Associations of Social Phobia and General Anxiety with Alcohol and Drug Use in A Community Sample of Adolescents
Associations of Social Phobia and General Anxiety with Alcohol and Drug Use in A Community Sample of Adolescents
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DOI：
10.1093/alcalc/agq096
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发表时间：
2011-03-01
影响因子：
2.8
通讯作者：
Marttunen, Mauri
中科院分区：
文献类型：
--
作者：
Frojd, Sari;Ranta, Klaus;Marttunen, Mauri
目的：这项研究探讨了焦虑与酒精和其他物质使用之间的关联是否在青春期中期已经很明显，以及一般焦虑或社交恐惧症的症状是否会影响频繁饮酒，频繁醉酒和大麻使用的连续性。研究方法：青少年心理健康队列研究是一项在芬兰对基线年龄为15-16岁的青少年进行的以学校为基础的调查，研究数据被用来评估社交恐惧症、普遍焦虑症、频繁饮酒、频繁醉酒和大麻使用等症状的患病率、发生率和持续性（在这种情况下，吸烟的“大麻”未知的选区），以及物质使用变量和焦虑变量之间的关联，在2年的随访。结果：焦虑先于物质使用，而没有观察到相互关联。抑郁介导了焦虑和物质使用之间的关联。社交恐惧症的症状并没有增加物质使用的发生率，但普遍的焦虑却增加了。与其他两个物质使用变量相比，频繁醉酒与焦虑的相关性较低。共病的一般性焦虑增加了频繁饮酒的持久性，而共病的社交恐惧降低了其持久性。经常醉酒和使用大麻的连续性不受共病焦虑的影响。结论：青春期中期的广泛性焦虑使青少年处于同时和随后物质使用的风险中。然而，这种风险可能与共病抑郁症有关。青春期中期的社交恐惧症可能会防止物质使用。有内化症状的青少年可能需要指导来应对症状，即使症状不符合情绪或焦虑症的标准。
Aims: This study explores whether associations between anxiety and alcohol and other substance use are already evident in middle adolescence, and whether general anxiety or symptoms of social phobia affect continuity of frequent alcohol use, frequent drunkenness and cannabis use. Methods: Data from the Adolescent Mental Health Cohort Study, a school-based Finnish survey among adolescents aged 15-16 years at baseline, was utilized to assess prevalence, incidence and continuity of symptoms of social phobia, general anxiety, frequent alcohol use, frequent drunkenness and cannabis use (which in this context was smoked 'hashish' of unknown constituency), and the associations between the substance use variables and the anxiety variables in 2-year follow-up. Results: Anxiety preceded substance use while no reciprocal associations were observed. Depression mediated the associations between anxiety and substance use. Symptoms of social phobia did not elevate the incidence of substance use, but general anxiety did. Frequent drunkenness was less significantly associated with anxiety than the other two substance use variables. Co-morbid general anxiety increased the persistence of frequent alcohol use while co-morbid social phobia decreased its persistence. Continuity of frequent drunkenness and cannabis use were unaffected by co-morbid anxiety. Conclusions: General anxiety in middle adolescence places adolescents at risk for concurrent and subsequent substance use. The risk may, however, be associated with co-morbid depression. Social phobia in middle adolescence may protect from substance use. Adolescents with internalizing symptoms may need guidance in coping with the symptoms even if the symptoms do not fulfil the criteria of mood or anxiety disorder.