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Arellano Spano M, Morris TT, Davies NM, Hughes A. Genetic associations of risk behaviours and educational achievement. Commun Biol 2024; 7:435. [PMID: 38600303 PMCID: PMC11006670 DOI: 10.1038/s42003-024-06091-y] [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: 12/04/2023] [Accepted: 03/22/2024] [Indexed: 04/12/2024] Open
Abstract
Risk behaviours are common in adolescent and persist into adulthood, people who engage in more risk behaviours are more likely to have lower educational attainment. We applied genetic causal inference methods to explore the causal relationship between adolescent risk behaviours and educational achievement. Risk behaviours were phenotypically associated with educational achievement at age 16 after adjusting for confounders (-0.11, 95%CI: -0.11, -0.09). Genomic-based restricted maximum likelihood (GREML) results indicated that both traits were heritable and have a shared genetic architecture (Riskh 2 = 0.18, 95% CI: -0.11,0.47; educationh 2 = 0.60, 95%CI: 0.50,0.70). Consistent with the phenotypic results, genetic variation associated with risk behaviour was negatively associated with education (r g = -0.51, 95%CI: -1.04,0.02). Lastly, the bidirectional MR results indicate that educational achievement or a closely related trait is likely to affect risk behaviours PGI (β=-1.04, 95% CI: -1.41, -0.67), but we found little evidence that the genetic variation associated with risk behaviours affected educational achievement (β=0.00, 95% CI: -0.24,0.24). The results suggest engagement in risk behaviour may be partly driven by educational achievement or a closely related trait.
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Affiliation(s)
- Michelle Arellano Spano
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom.
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom.
| | - Tim T Morris
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, United Kingdom
| | - Neil M Davies
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7NF, United Kingdom
- Department of Statistical Sciences, University College London, London, WC1E 6BT, United Kingdom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Amanda Hughes
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom
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2
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Bruffaerts R, Axinn WG. Associations Between Forced Intercourse and Subsequent Depression Among Women in the U.S. General Population. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:471-480. [PMID: 38158510 PMCID: PMC10872405 DOI: 10.1007/s10508-023-02774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N = 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental physical abuse or parental violence). Women who experienced childhood depression (prevalence: 15%) had 2.57 times the odds of experiencing forced intercourse after depression onset, even after adjusting for these other risk factors. However, even though childhood depression is a powerful risk factor for later MDE, independent of that women who experienced forced intercourse had 2.28 times the odds of experiencing MDE after the occurrence of forced intercourse, adjusting for childhood depression and other risk factors. This study provided the first clear evidence for time-ordered associations between forced intercourse and subsequent MDE among women in the general population.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum-KU Leuven, Leuven, Belgium
| | - William G Axinn
- Institute for Social Research, University of Michigan, 426 Thompson St., PO Box 1248, Ann Arbor, MI, 48106-1248, USA.
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Lustig S, Kaess M, Schnyder N, Michel C, Brunner R, Tubiana A, Kahn JP, Sarchiapone M, Hoven CW, Barzilay S, Apter A, Balazs J, Bobes J, Saiz PA, Cozman D, Cotter P, Kereszteny A, Podlogar T, Postuvan V, Värnik A, Resch F, Carli V, Wasserman D. The impact of school-based screening on service use in adolescents at risk for mental health problems and risk-behaviour. Eur Child Adolesc Psychiatry 2023; 32:1745-1754. [PMID: 35488938 PMCID: PMC10460322 DOI: 10.1007/s00787-022-01990-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/06/2022] [Indexed: 11/26/2022]
Abstract
Early detection and intervention can counteract mental disorders and risk behaviours among adolescents. However, help-seeking rates are low. School-based screenings are a promising tool to detect adolescents at risk for mental problems and to improve help-seeking behaviour. We assessed associations between the intervention "Screening by Professionals" (ProfScreen) and the use of mental health services and at-risk state at 12 month follow-up compared to a control group. School students (aged 15 ± 0.9 years) from 11 European countries participating in the "Saving and Empowering Young Lives in Europe" (SEYLE) study completed a self-report questionnaire on mental health problems and risk behaviours. ProfScreen students considered "at-risk" for mental illness or risk behaviour based on the screening were invited for a clinical interview with a mental health professional and, if necessary, referred for subsequent treatment. At follow-up, students completed another self-report, additionally reporting on service use. Of the total sample (N = 4,172), 61.9% were considered at-risk. 40.7% of the ProfScreen at-risk participants invited for the clinical interview attended the interview, and 10.1% of subsequently referred ProfScreen participants engaged in professional treatment. There were no differences between the ProfScreen and control group regarding follow-up service use and at-risk state. Attending the ProfScreen interview was positively associated with follow-up service use (OR = 1.783, 95% CI = 1.038-3.064), but had no effect on follow-up at-risk state. Service use rates of professional care as well as of the ProfScreen intervention itself were low. Future school-based interventions targeting help-seeking need to address barriers to intervention adherence.Clinical Trials Registration: The trial is registered at the US National Institute of Health (NIH) clinical trial registry (NCT00906620, registered on 21 May, 2009), and the German Clinical Trials Register (DRKS00000214, registered on 27 October, 2009).
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Affiliation(s)
- Sophia Lustig
- Institute of Psychology, University of Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany.
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Nina Schnyder
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- School of Public Health, The University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Romuald Brunner
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
- Clinic of Child and Adolescents Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Alexandra Tubiana
- Department of Psychiatry and Clinical Psychology, Centre Psychothérapique de Nancy, Nancy, France
| | - Jean-Pierre Kahn
- Department of Psychiatry and Clinical Psychology, Centre Psychothérapique de Nancy, Nancy, France
- Université de Lorraine, Nancy, France
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
- National Institute for Health, Migration and Poverty, Rome, Italy
| | - Christina W Hoven
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Shira Barzilay
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
- Department of Community Health, University of Haifa, Haifa, Israel
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Bjørknes University College, Oslo, Norway
| | - Julio Bobes
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, University of Oviedo, Oviedo, Spain
| | - Pilar Alejandra Saiz
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, University of Oviedo, Oviedo, Spain
| | - Doina Cozman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Padraig Cotter
- Child and Adolescent Mental Health Services North Cork Area, HSE South, Mallow, Ireland
| | - Agnes Kereszteny
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Tina Podlogar
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Vita Postuvan
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Airi Värnik
- Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia
- Tallinn University School of Natural Science and Health, Tallinn, Estonia
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - Vladimir Carli
- Department of Public Health Sciences, Methods Development and Training in Suicide Prevention, National Swedish Prevention of Mental Ill-Health and Suicide (NASP)WHO Collaborating Centre for ResearchKarolinska Institute, Stockholm, Sweden
| | - Danuta Wasserman
- National Institute for Health, Migration and Poverty, Rome, Italy
- Department of Public Health Sciences, Methods Development and Training in Suicide Prevention, National Swedish Prevention of Mental Ill-Health and Suicide (NASP)WHO Collaborating Centre for ResearchKarolinska Institute, Stockholm, Sweden
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Lloyd EC, Reed ZE, Wootton RE. The absence of association between anorexia nervosa and smoking: converging evidence across two studies. Eur Child Adolesc Psychiatry 2023; 32:1229-1240. [PMID: 34939143 PMCID: PMC10276073 DOI: 10.1007/s00787-021-01918-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
Previous studies have found increased smoking prevalence amongst adults with anorexia nervosa (AN) compared to the general population. The current investigation explored bidirectional associations between AN and smoking behaviour (initiation and heaviness), to address questions surrounding causation. In Study One, logistic regression models with variance robust standard errors assessed longitudinal associations between AN and smoking, using data from adolescent participants of the Avon Longitudinal Study of Parents and Children (N = 5100). In Study Two, two-sample Mendelian randomisation (MR) tested possible causal effects using summary statistics from publicly available genome-wide association studies (GWAS). Study One provided no clear evidence for a predictive effect of AN on subsequent smoking behaviour, or for smoking heaviness/initiation predicting later AN. MR findings did not support causal effects between AN and smoking behaviour, in either direction. Findings do not support predictive or causal effects between AN and smoking behaviour. Previously reported associations may have been vulnerable to confounding, highlighting the possibility of smoking and AN sharing causal risk factors.
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Affiliation(s)
- E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Zoe E Reed
- School of Psychological Science, University of Bristol, Priory Road, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
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Peng S, Peng R, Lei H, Liu W. Family functioning and problematic behavior among secondary vocational school students: The mediating role of hope and the moderating role of perceived social support. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2023.112156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Collins S, Hoare E, Allender S, Olive L, Leech RM, Winpenny EM, Jacka F, Lotfalian M. A longitudinal study of lifestyle behaviours in emerging adulthood and risk for symptoms of depression, anxiety, and stress. J Affect Disord 2023; 327:244-253. [PMID: 36754097 DOI: 10.1016/j.jad.2023.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Little research has examined how lifestyle behaviours cluster together to contribute to mental health outcomes. The current study aimed to identify latent classes of emerging adult lifestyle behaviours (diet, physical activity, sedentary time, smoking, alcohol, cannabis, and other drug use) at age 20 years and their associations with depression, anxiety, and stress symptoms at age 22 and 27 years. METHODS Participants were 616 emerging adults enrolled in the Raine Study. Lifestyle classes at baseline were identified using latent class analysis. Longitudinal associations between latent class membership and risk of depression, anxiety, and stress symptoms were examined using logistic regression models. RESULTS Three lifestyle classes were identified: Class 1 (healthier pattern, n = 399 [64.8 %]), Class 2 (predominantly female, high substance-use, low physical activity pattern, n = 121 [19.6 %]), and Class 3 (predominantly male, high substance-use, poor diet pattern, n = 96 [15.6 %]). Following adjustment, Class 2 were at a higher risk of depression, anxiety, and stress symptoms at age 22 years, and a higher risk of anxiety and stress symptoms at age 27 years, compared to Class 1. LIMITATIONS This study was limited by reliance on self-report data, lack of available indicators for parental socioeconomic status, and some measurement inconsistencies across variables. Adherence to lifestyle clusters over time was not assessed. CONCLUSIONS Latent classes of lifestyle behaviours were identified among emerging adults, and differences in mental health outcomes were found among the classes at two prospective time points. Future research and prevention strategies for common mental disorders should target emerging adults and focus on lifestyle patterns.
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Affiliation(s)
- Sam Collins
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia.
| | - Erin Hoare
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia
| | - Steven Allender
- Deakin University, Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Australia
| | - Lisa Olive
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Australia; Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Australia
| | - Rebecca M Leech
- Deakin University, The Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | | | - Felice Jacka
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Australia
| | - Mojtaba Lotfalian
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Australia
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Pietsch B, Arnaud N, Lochbühler K, Rossa M, Kraus L, Gomes de Matos E, Grahlher K, Thomasius R, Hanewinkel R, Morgenstern M. Effects of an App-Based Intervention Program to Reduce Substance Use, Gambling, and Digital Media Use in Adolescents and Young Adults: A Multicenter, Cluster-Randomized Controlled Trial in Vocational Schools in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1970. [PMID: 36767337 PMCID: PMC9915308 DOI: 10.3390/ijerph20031970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Vocational students are a risk group for problematic substance use and addictive behaviors. The study aim was to evaluate the effects of an app-based intervention on tobacco, e-cigarettes, alcohol, and cannabis use as well as gambling and digital media-related behaviors in the vocational school setting. A total of 277 classes with 4591 students (mean age 19.2 years) were consecutively recruited and randomized into an intervention (IG) or waitlist control group (CG). Students from IG classes received access to an app, which encouraged a voluntary commitment to reduce or completely abstain from the use of a specific substance, gambling, or media-related habit for 2 weeks. Substance use, gambling, and digital media use were assessed before and after the intervention in both groups with a mean of 7.7 weeks between assessments. Multi-level logistic regression models were used to test group differences. Intention-to-treat-results indicated that students from IG classes had a significantly larger improvement on a general adverse health behavior measure compared to CG (OR = 1.24, p = 0.010). This difference was mainly due to a significantly higher reduction of students' social media use in the IG (OR = 1.31, p < 0.001). Results indicate that the app "Meine Zeit ohne" is feasible for the target group and seems to have a small but measurable impact on students' health behavior.
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Affiliation(s)
- Benjamin Pietsch
- IFT-Nord Institute for Therapy and Health Research, 24114 Kiel, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre, Hamburg-Eppendorf, 20251 Hamburg, Germany
| | | | - Monika Rossa
- IFT Institut für Therapieforschung, 80804 Munich, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, 80804 Munich, Germany
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, 11419 Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, 1053 Budapest, Hungary
| | | | - Kristin Grahlher
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre, Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre, Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Reiner Hanewinkel
- IFT-Nord Institute for Therapy and Health Research, 24114 Kiel, Germany
- Institute for Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein (UKSH), 24105 Kiel, Germany
| | - Matthis Morgenstern
- IFT-Nord Institute for Therapy and Health Research, 24114 Kiel, Germany
- Institute for Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein (UKSH), 24105 Kiel, Germany
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Mohamed SMH, Börger NA, van der Meere JJ. Executive and Daily Life Functioning Influence the Relationship Between ADHD and Mood Symptoms in University Students. J Atten Disord 2021; 25:1731-1742. [PMID: 31971050 PMCID: PMC8404724 DOI: 10.1177/1087054719900251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Many studies have indicated a close relationship between ADHD and mood symptoms in university students. In the present study, we explore the role of daily functional impairments and executive functioning in the ADHD-mood relationship. Method: A total of 343 adults (126 males) filled out (a) the Conners' Adult ADHD Rating Scale, (b) the Depression Anxiety and Stress Scale, (c) the Weiss Functional Impairment Rating Scale, and (d) the Executive Function Index Scale. Results: The correlation between mood symptoms and ADHD was .48 (moderate correlation) and dropped to .15 (weak correlation) when controlling for functional problems and executive functioning. Hierarchical regression analyses showed that both functional impairments and executive functioning significantly explained 42% to 53% of the variance of mood symptoms. The addition of ADHD symptoms to the model slightly increased the explained mood variance by only 1%. Conclusion: These findings underline the role of experienced difficulties in triggering mood symptoms in ADHD symptomatology.
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Affiliation(s)
- Saleh M. H. Mohamed
- University of Groningen, The Netherlands,Saleh M. H. Mohamed, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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Caldwell DM, Davies SR, Thorn JC, Palmer JC, Caro P, Hetrick SE, Gunnell D, Anwer S, López-López JA, French C, Kidger J, Dawson S, Churchill R, Thomas J, Campbell R, Welton NJ. School-based interventions to prevent anxiety, depression and conduct disorder in children and young people: a systematic review and network meta-analysis. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background
Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people.
Objective
The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and young people.
Design
This study comprised a systematic review, a network meta-analysis and an economic evaluation.
Data sources
The databases MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to 4 April 2018, and the NHS Economic Evaluation Database (NHS EED) was searched on 22 May 2019 for economic evaluations. No language or date filters were applied.
Main outcomes
The main outcomes were post-intervention self-reported anxiety, depression or conduct disorder symptoms.
Review methods
Randomised/quasi-randomised trials of universal or targeted interventions for the prevention of anxiety, depression or conduct disorder in children and young people aged 4–18 years were included. Screening was conducted independently by two reviewers. Data extraction was conducted by one reviewer and checked by a second. Intervention- and component-level network meta-analyses were conducted in OpenBUGS. A review of the economic literature and a cost–consequence analysis were conducted.
Results
A total of 142 studies were included in the review, and 109 contributed to the network meta-analysis. Of the 109 studies, 57 were rated as having an unclear risk of bias for random sequence generation and allocation concealment. Heterogeneity was moderate. In universal secondary school settings, mindfulness/relaxation interventions [standardised mean difference (SMD) –0.65, 95% credible interval (CrI) –1.14 to –0.19] and cognitive–behavioural interventions (SMD –0.15, 95% CrI –0.34 to 0.04) may be effective for anxiety. Cognitive–behavioural interventions incorporating a psychoeducation component may be effective (SMD –0.30, 95% CrI –0.59 to –0.01) at preventing anxiety immediately post intervention. There was evidence that exercise was effective in preventing anxiety in targeted secondary school settings (SMD –0.47, 95% CrI –0.86 to –0.09). There was weak evidence that cognitive–behavioural interventions may prevent anxiety in universal (SMD –0.07, 95% CrI –0.23 to 0.05) and targeted (SMD –0.38, 95% CrI –0.84 to 0.07) primary school settings. There was weak evidence that cognitive–behavioural (SMD –0.04, 95% CrI –0.16 to 0.07) and cognitive–behavioural + interpersonal therapy (SMD –0.18, 95% CrI –0.46 to 0.08) may be effective in preventing depression in universal secondary school settings. Third-wave (SMD –0.35, 95% CrI –0.70 to 0.00) and cognitive–behavioural interventions (SMD –0.11, 95% CrI –0.28 to 0.05) incorporating a psychoeducation component may be effective at preventing depression immediately post intervention. There was no evidence of intervention effectiveness in targeted secondary, targeted primary or universal primary school settings post intervention. The results for university settings were unreliable because of inconsistency in the network meta-analysis. A narrative summary was reported for five conduct disorder prevention studies, all in primary school settings. None reported the primary outcome at the primary post-intervention time point. The economic evidence review reported heterogeneous findings from six studies. Taking the perspective of a single school budget and based on cognitive–behavioural therapy intervention costs in universal secondary school settings, the cost–consequence analysis estimated an intervention cost of £43 per student.
Limitations
The emphasis on disorder-specific prevention excluded broader mental health interventions and restricted the number of eligible conduct disorder prevention studies. Restricting the study to interventions delivered in the educational setting may have limited the number of eligible university-level interventions.
Conclusions
There was weak evidence of the effectiveness of school-based, disorder-specific prevention interventions, although effects were modest and the evidence not robust. Cognitive–behavioural therapy-based interventions may be more effective if they include a psychoeducation component.
Future work
Future trials for prevention of anxiety and depression should evaluate cognitive–behavioural interventions with and without a psychoeducation component, and include mindfulness/relaxation or exercise comparators, with sufficient follow-up. Cost implications must be adequately measured.
Study registration
This study is registered as PROSPERO CRD42016048184.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Deborah M Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah R Davies
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Joanna C Thorn
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jennifer C Palmer
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Sarah E Hetrick
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
| | - Sumayya Anwer
- Centre for Reviews and Dissemination, University of York, York, UK
| | - José A López-López
- Department of Basic Psychology and Methodology, Faculty of Psychology, University of Murcia, Murcia, Spain
| | - Clare French
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - James Thomas
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), University College London, London, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
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10
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Atorkey P, Paul C, Wiggers J, Bonevski B, Nolan E, Oldmeadow C, Mitchell A, Byrnes E, Tzelepis F. Clustering of multiple health-risk factors among vocational education students: a latent class analysis. Transl Behav Med 2021; 11:1931-1940. [PMID: 34155507 DOI: 10.1093/tbm/ibab068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Physical and mental health risks often commence during young adulthood. Vocational education institutions are an ideal setting for understanding how health-risks cluster together in students to develop holistic multiple health-risk interventions. This is the first study to examine clustering of tobacco smoking, fruit intake, vegetable intake, alcohol consumption, physical inactivity, overweight/obesity, depression, and anxiety in vocational education students and the socio-demographic characteristics associated with cluster membership. A cross-sectional survey with vocational education students (n = 1134, mean age = 24.3 years) in New South Wales, Australia. Latent class analysis identified clusters and latent class regression examined characteristics associated with clusters. Four clusters were identified. All clusters had moderate inadequate fruit intake and moderate overweight/obesity. Cluster 1 (13% of sample) had "high anxiety, high inadequate vegetable intake, low tobacco, and low alcohol use." Cluster 2 (16% of sample) had "high tobacco smoking, high alcohol use, high anxiety, high depression, and high inadequate vegetable intake." Cluster 3 (52% of sample) had "high risky alcohol use, high inadequate vegetable intake, low depression, low anxiety, low tobacco smoking, and low physical inactivity." Cluster 4 (19% of sample) was a "lower risk cluster with high inadequate vegetable intake." Compared to cluster 4, 16-25-year-olds and those experiencing financial stress were more likely to belong to clusters 1, 2, and 3. Interventions for vocational education students should address fruit and vegetable intake and overweight/obesity and recognize that tobacco use and risky alcohol use sometimes occurs in the context of mental health issues.
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Affiliation(s)
- Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia.,Priority Research Centre for Health Behaviour, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia.,Priority Research Centre for Health Behaviour, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia
| | - Erin Nolan
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales, Australia.,Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia.,Priority Research Centre for Health Behaviour, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
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11
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Atorkey P, Owiredua C. Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: A latent class analysis. SSM Popul Health 2021; 13:100707. [PMID: 33365380 PMCID: PMC7749432 DOI: 10.1016/j.ssmph.2020.100707] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/09/2020] [Accepted: 12/01/2020] [Indexed: 02/07/2023] Open
Abstract
This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, the association between socio-demographic characteristics, psychological distress and clusters and the relationship between number of health risk behaviours and psychological distress among adolescents in Ghana. Participants were senior high school (SHS) students aged 11-19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Participants were classified to be at risk if they indicated they smoked tobacco, did not eat fruit ≥ 2 times a day and vegetables ≥ 5 a day, drank alcohol during the past 30 days and did not engage in physical activity for ≥ 60 min per day during the past 7 days. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively. Multiple logistic regression was used to determine the relationship between number of health risk behaviours and psychological distress. The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: Cluster 1 ("Poor nutrition, inactive, low substance use cluster"; 91%); Cluster 2 ("High Risk Cluster"; 9%). Using cluster 1 as a reference group, adolescents in the 11-15 years category had lower odds of belonging to cluster 2 (OR = 0.21 CI 0.05-0.91, ρ = 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45 CI 1.45-4.14, ρ = 0.001). No significant relationship was found between number of health risk behaviour and psychological distress. Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.
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Affiliation(s)
- Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Mail Bag 10, Wallsend, New South Wales, 2287, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Australia
| | - Christiana Owiredua
- Ӧrebro University, School of Law, Psychology and Social Work, Sweden
- Centre for Health and Medical Psychology, Ӧrebro University, Sweden
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12
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Multiple Health Risk Factors in Vocational Education Students: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020637. [PMID: 33451108 PMCID: PMC7828627 DOI: 10.3390/ijerph18020637] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 12/13/2022]
Abstract
Health risk factors such as tobacco smoking, inadequate fruit intake, inadequate vegetable intake, risky alcohol consumption, physical inactivity, obesity, anxiety and depression often commence during adolescence and young adulthood. Vocational education institutions enrol many students in these age groups making them an important setting for addressing multiple health risk factors. This systematic review examined (i) co-occurrence of health risk factors, (ii) clustering of health risk factors, and (iii) socio-demographic characteristics associated with co-occurrence and/or clusters of health risks among vocational education students. MEDLINE, PsycINFO, EMBASE, CINAHL and Scopus were searched to identify eligible studies published by 30 June 2020. Two reviewers independently extracted data and assessed methodological quality using the National Heart, Lung and Blood Institute Quality Assessment Tool. Five studies assessed co-occurrence and three studies clustering of health risks. Co-occurrence of health risk factors ranged from 29–98% and clustering of alcohol use and tobacco smoking was commonly reported. The findings were mixed about whether gender and age were associated with co-occurrence or clustering of health risks. There is limited evidence examining co-occurrence and clustering of health risk factors in vocational education students. Comprehensive assessment of how all these health risks co-occur or cluster in vocational education students is required.
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13
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Atorkey P, Paul C, Bonevski B, Wiggers J, Mitchell A, Byrnes E, Lecathelinais C, Tzelepis F. Uptake of Proactively Offered Online and Telephone Support Services Targeting Multiple Health Risk Behaviors Among Vocational Education Students: Process Evaluation of a Cluster Randomized Controlled Trial. J Med Internet Res 2021; 23:e19737. [PMID: 33404504 PMCID: PMC7817359 DOI: 10.2196/19737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/22/2020] [Accepted: 11/11/2020] [Indexed: 01/21/2023] Open
Abstract
Background A high proportion of vocational education students smoke tobacco, have inadequate nutrition (ie, low fruit and vegetable intake), drink alcohol at risky levels, or are physically inactive. The extent to which vocational education students will sign up for proactively offered online and telephone support services for multiple health risk behaviors is unknown. Objective The aim of this study is to examine the uptake of proactively offered online and telephone support services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors, individually and in combination, among vocational education students in the Technical and Further Education (TAFE) setting. The characteristics associated with the uptake of online or telephone services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors were also examined. Methods Vocational education students enrolled in a TAFE class in New South Wales, Australia, which ran for 6 months or more, were recruited to participate in a cluster randomized controlled trial from May 2018 to May 2019. In the intervention arm, participants who did not meet the Australian health guidelines for each of the smoking, nutrition, alcohol consumption, and physical activity risk behaviors were provided electronic feedback and proactively offered online and telephone support services. Uptake of support was measured by whether participants signed up for the online and telephone services they were offered. Results Vocational education students (N=551; mean age 25.7 years, SD 11.1; 310/551, 56.3% male) were recruited into the intervention arm. Uptake of the proactive offer of either online or telephone services was 14.5% (59/406) for fruit and vegetables, 12.7% (29/228) for physical activity, 6.8% (13/191) for smoking, and 5.5% (18/327) for alcohol use. Uptake of any online or telephone service for at least two health behaviors was 5.8% (22/377). Participants who were employed (odds ratio [OR] 0.10, 95% CI 0.01-0.72) and reported not being anxious (OR 0.11, 95% CI 0.02-0.71) had smaller odds of signing up for online or telephone services for smoking, whereas participants who reported not being depressed had greater odds (OR 10.25, 95% CI 1.30-80.67). Participants who intended to change their physical activity in the next 30 days had greater odds (OR 4.01, 95% CI 1.33-12.07) of signing up for online or telephone services for physical activity. Employed participants had smaller odds (OR 0.18, 95% CI 0.06-0.56) of signing up for support services for at least two behaviors. Conclusions Although the uptake of proactively offered online and telephone support services is low, these rates appear to be higher than the self-initiated use of some of these services in the general population. Scaling up the proactive offer of online and telephone services may produce beneficial health outcomes. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12618000723280; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375001.
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Affiliation(s)
- Prince Atorkey
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Christine Paul
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - John Wiggers
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Christophe Lecathelinais
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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14
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Hu J, Yang R, Li D, Zhao S, Wan Y, Tao F, Fang J, Zhang S. A latent class analysis of psychological symptoms and health risk behaviors among Chinese adolescents. Asian J Psychiatr 2021; 55:102518. [PMID: 33370703 DOI: 10.1016/j.ajp.2020.102518] [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: 07/16/2020] [Revised: 11/12/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
Multiple health risk behaviors (HRBs) tend to co-occur which increase risks of mental disorder. In this study, we identified the association between latent class of HRBs and psychological symptoms in Chinese adolescents. We assessed 22 628 Chinese adolescents from November 2015 to January 2016. The average age of the students were (15.36 ± 1.79), among which there were 10 990 male students and 11 638 female students. A latent class analysis was applied to identity HRBs patterns. The multivariable logistic regression models were utilized to examine the association between HRBs patterns and psychological symptoms. Four latent classes were identified, characterized as low-risk class, moderate-risk class 1 (smoking/ alcohol use (AU)/screen time (ST)), moderate-risk class 2 (unhealthy losing weight (ULW)/ problematic mobile phone use (PMPU)), and high-risk class (ULW/smoking/AU/ST/ PMPU), which were 71.2 %, 3.2 %, 22.3 %, and 3.3 % of involved participants, respectively. Compared to the low-risk class, moderate-risk class 1, moderate-risk class 2, and high-risk class showed that adjusted OR (95 %CI) value of 1.97 (1.68-2.32), 3.98 (3.72-4.26) and 6.38 (CI: 5.47-7.44) were significantly associated with psychological symptoms (P < 0.001 for each). Our findings indicated that identifying different latent class of HRBs would be helpful for the design of tailored interventions, and prevention of different patterns of HRBs should be considered in the implementation of effective intervention programs related to psychological symptoms.
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Affiliation(s)
- Jie Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Rong Yang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Danlin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Shuai Zhao
- Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China
| | - Jun Fang
- Department of Toxicology, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China; Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto, 860-0082, Japan.
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032 Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle / Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032 Anhui, China.
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15
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Haraldsson J, Pingel R, Nordgren L, Tindberg Y, Kristiansson P. Understanding adolescent males' poor mental health and health-compromising behaviours: A factor analysis model on Swedish school-based data. Scand J Public Health 2020; 50:232-244. [PMID: 33323059 PMCID: PMC8873304 DOI: 10.1177/1403494820974555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The aim was to develop a factor model of the clustering of poor mental-health symptoms and health-compromising behaviours (HCBs) in adolescent males. Methods: The study was based on two cross-sectional school-based Swedish surveys in 2011 (response rate 80%, N=2823) and 2014 (response rate 85%, N=2358), both of which comprised questionnaires from males aged 15–16 and 17–18 years. A factor model was developed by exploratory factor analysis on the 2011 survey and validated by confirmatory factor analysis on the 2014 survey. Results: Four aspects of poor mental health and HCBs emerged in the exploratory factor analysis: (a) deviancy as a tendency to substance use and delinquency, (b) unsafety as an inclination towards feelings of unsafety in different environments, (c) gloominess as a tendency towards pessimism and feeling unwell and (d) pain as an inclination to experience physical pain. The model was validated with good model fit. Age did not affect the model structure, but older adolescent males were more influenced by deviancy and gloominess and less by unsafety compared to their younger peers. Conclusions: Separating symptoms of poor mental health and HCBs into four areas – deviancy, unsafety, gloominess and pain – brings new perspectives to the understanding of adolescent males’ health. To the best of our knowledge, our factor model is the first to include unsafety and pain in this context. Whenever a comprehensive approach to the health of adolescent males is needed in the clinic or in the field of public health, this factor model may provide guidance.
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Affiliation(s)
- Johanna Haraldsson
- Department of Public Health and Caring Sciences, Uppsala University, Sweden.,Centre for Clinical Research, Sörmland/Uppsala University, Sweden
| | - Ronnie Pingel
- Department of Statistics, Uppsala University, Sweden
| | - Lena Nordgren
- Department of Public Health and Caring Sciences, Uppsala University, Sweden.,Centre for Clinical Research, Sörmland/Uppsala University, Sweden
| | - Ylva Tindberg
- Centre for Clinical Research, Sörmland/Uppsala University, Sweden.,Department of Women's and Children's Health, Uppsala University, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
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Ssewanyana D, Abubakar A, Newton CRJC, Otiende M, Mochamah G, Nyundo C, Walumbe D, Nyutu G, Amadi D, Doyle AM, Ross DA, Nyaguara A, Williams TN, Bauni E. Clustering of health risk behaviors among adolescents in Kilifi, Kenya, a rural Sub-Saharan African setting. PLoS One 2020; 15:e0242186. [PMID: 33180831 PMCID: PMC7660520 DOI: 10.1371/journal.pone.0242186] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/29/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents tend to experience heightened vulnerability to risky and reckless behavior. Adolescents living in rural settings may often experience poverty and a host of risk factors which can increase their vulnerability to various forms of health risk behavior (HRB). Understanding HRB clustering and its underlying factors among adolescents is important for intervention planning and health promotion. This study examines the co-occurrence of injury and violence, substance use, hygiene, physical activity, and diet-related risk behaviors among adolescents in a rural setting on the Kenyan coast. Specifically, the study objectives were to identify clusters of HRB; based on five categories of health risk behavior, and to identify the factors associated with HRB clustering. METHODS A cross-sectional survey was conducted of a random sample of 1060 adolescents aged 13-19 years living within the area covered by the Kilifi Health and Demographic Surveillance System. Participants completed a questionnaire on health behaviors which was administered via an Audio Computer-Assisted Self-Interview. Latent class analysis on 13 behavioral factors (injury and violence, hygiene, alcohol tobacco and drug use, physical activity, and dietary related behavior) was used to identify clustering and stepwise ordinal logistic regression with nonparametric bootstrapping identified the factors associated with clustering. The variables of age, sex, education level, school attendance, mental health, form of residence and level of parental monitoring were included in the initial stepwise regression model. RESULTS We identified 3 behavioral clusters (Cluster 1: Low-risk takers (22.9%); Cluster 2: Moderate risk-takers (67.8%); Cluster 3: High risk-takers (9.3%)). Relative to the cluster 1, membership of higher risk clusters (i.e. moderate or high risk-takers) was strongly associated with older age (p<0.001), being male (p<0.001), depressive symptoms (p = 0.005), school non-attendance (p = 0.001) and a low level of parental monitoring (p<0.001). CONCLUSION There is clustering of health risk behaviors that underlies communicable and non-communicable diseases among adolescents in rural coastal Kenya. This suggests the urgent need for targeted multi-component health behavior interventions that simultaneously address all aspects of adolescent health and well-being, including the mental health needs of adolescents.
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Affiliation(s)
- Derrick Ssewanyana
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Charles R. J. C. Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Mark Otiende
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - George Mochamah
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Christopher Nyundo
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Walumbe
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Gideon Nyutu
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - David Amadi
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Aoife M. Doyle
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - David A. Ross
- London School of Hygiene & Tropical Medicine, Bloomsbury, London, United Kingdom
| | - Amek Nyaguara
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
| | - Thomas N. Williams
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
- INDEPTH (International Network for field sites with continuous Demographic Evaluation of Populations and Their Health in developing countries), East Legon, Accra, Ghana
- Department of Medicine, Imperial College, South Kensington Campus, London, United Kingdom
| | - Evasius Bauni
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya
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17
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van den Toren SJ, van Grieken A, Mulder WC, Vanneste YT, Lugtenberg M, de Kroon MLA, Tan SS, Raat H. School Absenteeism, Health-Related Quality of Life [HRQOL] and Happiness among Young Adults Aged 16-26 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3321. [PMID: 31505862 PMCID: PMC6765871 DOI: 10.3390/ijerph16183321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/03/2019] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
This study examines the association between school absenteeism, health-related quality of life (HRQOL) and happiness among young adults aged 16-26 years attending vocational education. Cross-sectional data from a survey among 676 young adults were analyzed. School absenteeism was measured by the self-reported number of sick days in the past eight weeks and hours of truancy in the past four weeks. HRQOL was measured by the 12-item Short Form Health Survey; physical and mental component summary scores were calculated. General happiness was assessed on a scale of 0-10, higher scores indicating greater happiness. Linear regression analyses were performed. The study population had a mean age of 18.5 years (SD 2.2); 26.1% were boys. Young adults with ≥5 sick days or ≥6 h of truancy reported lower mental HRQOL compared to young adults without sickness absence or truancy (p < 0.05). Young adults with 1-4 and ≥5 sick days reported lower physical HRQOL compared to young adults who had not reported to be sick (p < 0.05). Young adults with 1-5 h and ≥6 h of truancy reported higher physical HRQOL compared to young adults who were not truant (p < 0.05). No associations were observed between school absence and happiness. Lower self-reported mental HRQOL was observed among young adults with more school absenteeism due to sickness or truancy. Sickness absence was additionally associated with lower physical HRQOL.
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Affiliation(s)
- Suzanne J van den Toren
- Department of Public Health, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
| | - Wico C Mulder
- Dutch Center for Youth Health (NCJ), 3527 GV Utrecht, The Netherlands.
| | | | - Marjolein Lugtenberg
- Department of Public Health, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
| | - Marlou L A de Kroon
- Department of Health Sciences, University Medical Center Groningen, 9700 AB Groningen, The Netherlands.
| | - Siok Swan Tan
- Department of Public Health, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.
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Mewton L, Champion K, Kay-Lambkin F, Sunderland M, Thornton L, Teesson M. Lifestyle risk indices in adolescence and their relationships to adolescent disease burden: findings from an Australian national survey. BMC Public Health 2019; 19:60. [PMID: 30642325 PMCID: PMC6332686 DOI: 10.1186/s12889-019-6396-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The current study investigates the extent to which an adolescent-specific lifestyle risk factor index predicts indicators of the leading causes of adolescent morbidity and mortality. METHODS Data came from 13 to 17 year-old respondents from the 2013-2014 nationally representative Australian Child and Adolescent Survey of Mental Health and Wellbeing (n = 2314). Indicators of adolescent disease burden included Major Depressive Disorder, psychological distress, self-harm and suicide attempt. Risk factors included risky alcohol use, drug use, unprotected sex, smoking, BMI and sleep duration. The extent to which these risk factors co-occurred were investigated using tetrachoric correlations. Several risk indices were then constructed based on these risk factors. Receiver Operating Characteristic curves determined the precision with which these indices predicted the leading causes of adolescent disease burden. RESULTS Risky alcohol use, drug use, smoking, unprotected sex, and sleep were all highly clustered lifestyle risk factors, whereas BMI was not. A risk index comprising risky alcohol use, drug use, unprotected sex and sleep duration predicted the disease burden outcomes with the greatest precision. 31.9% of the sample reported one or more of these behaviours. CONCLUSIONS This lifestyle risk factor index represents a useful summary metric in the context of adolescent health promotion and non-communicable disease prevention. Lifestyle risk factors were found to cluster in adolescence, supporting the implementation of multiple health behaviour change interventions.
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Affiliation(s)
- Louise Mewton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Katrina Champion
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Frances Kay-Lambkin
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Matthew Sunderland
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Louise Thornton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Maree Teesson
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
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Gubelmann A, Berchtold A, Barrense-Dias Y, Akre C, Newman CJ, Suris JC. Youth With Chronic Conditions and Risky Behaviors: An Indirect Path. J Adolesc Health 2018; 63:785-791. [PMID: 30254008 DOI: 10.1016/j.jadohealth.2018.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare risk behaviors between youths living with a chronic condition (CC) and their healthy peers, controlling for condition severity. METHODS Data were drawn from the baseline wave of the GenerationFRee study (students aged 15-24 years in postmandatory education) during the 2014-2015 school year. The sample (N = 5,179) was divided into youths with CC without limitations (N = 536; 10.4%), youths with limitations (N = 114; 2.2%), and a control group (CG; N = 4,529; 87.4%). Groups were compared on internalizing (perceived health status, vision of their future, emotional wellbeing) and externalizing behaviors (substance use, gambling, excessive internet use, disordered eating, violent and antisocial acts) controlling for potential confounders. Statistical analyses were carried out through structural equation modeling. Results are given as unstandardized coefficients. RESULTS Overall, CC youths showed an association with internalizing behaviors (coefficient: .78) but not with externalizing behaviors. In fact, the connection with externalizing behaviors was indirect via the internalizing behaviors (.32). CC Youths reporting psychological issues were more likely to adopt every externalizing behavior. Analyzing separately youths with CC limiting daily life activities and those without limitations, the results did not change substantially. However, the association with internalizing behaviors was much higher for those reporting limitations (2.18 vs. .42). CONCLUSIONS Our results show that the link between suffering from a CC and adopting risk behaviors is indirect through internalizing behaviors. Health professionals should address emotional wellbeing and perception of the future rather than focus exclusively on the effects of risk behaviors on specific diseases.
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Affiliation(s)
- Alicia Gubelmann
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences & NCCR LIVES, University of Lausanne, Lausanne, Switzerland
| | - Yara Barrense-Dias
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christina Akre
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Christopher J Newman
- Pediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan-Carles Suris
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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Assanangkornchai S, Li J, McNeil E, Saingam D. Clusters of alcohol and drug use and other health-risk behaviors among Thai secondary school students: a latent class analysis. BMC Public Health 2018; 18:1272. [PMID: 30453913 PMCID: PMC6245619 DOI: 10.1186/s12889-018-6205-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 11/07/2018] [Indexed: 12/04/2022] Open
Abstract
Background Alcohol and drug use and other health-risk behaviors tend to cluster together among adolescents and contribute a large amount of harm to both themselves and to others. This paper aims to characterize secondary school students based on their clusters of health-risk behaviors and identify factors determining class membership to these behavior-clusters. Methods Data from a national school survey was used to identify clusters of alcohol and drug use and other health-risk behaviors among secondary school students aged 12–15 years using a latent class regression model. A multinomial logistic regression model was used to identify predictors of the cluster membership. Results A total of 25,566 students were included in the analysis, of which 88% were classified as having low-risk behaviors reporting only moderate alcohol use; 11% as having moderate-risk behaviors, such as driving under the influence of alcohol, fighting, carrying a weapon, and alcohol and tobacco use; and 0.6% as having high-risk behaviors, such as use of illicit drugs, particularly kratom and cannabis. Males, older students, those with a poor school performance, not living with parents, drug use by family members and peers, and having a low level of perceived disdain from their friends if they used drugs were significant risk factors for being in the moderate- and high-risk behavior classes. Conclusions Alcohol, tobacco and drug use, as well as other health-risk behaviors such as fighting, are clustered in Thai secondary school students. This result highlights the importance of comprehensive prevention and education strategies, particularly for moderate to high-risk groups.
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Affiliation(s)
- Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Jing Li
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Kunming Medical University, Kunming, Yunnan Province, China
| | - Edward McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
| | - Darika Saingam
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Blair MA, Stewart JL, May AC, Reske M, Tapert SF, Paulus MP. Blunted Frontostriatal Blood Oxygen Level-Dependent Signals Predict Stimulant and Marijuana Use. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:947-958. [PMID: 29681519 PMCID: PMC6150844 DOI: 10.1016/j.bpsc.2018.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/07/2018] [Accepted: 03/13/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Occasional recreational stimulant (amphetamine and cocaine) use is an important public health problem among young adults because 16% of those who experiment develop stimulant use disorder. This study aimed to determine whether behavioral and/or neural processing measures can forecast the transition from occasional to problematic stimulant use. METHODS Occasional stimulant users completed a Risky Gains Task during functional magnetic resonance imaging and were followed up 3 years later. Categorical analyses tested whether blood oxygen level-dependent (BOLD) responses differentiated occasional stimulant users who became problem stimulant users (n = 35) from those who desisted from stimulant use (n = 75) at follow-up. Dimensional analyses (regardless of problem stimulant user or desisted stimulant use status; n = 144) tested whether BOLD responses predicted baseline and follow-up stimulant and marijuana use. RESULTS Categorical results indicated that relative to those who desisted from stimulant use, problem stimulant users 1) made riskier decisions after winning feedback; 2) exhibited lower frontal, insular, and striatal BOLD responses to win/loss feedback after making risky decisions; and 3) displayed lower thalamic but greater temporo-occipital BOLD responses to risky losses than to risky wins. In comparison, dimensional results indicated that lower BOLD signals to risky choices than to safe choices in frontal, striatal, and additional regions predicted greater marijuana use at follow-up. CONCLUSIONS Taken together, blunted frontostriatal signals during risky choices may quantify vulnerability to future marijuana consumption, whereas blunted frontostriatal signals to risky outcomes mark risk for future stimulant use disorder. These behavioral and neural processing measures may prove to be useful for identifying ultra-high risk individuals prior to onset of problem drug use.
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Affiliation(s)
- Melanie A Blair
- Department of Psychology, Graduate Center, City University of New York, New York, New York; Department of Psychology, Queens College, City University of New York, New York, New York.
| | - Jennifer L Stewart
- Department of Psychology, Graduate Center, City University of New York, New York, New York; Department of Psychology, Queens College, City University of New York, New York, New York
| | - April C May
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Martina Reske
- Institute of Neuroscience and Medicine, Computational and Systems Neuroscience, Jülich Research Centre, Jülich, Germany
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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22
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Andersen S, Rod MH, Holmberg T, Ingholt L, Ersbøll AK, Tolstrup JS. Effectiveness of the settings-based intervention Shaping the Social on preventing dropout from vocational education: a Danish non-randomized controlled trial. BMC Psychol 2018; 6:45. [PMID: 30208956 PMCID: PMC6134754 DOI: 10.1186/s40359-018-0258-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of formal education is an important social determinant of health inequality and represents a public health problem. School dropout is particularly common in vocational education; however few prevention programs targeting dropout in the vocational school setting have been evaluated. The purpose of the present study was to test the effect on school dropout of a settings-based intervention program (named Shaping the Social) that targeted the school organization in order to create social and supportive learning environments. METHODS A non-randomized controlled design including four large intervention schools and six matched-control schools was used. The target population was students in technical and agricultural vocational education, which is provided to students from age 16. Students were enrolled at school start. Register-based data (n = 10,190) was used to assess the effect on school dropout during a 2-year period. Odds ratios (OR) and 95% confidence intervals (CI) were calculated in logistic regression models, adjusting for age, sex, ethnicity, parental income, prior school dropout and type of basic course. Student survey (n = 2396) at 10-week follow-up was used to examine wellbeing at school (four subscales: school connectedness, student support, teacher relatedness, and valuing the profession) which was the hypothesized proximal intervention effect. As a secondary aim, we examined how the student wellbeing factors were associated with school dropout, independently of the intervention, and we explored whether the student wellbeing factors were potential mediators. RESULTS The present study showed an intervention effect on school dropout with dropout rates lower in intervention schools (36%) than control schools (40%) (OR = 0.86, 95% CI: 0.74, 0.99). We had no attrition on the dropout outcome. School connectedness mediated the intervention effect; no significant mediation effects were found for student support, teacher relatedness, and valuing the profession. Independently of the intervention, each student wellbeing factor prevented dropout. CONCLUSIONS Findings from this study suggest that a comprehensive, multicomponent school-based intervention could prevent dropout from vocational education by promoting school connectedness; nevertheless, the dropout rate remained high. Our results point to the need to explore how to further improve the wellbeing at school among young people in vocational education. TRIALS REGISTRATION ISRCTN, ISRCTN57822968 . Registered 16 January 2013 (retrospective registered).
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Affiliation(s)
- Susan Andersen
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen K, Denmark.
| | - Morten Hulvej Rod
- National Research Centre for Disadvantaged Children and Youth, Kronprinsesse Sofies Vej 35, Frederiksberg, Denmark
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Liselotte Ingholt
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Janne Schurmann Tolstrup
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
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Pailing AN, Reniers RLEP. Depressive and socially anxious symptoms, psychosocial maturity, and risk perception: Associations with risk-taking behaviour. PLoS One 2018; 13:e0202423. [PMID: 30110384 PMCID: PMC6093696 DOI: 10.1371/journal.pone.0202423] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023] Open
Abstract
Risk-taking behaviour and onset of mental illness peak in adolescence and young adulthood. This study evaluated the interconnectedness of the domains of risk-taking behaviour, mental health (symptoms of depression and social anxiety), psychosocial maturity, risk perception, age, and gender in a sample of 306 adolescents and young adults. Participants between the ages of 16 and 35 completed online self-report measures assessing risk-taking behaviour, depressive symptoms, socially anxious symptoms, psychosocial maturity and risk perception. Socially anxious symptoms, psychosocial maturity, and risk perception were directly associated with risk-taking behaviour. Correlations between depressive symptoms, socially anxious symptoms, and psychosocial maturity were found. Psychosocial maturity proved a better predictor of risk-taking behaviour than age in this cohort. The findings indicate that mental health impacts upon risk-taking behaviour and that consideration should be given to psychosocial maturity in attempts to reduce adolescent and young adult risk-taking behaviour.
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Affiliation(s)
- Adam N. Pailing
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Renate L. E. P. Reniers
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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24
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Champion KE, Mather M, Spring B, Kay-Lambkin F, Teesson M, Newton NC. Clustering of Multiple Risk Behaviors Among a Sample of 18-Year-Old Australians and Associations With Mental Health Outcomes: A Latent Class Analysis. Front Public Health 2018; 6:135. [PMID: 29868543 PMCID: PMC5949382 DOI: 10.3389/fpubh.2018.00135] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/20/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Risk behaviors commonly co-occur, typically emerge in adolescence, and become entrenched by adulthood. This study investigated the clustering of established (physical inactivity, diet, smoking, and alcohol use) and emerging (sedentary behavior and sleep) chronic disease risk factors among young Australian adults, and examined how clusters relate to mental health. METHODS The sample was derived from the long-term follow-up of a cohort of Australians. Participants were initially recruited at school as part of a cluster randomized controlled trial. A total of 853 participants (Mage = 18.88 years, SD = 0.42) completed an online self-report survey as part of the 5-year follow-up for the RCT. The survey assessed six behaviors (binge drinking and smoking in the past 6 months, moderate-to-vigorous physical activity/week, sitting time/day, fruit and vegetable intake/day, and sleep duration/night). Each behavior was represented by a dichotomous variable reflecting adherence to national guidelines. Exploratory analyses were conducted. Clusters were identified using latent class analysis. RESULTS Three classes emerged: "moderate risk" (moderately likely to binge drink and not eat enough fruit, high probability of insufficient vegetable intake; Class 1, 52%); "inactive, non-smokers" (high probabilities of not meeting guidelines for physical activity, sitting time and fruit/vegetable consumption, very low probability of smoking; Class 2, 24%), and "smokers and binge drinkers" (high rates of smoking and binge drinking, poor fruit/vegetable intake; Class 3, 24%). There were significant differences between the classes in terms of psychological distress (p = 0.003), depression (p < 0.001), and anxiety (p = 0.003). Specifically, Class 3 ("smokers and binge drinkers") showed higher levels of distress, depression, and anxiety than Class 1 ("moderate risk"), while Class 2 ("inactive, non-smokers") had greater depression than the "moderate risk" group. DISCUSSION Results indicate that risk behaviors are prevalent and clustered in 18-year old Australians. Mental health symptoms were significantly greater among the two classes that were characterized by high probabilities of engaging in multiple risk behaviors (Classes 2 and 3). An examination of the clustering of lifestyle risk behaviors is important to guide the development of preventive interventions. Our findings reinforce the importance of delivering multiple health interventions to reduce disease risk and improve mental well-being.
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Affiliation(s)
- Katrina E. Champion
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Marius Mather
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Frances Kay-Lambkin
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Nicola C. Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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Wilson MN, Asbridge M, Langille DB. School Connectedness and Protection From Symptoms of Depression in Sexual Minority Adolescents Attending School in Atlantic Canada. THE JOURNAL OF SCHOOL HEALTH 2018; 88:182-189. [PMID: 29399841 DOI: 10.1111/josh.12595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/12/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND In examining associations of sexual orientation, school connectedness (SC), and depression, no studies have used a continuum of sexual orientation. Additionally, no study has examined whether individuals with higher SC within subgroups of the continuum of sexual orientation are protected from symptoms of depression when compared to others within their own group. Our study aimed to address these deficiencies. METHODS Data were from a cross-sectional survey of 6643 public high school students. Logistic regression was used to determine if higher SC was associated with protection from symptoms of depression comparing students with minority sexual orientations to heterosexual students, and whether SC was protective within subgroups of orientation. RESULTS Mean SC scores were higher in heterosexuals than in all other orientation subgroups. Except for bisexual boys, compared with being heterosexual, being in other subgroups of orientation was associated with symptoms of depression, independent of SC. In both sexes SC was protective against depression risk within all categories of orientation except mostly/100% homosexual girls. CONCLUSIONS Within all subgroups of sexual orientation except mostly/completely homosexual girls, SC was protective for symptoms of depression, indicating its potential importance for prevention of depression in all students, including perhaps particularly those with minority orientation.
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Affiliation(s)
- Maria N Wilson
- Department of Community Health and Epidemiology, Dalhousie University, Clinical Research Centre, 5790 University Avenue Halifax, Nova Scotia B3H, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Clinical Research Centre, 5790 University Avenue Halifax, Nova Scotia, Canada, B3H 1V7, Canada
| | - Donald B Langille
- Department of Community Health and Epidemiology, Dalhousie University, Clinical Research Centre, 5790 University Avenue Halifax, Nova Scotia B3H 1V7, Canada
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Anxiety, Depression, and Pain Symptoms: Associations With the Course of Marijuana Use and Drug Use Consequences Among Urban Primary Care Patients. J Addict Med 2018; 12:45-52. [DOI: 10.1097/adm.0000000000000362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ramji R, Arnetz BB, Nilsson M, Wiklund Y, Jamil H, Maziak W, Arnetz J. Waterpipe use in adolescents in Northern Sweden: Association with mental well-being and risk and health behaviours. Scand J Public Health 2017; 46:867-876. [PMID: 29226800 DOI: 10.1177/1403494817746534] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There is a lack of studies examining the association between waterpipe smoking and mental well-being among adolescents. This study sought to determine whether waterpipe smoking is associated with mental well-being and other risk and health behaviours in adolescents. METHODS A questionnaire was distributed to 1006 adolescents in grades 9-12 (with a response rate of >95%), containing questions on measures of stress, mental energy and sleep. In addition, the questionnaire assessed risk and health behaviours, including use of a waterpipe, cigarettes, e-cigarettes, snus, alcohol, narcotics, gambling and exercise. Logistic regression was used to assess factors associated with waterpipe use. RESULTS Thirty-seven per cent ( n=371) of the participants had used a waterpipe at some point. Waterpipe use was associated with lower mental energy (odds ratio [OR] = 0.90, 95% confidence interval [CI] 0.81-0.99), higher stress (OR = 1.10, 95% CI 1.02-1.20) and use of cigarettes (OR = 3.82, 95% CI 2.33-6.03), e-cigarettes (OR = 3.26, 95% CI 2.12-4.99), snus (OR = 2.29, 95% CI 2.12-4.99), alcohol (OR = 1.92, 95% CI 1.07-3.44) and narcotics (OR = 3.64, 95% CI 1.75-7.58). Waterpipe use was not significantly associated with gambling, exercise or sleep quality. CONCLUSIONS Waterpipe use in adolescents is associated with worse mental well-being, as well as use of other nicotine products, alcohol and narcotics. Prospective studies are needed to delineate causal and temporal relationships further between waterpipe use and mental well-being and its relationship to other risky behaviours in order to design effective prevention programs.
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Affiliation(s)
- Rathi Ramji
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Bengt B Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Maria Nilsson
- 2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,4 Västerbotten County Council, Sweden
| | | | - Hikmet Jamil
- 3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Wasim Maziak
- 5 Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Judy Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
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Yu J, Putnick DL, Hendricks C, Bornstein MH. Health-Risk Behavior Profiles and Reciprocal Relations With Depressive Symptoms From Adolescence to Young Adulthood. J Adolesc Health 2017; 61:773-778. [PMID: 28970061 PMCID: PMC5701859 DOI: 10.1016/j.jadohealth.2017.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/30/2017] [Accepted: 07/11/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE We examined co-occurrences of multiple health-risk behaviors among adolescents in a 5-year longitudinal design as well as their associations with mental health outcomes. METHODS Latent transition analyses explored subgroups of adolescents (N = 229; 51% males) who engaged in distinct patterns of health-risk behaviors and transitions over time. Moreover, longitudinal relations between risk behavior profiles and depressive symptoms were also explored. RESULTS We identified four latent profiles based on risk levels of safety and violence, sexual behavior, alcohol use, and marijuana and other drug use at both 18 years and 23 years: low risk, modest risk, medium risk, and high risk. Some adolescents maintained their latent profile membership over time, but more transitioned between risk profiles. Adolescents with more depressive symptoms had a higher probability of developing into the high-risk versus low-risk and modest risk profiles at 23 years. Adolescents in the high-risk, low-risk, and modest risk profiles at 18 years developed more depressive symptoms in young adulthood compared with medium risk adolescents. CONCLUSIONS This study provides a better understanding of the prevalence, distribution, and change patterns of health-risk profiles across adolescence and young adulthood in a European American sample. Reciprocal relations between high-risk profiles and depressive symptoms suggest the need for integrated but tailored prevention and intervention programs.
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Affiliation(s)
- Jing Yu
- Child and Family Research, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
| | - Diane L Putnick
- Child and Family Research, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Charlene Hendricks
- Child and Family Research, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Schilling L, Zeeb H, Pischke C, Helmer S, Schmidt-Pokrzywniak A, Reintjes R, Walter U, Girbig M, Krämer A, Icks A, Schneider S. Licit and illicit substance use patterns among university students in Germany using cluster analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:44. [PMID: 29058635 PMCID: PMC5651633 DOI: 10.1186/s13011-017-0128-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/10/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of multiple licit and illicit substances plays an important role in many university students' lives. Previous research on multiple substance use patterns of university students, however, often fails to examine use of different illicit substances and/or hookah. Our objective was to complement and advance the current knowledge about common consumption patterns regarding illicit substances and hookah use in this group. METHODS Students from eight German universities completed an online survey as part of the INSIST study ('INternet-based Social norms Intervention for the prevention of substance use among STudents') regarding their consumption of alcohol, tobacco, hookah, cannabis and other illicit substances. Cluster analysis identified distinct consumption patterns of concurrent and non-concurrent substance use and multinomial logistic regressions described key sociodemographic factors associated with these clusters. RESULTS Six homogeneous groups were identified: 'Alcohol Abstainers' (10.8%), 'Drinkers Only' (48.2%), 'Drinkers and Cigarette Smokers' (14.6%), 'Cannabis and Licit Substance Users' (11.2%), 'Hookah Users with Co-Use' (9.8%) and 'Illicit Substance Users with Co-Use' (5.4%). Illicit substance use clustered with the consumption of alcohol, tobacco and cannabis. Hookah use was regularly associated with alcohol consumption, less commonly associated with tobacco or cannabis use and very rarely associated with use of other illicit substances. Individuals consuming licit and illicit substances or hookah were mostly male and lived together with other students. Characteristics such as the number of years an individual had spent studying at a university, subject of study, immigrant background and religious affiliation were less commonly associated with cluster membership. CONCLUSIONS Although we found substance use patterns in our sample largely similar to previous reports, we identified an important subgroup of individuals using both illicit and licit substances. These individuals may benefit especially from targeted interventions that focus on modifying addictive behavior patterns. TRIAL REGISTRATION DRKS00007635 . Registered 17 December 2014 (retrospectively registered).
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Affiliation(s)
- Laura Schilling
- Mannheim Institute for Public Health, Social and Preventive Medicine, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167, Mannheim, Germany
| | - Hajo Zeeb
- Leibniz-Institute for Prevention Research and Epidemiology -BIPS, Achterstr. 30, D-28359, Bremen, Germany
| | - Claudia Pischke
- Leibniz-Institute for Prevention Research and Epidemiology -BIPS, Achterstr. 30, D-28359, Bremen, Germany
| | - Stefanie Helmer
- Leibniz-Institute for Prevention Research and Epidemiology -BIPS, Achterstr. 30, D-28359, Bremen, Germany
| | - Andrea Schmidt-Pokrzywniak
- Institute of Medical Epidemiology, Biostatistics and Informatics, Faculty of Medicine, Martin-Luther-University Halle, Ernst-Grube-Str. 40, D-06120, Halle, Germany
| | - Ralf Reintjes
- Department Health Sciences, Faculty Life Sciences, Hamburg University of Applied Sciences, Lohbrügger Kirchstr. 65, D-21033, Hamburg, Germany
| | - Ulla Walter
- Department of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Carl-Neuberg-Str. 1, D-30623, Hannover, Germany
| | - Maria Girbig
- Faculty of Medicine Carl Gustav Carus, Institute and Policlinic for Occupational and Social Medicine, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Alexander Krämer
- Faculty of Health Sciences, Bielefeld University, Universitätsstr. 25, D-33615, Bielefeld, Germany
| | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstr. 5, D-40225, Düsseldorf, Germany
| | - Sven Schneider
- Mannheim Institute for Public Health, Social and Preventive Medicine, Heidelberg University, Ludolf-Krehl-Str. 7-11, D-68167, Mannheim, Germany.
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Schulabsentismus bei jugendlichen ALG-II-Empfängern aus Bedarfsgemeinschaften. FORENSISCHE PSYCHIATRIE PSYCHOLOGIE KRIMINOLOGIE 2017. [DOI: 10.1007/s11757-017-0414-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rodríguez-Cano R, Paulus DJ, López-Durán A, Martínez-Vispo C, Fernández del Río E, Becoña E, Zvolensky MJ. The interplay of history of depression and craving in terms of smoking relapse among treatment seeking smokers. J Addict Dis 2017; 36:175-182. [DOI: 10.1080/10550887.2017.1314696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rubén Rodríguez-Cano
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Daniel J. Paulus
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Ana López-Durán
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Elena Fernández del Río
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Psychology and Sociology, Faculty of Social Sciences and Work, University of Zaragoza, Zaragoza, Spain
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Tomczyk S, Pedersen A, Hanewinkel R, Isensee B, Morgenstern M. Polysubstance use patterns and trajectories in vocational students--a latent transition analysis. Addict Behav 2016; 58:136-41. [PMID: 26943488 DOI: 10.1016/j.addbeh.2016.02.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 12/22/2015] [Accepted: 02/14/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The transition from late adolescence to early adulthood (16-20 years) represents a time of exploration and self-discovery for many young people. As such, it is often associated with experimentation in substance use. Vocational students in particular report high substance use. Thus, the aim of this study is to examine patterns and trajectories of their substance use behavior. METHODS On two occasions (interval 18 months), we investigated 5214 students (M=19.39 years; 54% male) from 49 vocational schools in seven German federal states. We identified classes of substance use and trajectories via latent transition analysis, controlling for gender, age, and socio-economic status. Additionally, we investigated work-related (job demands/stress/satisfaction) and psychopathological (depressive symptoms) predictors of substance use via multinomial regressions. RESULTS We found three latent stages of substance use: low use (baseline: 43%/follow-up: 44%), mainly alcohol use (50%/45%), and polysubstance use (7%/11%). Over time, 10% of alcohol users at baseline transitioned to polysubstance use at follow-up, while there were smaller transition rates (2-9%) between the other stages. Compared to low use, polysubstance use at follow-up was predicted by high job stress (aOR=1.45, 1.07-1.96) at baseline. CONCLUSIONS High alcohol use is associated with bidirectional transitions in young adults. Hence, future research needs to identify mechanisms of change to identify protective factors. Regarding vocational practice, early stress management seems to be a viable path to prevent polysubstance use in vocational students.
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Affiliation(s)
- Samuel Tomczyk
- Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany.
| | - Anya Pedersen
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Kiel, Olshausenstraße 62, 24118 Kiel, Germany
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Barbara Isensee
- Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany
| | - Matthis Morgenstern
- Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
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Andersen S, Tolstrup JS, Rod MH, Ersbøll AK, Sørensen BB, Holmberg T, Johansen C, Stock C, Laursen B, Zinckernagel L, Øllgaard AL, Ingholt L. Shaping the Social: design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools. BMC Public Health 2015; 15:568. [PMID: 26088693 PMCID: PMC4474364 DOI: 10.1186/s12889-015-1936-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/12/2015] [Indexed: 11/15/2022] Open
Abstract
Background The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. Methods/design The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011–2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73 % and 81 % of eligible students, and 22 % of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. Discussion Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. Trials registration ISRCTN57822968. Date of registration: 16/01/2013
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Affiliation(s)
- Susan Andersen
- Centre for Intervention Research in Health Promotion and Disease, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Janne Schurmann Tolstrup
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Morten Hulvej Rod
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Betina Bang Sørensen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Teresa Holmberg
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Christoffer Johansen
- The Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100, Copenhagen, Denmark.
| | - Christiane Stock
- Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark.
| | - Bjarne Laursen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Line Zinckernagel
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Anne Louise Øllgaard
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
| | - Liselotte Ingholt
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen, Denmark.
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