Headstrong's "My World" survey


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Dr Amanda Fitzgerald, UCD School of Psychology and co-author of Headstrong’s My World Survey, a National Study of Youth Mental Health, at Alcohol Action Ireland's conference "Time Please... For Change"

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  • Alcohol consumption among adolescents has increased in the last 30 years Use of multiple substances including tobacco and cannabis use Alcohol consumption during adolescence is associated with damage to the brain regions that are important for memory and learning capabilities, which can impair academic performance And this has been well documented Adolescents who start to consume alcohol at an early age have a higher risk of : Future development of alcohol dependency Unintentional alcohol-related injuries Early age of alcohol abuse Drug use Underage and binge drinking have negative effects on adolescent development and mental health (Chen et al 2008; Wells et al 2004) Drinking patterns in adolescence have been linked with poor psychosocial outcomes in late adolescence and early adulthood
  • Onset of drinking and volume of drinking is tracking at the same time as onset of mental health difficulties is drinking No. 1 health thing is their mental –combination of both is very dangerous At the time when mh issues, drinking is beginning to increase and these two things have long term consequences , particularly for those with a mh vulnerable, they are at risk for long term consequences for their drinking and mental health- the likelihood fo the two things together can have of drinking
  • What is the audit? Alcohol related consequences- injuries, feeling guilty, expressing cnocern
  • Sub-sample
  • The MWS consists of a battery of psychometrically sound instruments that have been used internationally-positive and negative domains of psychological functioning Help Seeking Behaviour (HSB)  = .66 Resilience Scale for Adolescents (READ)  =.905 Adolescent Connectedness (Hemingway )  =.825 Quality of Relationships (NRI)  789 to .850
  • In 4 th year , 35% don’t drink, in 5 th year 24% don’t drink and in 6 th year 9% don’t drink How often do you drink alcohol such as wine, spirits, cider, beers alco-pops? Never, less than monthly, monthly, weekly, daily- those who say monthly, weekly or daily How often do you have 6 or more drinks in one sitting or session? European School Survey Project on Alcohol and Other Drugs (2007) – trend in Ireland a ‘particular concern’ in 15-16 yr olds Similar to this, we begin to see the shift in drinking in 4 th year- 15-16 years
  • Typically, how many alcohol drinks do you have when you are drinking? There is a shift in the quantity of alcohol consumed across school year When young people reach 6 th year, as a cohort, 65% are drinking 5 or more drinks on a typical drinking occasion 15% of adolescents who drink had injured themselves or someone else because of their drinking in the last year Nearly 21% reported being unable to remember what happened the night before at least monthly(monthly, weekly, daily)
  • No difference between males and females WE used the cut-off scores recommended for adult populations to screen for alcohol use disorders among adolelscence We looked at the alcohol use among young people Of those who report they drink At the end of the junior cycle as they move into the senior years, alcohol use is a concern among young people
  • adult cutoffs for AUDIT are too high This is interesting because if we use more age specific cutoffs , a higher percentage of adolescents fall outside of the low risk range The authors concluded that these cutoff point make screening with the AUDIT more accurate for adolescent populations cutoff of 3
  • The typical drinking behaviour of 6 th years as a cohort is outside of the low risk range- School year Mean for Audit Ist year 0.93 2nd year 2.14 3rd year 3.74 4th year 4.48 5th year 6.33 6th year 8.52
  • Younger adolescents are vulnerable to the effects of alcohol on mental health If drinking is outside the normal range at this age, strongly linked with indicators of mental health distress- won’t know which child will be ok – reduce their potential of long-term mental health difficulties The longer you put off drinking , the more positive your mental health will be- you are reducing risk There are lots of risk factors, therefore, we reduce the likelihood Alcohol behaviour was also linked to self-esteem, where problem drinking behaviour was associated with lower self-esteem. This was evident in both the Junior Cycle, and Senior Cycle
  • Adolescents in the problem drinking category were more likely to report that they don’t cope well with problems, don’t enjoy their family life, report to be at the bottom of the class, and feeling angry a lot
  • Causality- we don’t whether those with mental health problems are more likely to drink or whether those who drink are at risk for mental health difficulties-research suggests Mixed messages- shouldn’t be drinking because their bodies are not equipped to deal with it, alcohol has an impact on the brain Parents are afraid that if they are drinking, they can’t tell their child not to drink Discuss the consequences of drinking with their child, us vs. them, Parents need to have conversations with their adolescents around alcohol- give them strategies to deal with not drinking with their peers- All or nothing- goes with their age and adolescence- need to be in that risk taking zone-how do you let them know it’s not suitable- delay gratification Hit instantly- everything is instant- thrill-seeking, front load for a buzz, Email instant, mobile phone instant, tv instant,- whole world operates instantly and this holds for both males and females. Causality cannot be determined
  • Headstrong's "My World" survey

    1. 1. The My World Survey (MWS):The Twin Track- Alcohol and mental health in young people today Amanda Fitzgerald1 & Barbara Dooley1,2 UCD School of Psychology1 Headstrong- National Centre for Youth Mental Health 2
    2. 2. The context• Drinking is part of the Irish culture• Research in Europe and the US has found that alcohol use is beginning in early adolescence, consumption rates are increasing and polysubstance use is evident (Newes-Adeyi et al 2005; WHO 2007)• Alcohol is a particular risk in adolescence(Strandheim et al 2009)• Underage and binge drinking have negative effects on adolescent development and mental health (Chen et al., 2008)
    3. 3. When do mental health issues begin toemerge? Victorian Burden of Disease Study (1996 )
    4. 4. Aims• Describe patterns of drinking behaviour across the second level school cycle• Determine the associations between drinking behaviour, as defined by the WHO AUDIT tool, and mental health indicators• Investigate the link between alcohol misuse and suicidal behaviours among young adults
    5. 5. Methodology• Sampling young people from 12-25 years of age in line with the WHO definition of adolescent and emerging adulthood – Second level students 12-18 (N = 6,085) • Randomly selected schools 72/145 participated (49%) – Third level students 17-25 N=8,221 • All universities and 5 ITs – Employed young people 18-25 (N =170) – Unemployed young people 18-25 (N =154) – Trainees 18-25 (N = 306) – Total sample: 14,936
    6. 6. The MWS• Positive Domains – Multidimensional Scale of Perceived Social Support (MSPSS) – Coping Strategy Indicator – Optimism – Resilience Scale for Adolescents (READ) – Self Esteem Scale (RSE) – Satisfaction with Life Scale• Negative Domains – Alcohol Use Disorders Identification Test (AUDIT) – Depression Anxiety Stress Scale (DASS) – Behavioural Adjustment Scale (BAS) – CRAFFT (risk taking scale)
    7. 7. Data from Second Level Sample
    8. 8. Data on alcohol frequency andbinge drinking49% (N=2784) of adolescents never drink alcohol School % of drinking at % of drinking, at least year least monthly monthly, 6 or more drinks in one session 1st year 6% 15% 2nd yr 13% 21% 3rd yr 22% 28% 4th yr 33% (11% weekly) 33% 5th yr 52% (19% weekly) 47% (10% weekly) 6th yr 69% (28% weekly) 57% (16% weekly)
    9. 9. Typical drinking volume• In 3rd yr the most prevalent typical drinking volume is 1-2 drinks (30%), 3-4 drinks (24%), 5-6 drinks (25%)• In 4th yr the most prevalent typical drinking volume is 3-4 drinks (38%), 5-6 drinks (24%)• In 5th & 6th yr the most prevalent typical drinking volume is 5-6 drinks (30%), 7-9 drinks (22%), with 15% of 6th yrs drinking 10+ on a typical drinking occasion
    10. 10. Alcohol behaviour classification –AUDIT (WHO, 2001)Classification Junior Cycle Senior Cycle (1st, 2nd, 3rd (4th, 5th, 6th year) year)Low risk 90% 65%drinkingProblem 6% 26%drinkingHazardous 2% 5%drinkingPossible alcohol 2% 4%dependence
    11. 11. AUDIT recommended cutoffs foradolescents (Knight et al., 2003;Santis et al., 2009)Classification Junior Cycle Senior Cycle (1st, 2nd, 3rd (4th, 5th, 6th year) year)Low risk 78% 33%drinkingProblem 22% 67%drinking
    12. 12. Alcohol behaviour across school year • Significant linear trend F(5,5807) =242.37, p < . 001. 6th yrs M=8.55, are in the problem drinking range and are significantly different from all other years • Similar pattern for males and females
    13. 13. Alcohol behaviour across age group• Significant linear trend F(6,14311) =691.67, p < .001. Similar pattern for males and females
    14. 14. Factors associated with use alcoholuse in adolescents• Chi-square analysis observed : – Adolescents in the Junior Cycle, classified in problem drinking category, were more likely to report severe/very severe depression. This was also evident for those in the Senior Cycle, but the association was stronger for Junior Cycle. – These patterns also emerged for stress and anxiety – Alcohol behaviour was also linked to self-esteem, where problem drinking behaviour was associated with lower self-esteem. This was evident in both the Junior Cycle, and Senior Cycle
    15. 15. Factors associated with use alcohol usein adolescents• Alcohol use was linked to positive and negative factors – Low levels of alcohol use were associated with higher optimism, support from family, life satisfaction and resilience – Higher rates of alcohol use were associated with increased risk taking, high family conflict, feeling angry, school misconduct and antisocial behaviour
    16. 16. Data from Young Adult Sample (17-25 years)
    17. 17. Alcohol misuse and suicidal behaviour• WHO (2004) – Risk of suicide is 8 times greater when a person is currently abusing alcohol than if not abusing alcohol• Ireland ranked 4th in Europe for suicide rate in 15-24 yr olds (NOSP, 2010)• Young adults (17-25 yrs) who were identified as having a possible alcohol dependence were at increased risk for self-harm, suicidal thoughts and suicide attempts
    18. 18. Conclusions• Problem alcohol behaviour has clear patterns of frequency, binge drinking and volume across year group in second level• Problem drinking was found to be linked to an increased risk for mental health difficulties and a reduction in self-esteem• Young people at low risk for drinking have better mental health, engage in more positive coping strategies and have a more positive outlook on life• Need to delay the onset of drinking
    19. 19. Thank You!Email: amanda.fitzgerald@ucd.ieLink to My World Survey Reportwww.headstrong.ie/content/my world