Socioeconomic status, alcohol use and the role of social support and neighbourhood environment among individuals meeting criteria for a mental health problem: a cross-sectional study.

PURPOSE: Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment. METHODS: A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment. RESULTS: A four-class model of SES was best-fitting; "economically inactive,GCSE-level and lower educated,social renters", "intermediate/routine occupation,GCSE-level educated,mixed owner/renters", "retired, no formal education,homeowners", and "professional occupation,degree-level educated,homeowners". Compared to "professional occupation,degree-level educated, homeowners", SES classes were more likely to be non-drinkers; odds were highest for "economically inactive,GCSE-level and lower educated,social renters" (OR = 4.96,95%CI 3.10-7.93). "Retired, no formal education,homeowners" were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20-0.59). Associations between "economically inactive,GCSE-level and lower educated,social renters" and "retired, no formal education,homeowners" and non- and harmful drinking via social support and neighbourhood environment were significant. CONCLUSIONS: In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.

Understanding alcohol use and changes in drinking habits among people with a severe mental illness: a qualitative framework analysis study.

Introduction: Individuals with a severe mental illness (SMI) are more likely to drink at harmful levels or abstain. While it is known that drinking patterns change over time, the reasons for this among those with a SMI are unclear. This study aimed to (i) explore the experiences with alcohol, particularly in relation to mental health symptoms, and (ii) how drinking patterns have changed over time, among individuals who have a SMI diagnosis, who either currently drink alcohol or no longer drink. Methods: One-to-one semi-structured telephone interviews were conducted to address the study aims. Current drinkers' alcohol use was assessed using the Alcohol Use Disorder Identification Test. A framework analysis was used to address the study aims with a specific focus on the differences in the experiences with alcohol use between current and former drinkers. Results: 16 participants were interviewed, and five themes were developed. The analysis highlighted how alcohol was increasingly used to cope with (i) trauma, (ii) SMI-related symptoms, or (iii) stress. Among those with a SMI, non-drinking was facilitated through declines in SMI-related symptoms, previous negative consequences due to alcohol and changing the social environment. Current drinking habits were facilitated through changes in the reasons for drinking and adopting different alcohol moderation techniques. Discussion: Among those with a SMI diagnosis and who either currently drink alcohol or no longer drink, our findings support the self-medication hypothesis and drinking motives model. However, our findings indicate the need for further development of drinking to cope with a focus on symptoms of a SMI and trauma. Our findings also have implications on specialist alcohol and mental health services, the need to improve individuals' understanding of SMI, and the need to identify reasons for drinking among those with a recent diagnosis of a SMI.

A comparison of probable post-traumatic stress disorder and alcohol consumption among active female members of the UK Police Service and UK Armed Forces.

BACKGROUND: The British Police Service and Armed Forces are male-dominated occupations, characterised by frequent trauma exposure and intensive demands. Female police employees and military personnel may have unique experiences and face additional strains to their male counterparts. This analysis compared the levels of post-traumatic stress disorder (PTSD), hazardous/harmful alcohol consumption, and comorbidity in female police employees and military personnel. METHODS: Police data were obtained from the Airwave Health Monitoring Study (N = 14,145; 2007-2015) and military data from the Health and Wellbeing Cohort Study (N = 928; phase 2: 2007-2009 and phase 3: 2014-2016). Multinomial/logistic regressions analysed sample differences in probable PTSD, hazardous (14-35 units per week) and harmful (35 + units per week) alcohol consumption, and comorbid problems. We compared covariate adjustment and entropy balancing (reweighting method controlling for the same covariates) approaches. RESULTS: There were no significant differences in probable PTSD (police: 3.74% vs military: 4.47%) or hazardous drinking (police: 19.20% vs military: 16.32%). Female military personnel showed significantly higher levels of harmful drinking (4.71%) than police employees (2.42%; Adjusted Odds Ratios [AOR] = 2.26, 95% Confidence Intervals [CIs] = 1.60-3.21), and comorbidity (1.87%) than police employees (1.00%, AOR = 2.07, 95% CI = 1.21-3.54). Entropy balancing and covariate-adjustments obtained the same results. CONCLUSIONS: Comparable levels of probable PTSD were observed, which are slightly lower than estimates observed in the female general population. Future research should explore the reasons for this. However, female military personnel showed higher levels of harmful drinking than police employees, emphasising the need for alcohol interventions in military settings.

Living with Drug Use and Addiction during the COVID-19 Pandemic.

Objectives: The present study aimed to investigate the lived experience of drug use and addiction during the COVID-19 pandemic. Methods: We analyzed 100 online forum (Reddit) posts discussing personal experiences of people who use drugs (PWUD) during the COVID-19 pandemic. Data were analyzed using inductive thematic analysis. Results: Seven themes were identified from the data: (i) Access to Illicit Drugs, (ii) Access and Adherence to Prescription Drugs and Treatment, (iii) Pandemic Specific Stressors, (iv) Boredom and Lack of Responsibility, (v) Disruption to Coping Strategies, (vi) Limited Formal Support, and (vii) Lockdown as an Opportunity. Conclusions: COVID-19 has had a considerable impact on PWUD, affecting their access to illicit and prescription drugs and exposing them to triggers such as stress and boredom. Though the pandemic negatively impacted on existing coping strategies and access to formal support services, a minority of PWUD viewed lockdown and quarantine as an opportunity to lower or stop their substance use.

A latent class analysis of health risk behaviours in the UK Police Service and their associations with mental health and job strain.

BACKGROUND: Health risk behaviours (e.g., harmful drinking and smoking) often cluster together and can be associated with poor mental health and stress. This study examined how health risk behaviours cluster together in individuals in a high stress occupation (UK Police Service), and the associations with mental health and job strain. METHODS: Data was obtained from the Airwave Health Monitoring Study (25,234 male and 14,989 female police employees), which included measures of health risk behaviours (alcohol use, diet, smoking status, physical activity), poor mental health (depression, anxiety, post-traumatic stress disorder [PTSD]), and job strain (low, high, active, passive). Classes of health risk behaviours were identified using Latent Class Analysis (LCA) and the associations with mental health and job strain were analysed through multinomial logistic regressions. RESULTS: For men and women, a 5-class solution was the best fit. Men and women with depression, anxiety, and/or PTSD (analysed as separate variables) had at least double the odds of being assigned to the "high health risk behaviours" class, compared to those with no mental health problem. Compared to those reporting low strain, men and women reporting high strain had increased odds of being assigned to the "low risk drinkers with other health risk behaviours" classes. CONCLUSIONS: These finding highlight the importance of holistic interventions which target co-occurring health risk behaviours, to prevent more adverse physical health consequences. Police employees with poor mental health are more likely to engage in multiple health risk behaviours, which suggests they may need additional support. However, as the data was cross-sectional, the temporal associations between the classes and mental health or job strain could not be determined.

"Drinkers Like Me": A Thematic Analysis of Comments Responding to an Online Article About Moderating Alcohol Consumption.

Background: There has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles' article, this study aimed to explore (i) posters' (someone who has posted a comment in response to the article) attitudes or beliefs toward moderating alcohol and (ii) posters' experiences of moderating or abstaining from alcohol. Method: A secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. Main outcome measures: Comments (n = 784) in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used. Results: For aim one, two themes were developed; "general attitudes toward drinking" and "general attitudes toward reducing consumption". These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: "moderation vs. abstention", "reflection on past drinking behaviours", and "current drinking behaviours". These themes represent posters' experiences and implications changing their drinking habits. Conclusion: Our analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives.

Does smoking cause lower educational attainment and general cognitive ability? Triangulation of causal evidence using multiple study designs.

BACKGROUND: Observational studies have found associations between smoking and both poorer cognitive ability and lower educational attainment; however, evaluating causality is challenging. We used two complementary methods to explore this. METHODS: We conducted observational analyses of up to 12 004 participants in a cohort study (Study One) and Mendelian randomisation (MR) analyses using summary and cohort data (Study Two). Outcome measures were cognitive ability at age 15 and educational attainment at age 16 (Study One), and educational attainment and fluid intelligence (Study Two). RESULTS: Study One: heaviness of smoking at age 15 was associated with lower cognitive ability at age 15 and lower educational attainment at age 16. Adjustment for potential confounders partially attenuated findings (e.g. fully adjusted cognitive ability ß -0.736, 95% CI -1.238 to -0.233, p = 0.004; fully adjusted educational attainment ß -1.254, 95% CI -1.597 to -0.911, p < 0.001). Study Two: MR indicated that both smoking initiation and lifetime smoking predict lower educational attainment (e.g. smoking initiation to educational attainment inverse-variance weighted MR ß -0.197, 95% CI -0.223 to -0.171, p = 1.78 × 10-49). Educational attainment results were robust to sensitivity analyses, while analyses of general cognitive ability were less so. CONCLUSION: We find some evidence of a causal effect of smoking on lower educational attainment, but not cognitive ability. Triangulation of evidence across observational and MR methods is a strength, but the genetic variants associated with smoking initiation may be pleiotropic, suggesting caution in interpreting these results. The nature of this pleiotropy warrants further study.

Examining pathways between genetic liability for schizophrenia and patterns of tobacco and cannabis use in adolescence.

BACKGROUND: It is not clear to what extent associations between schizophrenia, cannabis use and cigarette use are due to a shared genetic etiology. We, therefore, examined whether schizophrenia genetic risk associates with longitudinal patterns of cigarette and cannabis use in adolescence and mediating pathways for any association to inform potential reduction strategies. METHODS: Associations between schizophrenia polygenic scores and longitudinal latent classes of cigarette and cannabis use from ages 14 to 19 years were investigated in up to 3925 individuals in the Avon Longitudinal Study of Parents and Children. Mediation models were estimated to assess the potential mediating effects of a range of cognitive, emotional, and behavioral phenotypes. RESULTS: The schizophrenia polygenic score, based on single nucleotide polymorphisms meeting a training-set p threshold of 0.05, was associated with late-onset cannabis use (OR = 1.23; 95% CI = 1.08,1.41), but not with cigarette or early-onset cannabis use classes. This association was not mediated through lower IQ, victimization, emotional difficulties, antisocial behavior, impulsivity, or poorer social relationships during childhood. Sensitivity analyses adjusting for genetic liability to cannabis or cigarette use, using polygenic scores excluding the CHRNA5-A3-B4 gene cluster, or basing scores on a 0.5 training-set p threshold, provided results consistent with our main analyses. CONCLUSIONS: Our study provides evidence that genetic risk for schizophrenia is associated with patterns of cannabis use during adolescence. Investigation of pathways other than the cognitive, emotional, and behavioral phenotypes examined here is required to identify modifiable targets to reduce the public health burden of cannabis use in the population.

Associations of common mental disorder with alcohol use in the adult general population: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Research has shown that alcohol use and common mental disorders (CMDs) co-occur; however, little is known about how the global prevalence of alcohol use compares across different CMDs. We aimed to (i) report global associations of alcohol use (alcohol use disorder (AUD), binge drinking and consumption) comparing those with and without a CMD, (ii) examine how this differed among those with and without specific types of CMDs and (iii) examine how results may differ by study characteristics. METHODS: We used a systematic review and meta-analysis. Cross-sectional, cohort, prospective, longitudinal and case-control studies reporting the prevalence of alcohol use among those with and without a CMD in the general population were identified using PsycINFO, MEDLINE, PsyARTICLES, PubMed, Scopus and Web of Science until March 2020. Depression, anxiety and phobia were included as a CMD. Studies were included if they used a standardized measure of alcohol use. A random-effects meta-analysis was conducted to generate pooled prevalence and associations of AUD with CMD with 95% confidence intervals (CI). A narrative review is provided for binge drinking and alcohol consumption RESULTS: A total of 512 full-texts were reviewed, 51 included in our final review and 17 in our meta-analyses (n = 382 201). Individuals with a CMD had a twofold increase in the odds of reporting an AUD [odds ratio (OR) = 2.02, 95% CI = 1.72-2.36]. The odds of having an AUD were similar when stratified by the type of CMD (mood disorder: OR = 2.00, 95% CI = 1.62-2.47; anxiety/phobic disorder: OR = 1.94, 95% CI = 1.35-2.78). An analysis of study characteristics did not reveal any clear explanations for between-study heterogeneity (I2 > 80%). There were no clear patterns for associations between having a CMD and binge drinking or alcohol consumption, respectively. CONCLUSIONS: People with common mental disorders (depression, anxiety, phobia) are twice as likely to report an alcohol use disorder than people without common mental disorders.

The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use.

BACKGROUND: The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. METHODS: A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. RESULTS: The expert-based consensus agreed upon a three-layered hierarchical framework. Each layer-universal measures, detailed self-report and biological measures-reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. CONCLUSIONS: Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.

Menstrual Cycle Phase, Hormonal Contraception, and Alcohol Consumption in Premenopausal Females: A Systematic Review.

Women may be particularly vulnerable to alcohol harm, but many current theories fail to acknowledge the unique factors that influence female alcohol use. The biological mechanisms underlying female alcohol consumption have largely been unexplored, although recently the menstrual cycle has been highlighted as a potentially important factor. This systematic review, using a narrative synthesis, examined the association between the menstrual cycle phases on alcohol consumption and aimed to determine whether hormonal contraception influences this association. The review follows PRISMA and SWiM guidelines, registration number: CRD42018112744. Electronic searches were conducted in the relevant databases with keyword (e.g., "menstrua*"; "alcohol"). Thousand six hundred and sixty-two titles were identified, 16 of which were included in the review. Results were inconsistent regarding whether an association between menstrual cycle phase and alcohol consumption was found. Furthermore, there was inconsistency regarding which phase was associated with higher consumption, and different factors were reported to have moderated the direction, e.g., family history of alcohol use disorder (AUD), premenstrual syndrome (PMS). These conflicting results may be partly explained by variability in both study quality and design, and differences in measurement of cycle phase and alcohol consumption. More robust research is needed before conclusions can be drawn with regard to the role of the menstrual cycle and hormonal contraception on female drinking behavior. This review provides recommendations to strengthen research in this area.

Investigating the DNA methylation profile of e-cigarette use.

BACKGROUND: Little evidence exists on the health effects of e-cigarette use. DNA methylation may serve as a biomarker for exposure and could be predictive of future health risk. We aimed to investigate the DNA methylation profile of e-cigarette use. RESULTS: Among 117 smokers, 117 non-smokers and 116 non-smoking vapers, we evaluated associations between e-cigarette use and epigenome-wide methylation from saliva. DNA methylation at 7 cytosine-phosphate-guanine sites (CpGs) was associated with e-cigarette use at p < 1 × 10-5 and none at p < 5.91 × 10-8. 13 CpGs were associated with smoking at p < 1 × 10-5 and one at p < 5.91 × 10-8. CpGs associated with e-cigarette use were largely distinct from those associated with smoking. There was strong enrichment of known smoking-related CpGs in the smokers but not the vapers. We also tested associations between e-cigarette use and methylation scores known to predict smoking and biological ageing. Methylation scores for smoking and biological ageing were similar between vapers and non-smokers. Higher levels of all smoking scores and a biological ageing score (GrimAge) were observed in smokers. A methylation score for e-cigarette use showed poor prediction internally (AUC 0.55, 0.41-0.69) and externally (AUC 0.57, 0.36-0.74) compared with a smoking score (AUCs 0.80) and was less able to discriminate lung squamous cell carcinoma from adjacent normal tissue (AUC 0.64, 0.52-0.76 versus AUC 0.73, 0.61-0.85). CONCLUSIONS: The DNA methylation profile for e-cigarette use is largely distinct from that of cigarette smoking, did not replicate in independent samples, and was unable to discriminate lung cancer from normal tissue. The extent to which methylation related to long-term e-cigarette use translates into chronic effects requires further investigation.

The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression.

BACKGROUND: Trauma exposure is associated with hazardous and/or harmful alcohol use. Occupational groups frequently exposed to trauma may be at risk of alcohol harm. This meta-analysis determined the prevalence of hazardous and harmful alcohol use across trauma-exposed occupations and meta-regressions explored the impact of pre-defined covariates on the variance in prevalence estimates. METHOD: Literature was searched from 2000 to March 2020, using Scopus, Web of Science and PsycINFO. Studies were included in the meta-analysis if they used a standardized measure of alcohol use (e.g., Alcohol Use Disorder Identification Test (AUDIT)). Studies were excluded if they measured alcohol use following an isolated sentinel event (e.g., 9/11). The following occupations were included: first responders, health care workers, Armed Forces, war journalists and train drivers. RESULTS: 1882 studies were identified; 55 studies were eligible. The pooled prevalence of hazardous use was 22% (95% Confidence Intervals [CI]: 17%-27%) and 11% (95% CI: 8%-14%) for harmful use. Hazardous alcohol use was significantly lower in health care workers (13%; 95% CI: 10%-16%) than first responders (26%; 95% CI: 20%-32%) and Armed Forces (34%; 95% CI: 18%-52%). There was marked heterogeneity across studies and higher prevalence rates in low-quality studies. The meta-regression identified higher proportion of males and younger mean age as predictors of variance. CONCLUSIONS: Male-dominated occupations, such as police officers and military personnel, showed higher levels of hazardous and harmful alcohol use, indicating that interventions tailored specifically for these occupational groups may be needed.

Longitudinal associations with alcohol consumption during the first COVID-19 lockdown: Associations with mood, drinking motives, context of drinking, and mental health.

BACKGROUND: Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown. METHODS: An online survey was distributed through social media (8th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was 'weekly unit consumption' and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety. FINDINGS: A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores). CONCLUSIONS: Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support.

Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study.

Background: British Armed Forces' and Police Forces' personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use. Objective: We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees. Methods: Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007-2015) (N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007-2009, phase 3: 2014-2016) (N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample). Results: Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions: It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.

Antecedentes: El personal de las fuerzas armadas británicas y de la policía británica está entrenado para operar en condiciones potencialmente traumáticas. Consecuentemente, pueden experimentar trastorno de estrés postraumático (TEPT), el cual es frecuentemente comórbido con uso nocivo de alcohol.Objetivo: Buscamos evaluar las proporciones, y asociaciones, del probable TEPT y del uso nocivo de alcohol en una muestra balanceada por covariables de personal masculino, militares y empleados de policía.Métodos: Las proporciones de probable TEPT, uso nocivo de alcohol y atracones diarios de alcohol, fueron exploradas utilizando datos del estudio Airwave Health Monitoring Study de la policía (2007-2015) (N=23,826) y del estudio militar Health and Wellbeing Cohort Study (fase 2: 2007-2009, fase 3: 2014-2016) (N=7,399). Se aplicaron pesos de balance de entropía a la muestra más grande, de policía, para hacerla comparable a la muestra militar en un rango de variables pre-especificadas (ej. año de recolección de datos, edad y logros educacionales). Los análisis multinomiales y de regresión logística determinaron diferencias muestrales en las variables de resultado, y en los factores asociados (estratificados por muestra).Resultados: Las proporciones de TEPT probable fueron similares en el personal militar y los empleados de policía (3,67% vs 3,95%), aunque el gran tamaño muestral hizo fuera significativo al límite (Razón de probabilidades ajustada (AOR): 0.84; Intervalo de Confianza (IC) de 95%: 0.72 a 0.99). Se encontraron claras diferencias en el uso nocivo de alcohol entre el personal militar, comparado a los empleados de policía (9,59% vs 2.87%; AOR: 2.79; IC 95%: 2.42 a 3.21). El consumo actual de tabaco, que fue más prevalente en el personal militar, se asoció a consumo nocivo de alcohol y a atracones de alcohol en ambas muestras, pero se asoció a TEPT sólo en el personal militar.Conclusiones: Generalmente se asume que ambos grupos tienen altas tasas de TEPT desde la exposición traumática, sin embargo, se observó una baja proporción de TEPT en ambas muestras, lo que probablemente refleja el efecto protector de la cohesión de unidad o la resiliencia. El mayor nivel de consumo nocivo de alcohol en el personal militar puede estar relacionado una cultura de consumo de alcohol más prominente o a experiencias operacionales únicas.

Associations Between Adolescent Mental Health and Health-Related Behaviors in 2005 and 2015: A Population Cross-Cohort Study.

PURPOSE: Adolescent mental ill-health is a growing concern. There is little understanding of changes over time in the associations between mental health and health-related behaviors and outcomes (such as substance use, antisocial behavior, and obesity). We investigate whether the associations between different health and health-related outcomes in adolescence are changing over time in two recent cohorts of adolescents born 10 years apart. METHODS: Data from two UK birth cohort studies, the Avon Longitudinal Study of Parents and Children (ALSPAC, born 1991-92, N = 5,627, 50.7% female) and Millennium Cohort Study (MCS, born 2000-2, N = 11,318, 50.6% female) at age 14 are analyzed. The health outcomes of focus are depressive symptoms, substance use (alcohol, smoking, cannabis, and other drugs), antisocial behaviors (assault, graffiti, vandalism, shoplifting and rowdy behavior), weight (body mass index [BMI]), weight perception (perceive self as overweight), and sexual activity (had sexual intercourse). Regression analyses are conducted to examine associations between these variables with cohort as a moderator to examine cohort differences. RESULTS: The directions of associations between mental-health and health-related behaviors (e.g., smoking) are similar over time; however, their strength across the distribution has changed. While smoking and alcohol use behaviors are decreasing in adolescents, those that endorse these behaviors in 2015 are more likely to have co-occurring mental ill-health than those born in 2005. Similarly, higher BMI is more strongly associated with depressive symptoms in 2015 compared to 2005. CONCLUSIONS: Adverse health-related outcomes such as greater substance use, mental health difficulties, and higher BMI appear to be more likely to cluster together in the more recent cohort, with implications for public health planning, service provision, and lifelong disease burden.

Mobile Technology Use and Its Association With Executive Functioning in Healthy Young Adults: A Systematic Review.

Introduction: Screen-based and mobile technology has grown at an unprecedented rate. However, little is understood about whether increased screen-use affects executive functioning (EF), the range of mental processes that aid goal attainment and facilitate the selection of appropriate behaviors. To examine this, a systematic review was conducted. Method: This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive literature search was conducted using Web of Science, MEDLINE, PsycINFO and Scopus databases to identify articles published between 2007 and March 2020, examining the use of mobile technologies on aspects of EF in healthy adults aged 18-35 years. In total 6079 articles were screened by title, and 39 screened by full text. Eight eligible papers were identified for inclusion. Our methods were pre-registered on the PROSPERO international prospective register of systematic reviews. Results: A total of 438 participants were included across the eight studies. Five of the eight studies examined more than one EF. Five studies measured inhibition, and four studies measured decision-making. Smartphone use was negatively associated with inhibition and decision-making. Working memory performance was found to be improved by increased time engaging in video games and by refraining from smartphone use prior to bedtime. Quality assessments indicated high risk of methodological biases across the studies and a low quality of evidence for determining the relationship between technology use and executive functioning. Conclusions: This review highlights the scarcity of the literature in this area. It presents a call for rigorous and objective research to further our understanding of the impact of mobile technology on different aspects of executive function.

Associations of alcohol use, mental health and socioeconomic status in England: Findings from a representative population survey.

BACKGROUND: Alcohol use and mental health problems often co-occur, however, little is known about how this varies by type of mental health problem and to what extent associations are explained by socioeconomic status (SES). Our study examined the prevalence and associations of non-drinking, hazardous use, and harmful/probable dependence in individuals who do and do not meet criteria for different mental health problems and whether associations remained after adjustment for SES. METHODS: A secondary analysis of an English dataset, 2014 Adult Psychiatric Morbidity Survey (N = 7,218), was conducted. The Alcohol Use Disorder Identification Test was used to categorise participants as non-drinking, low risk, hazardous use and harmful/probable dependence. Mental health problems were screened using a range of validated tools. Multinomial logistic regression analyses were used to address study aims. RESULTS: The prevalence of non-drinking, hazardous and harmful/probable dependence was higher among those meeting criteria for a mental health problem. After adjustment for SES, non-drinking was most common in those meeting criteria for probable psychotic disorder (MOR = 3.42, 95 %CI = 1.74-6.70), hazardous use in those meeting criteria for anti-social personality disorder (MOR = 2.66, 95 %CI = 1.69-4.20) and harmful/probable dependence in those meeting criteria for borderline personality disorder (MOR = 9.77, 95 % CI = 4.81-19.84). CONCLUSIONS: There were marked increases in the odds of reporting both non-drinking and harmful drinking among those meeting criteria for a mental health problem, particularly more severe problems. Our findings indicate that the relationship between alcohol and mental health is more complex and comorbid alcohol and mental health problems should be treated in parallel with access to both services.