Trajectories of substance use and substance use problems in adolescents and young adults

This thesis examines the determinants of substance use behaviours and substance use problems at several stages in adolescence and adulthood. Analysis is based on a large, representative US-based longitudinal data set, the National Longitudinal Study of Adolescent to Adult Health (Add Health). The thesis consists of four linked empirical studies. The first investigates the effects of parental beliefs about their adolescent children’s smoking and drinking on adolescents’ actual engagement in these behaviours. Previous literature has shown a strong association between parental beliefs and adolescent substance use, but has not addressed the issue of causality in this relationship. This chapter attempts to identify causal relationships via propensity score matching techniques. The second study investigates the effects of parenting styles on substance use problems in adulthood. Previous studies have found a significant association between parenting styles and adolescent substance use; I investigate whether this effect persists into adulthood. Using structural equation modelling, I find that parental warmth has long-term effects on substance use in adulthood. Parental control, while reducing the likelihood of initiation in adolescence, does not reduce the incidence of substance use problems in adulthood. The third study focuses on the determinants of substance use cessation, among adults who are smokers, drinkers and users of illicit drugs. The effects of parenting behaviours are relatively modest, but I find that the level of religiosity is an important determinant of cessation. In the final study, I examine the effect of religiosity on cessation and find that religious faith and (particularly) participation in church services and activities increase the likelihood of substance use cessation. Taken together, these studies provide a thorough explanation of the association between parent-adolescent relationships, religiosity, and substance use trajectories. More importantly, the thesis uncovers the underlying mechanisms that explain various stages and levels of substance use at different periods of life

Comparisons of home-based arts engagement across three national lockdowns during the COVID-19 pandemic in England

Between March 2020 and March 2021, the United Kingdom (UK) experienced three lockdowns due to the COVID-19 pandemic. Given the evident association between arts engagement and wellbeing, this study was designed to compare the predictors and patterns of home-based arts engagement during these lockdowns. Data analysed in this study were from the UK COVID-19 Social Study run by University College London. Multinomial logistic regression was used to identify predictors of arts engagement and compare (i) respondents’ engagement levels during the first lockdown in April/May 2020 and their levels in pre-pandemic times (N = 23,086), (ii) their engagement levels during the second lockdown in November/December 2020 with their levels during the first lockdown (N = 11,481), and (iii) their engagement levels during the third lockdown in January/February 2021 with their levels during the first lockdown (N = 13,270). During first lockdown, 1 in 4 increased their arts engagement and 1 in 6 decreased it. Of those who increased, 2 in 5 maintained or further increased their engagement in subsequent lockdowns, but just 7% of those who had decreased their engagement increased it. Younger adults (aged 18–29) showed initial increases in first lockdown, whilst people who were not employed and those with a physical health condition showed decreases and people with a mental health condition showed changes during the first lockdown (both increases and decreases). Females and people with higher education showed continuous changes across the three lockdowns, with women being more likely to increase their engagement and those with higher education being less likely to decrease. People of ethnic minorities and those with higher income declined their engagement in the third lockdown. This study provides insight into levels of arts engagement across the three national lockdowns in the UK and suggests that the pandemic may have affected long-term cultural behaviours for some groups

Mental health and wellbeing among people with informal caring responsibilities across different time points during the COVID-19 pandemic: a population-based propensity score matching analysis

AIMS: Due to a prolonged period of national and regional lockdown measures during the coronavirus (COVID-19) pandemic, there has been an increase reliance on informal care for informal carers. In light of this, the current study compared the experiences of carers and non-carers on various mental health and wellbeing measures across six key time points during the pandemic. METHODS: Data analysed were from the University College London (UCL) COVID -19 Social Study. Our study focused on six time points in England: (1) the first national lockdown (March-April 2020); (2) the beginning of first lockdown rules easing (May 2020); (3) the second national lockdown (November 2020); (4) the third national lockdown (January 2021); (5) the easing of the third lockdown (March 2021); and (6) the end of restrictions (July-August 2021). We considered five mental health and wellbeing measures: depressive symptoms, anxiety symptoms, loneliness, life satisfaction, and sense of being worthwhile. Propensity score matching was applied for the analyses. RESULTS: We found that informal carers experienced higher levels of depressive and anxiety symptoms than non-carers across much of the pandemic. During the first national lockdown, carers also experienced a higher sense of life being worthwhile. No association was found between informal caring responsibilities and levels of loneliness and life satisfaction. CONCLUSION: Given that carers are an essential national healthcare support, especially during a pandemic, it is crucial to integrate carers' needs into healthcare planning and delivery. These results highlight that there is a pressing need to provide adequate and targeted mental health support for carers during and following this pandemic

Longitudinal associations between going outdoors and mental health and wellbeing during a COVID-19 lockdown in the UK

The COVID-19 pandemic led to national lockdowns in countries around the world. Whilst lockdowns were shown to be effective in reducing the spread of disease, they were also associated with adverse effects on people’s mental health and wellbeing. Previous studies have suggested that time spent outside may have played a role in mitigating these negative effects, but research on this topic remains limited. Therefore, this study was designed to explore the longitudinal associations between going outdoors and people’s mental health and wellbeing during the first national lockdown (March–May 2020) in the UK. Data from 35,301 participants from the COVID-19 Social Study were analysed. Fixed effects regression was used to explore the longitudinal association between changes in going outdoors (the number of days spent outside) and changes in depressive symptoms, anxiety symptoms, life satisfaction and loneliness. A range of household and neighbourhood moderators were examined. Results show that an increase in the number of days spent outside was associated with decreases in depressive and anxiety symptoms and an increase in life satisfaction. Associations were more salient amongst people living with others, and those with greater satisfaction with their neighbourhood walkability and green spaces. No longitudinal association was found with loneliness. Overall, our analyses showed a positive association between going outdoors and improved mental health and wellbeing during the first COVID-19 lockdown in the UK. These findings are important for formulating guidance for people to stay well at home during pandemics and for the on-going nature-based social prescribing scheme

Frequency of leisure activity engagement and health functioning over a 4-year period: a population-based study amongst middle-aged adults

Rationale: Leisure activities have wide-ranging benefits for physical and mental health. However, previous studies have often focused on “leisure” as a homogeneous group of activities. This study was therefore designed to take a prospective and comparative approach exploring different types of leisure activities, as well as investigating whether frequency of engagement is associated with strength of benefits. / Method: Data from the 1970 British Cohort Study Waves 9 (age 42) and 10 (age 46) were analysed (N = 5,639). Eight domains derived from the SF-36 health survey questionnaire were used to measure health functioning (general health, vitality, bodily pain, social functioning, physical functioning, mental health, role limitations due to emotional, and role limitations due to physical problems). Leisure activities included physical activity, culture engagement, arts participation, volunteering or community engagement, and literature activities. Both ordinary least squares and logistic regressions were applied. / Results: Physical activity was associated with greater levels of physical functioning, general health, and vitality at higher frequencies, while cultural engagement was associated with social functioning and physical functioning when engaged in several times a year. Arts participation and literature activities had a general negative association with health functioning. Engagements in volunteering/community groups showed varying associations with health functioning (both positive and negative) depending on the levels of engagements. / Conclusion: This research suggests that the types of leisure activities and levels of engagement can have differential associations with health amongst middle-aged adults. This may be helpful for public health initiatives and programmes such as social prescribing schemes when formulating programmes, especially regarding ‘dosage’ of engagement. Further, the overall benefits of high engagement frequency suggest that increasing leisure engagement could play an important role in supporting improving health and wellbeing at a population level

Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries

Growing aging populations pose a threat to global health because of the social and psychological challenges they experience. To mitigate this, many countries promote hobby engagement to support and improve mental health. Yet, it remains unclear whether there is consistency in benefits across different national settings. We harmonized measures of hobby engagement and multiple aspects of mental wellbeing across 16 nations represented in five longitudinal studies (N = 93,263). Prevalence of hobby engagement varied substantially across countries, from 51.0% of Spanish respondents to 96.0% of Danish respondents. Fixed effects models and multinational meta-analyses were applied to compare the longitudinal associations between hobbies and mental wellbeing. Independent of confounders, having a hobby was associated with fewer depressive symptoms (pooled coefficient = −0.10; 95% confidence intervals (CI) = −0.13, −0.07), and higher levels of self-reported health (pooled coefficient = 0.06; 95% CI = 0.03, 0.08), happiness (pooled coefficient = 0.09; 95% CI = 0.06, 0.13) and life satisfaction (pooled coefficient = 0.10; 95% CI = 0.08, 0.12). Further analyses suggested a temporal relationship. The strength of these associations, and prevalence of hobby engagement, were correlated with macrolevel factors such as life expectancy and national happiness levels but overall, little variance in findings was explained by country-level factors (<9%). Given the relative universality of findings, ensuring equality in hobby engagement within and between countries should be a priority for promoting healthy aging

Association between screen viewing duration and sleep duration, Sleep quality, And excessive daytime sleepiness among adolescents in Hong Kong

© 2014 by the authors; licensee MDPI, Basel, Switzerland. Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration w ith which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.Link_to_subscribed_fulltex