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Social relationships in adolescence and heavy episodic drinking from youth to midlife in Finland and Sweden: examining the role of individual, contextual and temporal factors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. National Institute for Health and Welfare, Helsinki, Finland.ORCID iD: 0000-0002-4115-3797
National Insitute for Health and Welfare, Helsinki, Finland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.ORCID iD: 0000-0003-3249-3383
National Institute for Health and Welfare, Helsinki, Finland.
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2018 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 1000Article in journal (Refereed) Published
Abstract [en]

Background

Applying the Process-Person-Context-Time (PPCT) model of the bioecological theory, this study considers whether proximal processes between the individual and the microsystem (social relationships within family, peer group and school) during adolescence are associated with heavy episodic drinking (HED), from youth to midlife, and whether the macro level context (country) plays a role in these associations.

Methods

Participants of two prospective cohort studies from Finland and Sweden, recruited in 1983/1981 at age 16 (n = 2194/1080), were followed-up until their forties using postal questionnaires. Logistic regression analysis was used to examine associations between social relationships at age 16 and HED (at least monthly intoxication or having six or more units of alcohol in one occasion) at ages 22/21, 32/30 and 42/43. Additive interactions between microsystem settings, as well as between settings and country, were also considered.

Results

Consistent with the PPCT model, we found individual, contextual and temporal aspects to be associated with drinking habits. Higher levels of poor family relationships were associated with an increased likelihood of HED (ages 22/21 and 32/30) in both Finnish women and men and Swedish men. Higher levels of peer contact were associated with an increased likelihood of HED in both Finnish women (ages 32 and 42) and men (ages 22 and 32), and Swedish men (age 21). In contrast with the other groups, poorer relationships with classmates were associated with an increased likelihood of HED (age 30) for Swedish women only. For women, the combined effect of having both daily peer contact and living in Finland for HED at age 42/43 was statistically distinguishable from a pure additive effect.

Conclusions

Micro and to a lesser extent macro level contexts are associated with heavy episodic drinking well into adulthood. The most relevant processes in the adolescent microsystem occur in family and peer settings. However, long-lasting protective or risk-raising effects between different settings and later HED were not found. Promoting good relationships across different contexts during adolescence may reduce the incidence of HED in adulthood.

Place, publisher, year, edition, pages
2018. Vol. 18, article id 1000
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-357152DOI: 10.1186/s12889-018-5885-8ISI: 000441410500002PubMedID: 30097023OAI: oai:DiVA.org:uu-357152DiVA, id: diva2:1238273
Funder
Swedish Research Council Formas, 259-2012-37Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-0445Västerbotten County Council, VLL-355661Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-10-18Bibliographically approved

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