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This study examined associations between school sector (Government, Catholic or Independent) and depressive symptomology over the secondary school years. Six waves of data collected annually from a representative Australian sample were examined. Multilevel piecewise linear and logistic regression controlling for a variety of demographic variables and protective factors was undertaken. In all sectors, depressive symptomology decreased between 10 and 13 years of age, but significantly increased for girls at age 13. Adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools. Adolescents in Catholic schools were less likely to report clinical levels of depressed mood compared to adolescents in Government schools.

Despite a decline in Australian adolescents reporting to have consumed alcohol, a high proportion of the adolescent population still consumes alcohol. Community-led prevention interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-behaviour change related to youth alcohol and drug use. This study evaluated the post-intervention effects of a multi-component community intervention in Australia. It comprised social marketing targeting adolescents and parents, and a community intervention to reduce underage alcohol sales. Structural equation modelling was used to examine direct and indirect effects of community intervention components on intention and consumption. Self-report surveys (N = 3377) and community sales data (27 communities) were analysed to evaluate the effect of the intervention components on intention and consumption before the age of 18. The intervention reduced alcohol sales to minors (OR = .82). Exposure to the social marketing was significantly associated with household no-alcohol rules (OR = 2.24) and parents not supplying alcohol (OR = .72). The intervention predicted intention not to consume alcohol before age 18; intention was associated with not consuming alcohol (OR = 5.70). Total indirect effects from the intervention through to intention were significant. However, parents setting a rule and not supplying alcohol were the only significant direct effects to intention. Parents setting a rule was directly associated with lower consumption. Overall, the intervention logic was supported by the data modelling. The study extends prior knowledge of community-based interventions to prevent adolescent alcohol use by identifying critical intervention components and effect mechanisms. ClinicalTrials.gov Identifier: ACTRN12612000384853.

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.

Introduction Internationally, the prevalence of young adult homelessness is concerning. Few data on life-course predictors from longitudinal studies exist, limiting our capacity to inform prevention strategies at the population-level. Methods Data were drawn from a state representative population-based sample of young adults from Victoria, Australia participating in the International Youth Development Study (IYDS; N = 927, 54% female). Participants were recruited in state-representative secondary school samples at Grade 7 (age 13, 2002), with follow-up in Grades 9 (age 15) and 11 (age 17) and at ages 21, 23 and 25. Using longitudinal path modelling, we conducted a series of analyses testing life-course predictors of young adult homelessness across multiple socializing contexts, and the interrelationships among them. Results The rate of young adult homelessness was 5.5%. Path modelling showed higher levels of family conflict at ages 13 and 15 uniquely predicted homelessness by age 25. This effect remained after accounting for other risk factors in peer-group (e.g., interactions with antisocial peers), school (e.g., low academic performance), and community contexts (e.g., low neighborhood attachment). Peer drug use and interaction with antisocial peers at age 15 mediated the association between family conflict at age 13 and homelessness by age 25. Conclusions Findings point to the vulnerability of early adolescents to family conflict. This vulnerability heightens risk for young adult homelessness. Findings strengthen the case for both primary prevention programs that build healthy relationships between family members from early on in adolescence and for investment in homelessness prevention at key developmental periods.

The Questionnaire for Autism Spectrum Conditions (Q-ASC; Attwood, Garnett & Rynkiewicz, 2011) is one of the few screening instruments that includes items designed to assess female-specific ASD-Level 1 traits. This study examined the ability of a modified version of the Q-ASC (Q-ASC-M; Ormond et al., 2018) to differentiate children with and without ASD-Level 1. Participants included 111 parents of autistic children and 212 parents of neurotypical children (5–12 years). Results suggested that the gendered behaviour, sensory sensitivity, compliant behaviours, imagination, and imitation subscales differentiated autistic females from neurotypical females. Compared to autistic males, autistic females had higher scores on gendered behaviour, sensory sensitivity, social masking, and imitation. Results are discussed in relation to early detection of autistic female children.

This study examined associations between school sector (Government, Catholic or Independent) and depressive symptomology over the secondary school years. Six waves of data collected annually from a representative Australian sample were examined. Multilevel piecewise linear and logistic regression controlling for a variety of demographic variables and protective factors was undertaken. In all sectors, depressive symptomology decreased between 10 and 13 years of age, but significantly increased for girls at age 13. Adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools. Adolescents in Catholic schools were less likely to report clinical levels of depressed mood compared to adolescents in Government schools.

Background Problematic internet use (PIU) is prevalent among Chinese adolescents. There is a need to better understand how the quality of parent-adolescent relationship is associated with adolescent PIU to guide the development of effective prevention and early intervention programs. Objective This study aims to evaluate parent-adolescent conflict and parenting styles as potential risk factors associated with adolescent PIU. Methods A sample of 6552 students (aged 10-19 years) from 22 schools in Guangdong, China, was recruited. The participants completed self-report questionnaires measuring their perceptions of conflict with their parents (involving verbal conflict, emotional abuse, and physical abuse) as well as their perceptions of their parents’ parenting styles (including parental care and parental control as measured by the Parental Bonding Inventory), and PIU using the Adolescent Pathological Internet Use Scale. Grade level and gender were examined as moderators of these associations. Results Using multiple regression analyses, we found that greater mother-adolescent conflict, father-adolescent conflict, and parental control, and lower levels of parental care, were associated with higher levels of adolescent PIU (P Conclusions These findings point to the value of interventions to reduce parental verbal conflict, emotional abuse, and physical abuse, and to increase positive parenting styles, to lower the risk of PIU in Chinese adolescents.

BACKGROUND Problematic internet use (PIU) is prevalent amongst Chinese adolescents. There is a need to better understand how parent-adolescent relationship quality is associated with adolescent PIU to guide the development of effective prevention and early intervention programs. OBJECTIVE This study aimed to examine parent-adolescent conflict and parental bonding as potential factors associated with adolescent PIU. METHODS A sample of 6552 students (age 10 to 19 years) from 22 schools in Guangdong, China, was recruited. Participants completed questionnaires measuring conflict (involving verbal conflict, emotional abuse, and physical abuse) and parental bonding with parents, and PIU. RESULTS Multiple regression analyses found that greater mother-adolescent conflict and father-adolescent conflict, and lower levels of parental bonding were associated with higher levels of PIU. The association of mother-adolescent conflict with PIU was stronger in older students than younger students, while the association of father-adolescent conflict with PIU was stronger in male students than female students. Compared to those who reported no mother-adolescent conflict, participants who experienced verbal conflict and emotional abuse, but not physical abuse from their mothers, reported higher levels of PIU. Compared to those who reported no father-adolescent conflict, participants who experienced verbal conflict, emotional abuse and physical abuse from their fathers were subject to significantly higher levels of PIU. CONCLUSIONS These findings point to the value of interventions to reduce parental verbal conflict, emotional abuse and physical abuse and to increase parental bonding to lower the risk of PIU in Chinese adolescents.

Despite a decline in Australian adolescents reporting to have consumed alcohol, a high proportion of the adolescent population still consumes alcohol. Community-led prevention interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-behaviour change related to youth alcohol and drug use. This study evaluated the post-intervention effects of a multi-component community intervention in Australia. It comprised social marketing targeting adolescents and parents, and a community intervention to reduce underage alcohol sales. Structural equation modelling was used to examine direct and indirect effects of community intervention components on intention and consumption. Self-report surveys (N = 3377) and community sales data (27 communities) were analysed to evaluate the effect of the intervention components on intention and consumption before the age of 18. The intervention reduced alcohol sales to minors (OR = .82). Exposure to the social marketing was significantly associated with household no-alcohol rules (OR = 2.24) and parents not supplying alcohol (OR = .72). The intervention predicted intention not to consume alcohol before age 18; intention was associated with not consuming alcohol (OR = 5.70). Total indirect effects from the intervention through to intention were significant. However, parents setting a rule and not supplying alcohol were the only significant direct effects to intention. Parents setting a rule was directly associated with lower consumption. Overall, the intervention logic was supported by the data modelling. The study extends prior knowledge of community-based interventions to prevent adolescent alcohol use by identifying critical intervention components and effect mechanisms. ClinicalTrials.gov Identifier: ACTRN12612000384853.

Internationally, youth crime is a significant social problem. Violent youth crime has been rising over the past decade in the state of Victoria, Australia. Communities That Care (CTC) is a coalition training process designed to prevent youth crime. There has been limited evaluation outside the USA. Using a non-experimental design, this study employed official state crime statistics to evaluate the impact on crime as the five-phase CTC process was implemented between 2010 and 2019 across communities in Victoria. The standard five-phase CTC implementation cycle was supplemented with universal programs to reduce sales and supply of alcohol to underage youth (under 18 years). Growth models evaluated community trends in youth crime (all, person, property and deception and other), comparing communities that implemented CTC at phase 4 or greater with communities that had not implemented CTC. In accord with the hypotheses, the study found significant reductions in crimes associated with CTC over the period between 2010 and 2019. A 2% annual reduction in risk was observed for crimes against persons for all age groups (IRR = 0.98, 95% CI [0.96, 0.998]). A 5% annual reduction was observed for crimes of property and deception for adolescents aged between 10 and 17 years (IRR = 0.95, 95% CI [0.90, 0.99]). These findings support CTC as an intervention for preventing youth crime at a population level. Future studies should evaluate intervention mechanisms and economic benefits.

The potential for adolescent mental health problems arising from heavy internet use is significant. There is a need to better understand the risk and protective factors related to problematic internet use (PIU) amongst adolescents. This study examined the role of adolescents’ perceptions of school-based relationships as potential contextual antecedents to problematic internet use. Specifically, 6552 adolescent students (55.9% boys, 13.51 ± 2. 93 years) from 22 primary and middle schools in southern China completed questionnaires to measure the degree of adolescent conflict with peers, teachers and other staff, school connectedness, perceived classroom atmosphere and problematic internet use. Self-reported data was collected using a two-level stratified sampling. Multiple regression analyses showed that conflict with peers and teachers was positively associated with higher levels of PIU, while school connectedness and perceived classroom atmosphere were negatively associated with PIU. An interaction effect was found for conflict with peers and grade level, such that the association between conflict with peers and PIU was stronger for secondary students compared to primary school students. The results support the need for school-based interventions for PIU to include a focus on conflict with peers and teachers, and for a focus on the enhancement of school connectedness and classroom atmosphere.

International research consistently shows that high school disengagement is related to lower subsequent participation in paid work, fewer employment opportunities, and lower engagement in further education. In Australia, the number of people who do not complete high school varies from 16 to 26 percent, and the average fiscal and social/community costs of high school non-completion are approximately $1 million per individual over a lifetime. High school exclusion is a key marker and potential driver of high school non-completion. The overall objective of this chapter is to examine empirical literature on how complex adolescent behavioural risk and protective profiles impact on high school engagement and performance and to overview empirical approaches to systemic intervention and prevention. Understanding complex determinants will provide much better information on the timing and focus of policies and programs designed to support schools in improving education outcomes for students at risk of exclusion. We make a series of evidence-based recommendations about the detection of students most at risk of exclusion and disengagement and about design features of programs most likely to work for at-risk youth.

IntroductionDespite declines in tobacco use during pregnancy and after childbirth, smoking remains unacceptably high among many parents. Smoking maintenance or relapse may be common in couple relationships when the other parent continues to smoke, when relationship satisfaction is low, or parental stress high.AimTo examine the longitudinal influence of partner tobacco use, relationship satisfaction and parental stress on tobacco use after childbirth.MethodsData was obtained from 115 Australian heterosexual adult couples (Mean age = 31.8) who reported being pregnant in the previous year and the female partner was a previous or current smoker. A household longitudinal survey was administered in which measures of tobacco use, relationship satisfaction and parental stress were assessed on four occasions over nine years.ResultsOverall reductions in tobacco use occurred over the nine-year assessment period, although a small percentage (9.6%) of parents reported being daily smokers at every assessment. Similarly, a small proportion (13.1%) of parents relapsed to using tobacco during the assessment period. A random effects binary logit model indicated that mothers and fathers were more likely to continue or relapse to tobacco use if their partners smoked. Mothers were more likely to quit smoking if they became pregnant between the assessment waves, but for males, having a pregnant partner was not a significant predictor of tobacco cessation.ConclusionWhile pregnancy is associated with smoking cessation for mothers, both mothers and fathers are at elevated risk of continued tobacco smoking or relapse if their partner smokes during the first nine years after childbirth. For parents who continue to smoke cigarettes or relapse after childbirth, engagement of the partner in smoking cessation may be a key factor in promoting positive outcomes.

Background: Alcohol use in adolescence predicts future alcohol misuse. However, the extent to which different patterns of adolescent use present risk remains unclear. Objectives: This study investigated how adolescent trajectories of alcohol consumption during the school years predict alcohol misuse at age 19 years. Methods: Data were drawn from 707 students from Victoria, Australia, longitudinally followed for 7 years. Five alcohol use trajectories were identified based on the frequency of alcohol use from Grade 6 (age 12 years) to Grade 11 (age 17 years). At age 19 years, participants completed measures indicating Heavy Episodic Drinking (HED), dependency – Alcohol Use Disorders Identification Test (AUDIT) and social harms. Results: At 19 years of age, 64% of participants reported HED, 42% high AUDIT scores (8+), and 23% social harms. Participants belonging to a steep escalator trajectory during adolescence had twice the odds at 19 years of age of high AUDIT scores and social harms, and three times greater odds of HED than participants whose alcohol use slowly increased. Stable moderate consumption was also associated with an increased risk of HED compared to slowly increasing use. Abstinence predicted a reduced likelihood of all forms of misuse at 19 years of age compared to slowly increased alcohol use. Conclusions: Trajectories of drinking frequency during adolescence predict alcohol misuse at age 19 years. Although rapid increasing use presents the greatest risk, even slowly increasing drinking predicts increased risk compared to abstinence. The findings indicate that alcohol policies should recommend nonuse and reduced frequency of use during adolescence.

BACKGROUND AND AIMS: Impulsivity impacts adolescent alcohol use. We aimed to prospectively evaluate the cognitive mechanisms outlined in two-factor models and the protective role of coping skills. METHODS: Two cohorts of adolescents followed for three years were included in the study (younger cohort: N = 908, aged 10–12 years at Time 1; older cohort: N = 943, aged 12–15 years at Time 1). Constructs measured included impulsivity (reward drive, rash impulsiveness), positive social alcohol expectancies (PSAE), drinking-refusal self-efficacy (DRSE), problem-based coping skills, family and community risk factors, and alcohol use including the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Data were analysed using structural equation modelling controlling for family and community risk factors, testing mediation and moderation. Impulsivity traits predicted cognitive mechanisms and these in turn predicted alcohol use in both cohorts (χ(2) = 1,139.79, df = 249, p < .001, CFI = .92, SRMR = .06, RMSEA = .04). DRSE and PSAE mediated the effects of rash impulsiveness and reward drive, respectively, on alcohol use. Problem-based coping skills moderated several pathways to drinking within each cohort, being protective even when adolescents have low DRSE, and buffering the impact of PSAE on alcohol use. CONCLUSIONS: The current study details the prospective interactive influences of impulsivity and cognitive risk factors on adolescent alcohol use. The findings have direct implications for prevention and treatment programs, providing information about possible high-impact targets for intervention.

Highlights • An RCT of 28 communities, targeting adolescent alcohol consumption in Australia • A multilevel intervention targeting adolescent's alcohol consumption, based on theory and evidence. • A decline in consumption was observed, but was not significantly different between 28 communities. • Subgroup analysis identified differences for primary and secondary measures. Abstract Background and aims In many countries adolescent alcohol use is a major health problem. To supplement national policies, it is important to trial community interventions as a potential strategy to prevent adolescent alcohol use. Methods This study evaluated a multicomponent community intervention that included community mobilisation, social marketing, and the monitoring of alcohol sales to minors. Evaluation was a clustered randomised trial design with 14 intervention and 14 control communities. Prior to randomisation, communities were matched on socioeconomic status and location. Intervention communities were not blinded. Participants 3545 Year 8 students (M = 12 years) were surveyed at baseline from 75 schools; 3377 students were surveyed post intervention in 2013 from 54 schools. Outcomes It was hypothesised that the primary outcome, individual alcohol consumption in last 30 days, after the intervention would be 15% lower in intervention communities. Secondary outcomes were consumption in the past year and intention not to drink before age 18. Results The intervention communities showed larger relative reductions compared to the controls in last 30-day consumption and past year (10%), but not significantly different. A significantly lower proportion of participants in the intervention community (63%), compared to the controls (71%), reported intending to drink before 18 years old. Subgroup analysis identified regional and state differences for some secondary measures. Conclusions Intervention assignment was associated with lower adolescent intention to drink before the age of 18. However, more intensive and longer-term intervention may be required to measure significant differences in behaviour change.

To assess gender differences in the relationship between eating and weight loss attitudes (EWAs), and 30-day tobacco and alcohol use among adolescents, while controlling for potential confounds (age, country of birth, psychological distress, pubertal development, peer alcohol and tobacco use, and sexual activity).School students aged between 11 and 17 years (N = 10,273) from high schools in the State of Victoria (Australia) completed surveys in class under conditions of anonymity and confidentiality.The interaction between EWAs and gender was significant for tobacco use but not for alcohol use, indicating that the effect of EWAs on tobacco use, but not alcohol use, vary by gender.Tobacco use was related to EWAs in adolescent females but not males, and this is consistent with the possibility that females use tobacco in an instrumental fashion to control weight. Implications and Contribution: Female adolescents high in eating and weight loss attitudes were more likely to engage in tobacco use. In contrast, eating and weight loss attitudes were not related to male tobacco use. These results point to the potential importance of developing gender-specific approaches towards addressing problematic behaviors in adolescent populations.

BackgroundRecent reports suggest an increase in use of extremely potent cannabis concentrates such as Butane Hash Oil (BHO) in some developed countries. The aims of this study were to examine the characteristics of BHO users and the effect profiles of BHO.DesignAnonymous online survey in over 20 countries in 2014 and 2015. Participants aged 18 years or older were recruited through onward promotion and online social networks. The overall sample size was 181,870. In this sample, 46% (N = 83,867) reported using some form of cannabis in the past year, and 3% reported BHO use (n = 5922).MeasurementsParticipants reported their use of 7 types of cannabis in the past 12 months, the source of their cannabis, reasons for use, use of other illegal substances, and lifetime diagnosis for depression, anxiety and psychosis. Participants were asked to rate subjective effects of BHO and high potency herbal cannabis.FindingsParticipants who reported a lifetime diagnosis of depression (OR = 1.15, p = 0.003), anxiety (OR = 1.72, p < 0.001), and a larger number of substance use (OR = 1.29, p < 0.001) were more likely to use BHO than only using high potency herbal cannabis. BHO users also reported stronger negative effects and less positive effects when using BHO than high potency herbal cannabis (p ConclusionMental health problems and other illicit drug use were associated with use of BHO. BHO was reported to have stronger negative and weaker positive effects than high potency herbal cannabis.

PurposeThe purpose of this study is to investigate the influence of macro-level regulatory systems on alcohol management for community sport organisations (CSOs). It examines how alcohol regulations translate into meso-level management actions and interactions that impact alcohol consumption in community sport clubs. Design/methodology/approachManagement of alcohol was explored through the holistic lens of macro, meso, and micro-levels of influence. Sixteen semi-structured interviews were conducted with Australian club administrators from community sports clubs. FindingsThematic analysis revealed macro-level influences on alcohol management in CSOs, with government regulations and the state sport associations being the most influential. Challenges arise in alcohol policy implementation when sport administrators do not prioritise alcohol consumption as a problem to be addressed, or where a conflict of interest arises between alcohol revenue generation and clubs positioning as health promoting environments. Practical implicationsTargeting club administrators’ attitudes towards alcohol as a benign influence and revising alcohol management practices are recommended as priority strategies to enhance the implementation and promotion of responsible alcohol management in sport clubs. Affiliate state sport associations were also identified as influential settings to provide administrative or strategic direction to CSOs, which would reduce the resources required by volunteers and standardise alcohol management practices across sports clubs. Originality/valueThe prevailing alcohol research focuses on the consumption behaviour of individual members and sports players. The study findings are novel and important as they explore the macro-level influences that administrators experience when enacting and policing alcohol management strategies in sports clubs. To-date, administrators of CSOs have not been included in many studies about alcohol consumption regulation; therefore, the findings provide an original perspective on alcohol regulation and demonstrate how CSOs operationalise alcohol management in club settings. The original insights from this study informed the conceptualisation of a multilevel sport system framework, which can be applied to guide future governance of alcohol consumption in sport settings.

Objective: To examine the extent to which family conflict, peer bullying and psychological distress account for eating and weight loss attitudes in adolescent females. This study examined the degree to which psychological distress mediated the association between family conflict and eating and weight loss attitudes, and the association of bullying and eating and weight loss attitudes. Method: Females aged between 11 and 17 years (N = 5125) were recruited from schools in the State of Victoria (Australia). Key measures included psychological distress, family conflict, and bullying victimisation. Results: A structural model showed good fit, and all predictors were significant. Psychological distress mediated the association between eating and weight loss attitudes, and family problems and bullying. Conclusion: Family conflict and peer bullying were associated with eating and weight loss attitudes and this association may occur via psychological distress. Early intervention programs may benefit from a focus on family and peer relationships.

The concept of life meaning and purpose is inherently developmentally referenced. We know that for adults, life meaning is indicated by a driving purpose that unifies different aspects of life, is consistent over time, and adds meaning or value to others. Adolescents may or may not have a clear sense of meaning and purpose, and by virtue of their developmental stage, are more likely to be in a search for such knowledge/experience. Searches for meaning carry risks and benefits, particularly at a stage where substantial transitions occur, including movement into upper-level schools, new performance expectations, the onset of puberty, “dating” and related dyadic relationships, and occupational change. In this chapter we explore developmental theory and research on adolescent meaning/purpose in life and focus on the role of parents and peers in integrating adolescent stories to make meaning across these transitions.

Academic self-efficacy is the degree to which students believe they are capable of learning or accomplishing an academic task within a specific area of education. High academic self-efficacy has been associated with positive education outcomes such as enhanced learning, motivation, self-determination, and ultimately academic performance. The current study designed, implemented and evaluated an educational intervention to enhance the academic self-efficacy and performance of 21 psychology students enrolled in a group supervised Honours course, the outcome being a thesis dissertation. Students completed pre-intervention surveys in class half way through the course and then another survey after the 8-week intervention. Measures of self-efficacy (based on student responses) were similar over the two assessments. Furthermore, self-efficacy did not predict academic outcomes as determined by two independent examiners’ final marks on their thesis. Findings are discussed in relation to limitations of the data and challenges faced when implementing interventions aimed to enhance academic self-efficacy.

Introduction: Despite declines in population tobacco use, smoking remains unacceptably high. Smoking cessation may be particularly difficult in couple relationships when partners continue to smoke, and when relationship satisfaction is low. This study examined the longitudinal influence of partner tobacco use and relationship satisfaction on the likelihood of smoking cessation. Methods: Data were obtained from 238 tobacco-using couples aged between 18 and 45 over three assessments from a nationally representative sample of Australian households. Results: There was high concordance between partner smoking six years after the initial assessment, with a little more than three-quarters (76.1%) of non-smokers residing with partners who had also ceased smoking. Step-wise logistic regression models indicated that females were more likely to cease smoking if their partners had previously quit. Males were more likely to quit smoking when they perceived their relationship as highly satisfying and their partner had stopped smoking. Female partners were also more likely to quit smoking when they were highly satisfied with their relationships. Conclusions: Both partner’s smoking status and relationship satisfaction are important considerations in smoking-related cessation. For entrenched smokers in couple relationships, involvement of partners in interventions may be useful.

AIMS: This study examined the association between peer drug use and adolescent polysubstance use, and investigated if this association was moderated by parenting and/or school factors. METHODS: The sample consisted of 9966 participants (mean age=14.3; 49.34% males) randomly selected from secondary schools in Victoria, Australia. Three 30-day polysubstance use profiles were derived from latent class analysis - no drug use (47.7%), mainly alcohol use (44.1%) and polysubstance use (8.2%). These profiles were then regressed on peer's drug use, family conflict, parental monitoring, parental disapproval of drug use, school commitment, reward for prosocial involvement in school and academic failure, and the interactions between peer's drug use and each of the parenting and school variables. RESULTS: Relative to non-users, peer's drug use was strongly associated with polysubstance use (OR=30.91, p

Military forces are among vulnerable groups to high-risk behaviors, especially substance use. Accordingly, this study aimed to investigate the role of personality traits and socio-familial factors in the prediction of risk of substance use among soldiers. A total of 309 soldiers doing military service in Tehran, Iran, were selected using convenience sampling, and completed measures included risk of substance use, personality traits, and social and familial risk/protective factors. Current results showed significant relationships between personality traits and socio-familial factors with tendency toward substance use. Moreover, linear regression analyses indicated that personality traits (i.e., conscientiousness and agreeableness), social factors (i.e., friends’ substance use and social disorganization), and familial factors (i.e., parents’ positive attitude toward substance use) were significantly associated with tendency toward smoking, drug use, and alcohol use in soldiers. Multimodal interventions targeting individual, familial, and social vulnerabilities may help reduce adjustment problems among Iranian soldiers.

The extent to which parental traits of autism are related to parenting efficacy has yet to be explored. Parents of children with Autism Spectrum Disorder (ASD) were studied in three groups: (a) families in which both the parent and the child had a DSM-IV-TR ASD diagnosis (n = 109); (b) families in which only the child had a DSM-IV-TR ASD diagnosis (n = 128); and (c) families in which no member had ASD (n = 109). Each subject completed the Autism Spectrum Quotient (AQ) and a measure of parenting efficacy. Fathers with ASD had the lowest parental efficacy, but mothers with ASD had comparable levels of parental efficacy to parents without ASD in the family. Results suggest that screening and intervention to build fathers parental efficacy may be a useful adjunct to therapy.

Introduction and Aims. This study investigated the extent to which parental monitoring and parental disapproval of alcohol use account for the association between country of birth and adolescent alcohol use. Design and Methods. The sample consisted of 10273 adolescents from grades 7 (Mean age=12.5 years), 9 (14.5 years) and 11 (16.4 years) in Victoria, Australia. Participants completed a questionnaire during class time. Mediation analyses were performed to examine the extent to which parental monitoring and parental disapproval of alcohol use accounted for variations in past 30 day alcohol use between Australian-born and immigrant adolescents. Results. Alcohol use in the past 30 days ranged from 8.0% to 44.4% for participants from different countries/regions of birth. Those born in Asia (odds ratio 0.20-0.51, P

Background Most adolescents begin alcohol consumption during adolescence, heavy alcohol use by adolescents is common, and alcohol-related harm amongst adolescents is a major public health burden. Parents are a common source of alcohol amongst adolescents, but little is known about how parental supply of alcohol has changed over recent years. This study examines national trends in parental supply of alcohol to adolescent children in Australia since 1998. Methods Six Australian National Drug Strategy Household Surveys (1998–2013) yielded rates of parental supply of current and first ever alcohol consumed. Lifetime and current alcohol use were also estimated. The surveys were conducted for households across all Australian states and territories. Surveyed adolescents were aged 14–17 years (N = 7357, 47.6 % male). Measures included the reported source of currently consumed alcohol and first ever alcoholic beverage (parents/friends/others), lifetime alcohol use, number of standard alcohol units consumed on drinking days, and frequency of alcohol use. Corrected Pearson chi-squared tests were used to compare survey years. Results There was a significant drop in parental supply of current alcohol use from 21.3 % in 2004 to 11.79 % in 2013 (p

Adolescent depressed mood is related to the development of subsequent mental health problems, and family problems have been linked to adolescent depression. Longitudinal research on adolescent depressed mood is needed to establish the unique impact of family problems independent of other potential drivers. This study tested the extent to which family conflict exacerbates depressed mood during adolescence, independent of changes in depressed mood over time, academic performance, bullying victimization, negative cognitive style, and gender. Students (13 years old) participated in a three-wave bi-national study (n = 961 from the State of Washington, United States, n = 981 from Victoria, Australia; 98 % retention, 51 % female in each sample). The model was cross-lagged and controlled for the autocorrelation of depressed mood, negative cognitive style, academic failure, and bullying victimization. Family conflict partially predicted changes in depressed mood independent of changes in depressed mood over time and the other controls. There was also evidence that family conflict and adolescent depressed mood are reciprocally related over time. The findings were closely replicated across the two samples. The study identifies potential points of intervention to interrupt the progression of depressed mood in early to middle adolescence.

Introduction Preventing adolescent alcohol use is an international public health priority. To further understand adolescent alcohol use, this study tested a model of adolescent intention to consume alcohol that incorporated multiple social systems influences. Methods Participants included 2529 Australian secondary school students (Mage = 14.20; 53.7% female). Participants completed a survey about risk and protective factors for alcohol use at individual, family, school and community levels. Structural Equation Modeling (path analysis) was used to evaluate an extended Theory of Planned Behavior (TPB) that incorporated social system determinants of intention to consume alcohol. Results The final model explained 60% of the variance in adolescent alcohol use intention. All TPB constructs correlated with intention and experience of lifetime alcohol use. More exposure to information about alcohol use had a weak but significant influence on adolescents’ stronger perceived behavioral control. Having less friends who use alcohol, stricter parental rules for adolescent alcohol use, and unfavorable parent attitudes towards alcohol use, were associated with stronger adolescent anti-alcohol attitudes and subjective norms. Community level pro-abstinence attitudes predicted unfavorable adolescent attitudes to alcohol and intention to consume alcohol. Parental rules showed significantly stronger influences on alcohol use intention amongst younger adolescents. Conclusions Key social systems around adolescents significantly predicted intention to consume alcohol, and the extended TPB model explained the major variance in adolescent alcohol use. The findings emphasize the importance of multi-level approaches to the prevention of alcohol use. Situation-based factors that could trigger impulsive emotional response may be a future intervention focus.

Aims: Alcohol use is a leading risk factor for disease burden among youth. This study estimated sex differences in the prevalence of alcohol use and consequences among adolescents living in low and middle-income countries (LMIC). Design: Multi-staged cross-sectional international standardized self-report questionnaires administered in the classroom. Setting: The Global school-based student health survey (GSHS) comprised adolescents from 68 LMIC between 2003–2014. Participants: 271,156 students aged 13–17 years old. Measurements: Alcohol measures included: past month alcohol consumption, history of intoxication and alcohol-related problems. Regions were based on the World Health Organization definitions: Africa, America, Eastern Mediterranean, Europe, South-east Asia, and Western Pacific. Findings: Overall, males had higher odds of alcohol use (OR = 2.38 [1.91–2.96]), a history of intoxication (OR = 2.64 [2.11–3.31]), and alcohol-related problems (OR = 1.72 [1.41–2.10]) than females. All regions recorded overall greater odds of alcohol use by males versus females; five regions (excluding Europe) recorded greater odds of intoxication in males; and three regions (America, South-east Asia, and Western Pacific) recorded greater odds of alcohol-related problems amongst males. However, there were country-level differences – in some countries, adolescent drinking rates and consequences were comparable by sex. Countries with the highest odds of alcohol use among males compared to females were Indonesia, Myanmar, Cambodia, Tuvalu, Morocco, Senegal, Kiribati, and Thailand. Conclusions: Among adolescents living in LMIC, males had on average two-fold higher odds of drinking alcohol and experiencing adverse consequences. Growing affluence and improvements in sex equality in societies may increase the future prevalence of hazardous drinking in females in LMICs.

Tobacco use frequently starts during adolescence, so understanding factors that drive the initiation and development of tobacco use over this developmental period is crucial in the development of responsive prevention and early intervention programs and policies. In this chapter, we explore the role that weight concerns have in the development and maintenance of tobacco use. We review longitudinal and prevention-oriented research on the association of tobacco use and weight control ideation, the epidemiology of tobacco use and emerging weight control problems, and the potential value of expanding tobacco prevention programs to better address the drivers of adolescent tobacco use.

Illicit drug use frequently starts during adolescence and young adulthood. Early initiation of illicit drug use in this period is associated with continued drug use in adulthood, the development of dependence, polydrug use and a number of adverse social, educational and mental health outcomes. Understanding when and why illicit drug use starts has important implications for preventing a major source of personal and financial cost to individuals, families and communities. In this chapter, we review research on the prevalence of drug use in the early years, the impact of early illicit drug use on psychosocial outcomes in young adulthood and widely researched models that explain the early initiation of drug use. We explore the implications of evidence-based models for prevention of the early initiation of illicit drug use.

This cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed. Fourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data. Community-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community. The trial was retrospectively registered in September, 2017 ( ACTRN12616001276448 ), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

PURPOSE Alcohol use is more prevalent in rural than urban areas in adult populations. Few studies have focused on adolescent drinking. This study investigated if adolescents in regional and rural areas of Australia were more likely to drink alcohol and if there were differences in parental drinking and alcohol supply across regions. METHODS A subsample from the National Drug Strategy Household Survey 2013, the largest nationally representative household survey on drug use in Australia, was used for this study. Participants who were aged 12-17 (N = 1,159) and participants who indicated they were parents or guardians of a dependent child (N = 7,059) were included in the analyses. Key measures were adolescent and parental alcohol use, parental supply of alcohol, and drinking location. FINDINGS Compared to those living in major cities, adolescents from inner regional and rural areas were at 85% and 121% higher odds, respectively, of obtaining their first alcohol from parents, and at 131% and 287% higher odds of currently obtaining their alcohol from their parents. Those from rural areas were at 126% higher odds of drinking in the past 12 months. Parents from inner regional and rural areas were at 45% and 63% higher odds, respectively, of heavy drinking; at 27% and 52% higher odds of weekly drinking; and at 26% and 37% higher odds of drinking at home. CONCLUSIONS Adolescents from rural areas were at higher risk of alcohol use. Parents in rural areas were more likely to use alcohol in ways that encourage adolescent drinking.

Polydrug use is relatively common among adolescents. Psychological distress is associated with the use of specific drugs, and may be uniquely associated with polydrug use. The purpose of this study was to test the association of psychological distress with polydrug use using a large adolescent sample. The sample consisted of 10,273 students aged 12-17 years from the State of Victoria, Australia. Participants completed frequency measures of tobacco, alcohol, cannabis, inhalant, and other drug use in the past 30 days, and psychological distress. Control variables included age, gender, family socioeconomic status, school suspensions, academic failure, cultural background, and peer drug use. Drug-use classes were derived using latent-class analysis, then the association of psychological distress and controls with drug-use classes was modeled using multinomial ordinal regression. There were 3 distinct classes of drug use: no drug use (47.7%), mainly alcohol use (44.1%), and polydrug use (8.2%). Independent of all controls, psychological distress was higher in polydrug users and alcohol users, relative to nondrug users, and polydrug users reported more psychological distress than alcohol users. Psychological distress was most characteristic of polydrug users, and targeted prevention outcomes may be enhanced by a collateral focus on polydrug use and depression and/or anxiety.

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