Role of personal and family factors in alcohol and substance use among adolescents: an international study with focus on developing countries

Cannabis use in sub-Saharan Africa: A systematic review and meta-analysis

BACKGROUND AND AIMS

The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in sub-Saharan Africa since 2010.

METHODS

A comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to 'substance', 'Substance-Related Disorders' and 'Prevalence' and 'Africa South of the Sahara' were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high-risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10-17 years) and adults (≥ 18 years) in sub-Saharan Africa were extracted.

RESULTS

The study included 53 studies for the quantitative meta-analysis and included 13 239 participants. Among adolescents, the life-time, 12-month and 6-month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4-10.9%], 5.2% (95% CI = 1.7-10.3%) and 4.5% (95% CI = 3.3-5.8%), respectively. The corresponding life-time, 12-month and 6-month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1-21.2%), 2.2% (95% CI = 1.7-2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3-6.4%), respectively. The male-to-female life-time cannabis use relative risk was 1.90 (95% CI = 1.25-2.98) among adolescents and 1.67 (CI = 0.63-4.39) among adults.

CONCLUSIONS

Life-time cannabis use prevalence in sub-Saharan Africa appears to be approximately 12% for adults and just under 8% for adolescents.

Correlates of alcohol experimentation and drunkenness episodes among secondary-school students in Nigeria

Background: Alcohol is the most used substance among adolescents in Nigeria. While risk factors for alcohol use among adolescents are well documented in Europe and the US, they have received less attention in the literature on African countries. This study aimed to investigate the factors associated with alcohol experimentation and drunkenness episodes in a national sample of Nigerian adolescents. Methods: A total sample of 4,078 secondary-school students participated in the survey during the school year 2015-2016. The survey involved 32 secondary schools of six geopolitical zones (South-South, South-West, South-East, North-Center, North-West, and North-East) and two metropolitan cities (Abuja and Lagos) of Nigeria. Sociodemographic characteristics, parental alcohol use and permissiveness, friends' alcohol use, risk perceptions and beliefs were investigated as correlates of alcohol experimentation and drunkenness episodes through multilevel, mixed-effect logistic regression models. Results: The prevalence of alcohol experimentation was 34.0%, while the prevalence of drunkenness episodes was 13.4%. Results showed that male gender, family structure different from both parents' families, parental and friends' alcohol use, parental permissiveness to drink, low risk perceptions on drinking alcohol, and positive beliefs on consequences of alcohol use were associated with an increased probability of alcohol experimentation and drunkenness episodes. Family affluence and one-parent family structure were related to an increased probability of alcohol experimentation but not of drunkenness episodes. Conclusions: The majority of risk factors analyzed in this study generalize across drinking-behavior outcomes. Since the young population is dominant in Nigeria, alcohol use could become a big public health problem in the near future. High investment in adolescents' well-being by addressing the factors that contribute to drinking behavior might help to reduce the burden of the problem. Evidence-based prevention curriculum addressing knowledge, risk perceptions, beliefs on consequences of alcohol use, and parental behaviors should be implemented as widely and early as possible.

Alcohol use and its determinants among adults living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Background

Alcohol use is a common practice of almost all communities worldwide and it is more common among persons with HIV infection. Alcohol consumption among people with HIV/AIDS may result in poor treatment adherence, further immunity suppression and increase the risk of comorbid illness (diseases) which collectively diminish the anti-retroviral therapy responses. Although there are separate studies conducted regarding alcohol use among people with HIV/AIDS in Ethiopia, the finding results are highly variable and inconsistent. Therefore, conducting a systematic review and meta-analysis has a paramount importance to show the pooled prevalence of alcohol use and to identify its determinants among people with HIV/AIDS.

Methods

A systematic search of electronic databases of PubMed/Medline, Science Direct, Hinnari and Cochrane library was employed. Additionally, the grey literature was searched from Google and Google Scholar. Data were extracted using a standardized data extraction format prepared in Microsoft Excel . STATA-version 14 statistical software was used for analysis. Heterogeneity of primary studies was found as evaluated using the I² test result. As a result, a random-effect meta-analysis model was used to estimate the pooled prevalence of alcohol use.

Results

A total of 22 primary studies which comprises 8,368 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime, current and hazardous alcohol use among HIV patients in Ethiopia were 36.42% [95% CI (19.96, 52.89)], 19.00% [95% CI (12.98, 25.01)] and 21.64% [95% CI (12.72, 30.55)], respectively. Khat chewing [OR = 3.53, (95% CI 1.31, 9.51)] and cigarette smoking [OR = 7.04, (95% CI 3.53, 14.04)] were found as statistically significant determinants of hazardous alcohol use among people with HIV infection.

Conclusions

The result of this review showed that alcohol drinking is highly practiced among people with HIV/AIDS in Ethiopia. The magnitude of alcohol use was highly variable based on the screening methods used to measure alcohol use. Comorbid substance use (khat and cigarette) increases the risk of alcohol consumption among HIV patients. This suggests a need for designing appropriate and culturally applicable intervention programs and policy responses.

Trial registration PROSPERO 2019, “CRD42019132524.”

Supplementary Information

The online version contains supplementary material available at 10.1186/s12954-021-00503-6.

How are depression and suicidal ideation associated with multiple health risk behaviours among adolescents? A secondary data analysis using the 2016 Korea Youth Risk Behavior Web-based Survey

WHAT IS KNOWN ON THE SUBJECT?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents' future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs. Population-based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. ABSTRACT: Introduction There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods This cross-sectional study was conducted using the 2016 Korea Youth Risk Behavior Web-based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43-4.47, 95% CI = 1.37-1.49 to 3.23-6.20) and/or who had suicidal ideation (OR = 1.33-3.19, 95% CI = 1.25-1.42 to 2.25-4.51) were more likely to engage in multiple HRBs. Discussion A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self-reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs.

Correlates of cannabis and other illicit drugs use among secondary school adolescents in Nigeria

BACKGROUND

The burden of cannabis and other illicit drug use among youth represent a serious public health problem. The aim of the present study is to explore factors associated with cannabis and other illicit drug use among Nigerian secondary school adolescents of the six geopolitical zones of the country.

METHODS

A total sample of 4078 secondary school adolescents of 32 schools from the six geopolitical zones of Nigeria participated in a cross-sectional survey in December 2015-January 2016. The association of sociodemographic characteristics, parental smoking, parental permissiveness to drink, friends' marijuana or other drugs use, risk perceptions and beliefs with the risk of lifetime cannabis and other illicit drugs use was examined through multilevel logistic regression models.

RESULTS

The mean age of the students involved in the study was 14.7 years. Older age, living in one-parent or family structures different from both parents household, parental smoking, parental permissiveness to drink alcohol, friends' use of marijuana or other drugs, low risk perception of harmful effects, and positive beliefs on marijuana or drugs use were associated with the risk of cannabis and illicit drugs use. The indicator of socioeconomic status was associated to the risk of using cannabis, but not to the risk of using illicit drugs.

CONCLUSIONS

The present study highlights some correlates that influence the uptake of cannabis and drugs among Nigerian adolescents. Preventive programs addressing these factors could help to reduce the burden of the problem. Specific attention should be given to interventions to contrast the incorrect beliefs and perceptions.

With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use

INTRODUCTION

Alcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence.

METHODS

The current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N = 3592; M_age = 14) participating in the HealthWise South Africa implementation quality trial.

RESULTS

Path model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences.

CONCLUSION

Findings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

A systematic review of interventions targeting men's alcohol use and family relationships in low- and middle-income countries

BACKGROUND

Problem drinking accounts for 9.6% of disability-adjusted life years worldwide. It disproportionally affects men and has disabling physical, psychological, and behavioral consequences. These can lead to a cascade of negative effects on men's families, with documented ties to intimate partner violence (IPV) and child maltreatment. These multi-level problems are often exacerbated where poverty rates are high, including low and middle-income countries (LMICs). In contexts where strong patriarchal norms place men in positions of power, family-level consequences are often even more pronounced.

METHODS

We conducted a systematic review of the literature on interventions in LMICs targeting men's problem drinking and any family-related outcomes. Cochrane and PRISMA procedures guided the review. The search was conducted in PsychInfo, PubMed, and Web of Science.

RESULTS

The search yielded 1357 publications. Nine studies from four different countries met inclusion criteria. Of those, only one had the primary goal of simultaneously improving drinking and a related family-level outcome (IPV). Six of the studies documented modest improvements on both drinking and couples or family outcomes. Strategies common to these included cognitive-behavioral techniques, communication skills training, narrative therapy, and participatory learning. Gender-transformative approaches were associated with reduced IPV and more equitable gender norms, and motivational interviewing and behavioral approaches were beneficial for reducing alcohol use.

CONCLUSIONS

Findings highlight the scarcity of interventions addressing men's drinking and its effects on families, particularly for parent-child outcomes. However, results point to strategies that, combined with other evidence-based family interventions can guide the development and rigorous evaluation of integrated programs.

Risk and protective factors for alcohol use among school-going adolescents in Montevideo (Uruguay)

Purpose

The purpose of this paper is to explore risk and protective factors for alcohol use among school-going adolescents in Montevideo (Uruguay).

Design/methodology/approach

A self-report survey was administered to 331 school-going adolescents in Montevideo (Uruguay) (Mage=13; SD=0.05), using the alcohol screening instrument of the Uruguayan National Drug Board to assess adolescents’ alcohol use (yes/no), a screening instrument for psychopathology and resilience (the adolescent self-report) and a socio-demographic questionnaire.

Findings

Logistic regression analyses identified antisocial behaviour, substance use and negative emotionality (F2), disruptive and dysregulated behaviour (F8), higher age and recent death of a close relative as risk factors, while the number of close friends was identified as a protective factor for past year alcohol use (yes/no). No straightforward relationship was found between schools and the risk for the past year alcohol use. In addition, age, F2, F8 and recent death of a close relative appeared to be the most robust predictors.

Research limitations/implications

The study was the first in Uruguay to relate adolescents’ alcohol use to risk and protective factors. Given the cross-sectional nature of the study, causal relationships could not be determined.

Originality/value

The study provides preliminary recommendations for policy makers and other stakeholders involved in youth affairs on core elements to focus on school-, community- and family-based alcohol prevention programmes for adolescents.

Substance misuse and sexual function in adolescents with chronic diseases

Objective:

To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs).

Methods:

A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk.

Results:

The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11–18) vs. 14 (10–18) years, p <0.0001] and education years [9 (5–14) vs. 8 (3–12) years, p <0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p <0.0001), menarche (p <0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p <0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226).

Conclusions:

A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns.

Substance use and sexual function in juvenile idiopathic arthritis

OBJECTIVE

To evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls.

METHODS

174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA.

RESULTS

The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18) years, p=0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p=0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18) years, p=0.032], particularly in polyarticular onset (p=0.040). High risk for substance abuse/dependence (CRAFFT score≥2) was found in both groups (13% vs. 15%, p=1.000), likewise bullying (p=0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19)years, p<0.001] and education years [11(6-13) vs. 7(3-12)years, p<0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p<0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p=0.032, r=+0.296).

CONCLUSION

A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.

Immediate drop-out rate in adolescent substance abusers: an out-patient chart review from North India

INTRODUCTION

Although a number of management strategies are available for adolescent substance abusers, the outcomes are limited due to high drop out. The factors related to drop out in adolescent substance users, especially in low and middle income countries (LAMIC) have been sparsely studied.

OBJECTIVE

To study the personal, family and clinical variables related to immediate drop out in adolescent substance abusers.

MATERIALS AND METHODS

A retrospective outpatient chart review was carried out for adolescent substance abusers aged 12-19 years from January 2012 to December 2014.

RESULTS

Of the 89 patients, 57 (64%) dropped out immediately. The majority of adolescent substance users were >17 years (85%), having some education (90%), belonging to a joint family (76%), having good family support (66%). Drop out was higher in those with later onset and less duration of substance abuse (3.42 vs. 2.36, p=0.014), not currently employed/attending school (OR=2.65, 95% CI=1.04-6.70), not having a psychiatric comorbidity, using a single substance and abusing cannabis. Factors like school drop out, background, family type and support and the relationship to the accompanying person were not associated with immediate drop out.

CONCLUSION

Later onset, lesser duration of substance use, not currently employed/attending school, absence of psychiatric illness and using cannabis were associated with drop out from outpatient treatment. These factors must be thoroughly addressed in substance abuse interventions.

Risk perception and correlates of alcohol use among out-of-school youth in motor parks in Lagos State, Nigeria

BACKGROUND AND AIM

The prevalence of alcohol use has increased globally. Out-of-school youth are a vulnerable group who might have missed opportunities for learning healthy behaviours in a formal school environment. The purpose of this study was to determine the risk perception, pattern of use, and correlates of alcohol use among out-of-school youth in Lagos, Nigeria.

METHODS

A cross-sectional study was conducted among 380 out-of-school youth in motor parks in Lagos State, Nigeria, using interviewer administered questionnaires.

RESULTS

The lifetime prevalence of alcohol use was 61.1%, while 55.5% were current drinkers. Beer (57.3%) was the most consumed type of alcohol, followed by distilled spirits (29.8%). Using the CAGE scoring system, more than half (57.8%) of the current drinkers had a drinking problem. Almost three quarters (70.1%) had experienced at least one episode of alcohol intoxication within the past month. A considerable number of current drinkers (63.5%) desired to reduce their alcohol intake or stop drinking, while 45.5% had made unsuccessful attempts to do so within the past year. Only 28.9% had received assistance to quit or reduce their drinking and of these less than half (39.3%) received assistance from a professional or healthcare worker. Males were more likely to be current drinkers and to have experienced episodes of alcohol intoxication. Parental and peer drinking were associated with alcohol use but not with intoxication.

CONCLUSIONS

It is important to design specific programmes to reduce alcohol use among out-of-school youth in these settings.

Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients

OBJECTIVE

To evaluate alcohol, smoking and/or illicit drug use, and history of bullying in adolescent childhood-onset systemic lupus erythematosus and healthy controls.

METHODS

174 adolescents with pediatric rheumatic diseases were selected. All of the 34 childhood-onset systemic lupus erythematosus patients and 35 healthy controls participated in this study. A cross-sectional study included demographic/anthropometric data and puberty markers assessments; structured questionnaire and CRAFFT screening interview.

RESULTS

McNemar tests indicated an excellent test-retest reliability of the structured questionnaire (p=1.0). The median current age was similar between childhood-onset systemic lupus erythematosus patients and controls [15 (12-18) vs. 15 (12-18) years, p=0.563]. The median of menarche age was significantly higher in childhood-onset systemic lupus erythematosus patients compared to controls [12 (10-15) vs. 11.5 (9-15) years, p=0.041], particularly in those that lupus had occurred before first menstruation [13 (12-15) vs. 11.5(9-15) years, p=0.007]. The other puberty marker and sexual function parameters were similar in both groups (p>0.05). Alcohol use was similar in both childhood-onset systemic lupus erythematosus patients and controls (38% vs. 46%, p=0.628). A trend of lower frequency of CRAFFT score ≥2 (high risk for substance abuse/dependence) was evidenced in childhood-onset systemic lupus erythematosus patients compared to controls (0% vs. 15%, p=0.053). Bullying was reported similarly for the two groups (43% vs. 44%, p=0.950). Further analysis in lupus patients regarding alcohol/smoking/illicit drug use showed no differences in demographic data, puberty markers, history of bullying, sexual function, contraceptive use, disease activity/damage scores, clinical/laboratorial features and treatments (p>0.05).

CONCLUSION

This study showed high frequencies of early alcohol use in lupus adolescents and healthy controls, despite of a possible low risk for substance abuse/dependence in childhood-onset systemic lupus erythematosus patients.

Substance use and sexual function in juvenile idiopathic arthritis

OBJECTIVE

to evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls.

METHODS

174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA.

RESULTS

The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18)years, p=0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p=0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18)years, p=0.032], particularly in poliarticular onset (p=0.040). High risk for substance abuse/dependence (CRAFFT score≥2) was found in both groups (13% vs. 15%, p=1.000), likewise bullying (p=0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19)years, p<0.001] and education years [11(6-13) vs. 7(3-12)years, p<0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p<0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p=0.032, r=+0.296).

CONCLUSION

A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.

Colour Vision Impairment in Young Alcohol Consumers

Alcohol consumption among young adults is widely accepted in modern society and may be the starting point for abusive use of alcohol at later stages of life. Chronic alcohol exposure can lead to visual function impairment. In the present study, we investigated the spatial luminance contrast sensitivity, colour arrangement ability, and colour discrimination thresholds on young adults that weekly consume alcoholic beverages without clinical concerns. Twenty-four young adults were evaluated by an ophthalmologist and performed three psychophysical tests to evaluate their vision functions. We estimated the spatial luminance contrast sensitivity function at 11 spatial frequencies ranging from 0.1 to 30 cycles/degree. No difference in contrast sensitivity was observed comparing alcohol consumers and control subjects. For the evaluation of colour vision, we used the Farnsworth-Munsell 100 hue test (FM 100 test) to test subject’s ability to perform a colour arrangement task and the Mollon-Reffin test (MR test) to measure subject’s colour discrimination thresholds. Alcohol consumers made more mistakes than controls in the FM100 test, and their mistakes were diffusely distributed in the FM colour space without any colour axis preference. Alcohol consumers also performed worse than controls in the MR test and had higher colour discrimination thresholds compared to controls around three different reference points of a perceptually homogeneous colour space, the CIE 1976 chromaticity diagram. There was no colour axis preference in the threshold elevation observed among alcoholic subjects. Young adult weekly alcohol consumers showed subclinical colour vision losses with preservation of spatial luminance contrast sensitivity. Adolescence and young adult age are periods of important neurological development and alcohol exposure during this period of life might be responsible for deficits in visual functions, especially colour vision that is very sensitive to neurotoxicants.

Validity and reliability of the Turkish version of CRAFFT Substance Abuse Screening Test among adolescents

AIM

This study aimed to validate the CRAFFT diagnostic test, against the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, Axis 1-based diagnostic inventory in a Turkish population of adolescents.

METHOD

The 124 adolescents who were 15-18 years old were enrolled to this study. CRAFFT was self-administered. Interviews took approximately 30 minutes, including the DSM-IV diagnostic interview for alcohol/drug dependence.

RESULTS

The mean age of subjects was 16.653 years (minimum: 15 years, maximum: 18 years). A score of 2 or higher in part B was found to be optimal for detecting youths with substance dependence problems (sensitivity: 0.82; specificity: 0.88) and it was sufficiently discriminative.

CONCLUSION

The CRAFFT is a valid and reliable instrument for identifying Turkish-speaking youths at risk for substance use disorders.