Familial risk and protective factors in alcohol intoxicated adolescents: psychometric evaluation of the family domain of the Communities That Care Youth Survey (CTC) and a new short version of the Childhood Trauma Questionnaire (CTQ)

Psychometrics and cultural adaptations of the Communities That Care Youth Survey: A systematic review

AIMS

The Communities That Care Youth Survey (CTCYS) is an assessment for youth risk and protective factors focused on antisocial behaviors, drug abuse, violence, and delinquency. The systematic review aimed to analyze psychometric validations and cross-cultural adaptation processes of CTCYS to prepare its Brazilian validation.

METHODS

PubMed, SpringerLink, Scopus, and Web of Science were the databases included. The study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol.

RESULTS

Twenty articles were selected based on the inclusion/exclusion criteria. In general, the construct validity indexes were considered adequate, and the measures of risk and protective factors were equivalent between ethnic groups, gender, and populations at risk. Reliability values for most scales are good, averaging about 0.78. We found cultural adaptations from six different countries with some satisfactory results, but not so good as the original properties of CTCYS and the adjustments to other ethnic groups or subpopulations in the United States.

CONCLUSION

This survey may be a potentially reliable and valid instrument to assess risk and protection in different cultures and populations. However, there is still a gap in the instrument's cross-cultural adaptation processes.

Cross-sectional relationship of perceived familial protective factors with depressive symptoms in vulnerable youth

BACKGROUND

There are multiple negative consequences associated with heavy episodic drinking and close associations between substance abuse and depression, alcohol-intoxicated adolescents (AIA) represent a vulnerable group. We aim to add to the current literature by investigating the cross-sectional relationship of perceived familial protective factors with depressive symptoms in AIA in hospitals, with respect to sex. Depression is among the 10 leading causes of disabilities during childhood and adolescence, with girls being more vulnerable than boys. Considerable evidence reveals a strong association between depression and alcohol abuse. The family provides the possibility to positively influence depressive symptoms.

METHODS

We present cross-sectional data of a German multisite, epidemiological cohort study on AIA. By using youth's self-reports, we assessed sociodemographic data, as well as data on perceived familial protective factors and depressive symptoms using items of the Communities that Care Youth Survey instrument. We performed descriptive and multigroup analyses to evaluate the measurement invariance of the used instruments. Moreover, to investigate the relationships between the constructs, we used structural equation modelling.

RESULTS

The study sample comprised 342 AIA, with a mean age of 15.5 years (SD = 1.2; 48.1% girls). The final structural equation model achieved an acceptable model fit of χ2 (69, 342) = 110.056; p = .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.046; SRMR = 0.042, and the rewards for prosocial involvement in the family context correlated significantly negatively with present depressive symptoms, (ß = - 0.540, p <  0.001). The effects were stronger in boys (ß = - 0.576, p <  0.001) than in girls (ß = - 0.519, p <  0.001).

CONCLUSION

In vulnerable youth in Germany, depressive symptoms are correlated to good experiences within the family. Future research should assess whether interventions that enhance parental support reduce the risk of depressive symptoms in AIA. Our findings highlight the need for family-based prevention programmes, particularly for AIA with an increased risk of depression.

Short- to Midterm Effectiveness of a Brief Motivational Intervention to Reduce Alcohol Use and Related Problems for Alcohol Intoxicated Children and Adolescents in Pediatric Emergency Departments: A Randomized Controlled Trial

OBJECTIVES

The proportion of children and adolescents receiving emergency care for acute alcohol intoxication (AAI) in Germany has sharply increased over the past years. Despite this, no randomized controlled trials (RCTs) have studied guideline- and evidence-based interventions to prevent future alcohol misuse within this population. The objective of our investigation was to evaluate the effectiveness of a brief motivational intervention (b-MI) to reduce drinking and associated problems within pediatric emergency departments (PED) in Hamburg, Germany.

METHODS

This stratified cluster-RCT compared a widely established but modified targeted b-MI and treatment as usual (TAU) for patients recruited and treated on Fridays, Saturdays, or Sundays from July 2011 to January 2014 for AAI in EDs of six pediatric hospitals in Hamburg, Germany. Patients under the age of 18 years and their caregivers were included in the study. Intervention was delivered by trained hospital-external staff. The intervention group (n = 141) received a single-session b-MI with a telephone booster after 6 weeks and a brief consultation for caregivers. All intervention material was manual-based. The TAU control group (n = 175) received youth-specific written information on alcohol use and contact information for community resources. Primary outcomes were changes in binge drinking frequency, number of alcoholic drinks on a typical occasion, and alcohol-related problems using the brief Rutgers Alcohol Problem Index. Outcomes were measured by research assistants not involved in intervention delivery. Baseline data were collected in person at the PED, and follow-up data were collected via telephone 3 and 6 months after baseline. Secondary outcome was postenrollment health service utilization. Analyses were based on linear mixed models and intent to treat.

RESULTS

A total of 86.1% (87.5%) of patients in the b-MI group and 82.4% (86.9%) in the TAU group provided valid outcome data after 3 (6) months, respectively. The differences between groups for all outcomes were statistically nonsignificant at both follow-ups (p > 0.05). After 3 months the mean change in binge drinking frequency was -1.36 (95% confidence interval [CI] = -1.81 to -0.91), a reduction of 62.1% in the b-MI group, and -1.29 (95% CI = -1.77 to -0.95), a reduction of 49.0% in the TAU group. The mean change in number of alcoholic drinks on a typical occasion was -2.24 (95% CI = -3.18 to -1.29), a reduction of 37.5% in the b-MI group, and -1.34 (95% CI = -2.54 to -0.14), a reduction of 26.4% in the TAU group. The mean change of alcohol-related problems was -6.72 (95% CI = -7.68 to -5.76), a reduction of 60.5% in the b-MI group, and -6.43 (95% CI = -7.37 to -5.49), a reduction of 58.3% in the TAU group. The differences in mean changes between groups were similar after 6 months for all outcomes.

CONCLUSION

This study provides new information on the effectiveness of b-MIs delivered at discharge of young AAI patients in emergency care. Both trial groups reduced alcohol use and related problems but the b-MI was not associated with significant effects. Although the intervention approach appears feasible, further considerations of improving the outcomes for this relevant target group are required.

Developmental Hazards Among Young Alcohol Intoxicated Patients

PURPOSE

The rising numbers of alcohol intoxicated adolescents (AIA) treated in emergency care units in several European countries have drawn attention to this target group for prevention. To our knowledge, this is the first study to assess a broad array of developmental hazards and their stability in AIA and to compare their distribution with representative samples (RS).

METHODS

A multisite cohort study of AIA aged 13-17 years assessed, in the hospital (t0) and 6 months later (t1), (family) violence, cannabis and alcohol use, school problems, delinquency, homelessness, depression, and suicidality, using items from representative German surveys: Children and Adolescent Health Survey (KiGGS), Childhood Trauma Questionnaire and Communities That Care Youth Survey. We calculated the differences between AIA and RS and corresponding 95% confidence intervals. For AIA respondents who completed t0 and t1 information, we calculated prevalence/persistence/incidence of developmental hazards and corresponding 95% confidence interval.

RESULTS

A total of 342 AIA participated at t0, 228 at t1 (67%). AIA had a significantly higher burden of concomitant risks regarding physical and emotional family abuse, (sexual) victimization, cannabis use, binge drinking, school expulsion, police arrest, gang membership, and being violent. Six months after hospitalization, emotional family abuse (34.1%), cannabis use (23.5%), depression (14.8%), and being violent (13.2%) were especially prevalent.

CONCLUSIONS

Developmental hazards are up to six times more prevalent in AIA than in RS. Therefore, when assessing the risk profile of AIA, it is important to consider developmental hazards as well as detrimental alcohol use.

Socioeconomic and sociodemographic factors related to allergic diseases in Korean adolescents based on the Seventh Korea Youth Risk Behavior Web-based Survey: a cross-sectional study

Background

Various international reports have shown that socioeconomic and sociodemographic variables are correlated with allergic diseases; however, little is known about how these variables affect Korean adolescents. This study was conducted to identify socioeconomic and sociodemographic risk factors for allergic diseases in Korean adolescents to provide information for preventing and managing such conditions.

Methods

Data from the 2011 Korea Youth Risk Behavior Web-based Survey (KYRBWS-VII) of 75,643 adolescents were used. An anonymously administered online survey was conducted to collect dependent variable information on perceived sexes, residence, family affluence (Family Affluence Scale; FAS), parental education levels, subjective academic achievement, obesity, drinking and smoking. The independent variables were asthma, allergic rhinitis and atopic dermatitis. Multivariate logistic regression was used to analyze the correlations between the dependent and independent variables.

Results

Low subjective academic achievement, obesity, drinking and smoking were risk factors for asthma. High FAS, parental bachelor’s degree and high subjective academic achievement were risk factors for allergic rhinitis. Finally, high FAS, maternal bachelor’s degree and high subjective academic achievement were risk factors for atopic dermatitis.

Conclusion

We found that high socioeconomic status (SES) was a risk factor for allergic diseases in Korean adolescents. We propose that the greater access to medical services and immunization (e.g., hygiene hypothesis) afforded by high SES influenced the prevalence of allergic diseases. Thus, as the Korean economy develops further, the prevalence of allergic diseases is likely to increase. Controlling harmful behavioral risk factors, such as drinking and smoking, may help to prevent adolescent allergic diseases.