Parosmia Is Positively Associated With Problematic Drinking, as Is Phantosmia With Depressive Symptoms.

OBJECTIVES: Alcohol use disorder (AUD) is a global health problem with significant negative consequences, including preventable deaths. Although olfactory dysfunction is associated with chronic alcohol drinking, the relationship among specific types of olfactory deficits, depressive symptoms, and problematic drinking remains to be explored. Here, we examined the prevalence of olfactory distortion (parosmia) and hallucination (phantosmia) and assessed their associations with problematic drinking and depressive symptoms. METHODS: In April-June 2022, 250 participants across the spectrum of AUD were recruited for assessment in the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol study. Surveys covered self-reported olfactory function, depressive symptoms, and problematic drinking, with key measures assessed, including the Alcohol Use Disorders Identification Test and the Patient Health Questionnaire. Predictors in the analysis included parosmia and phantosmia, with covariates comprising age, sex, socioeconomic status, race, ethnicity, COVID-19 infection status, and smoking status. RESULTS: Among 250 individuals, 5.2% experienced parosmia and 4.4% reported phantosmia. Parosmia was associated with higher Alcohol Use Disorders Identification Test scores (ß = 7.14; 95% confidence interval = 3.31, 10.96; P < 0.001), whereas phantosmia was linked to higher Patient Health Questionnaire scores (ß = 3.32; 95% confidence interval = 0.22, 6.42; P = 0.03). These associations persisted in both the full sample and the subset of participants without COVID-19. CONCLUSIONS: Our study highlights strong existing links among olfactory deficits, problem drinking, and depressive symptoms, underscoring the need to assess smell impairments in clinical settings. Future research should explore these connections further to develop new treatments for individuals with AUD and depression.

From everyday life predictions to suicide prevention: Clinical and ethical considerations in suicide predictive analytic tools.

Advances in artificial intelligence and machine learning have fueled growing interest in the application of predictive analytics to identify high-risk suicidal patients. Such application will require the aggregation of large-scale, sensitive patient data to help inform complex and potentially stigmatizing health care decisions. This paper provides a description of how suicide prediction is uniquely difficult by comparing it to nonmedical (weather and traffic forecasting) and medical predictions (cancer and human immunodeficiency virus risk), followed by clinical and ethical challenges presented within a risk-benefit conceptual framework. Because the misidentification of suicide risk may be associated with unintended negative consequences, clinicians and policymakers need to carefully weigh the risks and benefits of using suicide predictive analytics across health care populations. Practical recommendations are provided to strengthen the protection of patient rights and enhance the clinical utility of suicide predictive analytics tools.

Sexual Minority Status and Adolescent Eating Behaviors, Physical Activity, and Weight Status.

INTRODUCTION: This study examined sexual orientation differences in eating behaviors, physical activity, and weight status among adolescents in the U.S. Moreover, this study tested whether parental and peer influences contribute to sexual orientation disparities in adolescent eating behaviors, physical activity, BMI, and examined disparities in weight misperception. METHODS: Cross-sectional data were from 1,926 adolescents who participated in the NEXT Generation Health Study in 2010-2011. Linear and multinomial logistic regressions conducted in 2017-2018 were used to test disparities and interactions with social influences. RESULTS: Relative to their heterosexual peers, sexual minority males and females consumed fruits and vegetables more frequently; sexual minority males engaged in less frequent physical activity; and sexual minority females were more likely to be overweight, perceive themselves as overweight, and to overestimate their weight. High parental expectation for physical activity was associated with more frequent vigorous physical activity among heterosexual adolescents, but less frequent vigorous physical activity among sexual minority males. Exercising with a same-sex peer buffered against the risk of higher BMI among sexual minority females. CONCLUSIONS: Parental and peer influences may serve as potential intervention targets to reduce disparities in weight-related behaviors. Longitudinal research is needed to understand the consequences of weight misperception among sexual minority females.

Prospective associations between cannabis use and negative and positive health and social measures among emerging adults.

BACKGROUND: In light of on-going policy changes related to cannabis use in the United States, it is important to examine possible associations between cannabis use and subsequent behaviors of public health interest. This study identified prospective associations between cannabis use during first-year post high-school and a wide range of positive and negative health and social measures one year later. METHODS: Data were from Waves 4 (Time 1; 1st year after high-school) and 5 (Time 2; one year later) of the NEXT Generation Health Study, a national sample of emerging adults in the United States (n = 1915; mean age = 20.2; 61% female). Multinomial logistic regressions adjusting for pertinent covariates were conducted to examine odds of substance use, nutrition, physical activity, sedentary behaviors, school performance, family relations, mental health, driving behaviors and health perceptions at Time 2. RESULTS: Compared with non-use, frequent use (20+ times in the past year) at Time 1 was associated with Time 2 negative health and social measures, including risky driving behaviors (AOR = 1.78, CI-1.45-2.19), depressive symptoms (AOR = 1.68, CI-1.43-1.98), unhealthy weight control behaviors (AOR = 1.55, CI-1.31-1.84), psycho-somatic symptoms (AOR = 1.55, CI-1.30-1.83), and low school achievement (AOR = 1.46, CI-1.23-1.75). Frequent users relative to non-users had a lower probability of being overweight and obese (AOR = 0.75, CI-0.60-0.92). Regarding positive measures frequent users relative to non-users had a higher probability of meeting recommendation of physical activity (AOR = 1.28, CI-1.09-1.51), but a lower probability of consuming fruits and vegetables (AOR = 0.82, CI-0.70-0.96) or attending college/university (AOR = 0.57, CI-0.44-0.75). FINDINGS: on occasional cannabis use (1-19 times in the past year) were more similar to frequent cannabis use for negative than positive health and social measures. CONCLUSION: Results demonstrate complex prospective patterns in which significant prospective associations with most adverse measures were found for both occasional and frequent users, and with few significant associations of positive health measures mostly among occasional cannabis users.

Personal Income and Substance Use among Emerging Adults in the United States.

BACKGROUND: Taxation and other policy measures have been implemented across the United States to curb the accessibility of substance use, especially among youth. While the inverse relationship between price and youth consumption is well known, available research on youth earned income and substance use is sparser, particularly among emerging adults. OBJECTIVES: We examined the association between emerging adult past-year personal income and 30-day substance use. METHODS: We analyzed data from Wave 5 (n = 2,202) of the NEXT Generation Health Study, an annual survey study administered to a nationally representative sample of emerging adults in the U.S. Wave 5 (mean age = 20.28 years, SE = 0.02 years) was administered during the 2013-2014 academic year. After grouping participants into five levels of self-reported, pre-tax personal income, we used binomial logistic regression to examine the association between personal income and cigarette smoking, marijuana use, alcohol use, and heavy episodic drinking (HED). RESULTS: In unadjusted models, those at certain levels of higher past-year income were more likely to smoke cigarettes, consume alcohol, or engage in HED at least once in the past 30 days. Several associations remained significant after controlling for covariates. Most associations were no longer significant after including perceived peer norms as additional covariates. Personal income was not associated with 30-day marijuana use in unadjusted or adjusted models. Conclusions/Importance: Higher earned income may provide emerging adults greater economic access to cigarettes and alcohol, but the association might be partly attenuated by social factors, particularly perceived peer norms.

Testing the Amotivational Syndrome: Marijuana Use Longitudinally Predicts Lower Self-Efficacy Even After Controlling for Demographics, Personality, and Alcohol and Cigarette Use.

The marijuana amotivational syndrome posits that cannabis use fosters apathy through the depletion of motivation-based constructs such as self-efficacy. The current study pursued a two-round design to rule out concomitant risk factors responsible for the connection from marijuana intake to lower general self-efficacy. College students (N = 505) completed measures of marijuana use, demographics (age, gender, and race), personality (extraversion, agreeableness, conscientiousness, openness, and neuroticism), other substance use (alcohol and tobacco), and general self-efficacy (initiative, effort, and persistence) in two assessments separated by a month. Hierarchical regression models found that marijuana use forecasted lower initiative and persistence, even after statistically ruling out 13 pertinent baseline covariates including demographics, personality traits, alcohol use, tobacco use, and self-efficacy subscales. A cross-lagged panel model involving initiative, effort, persistence, alcohol use, cigarette use, and marijuana use sought to unravel the temporal precedence of processes. Results showed that only marijuana (but not alcohol or tobacco) intake significantly and longitudinally prompted lower initiative and persistence. Furthermore, in the same model, the opposite temporal direction of events from lower general self-efficacy subscales to marijuana use was untenable. Findings provide partial support for the marijuana amotivational syndrome, underscore marijuana as a risk factor for decreased general self-efficacy, and offer implications and insights for marijuana prevention and future research.

Sexual Orientation Differences in Adolescent Health Care Access and Health-Promoting Physician Advice.

PURPOSE: Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors. METHODS: Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice. RESULTS: Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49). CONCLUSIONS: Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males.

The co-occurrence of substance use and bullying behaviors among U.S. adolescents: understanding demographic characteristics and social influences.

This study examined the co-occurrence of subtypes of substance use and bullying behaviors using latent class analysis and evaluated latent class differences in demographic characteristics, peer and parental influences. Self-reported questionnaire data were collected from a nationally representative sample (N = 7508) of 6-10th grade adolescents in the United States. Four latent classes were identified: the non-involved (57.7%), substance users (19.4%), bullies (17.5%), and substance-using bullies (5.4%). Older and Hispanic adolescents were more likely to be substance users and substance-using bullies, whereas younger and African American adolescents were more likely to be bullies. Females were more likely to be substance users, whereas males were more likely to be bullies and substance-using bullies. Spending more evenings with peers posed greater risks for substance use, bullying, and the co-occurrence of both problem behaviors. Paternal knowledge exerted protective effects over-and-above the effects of maternal knowledge. Implications for prevention and intervention efforts are discussed.

Moderation of gender on smoking and depression in Chinese Americans.

This study examined the moderating role of gender in the association between smoking status and depression in a nationwide convenience sample of Chinese American current, former, and never smokers (N=1393). Participants were recruited in smoker-supporter dyads. Multilevel modeling was used to take into account the dyadic nature of the data. Depressive symptoms were measured by a 10-item CES-D (Center of Epidemiological Studies-Depression Scale). Results showed significant effects of smoking status by gender interaction and smoking status on depression after adjusting for acculturation and social support. Among Chinese females, current smokers reported elevated depression level than both former and never smokers. Among Chinese males, current smokers reported more depressive symptoms when compared to former smokers only. Chinese females reported higher depression level than males among current smokers; no gender difference in depression was observed among former or never smokers. The association between smoking and depression is moderated by gender among Chinese Americans where substantial gender difference in smoking prevalence exists. Findings highlight the importance of addressing depression in treating tobacco use among Chinese American smokers, especially among females.

Bullying victimization and substance use among U.S. adolescents: mediation by depression.

This study examined the link between bullying victimization and substance use and tested the mediating role of depression in male and female adolescents. Cross-sectional data were collected from a national sample of 1,495 tenth graders who participated in the 2005/06 Health Behaviors in School-aged Children U.S. Survey. Victimization, depression and substance use were all measured as latent variables. Substance use was measured by drinking alcohol, being drunk, smoking cigarettes and using marijuana in the past 30 days. Multiple-group structural equation modeling showed that victimization was linked to substance use in both males and females. Among females, depression was positively associated with both victimization and substance use and mediated the association between the two latter variables. Among males, depression was associated with victimization but not with substance use. Results highlight the elevated risk for victimization and substance use problems that depression poses among adolescent females.

Parent-child communication and substance use among adolescents: do father and mother communication play a different role for sons and daughters?

The purpose of this study was to investigate gender-specific variations in the associations between communication with father and mother, cigarette smoking, alcohol drinking and marijuana use in male and female adolescents. Cross-sectional data were collected from a national sample of 1308 tenth graders who participated in the 2005/06 U.S. HBSC. Outcome variables were self-reported substances used in the past 30 days. Logistic regression analyses controlling for race/ethnicity, family structure and socioeconomic status showed that the association of mother and father communication with adolescent substance use varied by substance and gender. Among sons, father communication was protective against marijuana use and mother communication was protective against smoking. Neither father nor mother communication was protective against substance use by daughters. Research is needed to understand gender-specific differences in correlates of adolescent substance use and the implications for prevention and intervention.

Socio-demographic variability in adolescent substance use: mediation by parents and peers.

The current study examined socio-demographic variability in adolescent substance use and the mediating roles of maternal knowledge, paternal knowledge and peer substance use. The data were obtained from the United States records (N = 8,795) of the Health Behavior in School-Aged Children 2005/2006 Survey, in grades 6 through 10. The analyses employed multiple indicator multiple cause and structural equation models. Adolescent substance use was measured by frequencies of alcohol use, being drunk, and cigarette and marijuana use in the past month. Peer influence had a direct influence on adolescent substance use. Maternal knowledge had both direct and indirect influences on adolescent substance use through its negative association with substance-using peers, whereas paternal knowledge only had an indirect influence. Parental knowledge and peer substance use totally mediated differences in adolescent substance use by grade; differences between Caucasian and African-American or Hispanic adolescents; and differences between adolescents from two-parent families and those from single-mother, single-father or mother-stepfather families. Parental knowledge and peer substance were important mediators which largely accounted for variability in the prevalence of adolescent substance use by grade, race/ethnicity, and family structure.