Psychometric properties and factor structure of an Ecuadorian version of the Alcohol Use Disorders Identification Test (AUDIT) in college students

Lifestyle behavior of physiotherapy students from Ecuador upon admission to higher education: a cross-sectional study

Introduction

Admission to university has been identified as a period involving the adoption of unhealthy lifestyle behaviors. However, few studies have addressed the extent of this experience among Latin American university students. The aim of this study was twofold: first, to describe anthropometric variables, body composition, physical activity, sedentary behavior, sleep duration and quality, diet, and alcohol consumption in first-year students entering physiotherapy school at the Universidad de las Americas in Quito, Ecuador; second, to test differences in these variables between sexes.

Methods

A total of 116 students were recruited. Sociodemographic variables, anthropometric indices, body composition, physical activity, sedentary behavior, sleep quality and duration, adherence to 24-hour movement guidelines, physical fitness (i.e., handgrip strength), diet, alcohol consumption, and smoking habits were evaluated.

Results

A total of 50 male (43.1%) and 66 female (56.9%) students were assessed. Overall, the adherence to the 24-hour movement guidelines of the students upon admission to university was 8.6%. Conversely, 86 students (74.1%) did not meet any of the recommendations. Upon admission to university, only 8.6% of the students (female 2.6%; male 6%) met the overall 24-hour movement guidelines. Additionally, 82 students (70.7%) needed changes in diet quality, 81 students (69.8%) had significant sleep disturbances, and 22 students (18.9%) had harmful alcohol consumption. A greater proportion of males met all three 24-h movement recommendations (p = 0.025) than females did. In addition, females reported a greater percentage of occasional smokers (p = 0.025) and a greater prevalence of obesity (p < 0.001), a lower level of physical activity (p < 0.001), and a greater percentage of sleep disturbance (p < 0.001). Conversely, males reported greater waist circumference (p = 0.005), weight (p < 0.001), handgrip strength (p < 0.001), and a greater percentage of harmful alcohol consumption (p < 0.001).

Discussion

Our study showed that upon admission to university, overall adherence to the 24-hour movement guidelines is low among university students. Additionally, a high percentage of students reported unhealthy lifestyle behaviors, with differences according to sex. Our findings could lead to the use of specific sex-specific strategies for the prevention and promotion of movement and lifestyle behaviors during this critical period.

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

Background

Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied.

Objective

The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador.

Methods

A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects.

Results

Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]).

Discussion

Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

Psychological Inflexibility and Loneliness Mediate the Impact of Stress on Anxiety and Depression Symptoms in Healthcare Students and Early-Career Professionals During COVID-19

Background: The current mental health state of healthcare professionals and students during the COVID-19 pandemic in Ecuador remains understudied and how to improve their mental health is a challenge.

Objective: This study aimed to explore the anxiety and depressive symptomatology among healthcare students and professionals in Ecuador and to examine the role of psychological inflexibility, loneliness, and psychological stress as predictors of anxiety and depression symptoms.

Methods: A total of 191 undergraduate and graduate healthcare students in clinical practice (early-career healthcare professionals) in Ecuador were surveyed between January and March 2021 using standardized measures of psychological stress (PSS), psychological inflexibility (AAQ), loneliness (UCLA), alcohol consumption (AUDIT-C), and anxiety and depressive symptomatology (PHQ). Macro Process for SPSS (models 4 and 7) were used to test mediation effects.

Results: Alcohol consumption varied between men and women and anxiety and depression symptomatology was generally low among the sample. Psychological inflexibility and loneliness mediated the impact of stress on anxiety and depressive mood in participants, regardless of gender and previous personal history of COVID-19.

Discussion: Implications of psychological inflexibility and the prevention and coping with stress in healthcare professionals during COVID-19 are further discussed.

Analysis of the AUDIT factor structure in adolescents between 18 and 19 years

OBJECTIVE

To determine the factor structure of the instrument Alcohol Use Disorders Identification Test (AUDIT) in a representative sample of adolescents aged 18 to 19 years.

METHODS

Cross-sectional study performed with adolescents born in São Luís (MA). The internal consistency of the instrument was determined by the Cronbach's alpha coefficient, and the validity of the construct was assessed by Confirmatory Factor Analysis (CFA). The Kaiser-Meyer-Olkin (KMO) was estimated to analyze the adequacy of the sample. The fit quality of the factor model was analyzed according to the indexes of the Chi-square adjustment test, comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA).

RESULTS

The sample of the study was composed of 1,002 adolescents aged from 18 to 19 years, being 56.8% girls, 68.5% with 18 years, 63.3% brown, 48.6% belonging to class C, 15.4% did not work or did not study, and 52.1% had divorced parents. The sample was suitable for confirmatory factor analysis (KMO = 0.79); Cronbach's alpha coefficient was 0.70, demonstrating satisfactory internal consistency with factor loads above 0.5, except for item 9, "was injured or someone else was injured due to drinking." Confirmatory factor analysis revealed the validity of the three-factor model for the studied sample based on the indices of psychometric adjustments.

CONCLUSION

The three-factor AUDIT factor structure was confirmed for the population of adolescents between 18 and 19 years old living in São Luís, ratifying the original conceptual domains proposed by the World Health Organization. AUDIT proved to be a reliable instrument to identify the consumption of alcohol.

Factor Validity of Alcohol Use Disorders Identification Test (AUDIT) Using Robust Estimations in Ecuadorian Adolescents

OBJECTIVE

Confirm the three correlated factors model of the Alcohol Use Disorders Identification Test (AUDIT) using robust estimations and evaluate its internal consistency with a sample of Ecuadorian adolescents.

METHOD

Descriptive and instrumental analysis that includes confirmatory factor analysis with robust estimation and the calculation of its internal consistency.

PARTICIPANTS

A total of 1113 adolescents in which 56.1% are men and 43.9% are women), and they were between 11 and 19 years old ($\overline{X} $= 14.9 years; s = 1.67). Students from eight educational centres in Cotopaxi (54.1%) and Tungurahua (45.9%) in Ecuador were also included.

RESULTS

The three correlated factors model from the AUDIT is confirmed with χ2 = 95.67; P < 0.001; df = 32; χ2/df = 2.98; comparative adjustment index = 0.93; Tucker-Lewis index = 0.90; standardized root mean square residual = 0.046; root mean square error of approximation = 0.042; 95% confidence interval [0.033-0.052].

CONCLUSIONS

The three correlated factors model from the AUDIT using robust estimations has an adequate fit and is also reliable in a sample of Ecuadorian adolescents.

Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension

The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n = 1523 Slovak university students). Descriptive, regression, and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9), and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, while in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.

Psychometric properties of the three versions of the Perceived Stress Scale in Ecuador

BACKGROUND

. The Perceived Stress Scale (PSS) is the most well-known self-report measure to assess perceived psychological stress.

OBJECTIVE

. The objective of the study was to analyze the psychometric properties of three versions of the Perceived Stress Scale (PSS-4, PSS-10 and PSS-14) in Ecuador.

METHODS

. A sample of 7905 university students (46% men and 54% women) from Ecuador were surveyed using all three versions of PSS.

RESULTS

. All three versions showed a satisfactory adjustment with a bifactorial structure based on the item structure rather than underlying dimensions of psychological stress. The reliability was also adequate, with Alpha and Omega coefficients [α = 0.85 and ω = 0.80 for PSS-14; α = 0.85 and ω = 0.87 for PSS-10; α = 0.74 and ω = 0.78 for PSS-4] respectively. Psychological stress scores positively correlated with multiple health indicators such as loneliness, psychological inflexibility, alcohol consumption, and presence of anxiety and depression symptoms, and negatively with resilience.

CONCLUSIONS

. The use of PSS-10 based on its best goodness of fit and PSS-4 as the shortest version are recommended to measure psychological stress, rather than the original PSS-14 version. Psychological stress was significantly higher in women than men.