Autonomy, competence and relatedness and cannabis and alcohol use among youth in Canada: a cross-sectional analysis. / Autonomie, compétence et appartenance sociale et consommation de cannabis et d'alcool chez les jeunes au Canada : une analyse transversale.

INTRODUCTION: There has been increasing attention on preventing problematic youth substance use in light of concerns about rates of use and policy changes in Canada. Strengths-based approaches that emphasize protective factors, including positive mental health, are at the forefront of current prevention recommendations. However, there is a dearth of research on the association between positive mental health and substance use among youth. This study examines the associations between cannabis and alcohol use among youth and positive mental health as measured through the lens of self-determination theory. METHODS: Secondary analyses of the 2014/2015 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) were conducted. Participating Grade 7 to 12 students residing in Canada completed the Children's Intrinsic Needs Satisfaction Scale (CINSS), which measures autonomy, competence and relatedness, and answered questions that measure past 30-day and more frequent cannabis use, alcohol use and binge-drinking. The associations between autonomy, competence and relatedness and substance use, stratified by sex, were examined using logistic regression. RESULTS: Fully adjusted models revealed that relatedness and competence were associated with lower odds of 30-day and more frequent cannabis use, alcohol use and binge-drinking. Higher autonomy was associated with higher odds of these behaviours. All associations were significant with the exception of competence and more frequent cannabis use among boys, and autonomy and more frequent alcohol use among girls. CONCLUSION: The findings offer new evidence on the associations between positive mental health and substance use among youth, specifically how autonomy, competence and relatedness are associated with cannabis use, alcohol use and binge-drinking. This evidence can be used to inform health promotion and substance use prevention programs.

Risk factors for continuous distress over a 12-month period in newly diagnosed cancer outpatients.

This analysis examined demographic and medical factors associated with continuous distress in the year following cancer diagnosis. Patients completed the Distress Thermometer, Fatigue and Pain Thermometers, and anxiety and depression measures, at baseline, 3-, 6-, and 12 months. A total of 480 patients were grouped into three trajectories for distress, pain, fatigue, anxiety, and depression. Logistic regression analyses were conducted to determine risk factors associated with each symptom pattern. Females were more likely to report continuous distress. Predictors of the remaining outcomes included younger age; a diagnosis of head and neck, gastrointestinal, or prostate cancer; and receipt of chemotherapy and radiation therapy. By identifying risk factors for continuous distress, interventions can be implemented more efficiently and targeted to those who are at an elevated risk.