Problem Gambling Among Ontario Students: Associations with Substance Abuse, Mental Health Problems, Suicide Attempts, and Delinquent Behaviours.

This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.

Prescription medication misuse among adolescents with severe mental health problems in Ontario, Canada.

The purpose of this study was to examine the prevalence of prescription medication misuse among adolescents with severe mental health problems in Ontario, Canada, and to explore some of the factors that influence the misuse of prescription medication. Data were obtained from the Resident Assessment Instrument for Mental Health. A total of 2,677 adolescents between the ages of 12 and 18 years who were admitted into adult mental health beds were analyzed. Logistic regression was used in estimating the likelihood of misusing prescription medication. Overall, 17% of adolescent inpatients misused prescription medication. In the multivariate model, the following were found to be associated with misuse: being female, having multiple psychiatric admissions, education, threat or danger to self, problem with addiction, history of emotional abuse, use of alcohol, past year use of opiates and cannabis, as well as symptoms of depression. Misuse of prescription medication was less likely to occur among adolescents with a diagnosis of schizophrenia and adolescents who were admitted as a result of posing a threat or danger to others. Implications of the findings are discussed with suggestions for future research.

Examining the independent protective effect of subjective well-being on severe psychological distress among Canadian adults with a history of child maltreatment.

The purpose of this study was to examine the independent protective effect of subjective well-being on severe psychological distress among adult Canadians with a history of child maltreatment. Data for this study were obtained from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). A sample of 8126 respondents aged 20-69 years old who experienced at least one child maltreatment event was analyzed using binary logistic regression with severe psychological distress as the outcome variable. Of the 8126 respondents with a history of child maltreatment, 3.9% experienced severe psychological distress within the past month. Results from the multivariate logistic regression revealed that emotional and psychological well-being each had a significant effect on severe psychological distress. For each unit increase in emotional well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 28% and for each unit increase in psychological well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 10%, net the effect of demographic, socioeconomic, and health factors. Other factors associated with psychological distress included: younger age, poor self-perceived physical health, and chronic condition. Having post-secondary education, having a higher income, and being non-White predicted lower odds of severe psychological distress. Although, child maltreatment is associated with stressful life events later in adulthood, subjective well-being could serve as a protective factor against severe psychological distress among adults who experienced maltreatment when they were children.

The enduring effects of early-childhood adversities and troubled sleep among Canadian adults: a population-based study.

OBJECTIVE: Although many studies have consistently found that early-childhood adversities are important risk factors for physical and mental health problems later in adulthood, few have examined the association between early-childhood adversities and troubled sleep. The objective of this study was to examine the association between early-childhood adversities and troubled sleep among adult Canadians. METHODS: Data for this paper (N = 19,349) were obtained from Statistics Canada's 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). Logistic regression analysis was conducted to examine the association between early childhood adversities and troubled sleep, while accounting for various sociodemographic, socioeconomic, health, and mental health factors. RESULTS: Of the 19,349 respondents examined, 2748 representing 14.2% had troubled sleep. Controlling for sociodemographic, socioeconomic, health, and mental health factors, it was observed that for each additional childhood adversity experienced, the odds of having troubled sleep increased by 10% (odds ratio = 1.10, p <0.001, 95% confidence interval = 1.07-1.13). In addition, psychological distress, older age, being female, being unmarried, being white, a lower annual income, chronic pain, poor perceived health, and mental health difficulties were associated with troubled sleep. CONCLUSION: The results of this paper provide population-based evidence for childhood adversities as a major predictor of troubled sleep in adulthood. The long-standing effects of these adversities on sleep highlight the importance of early detection, such as consistent assessment of sleep habits for children, adolescents, and adults, who have experienced childhood adversities, in health and mental health settings.

Discharge of adolescents with mental health problems against medical advice: findings from adult mental health inpatient facilities across Ontario, Canada.

Little is known about discharge against medical advice (DAMA) among adolescents with mental health problems. The objective of this study was to examine the prevalence of DAMA and provide some insight into the factors that influence DAMA among adolescents with mental health problems using a large dataset from Ontario, Canada. Data on 1811 adolescents aged 14-18 years who were discharged from adult mental health beds between October 2005 and March 2010 were analyzed using logistic regression. Of the 1811 discharges in the sample, 78(4.3%) were against medical advice. In the multivariate model, older age, having limited insight or no insight into mental illness, provisional DSM-IV diagnoses of substance-related disorders, eating disorders, and personality disorders increased the odds of DAMA. Length of stay was negatively associated with DAMA. The findings of this study highlight the importance of completing comprehensive assessments at the time of admission to identify adolescents who are at risk of treatment refusal and provide timely intervention to prevent DAMA.

BCFPI Validation for a High-risk High-needs Sample of Children and Youth Admitted to Tertiary Care.

OBJECTIVE: This study examined the validity and reliability of the Brief Child and Family Phone Interview (BCFPI) in a sample of high-risk, high-need children and youth admitted to a tertiary residential psychiatric facility. This is the first validation study of the BCFPI with children and youth functioning at the extreme clinical range. METHOD: Participants consisted of children and youth in a southwestern Ontario tertiary residential mental health facility. Two hundred twenty seven children and youth aged 6.28 to 16.74 (M = 12.06 years, SD = 2.46) were evaluated. Internal consistencies of each scale were tested using Cronbach's alpha, and subsequently confirmed with unidimensional principal components analyses. Concurrent validity was evaluated through Pearson product-moment correlations between each subscale and the empirically validated subscales in the Conners' Rating Scales. RESULTS: With exception of the conduct subscale (alpha =.68), all Cronbach's alpha estimates were in the acceptable range. Each scale demonstrated acceptable factor loadings on a single-factor principal components extraction derived from the pool of items within each scale. Concurrent validity was evidenced by moderate to strong correlations identified with selected measures of the Conners' Parent Rating Scale. CONCLUSIONS: Considered together, the results of this study indicate that the BCFPI is a reliable and valid indicator of child functioning within this client population, and is recommended in the assessment of tertiary populations.

OBJECTIF: Cette étude a examiné la validité et la fiabilité de la Brief Child and Family Phone Interview (BCFPI, enquête téléphonique abrégée pour l'enfant et la famille) dans un échantillon d'enfants et d'adolescents à haut risque et à besoins élevés, hospitalisés dans un établissement psychiatrique résidentiel tertiaire. Il s'agit de la première étude de validation de la BCFPI pour des enfants et des adolescents fonctionnant à l'extrémité de l'échelle clinique. MÉTHODE: Les participants étaient des enfants et des adolescents dans un établissement de santé mentale résidentiel tertiaire du Sud-Ouest de l'Ontario. Deux cent vingt-sept enfants et adolescents âgés de 6,28 à 16,74 ans (M = 12,06 ans, ET = 2,46) ont été évalués. La cohérence interne de chaque échelle a été vérifiée à l'aide de l'alpha de Cronbach, et subséquemment confirmée par des analyses en composantes principales unidimensionnelles. La validité concourante a été évaluée par les corrélations produit-moment de Pearson entre chaque sous-échelle et les sous-échelles validées empiriquement des échelles d'évaluation Conners. RÉSULTATS: À l'exception de la sous-échelle des conduites (alpha = 0,68), toutes les estimations alpha de Cronbach étaient dans un intervalle acceptable. Chaque échelle démontrait des saturations de facteur acceptables sur une extraction d'un seul facteur par l'analyse en composantes principales, dérivée du groupe d'items de chaque échelle. La validité concourante a été mise en évidence par des corrélations de modérées à fortes, identifiées par des mesures choisies de l'échelle d'évaluation Conners pour les parents. CONCLUSIONS: Pris en compte ensemble, les résultats de cette étude indiquent que la BCFPI est un indicateur fiable et valide du fonctionnement de l'enfant au sein de cette population de clients, et qu'elle est recommandée pour l'évaluation des populations tertiaires.