Is the Association Between Alcohol Consumption and Mental Well-Being in University Students Linear, Curvilinear or Absent?

Background: Both alcohol consumption and mental well-being problems have been found to be prevalent in higher educated students and often have severe consequences. However, previous findings of the association between these constructs are mixed, possibly because often linear models are fitted, while some theories suggest a curvilinear association between the two concepts. Objectives: To clarify previously mixed findings, the current study compared curvilinear and linear models for the relationship between alcohol consumption and mental well-being in university students. Because of potential gender differences in this relationship, these models were explored for females and males separately. Data from the first cross-sectional online survey wave of the Healthy Student Life project including 2,631 female and 998 male students was used. The Alcohol Use Disorders Identification Test-consumption was used to measure alcohol consumption. Mental well-being was assessed by six sub-concepts (i.e., depressive symptoms, anxiety, stress, life satisfaction, happiness, and self-rated mental health). Results: For females both linear (for anxiety, life satisfaction, and self-rated mental health) and curvilinear (for depression, stress, and happiness) associations were found, while for males no support for either curvilinear or linear models was found. Conclusions: Results should be interpreted with caution due to the small effect sizes in the relationships for females but may suggest that testing the curvilinear association between alcohol consumption and mental well-being is an important future endeavor.

Prevalence and clustering of health behaviours and the association with socio-demographics and mental well-being in Dutch university students.

The college years represent a vulnerable period for developing health-risk behaviours (e.g., physical inactivity/unhealthy eating habits/substance use/problematic internet use/insufficient sleep). This study examined current health behaviour levels (RQ1), health behaviour classes (RQ2) and between-class differences in socio-demographics (RQ3) and mental well-being (RQ4) among Dutch university students (n = 3771). Participants (Mage = 22.7 (SD = 4.3); 71.2% female/27.3% male/1.5% other) completed an online survey (Oct-Nov 2021). Descriptive statistics (RQ1), Latent Class Analysis (RQ2), and Kruskal-Wallis/Chi-square tests (RQ3-4) were used. RQ1: Prevalence rates suggest that a subsequent proportion of the student sample engages in health-risk behaviours. RQ2: Four classes were identified: class 1 (n = 862) "Licit substance use health-risk group", class 2 (n = 435) "Illicit and licit substance use health-risk group", class 3 (n = 1876) "Health-protective group" and class 4 (n = 598) "Non-substance use health-risk group". RQ3: Class 1 represents relatively more international students and students in a steady relationship. Class 2 represents relatively more older/male/(pre-)master students and students living with roommates/in a steady relationship/with more financial difficulty. Class 3 represents relatively more younger/female students and students living with family/with lower Body Mass Index (BMI)/less financial difficulty. Class 4 represents relatively more younger/non-Western/international/bachelor students and students living with children/single/part of LGBTIQ+ community/with higher BMI. RQ4: Class 3 has significantly higher mental well-being while class 4 has significantly lower mental well-being, relative to the other classes. Above findings provide new insights which can help educational institutes and governments better understand the clustering of students' health behaviours and between-class differences in socio-demographics and mental well-being.

Can Maternal Prenatal Self-Reported and Physiological Distress Predict Postnatal Caregiving Practices?

Maternal prenatal distress is associated with child outcomes, including health, neurocognitive, and socio-emotional development. Knowledge on underlying mechanisms is limited, yet relevant for prevention and intervention. This study investigated whether maternal prenatal distress predicts specific caregiving practices that are known for their effects on child outcomes. Caregiving practices studied were maternal caregiving quality and the initiation and course of breastfeeding and room-sharing. We hypothesized that more maternal prenatal distress would be associated with altered caregiving practices. Participants were 174 healthy mother-child dyads. During the 37th week of pregnancy maternal self-reported distress was assessed using questionnaires, and physiological stress by collecting saliva cortisol. Maternal caregiving quality was observed in postnatal week 5 during infant bathing. Weekly diaries on breastfeeding and daily diaries on room-sharing were completed during the first 6 postnatal months. In a regression analysis, no associations between maternal prenatal distress and caregiving quality were found. Multilevel analyses indicated that maternal prenatal evening cortisol was positively related to the initiation of breastfeeding and room-sharing. Replications are warranted, but these results suggest that breastfeeding and room-sharing initiation may be part of a mechanism underlying links between maternal prenatal physiological stress and child outcomes. As other prenatal cortisol markers and self-reported distress were not found to be related to the caregiving practices, it is likely that alternative mechanisms (co-)exist in explaining links between maternal prenatal distress and child outcomes. Future replication research including child outcomes and (other) potential mechanisms will inform prevention and intervention programs fostering healthy pregnancies and child development.

Student-, Study- and COVID-19-Related Predictors of Students' Smoking, Binge Drinking and Cannabis Use before and during the Initial COVID-19 Lockdown in The Netherlands.

Tobacco, alcohol and cannabis are commonly used among university students. However, student lives and their substance use have changed dramatically since the start of the COVID-19 pandemic. This study investigated the impact of COVID-19 on (trends in) weekly smoking, weekly binge drinking and weekly cannabis use in Dutch university students and investigated associated student-, study- and COVID-19-related characteristics. Between April and June 2020, several Dutch higher educational institutes invited their students to participate in an online survey. Data of 9967 students (Mage = 22.0 (SD = 2.6); Nfemale = 7008 (70.3%)) were available for analyses. Overall, weekly smoking remained stable (±11.5%), weekly binge drinking decreased (from 27.8% to 13.9%) and weekly cannabis use increased (from 6.7% to 8.6%). Male gender, not living with parents, being a bachelor student, having less financial resources and less adherence to the COVID-19 measures were found to increase the risk of substance use (before/during the first COVID-19 lockdown). Additionally, male gender, not living with parents, being a bachelor student, not being born in the Netherlands and having a student loan contributed to the likelihood of increased substance use during COVID-19. Patterns of characteristics contributing to the likelihood of decreased weekly substance use during COVID-19 were less clear. The risk factors male gender, not living with parents and being a bachelor student do not only contribute to the likelihood of using substances but also contribute to the likelihood of increased use during a lockdown. Prevention and intervention programs should especially target these risk groups.

Maternal prenatal and early postnatal distress and child stress responses at age 6.

Individuals differ in their physiological and behavioral stress responses. Alterations in these responses have been associated with mental and physical health. Therefore, it is important to understand how stress responses develop. This study investigated whether in a healthy, non-risk population, 6-year-old's physiological (cortisol) and behavioral (gazing) stress responses were associated with stress early in the child's life, in the form of maternal prenatal and early postnatal distress. Additionally, associations between the two stress responses were studied. At age 6, children (n = 149; Mage = 6.09; 70 girls) in a longitudinal project that started prenatally (n = 193), participated in a social evaluative stress test (Children's Reactions to Evaluation Stress Test, CREST) in front of a judge. To operationalize physiological stress responses six cortisol saliva samples were collected and cortisol stress reactivity and total stress cortisol scores were calculated. To operationalize behavioral stress responses, gazing at the judge during the stress test was observed. Maternal prenatal distress (week 37) was measured using questionnaires and physiological measures, that is, cortisol saliva samples. Early postnatal maternal distress (first 6 months) was measured using questionnaires. Results of hierarchical regression analyses indicated that less maternal prenatal fear of giving birth, higher maternal prenatal evening cortisol concentrations, and more maternal feelings of anxiety in the first 6 postnatal months were all uniquely associated with higher total stress cortisol concentrations in children at age 6. Additionally, correlations indicated that children with higher cortisol stress reactivity gazed less in the direction of the judge. Results indicate that maternal prenatal and early postnatal distress are associated with children's later hypothalamic-pituitary-adrenal-axis functioning and that in children gazing and physiological stress reactivity are related. Lay summary We examined whether maternal stress and anxiety during pregnancy, as measured by means of maternal self-reports and saliva cortisol samples, as well as maternal stress and anxiety in the first 6 months of the child's life, measured using maternal self-reports, were associated with children's physiological (cortisol) and behavioral (gazing) responses during a stressful laboratory situation at the age of 6. Results showed that mothers with higher levels of distress in late pregnancy and/or the early postnatal period had children with higher cortisol concentrations during the stressful situation. This suggests that maternal prenatal and early postnatal distress are associated with children's later hypothalamic-pituitary-adrenal-axis functioning.

Cortisol stress responses and children's behavioral functioning at school.

The present study investigated whether cortisol stress responses of 6-year-olds were associated with their behavioral functioning at school. Additionally, the moderating role of stress in the family environment was examined. To this end, 149 healthy children (Mage = 6.09 years; 70 girls) participated in an age-appropriate innovative social evaluative stress test. Saliva cortisol samples were collected six times during the stress test to calculate two indices of the cortisol stress response: cortisol stress reactivity and total stress cortisol. Teachers assessed children's internalizing, externalizing, and prosocial behaviors. Stress in the family environment was operationalized as maternally reported parenting stress. Results indicated a significant increase in cortisol concentrations in response to the stressor. No significant associations were found between cortisol stress responses and behavioral functioning at school and there was no evidence for moderation by maternal parenting stress. Potential theoretical and methodological explanations for these results are discussed.

Associations between circadian and stress response cortisol in children.

Hypothalamic-pituitary-adrenal (HPA) axis functioning is characterized by the baseline production of cortisol following a circadian rhythm, as well as by the superimposed production of cortisol in response to a stressor. However, it is relatively unknown whether the basal cortisol circadian rhythm is associated with the cortisol stress response in children. Since alterations in cortisol stress responses have been associated with mental and physical health, this study investigated whether the cortisol circadian rhythm is associated with cortisol stress responses in 6-year-old children. To this end, 149 normally developing children (Mage = 6.09 years; 70 girls) participated in an innovative social evaluative stress test that effectively provoked increases in cortisol. To determine the cortisol stress response, six cortisol saliva samples were collected and two cortisol stress response indices were calculated: total stress cortisol and cortisol stress reactivity. To determine children's cortisol circadian rhythm eight cortisol circadian samples were collected during two days. Total diurnal cortisol and diurnal cortisol decline scores were calculated as indices of the cortisol circadian rhythm. Hierarchical regression analyses indicated that higher total diurnal cortisol as well as a smaller diurnal cortisol decline, were both uniquely associated with higher total stress cortisol. No associations were found between the cortisol circadian rhythm indices and cortisol stress reactivity. Possible explanations for the patterns found are links with children's self-regulatory capacities and parenting quality.

Development of the cortisol circadian rhythm in the light of stress early in life.

The secretion of the stress hormone cortisol follows a diurnal circadian rhythm. There are indications that this rhythm is affected by stress early in life. This paper addresses the development of the cortisol circadian rhythm between 1 and 6 years of age, and the role of maternal stress and anxiety early in the child's life on this (developing) rhythm. Participants were 193 healthy mother-child dyads from a community sample. Self-reported maternal stress and anxiety and physiological stress (saliva cortisol), were assessed prenatally (gestational week 37). Postnatally, self-reported maternal stress and anxiety were measured at 3, 6, 12, 30, and 72 months. Saliva cortisol samples from the children were collected on two days (four times each day) at 12, 30, and 72 months of age. The total amount of cortisol during the day and the cortisol decline over the day were determined to indicate children's cortisol circadian rhythm. Multilevel analyses showed that the total amount of cortisol decreased between 1 and 6 years. Furthermore, more maternal pregnancy-specific stress was related to higher total amounts of cortisol in the child. Higher levels of early postnatal maternal anxiety were associated with flatter cortisol declines in children. Higher levels of early postnatal maternal daily hassles were associated with steeper child cortisol declines over the day. These results indicated developmental change in children's cortisol secretion from 1 to 6 years and associations between maternal stress and anxiety early in children's lives and children's cortisol circadian rhythm in early childhood.