Adolescent alcohol use and misuse : the influence of perceived family socialization factors

Alcohol-related problems are a worldwide phenomenon and, in the latter part of the twentieth century, have generated substantial academic interest. Some of this research has focussed on the alcohol use and misuse of young people. The present thesis falls squarely into this area, bringing to the investigation of adolescent drinking behaviour an emphasis on family environment from recent studies into problem drinking. The aim of this study, therefore, was to increase understanding of the formation of early drinking patterns by investigating perceived family socialization factors associated with self-reported adolescent alcohol use and misuse. The results should have implications for alcohol education and intervention strategies in the U.K.. Research into problem drinking and drug use/misuse, previous adolescent drinking research, developmental psychology, social psychology, family psychology, family systems and the sociology of deviance all informed this thesis, by contributing to the development of a theoretical model of family socialization influences on adolescent drinking behaviour. Two main areas of family environmental influence are outlined in this model, and demographic and structural variables form a third component of the model. In this study, family process behaviours are viewed as those aspects of family relationships and interactional styles which are important in the socialization of adolescent behaviours and the internalization of norms, are non-alcohol specific, and are characterized by two major dimensions of family functioning - support and control. Underlying the role of alcohol-specific family behaviours in the development of adolescent drinking is family social learning, which is characterized by family models and social reinforcement for drinking. The main study involved administering a fully piloted questionnaire to a large, cross-sectional, random sample of school students, aged 11-18, in Humberside (N=4386). In addition, a small number of semi-structured interviews were carried out, and each written up as a case study, to supplement the quantitative questionnaire data. Data from the questionnaire were analyzed on three levels. Descriptive statistics are presented and comparisons made with information from previous studies. ANOVA's tested for disordinal interactions and for nonlinear effects of family socialization variables on adolescent drinking behaviour. As no marked non-linear patterns or disordinal interactions were found a third level of analysis was carried out, involving structural equation modelling techniques. The main results from the study are summarized below: (i)As expected, both heavy drinkers and non/very light drinkers were more likely to report extreme patterns of family socialization behaviours. Low support and control, indifferent parents and more frequent family drinking were all linked with more self-reported adolescent drinking, whilst high support and control, disapproving parents and non/light family drinking were all linked with less adolescent drinking. The family profile linked with normative levels of adolescent drinking was moderate support and control, a moderating parental attitude, and moderate (mid-range) family drinking. (ii)Multivariate analyses pointed to the predominantly independent and additive effect of each family socialization variable on adolescent drinking behaviour. (iii)On the whole, family social learning variables, particularly parental attitude, were more important statistical predictors of adolescent drinking behaviour than family process variables. (iv)Contrary to predictions, when each school year/sex group was examined separately, an interesting transitional effect was found. For younger males and females, family social learning variables were significant predictors of drinking behaviour, but family process variables were not. However, in older year groups, the effect of family support and control on , drinking behaviour increased whilst, in a complementary fashion, the effect of family models and, in particular, parental attitude, decreased. (v)As expected, knowledge of friends' drinking predicted the respondent's drinking behaviour, but the impact and pattern of family socialization influences on drinking behaviour was not moderated by this peer influence variable. In addition, knowledge of friends' drinking was not as important, statistically, as family social learning influences. The thesis concludes by discussing the above findings and commenting on the generalizability of the results and the implications of the results for current alcohol education paradigms and for future research. The value of the family socialization model for the investigation of other adolescen

The effectiveness of brief personalized normative feedback in reducing alcohol-related problems amongst University students: protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Studies have shown that university/college students tend to have an exaggerated view of the quantities of alcohol being consumed by their peers. Making students aware of this misperception may help change behaviour and reduce problem drinking.</p> <p>Methods/Design</p> <p>A Solomon Three Group Design will be used. There is one intervention group and two control groups, controlling separately for measurement and for intervention effects. Recruitment, consent, randomisation and data collection are all on-line. The primary outcomes are AUDIT Score, weekly consumption, perceived social norms, and alcohol related problems; secondary outcomes include alcohol expectancies and other health behaviours.</p> <p>Discussion</p> <p>This trial will provide information on the effectiveness of an on-line personalized normative feedback intervention for alcohol misuse in university students.</p> <p>Trial registration</p> <p>International Standard Randomised Controlled Trial Number: ISRCTN30784467</p

Insights for Care:The Healthcare Utilisation and Cost Impact of Managing Type 2 Diabetes-Associated Microvascular Complications

Introduction: The increasing prevalence of type 2 diabetes (T2DM) in the UK imposes a significant burden on the National Health Service (NHS). Despite the availability of effective treatments, the loss of glycaemic control over time results in significant comorbidities, including nephropathy, neuropathy and retinopathy. The cost of treating these microvascular complications has not been well documented, and this study aimed to provide an accurate assessment of the healthcare resource utilisation (HCRU) associated with managing T2DM and its complications. Methods: This retrospective cohort study utilised electronic medical records from patients with T2DM from the Heart of England Foundation Trust (HEFT), which captures data from patients using secondary care services. Patients were diagnosed with microvascular complications based on ICD-10 or OPCS codes. HCRU over a 2-year period was based on NHS Tariffs for healthcare services for inpatient, accident and emergency, and dialysis clinic usage. Results: The study cohort comprised 26,629 patients with T2DM who used HEFT services during the study period, 22.6%, 20.8% and 3.1% of whom had comorbid nephropathy, retinopathy or neuropathy, respectively. While the prevalence of diabetes in the overall HEFT population was reported to be 7% in 2012, diabetes and its associated complications accounted for more than 30% of secondary care costs. Furthermore, while patients with diabetes represent only 17% of HEFT inpatients, they account for more than 20% of service usage. The economic burden of microvascular complications increased substantially with the severity of the condition, with the overall cost exceeding £70 million over the 2-year period. Conclusion: This study of patients with T2DM in a typical secondary care provider in the UK showed that avoiding the progression of microvascular complications could provide substantial cost savings through targeted interventions that improve outcomes and lower resource use. Funding: Merck Sharp & Dohme Limited

: a tutorial for psychology students and other beginners

Version françaçise de Navarro, D. J., & Foxcroft, D. R. (2019). Learning statistics with Jamovi: a tutorial for psychology students and other beginners. (Version 0.70). Consulté à l’adresse http://www.learnstatswithJamovi.comL'apprentissage des statistiques avec Jamovi couvre le contenu d'un cours d'introduction à la statistique, tel qu'il est généralement enseigné aux étudiants de premier cycle en psychologie. Le livre aborde la façon de commencer dans Jamovi et donne une introduction à la manipulation des données. D'un point de vue statistique, l'ouvrage traite d'abord des statistiques descriptives et la représentation graphique, puis de la théorie des probabilités, de l'échantillonnage et de l'estimation et de la vérification des hypothèses nulles. Après avoir présenté la théorie, le livre couvre l'analyse des tableaux de contingence, la corrélation, les tests t, la régression, l'ANOVA et l'analyse factorielle. Les statistiques bayésiennes sont présentées à la fin du livre

Implicit alcohol attitudes predict drinking behavior over and above intentions and willingness in young adults but willingness is more important in adolescents: implications for the Prototype Willingness Model

Objectives: Dual process models, such as the Prototype Willingness Model (PWM), propose to account for both intentional and reactive drinking behaviour. Current methods of measuring constructs in the PWM rely on self-report, thus require a level of conscious deliberation. Implicit measures of attitudes may overcome this limitation and contribute to our understanding of how prototypes and willingness influence alcohol consumption in young people. This study aimed to explore whether implicit alcohol attitudes were related to PWM constructs and if they would add to the prediction of risky drinking. Design: The study involved a cross-sectional design. The sample included 501 participants from the United Kingdom (Mean age 18.92; range 11-51; 63% female); 230 school pupils and 271 university students. Methods: Participants completed explicit measures of alcohol prototype perceptions, willingness, drunkenness, harms, and intentions. They also completed an implicit measure of alcohol attitudes, using the Implicit Association Test. Results: Implicit alcohol attitudes were only weakly related to the explicit measures. When looking at the whole sample, implicit alcohol attitudes did not add to the prediction of willingness over and above prototype perceptions. However, for university students implicit attitudes added to the prediction of behaviour, over and above intentions and willingness. For school pupils, willingness was a stronger predictor of behaviour than intentions or implicit attitudes. Conclusions: Adding implicit measures to the PWM may contribute to our understanding of the development of alcohol behaviours in young people. Further research could explore how implicit attitudes develop alongside the shift from reactive to planned behaviour

The effect of alcohol strength on alcohol consumption: Findings from a randomised controlled cross-over pilot trial.

Background. Reducing the alcohol content of drinks has the potential to reduce alcohol consumption. Aims: (1) test the feasibility of a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption within licensed premises in the United Kingdom (UK), (2) provide data to estimate key parameters for a RCT. Methods. Double-blind randomised controlled cross-over pilot trial based within four licensed premises in the UK. Participants (n=36) purchased and consumed ad libitum a 3.5% lager and a 4.8% lager during two separate study sessions. Descriptive statistics reported the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, and participant recruitment and attrition. Mean and the 95% confidence interval (CI) compared alcohol consumption between conditions. The mean, standard deviation (SD) and CI of UK units of alcohol consumed were used to calculate a sample size for a RCT. Responses to participant questionnaires and duration of participation in study sessions between conditions were analysed. Results. Components of the study protocol were effective and efficient. The venue recruitment rate was less than anticipated. The participant recruitment rate was greater than anticipated. The rate of attrition was 23% and varied by less than 1% according to the arm of the trial. There was a reduction of alcohol consumed under the intervention conditions. Estimated mean difference, and 95% CI (UK units): -3.76 (-5.01 to -2.52). The sample size required for a RCT is 53. Participants did not find one lager more pleasant in taste: (on a scale of one to 10) -0.95 (-2.11 to 0.21). Participants found the reduced-strength lager less enjoyable: (on a scale of one to 10) -1.44 (-2.64 to -0.24) and they perceived themselves to be less intoxicated after consuming it: (on a scale of one to 10) -1.00 (-1.61 to -0.40). Conclusion. A RCT is feasible with minor alterations to the study protocol and scoping work to establish different brands of alcohol that are more alike and more enjoyable than the products used in the pilot trial

Developmental trajectories of adolescent risky drinking: Predictors from the Drug Education in Victoria Schools (DEVS) study

With alcohol misuse one of the leading causes of disability among young Australians, determination of potential predictors of risky drinking trajectories of young people is crucial. This study aimed to identify risky drinking trajectories from early to mid-adolescence and to determine if membership of a harm minimization intervention, alcohol knowledge, attitudes towards alcohol and prevalence of alcohol harms would predict trajectory group membership. Longitudinal data from 1,746 students were used to identify alcohol consumption trajectory groups for both intervention and control students. Higher baseline knowledge predicted a higher, increasing, consumption trajectory for controls, whereas, safer attitudes at baseline was not associated with a higher, increasing trajectory. All other alcohol harms at baseline were strongly associated with higher consumption trajectories. The intervention group had fewer increasing trajectories and a lower level of consumption at the end of the program, suggesting the drug education program reduced the number of students who substantially increased their consumption over time, while at the same time reducing their level of consumption in relative terms. The consistency of better intervention student outcomes across all trajectories provides evidence that the drug education program was influential with all types of student drinkers and is suitable for universal deliver

The classification and organisation of alcohol misuse prevention with a focus on environmental prevention

Purpose of Review. Classifying prevention as universal, selective or indicated only considers the form of interventions. This is limited as it fails to explain the function, or purpose, of interventions. This paper discusses a taxonomy for alcohol misuse prevention that considers both the form and function of prevention interventions. It adds to the previous literature by incorporating subcategories of classification for environmental prevention. Recent Findings. Within each taxonomy category there are interventions which are more, and less effective, but not one single category has comprehensive evidence of efficacy. Environmental prevention may have the greatest potential to deliver interventions that are efficient, cost effective and reduce health inequalities. However, comprehensive, systems oriented, prevention coverage should combine all three functional approaches. Summary. This taxonomy can be used to organise and classify alcohol misuse prevention interventions and to determine where alcohol misuse prevention strategies and research is warranted. Furthermore, it can help practitioners and researchers to consider the subcategories of environmental prevention: an area that is rapidly gaining traction in the prevention field

The effect of alcohol strength on alcohol consumption: a randomised controlled cross-over pilot trial

Background: Effective interventions are required to reduce alcohol consumption and its associated harms at the population level. Reducing the alcohol content of beverages has the potential to reduce alcohol consumption through non-conscious processes. Before implementing a randomised controlled trial (RCT) to assess the effect of alcohol strength on alcohol consumption its feasibility needs to established. This study aims to pilot a RCT and obtain data to estimate key parameters required when designing a RCT. These key parameters include the direction and size of the intervention effect, the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, participant recruitment and attrition. Methods: A double blind randomised controlled cross-over pilot trial comparing the number of units of reduced strength lager consumed and the number of units of regular strength lager consumed in a single drinking occasion within licensed premises in the UK. Descriptive statistics will report the efficacy and efficiency of the study processes, and the rates of licensed premises recruitment, participant recruitment and attrition. Mean and 95% confidence intervals will be used to compare the consumption of alcohol, and the duration of participation in study sessions, between the intervention arm and the control arm. The mean and standard deviation of UK units of alcohol consumed will be used to calculate a sample size for a definitive RCT. Discussion: This is the first naturalistic experimental study to assess the effect of alcohol strength on alcohol consumption in a single drinking occasion within licensed premises. Results from this pilot study will establish the feasibility of, and inform key data parameters for, a larger-scale study