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BACKGROUND: Mild traumatic brain injury (mTBI) can profoundly impact overall health, employment, and family life. Incidence of mTBI in the workplace represents an important subgroup with poorer outcomes. Mental health (MH) and substance use (SU) challenges are a primary correlate of TBI, but are rarely assessed among individuals with a work-related (wr)-mTBI, particularly at a population-level. OBJECTIVE: This study aimed to assess the association between lifetime wr-mTBI and non-wr-mTBI and the experience of MH and SU challenges. METHODS: The 2019 Centre for Addiction and Mental Health (CAMH) Monitor is a cross-sectional telephone survey of adults aged≥18 years in Ontario, Canada, employing a stratified (six regions) two-stage (telephone number, respondent) list-assisted random digit dialing probability selection procedure (N = 1792). Adjusting for sociodemographic variables, binary logistic regression was conducted to assess the association between lifetime wr-mTBI and non-wr-mTBI (relative to no TBI) and four outcomes: hazardous use of alcohol and of cannabis, psychological distress, and fair/poor mental health. RESULTS: Adjusting for sociodemographic variables, non-wr-mTBI demonstrated increased odds of hazardous alcohol (AOR = 2.12, 95% CI = 1.41, 3.19) and cannabis use (AOR = 1.61, 95% CI = 1.05, 2.45), psychological distress (AOR = 1.68, 95% CI = 1.14, 2.49), and fair/poor mental health (AOR = 1.70, 95% CI = 1.11, 2.59). Lifetime wr-mTBI demonstrated increased odds of reporting psychological distress (AOR = 3.40, 95% CI = 1.93, 5.97) and fair/poor mental health (AOR = 2.16, 95% CI = 1.12, 4.19) only. CONCLUSIONS: Non-wr-mTBI was associated with both MH and SU, whereas wr-mTBI was associated with MH only. MH outcomes were more strongly associated with wr-mTBI than non-wr-mTBI. Physicians, employers, and insurers need to consider the potential association between wr-mTBI and MH, and provide care accordingly. [ABSTRACT FROM AUTHOR]

This study identified the social determinants of health (SDoH) associated with psychological distress in adults with and without a self-reported history of traumatic brain injury (TBI), stratified by sex. Data from the 2014–2017 cycles of the Centre for Addiction and Mental Health Monitor Survey, a representative survey of adults ≥18 years in Ontario, Canada, were analyzed (N = 7,214). The six-item version of the Kessler Psychological Distress Scale was used to determine moderate to severe psychological distress. Self-reported lifetime TBI was defined as a head injury resulting in a loss of consciousness for ≥5 minutes or at least one-night stay in the hospital (16.4%). Among individuals reporting a history of TBI, 30.2% of males and 40.1% of females reported psychological distress (p = 0.0109). Among individuals who did not report a history of TBI, 17.9% of males and 23.5% of females reported psychological distress (p<0.0001). Multivariable logistic regression analyses showed that the SDoH significantly associated with elevated psychological distress were similar between individuals with and without a history of TBI. This included unemployment, student, or 'other' employment status among both males and females; income below the provincial median and age 65+ among males; and rural residence among females. This study highlighted opportunities for targeted population-level interventions, namely accessible and affordable mental health supports for individuals with lower income. Notably, this study presented evidence suggesting adaptations to existing services to accommodate challenges associated with TBI should be explored, given the finite and competing demands for mental health care and resources. [ABSTRACT FROM AUTHOR]

Considering the widespread use of cannabis and opioids, examining the use of cannabis, opioids and their combination with serious psychological distress (SPD) is important. A total of N = 12,358 adults participating in the Monitor surveillance study between 2014 and 2019 were included. Cannabis and opioid use reflected any use of the substances in the past 12 months. SPD was defined as having a score of 13 or more on the Kessler‐6 questionnaire, a 6‐item scale that includes feeling nervous, hopeless, restless or fidgety, sad or depressed. Odds ratios (ORs) were estimated from logistic regression models accounting for complex survey design and sociodemographic factors. Overall, 12.8% of the sample reported cannabis use only, 18% reported opioid use only, and 4.9% reported both cannabis and opioid use. Use of both cannabis and opioids was significantly associated with SPD in both women (OR = 4.24; 95% CI, 2.34 to 7.69), and in men (OR = 2.99; 95% CI, 1.56 to 5.73) compared to use of neither. The joint association of cannabis and opioids with SPD was additive. Addressing those who use both cannabis and opioids may help reduce the burden of SPD among adults in Ontario. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Gambling Issues is the property of Centre for Addiction & Mental Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Traumatic brain injury (TBI) is characterized by a change in brain function after an external force or sudden movement to the head. TBI is associated with risk-taking, impulsivity, psychological distress, substance abuse, and violent crime. Previous studies have also linked problem gambling to TBI, but these studies have not controlled for possible confounding variables such as mental health problems and hazardous drinking which are also linked to TBI. This study examines the relationship between problem gambling and TBI among adolescents. Data were obtained from the 2011, 2013 and 2015 cycles of the OSDUHS, a biennial cross-sectional school-based study of children in grades 7 to 12 (N = 9,198). Logistic regression was used to estimate adjusted odds ratios (AOR) in controlled and uncontrolled analyses. Adjusting for sex and grade only, problem gambling was associated with a history of TBI (AOR = 2.8). This association remained significant after adjusting for hazardous drinking and suicidality (AOR = 2.0). In addition, problem gambling had a statistically significant relationship with being male (AOR = 4.7), hazardous drinking (AOR = 4.5), and suicidality (AOR = 3.1). This study provides further data to suggest a link between TBI and problem gambling. However, research is needed on the causal relationship between these variables and the potential implications for treatment and prevention. [ABSTRACT FROM AUTHOR]

Objective: Texting while driving (TWD) is considered a particularly hazardous form of distracted driving. It is highly prevalent among young drivers, but fewer studies of TWD among adult drivers exist and these prevalence rates may approach those of younger drivers. The effectiveness of measures to prevent distracted driving, and TWD specifically, is unclear. On September 1, 2015, Ontario introduced increased penalties for distracted driving accompanied by public education programs to increase public awareness of the new regulations. Provincial police also introduced enhanced enforcement efforts. The current study examined self-reported TWD in a representative sample of Ontario adults before and after introduction of the new legislation and the enhanced public education and enforcement efforts.Methods: Data were based on telephone interviews with 1,846 respondents who reported having driven in the past year. Data were derived from the 2015-2016 cycles of the Centre for Addiction and Mental Health (CAMH) Monitor, an ongoing cross-sectional telephone survey of adults aged 18+ years in Ontario, Canada. A binary logistic regression analysis of TWD in the previous 30 days was conducted, adjusting for demographic characteristics (sex, age), driving exposure, and introduction of the legislation (before versus after).Results: The proportion of the sample reporting TWD declined significantly from 37.6% before the law was introduced to 24.2% after the law was introduced. The impact appeared to be most pronounced among drivers who reported TWD more frequently. Adjusted odds of TWD declined 42% following introduction of the legislation and associated enhanced public education and enforcement.Conclusions: These results identify a decrease in TWD following the introduction of enhanced penalties with corresponding public education and enforcement efforts, adding to the existing evaluative evidence base to inform transportation safety policy. These results also support the need to examine TWD and its determinants among all age groups. [ABSTRACT FROM AUTHOR]

The increasing popularity of gambling as a leisure activity among older adults (+ 55) coupled with the rapid aging of the population makes it increasingly important to understand what divides problem and non-problem gambling for this age group. This study investigated the association of different types of motivations to visit a gambling venue with problem gambling. Using a sample of 2103 older adults collected at 7 gambling venues in Southern Ontario, principal component analysis was completed to identify groupings of motivations dividing them into three types: entertainment, emotions, and money. These types were then incorporated into a series of logistic regressions predicting problem gambling. The study found that motivations related to money and emotion were associated with higher odds of problem gambling while motivations related to entertainment were related to lower odds of problem gambling. An interaction effect with gender indicated that the association between emotion motivations and problem gambling was significantly stronger among males. Motivations to visit a gambling venue may be useful in identifying those who are at greater risk of harm. The findings of this study also suggest that typical associations of emotionally motivated gambling with women may distract from the association of emotionally motivated with gambling-related harm among men. [ABSTRACT FROM AUTHOR]

This paper reports on the cross validation of the Gambling Problem Severity Subscale of the Canadian Adolescent Gambling Index (CAGI/GPSS). The CAGI/GPSS was included in a large school based drug use and health survey conducted in 2015. Data from students in grades 9-12 (ages 13-20 years) derived from the (N = 3369 students). The CAGI/GPSS produced an alpha of 0.789. A principle component analysis revealed two eigenvalues greater than one. An oblique rotation revealed these components to represent consequences and over involvement. The CAGI/GPSS indicated that 1% of the students fell into the "red" category indicating a severe problem and an additional 3.3% scored in the "yellow" category indicating low to moderate problems. The CAGI/GPSS was shown to be significantly correlated with gambling frequency (r = 0.36), largest expenditure (r = 0.37), sex (more likely to be male) (r = -0.19), lower school marks (r = -0.07), hazardous drinking, (r = 0.16), problem video game play (r = 0.16), as well as substance abuse. The CAGI/GPSS was cross validated using a shorted version of the short SOGS, r = 0.48. In addition the CAGI/GPSS and short SOGS produced very similar patterns of correlations results. The results support the validity and reliability of the CAGI/GPSS as a measure of gambling problems among adolescents. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the association of ethnoracial background and immigrant status to cannabis use among students in Ontario, Canada. Data were derived from the Ontario Student Drug Use and Health Survey, a school-based, province-wide survey of students in Grades 7–12. The survey utilized a stratified two-stage cluster design. Analyses were based on a pooled subsample of 12,527 students in Grades 9–12 during the 2011 and 2013 survey cycles and included adjustments for the complex sample design. Results indicate that youth who were of South Asian or East/Southeast Asian background were at lower odds of cannabis use than those who were White, Black, or mixed-race backgrounds. Youth who were of mixed-race background (i.e., White and another group) were at higher odds of cannabis use than youth who were of White background. The association between ethnoracial background and cannabis use also varied for some foreign-born and native-born youth. These findings suggest that ethnoracial background should be an important consideration in investigations of cannabis use among foreign- relative to native-born youth. [ABSTRACT FROM PUBLISHER]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This article describes the patterns of self-reported driving under the influence of alcohol (DUIA) and driving under the influence of cannabis (DUIC) among licensed Ontario students in 2009 and examines their associations with graduated licensing, risk taking, and substance use problems for understanding DUIA and DUIC behaviors. Ontario's graduated licensing system requires new drivers to hold a G1 license for a minimum of 8 months and a G2 license for a minimum of 12 months before a full and unrestricted G license can be obtained. Among other restrictions, G1 drivers must maintain a 0 blood alcohol content (BAC), have an experienced driver in the passenger seat, not drive on any high-speed expressways, and not drive between the hours of midnight and 5 a.m. A G2 license is more similar to a G license, with fewer restrictions.Method: This study analyzed data from the 2009 Ontario Student Drug Use and Health Survey (OSDUHS). The OSDUHS is a biennial population-based survey of students (grades 7 to 12) in Ontario, Canada.Results: The results showed that 16.3% of licensed students in Ontario reported DUIC and 11.5% reported DUIA during the past year. After controlling for the effect of age, type of license emerged as a robust predictor for both DUIA and DUIC behavior, because students with a G2 and full license were significantly more likely to report DUIA and DUIC than drivers with a G1 license. Multivariate analyses suggested that risk-seeking behaviors were more important for understanding DUIA behavior than for DUIC behavior. Elevated problem indicators for alcohol and for cannabis were associated with DUIA and DUIC, respectively.Conclusions: Though much attention has been paid to drinking and driving among adolescents, this research shows that more Ontario students now report driving after cannabis use than after drinking alcohol. The results identify important correlates of both behaviors that may be useful for prevention purposes. [ABSTRACT FROM AUTHOR]

Objective: The current study compared characteristics of nonrecidivist versus recidivist drink-drivers and of recidivists in their first versus second appearance at Back on Track (BOT), the remedial measures program for impaired drivers in Ontario, Canada.Methods: Information from 59,134 convicted drivers who participated in BOT between 2000 and 2010 was examined to identify drivers who completed the program a second time following reconviction.Results: A total of 586 recidivists were identified. Compared to nonrecidivist drivers, recidivists at first attendance were more likely to be male and had higher scores on measures of alcohol dependence and adverse legal consequences of substance use. Compared to nonrecidivist drivers, recidivists at second attendance were significantly older, had a higher income, were more likely to be retired, and were less likely to be employed part-time. They had fewer legal problems. Recidivists reported fewer drinking days and fewer drinks per occasion but greater use of benzodiazepines than nonrecidivists and had higher scores on a measure of future risk of alcohol- and drug-related problems. Comparison of recidivists' characteristics at first versus second attendance confirmed many of these findings, with second-time recidivists reporting fewer drinks per drinking day and greater use of benzodiazepines and having higher scores on a measure of future substance use problems than first-time recidivists.Conclusions: Results suggest that identification of drivers at increased risk of recidivism may be possible at first program attendance by examining indicators of increased alcohol-related problems. In addition, recidivists appear to show a greater readiness to change at second attendance. Implications for remedial program development and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction and Aims: This study examined prevalence of alcohol consumption among immigrants and the Canadian-born populations of Ontario by ethnic origin, and the association between ethnicity, country of birth, age at arrival, length of residence in Canada and drinking measures.Design and Methods: Data were derived from the Centre for Addiction and Mental Health (CAMH) Monitor, a cross-sectional survey of Ontario adults, conducted between January 2005 and December 2010 (n = 13,557).Results: The prevalence of alcohol consumption and risk drinking was generally lower among foreign-born than Canadian-born respondents, but significant variations across ethnic groups were found. In general, foreign-born respondents of European descent reported higher rates of alcohol use and risk drinking than foreign-born respondents from other ethnic groups. We also observed that ethnicity effects varied by whether or not respondents were born in Canada, and by the age at which they arrived in Canada.Discussion and Conclusions: While previous studies generally found an increase in immigrants' alcohol consumption with years in Canada, our data suggest that longer duration of residence may have either positive or negative effects on immigrants' alcohol use, depending on the country of origin/traditional drinking pattern. More research is needed to explore determinants of alcohol use and risk drinking among immigrants and to identify those groups at highest risk. [ABSTRACT FROM AUTHOR]

Background: There is currently no active surveillance of metastatic and non-malignant brain tumours in Canada as well as data on the health service use of children and youth with brain tumours. The objective of this study was to identify pediatric primary, metastatic, benign, and unspecified brain tumours in Ontario, Canada and to describe their health service use from a population based perspective.Methods: The population based healthcare administrative databases National Ambulatory Care Reporting System and the Discharge Abstract Database were used. Patients with malignant (primary and metastatic), benign, and unspecified brain tumours in acute care between fiscal year 2003/04 and 2009/10 were identified using specified International Classification of Diseases version ten codes.Results: Between fiscal year 2003/04 and 2009/10, there were 4022 brain tumour episodes of care (18.4 per 100,000 children and youth). Malignant brain tumors had the highest rates of episodes of care (14.9 times higher than that of benign and 5.7 times higher than that of unspecified brain tumours). Compared to patients with malignant brain tumours, those with benign brain tumours spent a longer period of time in acute care (p < .05) and patients with unspecified brain tumours stayed in the intensive care units for a longer period of time (p < .0001) with a lower proportion were discharged home (p < .0001).Conclusion: Despite higher rates of malignant brain tumour episodes of care, patients with benign and unspecified brain tumours also use acute care services and post-acute services that are currently not taken into account in healthcare planning and resource allocation. Active surveillance and research of metastatic and non-malignant brain tumours that can inform the planning of healthcare services and resource allocation for this population is encouraged. [ABSTRACT FROM AUTHOR]

This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner. [ABSTRACT FROM AUTHOR]

This article examines prevalence and gender differences of alcohol use and risk drinking in a representative sample of Ontario adults. Data were drawn from the Centre for Addiction and Mental Health (CAMH) Monitor survey of Ontario adults aged 18 and older collected between January 2005 and December 2010. The prevalence of self-reported lifetime, current, and high-risk drinking were all higher among the Canadian and the European-origin groups compared with other ethnic groups. Within-group gender differences were evident for all ethnic groups. The narrowest gender gap was observed within the North European group and the widest in the South Asian group. The non-European ethnic groups had higher rates of abstinence and lower alcohol consumption rates; nevertheless, a considerable proportion of people from these groups may be at risk of alcohol-related harm due to risky and harmful alcohol consumption patterns. Future research should continue to investigate alcohol use in these groups and identify subgroups at risk and factors that increase or decrease their vulnerability to risky and problem drinking. [ABSTRACT FROM PUBLISHER]

Introduction: There are limited data on the use of electronic cigarettes (e-cigarettes) among youth, particularly with regard to the use of nicotine versus nonnicotine products. This study investigates ever use of nicotine and nonnicotine e-cigarettes and examines the demographic and behavioral correlates of e-cigarette use in Ontario, Canada.Methods: Data for 2,892 high school students were derived from the 2013 Ontario Student Drug Use and Health Survey. This province-wide school-based survey is based on a 2-stage cluster design. Bivariate and multivariate analyses were used to investigate the factors associated with ever use of e-cigarettes. Ever use of e-cigarettes was derived from the question, "Have you ever smoked at least one puff from an electronic cigarette?" All analyses included appropriate adjustments for the complex study design.Results: Fifteen percent of high school students reported using e-cigarettes in their lifetime. Most students who ever used e-cigarettes reported using e-cigarettes without nicotine (72%), but 28% had used e-cigarettes with nicotine. Male, White/Caucasian, and rural students, as well as those with a history of using tobacco cigarettes, were at greater odds of e-cigarette use. Seven percent of students who had never smoked a tobacco cigarette in their lifetime reported using an e-cigarette. Five percent of those who had ever used an e-cigarette had never smoked a tobacco cigarette.Conclusion: More students reported ever using e-cigarettes without nicotine than with nicotine in Ontario, Canada. This underscores the need for greater knowledge of the contents of both nicotine and nonnicotine e-cigarettes to better guide public health policies. [ABSTRACT FROM AUTHOR]

Objective:Attitudes and individual difference variables of car and racing enthusiasts regarding high-risk behaviors of street racing and stunt driving have recently been investigated. Positive attitudes toward high-risk driving, personality variables such as driver thrill seeking, and other self-reported risky driving acts were associated with these behaviors. However, probable relationships among high-risk driving tendencies, everyday driving behaviors, and negative road safety outcomes have remained largely unexamined. This study aimed to investigate the associations among car and racing enthusiasts’ high-risk driving attitudes, self-reported everyday driving violations (i.e., ordinary and aggressive violations), and self-reported negative outcomes (i.e., collisions and driving offense citations). Method:A web-based survey was conducted with members and visitors of car club and racing websites in Ontario, Canada. Data were obtained from 366 participants. The questionnaire included 4 attitude measures—(1) attitudes toward new penalties for Ontario's Street Racers, Stunt and Aggressive Drivers Legislation; (2) attitudes toward new offenses of stunt driving under the same legislation; (3) general attitudes toward street racing and stunt driving; (4) comparison of street racing with other risky driving behaviors—self-reported driving violations (i.e., ordinary and aggressive violations); self-reported collisions and offense citations; and background and driving questions (e.g., age, driving frequency). Results:Results revealed that attitudes toward stunt driving offenses negatively and general attitudes toward street racing and stunt driving positively predicted ordinary violations, which, in turn, predicted offense citations. Moreover, general attitudes toward street racing and stunt driving positively predicted aggressive violations, which, in turn, predicted offense citations. Conclusion:The findings indicate that positive high-risk driving attitudes may be transferring to driving violations in everyday traffic, which mediates driving offense citations. [ABSTRACT FROM AUTHOR]

In 1998, Ontario passed legislation requiring that all drivers convicted of drinking and driving complete a remedial program, called Back on Track (BOT), before their driver's licences could be reinstated. Based on an assessment, clients are assigned to complete either an 'education' program or a 'treatment' program, depending on levels of substance-related problems. Several months following completion of their program, participants complete a follow-up interview. We report substance use and related outcome measures on 22,277 BOT participants who completed follow-up between 2000 and 2005. Completion of BOT was associated with significant reductions in the frequency of alcohol and other drug use, number of drinks consumed per drinking occasion, total numbers of substance users, and negative consequences resulting from substance use. A large number of participants became 'non-users' of various substances over the course of the program. These findings provide evidence that the remedial program has beneficial effects for participants in both the education and treatment components of BOT. [ABSTRACT FROM AUTHOR]

Introduction and Aims To assess the prevalence and key covariates of non-medical prescription opioid use ( NMPOU) in two representative surveys of adults ( Centre for Addiction and Mental Health Monitor, CM) and secondary-school students ( Ontario Student Drug Use and Health Survey, OSDUHS). Design and Methods Data from the 2010 and 2011 cycles ( n = 4023) of CM-a stratified, multi-stage, random-digit-dialling telephone survey of adults (18 years and older)-and the 2011 cycle of OSDUHS ( n = 3266)-a self-administered written questionnaire-based survey of grade 7-12 public system students-were used. Besides NMPOU prevalence, associations were assessed by univariate and multi-step multivariate (logistic regression) analyses. NMPOU and key socioeconomic (i.e. sex, age, Aboriginal ethnicity, household location, income, subjective social status), health indicators (physical health status, psychological distress, suicidal ideation), drug use (cigarette smoking, binge drinking, cannabis use, other drug use) were measured. Results NMPOU (past year) prevalence was 15.5% in students and 5.9% in adults. Various univariate associations with social, health and drug use factors were found in both populations, with differences by sex. Based on multivariate analyses, other drug use (male students) and rural residence, subjective social status, other drug use and suicidal ideation (female students); marital status and cannabis use (male adults) and binge drinking (female adults) were independently associated with NMPOU in the respective study populations. Discussion and Conclusions NMPOU was high in adults and especially students. Independent predictors of NMPOU were largely inconsistent by sex. Notably, NMPOU is widely distributed across socio-demographic and -economic strata, and thus requires broad-based interventions. [ABSTRACT FROM AUTHOR]

Background: Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the world's highest PO use levels. In Ontario, Canada's most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010. Findings: We compared the prevalence of NMPOU in the Ontario general adult population (18 years+) in 2010 and 2011 based on data from the 'Centre for Addiction and Mental Health (CAMH) Monitor' (CM), a long-standing annual telephone interview-based representative population survey of substance use and health indicators. While 'any PO use' (in past year) changed non-significantly from 26.6% to 23.9% (Chi2 = 2.511; df = 1; p = 0.113), NMPOU decreased significantly from 7.7% to 4.0% (Chi2 = 14.786; df = 1; p < 0.001) between 2010 and 2011. Over-time changes varied by age group but not by sex. Conclusions: The observed substantial decrease in NMPOU in the Ontario adult population could be related to recent policy interventions, alongside extensive media reporting, focusing on NMPOU and PO-related harms, and may mean that these interventions have shown initial effects. However, other casual factors could have been involved. Thus, it is necessary to systematically examine whether the observed changes will be sustained, and whether other key PO-related harm indicators (e.g., treatment admissions, accidental mortality) change correspondingly in order to more systematically assess the impact of the policy measures. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the role of school connectedness in the association between a history of family involvement with child protective services (CPS) and symptoms of psychological distress and delinquency among youth. Data were obtained from 3181 participants within the 2009 cycle of the Ontario Student Drug Use and Health Survey, a province-wide school-based survey of 7th-12th grade students. The survey employed a two-stage cluster design and analyses presented include adjustments for this complex sample design. Results indicated that the association between CPS involvement and psychological distress varied with school connectedness. CPS involvement was more strongly associated with psychological distress among students with low-school connectedness than students with high-school connectedness. School connectedness did not significantly moderate the link between involvement with CPS and delinquency. Results suggest that improving school connectedness may be one way to protect youth with a history of family involvement with CPS and, along with effective mental health services, reduce the accumulation of risks as youth transition into adulthood. [ABSTRACT FROM AUTHOR]

Abstract: Background: Cocaine is one of the more commonly found illicit drugs in injured drivers. In this work, we examine the association between self-reported past year cocaine use and past year collision involvement in a large representative sample of adult drivers in Ontario. Methods: Data are based on the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 and older. Five years of data (2002, 2003, 2004, 2006, 2008) were merged for this study (N =8107) due to survey item availability. Logistic regression analysis was performed to identify the risk of self-reported collision involvement within the past 12 months associated with past year use of cocaine, while controlling for sociodemographic, driving exposure and drinking–driving (as a function of drinking status) factors. Due to listwise deletion, the logistic regression model was based on a reduced sample (N =7284). Results: The prevalence of self-reported collision involvement within the past year was 18.9% among those who used cocaine in the past year compared to 7.4% of non-users. Logistic regression analysis, controlling for the potential confounding effects of age, gender, income, driving exposure and drinking–driving measures, found the odds of collision involvement in the preceding year among cocaine users was over twice that of non-users (OR=2.11, 95% CI=1.06–4.18). Conclusions: This study suggests that cocaine users are significantly more likely to report collision involvement in the past year. Additional work to confirm these observations, and to assess possible causal pathways, is needed. [Copyright &y& Elsevier]

This study examined differences in stigmatizing attitudes toward individuals addicted to drugs among three immigrant generations of youth, and the role of adolescent drug use and friends'' drug use on the association. Data were derived from the 2005 cycle of the Ontario Student Drug Use Survey administered to students in grades 7--12 in the province of Ontario, Canada. A sample of 4078 students completed questionnaires that included a measure of stigma toward drug addiction. Results indicated some immigrant generational differences in negative attitudes toward individuals addicted to drugs, but much of this difference was explained by adolescents'' individual drug use and friendships with individuals who use drugs. The difference between second-generation immigrant youth and their third- and later-generation counterparts was not fully explained. This study highlights the need for greater research on adolescent stigma toward drug addiction given that stigma may reduce drug usage but also may reduce help-seeking among individuals with an addiction. [ABSTRACT FROM AUTHOR]

The Centre for Addiction and Mental Health is one of the premier centres for research related to substance use and addiction. This research began more than 50 years ago with the Addiction Research Foundation (ARF), an organization that contributed significantly to knowledge about the aetiology, treatment and prevention of substance use, addiction and related harm. After the merger of the ARF with three other institutions in 1998, research on substance use continued, with an additional focus on comorbid substance use and other mental health disorders. In the present paper, we describe the structure of funding and organization and selected current foci of research. We argue for the continuation of this successful model of integrating basic, epidemiological, clinical, health service and prevention research under the roof of a health centre. [ABSTRACT FROM AUTHOR]

Abstract: In this study we examine the effect of several alcohol-related measures on self-reported collision involvement within the previous 12 months while controlling for demographic and driving exposure factors based on a large representative sample of adults in Ontario. Data are based on the 2002–2006 Centre for Addiction and Mental Health Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 and older (n =8542). Three logistic regressions of self-reported collision involvement in the past 12 months were implemented, each consisting of 3 steps: (1) demographic factors and driving exposure entered, (2) driving after drinking within the last 12 months entered, and (3) one of three alcohol-related measures (AUDIT subscales of alcohol consumption, dependence and problems) entered. In each step, measures from the preceding step were included in order to control for those variables. In Step 1, age (OR=0.989), region overall, Central East region (OR=0.71), West region (OR=0.67), and North region (OR=0.67), income overall and those who did not state income (OR=0.64), marital status overall and those married or living common law (OR=0.60), and number of kilometers driven in a typical week (OR=1.00) were found to be significant predictors of collision involvement. The analyses revealed that driving after drinking was a significant predictor of collision involvement in Step 2 (OR=1.51) and each of the Step 3 models (ORs=1.52, 1.37, 1.34). The AUDIT Consumption subscale was not a significant factor in collision risk. Both the AUDIT Dependence and AUDIT Problems subscales were significantly related to collision risk (ORs=1.13 and 1.10, respectively). These findings suggest that alcohol, in addition to its effects on collision risk through its acute impairment of driving skills, may also affect collision risk through processes involved when individuals develop alcohol problems or alcohol dependence. [ABSTRACT FROM AUTHOR]

The current study examines the impact of psychological distress on the likelihood of reporting collision involvement in the preceding year. Two measures of psychological distress were obtained from the 12-item General Health Questionnaire (GHQ-12): depression–anxiety and social functioning. Data are based on the 2002–2004 Centre for Addiction and Mental Health Monitor (36 months), a repeated cross-sectional telephone survey of Ontario adults aged 18 and older (n = 4935). Logistic regression analyses were performed on collision involvement within the past 12 months with the measures of depression–anxiety, social functioning and demographic factors as independent variables. The analyses revealed that the odds of involvement in a collision in the last 12 months were significantly related to the demographic factors of age, location of residence, income, educational level and marital status. After controlling for demographic factors, the odds of collision involvement increased significantly as the depression–anxiety score increased (odds ratio = 1.05 for each unit increase). These results suggest that higher levels of psychological distress, as indicated by scores on the depression–anxiety scale of the GHQ-12, are associated with higher likelihood of collision involvement in the previous year. Research to understand the link observed here between distress and collision risk in the general population is needed. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Cannabis use has been linked to anxiety and mood disorders (AMD) in clinical cases, but little research on this relationship has been reported at the epidemiological level. Objectives: We examined the relationship between self-reported frequency of cannabis use and risk for AMD in the general Ontario adult population. Methods: Data were based on the CAMH Monitor survey of Ontario adults from 2001 to 2006 ( n = 14,531). AMD was assessed with the 12-item version of the General Health Questionnaire (GHQ12). Frequency of cannabis use within the past year was grouped into five categories: No use (abstainer), less than once a month but at least once a year, less than once a week but at least once a month, less than daily but at least once a week, almost every day to more than once a day. Logistic regression analysis of AMD and cannabis use was implemented while controlling for demographics and alcohol problems. Results: AMD was most common among heavy cannabis users (used almost every day or more) (18.1%) and lowest for abstainers (8.7%). Compared to abstainers, the risk of AMD was significantly greater for infrequent cannabis users ( OR = 1.43) and heavy cannabis users ( OR = 2.04) but not for those in between. Conclusion: These data provide epidemiological evidence for a link between both light and heavy cannabis use and AMD. Scientific Significance: Recognizing the comorbidity of heavy cannabis use and AMD should facilitate improved treatment efforts. Our results also suggest the possibility that, for some individuals, AMD may occur at relatively low levels of cannabis use. [ABSTRACT FROM AUTHOR]

Aims: On 29 November 1996, Ontario introduced an Administrative Driver's Licence Suspension (ADLS) law, which required that anyone charged with driving with a Blood Alcohol Concentration (BAC) over the legal limit of 80 mg% or failing to provide a breath sample would have their licence suspended for a period of 90 days at the time the charge was laid. This study evaluates the effects of Ontario's ADLS law on total driver fatalities over a 25-month period after the law was introduced, and compares Ontario's experience with that of two comparison provinces (Manitoba and New Brunswick) that did not introduce ADLS at that time. Methods: Interrupted time series analysis with ARIMA modeling was applied to the monthly number of drivers killed in Ontario and the control provinces for the period 1 January 1988 to 31 December 1998. Findings: A significant intervention effect was found in Ontario, with ADLS being associated with an estimated reduction of 14.5% in the numbers of fatally injured drivers. No corresponding effect was observed in the control provinces. Conclusions: These data provide evidence that the law produced a general deterrent effect resulting in a reduction in total driver fatalities. [ABSTRACT FROM AUTHOR]

Although the literature suggests that gambling among older adults is influenced by unique age-related factors, there is little information on the factors associated with the experience of gambling-related problems among older adults. The purpose of this study was to identify the sociodemographic health determinants and mental health-related problems, including alcohol and drug dependence, that are associated with the experience of gambling problems among older adults in Ontario. The research was an exploratory analysis of data from Ontario adults, aged 55 and over, who completed the Canadian Community Health Survey - Mental Health and Well-being, Cycle 1.2 (1,904 males and 2,622 females). Logistic regression analyses were conducted to identify sociodemographic, gambling behaviour, and mental health correlates of the experience of any gambling-related problems, as identified by responses to the Canadian Problem Gambling Index. Being married or living common law and having a higher education level were associated with reduced risk of gambling problems. Among mental health variables, alcohol dependence and any substance dependence significantly increased the odds of reporting a gambling problem. Gambling behaviour measures, such as more frequent gambling, participating in more types of gambling, and spending more on gambling were significant correlates of gambling problems. [ABSTRACT FROM AUTHOR]

Background: Research has shown a strong link between alcohol use and a variety of problems, including violence. Parker and colleagues have presented a selective disinhibition theory for the link between alcohol use and homicide (and other violence) that posits a causal relationship that is also influenced by other situational and contextual factors. This model is particularly well suited for aggregate-level investigations. In this study, we examine the impact of alcohol factors, including consumption measures and Alcoholics Anonymous (AA) membership rates, on homicide mortality rates in Ontario, and test predictions derived from the selective disinhibition model. Methods: Time series analyses with ARIMA modeling were applied to total, male, and female homicide rates in Ontario between 1968 and 1991. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines. Results: For the total population and males, homicide rates were significantly and positively related to total alcohol consumption and to the consumption of beer and spirits. They were also negatively related to AA membership rates in the analyses involving spirits and wine and positively related to unemployment rates in the analyses involving beer, wine, and total alcohol. Among females, none of the measures were significant predictors of homicide mortality rates. Conclusions: These data provide important support for the selective disinhibition model and confirm important relationships between per capita consumption measures and homicide mortality rates, especially among males, seen in other studies. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and treatment for misuse of alcohol can exert beneficial effects observable at the population level. [ABSTRACT FROM AUTHOR]

Objective: The goal of this study is to identify alcohol-related factors that influence mortality rates from suicide. Specifically, we examine the impact of per capita consumption of total alcohol, distilled spirits, and beer and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total and male and female suicide mortality rates in Ontario between 1968 and 1991. Method: We studied the impact of alcohol consumption levels, AA membership rates, and unemployment rates on suicide mortality rates in Ontario from 1968 to 1991. Time series analyses with Auto Regressive Integrated Moving Average (ARIMA) modeling were applied to total and male and female suicide rates. The analyses performed included total alcohol consumption, distilled spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines. Results: Total alcohol consumption and consumption of each of beer, distilled spirits, and wine were significantly and positively related to total and female suicide mortality rates. AA membership rates were negatively related to total and female suicide rates. Although data for males did not reach significance (except for the relationship between wine consumption and suicide rate), the direction of effects was consistent with that observed for female and total suicide rates. Unemployment rates were positively related to male and total suicide rates in some models. Conclusions: These data confirm the important relationships between per capita consumption measures and suicide mortality rates seen by previous investigators. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and treatment for misuse of alcohol can exert beneficial effects observable at the population level. [ABSTRACT FROM AUTHOR]

Background: To investigate the association among illicit drug use, psychiatric distress and road rage victimization and offending. Particular attention is given to the most serious forms of road rage behaviour. Methods: The data are based on the 2002 CAMH Monitor and include a sample of 2,421 Ontario adults aged 18 and older. Logistic regression analyses were conducted with illicit drug use and psychiatric distress (GHQ) and demographic factors as independent variables. Results: Past-year road rage victimization was reported by 42% of the sample and 31% reported any type of road rage offending. Approximately 5% were classified as respondents with serious road rage involvement. The logistic regression analyses revealed significant relationships between illicit drug use and road rage outcomes. Cannabis use was significantly associated with general road rage victimization and offending, while stimulant use substantially increased the likelihood of victimization and membership in the serious road rage classification. Psychiatric distress significantly increased the odds of both road rage victimization and serious road rage involvement. Conclusion: These data reveal different indicators of road rage offending, victimization and serious involvement. Further work is needed to clarify the mechanisms associated with the relationship among stimulant use, psychiatric distress and serious road rage involvement. [ABSTRACT FROM AUTHOR]

Aims We test the hypotheses that cirrhosis mortality rates are positively associated with per capita alcohol consumption and negatively associated with Alcoholics Anonymous (AA) membership rates. Design The impact of alcohol consumption levels and AA membership rates on cirrhosis mortality rates in Ontario from 1968 to 1989 were examined. Time-series analyses with ARIMA modelling were applied to male and female cirrhosis mortality rates in three age groups: 15–44, 45–64 and 65 + years. Missing AA membership data were interpolated using two methods: linear splines and cubic splines. Findings In general, cirrhosis mortality rates were positively associated with alcohol consumption and negatively associated with AA membership. For some age and gender combinations, these effects were not statistically significant. Conclusions The limits of this study include restrictions in the length of series available and in the ability to infer causality. Despite these limitations, these findings are consistent with previous research demonstrating that per capita consumption is a strong determinant of cirrhosis mortality rates, and also that higher levels of AA membership can reduce cirrhosis mortality rates. [ABSTRACT FROM AUTHOR]

Abstract: Problem: We report on trends in road rage victimization and perpetration based on population survey data. Method: Based on repeated cross-sectional telephone surveys of Ontario adults between July 2001 and December 2003, logistic regression analyses examined differences between years in road rage victimization and perpetration in the previous year controlling for demographic characteristics. Results: The prevalence of any road rage victimization in the previous year decreased significantly from 47.5% in 2001 to 40.6% in 2003, while prevalence of any road rage perpetration remained stable (31.0% to 33.6%). Logistic regression analyses revealed that the odds of experiencing any road rage victimization was 33% higher in 2001 and 30% higher in 2002, than in 2003. Discussion: Survey data provide a valuable perspective on road rage trends, but efforts to track road rage incidents is also needed. Summary: In Ontario, the proportion of adults experiencing any road rage victimization decreased from 2001 to 2003 while the proportion reporting any road rage perpetration remained stable. Impact on industry: None. [Copyright &y& Elsevier]

Objective: To investigate the relation between psychiatric distress and road rage, paying particular attention to the potential link between psychiatric illness and frequent involvement in serious forms of road rage.Method: This study reports data on road rage involvement, demographic characteristics, and mental health for a representative sample of 2610 adults in Ontario. The mental health indicator was the 12-item General Health Questionnaire.Results: A cluster analysis revealed 5 distinct groups of people affected by road rage. The most serious offenders (referred to hereafter as the hard core road rage group), representing 5.5% of those affected, exhibited frequent involvement in the most severe forms of road rage and were the most likely (27.5%) to report psychiatric distress.Conclusions: Road rage, particularly experiences of victimization, is related to psychiatric distress. Evidence of psychiatric distress was highest among hard core road rage perpetrators, individuals noted for frequent involvement in serious aggressive and violent conduct. Further research is needed on violence and road rage and its link to mental health. [ABSTRACT FROM AUTHOR]

Background: “Road rage” has increasingly generated public concern, however, the prevalence of this behaviour has not been available. We examine the prevalence and demographic correlates of road rage victimization and perpetration based on a population survey of adults in Ontario. Methods: Data are based on the CAMH Monitor, a repeated cross-sectional telephone survey of Ontario adults (n=1,395). The contribution of demographic factors to road rage was examined with logistic regression analysis. Results: About half of respondents (46.6%) were shouted at, cursed at or had rude gestures directed at them in the past year, and 7.2% were threatened with damage to their vehicle or personal Injury. Nearly a third of respondents (31.7%) admitted to shouting, cursing, etc. at someone, and 2.1 % threatened to hurt someone or damage their vehicle. Being a Toronto resident, being younger, and earning a higher income were associated with greater likelihood of being a victim of shouting, cursing and rude gestures; however, income was not associated with being threatened with vehicle damage or injury. The likelihood of admitting to shouting, etc. at someone was greater for males, younger respondents, Toronto residents, higher income earners, and never married respondents; however, threatening someone was associated with younger age and lower education level. Conclusion: These results provide a first indication of the prevalence of road rage in Ontario. Road rage, in its milder forms, appears to be common, involving between a third and a half of respondents as either a victim or a perpetrator. Nearly 1 in 10 Ontario residents were threatened with damage or personal injury. [ABSTRACT FROM AUTHOR]

We examined per capita alcohol consumption and survey-based measures of alcohol use in Ontario in relation to indicators of alcohol problems for the period 1977–1997. Per capita consumption and percentage of daily drinkers were significantly related to problem indicators, but percentage of drinkers and percentage of heavy drinkers were not. Of the measures we examined, per capita consumption was the strongest indicator of alcohol problems. [ABSTRACT FROM PUBLISHER]

In Ontario, per capita consumption of alcohol rose steadily from 1963 to 1975. Beginning in 1975, consumption stabilized and declined slightly (2.6%) to 1983. Correlational analyses of the data during the period of consumption increase demonstrated significant associations between consumption and all problem indices. During the period of consumption stabilization the linear relationships between consumption and problem indices appeared to break down; most of the problem indices declined more than would be expected. The possible contributions of changes in demographic factors, consumption patterns, and prevention/treatment efforts to these declines are discussed. [ABSTRACT FROM AUTHOR]

In this study, the trends in alcohol consumption, alcohol-related problems, alcohol availability and treatment efforts were examined for the province of Alberta, for the period 1975–1993. Most of the trends previously observed in Ontario were also observed in Alberta. We found: (1) stabilization followed by important declines in per capita consumption of alcohol; (2) large decreases in most measures of problems such as cirrhosis mortality and traffic fatalities related to drinking; (3) increases in treatment and Alcoholics Anonymous membership rates; (4) increases in measures of physical availability of alcohol. One problem, impaired driving arrest rate, increased substantially during the years examined. [ABSTRACT FROM AUTHOR]

Explores the potential impact of targeted and untargeted prevention measures on three alcohol-related problems in Ontario. Drinking among young people; Drinking and driving; Alcohol problems in the general population.

Examines the mortality experience of convicted drinking drivers (second offenders) randomly assigned to rehabilitation and control groups in two Ontario cities. Rehabilitation program; Participants; Follow-up and identification of deceased participants; Tendencies for total mortality from accidental and violent death in rehabilitated patients.

Reports on public awareness of Ontario's administrative suspension law for drinking-and-driving behavior and effectiveness of the law since 1996. Statistical evidence which shows that responses of awareness prior to and after the introduction of the law were improved; Indications for reducing drinking and driving.

• Examined risk perceptions of driving under the influence of cannabis (DUIC) and alcohol (DUIA). • Compared perceptions of non-medical (ie. recreational) to medical or dual-purpose cannabis users. • Medical or dual-purpose users were more likely to agree that DUIC is safer than DUIA. • No difference found in perception that DUIC increases collision risk. • No difference found in perception that risk of police enforcement is higher for DUIA than DUIC. Reduced perception of potential harm resulting from cannabis use is associated with greater risk of driving under the influence of cannabis (DUIC). Understanding risk perceptions of DUIC among subgroups of users will positively inform targeting and content of anti-DUIC driver education and public awareness campaigns. The current study compared DUIC-related risk perceptions among individuals who use cannabis exclusively for non-medical purposes versus those who use cannabis for exclusively medical or for both medical and non-medical purposes (i.e., dual-purpose users). Data were drawn from a regionally stratified cross-sectional general population telephone survey of adults (18 + years) in Ontario, Canada conducted in 2017. Respondents who reported past-year use of cannabis and answered questions regarding DUIC risk perceptions were selected (weighted N = 343). Modified Poisson regression models with robust standard error estimation were conducted for three attitudes: disagree that DUIC increases motor vehicle collision risk, agree that DUIC is safer than driving under the influence of alcohol (DUIA), agree that chances of being caught by police for DUIA higher than DUIC. In addition to type of cannabis user (non-medical only versus medical or dual-purpose), covariates included demographic characteristics and past-year alcohol and cannabis use frequency. Adjusting for other covariates, regression analyses indicated that medical or dual-purpose cannabis users were 45 % more likely than non-medical users to agree that DUIC is safer than DUIA (Adjusted Prevalence Ratio = 1.45, 95 %CI = 1.10, 1.91, p = 0.007). No other differences in risk perception between medical or dual-purpose and non-medical cannabis users were found. Although no difference between medical or dual-purpose and non-medical cannabis users was found in perceptions of collision risk associated with DUIC or risk of police enforcement, the perception that DUIC is safer than DUIA was stronger among medical or dual-purpose than non-medical users. Recognizing that the shift in public perception of DUIA as a high-risk behaviour contributed to reductions in incidence of DUIA, results of the current study support education and awareness campaigns that target medical or dual-purpose users and emphasize that, like DUIA, DUIC is also a high-risk behaviour. [ABSTRACT FROM AUTHOR]

The number of injuries and fatalities associated with drinking and driving continues to decline in the province of Ontario. However, this behavior remains as one of the major contributors to collision-related injuries and fatalities. Few large-scale studies of blood alcohol concentration (BAC) <0.08% limits exist in the literature, necessitating additional investigation. Here we evaluate the general deterrent effectiveness of three Ontario countermeasures implemented during 2009 and 2010, two of which impose lower allowable BAC on drivers in the province. Using ARIMA-based interrupted time-series analysis we found that Warn-range sanctions, which include immediate roadside suspension for the previously un-targeted BAC range of 0.05–0.08%, were associated with a 17% decrease in the number of people injured or killed in drinking and driving collisions (relative to the number injured or killed in other collisions). Similarly, we found that Zero BAC requirements newly applied to young drivers (<22 y.o.) were associated with a reduction in the numbers of two other dissimilar drinking and driving sanctions received by young drivers (relative to the number of these sanctions received by non-young drivers). A roadside seven-day vehicle impoundment for BAC > 0.08%, which was added to an already existing roadside 90-day license suspension, was not found to produce general deterrence. Taken together, our results suggest that sanctions which target previously untargeted groups, specifically via lower BAC requirements, are effective as general deterrents against drinking and driving. [ABSTRACT FROM AUTHOR]

Objective: Because both alcohol and depressed mood exert deleterious effects on psychomotor performance, the possibility that people with depressed mood may be more likely to drive after drinking may have important implications for traffic safety. In this work, we examine the association between depressed mood and self-reported driving after drinking in a large representative sample of adults in Ontario. Method: Data are based on the 2001-2004 Centre for Addiction and Mental Health Monitor, an ongoing cross-sectional telephone survey of Ontario adults ages 18 and older (N= 3,979). Logistic regression analysis was performed to identify the risk of driving after drinking two or more drinks in the previous hour within the past 12 months associated with scores on a screening measure of depressed mood (depression-anxiety and social functioning subscales of the 12-item General Health Questionnaire), while controlling for alcohol-use measures (weekly volume and frequency of heavy drinking), driving exposure, and demographic factors. Results: Logistic regression analysis revealed that the odds of reporting driving after drinking within the past year increase significantly as depressed mood (specifically, depression-anxiety scores) increases. Conclusions: Additional research on the nature of the link between depressed mood and impaired driving should be undertaken, including assessing whether there exists any synergistic effects of depressed mood and alcohol on collision risk and considering the implications of this relationship for prevention and remedial activities. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine debt stress and its association with psychological distress and overall health. Data were derived from the 2014–2016 annual cycles of a cross-sectional telephone survey of the general population of adults 18 years of age and older within the province of Ontario, Canada. The present analyses focused on a pooled sample of 8045 adults. Results indicated that a large proportion of the sample reported experiencing debt-related stress. Those who were female, separated or divorced, and from lower income households were at higher odds of greater debt stress relative to no debt stress. Debt stress was significantly associated with psychological distress, as well as self-rated overall mental health and general health. Adults who reported greater debt stress were at higher odds of moderate to serious psychological distress, poor to fair self-rated mental health, and poor to fair self-rated general health compared to those with lower levels of debt stress. The association between debt stress and health did not vary by age, gender, employment, education, or income. The findings suggest that the stress surrounding debt is an important factor in the association between debt and health, the association is robust across various sociodemographic characteristics, and that further research is needed to better understand the nature of debt stress and its impact on health. [ABSTRACT FROM AUTHOR]

Highlights • Traumatic brain injury (TBI) is a common injury. • Study based on a general population survey of adults ages 18+ from Ontario, Canada (N = 3809). • Adjusted odds ratio (AOR) indicates that people with TBI are 2.8 more likely to have a gambling problem (controlling for all other variables in the model). • People who report psychological distress are 2.7 times more likely to also report a gambling problem. • People who engage in hazardous drinking 2.7 times more likely to also report a gambling problem. Abstract Traumatic brain injury (TBI) is a common injury characterized by a change in brain function after an external blow to the head and is associated with substance abuse, psychological distress, risk-taking, and impulsivity. Convenience and clinical samples have also linked TBI to problem gambling, but have not ruled out confounding variables such as hazardous drinking and psychological distress. This study examines the relationship between TBI and moderate to severe problem gambling in a general population probability sample controlling for hazardous drinking and psychological distress. The data were obtained from a 2015–2016 cross-sectional general population telephone survey of adults ages 18+from Ontario, Canada (N = 3809). Logistic regression was used to estimate the association as adjusted odds ratios (AOR). Moderate to severe problem gambling was independently associated with a history of TBI after adjusting for potential confounders (AOR: 2.80), and had a statistically significant relationship with psychological distress (AOR = 2.74), hazardous drinking (AOR = 2.69), and lower educational levels (AOR = 0.37). This study provides further data to suggest a link between TBI and moderate to severe problem gambling; however, more research is needed to determine if there is a causal relationship or the potential implications for prevention and treatment. [ABSTRACT FROM AUTHOR]

Highlights • Men at higher risk of history of brain injury, hazardous-drinking or both compared to women. • Younger adults more at risk of both conditions, concurrently, compared to older adults. • Adults in one or both conditions had greater odds of mental health and roadway aggression. Abstract This study describes the association among lifetime traumatic brain injury (TBI) and past year hazardous/harmful drinking, as well as their unique and synergistic effects, on mental health problems and roadway aggression among Canadian adults. A cross-sectional sample of 6074 Ontario adults aged 18 years or older were surveyed between 2011 and 2013. TBI was defined as trauma to the head resulting in loss of consciousness or overnight hospitalization. Past year hazardous/harmful drinking was assessed using the Alcohol Use Disorders Identification Test. An estimated 13.1% (95%CI:12.0,14.2) adults reported a prior TBI (no hazardous/harmful drinking), 2.7% (95%CI:2.2,3.3) reported a prior TBI while concurrently screening positive for past year hazardous/harmful drinking and 9.8% (95%CI:8.9,10.9) screened positive for hazardous/harmful drinking (no TBI). Men had significantly higher odds of exhibiting all three conditions compared to women, especially for the concurrent class. Younger adults had significantly greater odds of hazardous/harmful drinking, or the concurrent class compared to adults 55 years and older. Adults in any of the three conditions had greater odds for mental health problems and roadway aggression. Concordance of both conditions corresponded to a greater than additive effect and greater odds of mild roadway aggression, than either condition alone. Results show that singly and jointly, these conditions are associated with adverse health and behavioral impediments. [ABSTRACT FROM AUTHOR]