J. Wanzer Drane

Relationship between perceived life satisfaction and adolescents' substance abuse

PURPOSE To explore the relationship between perceived global life satisfaction and selected substance use behaviors among 5032 public high school students. METHODS The 1997 South Carolina Youth Risk Behavior Survey substance abuse and life satisfaction variables were used. An adjusted polychotomous logistic regression analysis utilizing SAS/SUDAAN, revealed a significant race/gender interaction. Subsequent multivariate models were constructed individually for four race/gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess the magnitude of risk for selected substance abuse behaviors and their association with reduced global life satisfaction. RESULTS Cigarette smoking, chewing tobacco, marijuana, cocaine, regular alcohol use, binge drinking, injection drug, and steroid use were significantly (p < .05) associated with reduced life satisfaction for specific race/gender groups (white males; black males; white females; and black females). In addition, age (< or = 13 years) of first alcohol drink, first marijuana use, first cocaine use, and first cigarette smoked were also significantly (p < .05) associated with reduced life satisfaction. CONCLUSION Longitudinal studies are needed to determine whether dissatisfaction with life is a consequence or determinant of substance abuse behavior for adolescents.

Adolescent health-related quality of life and perceived satisfaction with life.

Purpose: To explore the relationship between perceived satisfaction with life and health-related quality of life (HRQOL) in a state-wide sample of 13–18-year-old adolescents (n=4914) in South Carolina, USA. Methods: Questions were added to the self-report Centers for Disease Control (CDC) Youth Risk Behavior Survey (YRBS) asking about perceived life satisfaction in six domains (self, family, friends, living environment, school, and overall) and HRQOL (self-rated health; and the number of poor physical health days, poor mental days, and activity limitation days during the past 30 days). Results: Adjusted logistic regression analyses and multivariate models constructed separately revealed that self-rated health, poor physical days (past 30 days), poor mental health days (past 30 days), and activity limitation days (past 30 days) were significantly related (p < 0.05) to reduced life satisfaction, regardless of race or gender. Moreover, as the number of reported poor health days increased, the greater the odds of reporting life dissatisfaction. Conclusions: This is the first study to document the relationship between poor physical health and perceived life satisfaction. This adds to the mounting evidence that life satisfaction is related to a variety of adolescent health behaviors and that life satisfaction may add additional information in longitudinal databases that track adolescent health because it appears to be related to HRQOL.

Life Satisfaction and Suicide Among High School Adolescents

Relationships between perceived life satisfaction, poor mental health, suicide ideation and suicide behaviors were examined in a statewide sample of 13 to 18 year old public high school students (n = 4,758) using the self-report CDC Youth Risk Behavior Survey (YRBS). Adjusted logistic regression analyses and multivariate models constructed separately (via SUDAAN), revealed that poor mental health (past 30 days), poor mental/physical health (past 30 days) serious suicide consideration (past 12 months), planning for suicide (past 12 months), attempted suicide (past 12 months) and suicide attempt requiring medical care (past 12 months) were significantly related to reduced life satisfaction. Also, differences across gender and race were demonstrated. Measures of life satisfaction as a component of comprehensive assessments of adolescent mental health, suicide ideation and suicide behavior in fieldwork, research, and program-evaluation efforts should be considered.

Association Between Life Satisfaction and Sexual Risk-Taking Behaviors Among Adolescents

Relationships between perceived life satisfaction and sexual risk-taking behaviors were examined in a statewide sample of public high school students (n = 4,758) using the self-report CDC Youth Risk Behavior Survey (YRBS). Adjusted polychotomous logistic regression analyses and multivariate models (via SUDAAN) constructed separately, revealed a significant race by gender interaction for each race-gender group. Age of first intercourse (≤13), two or more lifetime sexual intercourse partners, alcohol/drug use before last intercourse, no use of contraception at last intercourse, being forced to have sex, forcing someone to have sex, and having beaten up a date in the last 12 months and having been beaten up by a date (in last 12 months) were associated (p = .05) with reduced life satisfaction. Measures of life satisfaction as a component of comprehensive assessments of adolescent sexual risk-taking behaviors in fieldwork, research, and program-evaluation efforts should be considered.

The Impact of a Required College Health and Physical Education Course on the Health Status of Alumni

The impact of a required college health and physical education course on selected health knowledge, attitudes, and behaviors of alumni was evaluated. The design was a cross-sectional study (mail out/mail back survey) using a stratified random sample of 2,000 college alumni. The overall response rate was 50%. Results were analyzed by college of graduation (college with a required health/physical education course versus no required course). Alumni who took the course were more likely to know their blood pressure, blood cholesterol, and recommended dietary fat intake than the comparison group were. They also reported that the course positively influenced their attitudes toward exercise, eating, and smoking They were more likely to engage in aerobic exercise and less likely to smoke; and they had lower intakes of dietary fat, cholesterol, and sodium. The results suggested that a required college course enhanced selected health-related knowledge, attitudes, and behaviors of alumni.

Evaluating the Performance of the Centers for Disease Control and Prevention Core Health-Related Quality of Life Scale with Adolescents

Objective. The purpose of this study was to evaluate the performance of the Centers for Disease Control and Preventions core Health-Related Quality of Life (HRQOL) scale using data from 5,520 public high school students. Methods. The 1997 South Carolina Youth Risk Behavior Survey was the source of data. Chi-square analysis was applied to assess scale construct validity. Adjusted multiple logistic regression with selected tobacco and substance use variables was used to assess known-groups validity of the scales Healthy Days index (items regarding poor physical and mental health days during the past 30 days). Results. Construct validity was supported for the core HRQOL scale by the associations between self-perceived health and physical health, mental health, and activity limitation days. A greater number of poor physical health days, poor mental health days, or activity limitation days was associated with poorer self-perceived health (p<0.0001); however, correlation coefficients for the associations between self-perceived health and physical health days (r=0.24; p<0.001), self-perceived health and mental health days (r=0.26; p<0.0001), and self-perceived health and activity limitation days (r=0.23; p<0.0001), although significant, were low in magnitude. Logistic regression analyses conducted with the Healthy Days index revealed significant (p<0.05) HRQOL differences between users and non-users of tobacco and other substance use variables. As hypothesized, as the usage of each substance increased, reported poor HRQOL days increased, supporting the known-groups validity of the scale. Conclusions. This study provides preliminary evidence that the HRQOL scale items are valid and potentially useful for adolescent surveillance. The results, however, are mixed regarding the inclusion of self-perceived health as a measure of HRQOL for adolescents, given the low correlation coefficients for the associations between self-perceived health and the other HRQOL scale items. These results suggest that adolescents may be rating two separate dimensions of health when rating their self-perceived health and HRQOL. Further research is needed to confirm these findings in different adolescent populations.

A critique of the use of hormesis in risk assessment

There are severe problems and limitations with the use of hormesis as the principal dose-response default assumption in risk assessment. These problems and limitations include: (a) unknown prevalence of hormetic doseresponse curves; (b) random chance occurrence of hormesis and the shortage of data on the repeatability of hormesis; (c) unknown degree of generalizability of hormesis; (d) there are dose-response curves that are not hormetic, therefore hormesis cannot be universally generalized; (e) problems of post hoc rather than a priori hypothesis testing; (f) a possible large problem of ‘false positive’ hormetic data sets which have not been extensively replicated; (g) the ‘mechanism of hormesis’ is not understood at a rigorous scientific level; (h) in some cases hormesis may merely be the overall sum of many different mechanisms and many different dose-response curves - some beneficial and some toxic. For all of these reasons, hormesis should not now be used as the principal dose-response default assumption in risk assessment. At this point, it appears that hormesis is a long way away from common scientific acceptance and wide utility in biomedicine and use as the principal default assumption in a risk assessment process charged with ensuring public health protection.

Number of Sexual Intercourse Partners and Associated Risk Behaviors among Public High School Adolescents

Factors associated with the number of sexual partners were examined in a statewide sample of public high school students (N=3,732) using the self report Youth Risk Behavior Survey. Since simple polychotomous logistic regression models revealed a significant race by gender interaction, multivariate models were constructed separately for each race/gender group. Odds ratios and 95% confidence intervals were calculated from polychotomous logistic regression of number of sexual intercourse partners (five mutually exclusive ordered categories) with their potential correlates. Results showed consistently stronger associations with other risk behaviors (alcohol, tobacco, aggressive and reckless behaviors) at higher levels of sexual risk-taking. An increased number of sexual intercourse partners appears to be correlated with a cluster of risk behaviors that place adolescents at increased health risks of premature morbidity and mortality.

Public Opinion on School-Based Sex Education in South Carolina.

The purpose of this article was to determine opinions on the use of abstinence only versus comprehensive sex education by registered voters in South Carolina. A cross-sectional, random-digit dial sample was utilized. Approximately 81% of respondents indicated support for sex education that emphasizes abstinence but also teaches about the benefits and importance of using contraceptives to prevent pregnancy and/or sexually transmitted diseases. Results suggest that registered voters in South Carolina support teaching a comprehensive approach to sex education and favor a variety of sex education topics, regardless of political ideology, religion, or parental status.