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Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life
Örebro University, School of Medical Sciences. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-0066-4814
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 6, p. 469-501Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited.

METHODS: In this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression.

RESULTS: We found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates.

CONCLUSION: Low stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019. Vol. 73, no 6, p. 469-501
Keywords [en]
Alcohol, epidemiology, health behaviour, psychological stress, smoking
National Category
Substance Abuse
Identifiers
URN: urn:nbn:se:oru:diva-72375DOI: 10.1136/jech-2018-211815ISI: 000471850400004PubMedID: 30718261Scopus ID: 2-s2.0-85061156675OAI: oai:DiVA.org:oru-72375DiVA, id: diva2:1287479
Note

Funding Agencies:

European Research Council Consolidator Grant  726413 

Swedish Council for Information on Alcohol and Other Drugs  2017-0095 

Karolinska Institutet through a Senior Researcher Award  

Karolinska Institutet through a Strategic Research Area in Epidemiology Award 

Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-07-23Bibliographically approved

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Kennedy, BeatriceRuoqing, ChenMontgomery, ScottLarsson, HenrikFall, Katja

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