Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life

Why do people use drugs? A neglected question

The aim of this article is to revisit the multivariate causes of drug use. From the initial drive to experiment, to a progression towards dependence, this review endeavours to extrapolate the aetiology of causation. In doing so, prevalence of, and attitudes towards drug use are firstly examined. Influences on why people use illicit drugs are subsequently explored through the lens of established risk factors. Drug use and dependence are embedded within a complex interplay of invidual, genetic, cultural, and socio-economic components. By exploring the aetiology of drug use in a holistic sense, this will not only aid the therapeutic quality of intervention from clinicians, but enable the development of more comprehensive and tailored intervention plans in supporting recovery.

Intergenerational transmission of tobacco smoking: The role of the child's behavioral difficulties. Data from the Danish National Birth cohort (DNBC)

AIMS

This study explores the role of offspring behavioral difficulties in the intergeneration transmission of tobacco smoking.

METHODS

This longitudinal cohort study is based on children born in Denmark in 1996-2003 participating in the Danish National Birth Cohort (DNBC), followed-up until 18years of age. We included mother-child pairs with complete data regarding the exposure (4 trajectories of maternal daily smoking quantity during pregnancy: low, intermediate/stable, intermediate/decreasing and high), outcome (offspring daily smoking status at 18 years) and mediator (offspring symptoms of hyperactivity-inattention at 11 years), that is 24,588 mother-child pairs.

RESULTS

In our study population, during pregnancy respectively 86.2%, 6.80%, 4.08% and 2.97% mothers belonged to the low, intermediate/stable, intermediate/decreasing and high smoking trajectory groups. After controlling for covariates using propensity scores, the direct effect of maternal smoking in pregnancy on offspring smoking in adolescence was statistically significant, especially when the mother belonged to the intermediate/stable smoking trajectory group (ORIPW = 2.09, 95% CI: 1.70 - 2.61) or to the high smoking trajectory group (ORIPW = 2.08, 95% CI: 1.52 - 3.11) compared to the low smoking trajectory group. None of the indirect effects of maternal smoking in pregnancy were statistically significant, and neither were the proportions mediated.

CONCLUSION

Maternal pregnancy smoking seems to have an influence on offspring smoking in early adulthood, which does not appear to be mediated by offspring behavioral difficulties. Women should be strongly encouraged to quit smoking in pregnancy to reduce both short and long-term health risks among their offspring.

Anger and Aggression in Relation to Psychological Resilience and Alcohol Abuse among Health Professionals during the First Pandemic Wave

Mental health problems, behavior changes, and addictive issues have been consistently documented among healthcare workers during the pandemic. The objective of this study was to investigate the levels of anger and aggression in relation to psychological resilience and alcohol abuse among healthcare workers during the first wave of the COVID-19 pandemic. A total of 120 physicians and 123 nurses completed an online survey of the Dimensions of Anger Reactions-5 (DAR-5), the Brief Aggression Questionnaire (BAQ), the Brief Resilience Scale (BRS), and the Alcohol Screening questionnaire CAGE which is an acronym for the focus of the questions (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers). Demographic and professional data were also recorded. A total of 53 men and 190 women participated in the study. Almost one-third of the participants had a positive score on the DAR-5 scale and one out of ten respondents presented with current problematic alcohol use. Male participants demonstrated lower scores on the DAR-5 scale compared to females. Individuals with current problematic alcohol use displayed higher scores on the BAQ compared to those without alcohol use disorders. Regression analysis revealed that 16.4% of the variance in the BAQ scores can be attributed to scores on the DAR-5, 5.9% to the BRS scores, 2.1% to the CAGE scores, 1.7% to gender, and 1.2% to years of work experience. Mediation analysis highlighted the role of psychological resilience as a negative mediator in the DAR-5 and BAQ relationship. Professional experience and alcohol abuse emerged as positive and negative risk factors contributing to aggression and psychological resilience. The findings hold practical implications for implementing interventions to strengthen resilience in order to compensate for aggressive tendencies and discourage addictive issues.

Associations between Resilience and Food Intake Are Mediated by Emotional Eating in the NutriNet-Santé Study

BACKGROUND

Resilience, the ability to bounce back or recover from stress, has been associated with several health-related behaviors. However, data on food intake and emotional eating are lacking.

OBJECTIVES

The objective of this cross-sectional study was to analyze the associations between resilience and diet quality and ultraprocessed food (UPF) and food group consumption, and to assess whether emotional eating was a mediator of these associations.

METHODS

In 2017, 17,840 participants (73.5% female, mean age = 55.4 ± 14.0 y) of the NutriNet-Santé study completed the Brief Resilience Scale, the revised 21-item Three-Factor Eating Questionnaire, and ≥3 self-administered 24-h dietary records. Diet quality was assessed with the modified French National Nutrition and Health Program Guideline Score. Foods and beverages consumed were categorized according to their degree of processing by the NOVA classification. We assessed the association between resilience and emotional eating using linear regression models. We also assessed the mediating role of emotional eating in the associations between resilience and diet quality, energy intake, and UPF and food group consumption, controlling for sociodemographic characteristics.

RESULTS

In our study, resilience was negatively associated with emotional eating (P < 0.0001). More resilient participants had greater overall diet quality, greater intakes of seafood, whole-grain foods, fats, unsalted oleaginous fruits, and alcoholic beverages, and lower intakes of UPFs, starchy foods, dairy desserts, sugary fatty products, and sugar and confectionery (all P < 0.05). Emotional eating was a mediator of the inverse associations between resilience and intake of energy, UPFs, dairy desserts, sugary fatty products, and of the positive associations between resilience and alcoholic beverages (all P < 0.05), with a 20-70% mediation.

CONCLUSIONS

Our findings showed that resilience was associated with an overall better diet quality in the NutriNet-Santé population-based study. These associations were partially explained by emotional eating. These findings suggest that resilience should be considered in the promotion of healthy dietary habits.The study is registered at clinicaltrials.gov as #NCT03335644.

Roles of alcohol use disorder and resilience in risk of suicide attempt in men: A Swedish population-based cohort

INTRODUCTION

Alcohol use disorder (AUD) has been identified as a strong risk factor for suicide attempt. However, few studies have considered protective factors that may moderate this association, such as resilience.

METHODS

We used longitudinal nationwide Swedish data of 903,333 males born 1960-1980 and 48,285 males born 1949-1951. We performed Cox proportional hazards models to test the role of AUD, resilience, and their interaction on risk for suicide attempt. We used co-relative models to account for familial factors.

RESULTS

Alcohol use disorder was strongly associated with increased risk of suicide attempt [hazard ratio (HR) = 12.22], while resilience was associated with reduced risk (HR = 0.73). Multiplicative interaction (HR = 1.21) showed that, in the context of AUD, the protective role of resilience on risk of suicide attempt was somewhat attenuated. Co-relative analyses supported both familial liability and a possible causal pathway between AUD, resilience, and suicide attempt. In the cohort born 1949-1951, resilience subcomponents-social maturity, interests, psychological energy, home conditions, and emotional control-were all associated with reduced suicide attempt risk (HRs between 0.63 and 0.74).

CONCLUSION

While resilience is associated with reduced risk of suicide attempt, this effect is less pronounced in the context of AUD. These associations are potentially causal.

Areas of Convergence and Divergence in Adolescent Social Isolation and Binge Drinking: A Review

Adolescence is a critical developmental period characterized by enhanced social interactions, ongoing development of the frontal cortex and maturation of synaptic connections throughout the brain. Adolescents spend more time interacting with peers than any other age group and display heightened reward sensitivity, impulsivity and diminished inhibitory self-control, which contribute to increased risky behaviors, including the initiation and progression of alcohol use. Compared to adults, adolescents are less susceptible to the negative effects of ethanol, but are more susceptible to the negative effects of stress, particularly social stress. Juvenile exposure to social isolation or binge ethanol disrupts synaptic connections, dendritic spine morphology, and myelin remodeling in the frontal cortex. These structural effects may underlie the behavioral and cognitive deficits seen later in life, including social and memory deficits, increased anxiety-like behavior and risk for alcohol use disorders (AUD). Although the alcohol and social stress fields are actively investigating the mechanisms through which these effects occur, significant gaps in our understanding exist, particularly in the intersection of the two fields. This review will highlight the areas of convergence and divergence in the fields of adolescent social stress and ethanol exposure. We will focus on how ethanol exposure or social isolation stress can impact the development of the frontal cortex and lead to lasting behavioral changes in adulthood. We call attention to the need for more mechanistic studies and the inclusion of the evaluation of sex differences in these molecular, structural, and behavioral responses.

Resilience to the effects of social stress on vulnerability to developing drug addiction

We review the still scarce but growing literature on resilience to the effects of social stress on the rewarding properties of drugs of abuse. We define the concept of resilience and how it is applied to the field of drug addiction research. We also describe the internal and external protective factors associated with resilience, such as individual behavioral traits and social support. We then explain the physiological response to stress and how it is modulated by resilience factors. In the subsequent section, we describe the animal models commonly used in the study of resilience to social stress, and we focus on the effects of chronic social defeat (SD), a kind of stress induced by repeated experience of defeat in an agonistic encounter, on different animal behaviors (depression- and anxiety-like behavior, cognitive impairment and addiction-like symptoms). We then summarize the current knowledge on the neurobiological substrates of resilience derived from studies of resilience to the effects of chronic SD stress on depression- and anxiety-related behaviors in rodents. Finally, we focus on the limited studies carried out to explore resilience to the effects of SD stress on the rewarding properties of drugs of abuse, describing the current state of knowledge and suggesting future research directions.

Family Function Impacts Relapse Tendency in Substance Use Disorder: Mediated Through Self-Esteem and Resilience

BACKGROUND

Substance abuse has been a public health concern, and even after detoxification treatment, the relapse rate is still high. Family function is closely related to substance dependence. However, studies on psychological mechanisms between them are rare.

OBJECTIVES

We aimed to explore the mediating role of self-esteem and resilience in the pathway that family function impacts the relapse tendency among patients with substance use disorder (SUD).

METHODS

A total of 282 SUD patients were recruited, and standard questionnaires were administered for each patient. The relapse tendency, family function, self-esteem and resilience were assessed by the family care index questionnaire, the Connor-Davidson resilience scale, the Rosenberg self-esteem scale and the relapse tendency questionnaire. Bootstrap method was conducted for mediation analysis to test the effects of how family function affects relapse tendency mediated through self-esteem and resilience.

RESULTS

The average score of relapse tendency of the patients was 28.47 (SD = 11.89). Intermediary analysis found that self-esteem played an intermediary role in the relationship between family function and relapse tendency. Resilience plays an intermediary role in the relationship between family function and relapse tendency. Further, the path analysis showed that family function not only had a direct association with relapse tendency, but also indirectly related to relapse tendency through self-esteem and resilience.

CONCLUSIONS

Self-esteem and resilience are the key factors in the relationship between family function and relapse tendency of SUD patients.

Trajectories of brain development reveal times of risk and factors promoting resilience to alcohol use during adolescence

Alcohol use disorder (AUD) is recognized as harmful for the developing brain. Numerous studies have sought environmental and genetic risk factors that predict the development of AUD, but recently identified resilience factors have emerged as protective. This chapter reviews normal processes of brain development in adolescence and emerging adulthood, delineates disturbed growth neurotrajectories related to heavy drinking, and identifies potential endogenous, experiential, and time-linked brain markers of resilience. For example, concurrent high dorsolateral prefrontal activation serving inhibitory control and low nucleus accumbens activation serving reward functions engender positive adaptation and low alcohol use. Also discussed is the role that moderating factors have in promoting risk for or resilience to AUD. Longitudinal research on the effects of all levels of alcohol drinking on the developing brain remains crucial and should be pursued in the context of resilience, which is a promising direction for identifying protective biomarkers against developing AUDs.

Smoking and stress in the general population in Denmark

INTRODUCTION

The social pressure placed on smokers today might potentially lead to an increasing level of stress. We investigated if the proportion of persons with high stress level had increased over time more in smokers than in non-smokers.

METHODS

Data were obtained from repeated cross-sectional surveys of The Capital Region Health Survey conducted in 2010, 2013 and 2017. Survey data were weighted for survey design and non-response, and linked to national register data. Cohens Perceived Stress Scale (PSS-10) score was used. Logistic regression analyses, based on 136608 citizens’ self-reports, were adjusted for sex, age, education level, employment, and alcohol intake (and loneliness, in analysis investigating the associations between tobacco consumption and high stress level).

RESULTS

A significantly higher proportion of citizens reported a high stress level in 2017 compared with 2010 and 2013 but there was not a greater increase in smokers than in non-smokers. Daily smoking men had 69% higher odds of reporting perceived high stress level and daily smoking women had 36% higher odds, than never smokers of the same sex. There was a significant trend between higher daily tobacco consumption and a higher proportion of smokers with high stress level.

CONCLUSIONS

The increase in high stress level over time occurred independently of smoking status. Daily smokers had the highest odds of perceived high stress level, and a higher daily tobacco consumption was associated with a higher proportion of smokers with high stress level. Smoking cessation programs should, to a higher degree, consider implementing stress-coping elements to prevent relapse.

Using Artificial Neural Networks in Predicting the Level of Stress among Military Conscripts

The present study aims to elucidate the main variables that increase the level of stress at the beginning of military conscription service using an artificial neural network (ANN)-based prediction model. Random sample data were obtained from one battalion of the Lithuanian Armed Forces, and a survey was conducted to generate data for the training and testing of the ANN models. Using nonlinearity in stress research, numerous ANN structures were constructed and verified to limit the optimal number of neurons, hidden layers, and transfer functions. The highest accuracy was obtained by the multilayer perceptron neural network (MLPNN) with a 6-2-2 partition. A standardized rescaling method was used for covariates. For the activation function, the hyperbolic tangent was used with 20 units in one hidden layer as well as the back-propagation algorithm. The best ANN model was determined as the model that showed the smallest cross-entropy error, the correct classification rate, and the area under the ROC curve. These findings show, with high precision, that cohesion in a team and adaptation to military routines are two critical elements that have the greatest impact on the stress level of conscripts.

America's opioid crisis: the need for an integrated public health approach

Continued increases in overdose deaths and recent declines in life expectancy call for need to adopt comprehensive public health approaches to the United States opioid crisis and to establish an infrastructure to avert future crises. Successfully addressing the challenges posed by the crisis requires a translational, integrated approach that combines the contribution of neuroscience, pharmacology, epidemiology, treatment services and prevention. It also is critical to integrate interventions across settings, including healthcare, justice, education and social service systems. This review highlights four interconnected themes: (1) social determinants of health and disease; (2) person-centered approaches for prevention and treatment; (3) bridging the gap between implementation science and practice; and (4) using data to build learning systems of care, relevant to public health approaches to address the opioid crisis. We discuss how across these four themes taking into account the influence of developmental factors on brain function and sensitivity to environmental stimuli including drugs, addressing the complex interactions between biological and social factors, and promoting an ongoing dialogue across disciplines and settings will help accelerate public health advances that are evidenced based and sustainable to address the current opioid crisis and avert future ones.

Stress resilience in young men mediates the effect of childhood trauma on their offspring's birth weight - An analysis of 250,000 families

Experiencing the death of a parent during childhood is a severe trauma that seems to affect the next generation's birth weight. We studied the consequences of parental loss during childhood for men's psychological and physiological characteristics at age 18, and whether these were important for their first-born offspring's birth outcomes. We used a structured life-course approach and four-way decomposition analysis to analyse data for 250,427 three-generation families retrieved from nationwide Swedish registers and found that psychological resilience was impaired and body mass index was higher in men who had experienced parental death. Both characteristics were linked to offspring birth weight. This was lower by 18.0 g (95% confidence interval: 5.7, 30.3) for men who lost a parent at ages 8-17 compared to other ages. Resilience mediated 40% of this influence. Mediation by body mass index, systolic and diastolic blood pressure was negligible, as was the effect of parental loss on length of gestation. There was no mediation by the education of the men's future spouse. Previous literature has indicated that the period before puberty, the "slow growth period", is sensitive. Our evidence suggests that this may be too narrow a restriction: boys aged 8-17 appear to be particularly likely to respond to parental loss in a way which affects their future offspring's birth weight. We conclude that the observed transgenerational influence on birth weight is mediated by the father's psychological resilience but not by his body mass index or blood pressure.