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Brolin Låftman S, Östberg V, Wahlström J, Ramstedt M, Raninen J. Exposure to parental problem drinking during adolescence and symptoms of depression and anxiety in young adulthood: A Swedish national cohort study. Drug Alcohol Rev 2024. [PMID: 39031436 DOI: 10.1111/dar.13910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/03/2024] [Accepted: 07/06/2024] [Indexed: 07/22/2024]
Abstract
INTRODUCTION Previous research has shown associations between parental problem drinking and adverse mental health outcomes in children. However, while many studies assess parental alcohol problems based on clinical measures, longitudinal studies that investigate the impact of potentially less severe levels of parental alcohol problems are scarce. The aim of this study was to examine if the existence and severity of child-reported parental problem drinking in adolescence is associated with symptoms of depression and anxiety in young adult men and women. METHODS Data was obtained from the Swedish national cohort study Futura01, including 3143 participants born in 2001 who were surveyed in 2017 (age 15-16) and 2022 (age 20-21). Parental problem drinking was measured at age 15-16 with the short version of The Children of Alcoholics Screening Test. Depression and anxiety symptoms were measured at age 20-21 with the Patient Health Questionnaire-4. Registry information on gender, parental education and parental country of birth were included as covariates. RESULTS The results demonstrated an exposure-response pattern, with greater severity of parental problem drinking associated with an increased probability of reporting depression and anxiety symptoms 5 years later. The association between parental problem drinking and subsequent depression symptoms was however present only in females. DISCUSSION AND CONCLUSIONS Adolescents exposed to parental problem drinking have elevated risks of long-term adverse mental health. These risks increase with greater severity of parental problem drinking. It is thus crucial with efforts preventing parental problem drinking and efforts promoting health among children and adolescents who are exposed.
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Affiliation(s)
- Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
| | - Joakim Wahlström
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
| | - Mats Ramstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- The Swedish Council for Information on Alcohol and Other Drugs, Stockholm, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Workie HM, Wahlström J, Svensson J, Låftman SB. Perceived parental alcohol problems and drinking patterns among adolescents in Sweden. Addict Behav Rep 2024; 19:100535. [PMID: 38419748 PMCID: PMC10900252 DOI: 10.1016/j.abrep.2024.100535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/15/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Much research into the links between parental problematic alcohol use and adolescent substance use has focused on clinically diagnosed parental alcohol disorders. Few prior studies have utilised validated measures of adolescents' perception of parental alcohol problems and considered the severity of these problems. This study examined the associations between the severity of perceived parental alcohol problems and adolescents' drinking patterns in a Swedish national sample. Methods We used survey information from grade 9 and 11 students (15-18 years) from 2021 (n = 9,227). Perceived parental alcohol problems were measured by the short version of The Children of Alcoholics Screening Test (CAST-6). The outcomes were: alcohol consumption during the past 12 months, frequent heavy episodic drinking (HED), and early alcohol debut (before age 14). Sociodemographic characteristics were adjusted for. Results Binary logistic regressions showed that the severity of perceived parental alcohol problems was associated with alcohol consumption during the past 12 months (low severity OR 1.53, p < 0.001; moderate severity OR 1.85, p < 0.001; high severity OR 2.52, p < 0.001), HED (low severity OR 1.16, n.s.; moderate severity OR 1.31, n.s.; high severity OR 1.64, p < 0.01), and early alcohol debut (low severity OR 1.57, p < 0.001; moderate severity OR 1.65, p < 0.001; high severity OR 2.20, p < 0.001). Conclusions Adolescents with perceived parental alcohol problems are more likely to have risky drinking patterns themselves, and the likelihood becomes higher with increased severity. Effective interventions for children whose parents have drinking problems are important, and should also take the severity of the parents' drinking problem into account.
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Affiliation(s)
- Hiwot Mezgebe Workie
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden
| | - Joakim Wahlström
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden
| | - Johan Svensson
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Östgötagatan 90, SE-11664 Stockholm, Sweden
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden
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Låftman SB, Magnusson C, Olsson G, Wahlström J, Modin B. Perceived problematic alcohol use in the family and adolescents' stress-related complaints: examining the buffering role of the school's degree of student focus as rated by its teachers. BMC Public Health 2023; 23:1754. [PMID: 37684584 PMCID: PMC10492349 DOI: 10.1186/s12889-023-16505-x] [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] [Received: 04/14/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND A non-negligible proportion of children grow up with problematic alcohol use in the family. Problematic familial drinking can be regarded as a stressor, and prior studies have consistently reported poorer mental health among adolescents who are exposed. However, it is also of relevance to identify modifiable protective factors which may buffer against stress-related ill-health in this group of adolescents. One context where such factors may be present is the school. The aim of this study is to examine the relationship between perceived problematic familial alcohol use and students' stress-related complaints, and specifically to explore if the school's degree of student focus can buffer against any such negative health consequences of problem drinking at home. METHODS Data were drawn from four separate surveys, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS) conducted in 2014 and 2016 among 7,944 students (~ 15-16 years) and 2,024 teachers in 147 Stockholm senior-level school units. Perceived problematic familial alcohol use was measured by one item in the SSS. Stress-related complaints were captured by co-occurring somatic complaints and psychological distress, and reported by students in the SSS. The school's student focus was measured by an index based on teachers' ratings of four items in the STS. A set of covariates at the student and the school level were also included. Two-level binary logistic and linear regression models were performed. RESULTS Perceived problematic familial alcohol use was linked with an increased likelihood of reporting co-occurring somatic complaints as well as psychological distress. Cross-level interactions revealed that the association between perceived problematic familial alcohol use and co-occurring somatic complaints was weaker among students attending schools with stronger teacher-rated student focus. Regarding psychological distress, the association was weaker for students attending schools with intermediate or strong teacher-rated student focus, compared with those attending schools with weaker teacher-rated student focus. CONCLUSIONS The findings provide support for the assumption that favourable conditions in schools can buffer against negative health consequences of problematic conditions in the family, thus serving a compensatory role.
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Affiliation(s)
- Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Charlotta Magnusson
- Swedish Institute for Social Research (SOFI), Stockholm University, 10691 Stockholm, Sweden
| | - Gabriella Olsson
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Joakim Wahlström
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
| | - Bitte Modin
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691 Stockholm, Sweden
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Syed NR, Wahlström J, Låftman SB, Svensson J. Perceived parental alcohol problems and psychosomatic complaints among adolescents in Sweden. Addict Behav Rep 2023; 17:100491. [PMID: 37159749 PMCID: PMC10163609 DOI: 10.1016/j.abrep.2023.100491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 05/11/2023] Open
Abstract
Introduction For adolescents, parental problem drinking can be regarded as a chronic stressor, negatively affecting their health. There is limited knowledge and a relative lack of empirical evidence on this topic, especially in Sweden. The aim of the current study was to examine perceived parental alcohol problems and the links with psychosomatic complaints among adolescents in Sweden. Methods Data were obtained from the Swedish Council for Information on Alcohol and Other Drugs' national survey of 2021, collected amongst 9,032 students in grades 9 (∼15-16 years) and 11 (∼17-18 years). Perceived parental alcohol problems were measured by the Children of Alcoholics Screening Test (CAST-6) scale, using a cutoff at ≥ 3. Psychosomatic complaints were captured by a binary measure based on the frequency of headache, stomach ache, feeling depressed or down, difficulties to fall asleep, and sleeping poorly at night. Sociodemographic characteristics included gender, grade, parental education, and parental country of birth. Descriptive analyses with chi2 tests and binary logistic regression analyses were performed. Results Adolescents with perceived parental alcohol problems had higher odds of reporting psychosomatic complaints compared with adolescents without perceived parental drinking problems, even when adjusting for sociodemographic characteristics. Girls, grade 11 students, adolescent with at least one parent born in Sweden, and those without university-educated parents were more likely to report parental alcohol problems. Conclusions The findings highlight adolescents with perceived parental alcohol problems need support. The school, being an arena where adolescents spend much of their time, may play a vital role in this regard.
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Affiliation(s)
- Numan Raza Syed
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, 106 91 Stockholm, Sweden
| | - Joakim Wahlström
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, 106 91 Stockholm, Sweden
- Corresponding author.
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, 106 91 Stockholm, Sweden
| | - Johan Svensson
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, 106 91 Stockholm, Sweden
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Östgötagatan 90, 116 64 Stockholm, Sweden
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Fathers' alcohol consumption and risk of substance-related disorders in offspring. Drug Alcohol Depend 2022; 233:109354. [PMID: 35193083 DOI: 10.1016/j.drugalcdep.2022.109354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Few studies have assessed how children are affected by parental alcohol consumption without clinically diagnosed alcohol problems, especially in relation to more long-term and severe consequences. The aim is to investigate how fathers' alcohol use is related to the risk for substance-related disorders in offspring. METHOD A prospective cohort study of 64 710 Swedish citizens whose fathers were conscripted for compulsory military training at ages 18-20 in 1969/70. Information on fathers' alcohol consumption, frequency of intoxication and apprehended for drunkenness, was collected during conscription. Offspring was followed for substance-related disorders from age 12 to end of follow up in 2009. RESULTS All measures of fathers' alcohol use were significantly and positively associated with risk for substance-related disorders in offspring. The associations were to a large extent explained by other risk factors in childhood. In the fully adjusted model, those with fathers in the highest alcohol consumption quintile still had a 63% higher risk (HR=1.63 CI 1.26-2.12) of substance-related disorders compared to those whose fathers' reported abstinence. The highest risk was found among offspring to fathers with alcohol-related disorders or that had been apprehended for drunkenness, with a more than two-fold increased risk for substance-related disorders. CONCLUSIONS Despite the lower risk found among offspring to fathers with sub-clinical drinking when compared to those with alcohol-related disorders, the former group accounts for a much larger proportion of all cases of substance-related disorders in the population, prompting universal prevention efforts targeting the level of total alcohol consumption in society.
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Westman J, Jayaram-Lindström N, Kane K, Franck J, Gissler M. Mortality in adult children of parents with alcohol use disorder: a nationwide register study. Eur J Epidemiol 2022; 37:815-826. [PMID: 35737206 PMCID: PMC9463262 DOI: 10.1007/s10654-022-00883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/20/2022] [Indexed: 12/15/2022]
Abstract
Research suggests that adult children of parents with harmful alcohol use are at increased risk for premature death. This national cohort study investigated mortality in adult children of parents with alcohol use disorder (AUD), adjusting for sociodemographic variables. The study used 1973 to 2018 data from Swedish national registers to compare mortality risk in children who had ≥ 1 parent with AUD (ICD-10 code F10 and its ICD-8 and ICD-9 equivalents) (n = 122,947) and those who did not (n = 2,298,532). A Cox regression model adjusted for year of birth, sex, parental education, and childhood loss of a parent was used. Before the age of 18 years, about 5% of children born in Sweden lived with ≥ 1 parent who had a clinical diagnosis of AUD. Overall mortality was higher in adult children of parents with AUD: hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.71-1.82. Mortality remained elevated after adjustments for sociodemographic factors (HR 1.45, 95% CI 1.40-1.50). Children of parents with AUD had increased mortality from all investigated causes. The highest excess risk was for death from drug-related causes (excluding accidental poisonings) (HR 3.08, 95% CI 2.74-3.46). For most causes, mortality was higher if the mother had AUD than if the father had AUD. Patterns of mortality were similar in both sexes. This study provides evidence that parental AUD raises the risk of offspring mortality from preventable causes such as drug use, suicide (HR 2.16, 95% CI 1.98-2.36), accident (HR 2.00, 95% CI 1.87-2.13), and assault (HR 1.76, 95% CI 1.38-2.24).
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Affiliation(s)
- Jeanette Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Nitya Jayaram-Lindström
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Kimberly Kane
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Johan Franck
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Mika Gissler
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ,Academic Primary Health Care Centre, Region Stockholm, Sweden ,Department of Child Psychiatry, Turku University Hospital, Turku University, Turku, Finland ,Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
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Christiansen SG, Reneflot A, Stene-Larsen K, Hauge LJ. Alcohol-related mortality following the loss of a child: a register-based follow-up study from Norway. BMJ Open 2020; 10:e038826. [PMID: 32595167 PMCID: PMC7322283 DOI: 10.1136/bmjopen-2020-038826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/08/2020] [Accepted: 05/28/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The death of one's child is one of the most stressful events a person can experience. Research has shown that bereaved parents have a higher mortality than non-bereaved parents. This increased mortality might partly be caused directly by long-term stress. However, changes in health behaviour such as an increase in alcohol consumption might also play a role. This study examines the association between losing a child and alcohol-related mortality. In addition to Cox regression models using data covering the entire Norwegian adult population, we employ sibling fixed-effect models in order to partly control for genes and childhood experiences that might be associated with both losing a child and alcohol-related mortality. DESIGN A follow-up study between 1986 and 2014 based on Norwegian register data. SETTING Norway. PARTICIPANTS The entire Norwegian adult population. PRIMARY OUTCOME MEASURE Alcohol-related mortality. RESULTS An increased alcohol-related mortality was found among parents who had experienced the death of a child. The HR of alcohol-related mortality among those bereaved of a child was 1.59 (95% CI 1.48 to 1.71) compared with non-bereaved parents, for women 2.03 (95% CI 1.78 to 2.32) and for men 1.46 (95% CI 1.34 to 1.59). After including sibling fixed effects, the HR of alcohol-related mortality among parents who had lost a child was 1.30 (95% CI 1.03 to 1.64). CONCLUSIONS This study provides evidence of an elevated alcohol-related mortality among parents who have lost a child compared with non-bereaved parents. Although strongly attenuated, there is still an association when adjusting for genetic predisposition for alcohol problems as well as childhood environment using sibling fixed-effect models.
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Affiliation(s)
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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Landberg J, Danielsson A, Hemmingsson T. Fathers' alcohol use and suicidal behaviour in offspring during youth and young adulthood. Acta Psychiatr Scand 2019; 140:563-573. [PMID: 31487035 PMCID: PMC6899547 DOI: 10.1111/acps.13098] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the association between various indicators of father's alcohol use and suicidal behaviour in offspring during youth and young adulthood. METHODS The study is based on a cohort of 68 910 Swedish citizens who were born between 1970 and 1985 and have fathers who participated in conscription for compulsory military training in 1969/70. Information on fathers' alcohol use was collected during conscription. Offspring was followed for suicide attempts or completed suicides (through linkage with national registers) from age 12 to end of follow-up in 2008. RESULTS After adjustment for confounders, the hazard ratio (HR) for offspring to fathers who were heavy drinkers was 1.4 (95% CI 1.02, 1.93) while the associations turned non-significant for offspring to fathers who often drank into intoxication, HR 1.14 (0.68, 1.90). The highest risk for suicidal behaviour was found for offspring to fathers who had been apprehended for drunkenness two times or more, or with an alcohol-related hospitalization, with adjusted HRs of 2.1 (1.4, 3,14) and 1.9 (1.27, 2,85) respectively. CONCLUSION Fathers' alcohol use is associated with increased risk of suicidal behaviour among offspring in youth and young adulthood.
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Affiliation(s)
- J. Landberg
- Department of Public Health SciencesStockholm UniversityStockholmSweden,Department of Clinical NeuroscienceKarolinska InstituteSolnaSweden
| | - A.‐K. Danielsson
- Department of Public Health SciencesKarolinska InstituteSolnaSweden
| | - T. Hemmingsson
- Department of Public Health SciencesStockholm UniversityStockholmSweden,Institute of Environmental MedicineKarolinska InstituteSolnaSweden
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