Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study.

PURPOSE: Despite a large number of studies on the relation between cannabis use and mental distress in adolescence, results are inconclusive regarding the nature of this association. The aim of the present study is to expand this body of research by analyzing the within-person association between changes in cannabis use and changes in mental distress among young people. METHODS: We used longitudinal data from a national sample of young people in Norway. The cohort was assessed in 1992 (T1), 1994 (T2), 1999 (T3), and 2005 (T4). The cumulative response rate was 60%. Respondents who participated in all four waves, aged 11-18 years at T1 (N = 1,988) were analyzed. Within-person association between changes in cannabis use and changes in mental distress in terms of symptoms of depression, anxiety, suicidal ideation, and deliberate self-harm were estimated by applying fixed-effects modeling. RESULTS: For males, an increase in cannabis use from no use to more than 10 times/year was significantly associated with increased risk for anxiety (relative risk [RR]: 1.72, p = .009), depressed mood (RR: 1.49, p < .001), and suicidal ideation (RR: 3.43, p = .012). For females, the corresponding increase in cannabis use yielded an increased risk for anxiety (RR: 1.38, p = .023) and suicidal ideation (RR: 2.47, p = .002). DISCUSSION: Increased cannabis use during adolescence and young adulthood seem to increase the risk for symptoms of mental distress. Although the associations appear to be more pronounced among males, it was only for depression that there was a statistically significant gender difference in the association.

An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT). A prison population study.

Background: The eleven-item Drug Use Disorder Identification Test (DUDIT) is a recommended screening tool, but its length may impede its use in prison intake assessments. Hence, we examined the performance of eight brief DUDIT screeners against the full DUDIT, employing a sample of male inmates. Methods: Our study included male participants in the Norwegian Offender Mental Health and Addiction (NorMA) study who reported pre-prison drug use and who had been incarcerated three months or less (n = 251). We performed receiver operating characteristic curve (ROC) analyses and estimated the area under the curve (AUROC) to assess the performance of DUDIT-C (four drug consumption items) and five-item versions that consisted of DUDIT-C and one additional item. Results: Almost all (95%) screened positive on the full DUDIT (scores ≥6) and 35% had scores that were indicative of drug dependence (scores ≥25). The DUDIT-C performed very well in detecting likely dependence (AUROC=0.950), but some of the five-item versions performed significantly better. Of these, the DUDIT-C + item 5 (craving) had the highest AUROC (0.097). A cut-point of ≥9 on the DUDIT-C and ≥11 on the DUDIT-C + item 5 identified virtually all (98% and 97%, respectively) cases of likely dependence, with a specificity of 73% and 83%, respectively. At these cut-points, the occurrence of false positives was modest (15% and 10%, respectively) and only 4-5% were false negatives. Conclusions: The DUDIT-C was highly effective in detecting likely drug dependence (according to the full DUDIT), but some combinations of DUDIT-C and one additional item performed better.

Less adolescent alcohol and cannabis use: More deviant user groups?

INTRODUCTION AND AIMS: Adolescent drinking and cannabis use in Norway declined in the 2000s, and we tested the assumption that psychosocial problems were more strongly related to substance use when the prevalence was quite low (2012/2013) than when it was considerably higher (2002). DESIGN AND METHODS: Data stemmed from school surveys of almost 20 000 students aged 14-17 years in 2002 and 2012/2013 in the four largest cities in Norway. We assessed how various deviant behaviours and depressive mood were related to past-year measures on any alcohol intoxication, frequent intoxication (6+ times) and any cannabis use, and tested whether the associations varied significantly by survey year. RESULTS: The prevalence of any intoxication episodes dropped markedly from 2002 (50%) to 2012/2013 (28%), as did the prevalence of frequent intoxication (29% vs. 10%) and any cannabis use (15% vs. 7%). Deviant behaviours and depressive mood were either more closely related to the drinking outcomes in 2012/2013 than in 2002, or the associations showed no temporal change. None of the associations with cannabis use varied significantly by survey year. DISCUSSION AND CONCLUSION: The assumption that psychosocial problems correlated more strongly with alcohol and cannabis use in a low-prevalence period (2012/2013) as compared to a high-prevalence period (2002) was partly supported, but only with respect to drinking. The strength of the associations with cannabis use was stable, which may reflect that the proportion reporting any use of the drug was low even in the relatively 'high-prevalence' period.

Alcohol Problems among Prisoners: Subgroup Variations, Concurrent Drug Problems, and Treatment Needs.

BACKGROUND/AIMS: Alcohol problems in the prison population are understudied, underdetected, and undertreated. Our aims were to identify subgroups of inmates whose pre-prison drinking behavior indicated a high need for alcohol-related interventions, to assess the prevalence of concurrent alcohol and drug problems, and to compare dual-dependent inmates and those who were alcohol-dependent alone with respect to the severity of their drinking problems. METHODS: Data stemmed from the nationwide Norwegian Offender Mental Health and Addiction (NorMA) study. Both male (n = 1,356) and female (n = 90) inmates took part in the study, representing about 40% of the prison population in Norway at the time of the data collection (2013-2014). Pre-prison substance use problems were assessed using the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT). RESULTS: A majority (55%) had an AUDIT positive screen (score ≥8), which is indicative of alcohol problems of some severity, and 18% were possible alcohol-dependent (score ≥20). A positive screen was associated with younger age, lower education, violent offending, driving while intoxicated (DWI), and previous criminal convictions. Two-thirds (68%) of those who screened positive on the AUDIT had also a DUDIT positive screen (score ≥6), and a similar overlap between possible alcohol dependence and possible drug dependence (score ≥25) was observed. Inmates with possible dual dependence (12% of all) had higher mean scores on the AUDIT than those with possible alcohol dependence only (7% of all). CONCLUSIONS: More than half of the prisoners in Norway had AUDIT scores that indicated they could benefit from alcohol-related interventions, and the prevalence was elevated in younger, less educated groups of previously convicted DWI, and violent offenders. Alcohol problems were most often combined with drug problems, and possible dual dependence was associated with particularly severe drinking problems.

Decline in adolescent drinking: Some possible explanations.

INTRODUCTION AND AIMS: Adolescent drinking has decreased in numerous high-income countries in the 2000s, and how to explain this downward trend is far from clear. Focussing on the decline in drinking to intoxication among youth in Norway, we examined the following potential explanatory factors: family/home-based and peer-oriented leisure-time activities, perceived parental drinking, drug substitution, school conscientiousness and delinquency. DESIGN AND METHODS: Data stemmed from cross-sectional surveys of adolescents aged 13-17 years in the four largest cities in Norway in 2002 (n = 1204) and in 2013/2015 (n = 31 441). We examined the extent to which the decline in intoxication prevalence was attributable to the possible explanatory variables using logistic regression analysis. RESULTS: The proportion reporting any past-year intoxication episodes dropped markedly from 2002 (41%) to 2013/2015 (22%). Family/home-oriented leisure-time activities and school conscientiousness increased, whereas hanging out with friends in the evening and delinquent behaviours decreased. These factors together accounted for 43% of this decline. Decrease in going out with friends was the most important factor. We found no empirical support for assumptions that perceived parental drinking or drug substitution had contributed to the decrease in drinking to intoxication. DISCUSSION AND CONCLUSIONS: Since the millennium shift, urban adolescents in Norway have become more home-, family- and school-oriented, and less involved in unsupervised socialising with peers and delinquency. These changes may have contributed to some of the reduction in the prevalence of intoxication in this population group.

Adolescents drink less: How, who and why? A review of the recent research literature.

ISSUES: Today's teenagers have been described as a sober generation and we asked: 'What is known about the recent decline in youth drinking?' APPROACH: A literature review (2005-2017). KEY FINDINGS: Research from wealthier parts of the world provides solid evidence of less alcohol use by youth since the millennium shift. Some studies show that this is reflected at all levels of consumption, but there are also indications that the heaviest drinkers have not reduced their drinking. The decrease is predominately seen in underage youth, and has been larger for boys than for girls in several countries. Teenagers across social strata drink less, but some disadvantaged subgroups have not followed the downward trend. Underage drinkers have apparently not become a more deviant group as the prevalence of drinking has dropped, indicating no hardening of the group. The major gap in the literature pertains to the issue of underlying driving forces. We found no evidence in support of the widespread assumption that the digital revolution has been of importance. A decline in parenting practices that are conductive to underage drinking has occurred in several countries, but studies examining whether these changes have contributed to less alcohol use by youth are almost non-existent. IMPLICATIONS: To inform alcohol policy and prevention, it is imperative to find out why teenage drinking has decreased in a fairly consistent way across numerous countries. CONCLUSION: Future research into the issue of falling prevalence rates of youth drinking should focus on possible explanatory factors at the population level rather than at the individual level.

Social inequality in youth violence: The role of heavy episodic drinking.

INTRODUCTION AND AIMS: Alcohol use is an important risk factor for violence, and violent behaviour is more prevalent in lower socioeconomic status (SES) groups. The aim of this study was to examine whether the SES difference in youth violence can be explained by differential exposure to-and/or differential vulnerability to-heavy episodic drinking (HED). In the latter case, effect modification by impulsivity could be assumed. DESIGN AND METHODS: We analysed cross-sectional data from a school survey of 15- to 17-year-olds in Norway (n = 9853). We employed two measures of low-SES group. Associations between SES, HED and violence were estimated by Poisson regressions, applying a residual centring procedure to test effect modification. RESULTS: Violent behaviour frequency, HED frequency and impulsivity scores were all elevated in the low-SES group. The SES difference in violent behaviour was significantly reduced when adjusting for HED. The stronger association between HED and violence in the low, compared with the medium-SES/high-SES group, was modified when accounting for impulsivity. Sensitivity analyses suggested robust findings. DISCUSSION AND CONCLUSIONS: The findings lend support to both the differential exposure hypothesis and to the differential vulnerability hypothesis as well as the hypothesis of an enhancing effect of impulsivity on the HED-violence association. The SES difference in youth violence can be accounted for by: (i) an elevated prevalence of HED in low-SES groups; and (ii) a stronger than average link between HED and violence in low-SES groups due to their higher than average impulsivity score. [Norström T, Rossow I, Pape H. Social inequality in youth violence: The role of heavy episodic drinking. Drug Alcohol Rev 2017;00:000-000].

Social Class and Alcohol Use by Youth: Different Drinking Behaviors, Different Associations?

OBJECTIVE: Low socioeconomic status (SES) is related to hazardous alcohol use in adults, and the association seems to be stronger for more deviant and harmful drinking behaviors. We examined whether a similar pattern was present among adolescents. METHOD: Data stem from a Norwegian school survey of 14- to 17-year-olds (n = 12,966; response rate in participating schools: 86%). Parental education (high/ middle vs. low) was our main SES indicator. The outcomes comprised lifetime and past-year drinking and intoxication, and past-year symptoms of excessive drinking. We used Poisson regression to estimate relative risks (RR) and post-estimation Wald F tests to compare coefficient estimates. RESULTS: Parental education was related inversely to the lifetime measures of drinking and intoxication among all students but the 17-year-olds. The impact on any intoxication episodes was significantly stronger than that on any alcohol use only among the 14-year-olds (RR = 1.79, 95% CI [1.31, 2.43] vs. RR = 1.21, 95% CI [0.98, 1.49]) (p < .001). Among past-year drinkers at all ages (14-17 years; n = 7,796), the differential impact of low parental education was particularly large with respect to the frequency of intoxication (RR = 1.68, 95% CI [1.39, 2.02]) compared with the frequency of drinking (RR = 1.42, 95% CI [1.24, 1.62]) (p < .001) and frequent symptoms of excessive drinking (RR = 1.80, 95% CI [1.47, 2.20]) compared with any symptoms (RR = 1.07, 95% CI [1.01, 1.14]) (p < .001). A similar but somewhat less clear pattern emerged when using an alternative indicator for low parental SES. CONCLUSIONS: Parents' social standing was inversely related to alcohol use by youth and related more strongly so to more deviant and harmful drinking behaviors.

Drinking with parents: Different measures, different associations with underage heavy drinking?

AIMS: Is drinking with parents (DWP) likely to curb or to encourage adolescent heavy drinking? The scant number of studies addressing this issue have arrived at contradictory conclusions, which may reflect that different measures of DWP have been used. We pursued the assumption, taking potential confounding related to parental alcohol-specific rule-setting and parenting style into account. METHOD: Data stem from the Norwegian 2015 ESPAD survey of 15-16 year olds. Drinking with parents at the last drinking event and the frequency of DWP in the past year were assessed among those who had consumed alcohol (n = 1374). Severe drunkenness and binge drinking in the past month were the outcomes. Parental covariates were accounted for in Poisson regression models. RESULTS: One in five (21%) had been drinking with their parents the last time they consumed alcohol, and this DWP measure was strongly and inversely related to both drunkenness and binge drinking. Adolescents who reported no DWP episodes in the past year (61%) and those who reported 1-2 such episodes (30%) barely differed with respect to the two outcomes. More frequent DWP (9%) was significantly associated with an increased risk of heavy episodic drinking, but the statistical impact on severe drunkenness was no longer significant when adjusting for parental covariates. CONCLUSIONS: Different measures of DWP were related differently to adolescent heavy drinking, indicating that studies based on DWP at the last drinking event are biased in favour of the view that adolescents may "learn" sensible drinking by consuming alcohol with their parents.

Adolescent drinking-a touch of social class?

AIMS: To estimate whether parental socio-economic status (SES) is associated with adolescent drinking, and the degree to which a possible association may be accounted for by various parental factors. DESIGN AND SETTING: Cross-sectional Norwegian school survey from 2006 (response rate: 86%). PARTICIPANTS: Students aged 13-14 years (n = 5797), 15-16 years (n = 6613) and 17-18 years (n = 5351), of whom 51% were girls. MEASUREMENTS: Parents' education was our main SES indicator, and we distinguished between low (7%) and middle/high (93%) educational level. The outcomes comprised past-year drinking and intoxication. We also applied measures on general parenting, parents' alcohol-related permissiveness and parental intoxication. The main analyses were conducted using Poisson regression. FINDINGS: Parents' education had no statistically significant impact on alcohol use among the 17-18-year-olds, while 13-16-year-olds with low educated parents had an elevated relative risk (RR) of both drinking [RR = 1.21, 95% confidence interval (CI) = 1.13-1.29] and intoxication (RR = 1.32, 95% CI = 1.21-1.44). The RRs became statistically insignificant when including all the parental factors as covariates in the regression models. Among adolescents who had consumed alcohol, low parental education was related to more frequent drinking (RR = 1.24, 95% CI = 1.11-1.38) and intoxication episodes (RR = 1.42, 95% CI = 1.22-1.66). Again, the RRs became statistically insignificant when we accounted for all the parental factors. This pattern was replicated when we applied an alternative indicator for low parental SES. CONCLUSIONS: Adolescent drinking in Norway appears to be related inversely to parents' social standing. The elevated risk of low socio-economic status vanishes when general parenting, alcohol-related parental permissiveness and parents' drinking are accounted for.

Who are the adolescents saying "No" to cannabis offers.

BACKGROUND AND AIMS: Adolescents who refuse direct cannabis offers and remain non-users represent a potentially very informative, yet surprisingly understudied group. We examined a range of risk and protective factors putatively associated with this poorly understood "cannabis-resilient" profile. METHODS: Paper-and-pencil questionnaires assessing substance use, peer and family relations, and behavioral and personality characteristics were completed by 19,303 middle- and high-school students from 82 schools in Norway (response rate 84%) RESULTS: The lifetime prevalence of cannabis use was 7.6%. Another 10.4% reported no use of the drug despite having received recent cannabis offers. Results from the multinomial logistic regression revealed a set of characteristics differentiating adolescents who resisted such offers from those who: (a) neither received the offers nor used, and, more importantly, (b) used the drug. Specifically, parent-child relationship quality, negative drug-related beliefs, absence of close relationships with cannabis-users, low delinquency, no regular tobacco use, and infrequent alcohol intoxication were all associated with increased odds of being in the cannabis-resilient vs. cannabis-user group. This pattern of results was comparable across middle- and high-school cohorts, but the parent-child relationship quality and delinquency were significantly associated with cannabis-resilient vs. cannabis-use outcome only among younger and older adolescents, respectively. CONCLUSIONS: Among other low-risk characteristics, better relationships with parents and beliefs that drug use is problematic were associated with adolescents' refusals to accept cannabis offers. These results may have implications for novel preventive strategies targeting cannabis-exposed adolescents.

Associations between emotional distress and heavy drinking among young people: A longitudinal study.

INTRODUCTION AND AIMS: This study adds to the meagre body of longitudinal research on the link between emotional distress and alcohol use among young people. We address the following research questions: Are symptoms of anxiety and depressed mood likely to be causally related to heavy episodic drinking (HED)? Does the association change as individuals move from adolescence to early adulthood? DESIGN AND METHODS: Data stemmed from a national sample of young people in Norway that was assessed in 1992 (T1; mean age = 14.9 years), 1994 (T2), 1999 (T3) and 2005 (T4) (response rate: 60%, n = 2171). We applied fixed-effects modelling, implying that intra-individual changes in the frequency of HED were regressed on intra-individual changes in emotional distress. Hence, confounding due to stable underlying influences was eliminated. Self-perceived loneliness was included as a time-varying covariate. RESULTS: Emotional distress was unrelated to HED in adolescence (T1 to T2). In the transition from adolescence to early adulthood (T2 to T3), changes in depressiveness were positively and independently associated with changes in HED, whereas changes symptoms of anxiety were not. A similar pattern emerged in early adulthood (T3 to T4). DISCUSSION AND CONCLUSIONS: The potential causal relationship between emotional distress and heavy drinking did not manifest itself in adolescence, but increased symptoms of depressiveness were related to more frequent HED in subsequent periods of life. Hence, this study provides conditional support to the notion that emotional distress and HED may be causally related and indicates that the association among young people may be specific to depressiveness.

Who receives cannabis use offers: A general population study of adolescents.

BACKGROUND: Drug use is predicated on a combination of "willingness" and "opportunity". That is, independent of any desire to use drugs, a drug use opportunity is required; be it indirect (i.e., being in a drug-use setting) or direct (i.e., receiving a direct drug offer). However, whether some youth are more likely to encounter such direct drug use opportunities is not fully known. AIMS: We examined whether certain characteristics placed adolescents at greater risk for being offered cannabis, after accounting for a number of demographic-, contextual-, interpersonal-, and personal-level risk factors. METHODS: We utilized data from a Norwegian school survey (n=19,309) where the likelihood of receiving cannabis offer in the past year was estimated using logistic regression models. Substantive focus was on the individual and combined effects of personal (i.e., delinquency) and interpersonal (i.e., cannabis-using close friend) risk factors. Separate models were fit for middle- and high-school students. RESULTS: Delinquency was a significant risk factor for receiving cannabis offers, as was a cannabis-using best friend. In addition, peer cannabis use increased the risk of cannabis offers mostly for adolescents on the lower delinquency spectrum, but less so for highly delinquent adolescents. These interaction effects were primarily driven by the middle-school cohort. CONCLUSIONS: Cannabis offers were more likely to be extended to youth of certain high-risk profiles. Targeted prevention strategies can therefore be extended to a general profile of younger adolescents with externalizing problems and cannabis-using peers.

Is Drinking with Parents Associated with High-Risk Drinking among Adolescents?

BACKGROUND/AIMS: What are the implications of drinking with parents (DWP) on adolescents' drinking behavior? We expanded the meagre body of research on this controversial issue by assessing the association between the frequency of DWP and adolescent high-risk drinking, taking a number of parental factors into account. METHOD: Data stemmed from a subsample of 14-17-year-old current drinkers (n = 7,616) who participated in a cross-sectional Norwegian school survey (response rate: 84%). RESULTS: One in four reported DWP during the past year. The higher the frequency of DWP, the higher was the prevalence of high-risk drinking. Parental drunkenness, permissive alcohol-related parenting, and indicators of suboptimal parenting more generally also correlated with DWP. After controlling for these confounders, only frequent DWP remained significantly associated with high-risk drinking. CONCLUSIONS: DWP was related to adolescent high-risk drinking, yet the association was in part attributable to parents' drinking and parenting style. The risk of involvement in high-risk drinking was about the same for adolescents reporting no DWP and infrequent DWP, while it was significantly elevated among those reporting frequent DWP. This study thus demonstrated that the frequency of DWP matters and that parents who drink with their adolescent children differ from other parents in important ways.

Sexual assault while too intoxicated to resist: a general population study of Norwegian teenage girls.

BACKGROUND: Underage drinking is widespread, but studies on alcohol-related sexual victimization among teenage girls are almost non-existent. Research on individual correlates and risk factors of sexual victimization more generally is also meager. This study focuses on sexual assault while incapacitated due to drunkenness among 15-18 year-old girls and examines how age, drinking behavior, impulsivity and involvement in norm-violating activities are associated with such victimization experiences. METHODS: Data stemmed from a school survey (response rate: 85%) in 16 Norwegian municipalities. Almost all analyses were restricted to girls who had been intoxicated in the past year (n = 2701). In addition to bivariate associations, adjusted odds ratios and relative risks of incapacitated sexual assault (ISA) were estimated. Further, population-attributable fractions were calculated to explore how the prevalence of ISA victimization was likely to be affected if effective preventive measures were targeted solely at high-risk groups. RESULTS: The majority of the girls (71%) had been intoxicated in the past year, of which 7% had experienced ISA victimization in the same period. The proportion of victims decreased by age within the group that had been intoxicated, reflecting that the youngest girls were more likely to get severely drunk. Impulsivity and involvement in norm-violating behaviors were identified as potential risk factors, but the population-attributable fractions indicated that the groups with the highest risk of ISA victimization accounted for only a minority of all the cases of such victimization. CONCLUSION: Sexual assault against teenage girls who are too drunk to resist seems to be prevalent in Norway - notably among the youngest girls who engage in heavy episodic drinking. This study also suggests that one should reconsider the notion that no individual attributes are related to females' sexual assault victimization. It also indicates that a high risk approach to prevention, targeting groups with a high level of impulsivity or behavioral problems, may have limited effect on the prevalence of ISA victimization. Thus, from a public health perspective, it may be advisable to give priority to universal preventive measures to curb young girls' risk of being sexually assaulted in a state of alcohol-induced incapacitation.

Changes in alcohol consumption after a natural disaster: a study of Norwegian survivors after the 2004 Southeast Asia tsunami.

BACKGROUND: Many studies suggest that disaster exposure is related to a subsequent increase in alcohol consumption. Most of these studies have relied on retrospective self-reports to measure changes in alcohol use. The aim of the present study was to examine the association between disaster exposure and drinking behaviors more closely, analyzing data on both self-perceived changes in alcohol consumption and current drinking habits in groups with different extents of disaster exposure. METHODS: A sample of Norwegian adults (≥ 18 years) who resided in areas affected by the 2004 Southeast Asia tsunami (N = 899) were assessed by a postal questionnaire 6 months after the disaster. Based on detailed questions about experiences with the tsunami, participants were grouped according to their extent of disaster exposure. The Impact of Event Scale-Revised was applied to measure the level of post-traumatic stress. Participants were asked whether they had increased or decreased their alcohol consumption after the disaster. Moreover, weekly alcohol consumption and frequency of intoxication during the past month were used as indicators of current drinking behaviors. RESULTS: Severely exposed individuals more often reported changing their alcohol consumption compared with those who were less exposed. Severe exposure to the tsunami was associated with both a self-perceived increase (OR 21.38, 95% CI 2.91-157.28) and decrease in alcohol consumption (OR 7.41, 95% CI 1.74-31.51). The odds ratios decreased and were not significant when adjusting for post-traumatic stress symptoms. Weekly consumption and frequency of intoxication during the past month did not vary with extent of disaster exposure. CONCLUSIONS: Our findings indicate a polarization effect of severe disaster exposure on self-perceived changes in alcohol consumption; that is, disaster exposure was associated with self-perceived increases and decreases in drinking. However, the absence of associations between disaster exposure and indicators of current drinking behaviors suggests that the observed polarization effect may be overestimated because of attribution and recall bias.

Associations between adolescent heavy drinking and problem drinking in early adulthood: implications for prevention.

OBJECTIVE: We assessed how heavy episodic drinking (HED) in adolescence (Time 1) was related to hazardous drinking as well as symptoms of alcohol problems and dependence in early adulthood (Time 2). The key question was to what extent preventive measures targeted at underage HED may have a potential to reduce problem drinking in early adulthood. METHOD: Data are from the 1992 (Time 1, ages 14-17 years) and 2005 (Time 2) waves of the Young in Norway Longitudinal Study (N = 1,764). In addition to odds ratios and relative risks, we calculated population-attributable fractions to estimate how the prevalence of hazardous drinking and alcohol problems in early adulthood would be affected if adolescent HED at various frequencies were eliminated. The results were adjusted for age, gender, and measures on impulsivity and delinquency. RESULTS: The risk of problem drinking at Time 2 increased with increasing frequency of HED at Time 1, but a great deal of discontinuity in drinking behaviors was also observed. The population-attributable fractions indicated that if all instances of HED at Time 1 were eliminated, the expected reduction in hazardous drinking and alcohol problems at Time 2 would be 11% and 15%, respectively. CONCLUSIONS: Because of a marked discontinuity in drinking behaviors from adolescence to early adulthood, the potential long-term effects of interventions targeted at HED among youth are likely to be limited.

Young people's overestimation of peer substance use: an exaggerated phenomenon?

AIMS: This paper queries the notion that young people overestimate peer substance use, asking whether there is robust evidence that such misperceptions are widespread and whether the phenomenon may have been exaggerated in the research literature. METHOD: An examination of the research literature was conducted, focusing mainly on studies published since 2000. Some analyses of relevant data on cannabis use from a Norwegian youth survey were also undertaken. RESULTS: The research in question is characterized by many weaknesses, including low response rates and widespread use of convenience samples, as well as the presence of contextual factors and the use of assessment tools that may have created a bias in favour of 'demonstrating' that youth overestimate peer drinking or drug use. Moreover, in some cases, the apparent tendency to hold such misbeliefs may reflect the reality. Further, although most studies conclude that the modal tendency is to overestimate, high levels of underestimation of peer substance use have been reported. There is also suggestive evidence that many youth may have no pre-existing beliefs when responding to items on the issue. Results from the Norwegian youth survey added to this picture. CONCLUSION: Young people's tendency to overestimate peer drinking and drug use has been exaggerated, while the uncertainty surrounding the evidence in question has been understated.

Young women who commit intimate partner violence.

BACKGROUND: Only limited research has been undertaken on women who commit intimate partner violence (IPV). In this study I investigate how the abusive behaviour of young women towards their partners is correlated with characteristics of the relationship and with aggressiveness more generally. Furthermore, I investigate the assumption that the violence is mostly motivated by self-defence. MATERIALS AND METHODS: The analyses are based on a nationwide longitudinal study of the normal population. Data on IPV were collected when the women were 20 - 25 years old. RESULTS: Of the 1 250 women who had been in a relationship during the last six months, a total of 114 (9 per cent) had slapped their partner during the same period, while 70 (6 per cent) had hit, kicked or bitten. Altogether 77 (6 per cent) reported that they (and not their partner) had acted violently in this manner, whereas 68 (5 per cent) responded that the attacks had been reciprocal. Perpetration of IPV correlated with other forms of destructive interaction with the partner. Nevertheless, a majority of those women who had acted violently were satisfied with the relationship. Aggression-related personality traits and acting-out behaviour during the teens were both related to perpetration of IPV. INTERPRETATION: Young women who act violently towards their partners tend to be more aggressive than women in general, and are in many cases the only physically aggressive partner in the relationship. The study does not corroborate the assumption that selfdefence is the main motivation for women's perpetration of IPV. The results should be seen in light of the reservation that surveys of the normal population only to a limited extent capture really serious violence in intimate relationships.