Family relationship quality and early alcohol use : evidence for gender-specific risk processes

Objective: Family characteristics (relationship quality, parental behaviors, and attitudes relating to alcohol use) are known to influence alcohol use in the mid-teen years, and there is evidence that family characteristics have different influences on mid-teen girls versus boys. This study examined child gender differences in the association of family relationship quality, parental disapproval of children's alcohol use, and parental alcohol use with early adolescent alcohol use.

Method: Grade 6 and 8 students (modal age 11 and 13, respectively; N = 6,837; 52.6% female) were recruited from 231 schools across three Australian states. Hypotheses were tested using two-level ordinal logistic regression (individuals nested within schools). The main dependent measure was lifetime frequency of early adolescent alcohol consumption. Independent variables included mother's/father's alcohol use, closeness, conflict, and disapproval of adolescent alcohol use. Control variables included sensation seeking, peer alcohol use, and socioeconomic disadvantage.

Results: The key findings were that for the young age group (Grade 6), emotional closeness to the parent of the opposite sex was protective. Family conflict was associated with females' drinking in both age groups but not males' drinking.

Conclusions: There was evidence of gender differences in the epidemiology of family relationship quality and early alcohol use. Social developmental models may need revision to account for these child gender differences. Gender-specific family dynamics may be an important consideration for family-oriented prevention strategy.

Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents

INTRODUCTION AND AIMS: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample. DESIGN AND METHODS: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated. RESULTS: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23). CONCLUSIONS: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2015].

The influence of families on early adolescent school connectedness : evidence that this association varies with adolescent involvement in peer drinking networks

School connectedness is central to the long term well-being of adolescents, and high quality parent–child relationships facilitate school connectedness. This study examined the extent to which family relationship quality is associated with the school connectedness of pre- and early teenagers, and how this association varies with adolescent involvement in peer drinking networks. The sample consisted of 7,372 10–14 year olds recruited from 231 schools in 30 Australian communities. Participants completed the Communities that Care youth survey. A multi-level model of school connectedness was used, with a random term for school-level variation. Key independent variables included family relationship quality, peer drinking networks, and school grade. Control variables included child gender, sensation seeking, depression, child alcohol use, parent education, and language spoken at home. For grade 6 students, the association of family relationship quality and school connectedness was lower when peer drinking networks were present, and this effect was nonsignificant for older (grade 8) students. Post hoc analyses indicated that the effect for family relationship quality on school connectedness was nonsignificant when adolescents in grade 6 reported that the majority of friends consumed alcohol. The results point to the importance of family-school partnerships in early intervention and prevention.

A longitudinal study of the association of adolescent polydrug use, alcohol use and high school non-completion

AIMS: Failure to complete high school predicts substantial economic and social disadvantage in adult life. The aim of this study was to determine the longitudinal association of mid-adolescent polydrug use and high school non-completion, relative to other drug use profiles. DESIGN: A longitudinal analysis of the relationship between polydrug use in three cohorts at grade 9 (age 14-15 years) and school non-completion (reported post-high school). SETTING: A State-representative sample of students across Victoria, Australia. PARTICIPANTS: A total of 2287 secondary school students from 152 high schools. The retention rate was 85%. MEASUREMENTS: The primary outcome was non-completion of grade 12 (assessed at age 19-23 years). At grade 9, predictors included 30-day use of eight drugs, school commitment, academic failure and peer drug use. Other controls included socio-economic status, family relationship quality, depressive symptoms, gender, age and cohort. FINDINGS: Three distinct classes of drug use were identified-no drug use (31.7%), mainly alcohol use (61.8%) and polydrug use (6.5%). Polydrug users were characterized by high rates of alcohol, tobacco and cannabis use. In the full model, mainly alcohol users and polydrug users were less likely to complete school than non-drug users [odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.17-2.03) and OR = 2.51, 95% CI = 1.45-4.33), respectively, P < 0.001]. These effects were independent of school commitment, academic failure, peer drug use and other controls. CONCLUSIONS: Mid-adolescent polydrug use in Australia predicts subsequent school non-completion after accounting for a range of potential confounding factors. Adolescents who mainly consume alcohol are also at elevated risk of school non-completion.

Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study

BACKGROUND: The majority of in-hospital deaths of children occur in paediatric and neonatal intensive care units. For nurses working in these settings, this can be a source of significant anxiety, discomfort and sense of failure.

OBJECTIVES: The objectives of this study were to explore how NICU/PICU nurses care for families before and after death; to explore the nurses' perspectives on their preparedness/ability to provide family care; and to determine the emotional content of language used by nurse participants.

METHODS: Focus group and individual interviews were conducted with 22 registered nurses from neonatal and paediatric intensive care units of two major metropolitan hospitals in Australia. All data were audio recorded and transcribed verbatim. Transcripts were then analysed thematically and using Linguistic Inquiry to examine emotional content.

RESULTS: Four core themes were identified: preparing for death; communication challenges; the nurse-family relationship and resilience of nurses. Findings suggested that continuing to provide aggressive treatment to a dying child/infant whilst simultaneously caring for the family caused discomfort and frustration for nurses. Nurses sometimes delayed death to allow families to prepare, as evidenced in the Linguistic Inquiry analysis, which enabled differentiation between types of emotional talk such as anger talk, anxiety talk and sadness talk. PICU nurses had significantly more anxiety talk (p=0.018) than NICU nurses.

CONCLUSION: This study provided rich insights into the experiences of nurses who are caring for dying children including the nurses' need to balance the often aggressive treatments with preparation of the family for the possibility of their child's death. There is some room for improvement in nurses' provision of anticipatory guidance, which encompasses effective and open communication, focussed on preparing families for the child's death.

The Relationship of Childhood Family Characteristics and Current Attachment Styles to Depression and Depressive Vulnerability

The role of adult romantic attachment style in the relationship between childhood experiences and current depression was examined. Childhood maltreatment, parental separation/divorce, family adaptability and cohesion during childhood, current attachment style in romantic relationships, vulnerability to depression, and current depressive symptoms were measured in a self-selected sample of adults (N = 133). A large degree of overlap was found in the experience of different types of maltreatment during childhood. Depressive symptoms were uniquely predicted by the sexual abuse and neglect scales, with significant additional variance explained after entering the degree to which respondents' current romantic attachment style was “secure”. Maltreatment and family dysfunction in childhood were significant predictors of depression and vulnerability to depression. Although maltreatment scores did not differentiate between different attachment styles, the degree to which respondents were securely attached may explain -in part -the association between early childhood environment and depressive symptoms in adulthood.

The relationship between childhood injuries and family type

This article focuses on the relationship between childhood injuries and family type. Injury is the leading cause of death among children in Australia. While children in sole-parent families were over-represented among the 17 percent of children who sustained an injury in the Growing Up in Australia study, once socio-economic indicators were taken into account, the increased risk for injury for children in a sole-parent family was no longer apparent. The Draft National Injury Prevention Plan was developed by the Australian Government Department of Health and Aging to aid in efforts for the prevention of child injury.

Analytical relationship between family history and genetic and environmental risks, with application to female breast cancer

It is well established in genetic epidemiology that family history is an important indicator of familial aggregation of disease in a family. A strong genetic risk factor or an environmental risk factor with high familial correlation can result in a strong family history. In this paper, family history refers to the number of first-degree relatives affected with the disease. Cui and Hopper (Journal of Epidemiology and Biostatistics 2001; 6: 331-342) proposed an analytical relationship between family history and relevant genetic parameters. In this paper we expand the relationship to both genetic and environmental risk factors. We established a closed-form formula for family history as a function of genetic and environmental parameters which include genetic and environmental relative risks, genotype frequency, prevalence and familial correlation of the environmental risk factor. The relationship is illustrated by an example of female breast cancer in Australia. For genetic and environmental relative risks less than 10, most of the female breast cancer cases occur between the age of 40 and 60 years. A higher genetic or environmental relative risk will move the peak of the distribution to a younger age. A more common disease allele or more prevalent environmental risk factor will move the peak to an older age. For a proband with breast cancer, it is most likely (with probability ge80%) that none of her first-degree relatives is affected with the disease. To enable the probability of having a positive family history to reach 50%, the environmental relative risks must be extremely as high as 100, the familial correlation as high as 0.8 and the prevalence as low as 0.1. For genetic risk alone, even the relative risk is as high as 100, the probability of having a positive family history can only reach about 30%. This suggests that the environmental risk factor seems to play a more important role in determining a strong family history than the genetic risk factor.

Childhood cruelty to animals in China: the relationship with psychological adjustment and family functioning

Background
The current study broadened the general scope of research conducted on childhood cruelty to animals by examining the association between psychological adjustment, family functioning and animal cruelty in an Eastern context, China.

Method
The mothers and fathers of 729 children attending primary school in Chengdu, China participated in this study. Each parent completed the Strengths and Difficulties Questionnaire, the Chinese Family Assessment Instrument, and the Children's Attitudes and Behaviours towards Animals questionnaire.

Results
Findings from an actor partner interdependence model demonstrated that parents' ratings of family functioning and of their child's externalizing coping style predicted only modest amounts of variance in animal cruelty. In particular, parents' ratings of their child's externalizing coping style most consistently predicted animal cruelty. Family functioning, fathers' ratings in particular, played a minor role, more so for boys compared with girls.

Conclusion
This study provided the first insight into childhood animal cruelty in China, and suggests that further research may enhance our understanding of these phenomena.

Are married couples happier in their relationships than cohabiting couples? Intimacy and relationship factors

This study was designed to examine the relationship between dyadic adjustment and intimacy, and to determine how this varies for different types of relationships between males and females, and for relationships of different duration. Eighty-seven heterosexual couples (10 dating, 21 living together, 56 married) participated in the study. The results demonstrated that there was a strong interrelationship between intimacy and dyadic adjustment for both males and females. Those in relationships of longer duration and married couples experienced higher levels of intimacy and relationship satisfaction than other couples. There was a general trend for married couples and those who were living together to have a higher level of agreement on their levels of intimacy and relationship adjustment than couples who were dating. The implication of these findings for obtaining a better understanding of the lifecycle of relationships is discussed.

Child maltreatment, family characteristics and adult adjustment: mediating and moderating processes

Two alternate processes that may explain the relationship between child maltreatment, childhood family characteristics and adult adjustment (mediation and moderation) were tested using retrospective data from a community sample (N = 175). The levels of five different types of child maltreatment did not mediate the relationship between childhood family variables and adult adjustment. In contrast, family background played a mediating role in the relationship between maltreatment and adjustment. Evidence of moderation was found in the interactions between different maltreatment types in predicting adjustment. Partial support was found for the moderating influence of family factors on the relationship of maltreatment to adjustment.

Improving child and family outcomes following complicated births requiring admission to neonatal intensive care units

This paper reviews current research regarding the impact of birth complications, such as preterm labour, on parents and the nuclear family system. Specifically, how parents cope with the neonatal intensive care unit (NICU) experience and the associated decision-making tasks required during complicated births will be investigated. Consequences of poor adaptation to prematurity for the parent, family and infant relationships will also be discussed. The importance of informed decision-making, perceived control, self-esteem and the benefits of certain strategies, such as kangaroo care (skin-to-skin contact), in the facilitation of greater levels of attachment and improved relationships, will be highlighted. The paper concludes with suggestions for future research areas to focus on finding better ways to prepare and support parents in these situations, thus improving the quality of relationships between parents and with their child.