevalence, Co-Occurrence, and Correlates of Substance and Behavioral Addictions Among American Indian Adolescents in California

The present study investigated the prevalence and co-occurrence of addictions to tobacco, alcohol, other drugs, food/eating, the internet, texting, video games, shopping, love, sex, exercise, work, and gambling among American Indian (AI) youth in California. As with previous work in other cultural groups, the most prevalent addictions were love, internet, and exercise, though prevalence and co-occurrence of these addictions were relatively high among AI youth. A negative life events measure was associated with all the addictions, suggesting that life stressors are associated with high rates of multiple types of addictions among AI youth. There is a need for more research to better understand the relations of life stressors with multiple addictions among AI youth as well as how to remediate these behaviors.

The negative impact of long working hours on mental health in young Korean workers

Long working hours are known to have a negative effect on health. However, there is no clear evidence for a direct link between mental health and long working hours in the young adult populations. Therefore, we aimed to determine whether long working hours are associated with mental health in young adult workers. Data were collected from a 2012 follow-up survey of the Youth Panel 2007. A total of 3,332 young adult employees (aged 20 to 35) were enrolled in the study. We analyzed stress, depression, and suicidal thoughts by multivariate logistic regression analysis based on working hours (41 to 50, 51 to 60 and over 60 hours, compared to 31 to 40 hours per week), which was adjusted for sex, age, marriage status, region, and educational level. From the 3,332 young adult employees, about 60% of the workers worked more than 40 hours and 17% of the workers worked more than 50 hours per week. In a Chi-square test, stress level, depression, and suicidal thoughts increased with increasing working hours (p-value <0.001, 0.007, and 0.018, respectively). The multivariate logistic regression model showed that, compared to the 31 to 40 hours per week group, the adjusted odds ratios of the 41 to 50, 51 to 60, and over 60 hours per week groups for stress were 1.46(1.23–1.74), 2.25(1.79–2.83) and 2.55(1.72–3.77), respectively. A similar trend was shown in depression [odds ratios: 2.08(1.23–3.53), 2.79(1.44–5.39) and 4.09(1.59–10.55), respectively] and suicidal ideation [odds ratios: 1.98(0.95–4.10), 3.48(1.48–8.19) and 5.30(1.61–17.42), respectively]. We concluded that long working hours were associated with stress, depression, and suicidal ideation in young employees, aged 20 to 35.

Suicidal ideation in a population-based sample of adolescents: implications for family medicine practice

Introduction. This study investigated the relationship between suicidal ideation and demographic characteristics, health conditions, depression, and health care utilization patterns among adolescents. Methods. Secondary analysis of the regionally representative Canadian Community Health Survey conducted in 2000/2001 (response rate 85%). Adolescents aged 15 to 19 who reported suicidal ideation in the previous year (n = 260) were compared with their peers who did not (n = 5528). The association between suicidal ideation and socio-demographic and health characteristics were investigated. Findings. Almost three-quarters (73%) of suicidal adolescents had not spoken with any health professional about mental health issues in the preceding year. Despite the fact that 80% of suicidal adolescents had regular contact with their family doctor, only 5% had consulted with them about mental health issues. In addition to the well-known risk factors of depression and stress, suicidal ideation was highly elevated in adolescents with two or more chronic health conditions, self-reported poor health, migraines, and back pain and those whose activities were prevented by pain (P < .05). Other characteristics significantly correlated with suicidal ideation included smoking, living in single parent families, and having lower levels of social support. Conclusions. Family physicians should regularly screen for suicidal thoughts in their adolescent patients with these characteristics.

Trajectories of marijuana use and psychological adjustment among urban African American and Puerto Rican women

BACKGROUND

The current longitudinal study examined the developmental patterns of marijuana use and their relationship with subsequent psychological adjustment in a community-based sample of urban African American and Puerto Rican women.

METHOD

Participants were interviewed five times over a period ranging from adolescence (mean age 14.0 years) to adulthood (mean age 32.5 years). Outcome measures included depressive symptoms, anger/hostility and the presence of a substance use disorder (abuse/dependence).

RESULTS

Three distinct trajectories of marijuana use were identified: non-users, increasers and quitters. Increasers reported higher levels of depressive symptoms and anger/hostility than did non-users and were more likely to meet criteria for a substance use disorder at age 32.5 years.

CONCLUSIONS

Our findings indicate that early-starting long-term use of marijuana is associated with psychological maladjustment among women. Prevention efforts should emphasize the long-term cost associated with marijuana use, and that the best psychological health is reported by those who abstain from the drug.

Concurrent predictors of cigarette and alcohol use among U.S. and Russian adolescents

In the present study, we describe correlates of 30-day cigarette and alcohol use among two samples of high school students, one in the Russian Federation (n = 365), and one in the United States (n = 965). The correlates used in the analyses are based on the theory of triadic influence, which organizes predictors of adolescent substance use into three distinct types of influence. Overall, correlates from each of the types of influence were significant predictors of substance use in both samples. The most consistent positive predictors of cigarette and alcohol use across countries were friends' substance use and sensation seeking behavior. Perceived harmfulness of drug use was negatively associated with cigarette and alcohol use in both samples. Having a substance abuser in one's family was negatively associated with alcohol use in the Russian sample, but positively associated with alcohol use in the U.S. sample. In general, similar patterns of relationships between predictors and substance use were seen across both countries.

The impact of family violence, family functioning, and parental partner dynamics on Korean juvenile delinquency

The present study was aimed at determining the family factors related to juvenile delinquency and identifying the effect of family violence, family functioning, parental partner dynamics, and adolescents' personality on delinquent behavior among Korean adolescents. A cross-sectional study was performed using an anonymous, self-reporting questionnaire. The subjects for this study consisted of 1,943 Korean adolescents, including 1,236 students and 707 juvenile delinquents, using a proportional stratified random sampling method. Compared to student adolescents, delinquent adolescents perceived their parents as having a higher level of dysfunctional parental partner dynamics, poorer family functioning, and a higher level of family violence. Furthermore, delinquent adolescents were more likely to report a greater incidence of antisocial personality tendencies, a higher level of psychosomatic symptoms and frustration, and higher frequencies of delinquent behavior compared to student adolescents. Antisocial personality tendency and gender had the largest significant total effects on delinquent behavior, followed by family violence, psychosomatic symptoms, family functioning, parental partner dynamics and need frustration. On the other hand, family functioning and parental partner dynamics had the largest indirect effect on delinquent behavior. Gender, antisocial personality tendency, and family violence, in that order, had the largest direct effects on delinquent behavior. In conclusion, it is apparent from the results of the present study that delinquent Korean adolescents perceived and experienced significantly more family dysfunction, family violence, and poor parental partner dynamics than did non-delinquents.

Association between psychological factors and adolescent smoking in seven cities in China

BACKGROUND

Cigarette smoking is a culturally accepted behavior among adult males in China. However, there is limited information on smoking among Chinese adolescents, particularly the information on the relationship between psychological well-being and smoking behavior among this population.

PURPOSE

This study explored associations between three psychological factors--anxiety, hostility, and depressive symptoms--and smoking behavior among Chinese adolescents.

METHODS

The data presented in this study are a cross-sectional slice from a longitudinal investigation of tobacco use and lifestyle carried out in China. The study population consisted of 4,724 7th and 11th grade students from seven large cities in China.

RESULTS

Odds ratios showed that anxiety, hostility, and depressive symptoms were significantly associated with a higher risk of lifetime smoking for both boys and girls.

CONCLUSION

Much like their Western counterparts, Chinese adolescents face developmental stress. The resulting distress may increase their risk for substance use and other health-risk behaviors.

Protective and risk influences of drug use among a multiethnic sample of adolescent boys

A measurement model was analyzed to demonstrate a differential distribution and cumulative exposure to psychosocial risk and protective influences of adolescent drug use among ethnically-diverse adolescent samples. The sample included U.S.-born (US) Latino (N = 837), foreign-born (FB) Latino (N = 447), White (N = 632), and African American (N = 618) adolescent boys. Psychological Distress, Peer Drug Use, and Adolescent Drug Use were significantly positively correlated with Peer Drug Use and Adolescent Drug Use. In contrast, Family, School, law abidance, and guilt were significantly negatively correlated with Peer Drug Use and Adolescent Drug Use. Multiple group analyses indicated significant similarities and differences among US and FB Latinos, and Whites. Implications for early prevention, multi-level interventions, and suggestions for future research are discussed.

Influences affecting adolescent smoking behavior in China

This study examined multiple influences on the use of tobacco by adolescents in China. Using the theory of triadic influences as a guide, we selected interpersonal, attitudinal/cultural, and intrapersonal constructs from baseline data to predict adolescent smoking 1 year later. We used prospective data from middle and high school students (N = 11,583) and their parents from the China Seven Cities Study, a longitudinal study that is evaluating the effects of changing economic and social factors on health behaviors including tobacco use. A multilevel regression analysis provided some support that each of the influences in the theory of triadic influences affects adolescent smoking in China. After adjusting for important confounders including age, gender, socioeconomic status, and smoking behaviors (lifetime and past 30-day) at baseline, we found significant risk factors within each of the three categories, including interpersonal influences (parental monitoring, good friend smoking, and peer smoking), attitudinal/cultural influences (school academic ranking, initial liking of smoking, and the meaning of smoking), and intrapersonal influences (susceptibility to smoking, and low self-confidence to quit smoking). Results suggest that the etiology of smoking among adolescents in China might be similar to that observed in western countries and that some of the techniques used successfully in prevention programs in those countries might be useful guides when developing prevention programs in China.

Similarities and differences of longitudinal phenotypes across alternate indices of alcohol involvement: a methodologic comparison of trajectory approaches

Extant developmental research distinguishing young adults who moderate versus persist in alcohol consumption has not consistently evaluated the domain of alcohol involvement being modeled, making it difficult to compare findings across studies. In the present study, the authors characterized the developmental course of 5 indices of alcohol involvement using a prospective (6-wave) sample of 377 young adults (Year 1 age = 18.52 years; 55% female; 51% with family history of alcoholism) over 11 years. Growth mixture models were applied to each measure. Despite similarity in trajectory shape, predicted prevalences varied, and the consistency of trajectory classifications across alternate indices revealed low agreement. Correlates of drinking course, however, were somewhat robust across alcohol index. The finding that trajectories are conditional on the specific indices used suggests that it may be hazardous to generalize across alternate indices of alcohol involvement.

Gender differences in delinquent behavior among Korean adolescents

The present study examined gender differences in the rate, type, and relevant variables underlying delinquent behavior among South Korean adolescents. Although female delinquency is increasing and becoming more violent in South Korea, the rate of delinquent behavior was found to be much lower among female than among male adolescents and female adolescents were much less involved in antisocial, aggressive, and psychopathic delinquent behavior compared to male adolescents. Moreover, compared to female delinquent adolescents, male delinquent adolescents were found to have greater tendencies towards antisocial personality, sociability, being sexually abused, and alcohol and drug use. In contrast, female delinquent adolescents had a greater tendency toward depression than male delinquent adolescents. No gender differences were found in the association between family dynamics and delinquent behaviors. Age and antisocial personality had the most significant total effects on male delinquent behavior. In contrast, alcohol and drug abuse was the strongest contributing factors in female delinquent behavior, although the level of alcohol and drug abuse was much higher among male adolescents than among female adolescents.

Hostility, depressive symptoms, and smoking in early adolescence

Using logistic and multiple regression, we examined the association between hostility, level of depressive symptoms, and smoking in a sample of 1699 ethnically diverse students in California. Self-reports were collected twice from each student, at the beginning of the 6th and 7th grade years. Among 6th graders who had not smoked, depressive symptoms and hostility were associated with smoking initiation by the 7th grade. Among those students who had already tried smoking, increases in depressive symptoms and hostility were associated with more frequent smoking. The association between hostility and smoking was stronger for students reporting higher levels of depressive symptoms.

Exploring the association between cannabis use and depression

AIM

To examine the evidence on the association between cannabis and depression and evaluate competing explanations of the association.

METHODS

A search of Medline, Psychinfo and EMBASE databases was conducted. All references in which the terms 'cannabis', 'marijuana' or 'cannabinoid', and in which the words 'depression/depressive disorder/depressed', 'mood', 'mood disorder' or 'dysthymia' were collected. Only research studies were reviewed. Case reports are not discussed.

RESULTS

There was a modest association between heavy or problematic cannabis use and depression in cohort studies and well-designed cross-sectional studies in the general population. Little evidence was found for an association between depression and infrequent cannabis use. A number of studies found a modest association between early-onset, regular cannabis use and later depression, which persisted after controlling for potential confounding variables. There was little evidence of an increased risk of later cannabis use among people with depression and hence little support for the self-medication hypothesis. There have been a limited number of studies that have controlled for potential confounding variables in the association between heavy cannabis use and depression. These have found that the risk is much reduced by statistical control but a modest relationship remains.

CONCLUSIONS

Heavy cannabis use and depression are associated and evidence from longitudinal studies suggests that heavy cannabis use may increase depressive symptoms among some users. It is still too early, however, to rule out the hypothesis that the association is due to common social, family and contextual factors that increase risks of both heavy cannabis use and depression. Longitudinal studies and studies of twins discordant for heavy cannabis use and depression are needed to rule out common causes. If the relationship is causal, then on current patterns of cannabis use in the most developed societies cannabis use makes, at most, a modest contribution to the population prevalence of depression.

A preliminary validation of the Positive and Negative Suicide Ideation (PANSI) inventory with normal adolescent samples

The present study evaluated the factor structure, reliability, and validity of the Positive and Negative Suicide Ideation (PANSI; Osman, Gutierrez, Kopper, Barrios, & Chiros, 1998) inventory in a sample of high-school youths. The PANSI is designed as a measure of risk and protective factors related to suicidal behavior. Participants (114 boys and 103 girls) completed the PANSI and other self-report instruments. Results of the confirmatory factor analyses supported adequate fit of the 2-factor oblique model to the sample data. Both factor scales attained adequate levels of reliability. Boys and girls did not differ in their responses to the PANSI scales. The PANSI scale scores were associated with scores from related measures. Logistic-regression analyses were used to evaluate the contributions of the PANSI scale scores to differentiate between the study groups. Receiver Operating Characteristic (ROC) analyses, using data from the psychiatric suicide risk and high-school control youths, were used to identify cutoff scores of 1.63 and 3.33 for the PANSI-negative and PANSI-positive scales, respectively.

Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence

OBJECTIVE

To compare phenomenology, psychosocial correlates, and treatment seeking in DSM-Itt-R major depression and dysthymia among adolescents diagnosed as cases in a community-based study.

METHOD

A self-report questionnaire, including psychosocial data, life events, eating behaviors, depressive symptoms, substance use, pathological behaviors, and family and school functioning was administered to a nonselected sample (N = 3,287, 93.2% of targeted population) of adolescents aged 11 to 20 years from several Haute-Marne communities in France in 1988-1989. Subgroups of subjects (n = 205, 84.7% of eligible subjects) were interviewed with a structured diagnostic schedule, and adolescents with major depression (n = 49), dysthymia (n = 21) and controls (n = 135) were compared.

RESULTS

Nearly 30% of controls had at least one current symptom of depression. Patterns of affective symptoms were similar in major depression and dysthymia, but significant differences emerged in comorbid conditions (more anxiety disorders, suicidal behaviors, and alcohol intoxications associated with major depression) and stressor at onset (more severe in major depression). Experiences of loss during the prior 12 months were associated with both forms of affective disorder, while poor family relationships were specific correlates of dysthymia. In contrast, peer relationships and pathological behaviors did not differ between depressed subjects and controls. Although psychosocial functioning was significantly impaired in both groups of depressed adolescents, treatment seeking was limited to 34.7% for major depressive subjects and 23.8% for dysthymic subjects.

CONCLUSION

The results provide evidence that major depression and dysthymia in adolescence are equally severe but may have distinct patterns in associated factors. Despite free access to health care, the rate of treatment seeking for mood disorders in France is similar to that reported in U.S. studies.

The one-year prospective prediction of substance abuse and dependence among high-risk adolescents

The present study examined 1-year prospective predictors of self-reported substance abuse and dependence among a sample of 702 youths at high risk for drug abuse from 21 southern California continuation high schools. Triadic influence theory was used as a theoretical guide. Predictors were selected as measures of triadic influence theory. Among 13 predictors, a drug use and intention index, and concern that one is or will become an addict or alcoholic, were consistently predictive of self-reported substance abuse or substance dependence 1 year later, controlling for baseline abuse or dependence status. In addition, baseline substance abuse, White ethnicity, and relatively poor prosocial coping predicted later substance dependence. Apparently, adolescents can predict their future use, and abuse or dependence status. Also, instruction in prosocial coping (e.g., seeking social support) may help inhibit the transition from substance abuse to substance dependence.

One-year prospective prediction of drug use from stress-related variables

Six stress-related variables, gender, age, and ethnicity were investigated as concurrent and prospective predictors of three types of drug use (cigarettes, alcohol, and illicit drug use) among 875 "high risk" adolescents. The stress-related variables were socioeconomic status, "missing" one's parent(s), family conflict, victimization, perceived stress, and stress-drug beliefs. In general, concurrent regression models indicated that those who were lower in socioeconomic status, held stress-drug beliefs favorable toward drug use, and who had been victimized in the last year were more likely to be cigarette, alcohol, or illicit drug users. Prospective regression models indicated that those who had used drugs at baseline and had been victimized in the last year were relatively likely to use drugs the next year. Significant predictors in the multivariable models accounted for between 56 and 85% of those subjects who were above the median on later drug use. Victimization is apparently a relatively important source of stress in the prediction of future drug use. Drug-use intervention implications of these results include the need to provide supportive services to those who have been victims of violent attacks on their person or property.

Suicide ideation among US college students. Associations with other injury risk behaviors

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.

The association of current stimulant use with demographic, substance use, violence-related, social and intrapersonal variables among high risk youth

This paper reports the association of current stimulant use with demographic, other substance use, violence-related, social and intrapersonal variables among a large sample of high risk adolescents. A total of 21.4% of the sample reported using stimulants in the last 30 days. In a final, multivariable model, nonredundant concurrent predictors of current stimulant use were reports that friends use stimulants, reports that stimulants were likely to be used again in the next 12 months, use of alcohol, hallucinogens, or cocaine in the last 30 days, use of alcohol or other drugs to feel more safe, and reports of depression in the last week. Being above the median on 0 to all 7 of these correlates predicted from 0% to 85% of those who were above the median on current stimulant use. One may speculate that programming for these stimulant-using youth should include treatment of multiple substances, depression, and correction of social-cognitive misperceptions.