Relations between Depression, Alcohol and Gender in the Metropolitan Region of São Paulo, Brazil

As part of the GENACIS project, this paper sought to assess the prevalence of depression in an urban sample in the city of São Paulo, Brazil, as well as the association between depression and alcohol abuse according to gender. To achieve this, an epidemiological survey was conducted using a stratified probability sample, including 2,083 adults. CIDI SF was used to identify depression. The Rao Scott test and multivariate logistic regression were used for statistical analysis. The response rate was 74.9%. Females (58.3%) under 40 years of age (52%) were predominant. The prevalence of depression was 28.3% for women and 12.7% for men. Most men declared being drinkers (61.1%) in the last year. Depression was associated with an alcohol drinking pattern, mostly binge drinking, in addition to the occurrence of problems derived from alcohol use. Most women declared being abstainers (69.5%). Depression was associated with cohabiting with spouses with alcohol-related problems. Results reveal that the association between depression and alcohol consumption is distinct between genders.

Double Take Project: Using Applied Theatre For Campus Climate Change

Despite research gathered in the Campus Climate Report, I believe that it underrepresented the student experience of the social scene. The document primarily served as an identification tool for four major problems on campus: binge drinking, sexual assault, diversity, and disengagement in the classroom. Double Take Project also identifies similar issues however, this project uses theatrical techniques to gather the anecdotal reality of the student perspective. Double Take Project expands beyond the Campus Climate Report to inspire dialogue in a variety of student-to-student interactions and, more importantly, the project seeks action and solution plans. The social scene dominates our culture and its many issues result in concern for the safety, self-identity, and development of Bucknell students into thriving adults. Double Take Project is rooted in the belief that theatre is a palpable tool for social change. Over the course of many events, Double Take Project has utilized facets of theatre to provide opportunities to voice discontent, widen perception of normalcy on campus, and inspire confidence to act on personal beliefs. The Double Take Project uses many Applied Theatre methods to impact the social scene. For example, I conducted 36 student interviews and transformed the stories into a one-woman show, Rage Behind Curtains, which I performed at multiple venues across campus. I also used interviews to create a radio show airing one story per day. I conducted ten workshops with student groups, Fraternities and Sororities, and in the classroom utilizing Augusto Boal’s Theatre of the Oppressed (TO) techniques. I also created a “social scene confessional” where I stood outside the Elaine Langone Center with a sign that read, “Tell me a story about the social scene” from a wide variety of Bucknell students. Finally, I have assembled a Forum Theatre Company based on Augusto Boal’s method of the spect-actor, utilizing participants as both actors and spectators in the theatre piece. All of the names indicated in this paper have been altered to protect the identity of the participants. While planning events and conducting various theatrical experiences, I learned that there are a series of internal and external issues contributing to our social environment. Internally, students are conflicted with personal beliefs while battling outward social pressure. Whether they are on the outskirts or center of the social scene determines their response to this conflict. For example, I have discovered that students on the borders of the social culture respond with criticism because they feel excluded, whereas the student’s centrally involved critique the culture in private and while their persona appears to not want change. Externally, there are many structural issues that contribute to the current social climate such as without Fraternity meal plans, Cafeteria space is not sufficient to feed all of the students, exclusive party culture, and gendered housing. Through meetings with Deans and staff, I have learned there are also problems between administration and students, resulting in resentment and blame. Although addressing structural issues would instigate immediate change, in my opinion, internal student conflicts are the primary cause for the current negative social atmosphere. I believe that pressure to conform is rooted in lack of personal identity. Because students simply do not know themselves, they form strong social groups that become the definition of themselves. Without confident self-awareness, large and powerful groups coerce students to accept social norms resulting in the individual’s outward distaste for change, yet internal discomfort.

Evaluation of therapist and client language in Motivational Interviewing (MI) sessions: A secondary analysis of data from the Southern Methodist Alcohol Research Trial (SMART) study

In the United States, “binge” drinking among college students is an emerging public health concern due to the significant physical and psychological effects on young adults. The focus is on identifying interventions that can help decrease high-risk drinking behavior among this group of drinkers. One such intervention is Motivational interviewing (MI), a client-centered therapy that aims at resolving client ambivalence by developing discrepancy and engaging the client in change talk. Of late, there is a growing interest in determining the active ingredients that influence the alliance between the therapist and the client. This study is a secondary analysis of the data obtained from the Southern Methodist Alcohol Research Trial (SMART) project, a dismantling trial of MI and feedback among heavy drinking college students. The present project examines the relationship between therapist and client language in MI sessions on a sample of “binge” drinking college students. Of the 126 SMART tapes, 30 tapes (‘MI with feedback’ group = 15, ‘MI only’ group = 15) were randomly selected for this study. MISC 2.1, a mutually exclusive and exhaustive coding system, was used to code the audio/videotaped MI sessions. Therapist and client language were analyzed for communication characteristics. Overall, therapists adopted a MI consistent style and clients were found to engage in change talk. Counselor acceptance, empathy, spirit, and complex reflections were all significantly related to client change talk (p-values ranged from 0.001 to 0.047). Additionally, therapist ‘advice without permission’ and MI Inconsistent therapist behaviors were strongly correlated with client sustain talk (p-values ranged from 0.006 to 0.048). Simple linear regression models showed a significant correlation between MI consistent (MICO) therapist language (independent variable) and change talk (dependent variable) and MI inconsistent (MIIN) therapist language (independent variable) and sustain talk (dependent variable). The study has several limitations such as small sample size, self-selection bias, poor inter-rater reliability for the global scales and the lack of a temporal measure of therapist and client language. Future studies might consider a larger sample size to obtain more statistical power. In addition the correlation between therapist language, client language and drinking outcome needs to be explored.^

Air Force web-based preventive health assessement alcohol screening effectiveness using the Alcohol Use Disorders Identification Tool (AUDIT)

Alcohol consumption has a long-standing tradition in the United States Air Force (USAF). From squadron bars to officers and enlisted clubs, alcohol has been used in social settings to increase morale and also as a way to help decrease the stress of military operations. Surveys have demonstrated that the USAF has more than double the percentage of heavy drinkers than the US population. More than one-third of the Air Force reports binge drinking in the last month while only six percent of the nation reports the same consumption pattern.^ However, alcohol has a significant harmful health effect if consumed in excess. As part of an overall prevention and treatment program aimed at curbing the harmful effects of alcohol consumption, the USAF uses the Alcohol Use Disorder Identification Test (AUDIT) to screen for high-risk alcohol consumption patterns before alcohol disorder and disability occur. All Air Force active-duty members are required to complete a yearly Preventive Health Assessment questionnaire. Various health topics are included in this questionnaire including nutrition, exercise, tobacco use, family history, mental health and alcohol use. While this questionnaire has been available in a web-based format for several years, mandatory use was not implemented until 2009.^ Although the AUDIT was selected due to its effectiveness in assessing high-risk alcohol consumption in other populations, its effectiveness in the Air Force population had not been studied previously. In order to assess the sensitivity, specificity, and positive predictive value of this screening tool, the Air Force Web-based Preventive Health Assessment alcohol screening results were compared to whether any alcohol-related diagnosis was made from January 1, 2009 to March 31, 2010.^ While the AUDIT has previously been shown to have a high sensitivity and specificity, the Air Force screening values were 27.9% and 93.0% respectively. Positive predictive value was only 4.9%. With the screening statistics found, less than one-third of those having an alcohol disorder will be found with this screening tool and only 1 out of 20 Airmen who require further evaluation actually have an alcohol-related diagnosis.^

Diagnóstico da exposição fetal ao álcool através de biomarcadores em mecônio

A grande prevalência do consumo de álcool por mulheres em idade reprodutiva aliada à gravidez não planejada expõe a gestante a um elevado risco de se alcoolizar em algum momento da gestação, principalmente no início do período gestacional em que a maioria delas ainda não tomou ciência do fato. Assim, torna-se extremamente relevante o desenvolvimento de métodos de detecção precoce de recém-nascidos em risco de desenvolvimento de problemas do espectro dos transtornos relacionados à exposição fetal ao álcool. O objetivo desse estudo foi desenvolver, validar e avaliar a eficácia de um método de quantificação de ésteres etílicos de ácidos graxos (FAEEs) no mecônio de recém-nascidos para avaliação da exposição fetal ao álcool. Os FAEEs avaliados foram: palmitato de etila, estearato de etila, oleato de etila e linoleato de etila.O método consistiu no preparo das amostras pela extração líquido-líquido utilizando água, acetona e hexano, seguida de extração em fase sólida empregando cartuchos de aminopropilsilica. A separação e quantificação dos analitos foi realizada por cromatografia em fase gasosa acoplada à espectrometria de massas. Os limites de quantificação (LQ) variaram entre 50-100ng/g. A curva de calibração foi linear de LQ até 2000ng/g para todos os analitos. A recuperação variou de 69,79% a 106,57%. Os analitos demonstraram estabilidade no ensaio de pós-processamento e em solução. O método foi aplicado em amostras de mecônio de 160 recém-nascidos recrutados em uma maternidade pública de Ribeirão Preto-SP. O consumo de álcool materno foi reportado utilizando questionários de rastreamento validados T-ACE e AUDIT e relatos retrospectivos da quantidade e frequência de álcool consumida ao longo da gestação. A eficácia do método analítico em identificar os casos positivos foi determinada pela curva Receiver Operating Characteristic (ROC). O consumo alcoólico de risco foi identificado pelo T-ACE em 31,3% das participantes e 50% reportaram o uso de álcool durante a gestação. 51,3% dos recém-nascidos apresentaram FAEEs em seu mecônio, sendo que 33,1% apresentaram altas concentrações para a somatória dos FAEEs (maior que 500ng/g), compatível com um consumo abusivo de álcool. O oleato de etila foi o biomarcador mais prevalente e o linoleato de etila foi o biomarcador que apresentou as maiores concentrações. Houve uma variabilidade no perfil de distribuição dos FAEEs entre os indivíduos, e discordâncias entre a presença de FAEEs e o consumo reportado pela mãe. A concentração total dos FAEEs nos mecônio mostrou-se como melhor indicador da exposição fetal ao álcool quando comparado com o uso de um único biomarcador. O ponto de corte para esta população foi de aproximadamente 600ng/g para uso tipo binge (três ou mais doses por ocasião) com sensibilidade de 71,43% e especificidade de 84,37%. Este estudo reforça a importância da utilização de métodos laboratoriais na identificação da exposição fetal ao álcool.

Who will see me? The impact of type of audience on willingness to display group-mediated attitude-intention consistency

The present study examined the role that group norms, group identification, and imagined audience (in-group vs. out-group) play in attitude-behavior processes. University students (N = 187) participated in a study concerned with the prediction of consumer behavior. Attitudes toward drinking their preferred beer, subjective norm, perceived behavioral control, group norm, and group identification were assessed. Intentions and perceived audience reactions to consumption were assessed. As expected, group norms, identification, and imagined audience interacted to influence likelihood of drinking one's preferred beer and perceived audience reactions. High identifiers were more responsive to group norms in the presence of an in-group audience than an out-group audience. The present results indicate that audience concerns impact upon the relationship between attitude., and behavior.

Sense of coherence and diabetes:a prospective occupational cohort

Background: Sense of coherence (SOC) is an individual characteristic related to a positive life orientation leading to effective coping. A weak SOC has been associated with indicators of general morbidity and mortality. However, the relationship between SOC and diabetes has not been studied in prospective design. The present study prospectively examined the relationship between a weak SOC and the incidence of diabetes. Methods: The relationship between a weak SOC and the incidence of diabetes was investigated among 5827 Finnish male employees aged 18–65 at baseline (1986). SOC was measured by questionnaire survey at baseline. Data on prescription diabetes drugs from 1987 to 2004 were obtained from the Drug Imbursement Register held by the Social Insurance Institution. Results: During the follow-up, 313 cases of diabetes were recorded. A weak SOC was associated with a 46% higher risk of diabetes in participants who had been =<50 years of age on entry into the study. This association was independent of age, education, marital status, psychological distress, self-rated health, smoking status, binge drinking and physical activity. No similar association was observed in older employees. Conclusion: The results suggest that besides focusing on well-known risk factors for diabetes, strengthening SOC in employees of =<50 years of age can also play a role in attempts to tackle increasing rates of diabetes.

The role of context and timeframe in moderating relationships within the theory of planned behaviour

This study examined the moderating effect of context and timeframe on the predictive ability of Theory of Planned Behaviour (TPB) constructs. Three hundred and eighty-three students completed TPB measures either in a campus bar or a library and were randomly allocated to one of three timeframe conditions: tonight, tomorrow or next week. There was a threeway interaction such that the subjective norms of participants in a bar were more predictive of their intentions to binge drink that night, whereas thesubjective norms of participants in a library were less predictive of intentions to binge drink that night. This research provides empirical evidence that ignoring context may result in underestimation of the importance of normative factors in binge drinking. It also suggests that other research utilising the TPB needs to take greater account of the impact of context of data collection, which has been neglected to date.

What do people think about when they answer theory of planned behaviour questionnaires? A 'think aloud' study

Two studies aiming to identify the nature and extent of problems that people have when completing theory of planned behaviour (TPB) questionnaires, using a cognitive interviewing approach are reported. Both studies required participants to 'think aloud' as they completed TPB questionnaires about: (a) increasing physical activity (six general public participants); and (b) binge drinking (13 students). Most people had no identifiable problems with the majority of questions. However, there were problems common to both studies, relating to information retrieval and to participants answering different questions from those intended by researchers. Questions about normative influence were particularly problematic. The standard procedure for developing TPB questionnaires may systematically produce problematic questions. Suggestions are made for improving this procedure. Copyright © 2007 SAGE Publications.

The longitudinal influence of physical activity on adolescent alcohol use

The purpose of this research was to explore the influence of physical activity on depressive symptomatology and adolescent alcohol use during an underexplored transition from middle school to high school. The study initiative is supported by the fact that research has shown a unique and simultaneous decrease in physical activity (CDC, 2010), increase in depressive symptomatology (SAMHSA, 2010) and increase in alcohol use (USDHHS, 2011) during middle adolescence. A risk and resilience framework was used in efforts to conceptualize how these variables may be inter-related. Data from waves I and II of the National Longitudinal Study of Adolescent Health (Add Health, Bearman et al., 1997; Udry, 1997) was used (N = 2,054; aged 13–15 years). The sample was ethnically and racially diverse (58.2% White, 24% African American, 11.7% Hispanic, and 6.1% other). Structural equation models were developed to test the potential influence physical activity has on adolescent alcohol use (e.g., frequency of alcohol use and binge alcohol use) and whether any of the relationship was mediated by depressive symptomatology or varied as a function of gender. Results demonstrated that there was a significant influence of structured physical activity (e.g., sports) on adolescent alcohol use. However, contrary to the proposed hypothesis, engaging in structured physical activity appeared to contribute to greater binge drinking among adolescents. Instead of demonstrating a protective feature, the findings suggest that engaging in structured physical activity places adolescents at risk for binge drinking. Furthermore, no significant relationships, positive or negative, were found for the influence of physical activity (structured and unstructured) on frequency of alcohol use. The findings regarding mediation revealed binge drinking as a mediator between physical activity (structured) and depressive symptomatology. These findings provide support for research, practice, and policy initiatives focused on developing a more comprehensive understanding of alcohol use drinking behaviors, physical activity involvement, and depressive symptomatology among adolescents, which this study demonstrates are all associated with one another. Results represent an initial step toward evaluating these relationships at a much younger age.

Tequila at Sunrise: Spring Break Travel Motivations and Risk Behaviors of American Students in Acapulco, Mexico

Little research has been completed regarding spring break motivations and behaviors of American students in foreign destinations, specifically in Mexico. This paper looks at push and pull motivations in relation to drug and alcohol consumption and findings indicate greater drug and alcohol use among those who selected “party reputation” and “to go wild” as travel motivations. Binge drinking, sexual activity, and drug use among students on spring break in Acapulco, Mexico were also analyzed and compared to past findings within the United States. Results suggest that students are involved in heavy alcohol consumption and significant drug use. Additionally, high rates of sexual activity occur on spring break and results suggest low condom use, placing students at higher risks for the contraction of sexually transmitted infections.

Alcohol-Related Problems in Eastern Europe : A Comparative Perspective

This thesis investigates the association between alcohol consumption and alcohol-related harm in Eastern Europe. The main aim was to estimate to what extent changes in per capita alcohol consumption have an impact on different forms of alcohol-related mortality, and to put the results in an international comparative perspective. The thesis includes four papers; the first two papers use aggregate time-series analysis to assess how changes in per capita consumption affect rates in suicide mortality and fatal non-intentional injuries in several Eastern European countries, respectively. The third paper applies the same methodological approach to analyse the population-level relationship between alcohol and homicide in Russia and the U.S.. The fourth paper employs survey data to assess how the risk of experiencing alcohol-related problems in relation to volume of consumption in the Baltic countries compares to Sweden and Italy. The results of the first three papers suggests: (i) that changes in per capita consumption are significantly related to changes in mortality rates of suicide, non-intentional injuries and homicide in the countries under study; (ii) that the relationship is stronger for men than for women, and (iii) that the relationship tends to be stronger in the countries with more detrimental drinking patterns, e.g. Russia. The results of the fourth paper suggest that the risk of experiencing alcohol-related problems in relation to level of drinking in the Baltic countries is similar to the corresponding risk in Sweden, but considerably stronger than in Italy. In conclusion, the findings support the significance of a public health approach to alcohol-related problems in Eastern Europe, i.e., policy measures directed towards total alcohol consumption. In addition, strategies aimed at reducing the occurrence of binge drinking seem to have great potential for reducing alcohol-related harm and mortality in Eastern European countries.

Parental alcohol use and resilience in young people: A study of family, peer and school processes

Funded by HSC R&D Division, Public Health Agency Parental alcohol misuse or ‘hidden harm’ presents a very significant challenge to public health policy and practice in the UK and internationally. A parent’s alcohol problems can have a profound impact on their children. Children depend on their family to meet their physical, psychological and social needs, their economic security and well-being, all of which can be jeopardised by parents misusing substances (NACD, 2011). The prevalence of parental alcohol misuse is extremely difficult to estimate, due to the ‘hidden’ nature of the problem within the family unit. Approximately 40,000 children in Northern Ireland are estimated to live with parental alcohol misuse (DHSSPS, 2008). In the UK, 30% of children (3.3 to 3.5 million) under 16 years, live with at least one binge drinking parent and 22% of children (2.6. million) with a hazardous drinker (Manning et al., 2009).  

Envolvimento dos adolescentes com o álcool

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Educacional.

Mechanisms of influence: alcohol industry submissions to the inquiry into fetal alcohol spectrum disorders

INTRODUCTION AND AIMS: Industry groups with vested interests in policy regularly work to protect their profits via the endorsement of ineffective voluntary regulation and interventions, extensive lobbying activity and minimising the health impact of consumption behaviours. This study aims to examine all alcohol industry submissions to the Australian House of Representatives Standing Committee on Social Policy and Legal Affairs into Fetal Alcohol Spectrum Disorders (FASD), to assist in understanding how those with vested interests contribute to policy development. The analysis aims to document the strategies and arguments used by alcohol industry bodies in their submissions and to compare these with known strategies of vested-interest groups. DESIGN AND METHODS: All 92 submissions to the Inquiry were screened to include only those submitted by alcohol industry bodies (five submissions). Content domains were derived based on the major themes emerging from the industry submissions and on common vested-interest behaviours identified in previous literature. RESULTS: The following content categories were identified: Concerns about FASD; Current industry activities and FASD prevention; Value of mandatory warning labels; and Credibility of independent public health researchers and organisations. DISCUSSION AND CONCLUSIONS: Alcohol industry submissions sought to undermine community concern, debate the evidence, promote ineffective measure which are no threat to the profit margins and attack independent health professionals and researchers. In doing so, their behaviour is entirely consistent with their responses to other issues, such as violence and chronic health, and copies the tactics employed by the tobacco industry.