The Contribution of Environmental Science to Mental Health Research: A Scoping Review.

Mental health is influenced by multiple complex and interacting genetic, psychological, social, and environmental factors. As such, developing state-of-the-art mental health knowledge requires collaboration across academic disciplines, including environmental science. To assess the current contribution of environmental science to this field, a scoping review of the literature on environmental influences on mental health (including conditions of cognitive development and decline) was conducted. The review protocol was developed in consultation with experts working across mental health and environmental science. The scoping review included 202 English-language papers, published between 2010 and 2020 (prior to the COVID-19 pandemic), on environmental themes that had not already been the subject of recent systematic reviews; 26 reviews on climate change, flooding, air pollution, and urban green space were additionally considered. Studies largely focused on populations in the USA, China, or Europe and involved limited environmental science input. Environmental science research methods are primarily focused on quantitative approaches utilising secondary datasets or field data. Mental health measurement was dominated by the use of self-report psychometric scales. Measures of environmental states or exposures were often lacking in specificity (e.g., limited to the presence or absence of an environmental state). Based on the scoping review findings and our synthesis of the recent reviews, a research agenda for environmental science's future contribution to mental health scholarship is set out. This includes recommendations to expand the geographical scope and broaden the representation of different environmental science areas, improve measurement of environmental exposure, prioritise experimental and longitudinal research designs, and giving greater consideration to variation between and within communities and the mediating pathways by which environment influences mental health. There is also considerable opportunity to increase interdisciplinarity within the field via the integration of conceptual models, the inclusion of mixed methods and qualitative approaches, as well as further consideration of the socio-political context and the environmental states that can help support good mental health. The findings were used to propose a conceptual model to parse contributions and connections between environmental science and mental health to inform future studies.

The relationship between traumatic dental injuries and adolescents' non-suicidal self-injury behaviour: A cross-sectional analysis of an East London cohort.

BACKGROUND/AIM: Recent reviews of case reports have pointed out a potential connection between non-suicidal self-injury (NSSI) and traumatic dental injuries (TDIs). The aim of this study was to investigate the association of a history of NSSI with TDIs in 15- to 16-year-old adolescents. METHODS: This study analysed cross-sectional data from the Research with East London Adolescents Community Health Survey, a prospective population survey of adolescents attending state schools in East London, England. The history of NSSI was obtained using two items from the Lifestyle and Coping questionnaire (whether they have ever engaged with self-harm and the last time they engaged in such behaviours). The presence of TDIs, increased overjet and inadequate lip coverage were determined through clinical assessments by two trained dentists. Survey logistic regression was fitted to test the association of NSSI with TDIs. Odds ratios (ORs) were adjusted for socio-demographic and clinical characteristics as potential confounders. RESULTS: The lifetime and last-year prevalence of NSSI were 11.9% and 6.7%, respectively, whereas the prevalence of TDIs was 16.5%. Neither the lifetime prevalence of NSSI (OR: 1.02, 95% confidence interval: 0.56-1.85) nor the last-year prevalence of NSSI (OR: 0.76, 95% CI: 0.36-1.61) were associated with TDIs in regression models adjusted for confounders. CONCLUSION: This study did not support an association between history of NSSI and TDIs among adolescents aged 15-16 years old in East London.

Troublesome behaviour and traumatic dental injuries during adolescence.

BACKGROUND/AIM: Troublesome behaviour can lead to bodily injuries among young people, although a link with traumatic dental injuries (TDIs) remains unclear. The aim of this study was to evaluate the longitudinal association between troublesome behaviour and TDIs during adolescence. METHODS: This study analysed data from phases 2 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal study of public secondary schools in East London. Troublesome behaviour in the past 12 months was measured with 8 items (told lies to get things from others, started fight, bullied or threatened people, stayed late outside, stole valuable things, ran away from home, played truant from school and intentionally destroyed someone else's property) from the Development and Well-Being Assessment (DAWBA), when participants were 13-14 years old (Phase 2). Adolescents were dentally examined for TDIs when they were 15-16 years old (Phase 3). The association between troublesome behaviour and TDIs was tested in logistic regression models adjusting for socio-demographic characteristics and oral clinical factors. RESULTS: Forty-three per cent of adolescents reported one or more troublesome behaviours at age 13-14 years, and 16% had evidence of TDIs by age 15-16 years. Adolescents who answered 'perhaps' and 'definitely' to any troublesome behaviour item had, respectively, 1.37 (95% CI: 0.62-3.00) and 1.50 (95% CI: 0.69-3.30) greater odds of having TDIs than those who answered 'no' after adjustment for confounders. Of the 8 behaviours assessed, having run away from home, bullied or threatened people, often told lies, and stolen valuable things were associated with having TDIs. CONCLUSION: This study among adolescents shows that reporting troublesome behaviour was associated with TDIs two years later. Given the wide confidence intervals for these associations, the present findings require confirmation from further longitudinal studies.

Cumulative socio-economic disadvantage and traumatic dental injuries during adolescence.

BACKGROUND/AIM: Studies on the association between socio-economic circumstances and traumatic dental injuries (TDIs) are cross-sectional and inconclusive. The aim of this study was to investigate the association between cumulative socio-economic disadvantage and TDIs among adolescents. METHOD: Data from 668 participants in the East London Adolescents Community Health Survey (RELACHS) were analysed. Family socio-economic indicators (parental employment, car ownership and eligibility for free school meals) were collected when participants were in grades 7 (11-12 years), 9 (13-14 years) and 11 (15-16 years). The number of periods (RELACHS waves) adolescents lived in socio-economic disadvantage was counted for each socio-economic measure, ranging from 0 (never in disadvantage) to 3 (always in disadvantage). Adolescents were dentally examined for TDIs at age 15-16 years. The association between each measure of cumulative socio-economic disadvantage and TDIs was tested in logistic regression models adjusting for demographic factors. RESULTS: Significant positive linear trends in the prevalence of TDIs were observed by the number of periods of parental unemployment and being without a family car, but not by eligibility for free school meals. Adolescents whose parents were always unemployed had 2.06 (95% CI: 1.12-3.80) greater odds of having TDIs than those whose parents were never unemployed. Similarly, adolescents from families that never owned a car had 2.17 (95% CI: 1.26-3.74) greater odds of having TDIs than those that always had a family car. CONCLUSION: Cumulative socio-economic disadvantage during adolescence was associated with greater odds of having TDIs.

Depressive symptoms and traumatic dental injuries among adolescents.

BACKGROUND/AIM: A previous cross-sectional study found that young adults with depression were more likely to have traumatic dental injuries (TDIs). The aim of this study was to determine the relationship between depressive symptoms during early and middle adolescence, and TDIs at age 15-16 years. METHOD: This study used longitudinal data from phases 1 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based survey following a representative, multi-ethnic sample of adolescents attending public schools in East London (England). Information on depressive symptoms was collected using the Short Moods and Feelings Questionnaire (SMFQ) during early (age 11-12 years) and middle adolescence (age 15-16 years). TDIs were identified during clinical examinations in phase 3 when pupils were 15-16 years old. Logistic regression was used to test the association between depressive symptoms at different stages of adolescence and TDIs adjusting for confounders (age, gender, ethnicity, parental employment and overjet). RESULTS: Depressive symptoms were reported by 24% and 32% of adolescents in early and middle adolescence, respectively. Evidence of TDIs was found in 18% of adolescents at age 15-16 years. Adolescents with depressive symptoms, either in early or middle adolescence, had greater odds of experiencing TDIs. However, these estimates were not statistically significant. In regression models adjusted for confounders, the odds of having TDIs were 1.23 (95% CI: 0.77-1.96) and 1.23 (95% CI: 0.76-1.95) among pupils with depressive symptoms in early and middle adolescence, respectively. CONCLUSION: There was no association between depressive symptoms and TDIs in early and middle adolescents.

Depressive symptoms at age 9-13 and chronic disabling fatigue at age 16: A longitudinal study.

INTRODUCTION: We investigated whether depressive symptoms at ages 9-13 years were associated with chronic disabling fatigue (CDF) at age 16 among children in the Avon Longitudinal Study of Parents & Children (ALSPAC) birth cohort. METHODS: Depressive symptoms at ages 9, 10, 11, 12, and 13 years were defined as a child- or parent-completed Short Mood and Feelings Questionnaire (SMFQ) score ≥11 (range 0-26). SMFQ score was also analysed as a continuous exposure. Chronic disabling fatigue at 16 was defined as fatigue of ≥6 months' but <5 years' duration which prevented school attendance or activities, for which other causes were not identified, and with a Chalder Fatigue Questionnaire score ≥19. Logistic regression was used with multiple imputation to correct for missing data bias. We performed sensitivity analyses in which children who had CDF and depressive symptoms at age 16 were reclassified as not having CDF. RESULTS: In fully adjusted models using imputed data (N = 13,978), depressive symptoms at ages 9, 11, and 13 years were associated with 2- to 3-fold higher odds of CDF at age 16. Each one-point increase in SMFQ score at ages 9, 10, 11, 12, and 13 years was associated with 6-11% higher odds of CDF at age 16. Depressive symptoms and continuous SMFQ scores at each age were not associated with CDF if the outcome was reclassified to exclude children with comorbid depressive symptoms at age 16. CONCLUSIONS: Depressive symptoms at ages 9-13 were associated with chronic disabling fatigue at age 16, but causality is not certain.

Comment on Gjestland, T. A Systematic Review of the Basis for WHO's New Recommendation for Limiting Aircraft Noise Annoyance. Int. J. Env. Res. Pub. Health 2018, 15, 2717.

In his recent discussion paper in this journal, Truls Gjestland attempts a "systematic review", as he calls it, of the evidence base for aircraft noise annoyance, consolidated in a meta-analysis by Guski et al. that informed the recommended guideline value of 45 dB Lden in the recently published World Health Organization (WHO) Environmental Noise Guidelines. He questions the validity of the presented evidence, as "some of the referenced studies have not been conducted according to standardized methods, and the selection of respondents is not representative of the general airport population." Gjestland maintains that the new WHO Guidelines are based on a questionable selection of existing aircraft noise studies. Our reply comments on the arguments of Gjestland and refutes most of his critique.

The relationship between workplace psychosocial environment and retirement intentions and actual retirement: a systematic review.

Psychosocial work characteristics are potential determinants of retirement intentions and actual retirement. A systematic review was conducted of the influence of psychosocial work characteristics on retirement intentions and actual retirement among the general population. This did not include people who were known to be ill or receiving disability pension. Relevant papers were identified by a search of PubMed, PsycINFO and Web of Science databases to December 2016. We included longitudinal and cross-sectional papers that assessed psychosocial work characteristics in relation to retirement intentions or actual retirement. Papers were filtered by title and abstract before data extraction was performed on full texts using a predetermined extraction sheet. Forty-six papers contained relevant evidence. High job satisfaction and high job control were associated with later retirement intentions and actual retirement. No consistent evidence was found for an association of job demands with retirement intentions or actual retirement. We conclude that to extend working lives policies should increase the job control available to older employees.

Family environment and traumatic dental injuries in adolescents.

BACKGROUND/AIMS: No comprehensive assessment of the influence of the home environment on traumatic dental injuries (TDI) has been conducted to date. The aim of this study was to explore the relationship between family environment and TDI among adolescents from East London. MATERIALS AND METHODS: This cross-sectional study used data from 646 adolescents who participated in phase III of the Research with East London Adolescents Community Health Survey (RELACHS). Family environment was measured with four indicators (non-nuclear family, discordant parental relationship and levels of parental support and parental punishment) measured through a self-administered questionnaire. Clinical examinations were performed for TDI, overjet and lip coverage. Logistic regression was used to test the crude and adjusted (controlling for sociodemographic and clinical factors) association of each family environment characteristic with TDI prevalence. RESULTS: Twenty-nine percent of adolescents were from non-nuclear families, and 52.3% reported a discordant parental relationship. The mean score for parental support was -0.01 (SD: 0.90, range: -0.11 to 0.08), and the mean parental punishment score was 0.03 (SD: 0.86, range: -0.04 to 0.10). Adolescents from non-nuclear families had 1.63 (95% confidence interval: 1.06-2.53) greater odds of having TDI than those from nuclear families. However, this association was fully attenuated after adjusting for sociodemographic and clinical factors. The other three indicators of family environment were not associated with TDI either in crude or adjusted regression models. CONCLUSION: This study found weak evidence of an association between family environment and TDI.

Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA).

BACKGROUND: Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons. METHODS: We used waves 2-7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50-60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease. RESULTS: For employees, on diagnosis of chronic disease autonomy marginally decreased (-0.10, 95% CI -0.20 to 0.00) and physical job demands significantly increased (0.13, 95% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (-0.36, 95% CI -0.64 to -0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (-2.78, 95% CI -6.03 to 0.48). CONCLUSION: Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.

Mid-life psychosocial work environment as a predictor of work exit by age 50.

OBJECTIVES: To examine whether psychosocial work characteristics at age 45 years predict exit from the labour market by the age of 50 years in data from the 1958 British Birth Cohort. METHODS: Psychosocial work characteristics (decision latitude, job demands, job strain and work social support at 45 years and job insecurity at 42 years) measured by questionnaire were linked to employment outcomes (unemployment, retirement, permanent sickness, homemaking) at 50 years in 6510 male and female participants. RESULTS: Low decision latitude (RR = 2.01, 95%CI 1.06,3.79), low work social support (RR = 1.96, 95%CI 1.12,3.44), and high job insecurity (RR = 2.27, 95%CI 1.41, 3.67) predicted unemployment at 50, adjusting for sex, housing tenure, socioeconomic status, marital status, and education. High demands were associated with lower risk of unemployment (RR = 0.50, 95%CI 0.29,0.88) but higher risk of permanent sickness (RR = 2.14, 95%CI 1.09,4.21). CONCLUSIONS: Keeping people in the workforce beyond 50 years may contribute to both personal and national prosperity. Employers may wish to improve working conditions for older workers, in particular, increase control over work, increase support and reduce demands to retain older employees in the workforce.

Illicit drug use and traumatic dental injuries in adolescents.

OBJECTIVE: To explore the association between illicit drug use and traumatic dental injuries (TDI) among adolescents. METHOD: We used data from 618 adolescents who participated in Phases I and III of Research with East Adolescents Community Health Survey (RELACHS), a longitudinal school-based study of adolescents in East London. Illicit drug use was collected when participants were 11-12 and 15-16 years old (Phases I and III, respectively). Clinical examinations for TDI were conducted in Phase III only. The association of lifetime prevalence of illicit drug use at ages 11-12 and 15-16 years with TDI was evaluated in crude and adjusted binary logistic regression models. RESULTS: Overall, 6.3% and 25.4% of adolescents reported having ever used illicit drugs at ages 11-12 (Phase I) and 15-16 years (Phase III), respectively. Also, 8.7% of adolescents were found to have TDI at age 15-16 years. There was no significant association between lifetime prevalence of illicit drug use reported at age 11-12 years (Odds Ratio: 1.07; 95% Confidence Interval: 0.45-2.54) or age 15-16 years (OR: 1.19; 95%CI: 0.74-1.93) and TDI. CONCLUSION: This study found no support for an association between illicit drug use and TDI among adolescents from East London.

Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers? A 20-year follow-up of the Whitehall II study.

OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease. METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife. Using cause-specific Cox models, we examined the association of chronic disease and favourable psychosocial working conditions and their interaction, with the three types of work exit. We adjusted for gender, occupational grade, educational level, remaining in civil service, spouse's employment status and mental health. RESULTS: Chronic disease significantly increased the risk of any type of work exit (HR 1.27) and specifically the risk of health-related exit (HR 2.42). High skill discretion in midlife reduced the risk of any type of work exit (HR 0.90), retirement (HR 0.91) and health-related exit (HR 0.68). High work social support in midlife decreased the risk of health-related exit (HR 0.79) and unemployment (HR 0.71). Favourable psychosocial working conditions in midlife did not attenuate the association between chronic disease and work exit significantly. CONCLUSIONS: The chronically ill have increased risks of work exit, especially through health-related exit routes. Chronic disease is an obstacle to extended working lives. Favourable working conditions directly relate to reduced risks of work exit.

An Olympic Legacy? Did the Urban Regeneration Associated With the London 2012 Olympic Games Influence Adolescent Mental Health?

Public expenditure on large events such as the London 2012 Olympic Games is often justified by the potential legacy of urban regeneration and its associated health and well-being benefits for local communities. In the Olympic Regeneration in East London Study, we examined whether there was an association between urban regeneration related to the 2012 Games and improved mental health in young people. Adolescents aged 11-12 years attending schools in the Olympic host borough of Newham in London or in 3 adjacent comparison London boroughs completed a survey before the 2012 Games and 6 and 18 months after the Games (in 2013 and 2014, respectively). Changes in depressive symptoms and well-being between baseline and each follow-up were examined. A total of 2,254 adolescents from 25 randomly selected schools participated. Adolescents from Newham were more likely to have remained depressed between baseline and the 6- and 18-month follow-up surveys (for 6-month follow-up, relative risk = 1.78, 95% confidence interval: 1.12, 2.83; for 18-month follow-up, relative risk = 1.93, 95% confidence interval: 1.01, 3.70) than adolescents from the comparison boroughs. No differences in well-being were observed. There was little evidence that urban regeneration had any positive influence on adolescent mental health and some suggestion that regeneration may have been associated with maintenance of depressive symptoms. Such programs may have limited short-term impact on the mental health of adolescents.

Exposure to violence and mental health of adolescents: South African Health and Well-being Study.

BACKGROUND: Material and social environmental stressors affect mental health in adolescence. Protective factors such as social support from family and friends may help to buffer the effects of adversity. AIMS: The association of violence exposure and emotional disorders was examined in Cape Town adolescents. METHOD: A total of 1034 Grade 8 high school students participated from seven government co-educational schools in Cape Town, South Africa. Exposure to violence in the past 12 months and post-traumatic stress disorder (PTSD) symptoms were measured by the Harvard Trauma Questionnaire, depressive and anxiety symptoms by the Short Moods and Feelings Questionnaire and the Self-Rating Anxiety Scale. RESULTS: Exposure to violence was associated with high scores on depressive (odds ratio (OR)=6.23, 95% CI 4.2-9.2), anxiety (OR=5.40, 95% CI 2.4-12.4) and PTSD symptoms (OR=8.93, 95% CI 2.9-27.2) and increased risk of self-harm (OR=5.72, 95% CI 1.2-25.9) adjusting for gender and social support. CONCLUSIONS: We found that high exposure to violence was associated with high levels of emotional disorders in adolescents that was not buffered by social support. There is an urgent need for interventions to reduce exposure to violence in young people in this setting. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents.

OBJECTIVE: Little is known about persistence of or recovery from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents. Previous studies have small sample sizes, short follow-up or have focused on fatigue rather than CFS/ME or, equivalently, chronic fatigue, which is disabling. This work aimed to describe the epidemiology and natural course of CFS/ME in adolescents aged 13-18 years. DESIGN: Longitudinal follow-up of adolescents enrolled in the Avon Longitudinal Study of Parents and Children. SETTING: Avon, UK. PARTICIPANTS: We identified adolescents who had disabling fatigue of >6 months duration without a known cause at ages 13, 16 and 18 years. We use the term 'chronic disabling fatigue' (CDF) because CFS/ME was not verified by clinical diagnosis. We used multiple imputation to obtain unbiased estimates of prevalence and persistence. RESULTS: The estimated prevalence of CDF was 1.47% (95% CI 1.05% to 1.89%) at age 13, 2.22% (1.67% to 2.78%) at age 16 and 2.99% (2.24% to 3.75%) at age 18. Among adolescents with CDF of 6 months duration at 13 years 75.3% (64.0% to 86.6%) were not classified as such at age 16. Similar change was observed between 16 and 18 years (75.0% (62.8% to 87.2%)). Of those with CDF at age 13, 8.02% (0.61% to 15.4%) presented with CDF throughout the duration of adolescence. CONCLUSIONS: The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2-3 years.

Obesity, physical activity and traumatic dental injuries in adolescents from East London.

BACKGROUND/AIMS: Evidence on the interplay between obesity, physical activity and traumatic dental injuries (TDIs) is still inconclusive and heavily based on cross-sectional studies. The aim of this study was to explore the interrelationship of obesity and physical activity at age 11-12 years with TDI at age 15-16-years among schoolchildren from East London. MATERIALS AND METHOD: Data were analysed regarding 598 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal, school-based study of adolescents in East London. Participants reported their level of physical activity and their height and weight were measured to estimate body mass index Z-scores (according to the UK growth reference) when they were 11-12 years old. Oral clinical examinations were conducted to assess TDI, overjet and lip coverage when participants were 15-16 years old. The associations of obesity and physical activity with TDI were evaluated in crude and adjusted models using binary logistic regression. RESULTS: Overall, 22.6% of adolescents were obese and 7.2% exercised for 7 h or more a week at baseline, while 18.1% of adolescents had experienced TDI by age 15-16 years. Physical activity (7+ hours per week) was significantly associated with TDI (odds ratio: 2.19; 95% confidence interval: 1.08-4.43) in the crude model. However, no significant associations were found between obesity and TDI (1.18; 95% CI: 0.72-1.93) or physical activity and TDI (1.96; 95% CI: 0.94-4.07) in adjusted models. CONCLUSION: This study found no evidence of any associations of obesity and physical activity with TDI among adolescents from East London.

Longitudinal Associations Between Cyberbullying Involvement and Adolescent Mental Health.

PURPOSE: Cyberbullying differs from face-to-face bullying and may negatively influence adolescent mental health, but there is a lack of definitive research on this topic. This study examines longitudinal associations between cyberbullying involvement and adolescent mental health. METHODS: Participants were 2,480 teenagers taking part in the Olympic Regeneration in East London study. We collected information from participants when they were 12-13 years old and again 1 year later to examine links between involvement in cyberbullying and future symptoms of depression and social anxiety, and mental well-being. RESULTS: At baseline, 14% reported being cybervictims, 8% reported being cyberbullies, and 20% reported being cyberbully-victims in the previous year. Compared to uninvolved adolescents, cybervictims and cyberbully-victims were significantly more likely to report symptoms of depression (cybervictims: odds ratio [OR] = 1.44, 95% confidence interval [CI] [1.00, 2.06]; cyberbully-victims: OR = 1.54, 95% CI [1.13, 2.09]) and social anxiety (cybervictims: OR = 1.52, 95% CI [1.11, 2.07]; cyberbully-victims: OR = 1.44, 95% CI [1.10, 1.89]) but not below average well-being (cybervictims: relative risk ratio = 1.28, 95% CI [.86, 1.91]; cyberbully-victims: relative risk ratio = 1.38, 95% CI [.95, 1.99]) at 1 year follow-up, after adjustment for confounding factors including baseline mental health. CONCLUSIONS: This study emphasizes the high prevalence of cyberbullying and the potential of cybervictimization as a risk factor for future depressive symptoms, social anxiety symptoms, and below average well-being among adolescents. Future research should identify protective factors and possible interventions to reduce adolescent cyberbullying.

Alcohol consumption at age 11-12 years and traumatic dental injuries at age 15-16 years in school children from East London.

AIM: To explore the association between alcohol consumption at age 11-12 years and traumatic dental injuries (TDI) at age 15-16 years. METHODS: Data of 635 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal school-based survey of a representative sample of adolescents from East London, were used for this study. Information on socio-demographic characteristics and alcohol consumption was obtained from questionnaires in phase I when adolescents were 11-12 years of age. Data on TDI and clinical characteristics (incisor overjet and lip coverage) were taken from clinical examination in phase III when adolescents were 15-16 years of age. The association between (lifetime and last month) alcohol consumption and TDI was assessed in crude and adjusted logistic regression models. RESULTS: Overall, 14.5% of adolescents had ever consumed alcohol and 3.5% had consumed alcohol the month before the baseline survey, whereas 17% of adolescents had experienced TDI by age 15-16 years. No significant association of alcohol consumption with TDI was seen in these adolescents for either lifetime (adjusted odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.45-1.67) or last month consumption of alcohol (adjusted OR: 0.86; 95% CI: 0.28-2.69). CONCLUSION: This study did not support the association between alcohol use and TDI in adolescents.

Problem behaviour and traumatic dental injuries in adolescents.

AIM: To explore the relationship between problem behaviour and traumatic dental injuries (TDI) among 15- to 16-year-old schoolchildren from East London. METHODS: This cross-sectional study used data from 794 adolescents who participated in phase III of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents. Participants completed a questionnaire and were clinically examined for TDI, overjet and lip coverage. The Strength and Difficulties Questionnaire (SDQ) was used to assess problem behaviour, which provided a total score and five domain scores (emotional symptoms, conduct problems, hyperactivity, peer problems and pro-social behaviour). The association between problem behaviour and TDI was assessed in unadjusted and adjusted logistic regression models. Adjusted models controlled for demographic (sex, age and ethnicity), socio-economic (parental employment) and clinical factors (overjet and lip coverage). RESULTS: The prevalence of TDI was 17% and the prevalence of problem behaviour, according to the SDQ, was 10%. In the adjusted model, adolescents with problem behaviour were 1.87 (95% confidence interval: 1.03-3.37) times more likely to have TDI than those without problem behaviour. In subsequent analysis by SDQ domains, it was found that only peer problems were associated with TDI (OR = 1.78, 95% CI: 1.01-3.14), even after adjustment for confounders. CONCLUSION: This study found evidence for a relationship between problem behaviour and TDI among adolescents, which was mainly due to peer relationship problems.