Alcohol use in families: a 15-year prospective follow-up study

The effect of tobacco and alcohol consumption on poverty in the United Kingdom

BACKGROUND AND AIMS

Tobacco and alcohol use are major risk factors for premature mortality and morbidity. Tobacco and alcohol expenditure may also exacerbate poverty. This study aimed to estimate the financial impact of tobacco and alcohol consumption in low income households in the United Kingdom.

DESIGN

We undertook a cross-sectional study using a secondary dataset. A sample of 5031 households participated in the 2016-17 Living Costs and Food Survey. Measurements We measured the weekly household income and expenditure on tobacco and alcohol, and the proportion of households with expenditure on tobacco and alcohol overall, by income decile and in households in relative poverty (below 60% of the median household income). Estimates were extrapolated using population data to estimate the number of UK households, adults and children that would be classified as living in relative poverty on the basis of net income after subtracting tobacco or alcohol expenditure ('tobacco and alcohol expenditure-adjusted poverty').

FINDINGS

Spending on alcohol was more common in high income groups; 83% of households in the highest and 47% in the lowest income decile purchased alcohol. The reverse was true for tobacco, which was purchased by 8% and 24% of households in the highest and lowest income deciles respectively. Twenty-three percent of households in relative poverty purchased tobacco and 49% alcohol, with a median expenditure of £12.50 and £9.55 per week, respectively. A total of 320 000 households comprising 590 000 adults and 175 000 children were in alcohol expenditure-adjusted poverty, and 230 000 households, comprising 400 000 adults and 180 000 children in tobacco-expenditure adjusted poverty.

CONCLUSIONS

Tobacco and alcohol expenditure appear to exacerbate poverty in low income households in the United Kingdom. Hundreds of thousands of additional households would be defined as living in relative poverty based on their income after subtracting their tobacco and alcohol expenditure.

Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs): a novel and systematic method for building directed acyclic graphs

Background

Directed acyclic graphs (DAGs) are popular tools for identifying appropriate adjustment strategies for epidemiological analysis. However, a lack of direction on how to build them is problematic. As a solution, we propose using a combination of evidence synthesis strategies and causal inference principles to integrate the DAG-building exercise within the review stages of research projects. We demonstrate this idea by introducing a novel protocol: ‘Evidence Synthesis for Constructing Directed Acyclic Graphs’ (ESC-DAGs)’.

Methods

ESC-DAGs operates on empirical studies identified by a literature search, ideally a novel systematic review or review of systematic reviews. It involves three key stages: (i) the conclusions of each study are ‘mapped’ into a DAG; (ii) the causal structures in these DAGs are systematically assessed using several causal inference principles and are corrected accordingly; (iii) the resulting DAGs are then synthesised into one or more ‘integrated DAGs’. This demonstration article didactically applies ESC-DAGs to the literature on parental influences on offspring alcohol use during adolescence.

Conclusions

ESC-DAGs is a practical, systematic and transparent approach for developing DAGs from background knowledge. These DAGs can then direct primary data analysis and DAG-based sensitivity analysis. ESC-DAGs has a modular design to allow researchers who are experienced DAG users to both use and improve upon the approach. It is also accessible to researchers with limited experience of DAGs or evidence synthesis.

Contributions of parenting styles and parental drunkenness to adolescent drinking

Objective:

To estimate the association of parental drunkenness and parenting style with alcohol consumption among adolescents and the contributions of parental drunkenness and parenting style to the prevalence of binge drinking among adolescents.

Method:

Cross-sectional survey of a representative sample of secondary students aged 13 to 18 from 27 Brazilian state capitals (n=17,028). Private and public schools were included. A self-report questionnaire collected data on adolescents’ alcohol drinking behavior, parenting styles, and parenting and peer models of drunkenness.

Results:

Non-authoritative parenting style and parental drunkenness are associated with binge drinking among adolescents. Authoritarian, indulgent, and negligent parenting styles were associated with 1.50-, 2.51-, and 2.82-fold increases in prevalence of adolescent binge drinking, and parental drunkenness, with a 1.99-fold increase. The non-authoritative parenting style made a larger contribution than parental drunkenness to adolescent binge drinking.

Conclusions:

Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents’ binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place.

Exposure to drinking mediates the association between parental alcohol use and preteen alcohol use

OBJECTIVE

The aim of the present study was to test the link between exposure to parental alcohol use (i.e., preteens seeing their parents drinking) and preteen's alcohol use. Specifically, this study aimed to (a) replicate the association between parental alcohol use and preteen alcohol use and (b) test whether alcohol use exposure mediated this association.

METHOD

Families were recruited from five regions in the Netherlands from 104 schools that agreed to participate. Preteens (N = 755, M_age = 11.27, SD = 0.56, 45.8% boys) and their mothers (N = 755) participated in the study. Preteens reported lifetime alcohol use and parental alcohol use exposure. Mothers reported on alcohol use for both parents. Structural Equation Modelling was used to assess direct and mediated paths between parental alcohol use, preteen's exposure to alcohol use and preteen alcohol use in one model.

RESULTS

Unexpectedly, father's alcohol use was negatively associated (β = -0.121, p = .012) and mother's alcohol use was not associated (β = 0.056, p = .215) with preteen's alcohol use. A positive indirect effect emerged through alcohol use exposure, showing that exposure to father's alcohol use mediated the association between parent's and preteen's alcohol use (β = 0.064, p = .001). This effect was absent for mother's alcohol use (β = 0.026, p = .264). Gender differences were non-significant.

CONCLUSIONS

Parental alcohol exposure positively mediated the association of parental alcohol use with preteen's alcohol use. These effects were found for both boys and girls and were most robust for father's drinking. The findings might provide clues for preventive action, for example, by emphasizing that exposure should be restricted to prevent preteen's alcohol use.

Parental drinking in Australia: Does the age of children in the home matter?

INTRODUCTION AND AIMS

Parental role modelling of alcohol use is known to influence alcohol consumption in adolescence and in later life. This study aimed to assess relationships between parental status, child age and alcohol consumption, which have not been well documented.

DESIGN AND METHODS

Data were sourced from the 2013 Australian National Drug Strategy Household Survey. Analyses were conducted for 25-55 year olds (n = 11 591) by parental status, gender and age of youngest child in the household, controlling for socio-demographic factors.

RESULTS

Parents were less likely than non-parents to exceed the alcohol guideline for increased lifetime risk (18.2% vs. 24.2%) and short-term risk: at least weekly (14.2% vs. 21.2%); and at least monthly (27.5% vs. 35.9%). Fathers were just as likely to exceed the guidelines for lifetime risk as other men, but those with children aged 0-2, were less likely to exceed the guideline for short-term risk. Women were least likely to exceed the guideline for lifetime risk if they had children aged 0-2, 6-11 or 15 years and over, or the guideline for short-term risk, if they had children aged 0-2, or 15 years and over in the household. Parents were more likely to report drinking in the home.

DISCUSSION AND CONCLUSIONS

Parents were less likely to exceed alcohol guidelines than non-parents, especially mothers whose youngest child was an infant or in high school or older. Consistent with population rates in men, fathers were more likely to exceed alcohol guidelines than mothers, and this excess consumption warrants public health attention.

Climate schools plus: An online, combined student and parent, universal drug prevention program

Early initiation of substance use significantly increases one's risk of developing substance use dependence and mental disorders later in life. To interrupt this trajectory, effective prevention during the adolescent period is critical. Parents play a key role in preventing substance use and related harms among adolescents and parenting interventions have been identified as critical components of effective prevention programs. Despite this, there is currently no substance use prevention program targeting both students and parents that adopts online delivery to overcome barriers to implementation and sustainability. The Climate Schools Plus (CSP) program was developed to meet this need. CSP is an online substance use prevention program for students and parents, based on the effective Climate Schools prevention program for students. This paper describes the development of the parent component of CSP including a literature review and results of a large scoping survey of parents of Australian high school students (n = 242). This paper also includes results of beta-testing of the developed program with relevant experts (n = 10), and parents of Australian high school students (n = 15). The CSP parent component consists of 1) a webinar which introduces shared rule ranking, 2) online modules and 3) summaries of student lessons. The parent program targets evidence-based modifiable factors associated with a delay in the onset of adolescent substance use and/or lower levels of adolescent substance use in the future; namely, rule-setting, monitoring, and modelling. To date, this is the first combined parent-student substance use prevention program to adopt an online delivery method.

Stigma as a Barrier to Substance Abuse Treatment Among Those With Unmet Need: An Analysis of Parenthood and Marital Status

Substance use (SU) stigma is one factor contributing to unmet need for SU treatment. Additionally, theory suggests that women and single parents who use substances experience enhanced stigma because they do not adhere to normative social expectations. This study examines differences in perceived stigma by gender and parenthood among those with unmet need for SU treatment using the 2003-2010 National Survey of Drug Use and Health (N = 1,474). Results indicate that women are more likely to report stigma as a barrier to treatment compared with men, though the interaction between gender and parenthood is not significant. We find that married parents report the highest level of stigma. We situate our findings in past health-related stigma research. We suggest that these results shed a light on stigma, particularly as it relates to family status, as a contributing factor to differences regarding SU treatment utilization. Finally, we raise a provocative question concerning social status and anticipated stigma.

The association between parental attitudes and alcohol consumption and adolescent alcohol consumption in Southern Ireland: a cross-sectional study

Background

Alcohol plays a complex role in society. A recent study showed that over half of Irish adults drink hazardously. Adolescents report increased levels of alcohol consumption. Previous research has inferred the influence of the parent on their adolescent. Thus, the aim of the current study was to investigate the association between adolescent alcohol consumption and their parent’s consumption pattern and attitude toward alcohol use in Southern Ireland.

Methods

A cross-sectional survey was undertaken in November 2014. This involved distributing a survey to adolescents (n = 982) in their final two years of second level education and at least one of their parents from a local electorate area in Southern Ireland. This survey included: alcohol use, self- reported height and weight, smoking status, mental health and well-being along with attitudinal questions. Chi-square tests and multivariate logistic regression were utilised.

Results

A 37 % response rate was achieved. Over one-third (34.2 %) of adolescents and 47 % of parents surveyed reported hazardous drinking. Over 90 % of parents disagreed with allowing their adolescent to get drunk and rejected the idea that getting drunk is part of having fun as an adolescent. The majority (79.5 %) of parents surveyed believed that their alcohol consumption pattern set a good example for their adolescent. Multivariate logistic regression highlights the association between adolescent hazardous alcohol consumption and hazardous drinking by the father. Furthermore either parent permitting their adolescent to drink alcohol on special occasions was associated with hazardous alcohol consumption in the adolescent.

Conclusion

The findings of this research notes a liberal attitude to alcohol and increased levels of consumption by the parent are linked to hazardous adolescent drinking behaviour. Future action plans aimed at combatting adolescent hazardous alcohol consumption should also be aimed at tackling parents’ attitudes towards and consumption of alcohol.

Mental disorders and harmful substance use in children of substance abusing parents: A longitudinal register-based study on a complete birth cohort born in 1991

INTRODUCTION AND AIMS

Adverse childhood experiences and their accumulation over childhood have negative outcomes to children, yet earlier findings on the independent effect of parental substance abuse seem inconsistent. Our aims were to examine: (i) whether parental substance abuse is associated with children's mental disorders in mid-childhood (7-12 years) and mental disorders and own substance use in adolescence (13-17 years); and (ii) whether children are affected differently by a mother or father's substance abuse.

DESIGN AND METHODS

A register-based longitudinal data on a complete birth cohort of children born in Finland in 1991 (n = 65 117) and their biological parents. The children were followed until their 18^th birthday. Data were derived from the Finnish administrative registries. Bivariate and multivariate logistic regression models were used in the analysis.

RESULTS

Maternal, paternal and both parents' substance abuse were significant predictors of mental disorders and harmful substance use in children aged 13-17 years, even after controlling for other adverse childhood experiences, parental education and child's gender. Parental substance abuse predicted mental disorders in children aged 7-12 years in bivariate model but in multivariate model the association disappeared. Maternal substance abuse had stronger effect on harmful substance use in adolescent children than paternal. There were no significant interactions between substance abusing parents' gender and the child's gender.

DISCUSSION AND CONCLUSIONS

Early identification, prevention and treatment of substance abuse in families with children in primary health care, child welfare and other services are crucial in preventing intergenerational transmission of the problems associated with parental substance abuse. [Jääskeläinen M, Holmila M, Notkola I-L, Raitasalo K. Mental disorders and harmful substance use in children of substance abusing parents: A longitudinal register-based study on a complete birth cohort born in 1991. Drug Alcohol Rev 2016;35:728-740].

Genetic Modification of the Relationship between Parental Rejection and Adolescent Alcohol Use

AIMS

Parenting practices are associated with adolescents' alcohol consumption, however not all youth respond similarly to challenging family situations and harsh environments. This study examines the relationship between perceived parental rejection and adolescent alcohol use, and specifically evaluates whether youth who possess greater genetic sensitivity to their environment are more susceptible to negative parental relationships.

METHODS

Analyzing data from the National Longitudinal Study of Adolescent Health, we estimated a series of regression models predicting alcohol use during adolescence. A multiplicative interaction term between parental rejection and a genetic index was constructed to evaluate this potential gene-environment interaction.

RESULTS

Results from logistic regression analyses show a statistically significant gene-environment interaction predicting alcohol use. The relationship between parental rejection and alcohol use was moderated by the genetic index, indicating that adolescents possessing more 'risk alleles' for five candidate genes were affected more by stressful parental relationships.

CONCLUSIONS

Feelings of parental rejection appear to influence the alcohol use decisions of youth, but they do not do so equally for all. Higher scores on the constructed genetic sensitivity measure are related to increased susceptibility to negative parental relationships.

Precocious Initiation into Smoking, Alcohol Use, and Gambling among Children with Conduct Problems

OBJECTIVE

Adolescent participation in risky and addictive behaviours, such as smoking, substance use, and gambling has the potential to lead to many serious problems. The presence of conduct problems (CPs) and early initiation into risky and addictive behaviours have been independently shown to be associated with adolescent and young adult smoking, drinking, and gambling. Nevertheless, the relation between early initiation into risky and addictive behaviours and CPs remains to be explored among pre-adolescents. Our study aims to examine the prospective relation between CPs in early primary school and pre-adolescent initiation into smoking, alcohol use, and gambling.

METHOD

Our study used data from participants in an ongoing prospective, longitudinal study at the Université de Sherbrooke to examine cigarette, alcohol, and gambling initiation among primary school-aged boys and girls with CPs. Children were recruited between the ages of 6 and 9 years from several low socioeconomic status public schools in diverse geographical regions of Quebec. Initiation into cigarettes, alcohol, and gambling was measured 1 year later.

RESULTS

Children with CPs were found to be at greater risk for early initiation into smoking, alcohol, and gambling. These effects remained even once other known risk factors, such as poor parental supervision and child effortful control, were controlled for.

CONCLUSIONS

These results suggest that CPs present in early elementary school can predict early initiation in to potentially addictive behaviours among boys and girls. Implications for targeted preventive intervention are discussed.

Natural mentors and youth drinking: a qualitative study of Mexican youths

Parental influences on youth drinking are well documented but not the influence of extended family members. This article explores extended family influences on alcohol use among Mexican youths and whether extended family members can be considered natural mentors. We conducted a qualitative study using ethnographic open ended interviews with 117 first year university students in Mexico City. The ethnographic interviews revealed six drinking groups: excessive, heavy, regular, occasional, abstainers and non drinkers. Youths reported close relationships with extended family members who provided counsel and acted as representatives of familial norms and values. The alcohol beliefs and behaviors of these family members, including their alcohol misuse, had a positive influence on youths' alcohol attitudes. The naturally occurring mentoring relationships of Mexican extended family members can positively influence moderate youth drinking. Natural mentoring relationships should be encouraged and facilitated in prevention efforts for Mexican youths, Mexican-American youths and potentially other Hispanic/Latino youths.

The influence of parental drinking on offspring's drinking motives and drinking: a mediation analysis on 9 year follow-up data

BACKGROUND AND AIMS

The influence of parental drinking on offspring's drinking is well-documented. However, longitudinal evidence on the mediating role of drinking motives in this relationship is lacking. This study longitudinally investigates the mediating role of drinking motives in the relationship between parental and offspring's drinking.

METHODS

Using a prospective design, 587 Flemish children (response 30.0%) were followed for 9 years. Parental drinking was documented during the offspring's late childhood (10 and 11 years old) through paper-and-pencil questionnaires distributed by schools. The offspring's drinking habits and -motives were documented in early adulthood (18 and 19 year old) through a web-based questionnaire; invitations were sent by letter. Motives were measured using the Drinking Motives Questionnaire Revised Short-form, and mediation analyses were conducted with the product of coefficient test using bootstrapping.

RESULTS

Half the offspring were female (53.8%) and the mean age was 19.35 (SD = 0.52) years. A significant direct effect of maternal drinking during childhood on offspring drinking nine years later was found (β = 0.091, t = 2.071, p = 0.039). However, the association turned non-significant after stratifying the model for boys and girls. No direct effect was found for paternal drinking on offspring's drinking. Nevertheless, paternal drinking indirectly affected offspring's drinking through offspring's enhancement motives (β = 0.041, 95%CI[0.004, 0.082]) and maternal drinking indirectly affected male offspring's drinking through offspring's social motives (β = 0.067, 95%CI[0.007, 0.148]).

CONCLUSION

These results show that parental drinking during late childhood relates to a high level of those drinking motives among young adults that are known risk factors for heavy drinking in early adulthood.

Substance and Alcohol use in Young Adults in Turkey as Indicated by the CAGE Questionnaire and Drinking Frequency

INTRODUCTION

The purpose of this study was to determine drinking problems and to analyze the socio-demographic factors associated with problematic alcohol use in young adults.

METHODS

The study included 262 students who were surveyed for substance use problems in a postgraduate program using the Cut down, Annoyed, Guilty, Eye opener (CAGE) Questionnaire. The relationships between socio-demographic variables and alcohol use were assessed using both univariate and multivariate analyses.

RESULTS

Of the whole sample, 56.11% reported that they had tried drinking alcohol and 1.91% had tried cannabis. The prevalence of problematic alcohol use was 15.3% and 29.7% according to CAGE1+ and past-year drinking frequency, respectively. Alcohol use by mothers was an important differentiating factor for alcohol use by their daughters. Graduating from a university located in the Eastern/Southeastern Anatolia regions, graduating from a private high school, and having average academic performance levels were determinants of problematic alcohol use according to CAGE1+ and frequency of drinking.

CONCLUSION

This study suggests there is need for early intervention to prevent exposure to the risk factors for problematic alcohol use in young adults, emphasizing that probable presence of an alcohol use disorder and high frequency of drinking are related to socio-demographic factors (high school type, geographical location of the university, and family structure).

Intergenerational Hazardous Alcohol Use and Area Factors: The HUNT Study, Norway

BACKGROUND

Alcohol use among adolescents has been found to be associated with parental alcohol abuse, but it's relation to more prevalent forms of hazardous drinking patterns among parents has been less explored. Few studies have included area factors when investigating alcohol use across generations.

OBJECTIVES

The aims of this study were to investigate whether adolescent intoxication was associated with parental heavy episodic drinking (HED) and intoxication, area-level socioeconomic status (SES), and rates of area-level HED.

METHODS

General Estimation Equations (GEE) was applied to analyze data from the Nord-Trøndelag Health Study (2006-08) including 2,306 adolescents. Adolescent alcohol use was defined by self-reported frequency of intoxication. Parental alcohol use was defined by parental self-reports of drinking five glasses of alcohol at one occasion (HED), whether they had been strongly intoxicated, and adolescent reports of seeing parents intoxicated. Area-level SES and HED were based on data from HUNT3 and Statistics Norway.

RESULTS

Parental and offspring alcohol use were associated, although this varied to some extent with gender and exposures. The strongest associations were found between offspring intoxication and offspring reports of seeing their parent intoxicated (girls: OR 3.3, 95% CI 2.3-4.7; boys: OR 3.4, 95% CI 2.4-4.7). Intoxication was more common among girls, who lived in areas with a higher level of adult HED. Living in areas with higher SES was associated with less intoxication among adolescents.

CONCLUSION

Intoxication in adolescence was associated with factors at both family and area level, which emphasize the need of both population and high risk preventive approaches.

Adolescent alcohol use and alcohol use disorders in Mexico City

OBJECTIVE

To estimate the prevalence, sex, age distribution, and socio-demographic correlates of any alcohol use, consumption patterns, and any alcohol use disorder in a representative sample of Mexican adolescents.

METHODS

3005 youth (52.1% female) aged 12-17 from a stratified multistage area probability sample were representative of adolescents residing in the Mexico City Metropolitan Area. Alcohol use and disorder and their socio-demographic correlates were evaluated with the World Mental Health adolescent version of the Composite International Diagnostic Interview. Data were post-stratified to the total Mexico City adolescent population.

RESULTS

59% has used alcohol, this proportion increasing significantly with age. By age 17, 82.5% has used alcohol. Consumption patterns are mostly of low/moderate quantity or infrequent high quantity. Lifetime DSM-IV alcohol use disorder criteria are met by 3.8%, reaching 8.1% for 16-17 years-olds. While males have greater frequency and quantity of drinking, there are no gender differences for alcohol use disorders. Non-school attending youth have twice the odds of a lifetime (OR=2.0, 95% CI=1.13-3.53) and 12-month disorder (OR=2.1, 95% CI=1.10-4.15). Low parental monitoring is associated with 1.72 times the odds of a lifetime disorder (95% CI=1.10-2.68).

CONCLUSIONS

Over a third of 12 year-olds had ever drunk an alcoholic beverage in their lifetime suggesting that the prevention of alcohol use and disorders must begin in late childhood. Initiatives to foment parental monitoring and to prevent, identify, and treat alcohol use problems in non-school attending youth in particular should be a priority for the wellbeing of Mexico City adolescents.

The role of parental alcohol use, parental discipline and antisocial behaviour on adolescent drinking trajectories

BACKGROUNDS

Parental drinking, harsh parental discipline and adolescent antisocial behaviour have been independently implicated in adolescent alcohol use. Robust prospective studies are required to examine developmental relationships between these factors and their effect on trajectories of alcohol use across adolescence.

METHODS

Data were ascertained at three consecutive adolescent waves (13.5, 15.5 and 17.5 years) from the Australian Temperament Project, a 15-wave (30 year) general population birth cohort in Victoria, Australia. Adolescent alcohol trajectories, adjusted for time-varying measures of parenting and antisocial behaviour, were regressed on time-stable measures of parental alcohol use. The full case analysis comprised 751 individuals with complete data.

RESULTS

Two distinct alcohol trajectories were identified across the three adolescent waves after adjusting for time-varying factors: a higher and lower drinking group. Both trajectories increased linearly over the study period. Antisocial behaviour was positively associated with both trajectories while harsh parental discipline was positively associated with alcohol use in the lower-use group only. Increased maternal and paternal drinking at 13.5 years placed teenagers at a greater risk of being included in the high-risk trajectory.

CONCLUSION

Parental drinking was the strongest predictor of different drinking trajectories in adolescence. This finding underscores the importance of comprehensive public heath approaches that target both parental and adolescent drinking attitudes and behaviour.

Parental alcohol misuse and hazardous drinking among offspring in a general teenage population: gender-specific findings from the Young-HUNT 3 study

Background

Parental alcohol misuse may negatively affect drinking behaviours among offspring, but it is unclear to what extent influences are gender-specific and dependent upon the actual drinking behaviour measured. The aim of this study was to investigate whether hazardous drinking among Norwegian teenage boys (N = 2538) and girls (N = 2494) was associated with paternal and maternal alcohol misuse (CAGE).

Methods

Definitions of hazardous drinking among offspring were based on self-reported alcohol consumption (in litres a year), frequency of drinking, and frequency of drunkenness. Based on this information, two composite measures of hazardous drinking were also constructed. Cross-sectional data from the Norwegian Young-HUNT 3 survey (2006–2008) were linked to information from biological parents who participated in the adult part of the HUNT study.

Results

Logistic regression analyses showed that both boys and girls with alcohol misusing fathers were more likely to report high levels of alcohol intake compared to others of the same age and gender. This was contrary to boys with misusing mothers, who reported less alcohol consumption than other boys. Among girls, but not boys, high frequency of drunkenness was associated with maternal as well as paternal misuse.

Conclusions

This study suggests that adolescent hazardous drinking is more prevalent among boys and girls with alcohol misusing parents versus those whose parents do not misuse alcohol. However, findings were gender specific and varied depending on the drinking outcomes under investigation. More evidence-based knowledge in this field is of great importance for better understanding the possible role paternal and maternal alcohol misuse may play in the development of hazardous alcohol drinking patterns among adolescent boys and girls.

The Effect of Family Factors on Intense Alcohol Use among European Adolescents: A Multilevel Analysis

In Europe use of alcohol by adolescents is a large and increasing problem. The aim of this study is to examine the effects of family factors such as structure, social control, affluence, and negative life events on adolescents' risky alcohol use. Data on alcohol use and family factors were obtained from the International Self-Report Delinquency Study (ISRD-2). Using multilevel analysis, it was found that overall, complete family and high social control by parents were lowering the intense alcohol use whereas negative life events in the family and high family affluence were increasing youngsters' intense alcohol use. Differences between regions of Europe were present for all family factors except affluence. Namely, in Northern Europe the impact of family structure and social control on intense alcohol use was stronger than that in other regions (e.g., Western Europe, Mediterranean, and Postsocialist countries). Also, in Northern Europe where the proportion of adolescents who have not experienced negative life events is the highest, the impact of negative life events on intense alcohol use was stronger; that is, negative life events increased the alcohol use. We conclude that family plays a significant role in adolescents' risky alcohol use.

Do antenatal and postnatal parental psychological distress, and recognized need of help predict preadolescent's psychiatric symptoms? The Finnish Family Competence Cohort study

In a prospective population-based study, mothers and fathers of 1,247 children reported their physical and mental health during pregnancy, after delivery, within the child's first 18 months of life, and at 12 years. Additionally, maternal health clinic nurses rated parents' well-being and perceived need for support. At age 12, child outcomes were also measured using CBCL and YSR externalizing and internalizing scales. Results indicate that both ante- and postnatal maternal distress predicted future externalizing problems in offspring. Conversely, fathers' postnatal distress predicted subsequent internalizing problems. Furthermore, mother's depressed mood in the first trimester best predicted the child's externalizing problems at age 12. Nurses's ratings of mother's antenatal and perinatal need for support, perinatal distress, and family's need for support were associated with both internalizing and externalizing problems at age 12. Maternal antenatal distress increases the risk of offspring's externalizing problems in preadolescense, and postnatal distress in either parent increases the risk of internalizing problems. Parental self-reports and indirect ratings from health care providers during pregnancy and infancy may therefore reliably recognize offspring at risk for subsequent psychiatric symptomatology.

Socioeconomic inequalities in alcohol use of adolescents: the differences between China and Finland

OBJECTIVES

Findings from previous studies on socioeconomic inequalities in alcohol use among adolescents are not consistent. This study examined and compared the relationship between socioeconomic status and alcohol use of adolescents in China and Finland.

METHODS

The sample included 2,005 Chinese and 1,685 Finnish 15-year-old school children. The associations between Family Affluence Scale (FAS) and alcohol use were examined separately in two countries through binary logistic regression.

RESULTS

Chinese adolescents from the high FAS group were more likely to report experiencing monthly alcohol use (OR = 2.13) and early onset of alcohol use (OR = 1.55) (girls), and early onset of drunkenness (OR = 1.81) (boys). However, no statistically significant difference was found in three FAS groups for all four measures of alcohol use among Finnish adolescents.

CONCLUSIONS

This study indicated clear differences of socioeconomic inequalities in alcohol use between Chinese and Finnish adolescents. It suggested that interventions on adolescent alcohol use in China should be targeted on those who are from the high affluent family whereas in Finland efforts should be made to curb adolescents drinking across the socioeconomic spectrum.

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns with both initiation and development of adolescent alcohol use. Longitudinal data (four annual measurements) of parent-child dyads (N=2319) have been used. Parental drinking patterns have been identified using latent class analysis. The association of parental drinking patterns with the initiation and development of 12-15 year olds' drinking have been examined with latent growth curve modeling. Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking. When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant. Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES. Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts the initiation and development of alcohol consumption in their offspring. Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.

Parental alcohol-specific rules and alcohol use from early adolescence to young adulthood

BACKGROUND

  Several studies stress the importance of alcohol-specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow-up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study aimed to provide a developmental perspective on the link between alcohol-specific rules and alcohol use from early adolescence until early adulthood in the Netherlands.

METHODS

  The sample consisted of 428 Dutch families including fathers, mothers and adolescents from 2 age groups (13 and 15 years old) at Time 1 (T1), who have been surveyed annually for 6 years. To address the effect of alcohol-specific rules on adolescent alcohol use over time, a latent growth curve analytic approach with time-varying covariates was employed.

RESULTS

  Over time, adolescent alcohol use increased, whereas alcohol-specific rules decreased. Most importantly, however, the lagged paths of alcohol-specific rules consistently predicted subsequent alcohol use across the 6 assessments for both younger and older siblings. Thus, strict alcohol-specific rules at a certain point in time were related to a lower intensity of adolescent alcohol use a year later.

CONCLUSIONS

  Although parents turn somewhat less strict in alcohol-specific rules over time, and adolescent alcohol use increases over time, the specific rules parents set remain important in restraining the alcohol use of their adolescent offspring. Thus, parents should and can feel confident about their parenting capabilities, and they should maintain being strict to prevent their offspring from drinking.

Parenting factors associated with reduced adolescent alcohol use: a systematic review of longitudinal studies

OBJECTIVE

To identify parenting strategies associated with adolescent alcohol consumption that parents can use to implement new national guidelines regarding alcohol consumption by people under the age of 18.

METHODS

A systematic search of academic literature employing the PRISMA method identified 77 relevant articles. Inclusion criteria for the review were (i) longitudinal cohort studies; (ii) measurement of one or more parenting factors during adolescence or pre-adolescence (between the ages of 8 and 17) as a predictor (iii) outcome measurement of any alcohol use and/or alcohol related problems during adolescence at least one time point after the initial parenting factor was measured, and/or problem drinking in adulthood. Studies were excluded if alcohol use was combined with other substance use or problem behaviour as an outcome variable, or if different parenting factors were combined as a single predictor variable for analysis. Stouffer's method of combining p values was used to determine whether associations between variables were reliable.

RESULTS

Twelve parenting variables were investigated in these studies: parental modelling, provision of alcohol, alcohol-specific communication, disapproval of adolescent drinking, general discipline, rules about alcohol, parental monitoring, parent-child relationship quality, family conflict, parental support, parental involvement, and general communication. We found that delayed alcohol initiation was predicted by: parental modelling, limiting availability of alcohol to the child, parental monitoring, parent-child relationship quality, parental involvement and general communication. Reduced levels of later drinking by adolescents were predicted by: parental modelling, limiting availability of alcohol to the child, disapproval of adolescent drinking, general discipline, parental monitoring, parent-child relationship quality, parental support and general communication.

CONCLUSIONS

A number of parenting strategies were identified that parents can use to reduce their adolescent's alcohol consumption. These could be promoted to parents to help them implement new national guidelines on alcohol use.

Onset drinking: how it is related both to mother's drinking and mother-child relationships

Employing the National Longitudinal Survey of Youth (NLSY) as a sample of adolescents and their mothers, the present study connected the onset of adolescents' drinking to certain posited risk and protective factors characterizing their families. Via event history analysis and the discrete-time method, the data analysis involved more than 6,331 pair-interview-year units. The results show that both peer influences and mother's daily alcohol consumption enhance the risk that an adolescent aged between 10 and 14 years will begin drinking. At the same time, the quality of a mother's relationship with her child is an important posited protective factor delaying onset drinking.

The relationships of the level of response to alcohol and additional characteristics to alcohol use disorders across adulthood: a discrete-time survival analysis

BACKGROUND

A low level of response (LR) to alcohol has been shown to relate to a higher risk for alcohol use disorders (AUDs). However, no previous research has examined the association between LR and the development of AUDs in the context of additional robust risk factors for AUDs. This study evaluated whether LR and other related characteristics predicted the occurrence of AUDs across adulthood using discrete-time survival analysis (DTSA).

METHODS

A total of 297 probands from the San Diego Prospective Study reported on the LR to alcohol, a family history (FH) of AUDs, the typical drinking quantity, the age of drinking onset, the body mass index and the age at the baseline (T1) assessment. Alcohol use disorders (AUDs) were evaluated at the 10-year (T10), T15, T20, and T25 follow-ups.

RESULTS

A low LR to alcohol predicted AUD occurrence over the course of adulthood even after controlling for the effects of other robust risk factors. Interaction effects revealed that the impact of FH on AUDs was only observed for subjects with high T1 drinking levels, and probands with high T1 drinking were at high risk for AUDs regardless of their age of onset.

CONCLUSIONS

The findings illustrate that LR is a unique risk factor for AUDs across adulthood, and not simply a reflection of a broader range of risk factors. The continued investigation of how LR is related to AUD onset later in life will help inform treatment providers about this high-risk population, and future longitudinal evaluations will utilize DTSA to assess rates of AUD remission as well as the onset of drinking outcomes in adolescent samples.

Decrease in the prevalence of adolescent alcohol use and its possible causes in Japan: periodical nationwide cross-sectional surveys

BACKGROUND

Trends in alcohol drinking prevalence were assessed among Japanese adolescents, and possible reasons for a decrease in drinking prevalence observed in 2004.

METHODS

Cross-sectional nationwide surveys were conducted periodically. High schools were randomly sampled from throughout Japan in 1996, 2000, and 2004. All enrolled students in sampled schools were subjects of the surveys. Self-reporting anonymous questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. Questions about drinking prevalence of students and family members, proportion of students who have no friends, and sources of alcohol were included. Students who drunk at least one day of the 30 days preceding the survey were defined as the current drinkers.

RESULTS

The drinking prevalence in 2004 was decreased in comparison to that in 1996 and 2000 in both sexes and in all school grades. The current drinking rate (monthly drinker) among junior high school boys was 29.4% in 1996, 29.0% in 2000, and 20.5% in 2004, while that among senior high school boys was 49.7%, 48.7%, and 36.2%, respectively. The respective prevalence among junior and senior girls was 24.0%, 25.5%, and 20.0% and 40.8%, 42.1%, and 34.1%. The prevalent sources of alcohol beverages were searching in home, stores (convenience store, supermarket, or gas-stand), liquor shops, and bars. An analysis of the reasons for this decrease identified a decrease in drinking prevalence in students' families, especially by fathers and older brothers, and an increase in the proportion of students who had no friends.

CONCLUSIONS

A decrease in drinking prevalence of male family members and a limitation of sources of alcoholic beverages may contribute to the decrease in adolescent drinking prevalence.

Parental factors influence teen alcohol use after an emergency department visit

OBJECTIVES

To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit.

METHODS

Adolescents, 13 to 17 years, who either had evidence or reported usage of alcohol in the 6 hours before an ED visit, were eligible for this study. Alcohol use was assessed at baseline and at 3-month follow-up. Data on parental variables and parenting practices were collected at baseline. Linear regression models were created to determine the relationship between parental factors and follow-up drinking.

RESULTS

Parental alcohol use, socioeconomic status, and monitoring practices were significant predictors of adolescent alcohol use at 3-month follow-up.

CONCLUSIONS

Parental factors may significantly influence subsequent adolescent drinking after an ED visit. These factors should be assessed when treating alcohol-positive teens, and parents should be advised to closely monitor their teens.

Externalizing disorders in the offspring from the San Diego prospective study of alcoholism

OBJECT

Conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) may be more prevalent in relatives of alcoholics and may predict alcohol and drug problems, but not all studies agree. This paper evaluates these questions in well-educated families of alcoholics and controls.

METHODS

Data from 165, 14-25-year-old offspring in the San Diego Prospective Study were used to create Group 1 (n=17) with CD or ADHD and Group 2 (n=148) with no such diagnoses. Correlations and hierarchical logistic regressions evaluated characteristics associated with these disorders, comparing the impact of CD and ADHD.

RESULTS

The rates of CD (6.1%) and of ADHD (4.8%) were not strikingly elevated, and did not relate to the family history of alcohol or drug use disorders. Group 1 offspring were more likely to have divorced parents, a relative with bipolar disorder, a higher intake of alcohol and illicit substances, and associated problems.

Relative risks of adolescent and young adult alcohol use: the role of drinking fathers, mothers, siblings, and friends

The present study examined to what extent regular drinking of fathers, mothers, co-twins, siblings, and friends was related to adolescent regular drinking in three age groups: 12-15, 16-20 and 21-15-year olds. The sample consisted of 3760 twins (1687 boys, 2073 girls) with a mean age of 17.8 years. Data were based on twins' self-reported alcohol uses and reports about siblings' and friends' alcohol use, and on parents' self-reports. Results showed that generally in each of the three age groups, regular drinking of same-sex co-twins and friends posed the highest risk for regular drinking. Age differences indicated that these risks decreased with age. Irrespective of age, regular drinking of fathers and mothers posed the lowest risk. Findings were generally the same for males and females.

Socio-economic status in childhood and later alcohol use: a systematic review

AIM

To conduct a systematic review of longitudinal studies that examined the association between childhood socio-economic status (SES) and alcohol use in later life.

METHODS

A systematic search to identify all longitudinal population-based studies that examined the association between childhood SES and later alcohol use.

RESULTS

Nineteen relevant articles were identified (eight birth cohorts and 11 papers on school-aged cohorts). There was little consistent evidence to support an association between lower childhood SES and later (mis)use of alcohol. Only a minority of studies included assessment of problem alcohol use, and in only one study was the relationship between SES and alcohol use the main research question.

CONCLUSION

We found little robust evidence to support the assumption that childhood disadvantage is associated with later alcohol use/abuse. Given the importance of this issue in terms of policy, the lack of evidence is surprising and emphasizes the need for further research in order to inform future policies and public health messages.