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Rong F, Wang M, Peng C, Cheng J, Wang Y, Yu Y. Specific and cumulative effects of childhood maltreatment on nonsuicidal self-injury in Chinese adolescents: The moderating effect of sleep disturbance. CHILD ABUSE & NEGLECT 2024; 149:106627. [PMID: 38227985 DOI: 10.1016/j.chiabu.2023.106627] [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: 10/11/2022] [Revised: 12/03/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Numerous studies have examined the relationship between childhood maltreatment (CM) and nonsuicidal self-injury (NSSI). However, few studies have explored both the specific and cumulative effects of CM on NSSI. Additionally, the impact of sleep disturbance on the association between CM and NSSI remains unclear. OBJECTIVES To comprehensively explore the effects of CM on NSSI, and to determine whether these effects are moderated by sleep disturbance. PARTICIPANTS AND SETTING A retrospective study was conducted in April 2021 among a representative sample of 21,340 students aged 11-20 years in China. METHODS All participants completed questionnaires assessing CM, sleep disturbance, and NSSI. Adjusted multivariate logistic regression models were utilized to evaluate the associations between CM and NSSI, as well as the impact of sleep disturbance. RESULTS The findings revealed that 13.0 % of adolescents reported occasional NSSI, while 25.2 % reported repetitive NSSI. Except for sexual abuse, all subtypes of CM were significantly associated with increased odds of both occasional and repetitive NSSI. A significant dose-response relationship was observed between cumulative CM and repetitive NSSI. Stratification analyses by sleep disturbance indicated that adolescents reporting sleep disturbance had a higher risk of developing repetitive NSSI, irrespective of the type of CM experienced. Furthermore, a dose-response relationship was identified between cumulative CM and repetitive NSSI among adolescents reporting sleep disturbance. CONCLUSION This study demonstrated that CM increases the risk of NSSI among Chinese adolescents, and sleep disturbance plays a moderating role. Interventions targeting sleep disturbance may hold significance in reducing NSSI.
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Affiliation(s)
- Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China..
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Nagata JM, Zamora G, Smith N, Sajjad OM, Shim J, Ganson KT, Testa A, Jackson DB. Social epidemiology of early adolescent alcohol expectancies. BMC Public Health 2023; 23:2502. [PMID: 38093235 PMCID: PMC10720177 DOI: 10.1186/s12889-023-17434-5] [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: 12/07/2022] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE To determine the sociodemographic correlates of alcohol expectancies (i.e., beliefs regarding positive or negative effects of alcohol) in a national (U.S.) cohort of early adolescents 10-14 years old. A second aim was to determine associations between alcohol sipping and alcohol expectancies. METHODS We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,868; Year 2). Linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, household income, parental education, parent marital status, religiosity) and positive (e.g., stress reduction) and negative (e.g., loss of motor coordination) alcohol expectancies. Additional linear regression analyses determined associations between alcohol sipping and alcohol expectancies, adjusting for sociodemographic factors. RESULTS Overall, 48.8% of the participants were female and 47.6% racial/ethnic minorities, with a mean age of 12.02 (SD 0.67) years. Older age among the early adolescent sample, male sex, and sexual minority identification were associated with more positive and negative alcohol expectancies. Black and Latino/Hispanic adolescents reported less positive and negative alcohol expectancies compared to White non-Latino/Hispanic adolescents. Having parents with a college education or greater and a household income of $200,000 and greater were associated with higher positive and negative alcohol expectancies. Alcohol sipping was associated with higher positive alcohol expectancies. CONCLUSIONS Older age, White non-Latino/Hispanic race, male sex, sexual minority status, higher parental education, and higher household income were associated with higher positive and negative alcohol expectancies. Future research should examine the mechanisms linking these specific sociodemographic factors to alcohol expectancies to inform future prevention and intervention efforts.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0530, San Francisco, CA, 94158, USA.
| | - Gabriel Zamora
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0530, San Francisco, CA, 94158, USA
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0530, San Francisco, CA, 94158, USA
| | - Omar M Sajjad
- Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Rd, Hanover, NH, 03755, USA
| | - Joan Shim
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0530, San Francisco, CA, 94158, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, TX, 77030, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA
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Park YW, Gentzler AL. Parenting and Courage: Exploring the Mediating Role of Self-esteem and Emotion Regulation among Adolescents. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023; 87:101558. [PMID: 37484998 PMCID: PMC10358398 DOI: 10.1016/j.appdev.2023.101558] [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] [Indexed: 07/25/2023]
Abstract
With adolescence being a period for potential challenges but also positive growth, courage can aid adolescents in rising to some of these challenges. Yet few studies have investigated predictors and mechanisms of courage. The present study examined how three parenting constructs (attachment, autonomy support, and helicopter parenting) predict courage and if self-esteem or emotion regulation serve as mediators. The present study assessed predictors at Time 1 and courage at one-year follow-up. The sample included 203 American adolescents (51.7% girls, 14-15 year olds). Results suggested that relations between several parental variables (anxious attachment to parents, avoidant attachment to fathers, autonomy support of parents) and adolescent courage were mediated by self-esteem. In addition, cognitive reappraisal mediated associations between two mother-related variables (avoidant attachment, helicopter parenting) and courage. Findings contribute to the limited empirical research on adolescents' development of courage.
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Affiliation(s)
- Yea Won Park
- Department of Psychology, West Virginia University
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Wong SMY, Ip CH, Hui CLM, Suen YN, Wong CSM, Chang WC, Chan SKW, Lee EHM, Lui SSY, Chan KT, Wong MTH, Chen EYH. Prevalence and correlates of suicidal behaviours in a representative epidemiological youth sample in Hong Kong: the significance of suicide-related rumination, family functioning, and ongoing population-level stressors. Psychol Med 2023; 53:4603-4613. [PMID: 35650661 PMCID: PMC10388322 DOI: 10.1017/s0033291722001519] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Young people are most vulnerable to suicidal behaviours but least likely to seek help. A more elaborate study of the intrinsic and extrinsic correlates of suicidal ideation and behaviours particularly amid ongoing population-level stressors and the identification of less stigmatising markers in representative youth populations is essential. METHODS Participants (n = 2540, aged 15-25) were consecutively recruited from an ongoing large-scale household-based epidemiological youth mental health study in Hong Kong between September 2019 and 2021. Lifetime and 12-month prevalence of suicidal ideation, plan, and attempt were assessed, alongside suicide-related rumination, hopelessness and neuroticism, personal and population-level stressors, family functioning, cognitive ability, lifetime non-suicidal self-harm, 12-month major depressive disorder (MDD), and alcohol use. RESULTS The 12-month prevalence of suicidal ideation, ideation-only (no plan or attempt), plan, and attempt was 20.0, 15.4, 4.6, and 1.3%, respectively. Importantly, multivariable logistic regression findings revealed that suicide-related rumination was the only factor associated with all four suicidal outcomes (all p < 0.01). Among those with suicidal ideation (two-stage approach), intrinsic factors, including suicide-related rumination, poorer cognitive ability, and 12-month MDE, were specifically associated with suicide plan, while extrinsic factors, including coronavirus disease 2019 (COVID-19) stressors, poorer family functioning, and personal life stressors, as well as non-suicidal self-harm, were specifically associated with suicide attempt. CONCLUSIONS Suicide-related rumination, population-level COVID-19 stressors, and poorer family functioning may be important less-stigmatising markers for youth suicidal risks. The respective roles played by not only intrinsic but also extrinsic factors in suicide plan and attempt using a two-stage approach should be considered in future preventative intervention work.
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Affiliation(s)
- Stephanie M. Y. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Charlie H. Ip
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy L. M. Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y. N. Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Corine S. M. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - W. C. Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Sherry K. W. Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Edwin H. M. Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Simon S. Y. Lui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K. T. Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Michael T. H. Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Y. H. Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Kelly C, Major E, Durcan M, O'Donovan D, McNamara Á. Adolescent binge drinking in the West of Ireland: associated risk and protective factors. BMC Public Health 2023; 23:1064. [PMID: 37277777 DOI: 10.1186/s12889-023-15577-z] [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: 07/30/2022] [Accepted: 03/31/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Alcohol is a leading cause of morbidity and mortality worldwide. Adolescence is when alcohol use typically begins. Harmful patterns of alcohol consumption, such as binge drinking, may emerge during adolescence and become established. This study aimed to examine potential risk and protective factors for binge drinking among 15-16-year-old adolescents in the West of Ireland. METHODS This was a cross-sectional secondary analysis of 4473 participants from the Planet Youth 2020 Survey. The outcome was ever binge drinking, defined as ever consumption of five or more drinks in a two-hour period or less. Independent variables were selected a priori following review of peer-reviewed literature and were grouped as individual, parents and family, peer group, school, leisure time and local community factors. Statistical analysis was completed using SPSS version 27. Differences in medians and means for continuous variables were examined using the Mann-Whitney U test and Independent Samples t-test respectively. Multivariable logistic regression was used to examine independent associations between potential risk and protective factors and ever binge drinking. A p-value of < 0.05 was deemed statistically significant. RESULTS The prevalence of ever binge drinking was 34.1%. Self-rated 'bad/very bad' mental health (adjusted Odds Ratio (aOR) 1.61, 95% CI 1.26-2.06, p < 0.001), current cigarette use (aOR 4.06, 95% CI 3.01-5.47, p < 0.001) and current cannabis use (aOR 2.79, 95% CI 1.80-4.31, p < 0.001) increased odds of ever binge drinking. Parental supervision (aOR 0.80, 95% CI 0.73-0.88, p < 0.001) and negative parental reaction to adolescent drunkenness (aOR 0.51, 95% CI 0.42-0.61, p < 0.001) reduced odds of ever binge drinking. Getting alcohol from parents increased odds of ever binge drinking (aOR 1.79, 95% CI 1.42-2.25, p < 0.001). Adolescents with friends who drink alcohol had almost five times higher odds of ever binge drinking (aOR 4.59, 95% CI 2.65-7.94, p < 0.001). Participating in team/club sports also increased odds of ever binge drinking (aOR 1.30, 95% CI 1.07-1.57, p = 0.008 for 1-4 times/week, aOR 1.52, 95% CI 1.07-2.16, p = 0.020 for ≥ 5 times/week). CONCLUSION This study identifies individual and social environment factors associated with adolescent binge drinking in the West of Ireland. This can inform intersectoral action to protect adolescents from alcohol-related harm.
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Affiliation(s)
- Ciara Kelly
- PricewaterhouseCoopers Ireland, 1 North Wall Quay, North Dock, Dublin 1, Ireland
- Department of Public Health West, Health Service Executive, Merlin Park, Galway, Ireland
| | - Emmet Major
- Western Region Drug & Alcohol Task Force, Galway Roscommon Education Training Board, Parkmore, Galway, Ireland
| | - Michéal Durcan
- Western Region Drug & Alcohol Task Force, Health Service Executive, Parkmore, Galway, Ireland
| | - Diarmuid O'Donovan
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University, Belfast, BT97BL, UK.
| | - Áine McNamara
- Department of Public Health West, Health Service Executive, Merlin Park, Galway, Ireland
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Lai W, Li W, Guo L, Wang W, Xu K, Dou Q, Shi J, Teopiz KM, McIntyre RS, Lu C. Association between bullying victimization, coping style, and mental health problems among Chinese adolescents. J Affect Disord 2023; 324:379-386. [PMID: 36587905 DOI: 10.1016/j.jad.2022.12.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/10/2022] [Accepted: 12/18/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study aimed to examine the association of bullying victimization with anxiety and depressive symptoms among Chinese adolescents and explored the role of coping styles in the foregoing associations. METHOD Data were drawn from the 2019 School-based Chinses Adolescents Health Survey (n = 19,809). Information about bullying victimization, coping styles, anxiety symptoms, and depressive symptoms were measured. Linear mixed-effects models were performed. RESULTS After adjusting for covariates, verbal victimization (β = 1.94 for anxiety symptoms; β = 4.62 for depressive symptoms), relational victimization (β = 3.40 for anxiety symptoms; β = 8.37 for depressive symptoms), physical victimization (β = 2.63 for anxiety symptoms; β = 6.07 for depressive symptoms) and cyber victimization (β = 4.68 for anxiety symptoms; β = 10.72 for depressive symptoms) were associated with anxiety and depressive symptoms. Moreover, the severity of anxiety and depressive symptoms tended to increase with the number of victimization types. The interaction effects between bullying victimization and coping style on anxiety and depressive symptoms were significant. Further stratified analyses by coping styles indicated that the association of relational and cyber victimization on anxiety and depressive symptoms were significantly stronger in adolescents with negative coping style than in those with positive coping style. LIMITATIONS Causal inference is limited due to the cross-sectional design. CONCLUSION Bullying victimization is associated with anxiety and depressive symptoms, and coping styles may play a moderate role in these associations. Interventions to promote mental health could focus on developing positive coping styles, particularly among adolescents with bullying victimization.
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Affiliation(s)
- Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Ke Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Qiufen Dou
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
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Chau SL, Wu Y, Wang MP, Ho SY. Interactive Video-Based Passive Drinking and Forced Drinking Education to Reduce Intention to Drink in Adolescents: A Pre-Post Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:332. [PMID: 36612654 PMCID: PMC9820002 DOI: 10.3390/ijerph20010332] [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: 10/20/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Passive and forced drinking harm was prevalent but less recognized in Chinese adolescents. We educated adolescents on such harm to reduce their intention to drink. Students (n = 1244) from seven secondary schools in Hong Kong participated in a video-based health talk on passive and forced drinking harm. Paired t-test was used to assess their change in knowledge of passive and forced drinking, and health and social harm of drinking after, the health talk. McNemar's chi-squared test and adjusted multivariable logistic regression (AOR) were used to assess their change in intention to drink and intention to quit. Students were less likely to drink (OR 0.29, 95% CI 0.19-0.42) and more likely to quit drinking (OR 3.50, 1.10-14.6) after the health talk. Increased knowledge of passive drinking was associated with less intention to drink (AOR 0.93, 0.90-0.97), increased knowledge of health harm (adjusted b 0.06, 0.05-0.08), and social harm of drinking (adjusted b 0.12, 0.10-0.16). Similar associations were observed in forced drinking (intention to drink: AOR 0.87, 0.79-0.96; health harm: adjusted b 0.16, 0.12-0.19; social harm: adjusted b 0.36, 0.28-0.43). We showed preliminary evidence that the health talk on passive and forced drinking reduced the intention to drink in adolescents.
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Affiliation(s)
- Siu Long Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Yongda Wu
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Frobel W, Grafe N, Meigen C, Vogel M, Hiemisch A, Kiess W, Poulain T. Substance use in childhood and adolescence and its associations with quality of life and behavioral strengths and difficulties. BMC Public Health 2022; 22:275. [PMID: 35144574 PMCID: PMC8831000 DOI: 10.1186/s12889-022-12586-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance use in childhood and adolescence continues to be a current health concern. The aims of the present study were to identify trends in the use of alcohol, cigarettes, and cannabis in children and adolescents in the last 10 years and to assess associations between substance use and quality of life and behavioral strengths and difficulties. METHODS Substance use was examined in 1829 9- to 18-year-old German children and adolescents participating in the LIFE Child cohort study between 2011 and 2020. Quality of life was investigated using the KIDSCREEN-27 questionnaire. The Strength and Difficulties Questionnaire was used to assess behavioral strengths and difficulties. Associations were assessed using linear regression analyses. All effects were adjusted for age, gender, and family socio-economic status. RESULTS 38.44% of participants reported drinking alcohol at least sometimes. Smoking (6.23%) and the use of cannabis (3.94%) were less frequent. While we observed no significant changes in smoking between 2011 and 2021, the consumption of cannabis and the frequent consumption of alcohol has increased in this time period. Cigarette and cannabis use were associated with additional symptoms of hyperactivity/inattention and reduced prosocial behavior. For all three substances, usage was associated with more conduct problems. We also found significant associations between substance use and a lower quality of life in the areas of physical wellbeing, psychological wellbeing, parent relation and autonomy, and school environment. One noteworthy finding was that cigarette consumption and frequent alcohol use were associated with higher quality of life in terms of social support/peer group relations. Some significant interactions between substance use and child age indicated that associations between substance use and quality of life or behavioral difficulties were stronger in younger than in older children. CONCLUSIONS The results show that quality of life and behavioral difficulties are associated with substance use and should be considered when developing or implementing preventive measures to counter substance use. Furthermore, the findings indicate that substance use can be accompanied by improved peer relations. Therefore, the influence of peers, especially of peers who use these substances, should not be underestimated.
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Affiliation(s)
- Wiebke Frobel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. .,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Nico Grafe
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Christof Meigen
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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Longitudinal associations between problematic Internet use, self-esteem, and depressive symptoms among Chinese adolescents. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01944-5. [PMID: 35034212 DOI: 10.1007/s00787-022-01944-5] [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: 08/31/2021] [Accepted: 01/07/2022] [Indexed: 11/03/2022]
Abstract
Problematic Internet use (PIU) has a negative impact on self-esteem among adolescents, thereby making them be vulnerable to developing depressive symptoms. However, there is a lack of longitudinal studies focusing on the process. This study aimed to explore the longitudinal associations between PIU, self-esteem, and depressive symptoms. A total of 1,736 adolescents completed this longitudinal study. The baseline survey was conducted in 2019, and the follow-up surveys were performed at 1-year and 2-year later. PIU, self-esteem, and depressive symptoms were measured. A cascade model was used to examine the longitudinal associations between PIU, self-esteem, and depressive symptoms. The mean age of participants was 13.6 (1.5) years at baseline. The final results observed significant within-time associations between PIU, self-esteem, and depressive symptoms at each time point. PIU and low level of self-esteem could predict subsequent depressive symptoms among adolescents, and depressive symptoms were also associated with subsequent PIU and self-esteem. Both PIU and self-esteem show bidirectional predictions with depressive symptoms among Chinese adolescents. Schools and parents should give more attention to adolescents prone to developing depressive symptoms and more social support to reduce their negative emotions. Health-related professionals should incorporate practical knowledge and skills into the education of adolescents to help them better control Internet use, attenuating the risk of future depressive symptoms.
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Oxidative Stress and Inflammation Are Associated with Coexistent Severe Multivessel Coronary Artery Stenosis and Right Carotid Artery Severe Stenosis in Elderly Patients. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2021:2976447. [PMID: 34976297 PMCID: PMC8716240 DOI: 10.1155/2021/2976447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022]
Abstract
Oxidative stress and inflammatory response are the main pathogenic pathways in atherosclerosis stenosis. This study is aimed at evaluating the roles of oxidative stress and inflammatory response in coexistent right carotid artery severe stenosis and severe multivessel coronary artery stenosis in elderly patients. Circulating levels of total oxidant status (TOS), lipid hydroperoxide (LHP), 8-isoprostane (8-IP), malondialdehyde (MDA), monocyte chemotactic protein-4 (MCP-4), amyloid A (AA), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α) were measured by standardised laboratory test methods. Markers of oxidative stress and inflammatory response: levels of TOS, LHP, 8-IP, MDA, MCP-4, AA, hs-CRP, and TNF-α, were increased (P < 0.001) in elderly patient. These results suggested that oxidative stress and inflammatory response may be involved in carotid artery severe stenosis and severe multivessel coronary artery stenosis and measuring oxidative stress and inflammation biomarkers may also be a promising step in the development of an effective method for monitoring the severity of right carotid artery stenosis and multivessel coronary artery stenosis in elderly patients.
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Lai W, Li W, Du X, Guo Y, Wang W, Guo L, Lu C. Association Between Childhood Maltreatment, FKBP5 Gene Methylation, and Anxiety Symptoms Among Chinese Adolescents: A Nested Case-Control Study. Front Psychiatry 2022; 13:761898. [PMID: 35185646 PMCID: PMC8850925 DOI: 10.3389/fpsyt.2022.761898] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Anxiety symptoms are common mental health problems among adolescents worldwide. This study aimed to explore (1) the longitudinal association between childhood maltreatment and anxiety symptoms, (2) the association between childhood maltreatment and DNA methylation of the FKBP5 gene, and (3) the association of DNA methylation of the FKBP5 gene with anxiety symptoms at follow-up. METHODS A nested case-control design was conducted to identify a case group and control group from a longitudinal study of adolescents aged 13-18 years in Guangzhou from 2019 to 2020. Adolescents with anxiety symptoms at baseline and follow-up were considered the case group, while those without anxiety symptoms at baseline and follow-up were considered the control group. The case and control groups were matched according to age and sex. Our study finally included 97 cases and 141 controls. RESULTS After adjusting for significant covariates, childhood emotional abuse was associated with subsequent anxiety symptoms (β = 0.146, 95% CI = 0.010~0.283); students with physical and emotional neglect were more likely to get a lower level of DNA methylation at most CpG units of FKBP5 gene (P < 0.05); FKBP5-12 CpG 15 methylation was associated with anxiety symptoms at follow-up (β = -0.263, 95% CI = -0.458~-0.069). However, after multiple hypothesis testing, childhood maltreatment was not associated with FKBP5 DNA methylation (q > 0.10); FKBP5 DNA methylation did not show an association with subsequent anxiety symptoms (q > 0.10). CONCLUSIONS Childhood emotional abuse was associated with an increased risk of anxiety symptoms among Chinese adolescents. After multiple hypothesis testing, childhood maltreatment was not significantly associated with FKBP5 DNA methylation. DNA methylation of the promoter region of the FKBP5 gene was not a significant predictor of anxiety symptoms. More attention should be paid to the mental health of adolescents with childhood maltreatment.
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Affiliation(s)
- Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xueying Du
- Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Yangfeng Guo
- Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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12
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Zhang X, Huang R, Ho SY, Lo WS, Lam TH, Wang MP. Alcohol drinking, especially light drinking, and depressive symptoms in adolescents. Drug Alcohol Depend 2021; 227:108932. [PMID: 34365224 DOI: 10.1016/j.drugalcdep.2021.108932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The association of depressive symptoms with moderate and heavy drinking in adolescents have been reported in many studies, but that with light drinking is unclear. METHODS In a 2012-13 school-based survey, 20,951 secondary school students (aged 11-20 years, 51.3 % boys) from 44 schools in Hong Kong reported their sociodemographic information, depressive symptoms, drinking patterns and other lifestyle factors. The associations of depressive symptoms with drinking status, drinking frequency and quantity, and the usual type of alcohol beverage consumed were examined using robust Poisson regression accounting for school clustering and covariates. RESULTS The prevalence of current drinking and depressive symptoms was 13.6 % and 19.0 %, respectively. Depressive symptoms were associated with former drinking (adjusted prevalence ratio 1.48, 95 % confidence interval 1.30-1.68) and measures of light drinking: experimental drinking (1.29, 1.19-1.39), less-than-monthly drinking (1.40, 1.18-1.67) and consuming half a drink or less (1.33, 1.12-1.58), and such associations were stronger in younger adolescents. Associations were also observed for light drinking patterns of 1-2 drinks less than monthly (1.72, 1.40-2.11) and half a drink monthly (1.51, 1.21-1.88). Consuming fruit wine (1.51, 1.27-1.79) and beer (1.63, 1.42-1.88) with relatively low alcohol contents was also associated with depressive symptoms. CONCLUSIONS Our study provided first evidence that even light drinking in terms of the amount, frequency and type of alcohol beverages or light drinking patterns such as consuming 1-2 drinks less than monthly and half a drink monthly were associated with depressive symptoms in adolescents. Our results support total alcohol abstinence in adolescents.
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Affiliation(s)
- Xiaoyu Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Rong Huang
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Wing Sze Lo
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China.
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13
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Li W, Guo L, Zhang S, Wang W, Chen X, Li Q, Lu C. Association among emotional and behavioural problems, sexual minority status and suicidal behaviours in adolescents: a cross-sectional study from Guangdong Province in China. BMJ Open 2021; 11:e051485. [PMID: 34531220 PMCID: PMC8449960 DOI: 10.1136/bmjopen-2021-051485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study was conducted to estimate whether emotional and behavioural problems mediate the association between sexual minority status and suicidal behaviour among Chinese adolescents. We also tested whether such mediation is moderated by the sex assigned at birth. DESIGN Cross-sectional observational study. SETTING A secondary analysis of the cross-sectional data collected from 7th-grade to 12th-grade students in junior high schools (n=36), senior high schools (n=24) and vocational high schools (n=12) in six cities of Guangdong Province, China. A multistage, stratified cluster, random sampling method was used in the 2019 School-based Chinese Adolescents Health Survey. PARTICIPANTS A total of 16 663 students aged 11-20 years. OUTCOME MEASURES Two main psychological and mental health outcomes: (1) self-reported version of the Strengths and Difficulties Questionnaire to measure emotional and behavioural problems; and (2) presence of suicidal ideation and suicide attempts in the past 12 months. RESULTS Emotional and behavioural problems (peer problems, emotional problems, conduct problems and hyperactivity) partially mediated the effects of sexual minority status on suicidal ideation (indirect effect=0.020, 95% CI 0.015 to 0.025) and suicide attempts (indirect effect=0.012, 95% CI 0.009 to 0.016), accounting for 18.18% and 14.46% of the total effect, respectively. Further moderated mediation analyses revealed a greater risk of suicidality among sexual minority girls. CONCLUSIONS Emotional and behavioural problems partially explained the increased risk of suicidality among sexual minority adolescents, and appreciably higher among sexual minority girls than boys. To prevent subsequent suicidality, the risks of emotional and behavioural problems in sexual minority adolescents should be identified at an early stage and reduced by means of preventive measures.
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Affiliation(s)
- Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Sheng Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaoliang Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qian Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
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14
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Amiri S, Fathi-Ashtiani M, Sedghijalal A, Fathi-Ashtiani A. Parental divorce and offspring smoking and alcohol use: a systematic review and meta-analysis of observational studies. J Addict Dis 2021; 39:388-416. [PMID: 33648433 DOI: 10.1080/10550887.2021.1886576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study was conducted to investigate the relationship between parental divorce and smoking and alcohol consumption in offspring, which is based on a systematic review method and ultimately meta-analysis. Method: In a systematic search, three databases were selected. The manuscripts were searched based on the keywords and the time limit for the search was published manuscripts in English until November 2020. For the relationship between parental divorce and smoking/alcohol use in offspring, one main analysis, and four analyses based on sex, study design, adjusted level, and continents were performed. Result: Forty-three studies were synthesized from the collection of manuscripts. The odds of smoking in offspring whose parents were separated was 1.45 (CI 1.37-1.54) and this odds in men was equal to 1.38 (CI 1.11-1.71; Z = 2.91; p = 0.004; I2 = 81.5%) and in women, 1.78 (CI 1.51-2.10; Z = 6.88; p < 0.001; I2 = 69.6%). The odds of alcohol use in offspring whose parents were separated was 1.43 (CI 1.15-1.77) and this odds in men was equal to 1.69 (CI 1.16-2.47; Z = 2.73; p = 0.006; I2 = 99.6%) and in women 1.79 (CI 1.07-2.99). Discussion: The findings of the present study can be used in health-related policies, prevention, and clinical interventions. This study was a subject with limitations, also.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Azadeh Sedghijalal
- Department of Sociology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Fathi-Ashtiani
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Iranian Academy of Medical Sciences, Tehran, Iran
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15
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Wu R, Guo L, Rong H, Shi J, Li W, Zhu M, He Y, Wang W, Lu C. The Role of Problematic Smartphone Uses and Psychological Distress in the Relationship Between Sleep Quality and Disordered Eating Behaviors Among Chinese College Students. Front Psychiatry 2021; 12:793506. [PMID: 34966312 PMCID: PMC8710586 DOI: 10.3389/fpsyt.2021.793506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Sleep problems and eating disorders (EDs) are both serious public health concerns often seen in young adults. Yet, the underlying mechanisms for such associations are largely unknown. This study aims to examine potential serial multiple mediation effects of problematic smartphone use (PSU) and psychological distress (i.e., depressive and anxiety symptoms) in the relationship between sleep quality and disordered eating behaviors/attitudes (DEBs). Methods: A total of 4,325 students from two Tibet universities in China (2,657 females and 1,668 males) completed an online survey that included the following measurements: Eating Attitude Test-26 for disordered eating behaviors/attitudes, the Chinese Version of Pittsburgh Sleep Quality Index (CPSQI), Smartphone Addiction Scale-Short Version (SAS-SV) for problematic smartphone use, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) for psychological distress. Results: While the direct path linking sleep quality and DEBs was not found to be significant (Standardized β = 0.006, 95% CI = -0.0667~0.0970), both PSU (Standardized β = 0.016, 95% CI = 0.0256~0.0591) and anxiety symptoms (Standardized β = 0.014, 95% CI = 0.0203~0.0526) may mediate a link between sleep quality and DEBs; serial multiple mediation analysis revealed that a serial indirect pathway of "sleep quality -> PSU -> anxiety symptoms -> DEBs" existed(Standardized β = 0.001, 95% CI = 0.0002~0.0012). Similarly, while the direct path linking sleep quality and DEBs was not found to be significant (Standardized β = 0.006, 95% CI = -0.0667~0.0970), both PSU (Standardized β = 0.020, 95% CI = 0.0337~0.0692) and depressive symptoms (Standardized β = 0.015, 95% CI = 0.0139~0.0652) may mediate a link between sleep quality and DEBs; serial multiple mediation analysis revealed that a serial indirect pathway of "sleep quality -> PSU -> depressive symptoms -> DEBs" existed (Standardized β = 0.001, 95% CI = 0.0006~0.0038). Conclusions: Psychological and behavioral factors may comprehensively work together, leading to flow-on effects from sleep problems to disordered eating behaviors among university students. Appropriate interventions that target problematic smartphone use could thus potentially reduce anxiety and depression levels, which in turn will provide a buffer against the negative impact of poor sleep quality on eating disorder symptoms.
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Affiliation(s)
- Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.,Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China.,Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Hao Rong
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Jingming Shi
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China.,Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Minxia Zhu
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Yongjun He
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
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16
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Chen L, Lu RR, Duan JL, Ma J, Zhu G, Song Y, Lau PWC, Prochaska JJ. Combined Associations of Smoking and Bullying Victimization With Binge Drinking Among Adolescents in Beijing, China. Front Psychiatry 2021; 12:698562. [PMID: 34603100 PMCID: PMC8481949 DOI: 10.3389/fpsyt.2021.698562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Binge drinking and smoking among adolescents are serious public concerns. However, very few studies have explored the reinforcement of bullying victimization by such behavior. Our study aimed at examining the individual and combined associations of smoking and bullying victimization with binge drinking among adolescents in Beijing, China. Methods: A total of 33,694 students aged 13-17 years old in Beijing, China were anonymously investigated via the cross-sectional Chinese Youth Risk Behavior Surveillance Survey from April to May 2014. A three-stage stratified sampling was used to select participants. Factors such as sociodemographic variables and indicators of smoking, bullying victimization, and binge drinking were analyzed with multiple logistic regressions, and joint and additive interaction effects were tested. Results: Overall, ever-drinking prevalence was 59.1% (boys: 64.4%; girls: 53.7%). Past 30-day binge drinking was 11.5% (boys: 15.6%; girls: 7.4%) and frequent binge drinking was 2.3% (boys: 3.3%; girls: 1.0%). Past 30-day smoking was 10.7% (boys: 16.4%; girls: 5.0%) and past 30-day bullying victimization was 48.7% (boys: 57.3%; girls: 40.1%). The combined effects of smoking and bullying victimization on occasional binge drinking (OR = 6.49, 95% CI = 5.60-7.52) and frequent binge drinking (OR = 10.32, 95% CI = 7.52-14.14) were significant, and the additive interaction effect was significant for current smoking and bullying victimization on frequent binge drinking (OR = 10.22, 95% CI = 9.43-11.07). The additive interaction effect for current smoking and bullying victimization on frequent binge drinking was significant among boys. Conclusion: Bullying victimization reinforced the association of smoking with frequent binge drinking, especially with findings specific to boys. Programs to prevent smoking or bullying or both may reduce binge drinking among adolescents in China.
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Affiliation(s)
- Li Chen
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Ruo-Ran Lu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jia-Li Duan
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jun Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Guangrong Zhu
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yi Song
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Patrick W C Lau
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, SAR China.,Laboratory of Exercise Science and Health, BNU-HKBU United International College, Zhuhai, China
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, United States
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17
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Understanding alcohol-specific antecedents among Chinese vocational school adolescents. Addict Behav 2020; 110:106483. [PMID: 32540631 DOI: 10.1016/j.addbeh.2020.106483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Alcohol use among Chinese vocational school students is widespread and associated with many negative consequences. However, alcohol-specific antecedents for this population are understudied. OBJECTIVES The current study explored: (a) which alcohol-specific antecedents are the most salient predictors for alcohol use intentions, (b) whether any mediational relationships exist among these alcohol-specific antecedents, and (c) whether gender-based differences exist among these relationships. METHODS This study analyzed data from 1,230 vocational school adolescents in three Chinese cities. Survey data were analyzed using dominance analysis and structural equation modeling. RESULTS Personal norms were the most salient antecedents for alcohol use intentions, followed by injunctive norms from friends and parents, descriptive norms from friends and classmates, and positive belief about drinking. We observed a statistically significant mediational chain from descriptive norms to injunctive norms, and in turn to personal norms and positive beliefs, and finally to alcohol use intentions. Gender moderated some of the paths. CONCLUSIONS Alcohol use norms and beliefs among Chinese vocational school students have distinct predictive relationships with alcohol use intentions. Alcohol use prevention programs designed for this population need to address normative beliefs (descriptive, injunctive, and personal norms) and the perceived benefit of alcohol use.
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18
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Vargas-Martínez AM, Trapero-Bertran M, Mora T, Lima-Serrano M. Social, economic and family factors associated with binge drinking in Spanish adolescents. BMC Public Health 2020; 20:519. [PMID: 32303203 PMCID: PMC7165377 DOI: 10.1186/s12889-020-08605-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background The main aim of this study was to determine the socioeconomic and family factors associated with binge drinking (BD) in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known as Alerta Alcohol. Methods Longitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial with an intervention group (IG) who received the Alerta Alcohol programme and a control group (CG) who did not receive any active intervention. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. The endogenous variable in all models was the number of BD occasions in the last 30 days. A total of 1247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period (4 months later), were included in the analysis. Results In relation to findings, being older (≥ 17 years old), having more pocket money and higher family alcohol consumption were associated with greater BD. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of BD occasions. Conclusions Our results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between BD and both family alcohol consumption and weekly pocket money or availability of money to adolescents. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent BD would be justified. Trial registration (ClinicalTrials.gov): NCT03288896. Registration date: September 20, 2017. “Retrospectively registered”.
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Affiliation(s)
| | - Marta Trapero-Bertran
- Faculty of Economics and Social Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Toni Mora
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Lima-Serrano
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Seville, Spain
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19
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Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents. J Affect Disord 2020; 265:595-602. [PMID: 32090782 DOI: 10.1016/j.jad.2019.11.099] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/15/2019] [Accepted: 11/21/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences. METHODS A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively. RESULTS The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys. LIMITATIONS The study only included school students, and the cross-sectional design limited our ability to make causal inferences. CONCLUSIONS The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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20
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Xiao D, Guo L, Zhao M, Zhang S, Li W, Zhang WH, Lu C. Effect of Sex on the Association Between Nonmedical Use of Opioids and Sleep Disturbance Among Chinese Adolescents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4339. [PMID: 31703294 PMCID: PMC6888280 DOI: 10.3390/ijerph16224339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 11/16/2022]
Abstract
Sleep disturbance and non-medical prescription opioid use (NMPOU) are currently growing public health concerns, and sex differences may result in differential exposure to frequency of NMPOU or sleep disturbance. This study aimed to explore the association between the frequency of lifetime or past-year NMPOU and sleep disturbance and to evaluate whether there was any sex difference in this association among Chinese adolescents. A cross-sectional study was performed in seven randomly selected Chinese provinces through the 2015 School-Based Chinese Adolescents Health Survey. A total of 159,640 adolescents were invited to participate and among them, 148,687 adolescents' questionnaires were completed and qualified for this study (response rate: 93.14%). All analyses were performed for boys and girls separately. There were significant sex differences in the prevalence of lifetime or past-year opioid misuse and sleep disturbance (p < 0.05). Among girls, frequent lifetime NMPOU (adjusted odds ratio [aOR] = 2.09, 95% CI = 1.80-2.44) and past-year NMPOU (aOR = 2.16, 95% CI = 1.68-2.77) were positively associated with sleep disturbance. Among boys, these associations were also statistically significant, while the magnitudes of associations between frequent lifetime NMPOU or past-year NMPOU and sleep disturbance were greater in girls than those in boys. There is a significant sex difference in the prevalence of lifetime or past-year NMPOU and sleep disturbance. Furthermore, exposure to more frequent lifetime or past-year NMPOU is associated with a greater risk of sleep disturbance, especially among girls. Taking into account the sex difference for lifetime or past-year NMPOU may help to decrease the risk of sleep disturbance.
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Affiliation(s)
- Di Xiao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Ghent University, 9000 Gent, Belgium
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
| | - Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
| | - Sheng Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Ghent University, 9000 Gent, Belgium
- Research Laboratory for Human Reproduction, Faculty of Medicine, Université Libre de Bruxelles (ULB), 1050 Bruxelles, Belgium
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (D.X.); (L.G.); (M.Z.); (S.Z.); (W.L.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
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Guo L, Xu Y, Huang G, Gao X, Deng X, Luo M, Xi C, Zhang WH, Lu C. Association between body weight status and suicidal ideation among Chinese adolescents: the moderating role of the child's sex. Soc Psychiatry Psychiatr Epidemiol 2019; 54:823-833. [PMID: 30712066 DOI: 10.1007/s00127-019-01661-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Suicidality (ranging from suicidal ideation to suicidal attempts and completed suicide) is a major and preventable public health concern, and body weight is considered a modifiable factor which might be helpful to the early risk assessment of suicidal ideation. This study aimed to comprehensively evaluate the association of body weight status with suicidal ideation across sex among Chinese adolescents. METHODS Data were drawn from the 2015 National School-based Chinese Adolescents Health Survey, and 54,640 students' questionnaires were completed and qualified for the survey. Body mass index z scores were calculated and categorized into four levels: underweight (less than the 5th percentile for sex and age), normal weight (between the 5th and 85th percentile), overweight (between the 85th and 95th percentile), and obese (above the 95th percentile). RESULTS Of the total sample, 47.3% (25,852) were boys. The weighted prevalence of suicidal ideation among Chinese adolescents is 15.7% (14.6% in boys and 17.3% in girls). After adjusting for demographics, smoking, drinking, and depressive symptoms, our final multivariate logistic regression models demonstrated that only boys identified as underweight (Adjusted odds ratio [AOR] = 1.23, 95% CI = 1.06-1.44) or obese (AOR = 1.19, 95% CI = 1.02-1.38) were at a higher risk of suicidal ideation. Additionally, the association between weight status and suicidal ideation among boys might be moderated by academic pressure, smoking, and depressive symptoms. CONCLUSIONS There was a significant J-shaped association between relative body weight and suicidal ideation in boys. The child's sex should be taken into consideration when developing interventions against unhealthy weight and suicidal ideation.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yan Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Xue Gao
- Center for ADR Monitoring of Guangdong, Guangzhou, 510080, People's Republic of China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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Huang Y, Li P, Lai Z, Jia X, Xiao D, Wang T, Guo L, Lu C. Role of sleep quality in mediating the relationship between sexual minority status and suicidal behavior among Chinese adolescents. Psychol Res Behav Manag 2018; 11:607-615. [PMID: 30573996 PMCID: PMC6292244 DOI: 10.2147/prbm.s186586] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Studies suggest that sexual minority adolescents experience higher rates of sleep disturbance than their heterosexual peers, and disturbed sleep is a well-known risk factor for suicidality. This study aimed to explore whether sleep quality had mediating effects on the relationship between sexual minority status and suicidal behavior in Chinese adolescents. Methods We analyzed data collected from 7th to 12th graders from seven randomly selected provinces of People’s Republic of China in the 2015 School-Based Chinese Adolescents Health Survey. The 123,459 students who completed questionnaires regarding sexual attraction, the Pittsburgh Sleep Quality Index, past-year suicidal ideation, and past-year suicide attempts were included in our study (response rate: 95.9%). Results After adjustment for covariates, sexual minority status was associated with suicidal ideation (adjusted odds ratio =1.82, 95% CI=1.69–1.95) and suicide attempts (adjusted odds ratio =2.16, 95% CI=1.82–2.56). Sleep quality partially mediated the effects of sexual minority status on suicidal ideation (standardized β estimate=0.009, 95% CI=0.007–0.012) and suicide attempts (standardized β estimate=0.004, 95% CI=0.003–0.005). Conclusion Poor sleep quality partially explained the increased risk of suicidality for Chinese sexual minority adolescents. To prevent subsequent suicidality, suicide interventions targeting sexual minorities should be made, with a focus on their disparities in sleep disturbance and sleep health promotion.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Zhisheng Lai
- Department of HIV/AIDS Prevention and Control, Yuexiu District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Xiaofei Jia
- Department of HIV/AIDS Prevention and Control, Tianhe District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Di Xiao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
| | - Lan Guo
- Department of HIV/AIDS Prevention and Control, Yuexiu District Center for Disease Control and Prevention, Guangzhou, Guangdong, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China, .,Guangdong Provincial Key Laboratory of Food, Guangdong Engineering Technology Research Center of Nutrition Translation, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China,
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Chinese Sexual Minority Male Adolescents' Suicidality and Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112558. [PMID: 30445669 PMCID: PMC6266787 DOI: 10.3390/ijerph15112558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 11/16/2022]
Abstract
Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image.
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Huang Y, Li P, Lai Z, Jia X, Xiao D, Wang T, Guo L, Lu C. Association between sexual minority status and suicidal behavior among Chinese adolescents: A moderated mediation model. J Affect Disord 2018; 239:85-92. [PMID: 29990667 DOI: 10.1016/j.jad.2018.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/25/2018] [Accepted: 07/01/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Evidence shows sexual minority adolescents have a higher risk of suicidality than their heterosexual peers due to minority stressors or lack of social support, but it remains unclear how the combined effects of these influence factors impact suicidality in this population. In this study, we examine whether school victimization mediates association between sexual minority status and suicidal behavior of adolescents and explore whether such mediation is moderated by interpersonal relationships. METHODS We sampled a large nationally representative dataset comprising data collected from 7th to 12th graders (the 2015 School-based Chinese Adolescents Health Survey) using a multistage, stratified-cluster, random-sampling method. Our sample consisted of 123,459 students who completed questionnaires regarding their sexual minority status, suicidal ideation, suicide attempts, school victimization, classmate relations, and teacher-classmate relations. RESULTS Using a moderated mediation model, we found that school victimization mediated the effects of sexual minority status on suicidal ideation (indirect effect = 0.0296, 95% confidence intervals (CI) = 0.0259-0.0333) and suicide attempts (indirect effect = 0.0086, 95% CI = 0.0074-0.0100). These indirect effects were moderated by interpersonal relationships, and a greater effect was seen among sexual minority students with poor classmate or teacher-classmate relations. LIMITATIONS Our study sample included only students attending school, and interpretation of the direction of the observed associations is limited due to the cross-sectional design. CONCLUSIONS Interpersonal relationships moderate the indirect effects of school victimization on association between sexual minority status and suicidal behavior. Early intervention addressing school violence combined with improving the quality of relationships with school peers would help prevent suicidality in sexual minority adolescents.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Zhisheng Lai
- Yuexiu District Center for Disease Control and Prevention, Guangzhou 510080, People's Republic of China
| | - Xiaofei Jia
- Tianhe District Center for Disease Control and Prevention, Guangzhou 510655, People's Republic of China
| | - Di Xiao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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Huang Y, Li P, Guo L, Gao X, Xu Y, Huang G, Deng X, Lu C. Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study. BMJ Open 2018; 8:e020969. [PMID: 30093513 PMCID: PMC6089305 DOI: 10.1136/bmjopen-2017-020969] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents. DESIGN Cross-sectional survey. SETTING A total of 506 high schools in 7 provinces of China. PARTICIPANTS A total of 150 822 students in grades 7-12 who completed the questionnaires (response rate of 95.9%) were included. MAIN OUTCOME MEASURES Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status. RESULTS Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06). CONCLUSIONS Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xue Gao
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Yan Xu
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Guoliang Huang
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
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Abstract
PURPOSE OF REVIEW The current article reviews recent research (from 2016 onward) on drinking behaviors and alcohol-related problems among young people in Asia with an emphasis on population-based evidence. RECENT FINDINGS Recent evidence concerning underage drinking in Asia was limited to certain countries and societies with most data derived from cross-sectional surveys. Measures of alcohol drinking or problems were less sophisticated. The prevalence of recent alcohol drinking varies widely with the highest estimates reported in Hong Kong and Korea (∼21%). Certain emotional, behavioral, and cognitive characteristics have been linked with increased drinking behaviors, including internalizing or externalizing problems. Parents (or family) are the most studied predictors within the domain of socioenvironmental characteristics, whereas little attention has been paid to the macro environments (e.g., media, alcohol advertisement, and alcohol control policy/regulations). SUMMARY Research on underage drinking behaviors in Asia is urgently needed, particularly in some emerging markets. Follow-up studies with longitudinal measurements and large diverse samples will provide a better understanding of developmental stage-dependent and ever-changing macroenvironmental factors, as well as possible mechanisms.
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Abstract
OBJECTIVES To test, among older Chinese adolescents, the associations of childhood maltreatment with single and multiple suicide attempts and whether these associations vary in relation to the presence of sleep disturbance. STUDY DESIGN We analyzed data collected from 10th to 12th graders from 7 randomly selected provinces of China in the 2015 School-based Chinese Adolescents Health Survey. There were 83 200 students who were invited to participate, and 75 715 students' questionnaires were completed and qualified for the survey. Adjusted multinomial logistic regression models were conducted to evaluate the associations of childhood maltreatment with suicide attempts. RESULTS Compared with no suicide attempts, each type of adjusted childhood maltreatment (physical abuse, emotional abuse, sexual abuse, physical neglect, or emotional neglect) was associated with an increased risk of single and multiple suicide attempts (P < .05). The magnitude of the aORs in multiple suicide attempters was greater than those in single suicide attempters. Moreover, the adjusted interaction effects for a single suicide attempt between each type of childhood maltreatment and sleep disturbance were all statistically significant in the multivariable multinomial logistic regression models (P < .001). However, the adjusted interaction effects for multiple suicide attempts were not significant (P > .05). CONCLUSIONS Maltreatment during one's childhood is associated with an increased risk of single and multiple suicide attempts among older Chinese adolescents. Sleep disturbances play a moderating role in these associations for a single suicide attempt.
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Wang H, Hu R, Zhong J, Du H, Fiona B, Wang M, Yu M. Binge drinking and associated factors among school students: a cross-sectional study in Zhejiang Province, China. BMJ Open 2018; 8:e021077. [PMID: 29654047 PMCID: PMC5898305 DOI: 10.1136/bmjopen-2017-021077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To investigate the prevalence and correlating factors of binge drinking among middle and high school students in Zhejiang Province, China. METHODS We performed a cross-sectional study using data from a school-based survey. A total of 23 543 (response rate=97.5%) eligible adolescents from 442 different schools (including middle schools, academic high schools and vocational high schools) were asked to fill in an anonymous self-administered behaviour questionnaire between April and May 2017. Multivariable logistic regression models were used to examine the associations of sociodemographic and behavioural factors with binge drinking. RESULTS The mean (SD) age of participants was 15.6 (1.7) years and 51.3% were boys. The proportions of students from middle schools, academic high schools and vocational high schools were 51.9%, 27.5% and 20.6%, respectively. In total, 22.8% (95% CI 21.6 to 23.9) of students reported drinking alcohol in the past 30 days and 9.2% (95% CI 8.5 to 10.0) of students reported binge drinking (defined as drinking four or more alcoholic drinks in 1-2 hours period among girls and five or more alcoholic drinks among boys) during the past month. The prevalence of binge drinking was highest among vocational high school students (17.9% vs 6.3% and 7.7% among middle school and academic high school students, respectively). Older age, studying at high school, poor academic performance, higher levels of physical activity, excessive screen-time, loneliness, insomnia, previous suicide attempt, cigarette smoking, fighting, being bullied and sexual experience were found to be positively associated with adolescent binge drinking. CONCLUSIONS Binge drinking is common among middle and high school students in Zhejiang, China. Efforts to prevent binge drinking may need to address a cluster of sociodemographic and behavioural factors. Our findings provide information to enable healthcare providers to identify students at high-risk of binge drinking and to inform planning of intervention measures for at-risk students.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China
| | - Ruying Hu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China
| | - Huaidong Du
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bragg Fiona
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Meng Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou, China
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Kuntsche E, Kuntsche S, Thrul J, Gmel G. Binge drinking: Health impact, prevalence, correlates and interventions. Psychol Health 2017; 32:976-1017. [PMID: 28513195 DOI: 10.1080/08870446.2017.1325889] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and psychosocial correlates of, and interventions for, binge drinking. DESIGN Narrative review. RESULTS Mostly occurring among young people at weekends, binge drinking increases the risk of both acute (e.g. injuries) and long-term negative consequences (e.g. alcohol disorders). Binge drinkers tend to be extrovert, impulsive and sensation-seeking. Stress, anxiety, traumatic events and depression are also related to binge drinking. Both alcohol-related behaviour of parents and general parenting (e.g. parenting styles, monitoring) are also important. Other major risk factors for binge drinking are frequently spending time with friends who drink, and the drinking norms observed in the wider social environment (e.g. school, community, culture). Emergency departments, birthday parties, fraternities and the workplace serve as settings for interventions; these are increasingly delivered via digital and mobile technology. There is evidence of small-sized effects across approaches (brief interventions, personalised normative feedback, protective behavioural strategies etc.) and populations. CONCLUSION A more consistent terminology, investigating multi-level influences and identifying the most effective intervention components are challenges for future research.
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Affiliation(s)
- Emmanuel Kuntsche
- a Addiction Switzerland, Research Department , Lausanne , Switzerland.,b Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands.,c Institute of Psychology , Eötvös Loránd University , Budapest , Hungary
| | - Sandra Kuntsche
- a Addiction Switzerland, Research Department , Lausanne , Switzerland
| | - Johannes Thrul
- d Center for Tobacco Control Research and Education , University of California , San Francisco , CA , USA
| | - Gerhard Gmel
- a Addiction Switzerland, Research Department , Lausanne , Switzerland.,e Alcohol Treatment Centre , Lausanne University Hospital , Lausanne , Switzerland
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Guo L, Deng J, He Y, Deng X, Huang J, Huang G, Gao X, Zhang WH, Lu C. Alcohol use and alcohol-related problems among adolescents in China: A large-scale cross-sectional study. Medicine (Baltimore) 2016; 95:e4533. [PMID: 27661013 PMCID: PMC5044883 DOI: 10.1097/md.0000000000004533] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Alcohol misuse among adolescents is a common issue worldwide and is an emerging problem in China. This study aimed to investigate the prevalence of alcohol drinking and alcohol-related problems among Chinese adolescents and to explore their risk factors and connections.A cross-sectional study using an anonymous questionnaire was conducted among junior and senior high school students between 2010 and 2012. Data on self-reported alcohol use, alcohol-related problems, school factors, family factors, and psychosocial factors were collected. Descriptive analyses were made of the proportions of sociodemographics, family, school, and psychosocial factors. Multilevel logistic regression models were conducted to analyze the risk factors for alcohol drinking and alcohol-related problems.Of the 105,752 students who ranged in age from 9 to 21 years, the prevalence of current drinking among students was 7.3%, and 13.2% students reported having alcohol-related problems. Male students were 1.78 (95% confidence interval [CI] = 1.69-1.87) times more likely to be involved in current drinking and 1.86 (95% CI = 1.79-1.93) times more likely to have alcohol-related problems. Higher grade level students were at a higher risk of current drinking (adjusted odds ratio [AOR] = 1.09, 95% CI = 1.05-1.13) and having alcohol-related problems (AOR = 1.43, 95% CI = 1.42-1.58). Older students were more likely to report current drinking (AOR = 1.06, 95% CI = 1.04-1.17) and having alcohol-related problems (AOR = 1.83, 95% CI = 1.82-1.85). Having poor classmate relations (AOR = 1.28, 95% CI = 1.03-1.37), having poor relationships with teachers (AOR = 1.08, 95% CI = 1.00-1.16), and below average academic achievement (AOR = 1.50, 95% CI = 1.41-1.59) were positively associated with current drinking. Moreover, students with suicidal ideation were at a higher risk of current drinking (AOR = 1.70, 95% CI = 1.61-1.81) and having alcohol-related problems (AOR = 2.08, 95% CI = 1.98-2.16). Having higher Center for Epidemiology Scale for Depression scores was positively associated with current drinking (AOR = 1.09, 95% CI = 1.05-1.11) and having alcohol-related problems (AOR = 1.08, 95% CI = 1.06-1.18).Alcohol drinking and alcohol-related problems among Chinese adolescents are major public health problems, and effective preventive programs will require full consideration of the individual, social, and environmental factors that facilitate and prevent alcohol use.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University
- Department of Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
| | - Jianxiong Deng
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Yuan He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University
| | - Jinghui Huang
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Guoliang Huang
- Center for ADR Monitoring of Guangdong, Guangzhou 510080, People's Republic of China
| | - Xue Gao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University
| | - Wei-Hong Zhang
- Department of Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Belgium
- Correspondence: Prof Wei-Hong Zhang, Department of Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Campus Erasme—CP591, 808 route de Lennik, 1070 Bruxelles, Belgium (e-mail: ); Prof Lu Ciyong, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China (e-mail: )
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University
- Correspondence: Prof Wei-Hong Zhang, Department of Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Campus Erasme—CP591, 808 route de Lennik, 1070 Bruxelles, Belgium (e-mail: ); Prof Lu Ciyong, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhonshan Rd 2, Guangzhou 510080, People's Republic of China (e-mail: )
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Huang R, Ho SY, Wang MP, Lo WS, Lam TH. Reported alcohol drinking and mental health problems in Hong Kong Chinese adolescents. Drug Alcohol Depend 2016; 164:47-54. [PMID: 27177803 DOI: 10.1016/j.drugalcdep.2016.04.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 04/15/2016] [Accepted: 04/16/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate the association between reported alcohol drinking and mental health problems in Hong Kong adolescents. METHODS In a school-based questionnaire survey in 2012-13 on 4620 Secondary one (US Grade seven) to six students (mean age 14.5, SD 1.6 years; 53.4% boys), alcohol drinking was classified as never drinking (reference), experimental, former, less-than-weekly and weekly drinking. Binge drinking was defined as drinking at least five drinks on one occasion. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) with five subscales (emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial activity) and the total difficulties score (sum of the first four subscales). Multilevel regression was used to analyse the associations of mental health problems with drinking frequency and binge drinking, adjusting for potential confounders. RESULTS Compared with never drinking, higher total difficulties scores were associated with less-than-weekly drinking (adjusted odds ratio AOR 1.39, 95% CI 1.01-1.91), weekly drinking (AOR 3.21, 95% CI 2.18-4.70), and binge drinking (AOR 2.18, 95% CI 1.42-3.32). Weekly drinking was most strongly associated with hyperactivity (AOR 6.27, 95% CI 1.42-3.32) among all subscales. Girls were more likely than boys to report emotional problems (AOR 3.36 vs 1.47) and hyperactivity (AOR 19.2 vs 2.31) related to weekly alcohol drinking (both P for interaction <0.05). CONCLUSIONS In Hong Kong adolescents, less-than-weekly, weekly, and binge drinking are associated with higher risks of mental health problems based on self-reported data. Prospective studies are warranted to explore the causality between alcohol drinking and mental health problems.
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Affiliation(s)
- R Huang
- Zhejiang Medical College, Hangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong
| | - S Y Ho
- School of Public Health, The University of Hong Kong, Hong Kong.
| | - M P Wang
- School of Nursing, The University of Hong Kong, Hong Kong
| | - W S Lo
- School of Public Health, The University of Hong Kong, Hong Kong
| | - T H Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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