Tomi Lintonen

INTERNET ADDICTION? POTENTIALLY PROBLEMATIC USE OF THE INTERNET IN A POPULATION OF 12-18 YEAR-OLD ADOLESCENTS

On-line surveys indicate harmful excessive use of the Internet resulting in psychosocial problems (Internet addiction). Population studies are scarce, particularly on adolescents who are a vulnerable group in the middle of their personality development. The prevalence of features suggesting harmful use of the Internet is studied in a representative sample of 12–18 year-old Finns (N = 7292) in a postal survey in 2001. Criteria were tailored analogously to the criteria of pathological gambling, fulfilling four of the seven criteria operationalised as Internet addiction. Eighty five percent used the Internet. Among daily users 4.6% of boys and 4.7% of girls fulfilled the four criteria, infrequent users 0.3 and 0.5%, and all respondents 1.7 and 1.4%, respectively. The “addicts” spent more hours (mean = 2.7) in the Internet daily than the “non-addicts” (mean = 1.3). Some adolescents reported a potentially harmful relationship with the Internet comparable to addictive disorders. Although not common now, it will most likely increase with the increasing Internet use.

Use of information and communication technology and prevalence of overweight and obesity among adolescents.

BACKGROUND:The prevalence of overweight and obesity has increased among children and adolescents, as well as among adults, and television viewing has been suggested as one cause. Playing digital games (video, computer and console games), or using computer may be other sedentary behaviors related to the development of overweight and obesity.OBJECTIVE:To study the relationships of times spent on viewing television, playing digital games and using computer to overweight among Finnish adolescents.DESIGN:Mailed cross-sectional survey.SUBJECTS:Nationally representative samples of 14-, 16-, and 18-y-old (N=6515, response rate 70%) in 2001.METHODS:Overweight and obesity were assessed by body mass index (BMI). The respondents reported times spent daily on viewing television, playing digital games (video, computer and console games) and using computer (for e-mail, writing and surfing). Data on timing of biological maturation, intensity of weekly physical activity and familys socio economic status were taken into account in the statistical analyses.RESULTS:Increased times spent on viewing television and using computer were associated with increased prevalence of overweight (obesity inclusive) among girls: compared to girls viewing television <1 h daily, the adjusted odds ratio (OR) for being overweight was 1.4 when spending 1–3 h, and 2.0 when spending ≥4 h daily on viewing television. In girls using computer ≥1 h daily, the OR for being overweight was 1.5 compared to girls using computer <1 h daily. The results were similar in boys, although not statistically significant. Time spent on playing digital games was not associated with overweight.CONCLUSION:Overweight was associated with using information and communication technology (ICT), but only with certain forms of ICT. Increased use of ICT may be one factor explaining the increased prevalence of overweight and obesity at the population level, at least in girls. Playing digital games was not related to overweight, perhaps by virtue of game playing being less sedentary or related to a different lifestyle than viewing television and using computer.

Evaluation of Well-Being in Schools – A Multilevel Analysis of General Subjective Well-Being

The aim of this study was to explore the variation of general subjective well-being on individual and school levels. The classroom survey data of the School Health Promotion Survey (SHPS) were gathered in 1998 (N = 39 886) and in 1999 (N = 47 455) in different parts of Finland. The subjects were 8th and 9th graders from 458 secondary schools. Well-being was measured using the General Subjective Well-being Indicator (GSWI). The variation was studied using linear multilevel modeling. One percent of the variation in GSW occurred at the school level. The great majority of subjective well-being variation occurred between pupils.

Sociodemographic factors and a secular trend of adolescent overweight in Finland

BACKGROUND AND AIM The prevalence of overweight and obesity increased three-fold among Finnish adolescents during the past three decades. The aim of the present study was to evaluate whether this secular trend differed between sociodemographic subgroups of adolescents. METHODS Mailed surveys were conducted among nationally representative samples of 12-18 year olds biennially in 1979-2005 (N=3,105-8,390 per year, response rates 88%-66%). Body mass index was calculated from self-reported weight and height, and overweight (including obesity) was defined according to the IOTF reference for children. Associations between sociodemographic factors and secular trend in the prevalence of overweight were tested by logistic regression including interaction terms between survey year and sociodemographic variables. RESULTS Throughout the study period a higher prevalence of overweight, as compared with the respective reference groups, was observed among adolescents from rural areas, Western or Eastern Finland; or from lower socioeconomic status families (as measured by fathers/guardians education or occupational status or by mothers education); adolescents reporting lower school achievement, attending vocational school or not going to school at all; adolescents whose fathers were not employed outside home; and among girls living in non-nuclear families or whose mothers were unemployed/laid-off or retired/on long-lasting sick leave. The statistically significant interactions between survey year and sociodemographic variables on the prevalence of overweight were few and inconsistent. CONCLUSION The prevalence of overweight varied across sociodemographic subgroups of adolescents but in general no sociodemographic differences in the trends over time were observed. These results suggest that factors underlying the increasing trend of overweight have affected the entire adolescent population.

Trends in driving under the influence of drugs: A register-based study of DUID suspects during 1977–2007

Our aim was to describe the incidence and trends of driving under the influence of drugs (DUID) and to examine the main drug findings and their trends in suspected DUID cases in Finland. A register-based study was conducted of all suspected DUID cases during 1977-2007. The data included 31,963 DUID offenders apprehended by the police with a positive finding for illicit/licit drug impairing driving performance. Toxicological results were analyzed in blood and/or urine specimens in one central laboratory. The incidence of suspected DUID cases increased 18-fold during 1977-2007. Most of the suspects were men (89.7%). However, the male-female ratio decreased from 13.9 to 7.3. The mean age decreased from 36.2 years in 1977 to 29.9 years in 2001 but has since reincreased. Most often found substances were benzodiazepines (75.7%), amphetamines (46.0%), cannabinoids (27.7%) and opioids (13.8%). Most common illicit drugs, amphetamines and cannabinoids, started to appear at the end of the 1980s. Poly-drug findings were common (77.1%). Suspected DUID cases have increased sharply after the introduction of a zero tolerance law, especially in regard to amphetamines. DUID is an increasing problem in Finland, and needs serious attention.

Sexual behavior and drinking style among teenagers: a population-based study in Finland.

In this large-scale study, we examined the relationship between an adolescents sexual behavior and drinking style. Three aspects of sexual risk-taking were included: early activity, unprotected sexual intercourse and having sex with multiple partners. A distinction was made between different drinking styles, i.e. alcohol drinking and drunkenness-related drinking. Cross-sectional school survey data from the School Health Promotion Study was collected in Finland in 2002-2003. The national sample consisted of adolescents from the eighth and ninth grades (n = 100,790). The mean ages were 14.8 and 15.8 years. Using logistic regression analysis, we investigated the association between sexual behavior and drinking style among teenagers. The likelihood of engaging in sexual intercourse increased with the frequency of alcohol use. In particular, frequent drunkenness-related drinking increased the probability that the teenager had experienced sexual intercourse. The likelihood of engaging in unprotected sex and/or having multiple sexual partners was many-fold for adolescents drinking frequently until they were in a state of drunkenness. Particularly for girls, weekly drunkenness-related drinking was associated with multiple partners. The vast majority of sexually experienced under-aged adolescents drink alcohol, many of them until they are drunk. Thus, it could be effective to combine both alcohol education and sex education, including contraceptive counseling, in early adolescence.

The validity of the concept of 'self-perceived drunkenness' in adolescent health surveys

The aim was to explore the validity of self-perceived state of drunkenness as an indicator of heavy drinking among adolescents. The data from a cross-sectional mailed survey, The Adolescent Health and Lifestyle Survey, in Finland in 1999, were used in analysis. The participants formed representative samples of 12, 14, 16 and 18 year-olds ( n = 7751, age/gender adjusted response rate 77%). An estimate of the Maximum Theoretical Blood Alcohol Concentration (MTBAC) was calculated using self-reported beverage quality/quantity data and analysed for relatedness with subjective perceptions of drunkenness. Among 12 year-olds drinking was rare. For the adolescents aged 14 to 18, the mean estimated MTBACs for the perceived drunkenness categories were similar: 0.05 - 0.07% among the completely sober, 0.17 - 0.10% among the slightly drunk and 0.29 - 0.12% among the really drunk. Correlation between MTBAC and perceived drunkenness among 14 to 18 year-olds was 0.69. No age or gender differences were evident. It seems that, as a group, the adolescents from age 14 understood well the concept of drunkenness and their perception was highly correlated with their estimated Blood Alcohol Concentration (BAC). In this respect, validity was established for the measure of self-perceived drunkenness used widely in adolescent health surveys.

Comparative vs global self-rated health: associations with age and functional ability.

Background and aims: This study examined the relationship of age and functional ability with comparative (age-referential) and global self-rated health (SRH), and the possible effect of selection bias. The focus is on differences between these questions and on the consequences which these differences have in research. Methods: The data came from the second wave of the Tampere Longitudinal Study on Ageing (TamELSA), consisting of 830 persons aged 60–99 years. The associations of both self-rated health measures with age and functional ability were examined using multinomial regression analyses. Results: People with increasing age, particularly over 80-year-old, are inclined to rate their health better than that of their age peers. The association of older age with better comparative SRH became even stronger after adjustment for functional ability, chronic diseases and sociodemographic factors. The relation of older age with global SRH was weaker than that with age-referential SRH. By contrast, functional ability was more strongly associated with global than with comparative SRH. Conclusions: Our results suggest that comparative and global self-rated health cannot be used interchangeably. The comparative measure is more strongly “calibrated” by age. Therefore, when SRH is used as a measure in survey studies or in clinical settings, the global question should be preferred.

A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage

AIMS The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood. METHODS Finnish cohort studys participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42. RESULTS Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage. CONCLUSION Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.

Drug Use Among Prisoners: By Any Definition, It's a Big Problem

According to several studies, the prevalence of drug use1 among prisoners is manyfold compared to general population. However, comparisons across studies are hampered by the use of a variety of mutually noncomparable methodologies. We report substance use among Finnish prisoners using three methods and analyze these differences. The material consisted of 610 Finnish prisoners in 2006 and represents all Finnish prisoners. The subjects participated in a comprehensive field study including a standardized psychiatric interview (SCID-I). Alcohol abuse/dependence was diagnosed in 68% (SCID-I) and 72% (ICD-10) among men and 70% (both SCID-I and ICD-10) among women. Drug abuse/dependence was diagnosed in 62% (SCID-I) and 69% (ICD-10) among men and 64% (SCID-I) and 70% (ICD-10) among women prisoners. Interview data revealed that the majority had at least tried most substances. Both alcohol and drug abuse/dependence were vastly more common among Finnish prisoners than reported elsewhere. The DSM-IV-based SCID-I produced slightly lower prevalence estimates than an ICD-10 clinical examination, but overall SCID/ICD agreement was very good. It seems that physicians use information other than that captured by standardized structured clinical interview when placing a diagnosis. Nonclinical interview-based prevalence figures may overestimate harmful use of drugs unless known risk patterns of use (e.g., intravenous use) are specifically addressed.