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ABSTRACT: We developed a 'senior friendly' suite of online 'games for learning' with interactive calibration for increasing difficulty, and evaluated the feasibility of a randomized clinical trial to test the hypothesis that seniors aged 60-80 can improve key aspects of cognitive ability with the aid of such games. Sixty community-dwelling senior volunteers were randomized to either an online game suite designed to train multiple cognitive abilities, or to a control arm with online activities that simulated the look and feel of the games but with low level interactivity and no calibration of difficulty. Study assessment included measures of recruitment, retention and play-time. Cognitive change was measured with a computerized assessment battery administered just before and within two weeks after completion of the six-week intervention. Impediments to feasibility included: limited access to in-home high-speed internet, large variations in the amount of time devoted to game play, and a reluctance to pursue more challenging levels. Overall analysis was negative for assessed performance (transference effects) even though subjects improved on the games themselves. Post hoc analyses suggest that some types of games may have more value than others, but these effects would need to be replicated in a study designed for that purpose. We conclude that a six-week, moderate-intensity computer game-based cognitive intervention can be implemented with high-functioning seniors, but the effect size is relatively small. Our findings are consistent with Owen et al. (2010), but there are open questions about whether more structured, longer duration or more intensive 'games for learning' interventions might yield more substantial cognitive improvement in seniors.
Archives of gerontology and geriatrics 03/2013; · 1.36 Impact Factor
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J Elisabeth Wells,
Ronald C Kessler,
Giovanni de Girolamo,
Sing Lee,
Ronny Bruffaerts,
Jean-Pierre Lépine,
Nancy Sampson,
Ron de Graaf, Louisa Degenhardt,
Lisa Dierker, [......],
Daphna Levinson,
Wai Tat Chiu,
Yehuda Neumark,
Stanislav Kostyuchenko,
Matthias Angermeyer,
Yosikazu Nakamura,
Maria Elena Medina-Mora,
Jose Posada-Villa,
Dan Stein,
James C Anthony
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Jonathan P Troost,
David A Barondess,
Carla L Storr,
J Elisabeth Wells,
Ali Obaid Al-Hamzawi,
Laura Helena Andrade,
Evelyn Bromet,
Ronny Bruffaerts,
Silvia Florescu,
Giovanni de Girolamo, [......],
Jean-Pierre Lepine,
Herbert Matschinger,
Maria Elena Medina-Mora,
Siobhan O'Neill,
Jose Posada-Villa,
Rajesh Sagar,
Tadashi Takeshima,
Toma Tomov,
David R Williams, James C Anthony
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ABSTRACT: Cross-national variance in smoking prevalence is relatively well documented. The aim of this study is to estimate levels of smoking persistence across 21 countries with a hypothesized inverse relationship between country income level and smoking persistence.
Data from the World Health Organization World Mental Health Survey Initiative were used to estimate cross-national differences in smoking persistence-the proportion of adults who started to smoke and persisted in smoking by the date of the survey.
There is large variation in smoking persistence from 25% (Nigeria) to 85% (China), with a random-effects meta-analytic summary estimate of 55% with considerable cross-national variation. (Cochran's heterogeneity Q statistic=6,845; p<0.001). Meta-regressions indicated observed differences are not attributable to differences in country income level, age distribution of smokers, or how recent the onset of smoking began within each country.
While smoking should remain an important public health issue in any country where smokers are present, this report identifies several countries with higher levels of smoking persistence (namely, China and India).
Journal of epidemiology and global health. 09/2012; 2(3):135-144.
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ABSTRACT: This study was designed to examine geographic variation in illegal drug purchase opportunity among young people living in
the United States; there was a subfocus on age, sex, and urban/rural residence. Data from the 1996–1997 National Household
Surveys on Drug Abuse were analyzed; the nationally representative sample of community residents included 21,531 participants
aged 12–24 years old. Respondents were asked if someone had approached them to sell them an illegal drug during the past 30
days. To protect responsents’ confidentiality, there is no fine-grained geographical coding of data in the National Household
Surveys on Drug Abuse public use data files, but mine geographical divisional indicators are provided (i.e., West Norht Central,
New England, etc.). Results indicated males were an estimated 1.8 times more likely than females to have had a recent illicit
drug purchase opportunity, and urban residents were 1.5 times more likely than rural residents to have had a recent drug purchase
opportunity. As for geographic divisions, the Pacific division surpassed all other divisions: Its residents were 1.5 times
more likely to have recent drug purchase opportunities tha the West North Central division (used bere as a reference category).
After controlling statistically for age, sex, and urban/rural residence, fresidence in four divisions was foun to be associated
with greater likelihood of an illicit drug purchase opportunity. The observed patterns of drug purchase opportunity add new
features to our understanding of illicit drug involvement across the United States.
KeywordsAdolescence-Adult-Neighborhood-Street Drugs-Substance-Related Disorders-Urban-Rural
Journal of Urban Health 04/2012; 79(1):104-112. · 2.13 Impact Factor
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ABSTRACT: Smoking cannabis before adulthood is associated with subsequent adverse psychiatric outcomes and might be prevented via parenting interventions such as programs to increase parents' effective monitoring of their children. The aim of this study was to estimate the influence of parental monitoring assessed at age 11 on the initiation of cannabis use before age 18.
Data are from a longitudinal study of 823 children randomly selected from 1983 to 1985 newborn discharge lists from two major hospitals in southeast Michigan. Parental monitoring was assessed at age 11 via a standardized 10-item scale, and the parental monitoring-cannabis initiation relationship was estimated for the 638 children with complete data. Poisson regression with robust error variances was used to estimate the association that links levels of parental monitoring at age 11 with the risk of cannabis use up to age 17, adjusting for other important covariates.
Higher levels of parental monitoring at age 11 were associated with a reduced risk of cannabis initiation from ages 11 to 17 (adjusted estimated relative risk = 0.96; 95% CI [0.93, 0.98]).
This prospective investigation found that higher levels of parental monitoring were associated with a reduced occurrence of cannabis initiation from ages 11 to 17 years. Consistent with evidence reported elsewhere, these findings from prospective research lend further support to theories about parenting and familial characteristics that might exert long-lasting influences on a child's risk of starting to use drugs.
Journal of studies on alcohol and drugs 03/2012; 73(2):173-7. · 2.25 Impact Factor
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ABSTRACT: Psychiatric researchers tend to select the discordant co-twin design when they seek to hold constant genetic influence while estimating exposure-associated disease risk. The epidemiologic case-crossover research design developed for the past two decades represents a viable alternative, not often seen in psychiatric studies. Here, we turn to the epidemiologic case-crossover approach to examine the idea that cannabis onset is a proximal trigger for cocaine use, with the power of "subject-as-own-control" research used to hold constant antecedent characteristics of the individual drug user, including genetic influence and other traits experienced up to the time of the observed hazard and control intervals. Data are from newly incident cocaine users identified in the 2002-2006 US National Surveys on Drug Use and Health. Among these cocaine users, 48 had both cannabis onset and cocaine onset in the same month-long hazard interval; the expected value is 30 users, based on the control interval we had pre-specified for case-crossover estimation (estimated relative risk, RR = 1.6; exact mid-p = 0.042). Within the framework of a subject-as-own-control design, the evidence is consistent with the hypothesis that cannabis onset is a proximal trigger for cocaine use, with genetic influences (and many environmental conditions and processes) held constant. Limitations are noted and implications are discussed.
International journal of methods in psychiatric research. 01/2012; 21(1):66-75.
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ABSTRACT: Evidence in support of a suspected causal association linking childhood physical punishment (CPP) and later alcoholic beverage-related disturbances has been found in metropolitan China. Here, the focus shifts to the CPP association with the estimated risk of starting to drink, having the first drinking problem, and transitioning from first drink to the first drinking problem.
Data are from the World Mental Health Surveys-metropolitan China study, with representative samples of adult household residents living in two metropolitan cities, Beijing and Shanghai. Recalled information was available for early life experiences (including CPP, other childhood adversities, and parental alcohol and drug problems), as well as the onset age of drinking and drinking problems. Survival analyses were used to estimate the Hazard Ratio. A structural equation modeling approach was used to control for other inter-correlated childhood adversities.
Cox proportional hazards modeling discloses statistically robust associations linking CPP with drinking and drinking problems, as well as more rapid transitions from first drink to first drinking problem, even after accounting for other childhood adversities and parental drinking problems. These associations cannot be attributed to a more general noxious family environment.
These results lay a foundation for future experimental studies on the possible causal relationship linking CPP with the onset of drinking problems and the transition from drinking to drinking problems.
Drug and alcohol dependence 04/2011; 118(1):31-9. · 3.60 Impact Factor
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J Elisabeth Wells,
Josep Maria Haro,
Eli Karam,
Sing Lee,
Jean-Pierre Lepine,
Ma Elena Medina-Mora,
Hideyuki Nakane,
Jose Posada, James C Anthony,
Hui Cheng,
Louisa Degenhardt,
Matthias Angermeyer,
Ronny Bruffaerts,
Giovanni de Girolamo,
Ron de Graaf,
Meyer Glantz,
Oye Gureje
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ABSTRACT: Sex differences in opportunities to use alcohol or drugs, and transition to use, were investigated in 15 surveys, in 2001-2004 (Europe 6; Americas 3; Africa 2, Asia 3; Oceania 1). The paper focuses on 18-29 year olds (N = 9,873). The World Mental Health Survey Initiative oversaw the surveys; each country obtained its own funding. A complex picture emerged with different results for alcohol and for drugs and for opportunity to use and the transition to use. Sex differences in opportunity to use alcohol were small except in Lebanon and Nigeria, whereas for drugs, the largest differences were in Mexico and Colombia.
Substance Use & Misuse 03/2011; 46(9):1169-78. · 1.10 Impact Factor
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ABSTRACT: PURPOSE: Stigma-related feelings, including degree of enthusiasm and willingness to work with alcohol, drug, and mental disorder (ADM) patients, as well as anticipated success in such work, will be required for the United States to be successful in its new initiatives for ADM screening, brief intervention, and effective referral to treatment and rehabilitation services (SBIRT). This study investigates students of medicine and social work with respect to their stigma-related feelings and degree of enthusiasm or willingness to treat patients affected by alcohol dependence, nicotine dependence, or major depression. Inference is strengthened by an anonymous online survey approach, with use of randomized reinforcers to gain at least partial experimental control of nonparticipation biases that otherwise are present in student survey data. MATERIAL AND METHODS: All students on required course rosters were asked to participate in a two-part in-class and online assessment; 222 participated, with a gradient of participation induced via randomly drawn reinforcers for online survey participation. Between-group comparisons were made with a multivariate generalized linear model and generalized estimating equations approach that adjusts for covariates. RESULTS: Medical and social work students did not differ from each other with respect to their willingness to treat patients affected by major depression, alcohol dependence, or nicotine dependence, but together were less willing to treat nicotine and alcohol dependence-affected patients as compared to depression-affected patients. Personal history was not associated with the students' willingness to treat, but men were less willing to treat. Drawing strength from the randomized reinforcer experimental design nested within this survey approach, the study evidence suggests potential nonparticipation bias in standard surveys on this topic. CONCLUSION: These results indicate that future health professionals may prefer to treat depression as opposed to drug dependence conditions. For SBIRT success, curriculum change with educational interventions may be needed to increase willingness to treat patients with neuropsychiatric conditions such as drug dependence. Future research requires attention to a possible problem of nonparticipation bias in surveys of this type.
Substance abuse and rehabilitation. 03/2011; 2011(2):43-51.
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ABSTRACT: This epidemiological study of a sample of smokers from the general population of Colombia examined the population distribution and dimensionality of eight hypothesized inter-correlated clinical features (CFs) associated with tobacco dependence syndrome (TDS). Data were drawn from interviews of 4 426 smokers conducted in a national survey in Colombia as part of the World Mental Health Survey Initiative. Daily smokers completed a Spanish-language TDS module, and the 237 smokers who had begun smoking during the five years prior to the assessment were selected. Confirmatory factor analysis (CFA) for a unidimensional TDS provided discrimination and difficulty parameter estimates. Two CFs that were reported very infrequently among the study sample were dropped from the CFA. Among the six remaining CFs, discrimination (D1) estimates ranged from 1.1 to 6.0 and difficulty (D2) estimates ranged from 1.1 to 2.2, providing evidentiary support for a unidimensional tobacco dependence construct. The Spanish-language TDS module used in this study could serve as a valuable tool in future studies for evaluating public health outreach and early intervention programs directed toward community residents who have begun smoking tobacco.
Revista Panamericana de Salud Pública 01/2011; 29(1):52-6. · 0.85 Impact Factor
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ABSTRACT: To prospectively examine the linkage between childhood antecedents and progression to early cannabis involvement as manifest in first chance to try it and then first onset of cannabis use.
Two consecutive cohorts of children entering first grade of a public school system of a large mid-Atlantic city in the mid 1980s (n=2311) were assessed (mean age 6.5 years) and then followed into young adulthood (15 years later, mean age 21) when first chance to try and first use were assessed for 75% (n=1698) of the original sample. Assessments obtained at school included standardized readiness scores (reading; math) and teacher ratings of behavioral problems. Regression and time to event models included covariates for sex, race, and family disadvantage.
Early classroom misconduct, better reading readiness, and better math readiness predicted either occurrence or timing of first chance to try cannabis, first use, or both. Higher levels of childhood concentration problems and lower social connectedness were not predictive.
Childhood school readiness and behavioral problems may influence the risk for cannabis smoking indirectly via an increased likelihood of first chance to use. Prevention efforts that seek to shield youths from having a chance to try cannabis might benefit from attention to early predictive behavioral and school readiness characteristics. When a youth's chance to try cannabis is discovered, there are new windows of opportunity for prevention and intervention.
Drug and alcohol dependence 01/2011; 117(1):7-15. · 3.60 Impact Factor
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ABSTRACT: Research suggests that stigma plays a major role in discouraging clients from participating in mental health treatment. Because social workers provide a significant amount of such services, this study investigates social work student stigma as a function of their willingness to treat clients with alcohol dependence, nicotine dependence, depression, and Alzheimer's disease. Students' held higher levels of stigma toward nicotine dependent clients and less toward those with depression. Personal histories of depression and student age - but not smoking or alcohol use - were predictive of higher stigma levels towards nicotine dependent clients. Implications for social work are discussed.
Social Work in Mental Health 01/2011; 9(4):253-271.
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ABSTRACT: The aim of the current study is to estimate the association between childhood physical punishment (CPP) and level of alcohol use disorder (AUD), using two different approaches to take other childhood adversities into account.
Population survey using face-to-face interviews to a representative sample of non-institutionalized adult residents of Beijing and Shanghai, China.
A total of 5201 participants aged 18-70 years.
A version of the World Mental Health Composite International Diagnostic Interview was used. Standardized assessments covered early life experiences of childhood physical punishment, other childhood adversities, parental drinking problems, childhood conduct problems and clinical features of AUD.
A robust association linking CPP and level of AUD was found, holding other childhood adversities constant (probit coefficient = 0.70, 95% CI = 0.40, 1.00) via covariate terms in structural equations modeling. Furthermore, there was evidence that CPP might exert an additional influence on level of AUD over and above a generally noxious family environment (probit coefficient = 0.20, 95% CI = 0.02, 0.38).
There appears to be a robust association between reports of harsh punishment in childhood and alcohol dependence in adulthood adjusting for a range of possible confounding factors. Whether the association is causal or whether both are related to a common underlying factor or recall bias needs to be investigated further.
Addiction 12/2010; 105(12):2097-105. · 4.31 Impact Factor
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ABSTRACT: There is considerable interest in using propensity score (PS) statistical techniques to address questions of causal inference in psychological research. Many PS techniques exist, yet few guidelines are available to aid applied researchers in their understanding, use, and evaluation. In this study, the authors give an overview of available techniques for PS estimation and PS application. They also provide a way to help compare PS techniques, using the resulting measured covariate balance as the criterion for selecting between techniques. The empirical example for this study involves the potential causal relationship linking early-onset cannabis problems and subsequent negative mental health outcomes and uses data from a prospective cohort study. PS techniques are described and evaluated on the basis of their ability to balance the distributions of measured potentially confounding covariates for individuals with and without early-onset cannabis problems. This article identifies the PS techniques that yield good statistical balance of the chosen measured covariates within the context of this particular research question and cohort.
Psychological Methods 09/2010; 15(3):234-49. · 4.45 Impact Factor
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Ron de Graaf,
Mirjana Radovanovic,
Margriet van Laar,
Brian Fairman,
Louisa Degenhardt,
Sergio Aguilar-Gaxiola,
Ronny Bruffaerts,
Giovanni de Girolamo,
John Fayyad,
Oye Gureje, [......],
Jean-Pierre Lépine,
Herbert Matschinger,
Maria Elena Medina Mora,
Yehuda Neumark,
Johan Ormel,
Jose Posada-Villa,
Dan J Stein,
Hisateru Tachimori,
J Elisabeth Wells, James C Anthony
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ABSTRACT: Early-onset cannabis use is widespread in many countries and might cause later onset of depression. Sound epidemiologic data across countries are missing. The authors estimated the suspected causal association that links early-onset (age <17 years) cannabis use with later-onset (age > or =17 years) risk of a depression spell, using data on 85,088 subjects from 17 countries participating in the population-based World Health Organization World Mental Health Survey Initiative (2001-2005). In all surveys, multistage household probability samples were evaluated with a fully structured diagnostic interview for assessment of psychiatric conditions. The association between early-onset cannabis use and later risk of a depression spell was studied using conditional logistic regression with local area matching of cases and controls, controlling for sex, age, tobacco use, and other mental health problems. The overall association was modest (controlled for sex and age, risk ratio = 1.5, 95% confidence interval: 1.4, 1.7), was statistically robust in 5 countries, and showed no sex difference. The association did not change appreciably with statistical adjustment for mental health problems, except for childhood conduct problems, which reduced the association to nonsignificance. This study did not allow differentiation of levels of cannabis use; this issue deserves consideration in future research.
American journal of epidemiology 07/2010; 172(2):149-59. · 5.59 Impact Factor
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ABSTRACT: Large-sample epidemiological studies of tobacco cigarette smoking routinely assess so-called "lifetime prevalence" of tobacco dependence. This work delves into the earliest stages of smoking involvement, focusing on newly incident tobacco cigarette smokers in the very recent past, and examines hypothesized subgroup variation in count processes that become engaged once smoking starts. Here, the term "count process" has two components: (a) whether smoking will be persistent and (b) the rate of smoking, conditional upon membership in a latent class of smokers who will persist, as estimated under the zero-inflated Poisson (ZIP) model for complex survey data.
We estimate these ZIP parameters for nationally representative samples of newly incident smokers in the United States (all with smoking initiation within 24 months of assessment). Data are from the 2004-2007 National Surveys on Drug Use and Health.
Once cigarette smoking started, roughly 40%-45% persisted, and the estimated median rate was five smoking days/30 days, conditional on membership in the latent class of persistent smokers. Among non-Hispanic recent-onset cigarette smokers, Whites, Black/African Americans, Asians, and Native American/Alaskan Natives did not differ, but recent-onset smokers of Hispanic origin and those of Pacific Islander background had comparatively less cigarette involvement.
Tobacco prevention and control initiatives may require elaboration in the form of brief interventions, including interpersonal and social transactions that might constrain a mounting frequency of days of smoking before daily smoking starts, and until conventional smoking cessation medication aids become indicated. These very-early stage interventions (VESI) might be mounted within family or peer groups or in the primary care or school settings, but randomized trials to evaluate VESI interventions will be required.
Nicotine & Tobacco Research 07/2010; 12(7):734-41. · 2.58 Impact Factor
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Louisa Degenhardt,
Lisa Dierker,
Wai Tat Chiu,
Maria Elena Medina-Mora,
Yehuda Neumark,
Nancy Sampson,
Jordi Alonso,
Matthias Angermeyer, James C Anthony,
Ronny Bruffaerts, [......],
Aimee N Karam,
Stanislav Kostyuchenko,
Sing Lee,
Jean-Pierre Lépine,
Daphna Levinson,
Yosikazu Nakamura,
Jose Posada-Villa,
Dan Stein,
J Elisabeth Wells,
Ronald C Kessler
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ABSTRACT: It is unclear whether the normative sequence of drug use initiation, beginning with tobacco and alcohol, progressing to cannabis and then other illicit drugs, is due to causal effects of specific earlier drug use promoting progression, or to influences of other variables such as drug availability and attitudes. One way to investigate this is to see whether risk of later drug use in the sequence, conditional on use of drugs earlier in the sequence, changes according to time-space variation in use prevalence. We compared patterns and order of initiation of alcohol, tobacco, cannabis, and other illicit drug use across 17 countries with a wide range of drug use prevalence.
Analyses used data from World Health Organization (WHO) World Mental Health (WMH) Surveys, a series of parallel community epidemiological surveys using the same instruments and field procedures carried out in 17 countries throughout the world.
Initiation of "gateway" substances (i.e. alcohol, tobacco and cannabis) was differentially associated with subsequent onset of other illicit drug use based on background prevalence of gateway substance use. Cross-country differences in substance use prevalence also corresponded to differences in the likelihood of individuals reporting a non-normative sequence of substance initiation.
These results suggest the "gateway" pattern at least partially reflects unmeasured common causes rather than causal effects of specific drugs on subsequent use of others. This implies that successful efforts to prevent use of specific "gateway" drugs may not in themselves lead to major reductions in the use of later drugs.
Drug and alcohol dependence 04/2010; 108(1-2):84-97. · 3.60 Impact Factor
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ABSTRACT: Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs.
Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426), Colombia (n = 5,782) and the United States (USA; n = 8,228). The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO) users across these surveyed populations.
The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004) and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001).
This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that might make cannabis-related social and legal problems more frequent in Colombia than in the USA.
BMC Public Health 03/2010; 10:152. · 2.00 Impact Factor
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ABSTRACT: There is evidence that alcohol, tobacco, and other drug use may be rising in China, but epidemiological studies that examine several drugs simultaneously and the transition from initial try to current use are limited. The present study provides an epidemiological profile of drug use in contemporary metropolitan China.
A multistage probability sampling method was used to select household-dwelling adults in Beijing and Shanghai. Standard face-to-face interviews with 5,201 participants were completed during 2002-2003.
An estimated 70-76% had used any type of drug: alcohol and tobacco were the most commonly used drugs (alcohol, 67%; tobacco, 39%). Regarding extra-medical use of internationally regulated drugs, sedatives and analgesics were most common and illegal drug use was rare. The majority of tobacco users used it recently (82.5%), especially young adults. Male-female differences were observed in lifetime tobacco use, but not for recent use. Concurrent use of alcohol and tobacco was very common.
Psychoactive drug use is common in metropolitan China. Public health policies and prevention initiatives may be needed to address associated problems that may increase following the country's rapid socioeconomic change.
International Journal of Public Health 02/2010; 55(6):645-53. · 2.54 Impact Factor
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ABSTRACT: The aim of the current study is to estimate a link between early physical punishment in childhood and later alcohol outcomes, taking family history of drinking problems into account, with epidemiological data from China. The yield from previous studies on this relationship is mixed evidence, largely traceable to research design variations, including model specifications that concern parental alcohol or other drug problems (AODPs) that might account for both earlier discipline practices and later drinking problems in the offspring.
Data are from the World Mental Health Surveys-metropolitan China study, with cross-sectional representative sample surveys of adult household residents living in two metropolitan cities, Beijing and Shanghai. Participants in this general mental health survey were asked about early life experiences (e.g., parental AODP, childhood misbehavior), as well as their own drinking outcomes. Stratification was used to control for parental AODP.
Logistic regressions found robust associations linking childhood physical punishment with drinking outcomes, even with stratification for parental AODP and childhood misbehavior.
These results from a cross-sectional survey lay a foundation for future prospective and longitudinal research on possible causal relationships that link childhood physical punishment with later drinking outcomes in China.
Journal of studies on alcohol and drugs 01/2010; 72(1):24-33. · 2.25 Impact Factor
