Katia Iglesias

Not in Education, Employment, or Training Status Among Young Swiss Men. Longitudinal Associations With Mental Health and Substance Use

PURPOSE Not in Education, Employment, or Training (NEET) youth are youth disengaged from major social institutions and constitute a worrying concern. However, little is known about this subgroup of vulnerable youth. This study aimed to examine if NEET youth differ from other contemporaries in terms of personality, mental health, and substance use and to provide longitudinal examination of NEET status, testing its stability and prospective pathways with mental health and substance use. METHODS As part of the Cohort Study on Substance Use Risk Factors, 4,758 young Swiss men in their early 20s answered questions concerning their current professional and educational status, personality, substance use, and symptomatology related to mental health. Descriptive statistics, generalized linear models for cross-sectional comparisons, and cross-lagged panel models for longitudinal associations were computed. RESULTS NEET youth were 6.1% at baseline and 7.4% at follow-up with 1.4% being NEET at both time points. Comparisons between NEET and non-NEET youth showed significant differences in substance use and depressive symptoms only. Longitudinal associations showed that previous mental health, cannabis use, and daily smoking increased the likelihood of being NEET. Reverse causal paths were nonsignificant. CONCLUSIONS NEET status seemed to be unlikely and transient among young Swiss men, associated with differences in mental health and substance use but not in personality. Causal paths presented NEET status as a consequence of mental health and substance use rather than a cause. Additionally, this study confirmed that cannabis use and daily smoking are public health problems. Prevention programs need to focus on these vulnerable youth to avoid them being disengaged.

Is the relationship between major depressive disorder and self-reported alcohol use disorder an artificial one?

AIMS Many studies have suggested a close relationship between alcohol use disorder (AUD) and major depressive disorder (MDD). This study aimed to test whether the relationship between self-reported AUD and MDD was artificially strengthened by the diagnosis of MDD. This association was tested comparing relationships between alcohol use and AUD for depressive people and non-depressive people. METHODS As part of the Cohort Study on Substance Use Risk Factors, 4352 male Swiss alcohol users in their early twenties answered questions concerning their alcohol use, AUD and MDD at two time points. Generalized linear models for cross-sectional and longitudinal associations were calculated. RESULTS For cross-sectional associations, depressive participants reported a higher number of AUD symptoms (β = 0.743, P < 0.001) than non-depressive participants. Moreover, there was an interaction (β = -0.204, P = 0.001): the relationship between alcohol use and AUD was weaker for depressive participants rather than non-depressive participants. For longitudinal associations, there were almost no significant relationships between MDD at baseline and AUD at follow-up, but the interaction was still significant (β = -0.249, P < 0.001). CONCLUSION MDD thus appeared to be a confounding variable in the relationship between alcohol use and AUD, and self-reported measures of AUD seemed to be overestimated by depressive people. This result brings into question the accuracy of self-reported measures of substance use disorders. Furthermore, it adds to the emerging debate about the usefulness of substance use disorder as a concept, when heavy substance use itself appears to be a sensitive and reliable indicator.

Relative Deprivation and Well-being: Switzerland in a Comparative Perspective

Using data from a European welfare survey this contribution examines the actual Swiss standard of living, the degree and distribution of relative deprivation (the lack of socially perceived necessities) and their consequences for subjective well-being within a European context Although Switzerland has maintained its high level of standard of living, its low level of relative deprivation and its high level of subjective well-being, the differences between Switzerland and the other European countries have become less pronounced. Despite disparities concerning the actual standard of living and a corresponding east-west gradient there is a large consensus among the examined four countries concerning the minimum standard of living regarded as absolutely necessary for a decent life. In all countries relative deprivation negatively impacts on individual well-being whereas societal well-being that concerns the broader social environments of the individuals remains largely unaffected by deprivation, income and other inequality measures.

Co-morbidity of gambling and Internet use among Internet and land-based gamblers: classic and network approaches

Abstract This study investigated co-morbidity of problem gambling and problematic Internet use (PIU) among adolescent Internet and land-based gamblers, with the classic approach using sum-scores of symptoms and a promising new method, namely the network perspective. This perspective allows testing for how multiple disorders are associated, showing symptoms overlap and centralities. We used cross-sectional data from two population-based samples of adolescents aged 17 years in France (n = 2,240) and Switzerland (n = 944). Measures included Internet gambling, problem gambling and PIU. The classic approach showed that Internet gambling was associated with increased levels of disordered gambling and PIU, but that correlations between disorders were weak (R2 min = 3.2%, R2 max = 17.6%). The network perspective showed that the co-morbid network of Internet gamblers was more connected in comparison with land-based gamblers. Problem gambling and PIU appeared as separate disorders, but their relationship was increased among Internet gamblers in comparison with land-based gamblers. The network perspective appeared as a promising avenue for a better understanding of addictive disorders, but it should not replace the classic approach, which showed increased levels of addictive behaviours among Internet gamblers.

Associations between perceived discrimination and health status among frequent Emergency Department users.

Objective Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users’ perceptions of discrimination and to test whether they were associated with increased vulnerability. Methods In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues – dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) – mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer’s exact tests, Mann–Whitney U-tests). Results A total of 35.2% of the frequent ED users surveyed reported at least one source of perceived discrimination. Objective health status was not significantly related to perceived discrimination. In contrast, experiencing perceived discrimination was associated with worse subjective health status (P<0.001). Conclusion Frequent ED users are highly likely to report perceived discrimination during ED use, and this was linked to a decrease in their own rating of their health. Hence, discrimination should be taken into account when providing care to such users as it may constitute an additional risk factor for this vulnerable population. Perceived discrimination may also be of concern to professionals seeking to improve practices and provide optimal care to frequent ED users.

From support to overload: Patterns of positive and negative family relationships of adults with mental illness over time

Family relationships account for much of the support available to individuals with mental illness. Although some studies have acknowledged the importance of family support, and while others have underlined the harmful effects of negative relationships, research has seldom empirically considered the complex web of positive and negative relationships in family networks. This research hypothesised that social capital has distinct consequences for psychological health depending on the presence or absence of negative family relationships. Through a five-wave follow-up of 60 individuals undergoing psychotherapy in a private practice, the study explored the structural features of positive and negative relationships, considered jointly, in the family networks of adults with mental illness. Four patterns of relationships were found: bonding social capital, bridging social capital, overload and ego-centred conflict. Compared to individuals within a bonding or bridging social capital pattern, those experiencing overload and ego-centred conflict patterns showed higher levels of psychological distress. These results highlight the importance of considering the structural dimensions of positive and negative relationships together to understand the lasting connection between family networks and the psychological health of individuals with mental illness.

Independent and combined associations of risky single-occasion drinking and drinking volume with alcohol use disorder: Evidence from a sample of young Swiss men.

BACKGROUND Risky single-occasion drinking (RSOD) is a prevalent and potentially harmful alcohol use pattern associated with increased alcohol use disorder (AUD). However, RSOD is commonly associated with a higher level of alcohol intake, and most studies have not controlled for drinking volume (DV). Thus, it is unclear whether the findings provide information about RSOD or DV. This study sought to investigate the independent and combined effects of RSOD and DV on AUD. METHODS Data were collected in the longitudinal Cohort Study on Substance Use Risk Factors (C-SURF) among 5598 young Swiss male alcohol users in their early twenties. Assessment included DV, RSOD, and AUD at two time points. Generalized linear models for binomial distributions provided evidence regarding associations of DV, RSOD, and their interaction. RESULTS DV, RSOD, and their interaction were significantly related to the number of AUD criteria. The slope of the interaction was steeper for non/rare RSOD than for frequent RSOD. CONCLUSIONS RSOD appears to be a harmful pattern of drinking, associated with increased AUD and it moderated the relationship between DV and AUD. This study highlighted the importance of taking drinking patterns into account, for both research and public health planning, since RSO drinkers constitute a vulnerable subgroup for AUD.

Emerging Adulthood A Time of Changes in Psychosocial Well-Being

The principal aim of this study was to investigate the psychosocial well-being of emerging adults using psychological states associated with this transitional phase and classic measures of emerging adulthood. We expected psychological states to be more closely associated with psychological well-being than classic markers of achieved adulthood. Data were collected in the Cohort Study on Substance Use Risk Factors from 4,991 Swiss men aged 18–25 years. The assessment included the Short Form of the Inventory of Dimensions of Emerging Adulthood (IDEA-8), classic markers of achieved adulthood (e.g., financial independence, stable relationship), and psychosocial well-being. Structural equation models (SEMs) were conducted to test the association between measures of emerging adulthood and psychosocial well-being. Overall, the results highlighted contrasting associations of measures of emerging adulthood and psychosocial well-being. Youths facing negative psychological states (dimension “negativity”) and exploring life without knowing how to define themselves (dimension “identity exploration”) had a decreased psychosocial well-being. On the contrary, youths exploring many opportunities with an optimistic perspective (dimension “experimentation”) had an increased psychosocial well-being. By contrast, classic markers of adulthood were less related to psychosocial well-being. The IDEA-8 Scale appeared to be a useful screening tool for identifying vulnerable youths, and emerging adulthood should be measured with a focus on the psychological states associated with this period. This information may be valuable for mental health systems that have not yet adapted to emerging adults’ needs.

Explaining the Decline in Subjective Well-Being Over Time in Panel Data

Switzerland reached the top five countries which have the highest rate of subjective well-being (SWB), which converges with the economic prosperity and high quality of life in this country. Based on transversal data (European Social Survey), SWB measured through a global question remained globally constant over the last decades. However, SWB declined between 2000 and 2015 when measured with longitudinal data (Swiss Household Panel, SHP). In this context, the aim of this contribution is to examine to what extent the decline in SWB in longitudinal data is a robust result showing an actual decrease or reflect some specific methodological artifacts of these data. We identified more precisely four possible methodological issues: non-random attrition (NRA), panel conditioning (PC), refreshment sample, and aging of participants. Because of its structure, SHP data are particularly appropriate to challenge these issues, with a special attention to panel conditioning on several measures of SWB (i.e., global question vs. questions by life domains). SHP has been administered annually since 1999. A first sample was randomly selected in 1999, a second sample in 2004, and a third sample in 2013. First, we found that attrition was selective in the predictors of SWB all along the waves and that the respondents leaving the panel were more frequently represented in modalities of predictors associated with lower SWB. Second, panel conditioning was found to affect SWB measure in the first five waves for the global question and no specific patterns for questions by life domains were found. Third, we found higher SWB mean score in new samples than in old ones. And fourth, we found that aging modified the characteristics of the sample—for example, an increase of inactive persons or a decrease of persons with a low education affected the levels of SWB. Thus, SWB and its determinants were affected by NRA, PC, refreshment, and aging. Moreover, it has to be noted that it was difficult or impossible to distinguish these methodological issues from one another—aging from PC or refreshment from PC for example—as well as to propose methodological “remedies” to them. Finally, it resulted from our research that once these methodological issues have been neutralized, SWB did not decline anymore over the last fifteen years in Switzerland.

Measuring internet use: comparisons of different assessments and with internet addiction

Abstract Background: The measurement of Internet use is an under-documented topic despite the worldwide growth of problematic Internet use and the recent debate in addiction research suggesting that heavy use over time should be suitable for population-based assessment. This study compared different measures of Internet use to identify the most relevant one, and tested whether Internet use was a good proxy of self-reported Internet addiction. Methods: Data were collected in the ado@internet.ch study among 3054 Swiss 8th grade adolescents. Different assessments of Internet use (frequency, number of hours spent on Internet, quantity-frequency measure, latent score) were compared using rank invariance across instruments. We also examined associations of Internet use with health outcomes (Internet addiction, wellbeing, somatic health problems, and quantity of sleeping). Additionally, associations of Internet addiction with health outcomes were investigated. Results: Quantity-frequency captured 82% of the variability of average quantity and 64% of the variability of frequency, whereas the latent score captured respectively 94% and 52%. Regression models showed that frequency displayed the lowest associations with Internet addiction (b = 0.128) and wellbeing (b=−0.038). The associations of other Internet use measures were very similar. Associations of Internet addiction with wellbeing were higher than those of Internet use with wellbeing, whereas the other associations were similar. Conclusions: The quantity-frequency appeared as the most reliable and straightforward measure of Internet use. However, Internet use seemed to be only one factor in Internet addiction. This study was a first step toward proposing a unique relevant tool of Internet use in epidemiological research.