How well do DSM-5 criteria measure alcohol use disorder in the general population of older Swedish adolescents? An item response theory analysis.

BACKGROUND: This study assesses the psychometric properties of DSM-5 criteria of AUD in older Swedish adolescents using item response theory models, focusing specifically on the precision of the scale at the cut-offs for mild, moderate, and severe AUD. METHODS: Data from the second wave of Futura01 was used. Futura01 is a nationally representative cohort study of Swedish people born 2001 and data for the second wave was collected when participants were 17/18 years old. This study included only participants who had consumed alcohol during the past 12 months (n = 2648). AUD was measured with 11 binary items. A 2-parameter logistic item response theory model (2PL) estimated the items' difficulty and discrimination parameters. RESULTS: 31.8% of the participants met criteria for AUD. Among these, 75.6% had mild AUD, 18.3% had moderate, and 6.1% had severe AUD. A unidimensional AUD model had a good fit and 2PL models showed that the scale measured AUD over all three cut-offs for AUD severity. Although discrimination parameters ranged from moderate (1.24) to very high (2.38), the more commonly endorsed items discriminated less well than the more difficult items, as also reflected in less precision of the estimates at lower levels of AUD severity. The diagnostic uncertainty was pronounced at the cut-off for mild AUD. CONCLUSION: DSM-5 criteria measure AUD with better precision at higher levels of AUD severity than at lower levels. As most older adolescents who fulfil an AUD diagnosis are in the mild category, notable uncertainties are involved when an AUD diagnosis is set in this group.

Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents - A cohort study from Sweden.

BACKGROUND AND AIMS: This study addresses a significant gap in existing research by investigating the longitudinal relationship between various measures of alcohol use and the development of alcohol use disorders (AUDs) in a cohort of Swedish adolescents. METHODS: A prospective longitudinal survey was conducted on 3999 adolescents in Sweden who were in 9th grade in 2017 and were followed up in 2019. Baseline assessments included lifetime alcohol use, recent use (past 30 days), risky drinking (AUDIT-C), and heavy episodic drinking (HED). Follow-up assessments comprised eleven items measuring DSM-5 AUD criteria. The study explores prospective associations between these diverse alcohol use measures and the occurrence of AUD, while also calculating population attributable fractions (PAF). FINDINGS: The proportion of alcohol consumers who met the criteria for AUD at follow-up was 31.8%. All baseline measures of alcohol use exhibited associations with subsequent AUD. Notably, the HED group demonstrated the highest prevalence of AUD at 51.4% (p<.001). However, when calculating PAFs, any lifetime alcohol use emerged as the most substantial contributor, accounting for 10.8% of all subsequent AUD cases. CONCLUSIONS: This study underscores that alcohol use during mid-adolescence heightens the risk of developing AUD in late adolescence. Among the various measures, heavy episodic drinking presents the highest risk for later AUD. From a public health perspective, preventing any alcohol use emerges as the most effective strategy to mitigate the population-level burden of disease of AUD.

Early Drinking Onset and Subsequent Alcohol Use in Late Adolescence: a Longitudinal Study of Drinking Patterns.

PURPOSE: The age of drinking onset is a central concept for both policy and prevention of alcohol-related harm, yet evidence on the predictive value of the age of onset is lacking. This study compares alcohol outcomes of adolescents who started to drink early with those who started later, and tests if associations are moderated by other explanatory factors. METHODS: Data from a two-wave longitudinal prospective cohort survey with a Swedish nationwide sample of 4,018 adolescents aged 15/16 years at baseline (T1) and 17/18 years at follow-up (T2) were used. Outcome variables at T2 were Alcohol Use Disorders Identification Test (AUDIT)-C, risky drinking, and binge drinking monthly or more often. A vast number of explanatory factors at T1 were controlled for. RESULTS: Early drinking onset predicted later higher AUDIT-C scores (ß = 0.57, p value < .001), and higher probability of risky drinking (odds ratio = 1.95, 95% confidence interval = 1.56-2.44), and binge drinking (odds ratio = 1.38, confidence interval = 1.06-1.81), controlled for other explanatory factors. If binge drinking frequency at T1 was included, the associations remained for AUDIT-C and risky drinking, but not for binge drinking at T2. No significant interactions between early drinking onset and the explanatory factors were found. DISCUSSION: Early drinking onset predicts subsequent higher alcohol consumption in late adolescence. Adolescents who had an early drinking onset drank more after 2 years than their peers who started later. The age of drinking onset is an independent predictor of alcohol use outcomes, beyond the effect of age of binge drinking onset.

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study.

BACKGROUND: Loneliness and belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17-18-years-olds who were followed over 3 years, and the associations that these aspects share with young people's psychosomatic complaints during these ages. METHODS: Swedish cohort data collected among late adolescents (age 17-18 in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. RESULTS: Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. CONCLUSIONS: Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.

Bullying experiences before and after the transition from lower to upper secondary school: associations with subsequent mental health in a Swedish cohort.

BACKGROUND: Previous research has shown that exposure to bullying is linked to long-term adverse mental health consequences. However, prospective studies examining the persistence of bullying, using information from repeated time points, are limited. The aim of this study was to examine, firstly, the extent to which exposure to bullying among adolescents in Sweden changes between grades 9 (age 15-16) and 11 (age 17-18) (i.e., before and after the transition from lower to upper secondary school); secondly, whether being bullied in grade 9 or 11 is associated with depression and anxiety symptoms at age 20-21; and thirdly, if being bullied in both grade 9 and 11 is linked to an even higher likelihood of subsequent depression and anxiety symptoms. Potential differences by gender were investigated throughout. METHODS: Data was derived from the Swedish cohort study Futura01 involving individuals attending grade 9 in the school year 2016/17 (n = 2323). We utilised self-reported information from three survey waves conducted in 2017, 2019, and 2022, and linked registry information on sociodemographic characteristics. Bullying was assessed using a single item in waves 1 and 2. Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4) in wave 3. Gender stratified binary logistic regressions were performed. RESULTS: Among those who were bullied in grade 9, 22.6% of males and 35.8% of females continued to experience bullying in grade 11. For females, exposure to bullying in grade 9 or 11 was associated with an increased likelihood of reporting depression and anxiety symptoms at age 20-21, with the highest odds for those bullied at both time points. For males, only one statistically significant association was identified - specifically, between being bullied in grade 9 and subsequent depression symptoms. CONCLUSIONS: For a majority of adolescents who experience bullying in lower secondary school, but not all, the transition to upper secondary school proves to be beneficial as the bullying typically does not persist. However, bullying can have long-term health effects, in particular for females. These findings emphasise the importance of effective measures to address bullying within schools.

Trust in adolescence and depression and anxiety symptoms in young adulthood: findings from a Swedish cohort.

OBJECTIVE: Trust and health are both fundamental elements of a socially sustainable society. While much research has shown that trust is associated with better mental health outcomes in adults, studies of young people are relatively scarce, despite the fact that mental health problems are common in young ages. In particular, there are few longitudinal studies that cover different dimensions of trust. Building on a previous study on trust and psychosomatic complaints in adolescents, the aim was to examine the links between generalised and institutional trust in adolescence and depression and anxiety symptoms in young adulthood. Data was obtained from a Swedish cohort study with self-reported information on generalised and institutional trust at ages 15-16 and 17-18 and depression and anxiety symptoms at age 20-21 (n = 2,668). Covariates included sociodemographic characteristics and indicators of prior mental health status. RESULTS: Binary logistic and linear regressions showed that higher levels of generalised trust at ages 15-16 and 17-18 were inversely associated with depression and anxiety symptoms at age 20-21. Institutional trust was however not linked with subsequent depression and anxiety symptoms when adjusting for generalised trust and covariates. The findings indicate that generalised trust is a social determinant for mental health in young people.

Psychosocial correlates of drinking transitions: A longitudinal study among adolescents in Sweden.

INTRODUCTION: Non-drinkers have been shown in older studies to have poorer mental health and social life compared to their alcohol-using counterparts. Given the profound decline in adolescent drinking observed in most high-income countries, this pattern may have changed. This study explores drinking transitions and examines psychosocial factors among adolescents by longitudinal drinking status. METHODS: Data were based on two waves of a prospective longitudinal nationwide study (n = 4018). The first wave (T1) of data was collected in 2017 (age 15/16) and the second wave (T2) was in 2019 (age 17/18). Respondents were asked about their past year drinking status, general health, psychosomatic problems, psychiatric medication, school enjoyment, emotional symptoms, peer relationship problems, prosocial ability, friendships satisfaction and satisfaction with relation to mother/father. Comparisons by mean values were assessed and multinomial logistic regressions were used to examine associations. RESULTS: Abstainers and later drinkers differed significantly from early drinkers on 9/10 factors respectively at T1. Fewer psychosomatic problems, less psychiatric medication, higher school enjoyment, more emotional symptoms, higher parental relationship satisfaction, more peer problems and lower friendships satisfaction at T1 were associated with abstaining and/or later drinking. All factors were more strongly associated with abstaining. School enjoyment predicted abstaining but not later drinking. DISCUSSION AND CONCLUSIONS: Longitudinal drinking status relates to small to moderate systematic psychosocial differences. Adolescents with better mental health, more content relationships with parents and lower friendships satisfaction are more often abstainers. Those generally worse off are more likely early drinkers but they also have better friendships.

Mind the gap! Gender differences in alcohol consumption among Swedish ninth graders 1989-2021.

INTRODUCTION: To examine gender differences in drinking habits among Swedish ninth graders over the period 1989-2021. METHODS: Annual school surveys with nationally representative samples of ninth-grade students in Sweden covering the period 1989-2021, total sample of 180,538 students. Drinking habits were measured with self-reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors. RESULTS: Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years. DISCUSSION AND CONCLUSIONS: There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls.

Is there a gender paradox in the association between conduct problems and cannabis use? A cohort-study among Swedish adolescents.

INTRODUCTION: Conduct problems (CP) predict cannabis use prospectively but the research is mixed as to whether this association is stronger among girls. A stronger association among girls would suggest a 'gender paradox' as both CP and cannabis use is less common in this group. This study aimed to assess whether the longitudinal association between CP and cannabis use in Swedish adolescents is stronger among girls. METHODS: Data from two waves of a nationally representative cohort study of Swedish adolescents born in 2001 were used. Baseline measurements were collected in 9th grade (at age 15-16) and follow-up measures at 11th grade (at age 17-18). RESULTS: CP at baseline were significantly associated with cannabis use at follow-up adjusted for hyperactivity problems, emotional problems, socio-demographics, parental monitoring, school grades and truancy at baseline (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.06-1.24) but not when also adjusting for substance use at baseline. Boys were more likely to have used cannabis during the past year, even when controlling for prior substance use (OR 2.29, 95% CI 1.76-2.98). The association between CP and cannabis use was significantly weaker for boys (OR 0.83, 95% CI 0.72-0.95 in the fully adjusted model). The predicted probability of cannabis use was stable at 0.13 for boys across levels of CP, but ranged from 0.05 to 0.16 for girls. DISCUSSION AND CONCLUSION: The longitudinal association between CP and cannabis use was stronger among girls. The findings are indicative of a 'gender paradox' in the association between CP and cannabis use.

Trends in alcohol-related harm among Swedish youth: Do in-patient care registry data match drinking trends?

INTRODUCTION: Youth drinking has been declining in Sweden since the year 2000. There is a paucity of studies examining trends in alcohol-related harm during this period. The overall aim of the present study is to examine how trends in alcohol-related harm match trends in drinking among Swedish youths during 2000-2021. METHODS: Measures of alcohol use were obtained from national school surveys. Prevalence rates of any alcohol use and heavy episodic drinking were used. Alcohol-related harm indicators were obtained from registry information from the National Board of Health and Welfare. Annual trends in harm indicators were tested with linear regression models and correlations between alcohol use and alcohol-related harm indicators were assessed using Pearson's correlation on annual data. RESULTS: Statistically significant negative trends were observed for all alcohol-related harm indicators for the period 2000-2021. Significant correlations were found for both measures of alcohol use and all alcohol-related harm indicators. DISCUSSION AND CONCLUSIONS: The levels of alcohol-related harm have declined among youths in Sweden during the period 2000-2021. The trends in harm seem to reflect the decline in youth drinking that has occurred during the same period.

Trust and Psychosomatic Complaints in Adolescence: Findings From a Swedish Cohort Study.

Objectives: To examine the cross-sectional and longitudinal associations between generalised and institutional trust and psychosomatic complaints in mid and late adolescence. Methods: Data were derived from the Swedish cohort study Futura01, using survey information collected amongst 3,691 grade 9 students (∼15-16 years, t1) who were followed-up 2 years later (∼17-18 years, t2). Registry information on sociodemographic characteristics was linked to the data. Linear regression analyses were performed. The longitudinal analyses applied the first difference (FD) approach as well as the lagged dependent variable (LDV) approach. Covariates included gender, family type, parental education, parental country of birth, and upper secondary programme. Results: Higher levels of generalised and institutional trust were cross-sectionally associated with lower levels of psychosomatic complaints at both time points. The FD analyses showed that increases in generalised and in institutional trust between ages 15-16 and 17-18 years were associated with corresponding decreases in psychosomatic complaints. The LDV analyses demonstrated reciprocal temporal associations between trust and psychosomatic complaints. Conclusion: The findings indicate that trust is a social determinant of psychosomatic complaints in adolescents, but also that health may affect trust.

Prospective associations between psychosomatic complaints in adolescence and depression and anxiety symptoms in young adulthood: A Swedish national cohort study.

Background: Psychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood. Methods: A Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779). Results: The frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls. Conclusions: Psychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.

Trends in Tobacco Use among 9th Graders in Sweden, 1991-2020.

Tobacco use was measured with self-reports of lifetime use of cigarettes and snus to examine trends in tobacco use among Swedish 9th graders over the period 1991-2020. Annual school surveys with nationally representative samples of 9th-grade students in Sweden covering the period 1991-2020 with a total sample of 163,617 students. We distinguished between the use of cigarettes only, use of snus only, dual use (use of both cigarettes and snus), and total tobacco use (use of any of these tobacco products). In addition to a graphical description of trends in the various measures of tobacco use, the correlation between these trends was calculated with the Pearson correlation coefficient (Rxy). The prevalence of total tobacco use declined from 72% in 1991 to 36% in 2020. The declining trend in total tobacco use was positively correlated with the trend in dual use (Rxy = 0.98) and the trend in cigarette use only (Rxy = 0.87). The trend in total tobacco use was, on the other hand, negatively correlated with snus use only (Rxy = -0.41), and snus use only was negatively correlated with cigarette use only (Rxy = -0.71). The situation became different after 2017 when total tobacco use increased as a result of an increasing prevalence of snus use. The sharp decline in tobacco use among 9th graders in Sweden over the past three decades is driven by declining cigarette use. The correlations between the various forms of tobacco use suggest that snus use may have contributed to the decline in cigarette use and, by that, overall tobacco use. The situation changed after 2017 when a sharp rise in snus use seems to have increased total tobacco use among adolescents in Sweden. A possible explanation behind this development is the introduction of a new form of snus called "All white snus", which was introduced in Sweden in 2014.

Do non-drinking youth drink less alcohol in young adulthood or do they catch up? Findings from a Swedish birth cohort.

BACKGROUND: Alcohol consumption among adolescents has declined considerably during the last two decades. However, it is unknown if these adolescents' alcohol consumption will remain low as they grow older. To our knowledge, this is one of the first studies that uses longitudinal data to examine if non-drinking adolescents have a lower alcohol consumption in young adulthood or if they catch up. METHODS: A self-report survey was distributed to a birth cohort (n = 794) born in 1997 in a Swedish region when cohort members attended ninth grade (age 14-15 years) in 2012. Responders were divided into non-drinkers and alcohol users and assessed again in their late teens (17-18 years) and young adulthood (20-21 years). RESULTS: In their late teens (17-18 years), non-drinkers at baseline consumed less alcohol and had a lower probability of harmful use compared with their alcohol-using peers. In young adulthood (20-21 years), these effects disappeared when adjustment was made for covariates. However, a stratified analysis showed that non-drinking adolescents low in conduct problems consumed less alcohol and had a lower probability of harmful use in young adulthood than alcohol-using peers. CONCLUSIONS: This study suggests that the decline in alcohol use among adolescents in the past decades may be associated with a lower alcohol consumption in the late teens and young adulthood among those low in conduct problems. This may have promising implications for alcohol-related morbidity and mortality.

Abstainers and Drinkers - Two Sides of the Same Coin?

This commentary discusses a recently published literature review focussing on the growing trend of young people abstaining from drinking alcohol. Despite the recent increase in research on the decline in youth drinking, the review only identified 10 papers that explicitly examined abstainers. The inclusion criteria used thus excluded and overlooked the vast literature available on the decline in youth drinking. This commentary discusses the implications of this and raises the issue of how the adolescent abstainer should be viewed in research; is it a distinct social phenomenon with unique determinants or are abstainers merely the flip side of drinkers?

Children with problem-drinking parents in a Swedish national sample: is the risk of harm related to the severity of parental problem drinking?

BACKGROUND: The aim of this paper is to examine the link between severity in exposure to parental problem drinking in a Swedish national population sample of children aged 15-16 years. Specifically, we assessed whether the risk of poor health, poor relationships and a problematic school situation increase with severity in exposure to parental problem drinking. METHODS: National population survey from 2017 with a representative sample of 5 576 adolescents born in 2001. Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CIs). A short version of The Children of Alcoholics Screening Test, CAST-6, was used to identify children with problem-drinking parents. Health status, social relations and school situation were assessed by well-established measures. RESULTS: The risk of having poor health, poor school performance and poor social relations increased with severity of parental problem drinking. The risk was lowest among children least severely affected (Crude models ranged from OR: 1.2, 95% CI 1.0-1.4 to OR: 2.2, 95% CI 1.8-2.6) and highest among children most severely affected (Crude models ranges from OR: 1.7, 95% CI 1.3-2.1 to OR: 6.6, 95% CI 5.1-8.6). The risk became lower when adjusting for gender and socioeconomic position but were still higher compared to children without problem-drinking parents. CONCLUSIONS: Appropriate screening and intervention programs are necessary for children with problem-drinking parents especially when exposure is severe but also at mild forms of exposure.

Exploring the Link between ADHD and Cannabis Use in Swedish Ninth Graders: The Role of Conduct Problems and Sensation-Seeking.

Background: Attention deficit hyperactivity disorder (ADHD) has in several studies been linked to substance use, including cannabis use. However, crucial gaps remain regarding how to understand this association. Analyzing the association between ADHD and substance use is complicated because of a pronounced overlap between ADHD, conduct problems, and traits such as sensation-seeking. Objectives: Using data from a large and nationally representative study among Swedish adolescents, this study explored the role of conduct problems, but also of sensation-seeking, in accounting for the association between ADHD and cannabis use. Results: There was a notable association between ADHD and cannabis use that was attenuated when conduct problems were controlled for. The association between cannabis use and conduct problems, in turn, was attenuated when sensation-seeking was controlled for. Individuals with both ADHD and conduct problems were more likely to have used cannabis than individuals with ADHD only, but not compared with individuals with conduct problems only. Conclusions: Whereas conduct problems largely explain the link between ADHD and cannabis use, sensation-seeking seems to account for the association between conduct problems and cannabis use.

The relationship between age at first drink and later risk behaviours during a period of youth drinking decline.

AIMS: Alcohol consumption among teenagers in many high-income countries has steadily declined since the early 2000s. There has also been a steady increase in the average age at first drink, a reliable marker of later alcohol problems. This study measured whether young people who initiated drinking early were at increased risk of alcohol problems in young adulthood in recent cohorts where early initiation was comparatively rare. DESIGN: Analysis of six waves of a repeated cross-sectional household survey (2001-16). SETTING: Australia. PARTICIPANTS: A total of 9576 young adults (aged 20-25 years) who had initiated drinking before the age of 20 years. MEASUREMENTS: Respondents were classified into three groups based on their self-reported age at first drink (< 16, 16-17, 18-19 years). Outcome variables were self-reported experiences of memory loss while drinking, risky and delinquent behaviour while drinking and monthly or more frequent drinking occasions of 11 or more 10-g standard drinks. FINDINGS: Later initiators reported lower levels of all outcomes [e.g. odds ratios (ORs) for memory loss were 0.56, 95% confidence interval (CI) = 0.50, 0.63] for those who first drank at 16 or 17 years compared with those who first drank at age 15 or younger). Significant interactions between age at first drink and survey year showed that early initiation was more strongly associated with harms (e.g. for memory loss, OR = 0.97, 95% CI = 0.94, 0.99 for 18-19 versus 15 or younger) in young adulthood for recent cohorts where early drinking was less common. CONCLUSIONS: The decline in youth drinking may have contributed to a concentration of risk of alcohol problems among those young people who consume alcohol in early adolescence. Early initiation of drinking may be an increasingly important marker of broader risk taking as alcohol becomes less normative for teenagers.

Parenting Practices and Psychosomatic Complaints Among Swedish Adolescents.

Objectives: Parent-adolescent relationships play a crucial role in youth development. This study examines the associations between parenting practices (parental support, knowledge, and rule-setting) and psychosomatic complaints across middle and late adolescence. Methods: The study utilised data from a Swedish national cohort (n = 3,678). Participants completed self-report questionnaires in 2017 (∼15-16 years) and again in 2019 (∼17-18 years). Results: Parental support exhibited the strongest and most consistent inverse cross-sectional associations with psychosomatic complaints during both middle and late adolescence. Furthermore, increases in parental support and parental knowledge were associated with decreases in adolescent psychosomatic complaints. However, parental support and knowledge at age 15-16 were not prospectively associated with psychosomatic complaints at age 17-18. Conclusion: These findings underscore the importance of ongoing parental engagement, particularly in terms of providing constant support, throughout middle and late adolescence.