Associations between emotional distress and heavy drinking among young people: A longitudinal study

Abstract

IntroductionDepression has generally been found to be associated with heavy drinking and alcohol use disorders [1][2][3][4]. There is also evidence of a link between anxiety and extensive use of alcohol [5][6][7][8], but this association has been less extensively scrutinized and the findings seem less clear. Thus, some studies of young people report null-findings [9] or a link between anxiety and heavy drinking that is attributable to concurrent symptoms of depression and/or other confounding factors [10][11][12].The bulk of previous studies focus on severe forms of internalizing problems and harmful drinking, and have typically relied on diagnoses or other dichotomous measures. Obviously, such research may be of clinical significance, yet the findings do not necessarily apply to mild forms of emotional distress and non-pathological drinking [13]. To address subclinical conditions is important in its own right, not least because they may contribute to the total burden of harm and social cost at least as much as the clinical ones -simply by being far more prevalent.Furthermore, studies of adult samples predominate in the field, and the association between emotional distress and heavy drinking may be different among young people. The onset of drinking typically occurs in adolescence, and the consumption of alcohol and related harm escalate during the late teens and reaches a peak in early adulthood [14,15]. Problems related to mood and emotions also tend to increase in this period of life [16]. Moreover, it has been hypothesized that risk factors related to mental health may become increasingly important in influencing drinking behaviour as individuals approach adulthood, reflecting the challenges of leaving a protected environment, and entering an independent adult role [17].Indeed, a recent study showed that the association between depression and alcohol use disorders was stronger in early adulthood than in adolescence [18]. The present paper pursues this issue further by analysing four-wave panel data on less severe forms of emotional distress and heavy drinking from a general population study of young people.

Binge drinking and subsequent depressive symptoms in young women in Australia

“…Despite the exclusion of women with depressive symptoms at baseline, the reverse association is still possible (that poor mental health leads to binge drinking) and has been supported by several studies (Bell and Britton, 2014;Pape and Norström, 2015). Others have supported a bidirectional relationship between alcohol dependence and depression (Brière et al, 2014;Bulloch et al, 2012), or that heavy and/or binge drinking precedes depression (Fergusson et al, 2009;Paljarvi et al, 2009;Wang and Patten, 2002).…”

The association between early life mental health and alcohol use behaviours in adulthood: A systematic review

“…Although causality in observational data is not easy to infer, a range of techniques such as cross-contextual comparisons, negative controls, sensitivity analysis for unmeasured confounders, instrumental variable analysis or Mendelian Randomization [101,102], and fixed-effect models that eliminate time-invariant confounders [103] can be used for more robust causal inference. To the best of our knowledge, only two articles in this area have applied fixed-effect models [104,105]. However, their exposure and outcome were measured within the same period and the direction of the association they found could be from alcohol use behaviours to mental health problems [104,106].…”

Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study

“…While some longitudinal studies have linked early depressive symptoms to later alcohol use [14], other studies have not found this association [15,16]. In terms of alcohol problems, evidence suggests that these are generally preceded by depressive symptoms [17–21].…”

“…Our understanding of the complexity of the association between alcohol use and depression remains limited [17,21,22], but there is reason to believe that early onset of alcohol use, and high levels of alcohol use is associated with later poor mental health, as well as functional, economic and social problems [23–31]. However, variability in alcohol use trajectories may be differentially associated with symptoms of depression.…”