1
|
Hatz LE, Courtney KE, Wade NE, Thompson C, Baca R, Andrade G, Doran N, Jacobus J. First Used Nicotine/Cannabis Product and Associated Outcomes in Late Adolescents. Subst Use Misuse 2024; 59:699-706. [PMID: 38170177 PMCID: PMC10923017 DOI: 10.1080/10826084.2023.2294975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND Nicotine and tobacco product (NTP) and cannabis use are common in adolescence/young adulthood and increase risk for negative psychosocial outcomes. This study investigated associations among adolescent/young adults' initial experiences with NTPs, lifetime frequency of substance use, substance-related problems, and mental health symptoms. METHOD Adolescents and young adults enrolled in a study on NTP and cannabis use were asked at what age they initiated the use of NTPs and were assigned to groups based on which product or substance(s) they reported using at the earliest age. Participants who reported use of NTPs (in isolation, without cannabis) first (N = 78, "NTP-only"), simultaneous use of NTPs and cannabis first (e.g., blunt or bowl; N = 25, "Simult-only"), use of both NTPs in isolation and simultaneous use at the same age (N = 48, "NTP + Simult"), and no NTP use (N = 53, "NTP-naïve") were compared on substance use, substance-related problems, and mental health symptoms. RESULTS Groups differed on lifetime frequency of NTP, simultaneous, and cannabis use, with NTP users reporting more substance use episodes and substance-related problems than the NTP-naïve group. The lifetime frequency of cannabis use did not differ across NTP use groups. NTP use was associated with increased anxiety and depression, with no significant differences between groups. CONCLUSIONS Adolescents and young adults who use nicotine may be at increased risk for greater nicotine use and mental health consequences, but initiating NTP use simultaneously with cannabis may not increase the risk of negative outcomes above and beyond nicotine initiation. Prospective longitudinal research is needed to establish temporal associations between first-used NTP/cannabis products and relevant outcomes.
Collapse
Affiliation(s)
- Laura E. Hatz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Kelly E. Courtney
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Natasha E. Wade
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Courtney Thompson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Rachel Baca
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Gianna Andrade
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Neal Doran
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
2
|
Essadek A, Musso M, Assous A, Widart F, Mathieu J, Robin M, Shadili G. Alcohol and psychoactive substance use in a cohort of children followed by child protection in France. Front Psychiatry 2023; 14:1180292. [PMID: 37953931 PMCID: PMC10634220 DOI: 10.3389/fpsyt.2023.1180292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background and aim Many studies have investigated the association between maltreatment and substance use in adulthood.In this study, we sought to explore the association between substance use during adolescence, diverse forms of child maltreatment, and psychological symptoms within a cohort of individuals under the purview of child protection services in France. Method The dataset was culled from a retrospective, population-based study encompassing minors and young adults aged 0 to 21, who were under the care of child protection services. Specifically, we conducted a comparative analysis between minors exhibiting substance use (N = 72) and those without such use (N = 776). Result The odds ratios predominantly illuminated a significant correlation between Substance Use and the manifestation of self-destructive behavior (OR = 4.35; CI 2.02-9.59), as well as aggressive behavior (OR = 5.75; CI 2.87-11.84). Univariate analysis also hinted at an association between SUD and suicidal ideation (OR = 3.52; CI 2.1-5.90). Conclusion Children in France who are in the care of child protection services and who use psychoactive substances are at greater risk of dropping out of school and of having other psychological symptoms. It is important that the public authorities take account of these results in order to adjust the care given to these minors, who often do not receive psychological support.
Collapse
Affiliation(s)
| | - Maeva Musso
- Department of Psychiatry, Hopital Saint-Maurice, Paris, France
| | | | - Frédéric Widart
- Department of Psychology, University of Liège, Liège, Belgium
| | - Joris Mathieu
- Université de Lorraine, INTERPSY, Nancy, France
- Centre Spécialisé de l’Obésité (CSO) et Service d’Endocrinologie, Diabétologie et Nutrition (EDN), CHRU-Nancy, Vandoeuvre-lès-Nancy, France
| | - Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- INSERM U1178, Team PsyDev, Villejuif, Paris, France
| | - Gérard Shadili
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| |
Collapse
|
3
|
Rieselbach MM, Corley RP, Hewitt JK, Rhee SH. Anxiety-specific associations with substance use: Evidence of a protective factor in adolescence and a risk factor in adulthood. Dev Psychopathol 2023; 35:1484-1496. [PMID: 35491700 PMCID: PMC9626393 DOI: 10.1017/s0954579422000232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Externalizing psychopathology is a strong risk factor for substance use, whereas the role of internalizing manifestations of distress, and anxiety in particular, in predicting substance use remains unclear. Studies have suggested that anxiety may be either a protective or risk factor for substance use. The present study aimed to clarify evidence for anxiety-specific associations with substance use, examining sex and developmental period (adolescence vs. adulthood) as potential moderators that may help explain conflicting results in the literature. In a longitudinal twin sample, cross-sectional associations of anxiety with substance use differed in adolescents and adults and in girls/women and boys/men. Controlling for externalizing psychopathology and depression, anxiety was associated with reduced substance use in adolescent girls and increased substance use in adult women. In contrast, anxiety-specific associations with substance use were not significant in boys and men. Possible explanations for these contrasting results across development and sex are discussed.
Collapse
Affiliation(s)
- Maya M. Rieselbach
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - John K. Hewitt
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder
- Institute for Behavioral Genetics, University of Colorado Boulder
| |
Collapse
|
4
|
Roberts W, Schick MR, Tomko RL, McRae-Clark AL, Pittmann B, Gueorgieva R, McKee SA. Developmental trajectories of alcohol and cannabis concurrent use in a nationally representative sample of United States youths. Drug Alcohol Depend 2023; 248:109908. [PMID: 37149960 PMCID: PMC10330385 DOI: 10.1016/j.drugalcdep.2023.109908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/27/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Previous studies have identified common trajectories of single type substance use over the course of adolescence; however, no study to date has examined joint trajectories of cannabis and alcohol concurrent use. Given that expansion of legal cannabis has increased availability, it is important to understand patterns of concurrent use in adolescents and factors that place male and female youth at risk for harmful trajectories of concurrent use. The current study sought to identify joint trajectories of cannabis and alcohol use - and predictors of harmful use trajectories - among male and female adolescents. METHOD We used 4 waves of data from 6997 early adolescent participants (age 12-14 years at Wave 1) in the Population Assessment of Tobacco and Health, a nationally representative longitudinal study in the United States. Participants reported their cannabis and alcohol use reassessed yearly for 5 years (2013-2018). We used joint trajectory growth mixture modeling to identify trajectory groups as defined by changes in alcohol and cannabis use over time. RESULTS Five classes of alcohol and cannabis concurrent use trajectories were identified. Both internalizing and externalizing symptoms at Wave 1 increased the odds of membership in trajectory groups characterized by more harmful use trajectories. Internalizing symptomatology was a stronger predictor of membership in escalating use trajectories among girls, whereas externalizing symptomatology stronger predictor among boys. CONCLUSIONS These findings underscore the utility of jointly considering alcohol and cannabis use when describing common developmental trajectories of use and identifying risk factors for trajectories characterized by harmful use.
Collapse
Affiliation(s)
- Walter Roberts
- Department of Psychiatry, Yale University, United States.
| | | | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, United States; Ralph H. Johnson VA Medical Center, United States
| | - Brian Pittmann
- Department of Biostatistics, Yale University, United States
| | | | - Sherry A McKee
- Department of Psychiatry, Yale University, United States
| |
Collapse
|
5
|
Scoppetta O, Avendaño Prieto BL, Cassiani Miranda C. Individual factors associated with the consumption of illicit substances: a review of reviews. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:206-217. [PMID: 36085126 DOI: 10.1016/j.rcpeng.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 01/30/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. METHODS This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. RESULTS Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. CONCLUSIONS The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.
Collapse
Affiliation(s)
- Orlando Scoppetta
- Psicólogo, Magister en Estudios de Población, Universidad Católica de Colombia, Avenida Caracas No. 46-22, Bogotá, Colombia.
| | | | | |
Collapse
|
6
|
Scoppetta O, Avendaño BL, Cassiani C. Factors Associated with the Consumption of Illicit Drugs: a Review of Reviews. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-020-00464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Min MO, Lewis BA, Minnes S, Gonzalez-Pons KM, Kim JY, Singer LT. Preschool blood lead levels, language competency, and substance use in adolescence. ENVIRONMENTAL RESEARCH 2022; 206:112273. [PMID: 34710438 PMCID: PMC8810688 DOI: 10.1016/j.envres.2021.112273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/22/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Elevated lead levels in children are a persistent public health problem, particularly in urban areas in the United States, yet few prospective studies have examined the association of childhood lead levels with substance use in adolescence. OBJECTIVES To determine the association of early lead levels with adolescent substance use and whether childhood IQ, language skills, and externalizing (aggressive and disruptive) behavior mediate the association, controlling for confounding biological and environmental factors. METHODS The participants (N = 265) were a subsample of a prospective birth cohort study on the developmental effects of prenatal cocaine exposure in the Midwest United States. Blood lead levels (BLL) were assessed at age 4, IQ at age 11, language skills and externalizing behavior at age 12, and substance (alcohol, tobacco, marijuana) use and substance use-related problems at age 15. Biologic assays (hair, urine, bloodspots), along with self-report, were utilized to determine adolescent substance use. Path analyses were conducted to examine the direct and indirect associations of BLL with adolescent substance use. RESULTS The children's mean BLL at 4 years of age was 7.07 (SD = 4.12) μg/dL. Approximately 31% of adolescents used tobacco or marijuana, 40% used alcohol, and 23% reported experiencing substance use-related problems at age 15.7 (SD = 0.28). Elevated BLL was related to a higher likelihood of substance use. Childhood language skills fully mediated the relationship of BLL with substance use-related problems. IQ was related to neither substance use nor substance use-related problems. DISCUSSION Elevated BLL in preschool years is a risk factor for adolescent substance use and related problems. Early screening and intervention for language impairment may reduce substance use-related problems.
Collapse
Affiliation(s)
- Meeyoung O Min
- College of Social Work, University of Utah, United States.
| | - Barbara A Lewis
- Department of Psychological Sciences, Case Western Reserve University, United States
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, United States
| | | | - June-Yung Kim
- Department of Social Work, University of North Dakota, United States
| | - Lynn T Singer
- Departments of Population and Quantitative Health Sciences, Psychological Sciences, Psychiatry and Pediatrics, Case Western Reserve University, United States
| |
Collapse
|
8
|
Kim K, Yee J, Chung JE, Kim HJ, Han JM, Kim JH, Lee KE, Gwak HS. Smartphone Addiction and Anxiety in Adolescents - A Cross-sectional Study. Am J Health Behav 2021; 45:895-901. [PMID: 34702436 DOI: 10.5993/ajhb.45.5.9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: The overuse of smartphones affects physical, social, and psychological well-being. However, research on smartphone addiction and anxiety disorders is scarce. Therefore, the objective of this study was to investigate the association between anxiety and smartphone addiction risk in Korean adolescents. Methods: This study used a cross-sectional survey method. We used the Revised Children's Manifest Anxiety Scale to assess anxiety symptoms and we used the Korean Smartphone Addiction Proneness Scale index to evaluate the degree of high-risk or at-risk for smartphone addiction. Results: Analyses were performed for 1733 adolescents, including 771 boys and 962 girls. The high-risk or at-risk group for smartphone addiction accounted for 20.1% (p < .0001). Total anxiety scale score, as well as physiological anxiety, oversensitivity, and social concern categories were statistically different among levels of smartphone addiction risk (all ps < .0001). Multivariate analysis showed that poor self-reported health level, higher risk of smartphone addiction, having fewer close friends, caffeine drink consumption, female sex, and alcohol use were associated with greater anxiety. Conclusions: Management of smartphone addiction seems to be essential for proper psychological health. There is an urgent need to develop a way to prevent smartphone addiction on a social level.
Collapse
Affiliation(s)
- Kitai Kim
- Kitai Kim, Professor, Department of Journalism & Broadcasting, Honam University, Gwangju, Republic of Korea
| | - Jeong Yee
- Jeong Yee, Researcher, College of Pharmacy & Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Jee Eun Chung
- Jee Eun Chung, Professor, College of Pharmacy, Hanyang University, Ansan, Republic of Korea
| | - Hyun Jeong Kim
- Hyun Jeong Kim, Researcher, College of Pharmacy, Chungbuk National University, Cheongju, Republic of Korea
| | - Ji Min Han
- Ji Min Han, Professor, College of Pharmacy, Chungbuk National University, Cheongju, Republic of Korea
| | - Joo Hee Kim
- Joo Hee Kim, Professor, College of Pharmacy & Institute of Pharmaceutical Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Kyung Eun Lee
- Kyung Eun Lee, Professor, College of Pharmacy, Chungbuk National University, Cheongju, Republic of Korea;,
| | - Hye Sun Gwak
- Hye Sun Gwak, Professor, College of Pharmacy &Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea;,
| |
Collapse
|
9
|
Duko B, Pereira G, Betts K, Tait RJ, Newnham J, Alati R. Associations of prenatal alcohol exposure and offspring harmful alcohol use: findings from the Raine Study. Drug Alcohol Depend 2020; 217:108305. [PMID: 33032247 DOI: 10.1016/j.drugalcdep.2020.108305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Epidemiological evidence suggests offspring exposed to prenatal alcohol are at increased risk of alcohol use disorders in adulthood. The evidence on the risk of developing harmful alcohol use in adolescence is less clear. METHODS We used data from the Raine Study, a multi-generational birth cohort study, to examine the association between prenatal alcohol exposure and the risk of harmful alcohol use in offspring at the age of 17 years. Log binomial regression was used to estimate the relative risks (RRs) of harmful alcohol use in offspring exposed to maternal alcohol use in the first (early) and third (late) trimesters of pregnancy. Maternal pre-pregnancy alcohol use was used as a negative control for intrauterine exposure for comparison. RESULTS Complete data were available for 1200 mother-offspring pairs. After adjustment for potential confounders, we found increased RRs of harmful alcohol use in offspring born to mothers who consumed four or more standard drinks of alcohol per week during the first trimester [RR 1.45(95% CI: 1.08-1.93)], third trimester [RR 1.34 (95% CI: 1.04-1.72)] and during both trimesters of pregnancy [RR 1.86 (95% CI: 1.16-2.96)]. Maternal pre-pregnancy alcohol use was not associated with an increased risk of harmful alcohol use in offspring [RR 1.15 (95% CI: 0.89-1.48)]. CONCLUSION Observed associations for maternal prenatal alcohol exposure but not maternal pre-pregnancy alcohol use suggests a biological mechanism for intrauterine alcohol exposure on the risk of harmful alcohol use in the offspring.
Collapse
Affiliation(s)
- Bereket Duko
- School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia.
| | - Gavin Pereira
- School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Betts
- School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, 7 Parker Place Building 609, Level 2 Technology Park, Bentley, WA 6102, Australia
| | - John Newnham
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, The University of Western Australia, 17 Monash Ave, Nedlands, WA 6009, Australia
| | - Rosa Alati
- School of Public Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, Queensland 4068 Australia
| |
Collapse
|
10
|
Scoppetta O, Avendaño Prieto BL, Cassiani Miranda C. Individual Factors Associated with the Consumption of Illicit Substances: a Review of Reviews. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30030-5. [PMID: 33735052 DOI: 10.1016/j.rcp.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/11/2019] [Accepted: 01/30/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. METHODS This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. RESULTS Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. CONCLUSIONS The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.
Collapse
Affiliation(s)
- Orlando Scoppetta
- Psicólogo. Magister en Estudios de Población. Universidad Católica de Colombia. Avenida Caracas No. 46-22, Bogotá, Colombia.
| | | | | |
Collapse
|
11
|
Pengpid S, Peltzer K. High alcohol use and misuse in a representative sample of in-school adolescents in the Seychelles. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1677058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, Thailand
- Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom, South Africa
| | - Karl Peltzer
- Deputy Vice Chancellor Research and Innovation Office, North West University, Potchefstroom, South Africa
| |
Collapse
|
12
|
Alcohol Use and Misuse Among School-Going Adolescents in Thailand: Results of a National Survey in 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111898. [PMID: 31146363 PMCID: PMC6603660 DOI: 10.3390/ijerph16111898] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/10/2019] [Accepted: 05/11/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to assess the prevalence of alcohol use and misuse, and to identify its associated factors among in-school adolescents in the 2015 Thailand Global School-based Student Health Survey (GSHS). The sample included 5994 school-going adolescents (mean age 14.5 years, SD = 1.7) from Thailand that responded to the 2015 GSHS. Overall, 22.2% were current alcohol users, 24.3% had ever been drunk, 12.1% had drunk two or more alcoholic drinks in a day in the past 30 days and 10.8% had gotten into trouble because of drinking alcohol. In adjusted Poisson regression analysis, older age, psychological distress, current tobacco use, the consumption of one or more soft drinks a day, school truancy, having been in a physical fight in the past 12 months, and having been seriously injured in the past 12 months were associated with current alcohol use. Older age, psychological distress, current tobacco use and injury also increased the odds for lifetime drunkenness, having two or more drinks in a day and trouble resulting from drinking. Soft drink consumption and having been in a physical fight also increased the odds for lifetime drunkenness and having two or more drinks in a day and school truancy also increased the odds for lifetime drunkenness and trouble resulting from drinking. In addition. Parental tobacco use was associated with lifetime drunkenness and trouble resulting from drinking, cannabis use with trouble resulting from drinking, and parental support was protective from trouble resulting from drinking. There were no significant sex differences regarding any of the four alcohol use indicators. More than one in five school-going adolescents in Thailand use and misuse alcohol, and strategies to prevent alcohol misuse, including a cluster of risk behaviours, are needed.
Collapse
|
13
|
Abstract
Purpose Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences. Design/methodology/approach This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis. Findings Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator. Practical implications Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles. Originality/value Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.
Collapse
Affiliation(s)
- Monica Stolt Pedersen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, University of Oslo , Oslo, Norway
| | - Anne Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway
- Innland University of Applied Sciences , Campus Elverum, Elverum, Norway
| | | | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway
- Innland University of Applied Sciences , Campus Elverum, Elverum, Norway
| |
Collapse
|
14
|
Francis JM, Myers B, Nkosi S, Petersen Williams P, Carney T, Lombard C, Nel E, Morojele N. The prevalence of religiosity and association between religiosity and alcohol use, other drug use, and risky sexual behaviours among grade 8-10 learners in Western Cape, South Africa. PLoS One 2019; 14:e0211322. [PMID: 30759112 PMCID: PMC6374069 DOI: 10.1371/journal.pone.0211322] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 01/11/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Alcohol and other drug use (AOD) and risky sexual behaviours remain high among adolescents in South Africa and globally. Religiosity influences, mitigates and provides resilience against engaging in risky behaviours among young people but few South African studies have explored potential associations between religiosity, AOD use and risky sex. We report the prevalence of religiosity and association between religiosity and AOD use and risky sexual behaviours among learners in the Western Cape Province, South Africa. METHODS Between May and August 2011, a cross sectional survey was conducted among 20 227 learners from 240 public schools randomly selected through a stratified multistage sampling design to determine the prevalence of AOD use and sexual risk behaviours. We performed univariate and multivariate logistic regression analyses to assess the association between religiosity, AOD use and risky sexual behaviours. RESULTS The learners were aged 10-23 years. Almost three quarters (74%) of learners reported high religiosity (defined as attending religious services or activities at least 1-2 times a month). More female than male learners had high religiosity. The prevalence of past 30 day reported alcohol, tobacco and cannabis use was 23%, 19% and 8% respectively. Compared to learners with low religiosity, those with high religiosity were less likely to engage in AOD use: specifically alcohol use, (AOR = 0.86, 95%CI: 0.76-0.97), tobacco use (AOR = 0.76, 95%CI: 0.67-0.87), cannabis use (AOR = 0.57, 95%CI: 0.48-0.68) in the last 30 days. They were also less likely to engage in risky sexual behaviours (AOR = 0.90, 95%CI: 0.81-0.99). CONCLUSION Religiosity was associated with lower odds of reported AOD use and risky sexual behaviours among learners in the Western Cape. This calls for further exploration on how to incorporate religiosity into AOD use and risky sexual behaviour interventions.
Collapse
Affiliation(s)
- Joel Msafiri Francis
- Visiting scholar, Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
- Wits Reproductive Health & HIV Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bronwyn Myers
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Sebenzile Nkosi
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Petal Petersen Williams
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Tara Carney
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Elmarie Nel
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Neo Morojele
- Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
15
|
González-Bueso V, Santamaría JJ, Fernández D, Merino L, Montero E, Ribas J. Association between Internet Gaming Disorder or Pathological Video-Game Use and Comorbid Psychopathology: A Comprehensive Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E668. [PMID: 29614059 PMCID: PMC5923710 DOI: 10.3390/ijerph15040668] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/30/2018] [Accepted: 03/31/2018] [Indexed: 12/15/2022]
Abstract
The addictive use of video games is recognized as a problem with clinical relevance and is included in international diagnostic manuals and classifications of diseases. The association between "Internet addiction" and mental health has been well documented across a range of investigations. However, a major drawback of these studies is that no controls have been placed on the type of Internet use investigated. The aim of this study is to review systematically the current literature in order to explore the association between Internet Gaming Disorder (IGD) and psychopathology. An electronic literature search was conducted using PubMed, PsychINFO, ScienceDirect, Web of Science and Google Scholar (r.n. CRD42018082398). The effect sizes for the observed correlations were identified or computed. Twenty-four articles met the eligibility criteria. The studies included comprised 21 cross-sectional and three prospective designs. Most of the research was conducted in Europe. The significant correlations reported comprised: 92% between IGD and anxiety, 89% with depression, 85% with symptoms of attention deficit hyperactivity disorder (ADHD), and 75% with social phobia/anxiety and obsessive-compulsive symptoms. Most of the studies reported higher rates of IGD in males. The lack of longitudinal studies and the contradictory results obtained prevent detection of the directionality of the associations and, furthermore, show the complex relationship between both phenomena.
Collapse
Affiliation(s)
- Vega González-Bueso
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network, Generalitat de Catalunya (XHUB), C/Forn-7-9 Local, 08014 Barcelona, Spain.
| | - Juan José Santamaría
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network, Generalitat de Catalunya (XHUB), C/Forn-7-9 Local, 08014 Barcelona, Spain.
| | - Daniel Fernández
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain.
- School of Mathematics and Statistics, Victoria University of Wellington, Wellington 6140, New Zealand.
| | - Laura Merino
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network, Generalitat de Catalunya (XHUB), C/Forn-7-9 Local, 08014 Barcelona, Spain.
| | - Elena Montero
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network, Generalitat de Catalunya (XHUB), C/Forn-7-9 Local, 08014 Barcelona, Spain.
| | - Joan Ribas
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network, Generalitat de Catalunya (XHUB), C/Forn-7-9 Local, 08014 Barcelona, Spain.
| |
Collapse
|
16
|
Herz V, Franzin N, Huemer J, Mairhofer D, Philipp J, Skala K. Substance use and misuse among children and youth with mental illness : A pilot study. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2018; 32:18-25. [PMID: 28639209 PMCID: PMC5842275 DOI: 10.1007/s40211-017-0231-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/06/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to examine prevalence, patterns and predictors of substance use among a sample of adolescent psychiatric inpatients. METHODS Participants included 25 minors aged 12-17 years admitted to an Austrian department of child and adolescent psychiatry. Lifetime use, initiation, frequency and quantity of substance use, sociodemographic, family and school-related data were collected by self-report measures. Substance use disorders were detected using CAGE (a screening instrument for problem drinking) and FTND (Fagerström Test For Nicotine Dependence). Clinical characteristics were extracted from medical records. RESULTS Lifetime prevalence of any substance use (76%) and regular use (32%) were common. Prevalence was high for alcohol (76%), nicotine (44%) and illicit drug use (36%). Older age was associated with tobacco (p = 0.023), drug (p = 0.021) and cannabis use (p = 0.015) and regular use of psychotropic substances (p = 0.027). Family dysfunction predicted regular (p = 0.035) and cannabis use (p = 0.02). History of trauma prognosticated regular (p = 0.047) and tobacco use (p = 0.011). Use of any substance (p < 0.001) as well as regular use (p = 0.026) were significantly associated with peer substance use. Consuming adolescents were more likely to show academic failure, school absenteeism and behavioral problems. Alcohol (p = 0.02), drug (p = 0.017) and regular substance use (p = 0.007) were linked to suicidal ideation. A remarkable relationship between affective as well as externalizing disorders and alcohol, nicotine and drug use was found. CONCLUSIONS Substance use is highly prevalent among youth with mental illnesses and associated with psychosocial consequences. These data highlight the need to carefully explore this population at high risk.
Collapse
Affiliation(s)
- V Herz
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - N Franzin
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - J Huemer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - D Mairhofer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - J Philipp
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - K Skala
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| |
Collapse
|
17
|
Pedersen MS, Landheim A, Møller M, Lien L. Acting on audit & feedback: a qualitative instrumental case study in mental health services in Norway. BMC Health Serv Res 2018; 18:71. [PMID: 29386020 PMCID: PMC5793343 DOI: 10.1186/s12913-018-2862-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 01/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation process. It aims to measure the research-practice gap, but its effect varies greatly. Less is known of how audit and feedback is used in natural settings. The aim of this study was to describe and investigate what is discussed and thematised when Quality Improvement (QI) teams in a District Psychiatric Centre (DPC) work to complete an action form as part of an A&F cycle in 2014. METHODS This was an instrumental multiple case study involving four units in a DPC in Norway. We used open non-participant observation of QI team meetings in their natural setting, a total of seven teams and eleven meetings. RESULTS The discussions provided health professionals with insight into their own and their colleagues' practices. They revealed insufficient knowledge of substance-related disorders and experienced unclear role expectations. We found differences in how professional groups sought answers to questions of clinical practice and that they were concerned about whether new tasks fitted in with their routine ways of working. CONCLUSION Acting on A&F provided an opportunity to discuss practice in general, enhancing awareness of good practice. There was a general need for arenas to relate to practice and QI team meetings after A&F may well be a suitable arena for this. Self-assessment audits seem valuable, particular in areas where no benchmarked data exists, and there is a demand for implementation of new guidelines that might change routines and develop new roles. QI teams could benefit from having a unit leader present at meetings. Nurses and social educators and others turn to psychiatrists or psychologists for answers to clinical and organisational questions beyond guidelines, and show less confidence or routine in seeking research-based information. There is a general need to emphasise training in evidence-based practice and information seeking behaviour for all professional groups.
Collapse
Affiliation(s)
- Monica Stolt Pedersen
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Anne Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway.,Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | | | - Lars Lien
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway.,Inland Norway University of Applied Sciences, Campus Elverum, Elverum, Norway
| |
Collapse
|
18
|
Burden of depressive symptoms and non-alcohol substance abuse; and their association with alcohol use and partner violence: a cross-sectional study in four sub-Saharan Africa countries. Glob Ment Health (Camb) 2018; 5:e31. [PMID: 30455966 PMCID: PMC6236214 DOI: 10.1017/gmh.2018.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/23/2018] [Accepted: 06/13/2018] [Indexed: 12/14/2022] Open
Abstract
In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR = 1.49, p = 0.008), NAS abuse (PR = 2.06, p = 0.02) and IPV (PR = 2.93, p < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, p < 0.001)], female (OR = 0.48, p = 0.036) were protective of NAS but current smokers (OR = 2.98, p < 0.001) and those reporting IPV (OR = 2.16, p = 0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.
Collapse
|
19
|
Skogen JC, Bøe T, Sivertsen B, Hysing M. Use of alcohol, tobacco and illicit drugs among ethnic Norwegian and ethnic minority adolescents in Hordaland county, Norway: the youth@hordaland-survey. ETHNICITY & HEALTH 2018; 23:43-56. [PMID: 27764960 DOI: 10.1080/13557858.2016.1246422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe potential differences in unhealthy behaviours among ethnic Norwegian adolescents and minority adolescents from countries within the European Union, European Economic Area or US (EU/EEA countries) and adolescents from non-EU/EEA countries. Specifically, we aimed to investigate ethnic differences in use of alcohol, tobacco and illicit drugs, and potential confounding due to socio-demographic characteristics. DESIGN Cross-sectional population-based study of adolescents aged 16-19 (N = 10,122), with self-reported ethnicity as grouping variable, and self-reported use of alcohol, tobacco and illicit drugs as dependent variables. RESULTS We found that minority adolescents from EU/EEA and non-EU/EEA countries differed from ethnic Norwegian adolescents on important indicators of unhealthy behaviours. Compared to Norwegian adolescents, adolescents from EU/EEA were more likely to report having tried to smoke, to be a daily smoker and to ever having tried an illicit drug (adjusted odds ratio (OR) ranging from 2.01 to 3.74). They were, however, less likely to have tried snus (a form of smokeless tobacco; adjusted OR 0.64; confidence interval (CI) 95% 0.43-0.97) and to report daily snus use (adjusted OR 0.31; CI95% 0.15-0.67). There were no differences in having tried alcohol. Non-EU/EEA adolescents were less likely to have ever tried alcohol (OR 0.24; CI95% 0.18-0.31), snus (OR 0.47; CI95% 0.34-0.65) and to smoke (0.68; CI95% 0.52-0.91), and less likely to report daily snus use (OR 0.36; CI95% 0.21-0.62) compared to Norwegian adolescents. There were no differences with regard to having tried illicit drugs and reporting being a daily smoker. All differences observed were robust to adjustment for age, gender and family socio-economic status. CONCLUSION The presents study identified important differences in unhealthy behaviours across different ethnic groups in Norway. The differences in the prevalence of unhealthy behaviours among ethnic minorities are still relevant in a public health perspective, and potential mechanisms should be investigated further.
Collapse
Affiliation(s)
- Jens Christoffer Skogen
- a Alcohol and Drug Research Western Norway , Stavanger University Hospital , Stavanger , Norway
- b Department of Health Promotion , Norwegian Institute of Public Health , Bergen , Norway
| | - Tormod Bøe
- c Regional Centre for Child and Youth Mental Health and Child Welfare , Uni Research Health , Bergen , Norway
| | - Børge Sivertsen
- b Department of Health Promotion , Norwegian Institute of Public Health , Bergen , Norway
- c Regional Centre for Child and Youth Mental Health and Child Welfare , Uni Research Health , Bergen , Norway
- d Department of Psychiatry , Helse Fonna HF , Haugesund , Norway
| | - Mari Hysing
- c Regional Centre for Child and Youth Mental Health and Child Welfare , Uni Research Health , Bergen , Norway
| |
Collapse
|
20
|
Saban A, Morojele N, London L. A descriptive study of treatment provision for problem alcohol drinking in adult males in Khayelitsha, Cape Town, South Africa. BMC Health Serv Res 2017; 17:740. [PMID: 29219083 PMCID: PMC5773865 DOI: 10.1186/s12913-017-2643-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor, Black African males are underrepresented as patients in facilities that treat problem drinking in Cape Town, South Africa. Reasons for this remain unclear, but factors such as the kinds of treatment provided, perceptions of treatment efficacy, social stigma and traditional treatment beliefs have been suggested as possible barriers to treatment seeking. This descriptive study examined the availability and nature of problem drinking treatment facilities in Khayelitsha, a largely poor township of Black, Xhosa-speaking Africans, on the outskirts of Cape Town. METHODS Seven treatment facilities for problem drinking in adult males were identified using data from the Department of Social Development in the City of Cape Town. Staff members were identified as key informants at each of the treatment facilities, and were interviewed using a structured questionnaire. Twelve interviews were conducted. RESULTS Findings indicated that the available alcohol treatment facilities were relatively new, that treatment modalities varied both across and within treatment facilities, and that treatment was provided largely by social workers. Treatment facilities did not accommodate overnight stay for patients, operated during weekday office hours, and commonly referred patients to the same psychiatric hospital. DISCUSSION The study provides a baseline for assessing barriers to treatment for problem drinking in Khayelitsha by highlighting the nature of available facilities as playing a predominantly screening role with associated social work services, and a point of referral for admission to a psychiatric institution for treatment. The social and financial implications of such referral are pertinent to the discussion of treatment barriers. CONCLUSIONS Recommendations are made to inform policy towards locally-provided integrated care to improve treatment provision and access.
Collapse
Affiliation(s)
- Amina Saban
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Neo Morojele
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
21
|
Abreu-Villaça Y, Manhães AC, Krahe TE, Filgueiras CC, Ribeiro-Carvalho A. Tobacco and alcohol use during adolescence: Interactive mechanisms in animal models. Biochem Pharmacol 2017; 144:1-17. [DOI: 10.1016/j.bcp.2017.06.113] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 06/05/2017] [Indexed: 12/13/2022]
|
22
|
Chao M, Li X, McGue M. The Causal Role of Alcohol Use in Adolescent Externalizing and Internalizing Problems: A Mendelian Randomization Study. Alcohol Clin Exp Res 2017; 41:1953-1960. [PMID: 28876462 DOI: 10.1111/acer.13493] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The co-occurrence of alcohol use and externalizing/internalizing problems threatens adolescents' mental health. Research on whether alcohol use and these problems are causal and the direction of the potential causal relationships is needed to understand the mechanisms of the co-occurrence. METHODS A Mendelian randomization analysis was conducted in which the aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol use phenotypes. In total, 1,608 Chinese adolescents (mean age 14.11 ± 1.83 years) were genotyped for the ALDH2 rs671 polymorphism. Three externalizing problems (aggression, delinquency, and attention problems) were measured with the Youth Self-Report inventory, and 2 internalizing problems (depression and anxiety) were measured with the self-reported Children's Depression Inventory and the Trait subscale of the State-Trait Anxiety Inventory. RESULTS Alcohol use was positively associated with all 3 externalizing and 2 internalizing problems, and the ALDH2 polymorphism had a significant effect on alcohol use. Aggression and attention problems were also significantly affected by the ALDH2 polymorphism, whereas no significant association was observed between the ALDH2 polymorphism and delinquency, anxiety, or depression. CONCLUSIONS The results suggest that alcohol use is a cause of adolescent aggression and attention problems but not adolescent delinquency, anxiety, or depression.
Collapse
Affiliation(s)
- Miao Chao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chaoyang District, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xinying Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chaoyang District, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
23
|
Fernandez ME, Daset L, Vanderplasschen W, Costa Ball CD, Van Damme L, Vindevogel S. Risk and protective factors for alcohol use among school-going adolescents in Montevideo (Uruguay). DRUGS AND ALCOHOL TODAY 2017. [DOI: 10.1108/dat-01-2016-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore risk and protective factors for alcohol use among school-going adolescents in Montevideo (Uruguay).
Design/methodology/approach
A self-report survey was administered to 331 school-going adolescents in Montevideo (Uruguay) (Mage=13; SD=0.05), using the alcohol screening instrument of the Uruguayan National Drug Board to assess adolescents’ alcohol use (yes/no), a screening instrument for psychopathology and resilience (the adolescent self-report) and a socio-demographic questionnaire.
Findings
Logistic regression analyses identified antisocial behaviour, substance use and negative emotionality (F2), disruptive and dysregulated behaviour (F8), higher age and recent death of a close relative as risk factors, while the number of close friends was identified as a protective factor for past year alcohol use (yes/no). No straightforward relationship was found between schools and the risk for the past year alcohol use. In addition, age, F2, F8 and recent death of a close relative appeared to be the most robust predictors.
Research limitations/implications
The study was the first in Uruguay to relate adolescents’ alcohol use to risk and protective factors. Given the cross-sectional nature of the study, causal relationships could not be determined.
Originality/value
The study provides preliminary recommendations for policy makers and other stakeholders involved in youth affairs on core elements to focus on school-, community- and family-based alcohol prevention programmes for adolescents.
Collapse
|
24
|
Bailly D. [The adolescent abstainers: A risk group?]. Encephale 2016; 43:480-485. [PMID: 27693044 DOI: 10.1016/j.encep.2016.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE If abstinence from substance in adolescents may nowadays be regarded statistically as a deviant behavior, what is its significance from a developmental point of view? The aim of this article is to examine the mental health characteristics and the social integration of adolescent abstainers. METHODS A comprehensive literature review of epidemiological studies including data on adolescent abstainers was conducted. RESULTS Compared to the abundant literature devoted to adolescent substance abusers, few studies report data on adolescent abstainers. In addition, many methodological problems limit their interpretability and their comparison. However that may be, this body of work suggests that if abstinence may be due to something intrinsic about the individual (such as psychosocial adjustment difficulties, personality traits or gender), many other environmental factors (such as family background of temperance, cultural practices, upbringing or religion) may determine abstaining behavior. By this way, from a psychopathological angle, adolescent abstainers certainly constitute a more heterogeneous group than the adolescent substance abusers. Some of them are quite psychologically healthy, whereas others are more socially withdrawn and may suffer from emotional disorders. CONCLUSION In terms of prevention, these data highlight the need for longitudinal prospective studies examining the psychosocial status of adolescent abstainers, their antecedents, their outcome and their motivations.
Collapse
Affiliation(s)
- D Bailly
- Pôle universitaire de psychiatrie, hôpital Sainte-Marguerite, AP-HM, 270, boulevard de Sainte-Marguerite, 13374 Marseille cedex 09, France; Aix-Marseille université, 13284 Marseille, France.
| |
Collapse
|
25
|
Why young people's substance use matters for global health. Lancet Psychiatry 2016; 3:265-79. [PMID: 26905482 DOI: 10.1016/s2215-0366(16)00013-4] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 01/16/2023]
Abstract
During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.
Collapse
|
26
|
Pelletier R, Bacon SL, Arsenault A, Dupuis J, Laurin C, Blais L, Lavoie KL. Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study. BMJ Open 2015; 5:e006582. [PMID: 26671946 PMCID: PMC4679922 DOI: 10.1136/bmjopen-2014-006582] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/03/2015] [Accepted: 02/11/2015] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD). DESIGN AND SETTING, AND PATIENTS DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8 years, between 1998 and 2009. Depression and anxiety were assessed using a psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD). Outcomes data were obtained from Quebec provincial databases. MAIN OUTCOME MEASURES All-cause mortality and MACE. RESULTS After adjustment for covariates, patients with depression were at increased risks of all-cause mortality (relative risk (RR)=2.84; 95% CI 1.25 to 6.49) compared with patients without depression. Anxiety was not associated with increased mortality risks (RR=0.86; 95% CI 0.31 to 2.36). When patients were stratified according to CAD status, depression increased the risk of mortality among patients with no CAD (RR=4.39; 95% CI 1.12 to 17.21), but not among patients with CAD (RR=2.32; 95% CI 0.78 to 6.88). Neither depression nor anxiety was associated with MACE among patients with or without CAD. CONCLUSIONS AND RELEVANCE Depression, but not anxiety, was an independent risk factor for all-cause mortality in patients without CAD. The present study contributes to a better understanding of the relative and unique role of depression versus anxiety among patients with versus without CAD.
Collapse
Affiliation(s)
- Roxanne Pelletier
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montréal, Québec, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
| | - André Arsenault
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
| | - Jocelyn Dupuis
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Departement of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Catherine Laurin
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
| | - Lucie Blais
- Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada
- Department of Psychology, University of Québec at Montréal (UQAM), Montréal, Québec, Canada
| |
Collapse
|
27
|
Differential susceptibility to environmental influences: Interactions between child temperament and parenting in adolescent alcohol use. Dev Psychopathol 2015; 28:265-75. [PMID: 26030853 DOI: 10.1017/s0954579415000437] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Temperament and parental practices (PP) are important predictors of adolescent alcohol use (AU); however, less is known about how they combine to increase or decrease risk of AU. This study examined whether age 6 temperament (i.e., impulsivity and inhibitory control) interacted with age 6 coercive PP and/or age 14 parental monitoring to predict AU at 15 years among 209 adolescents. Results showed that low parental monitoring was associated with more frequent AU and that coercive PP interacted with impulsivity to predict AU. This interaction was examined as a function of two models that were not studied before in the prediction of AU: the diathesis-stress model (i.e., impulsive children are more "vulnerable" to adverse PP than those with an easy temperament); and the differential susceptibility model (i.e., impulsive children are also more likely to benefit from good PP). Results supported the differential susceptibility model by showing that impulsive children were not only at higher risk for AU when combined with high coercive PP but also benefit from the absence of coercive PP. This supports the suggestion that the conception of certain temperament characteristics, or in this case impulsivity, as a "vulnerability" for adolescent AU, may need revision because it misrepresents the malleability it may imply.
Collapse
|
28
|
Costa MDA, Salum Junior GA, Isolan LR, Acosta JR, Jarros RB, Blaya C, Diemen LV, Manfro GG. Association between anxiety symptoms and problematic alcohol use in adolescents. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015; 35:106-10. [PMID: 25923300 DOI: 10.1590/s2237-60892013000200003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 08/16/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anxiety disorders are highly prevalent, affecting approximately 10% of individuals throughout life; its onset can be detected since early childhood or adolescence. Studies in adults have shown that anxiety disorders are associated with alcohol abuse, but few studies have investigated the association between anxiety symptoms and problematic alcohol use in early ages. OBJECTIVE To evaluate if anxiety symptoms are associated with problematic alcohol use in young subjects. METHODS A total of 239 individuals aged 10-17 years were randomly selected from schools located in the catchment area of Hospital de Clínicas de Porto Alegre. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) was used to evaluate the presence of anxiety symptoms, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), to evaluate alcohol use. RESULTS One hundred twenty-seven individuals (53.1% ) reported having already used alcohol. Of these, 14 individuals showed problematic alcohol use (5.8% ). There was no association between lifetime use of alcohol and anxiety symptoms, but mean SCARED scores in individuals with problematic alcohol use was higher if compared to those without problematic use, even after adjustment for age and gender (29.9±8.5 vs. 23.7±11.8, p < 0.001). CONCLUSIONS Despite the limitation of a cross-sectional design, our study suggests that anxiety symptoms are associated with problematic alcohol use early in life.
Collapse
Affiliation(s)
- Marianna de Abreu Costa
- Anxiety Disorders Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Jandira Rahmeier Acosta
- Anxiety Disorders Program for Child and Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Lísia Von Diemen
- Center for Drug and Alcohol Research, HCPA, UFRGS, Porto Alegre, RS, Brazil
| | | |
Collapse
|
29
|
Poutiainen H, Levälahti E, Hakulinen-Viitanen T, Laatikainen T. Family characteristics and health behaviour as antecedents of school nurses' concerns about adolescents' health and development: a path model approach. Int J Nurs Stud 2015; 52:920-9. [PMID: 25744429 DOI: 10.1016/j.ijnurstu.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 12/22/2014] [Accepted: 01/04/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Family socio-economic factors and parents' health behaviours have been shown to have an impact on the health and well-being of children and adolescents. Family characteristics have also been associated with school nurses' concerns, which arose during health examinations, about children's and adolescents' physical health and psychosocial development. Parental smoking has also been associated with smoking in adolescents. OBJECTIVES The aim of this study was to determine to what extent school nurses' concerns about adolescents' physical health and psychosocial development related to family characteristics are mediated through parents' and adolescents' own health behaviours (smoking). DESIGN A path model approach using cross-sectional data was used. SETTINGS In 2008-2009, information about health and well-being of adolescents was gathered at health examinations of the Children's Health Monitoring Study. PARTICIPANTS Altogether 1006 eighth and ninth grade pupils in Finland participated in the study. METHODS The associations between family characteristics, smoking among parents and adolescents and school nurses' concerns about adolescents' physical health and psychosocial development were examined using a structural equation model. RESULTS Paternal education had a direct, and, through fathers' and boys' smoking, an indirect association with school nurses' concerns about the physical health of boys. Paternal labour market status and family income were only indirectly associated with concerns about the physical health of boys by having an effect on boys' smoking through paternal smoking, and a further indirect effect on concerns about boys' health. In girls, only having a single mother was strongly associated with school nurses' concerns about psychosocial development through maternal and adolescent girl smoking. CONCLUSIONS Socio-economic family characteristics and parental smoking influence adolescent smoking and are associated with school nurses' concerns about adolescents' physical health and psychosocial development. The findings underline the importance of comprehensively taking into account adolescents' and parents' health behaviours and the family situation in health-care contacts when providing health counselling.
Collapse
Affiliation(s)
- Hannele Poutiainen
- Social and Health Affairs, City of Lahti, P.O. Box 116, 15101 Lahti, Finland.
| | - Esko Levälahti
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, P.O. Box 30, 00271 Helsinki, Finland.
| | - Tuovi Hakulinen-Viitanen
- National Institute for Health and Welfare, Department of Children, Young People and Families, P.O. Box 30, 00271 Helsinki, Finland.
| | - Tiina Laatikainen
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition, P.O. Box 1627, 70211 Kuopio, Finland; National Institute for Health and Welfare, Department of Chronic Disease Prevention, P.O. Box 30, 00271 Helsinki, Finland; Hospital District of North Karelia, Tikkamäentie 16, 80210 Joensuu, Finland.
| |
Collapse
|
30
|
The risk and protective factors associated with depression and anxiety in a national sample of Irish adolescents. Ir J Psychol Med 2015; 32:93-105. [PMID: 30185277 DOI: 10.1017/ipm.2014.83] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The aim of this study is to examine the risk and protective factors associated with anxiety and depression in a representative sample of Irish adolescents. METHODS Data used in this study were drawn from a subset of the My World Survey (MWS). The MWS-Second Level (MWS-SL) subset consists of a randomised sample of 72 schools, with a final sample of 6085 students. Outcome measures were depression and anxiety. Risk and protective factors included measures within the socio-demographic, psychosocial and risk-taking domains. RESULTS One in three adolescents experienced elevated levels of depression and anxiety. Age, gender, maternal education, family composition, parental mental health as well as the experience of racism and bereavement were associated with elevated distress. Psychosocial factors associated with depression and anxiety included optimism, personal competence, life-satisfaction, self-esteem, anger, body dissatisfaction, family competence, maternal and paternal criticism, experiencing the break-up of a romantic relationship, school and peer connectedness as well as the availability of one good adult. Finally, engaging in substance misuse was found to increase the likelihood of anxiety and depression. CONCLUSION Since factors protecting and putting adolescents at risk of anxiety and depression exist at every level of the adolescent's ecological system, the study supports a community-based approach to youth mental health.
Collapse
|
31
|
Smoking, alcohol consumption, and drug use among adolescents with psychiatric disorders compared with a population based sample. J Adolesc 2014; 37:1189-99. [PMID: 25190498 DOI: 10.1016/j.adolescence.2014.08.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 07/28/2014] [Accepted: 08/07/2014] [Indexed: 12/12/2022]
Abstract
This study investigated frequencies of smoking, alcohol use, and illicit drug use by diagnostic category in 566 adolescent psychiatric patients, comparing this sample with 8173 adolescents from the general population in Norway who completed the Young-HUNT 3 survey. Frequencies of current alcohol use were high in both samples but were lower among psychiatric patients. Compared with adolescents in the general population, adolescents in the clinical sample had a higher prevalence of current smoking and over four times higher odds of having tried illicit drugs. In the clinical sample, those with mood disorders reported the highest frequencies of smoking, alcohol use, and illicit drug use, whereas those with autism spectrum disorders reported the lowest frequencies. Our results show an increased prevalence of risky health behaviors among adolescents with psychiatric disorders compared with the general population. The awareness of disorder-specific patterns of smoking and substance use may guide preventive measures.
Collapse
|
32
|
Phillips NL, Milne B, Silsbury C, Zappia P, Zehetner A, Klineberg E, Towns S, Steinbeck K. Addressing adolescent substance use in a paediatric health-care setting. J Paediatr Child Health 2014; 50:726-31. [PMID: 24943123 DOI: 10.1111/jpc.12622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2014] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to review the operation of a specialist adolescent drug and alcohol consultation liaison service in a tertiary paediatric hospital. METHOD A retrospective review of patient records was conducted to identify patient characteristics and assess service utilisation. RESULTS Two hundred adolescents were referred over 4 years. Most presented during mid-adolescence (14-16 years). Alcohol, cannabis and nicotine were the most frequently reported substances, and almost half of referrals involved polysubstance use. Mental health diagnoses and behavioural problems were commonly reported. Almost two-thirds (63.5%) attended an appointment for drug and alcohol assessment and intervention (n = 92) or were referred to appropriate services (n = 35). Adolescents more likely to engage and attend an appointment with the specialist adolescent addiction medicine service included those with amphetamine use, polysubstance use, chronic illness, any mental health diagnosis and mood disorder. Indigenous Australians and those with a history of aggression were more difficult to engage. CONCLUSIONS Adolescents present to paediatric health settings with drug- and alcohol-related issues, including associated harms. These comprise, but are not limited to, physical and sexual assault, family conflict, mood and behavioural concerns (including psychosis), and forensic issues. Early intervention aims to reduce long-term risks such as dependence in adulthood. Specialist adolescent drug and alcohol services may assist in identifying and engaging these high-risk and often complex young people in developmentally appropriate treatment.
Collapse
Affiliation(s)
- Natalie Lynette Phillips
- The Department of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Edwards AC, Heron J, Dick DM, Hickman M, Lewis G, Macleod J, Kendler KS. Adolescent alcohol use is positively associated with later depression in a population-based U.K. cohort. J Stud Alcohol Drugs 2014; 75:758-65. [PMID: 25208193 PMCID: PMC4161696 DOI: 10.15288/jsad.2014.75.758] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 06/06/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alcohol use and internalizing problems are often positively associated during adolescence and adulthood. However, the basis of this relationship remains poorly understood, and longitudinal data collected in population-based samples could improve the development of etiological models. METHOD Using a prospective population-based U.K. cohort, the current study examined the relationship between frequency of drinking during adolescence (ages 13-15, N = 7,100) with problems with depression and anxiety at average age 17 years 10 months (n = 4,292). Analyses were conducted separately by sex and adjusted by the inclusion of potential individual- and familial-level confounders. RESULTS Among boys, drinking frequency was positively associated with later depression but not anxiety. This association was robust to adjustment for covariates/confounders. Among girls, drinking frequency was related to later depression and anxiety in univariable analyses. In multivariable analyses, only the association with depression remained after adjustment for covariates/confounders. RESULTS were comparable across sexes, although the effect size of drinking frequency was higher among boys. CONCLUSIONS Higher adolescent alcohol use, even at sub-clinical levels, is associated with an increased risk of later problems with depression but may not be associated with an aggregate measure of anxiety. Future research should consider the possibility of differential relationships between multiple measures of adolescent alcohol use and distinct internalizing outcomes later in development.
Collapse
Affiliation(s)
- Alexis C Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Danielle M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Matt Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, England
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
34
|
Thayer RE, Callahan TJ, Weiland BJ, Hutchison KE, Bryan AD. Associations between fractional anisotropy and problematic alcohol use in juvenile justice-involved adolescents. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 39:365-71. [PMID: 24200206 DOI: 10.3109/00952990.2013.834909] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies have shown associations between heavy alcohol use and white matter alterations in adolescence. Youth involved with the juvenile justice system engage in high levels of risk behavior generally and alcohol use in particular as compared to their non-justice-involved peers. OBJECTIVES This study explored white matter integrity among justice-involved adolescents. Analyses examined fractional anisotropy (FA) and mean diffusivity (MD) between adolescents with low and high levels of problematic alcohol use as assessed by the Alcohol Use Disorders Identification Test (AUDIT). METHODS Participants (N = 125; 80% male; 14-18 years) completed measures assessing psychological status and substance use followed by diffusion tensor imaging (DTI). DTI data for low (n = 51) and high AUDIT (n = 74) adolescents were subjected to cluster-based group comparisons on skeletonized FA and MD data. RESULTS Whole-brain analyses revealed significantly lower FA in clusters in the right and left posterior corona radiata (PCR) and right superior longitudinal fasciculus (SLF) in the high AUDIT group, as well as one cluster in the right anterior corona radiata that showed higher FA in the high AUDIT group. No differences in MD were identified. Exploratory analyses correlated cluster FA with measures of additional risk factors. FA in the right SLF and left PCR was negatively associated with impulsivity. CONCLUSION Justice-involved adolescents with alcohol use problems generally showed poorer FA than their low problematic alcohol use peers. Future research should aim to better understand the nature of the relationship between white matter development and alcohol use specifically as well as risk behavior more generally.
Collapse
Affiliation(s)
- Rachel E Thayer
- Department of Psychology and Neuroscience, University of Colorado Boulder , Boulder, CO , USA
| | | | | | | | | |
Collapse
|
35
|
Abstract
AbstractObjectives: To investigate schema modes currently activated in individuals with psychiatric disorders and to attain a greater understanding of healthy and dysfunctional schema modes in this population. Furthermore, we wish to ascertain if individuals who fulfil criteria for clinical (psychiatric) disorders with the Minnesota Multiphasic Personality Inventory (MMPI), also manifest dysfunctional modes and weaker healthy modes on the Schema Mode Inventory (SMI).Method: Fifty individuals were administered the MMPI and SMI during routine psychological assessments between September 2008 and June 2010.Results: Both healthy schema modes (Happy Child (HC) and dysfunctional schema modes (Compliant Surrender (CS), Detached Self-soother (DSS) and Demanding Parent (DP)) were evident in this population. Positive correlations were noted between several dysfunctional schema modes from the Child, Maladaptive Coping and Maladaptive Parent domains of the SMI and several scales of the MMPI including: Depression (D), Psychopathic deviate (Pd), Masculine feminine (Mf), Paranoia (Pa), Psychasthenia (Ps), Mania (Ma), Schizophrenia (Sc), and Social introversion (Si) (p < 0.001). A negative correlation (p < 0.001) was found between the Healthy Adult (HA) and Happy Child (HC) schema modes of the SMI and the Hypochondriasis (Hs), Depression (D), Psychopathic deviate (Pd), Psychasthenia (Pt), and Social introversion (Si) scales of MMPI.Conclusion: This study demonstrates the presence of several dysfunctional schema modes in individuals with a wide range of clinical (psychiatric) disorders and a strong correlation between dysfunctional schema modes and clinical disorders of the MMPI. The SMI can aid in the assessment and understanding of individuals with a wide range of psychiatric disorders and can also form the basis for Schema Focused Therapy (SFT), a therapy showing promise for a number of clinical conditions, particularly borderline personality disorder.
Collapse
|
36
|
Saban A, Flisher AJ, Grimsrud A, Morojele N, London L, Williams DR, Stein DJ. The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey. Pan Afr Med J 2014; 17 Suppl 1:11. [PMID: 24624244 PMCID: PMC3946226 DOI: 10.11694/pamj.supp.2014.17.1.3328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/26/2013] [Indexed: 11/23/2022] Open
Abstract
Introduction Although substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population. Methods Data were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates. Data from a subset (n = 1766; aged 18 to 30 years) of the SASH sample of 4351 individuals were analysed. The Composite International Diagnostic Interview Version 3 (CIDI 3.0) was used to elicit basic demographic details and information regarding mental illness and substance use. Multiple regression analyses, adjusted for age and gender, were used to identify associations between mental disorders and substance use. Results Significant associations were found between substance use and mood and anxiety disorders, with a particularly strong relationship between cannabis use and mental disorder. Conclusion The results are consistent with those from previous studies, and reinforce the argument that comorbid substance use and mental disorders constitute a major public health burden.
Collapse
Affiliation(s)
- Amina Saban
- Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa ; School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | - Alan J Flisher
- Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Anna Grimsrud
- School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | - Neo Morojele
- Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa
| | - Leslie London
- School of Public Health, University of Cape Town, Cape Town, Cape Town, South Africa
| | | | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
37
|
Saban A, Flisher A, Laubscher R, London L, Morojele N. The association between psychopathology and substance use: adolescent and young adult substance users in inpatient treatment in Cape Town, South Africa. Pan Afr Med J 2014; 17 Suppl 1:8. [PMID: 24643118 PMCID: PMC3948364 DOI: 10.11694/pamj.supp.2014.17.1.3044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/26/2013] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Evidence suggests that comorbid psychopathology can negatively affect treatment outcomes in substance users. In South Africa, limited information exists regarding the prevalence, nature and role of psychiatric comorbidity in substance users. This study examined psychiatric comorbidity and its association with specific substance use, and young adult substance users in treatment for substance use. METHODS Male and female inpatient substance users (n=95; ages 17-30 years) were sampled consecutively in order of admission from three clinics in Cape Town. An interview schedule was administered to elicit patients' sociodemographic and substance use history details. The computer-assisted Diagnostic Interview Schedule DSM IV (C-DIS IV) was administered to screen patients for current psychiatric disorders. RESULTS The sample was largely male, Coloured, Muslim and single. Cannabis (51.6%) and crystal methamphetamine (17.9%) were the most common first substances of use. Heroin (53.7%) and crystal methamphetamine (33.7%) were the most common substances for which treatment was sought (primary substances). The most common comorbid psychopathologies were anti-social personality disorder (ASPD 87.4%) and conduct disorder (CD 67.4%). Regression analyses showed a marginally significant association between specific phobia and first use of cannabis, but indicated no statistically significant associations between psychopathology and substance use. CONCLUSION The results demonstrated a high proportion of previously unidentified comorbid psychopathology in inpatient substance users. Further research is needed to investigate psychiatric comorbidity in inpatient substance users.
Collapse
Affiliation(s)
- Amina Saban
- Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,School of Public Health and Family Medicine, University of Cape Town, South Africa,Corresponding author: Dr.Amina Saban, Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa and School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Alan Flisher
- Adolescent Health and Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,Deceased
| | - Ria Laubscher
- Biostatistics Unit, Medical Research Council, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Neo Morojele
- Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa
| |
Collapse
|
38
|
Flórez-Salamanca L, Secades-Villa R, Hasin DS, Cottler L, Wang S, Grant BF, Blanco C. Probability and predictors of transition from abuse to dependence on alcohol, cannabis, and cocaine: results from the National Epidemiologic Survey on Alcohol and Related Conditions. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2013; 39:168-79. [PMID: 23721532 DOI: 10.3109/00952990.2013.772618] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little is known about the transition from substance abuse to substance dependence. OBJECTIVES This study aims to estimate the cumulative probability of developing dependence and to identify predictors of transition to dependence among individuals with lifetime alcohol, cannabis, or cocaine abuse. METHODS Analyses were done for the subsample of individuals with lifetime alcohol abuse (n = 7802), cannabis abuse (n = 2832), or cocaine abuse (n = 815) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Estimated projections of the cumulative probability of transitioning from abuse to dependence were obtained by the standard actuarial method. Discrete-time survival analyses with time-varying covariates were implemented to identify predictors of transition to dependence. RESULTS Lifetime cumulative probability estimates indicated that 26.6% of individuals with alcohol abuse, 9.4% of individuals with cannabis abuse, and 15.6% of individuals with cocaine abuse transition from abuse to dependence at some point in their lives. Half of the transitions of alcohol, cannabis, and cocaine dependence occurred approximately 3.16, 1.83, and 1.42 years after abuse onset, respectively. Several sociodemographic, psychopathological, and substance use-related variables predicted transition from abuse to dependence for all of the substances assessed. CONCLUSION The majority of individuals with abuse do not transition to dependence. Lifetime cumulative probability of transition from abuse to dependence was highest for alcohol, followed by cocaine and lastly cannabis. Time from onset of abuse to dependence was shorter for cocaine, followed by cannabis and alcohol. Although some predictors of transition were common across substances, other predictors were specific for certain substances.
Collapse
Affiliation(s)
- Ludwing Flórez-Salamanca
- Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | | | | | | | | | | | | |
Collapse
|
39
|
Shoval G, Mansbach-Kleinfeld I, Farbstein I, Kanaaneh R, Lubin G, Krivoy A, Apter A, Weizman A, Zalsman G. The use of mental health services by adolescent smokers: a nationwide Israeli study. Eur Psychiatry 2013; 28:269-75. [PMID: 22542329 DOI: 10.1016/j.eurpsy.2012.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 01/26/2012] [Accepted: 01/28/2012] [Indexed: 10/28/2022] Open
Abstract
In this study, we aimed to evaluate the utilization of mental health services by adolescent smokers, the presence of untreated mental disorders in this young population and the associated emotional and behavioral difficulties. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA) Inventory. Emotional and behavioral difficulties were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Mental health services use and smoking habits were evaluated by relevant questionnaires. Adolescent smokers were using significantly more mental health services than non-smokers (79% vs. 63%, respectively, P<0.001), independently of their mental health status or ethnic group. Adolescent smokers also reported more emotional and behavioral difficulties in most areas (P<0.001), which are consistent with their mothers' reports, except in the area of peer relationships. The treatment gap for the smoking adolescents was 53% compared to 69% in the non-smokers (P<0.001). This is the first study characterizing the use of mental health services and the related emotional and behavioral difficulties in a nationally-representative sample of adolescents. The findings of a wide treatment gap and the rates of the associated emotional and behavioral difficulties are highly relevant to the psychiatric assessment and national treatment plans of adolescent smokers.
Collapse
Affiliation(s)
- G Shoval
- Child and Adolescent Psychiatry Division, Geha Mental Health Center, Tel Aviv University, P.O. Box 102, 49100 Petah Tiqva, Israel
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Rasic D, Weerasinghe S, Asbridge M, Langille DB. Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students. Drug Alcohol Depend 2013; 129:49-53. [PMID: 23041136 DOI: 10.1016/j.drugalcdep.2012.09.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 09/12/2012] [Accepted: 09/13/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine associations of cannabis and other illicit drug use with depression, suicidal ideation and suicidal attempts over a two year period during adolescence. METHODS Nine hundred and seventy-six school students in four high schools in northern Nova Scotia, Canada, were surveyed in grade 10 and followed up in grade 12. Assessments of past 30 day cannabis and illicit drug use as well as mental health variables (risk of depression, suicidal ideation and suicide attempts) were obtained at baseline (2000 and 2001) and follow-up two years later (2002 and 2003). Generalized estimating equations modelled depression, suicidal ideation and attempts among illicit drug users and non-users. RESULTS Illicit drug use with or without cannabis use was significantly associated with higher odds of depression, suicidal ideation and suicide attempt. Heavy cannabis use alone predicted depression but not suicidal ideation or attempt. CONCLUSIONS Illicit drug use, with and without accompanying cannabis use, among high school students increases the risk of depression, suicidal ideation and suicidal attempts. Heavy cannabis use alone predicts depression but not suicidal ideation or attempts.
Collapse
Affiliation(s)
- Daniel Rasic
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, NS B3H 1V7, Canada
| | | | | | | |
Collapse
|
41
|
Aydogan U, Akbulut H, Uzun O, Yuksel S, Turker T, Gevrek O, Mutlu S, Nerkiz P, Sari O, Celik C, Saglam K. Distribution of psychiatric symptoms among young Turkish males and the relationship between these symptoms and socio-demographic characteristics. Compr Psychiatry 2013; 54:269-75. [PMID: 23006822 DOI: 10.1016/j.comppsych.2012.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 07/15/2012] [Accepted: 07/23/2012] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Youth is a period during which individuals undergo rapid physical and psychological changes in their transition from childhood to adulthood. This study aimed to determine the psychological problems of young males from different socio-cultural backgrounds living in different cities of Turkey and to examine the socio-cultural factors possibly associated with these problems. METHODS The study was conducted in six different cities in Turkey with the participation of 3655 young male adults. Participants were administered a questionnaire to collect socio-demographic data such as age, marital status, educational background, the history of smoking and alcohol use, income level, occupation, place of residence and the history of chronic disease and allergies. Psychological symptoms were detected via the Symptom Check List (SCL-90 R). The study data were transferred to the SPSS-15 database for statistical analysis. RESULTS The median age of the participants was 20.49±1.48years (20-29 age range, median age=20). Based on the SCL-90 R scores, the mean General Symptom Index (GSI) score of the study participants was found to be 0.44±0.27 (0.00-2.61). 13.5% of the participants (n=493) were recorded to have above-the-average GSI scores (≥1.0). Occupation, smoking and alcohol use were found to effect depression. Factors effecting anxiety were occupation, smoking, alcohol use and place of residence. CONCLUSION Psychological symptoms that young people suffer from can be diagnosed at early stages and the psychological problems that are triggered by these symptoms can be prevented with the help of such questionnaires. These questionnaires can easily be administered in primary care settings.
Collapse
Affiliation(s)
- Umit Aydogan
- Department of Family Medicine, Gulhane Military Medical Faculty, Ankara, Turkey.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study. Soc Psychiatry Psychiatr Epidemiol 2013; 48:407-16. [PMID: 22872359 DOI: 10.1007/s00127-012-0561-2] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 07/23/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE This study investigated the symptoms of anxiety and depression in adolescence, their associations with lifestyle and resilience and the possibility that resilience factors can attenuate the associations between unhealthy lifestyle and symptoms of anxiety and depression. METHODS Adolescents (n = 7,639) aged 13-18 years completed a questionnaire regarding lifestyle and health. Symptoms of anxiety and depression were measured by the SCL-5, a five-item shortened version of the Hopkins Symptom Checklist. Resilience factors included questions on friends and family relations and two sub-scales of the Resilience Scale for Adolescents; Family cohesion and Social competence. RESULTS Of the total population, 13% reported symptoms of anxiety and depression. Resilience characteristics were associated with lower symptom levels (ORs ranging from 0.2 to 0.6), and substance use and infrequent physical activity with higher symptom levels (ORs ranging from 2.1 to 4.0). The associations with substance use were strengthened by social competence, but attenuated by family cohesion. The association with physical activity was attenuated by both social competence and family cohesion. CONCLUSION Symptoms of anxiety and depression were frequent in adolescents and were associated with unhealthy lifestyle factors as substance use and low physical activity. Resilience characteristics seemed to protect against symptoms and markedly influenced the associations between lifestyle factors and symptoms of anxiety and depression. The importance of family and other supportive relationships should be emphasized in treatment and prevention of anxiety and depression in adolescence.
Collapse
|
43
|
Albertella L, Norberg MM. Mental Health Symptoms and their Relationship to Cannabis Use in Adolescents Attending Residential Treatment. J Psychoactive Drugs 2012; 44:381-9. [DOI: 10.1080/02791072.2012.736808] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Melissa M. Norberg
- b National Clinical Services and Evaluation Manager, National Cannabis Prevention and Information Centre, National Drug and Alcohol Research Centre , University of New South Wales , Randwick , NSW , Australia
| |
Collapse
|
44
|
Papousek I, Ruggeri K, Macher D, Paechter M, Heene M, Weiss EM, Schulter G, Freudenthaler HH. Psychometric evaluation and experimental validation of the statistics anxiety rating scale. J Pers Assess 2012; 94:82-91. [PMID: 22176269 DOI: 10.1080/00223891.2011.627959] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The Statistics Anxiety Rating Scale (STARS) was adapted into German to examine its psychometric properties (n = 400). Two validation studies (n = 66, n = 96) were conducted to examine its criterion-related validity. The psychometric properties of the questionnaire were very similar to those previously reported for the original English version in various countries and other language versions. Confirmatory factor analysis indicated 2 second-order factors: One was more closely related to anxiety and the other was more closely related to negative attitudes toward statistics. Predictive validity of the STARS was shown both in an experimental exam-like situation in the laboratory and during a real examination situation. Taken together, the findings indicate that statistics anxiety as assessed by the STARS is a useful construct that is more than just an expression of a more general disposition to anxiety.
Collapse
Affiliation(s)
- Ilona Papousek
- Department of Psychology, Biological Psychology Unit, Karl-Franzens University, Graz, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
This study examines predictors of drinking during pregnancy among first-time mothers, in order to distinguish those in need of targeted screening and intervention. Data from the prenatal panel of the Parenting for the First Time study were used in hierarchical linear regressions to determine likelihood of prenatal alcohol consumption among a sample of 645 women. African-American women and those of race/ethnicities other than White were less likely to drink, regardless of age or level of education. Among all women, being in school was associated with abstention (P = 0.05). Among teens, endorsing a perception of feeling "pushed around" was a significant indicator of prenatal alcohol consumption (P = 0.05), as was not having plans for infant feeding shortly before delivery (P = 0.05). Among adults with some level of college education, having a first prenatal visit after the fourth month of pregnancy was a significant predictor of drinking (P = 0.01). This study indicates that women who evidence behaviors or attitudes indicating an ego-dystonic pregnancy (one that is psychologically or emotionally uncomfortable), may be more likely to self-medicate and cope via avoidance through drinking. These behaviors and attitudes may be indicators of the need for targeted screening and intervention, as well as indicators of underlying problems to be targeted in treatment. Further, among all women for whom continued education is a possibility, retaining the ability to attend school during the pregnancy can be protective.
Collapse
Affiliation(s)
- Peggy L O'Brien
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
| |
Collapse
|
46
|
Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of current evidence. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:809653. [PMID: 22969831 PMCID: PMC3434451 DOI: 10.1155/2012/809653] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/01/2012] [Indexed: 12/11/2022]
Abstract
Use of complementary medicines and therapies (CAM) and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.
Collapse
|
47
|
|
48
|
Dunn EC, Johnson RM, Green JG. The Modified Depression Scale (MDS): A Brief, No-Cost Assessment Tool to Estimate the Level of Depressive Symptoms in Students and Schools. SCHOOL MENTAL HEALTH 2011; 4:34-45. [PMID: 22639697 DOI: 10.1007/s12310-011-9066-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adolescent health researchers and practitioners are frequently interested in assessing depression as part of student screening and for school-wide prevention and intervention planning. However, this task is challenging given the lack of free, brief assessments of depressive symptoms in youth. This study evaluated the psychometric properties of an adapted version of the Modified Depression Scale (MDS). Data came from a school-based survey of 9th-12th graders in Boston (N=1,657). We assessed internal consistency reliability and known-groups validity, in addition to the feasibility of establishing a dichotomous cut-point to classify adolescents as having high versus low depressive symptoms. We also evaluated the validity of the adapted MDS as a school-wide measure. At the student-level, the adapted MDS demonstrated acceptable internal consistency. Students engaging in risk behaviors (e.g., substance use) or who were victimized (e.g., bullied) had significantly higher depressive symptom scores. Students who endorsed four or five MDS symptoms often or always had a heightened risk of suicidal ideation, substance use, and failing grades when compared to students who endorsed three or fewer symptoms often or always. At the school-level, higher mean levels of depressive symptoms in a school were associated with higher mean levels of suicidal ideation and failing grades. Results of this study suggest that the adapted MDS is a promising measurement tool that could be useful to school-based professionals and researchers to evaluate depressive symptoms in adolescents and ascertain the prevalence of depressive symptoms in schools.
Collapse
Affiliation(s)
- Erin C Dunn
- Department of Society, Human Development, and Health, Harvard School of Public Health. 677 Huntington Avenue, Boston, MA 02115. phone: 617-935-1290
| | | | | |
Collapse
|
49
|
Brook DW, Rubenstone E, Zhang C, Morojele NK, Brook JS. Environmental stressors, low well-being, smoking, and alcohol use among South African adolescents. Soc Sci Med 2011; 72:1447-53. [PMID: 21492977 DOI: 10.1016/j.socscimed.2011.02.041] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 11/20/2010] [Accepted: 02/25/2011] [Indexed: 11/29/2022]
Abstract
This is the first study to examine the pathways from environmental stressors to substance use among a sample of South African adolescents (N = 2195). The study objective was to assess how environmental stressors might affect cigarette smoking and alcohol use among South African adolescents, and to focus on one mechanism, low well-being, which might mediate this association. Participants consisted of 2195 Black, mixed ancestry ("Colored"), Indian, and White youth, aged 12-17 years old (mean age = 14.6; SD = 1.8), recruited via a multi-stage stratified sampling procedure in Durban, Cape Town, and Johannesburg, South Africa. Data were collected via individual in-person structured interviews, administered by trained interviewers in the participant's preferred language. Structural equation modeling was used to analyze the interrelationships of environmental stressors (violent victimisation, legal and illegal drug availability) and low well-being (depressive symptoms, low self-esteem, health problems) with respect to adolescent cigarette smoking and alcohol use. The results supported our hypotheses: Environmental stressors were related to low well-being which, in turn, was linked to both adolescent smoking and alcohol use. There were also direct pathways from environmental stressors to both adolescent smoking and alcohol use. Smoking and alcohol use were significantly correlated. The findings suggest that environmental stressors may be associated with diminished psychological and physical well-being, as well as smoking and alcohol use, among South African adolescents. Longitudinal research is warranted to further understand the interrelationship of environmental stressors, low well-being, and adolescent substance use, so that these issues may be addressed by South African programmes and policies.
Collapse
Affiliation(s)
- David W Brook
- New York University School of Medicine, 215 Lexington Ave., 15th Floor, NY 10016, USA.
| | | | | | | | | |
Collapse
|
50
|
Lynch ME, Johnson KC, Kable JA, Carroll J, Coles CD. Smoking in pregnancy and parenting stress: maternal psychological symptoms and socioeconomic status as potential mediating variables. Nicotine Tob Res 2011; 13:532-9. [PMID: 21436299 DOI: 10.1093/ntr/ntr037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the impact of smoking in pregnancy on parenting stress. Maternal psychological symptoms and socioeconomic status (SES) were evaluated as potential mediating factors between prenatal cigarette use and later parenting stress. METHOD The sample included 218 mothers who were recruited at the hospital after birth and completed a 6-month visit with their infants at a university laboratory. Based on the mothers' responses to interviews at the hospital on tobacco use during pregnancy, the sample included 77 nonsmokers and 141 smokers. Information on sociodemographic variables, prenatal care, and other substance use during pregnancy was collected at the hospital interview. At the 6-month visit, the mothers completed measures of parenting stress and psychological symptoms. Cotinine levels were assessed at both timepoints. RESULTS Regression analysis showed that maternal smoking during pregnancy predicted parenting stress in infancy. Maternal symptoms of psychological distress and SES were evaluated simultaneously to determine whether they functioned as mediating variables between smoking in pregnancy and parenting stress. A multiple mediation analysis (Preacher & Hayes, 2008a) showed that maternal psychological symptoms functioned as a mediating variable but that SES did not. CONCLUSIONS Results suggest that mothers who smoke in pregnancy are likely to experience higher levels of psychological symptoms, which, in turn, predict higher levels of parenting stress. Smoking in pregnancy may be a marker for symptoms of psychological distress in mothers.
Collapse
Affiliation(s)
- Mary Ellen Lynch
- Emory University, Briarcliff Campus, 1256 Briarcliff Rd., Atlanta, GA 30306, USA.
| | | | | | | | | |
Collapse
|