Timothy Slade

Timothy Slade
The University of Sydney · Matilda Centre for Research in Mental Health and Substance Use

PhD

About

314
Publications
112,831
Reads
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17,995
Citations
Citations since 2016
146 Research Items
12073 Citations
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201620172018201920202021202205001,0001,5002,000
Additional affiliations
December 2018 - January 2019
The University of Sydney
Position
  • Professor (Associate)
January 1996 - July 2007
UNSW Sydney
Position
  • Research Assistant
Education
May 1998 - May 2003
UNSW Sydney
Field of study
  • Psychiatry

Publications

Publications (314)
Article
Full-text available
Background: Estimates of the prevalence of DSM-IV alcohol use disorders (AUD; i.e., abuse and dependence) are consistently higher for younger adults compared with their older counterparts. However, questions remain as to whether this "youthful epidemic" of AUD is real or a methodological artifact of the prevailing classification criteria. The aim...
Article
The use in hazardous situations criterion (hazard) is 1 of 4 criteria related to alcohol abuse in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and 1 of the 11 criteria related to the new alcohol use disorder (AUD) proposed for DSM-5. The current study aims to evaluate the hazard criterion in the context of bot...
Article
Full-text available
There has been substantial recent interest in the development of a quantitative, empirically based model of psychopathology. However, the majority of pertinent research has focused on analyses of diagnoses, as described in current official nosologies. This is a significant limitation because existing diagnostic categories are often heterogeneous. I...
Article
Full-text available
Background Disadvantage and transgenerational trauma contribute to Aboriginal and Torres Strait Islander (Indigenous) Australians being more likely to experience adverse health consequences from alcohol and other drug use than non-Indigenous peoples. Addressing these health inequities requires local monitoring of alcohol and other drug use. While c...
Article
Importance Alcohol consumption is one of the leading preventable causes of burden of disease worldwide. Selective prevention of alcohol use can be effective in delaying the uptake and reducing harmful use of alcohol during the school years; however, little is known about the durability of these effects across the significant transition from early a...
Article
Full-text available
Several universal school-based prevention programs, notably the Australian Climate Schools program, have proven efficacious at reducing and maintaining a lower level of harmful alcohol consumption relative to a control condition. Yet, there are limited studies investigating the potential mechanisms that account for the reduction in harmful alcohol...
Article
Full-text available
Introduction: Trauma exposure among clients of substance use treatment services is almost universal and rates of trauma-related symptoms are correspondingly high. This study examined one aspect of clinical care-clinical documentation-and sought to systematically assess the documentation of trauma-related comorbidities and their treatment in a subs...
Presentation
Introduction and Aims: Trauma-related comorbidities are extremely prevalent in substance use treatment settings. Advancements in the field have seen the establishment of complex post-traumatic stress disorder (CPTSD) as a new diagnosis in the International Classification of Diseases, 11th Revision; however, there is no available evidence to inform...
Article
Aims: To examine age, period, and birth cohort trends in the prevalence of any alcohol-related risky behaviour, and to compare these trends between men and women. Design and setting: Age, period, cohort analysis of repeated cross-sectional survey data from the Australian National Drug Strategy Household Survey from 2001 to 2016. Participants:...
Article
Lifestyle risk behaviors often co-occur and are prevalent among adolescents. Parent-based interventions addressing risk behaviors concurrently have the potential to improve youth and parent outcomes. This systematic review evaluated the efficacy of parent-based interventions targeting multiple lifestyle risk behaviors among adolescents and parents....
Preprint
Several universal school-based prevention programs, notably the Australian Climate Schools program, have proven efficacious at reducing and maintaining a lower level of harmful alcohol consumption relative to a control condition. Yet, there are limited studies investigating the potential mechanisms that account for the reduction in harmful alcohol...
Preprint
Background: Moderate alcohol consumption appears to be associated with reduced inflammation compared to abstinence. However, there are concerns about the impact of common variations in researcher-defined data processing and analysis parameters on this relationship. In light of this, we performed comprehensive multiverse and vibration of effects ana...
Article
Full-text available
Purpose Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. T...
Article
Background Lifetime trajectories of mental ill-health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the cognitive behavioural therapy (CBT)-informed Climate Schools universal eHealth preventive mental health programme,...
Article
Background and aims: Tolerance to the effects of alcohol is an important element in the diagnosis of alcohol use disorders (AUD); however, there is ongoing debate about its utility in the diagnosis AUD in adolescents and young adults. This study aimed to refine the assessment of tolerance in young adults by testing different definitions of toleran...
Article
Aim Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, an...
Article
Background: Supply of alcohol to adolescents is associated with increased alcohol consumption and harms including alcohol use disorder (AUD). We aimed to identify: (1) trajectories of alcohol supply to adolescents; (2) sociodemographic characteristics associated with supply trajectory; (3) patterns of alcohol consumption by supply trajectory; and...
Article
Full-text available
Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar diso...
Article
Background: The COVID-19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and public health efforts to manage the outbreak, may result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with diff...
Preprint
BACKGROUND Physical inactivity is a preventable risk factor for several chronic diseases and one of the driving forces behind the growing global burden of disease. Recent evidence has shown that interventions using mobile smartphone applications (apps) can promote a significant increase in physical activity (PA) levels. However, the accuracy and re...
Article
Background Physical inactivity is a preventable risk factor for several chronic diseases and one of the driving forces behind the growing global burden of disease. Recent evidence has shown that interventions using mobile smartphone apps can promote a significant increase in physical activity (PA) levels. However, the accuracy and reliability of us...
Article
Objective Physical inactivity, sugar sweetened beverage consumption, alcohol use, smoking, poor sleep and excessive recreational screen time (the ‘Big 6’ lifestyle risk behaviours) often co-occur and are key risk factors for psychopathology. However, the best fitting latent structure of the Big 6 is unknown and links between multiple lifestyle risk...
Article
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and...
Article
Full-text available
Background Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. This review aimed to identify all observational studies employing improved approaches to mitigate co...
Article
Full-text available
The Australian Government will set the direction for addressing road safety over the next decade with its 2021–2030 National Road Safety Strategy. This road map will detail objectives and goals agreed upon by all Australian states and territories. Similar to previous national strategies, Aboriginal and Torres Strait Islander (Indigenous) Australian...
Article
Background Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patt...
Article
Aim We examined prevalence and factors associated with receiving perceived helpful alcohol use disorder (AUD) treatment, and persistence in help-seeking after earlier unhelpful treatment. Methods Data came from 27 community epidemiologic surveys of adults in 24 countries using the World Health Organization World Mental Health surveys (n = 93,843)....
Preprint
Importance: Prevention of depressive symptoms and disorders is a key public health priority but requires an improved understanding of modifiable risk and protective factors. A salient unanswered question in this context is whether the apparent protective effect of alcohol against depression may be causal.Objective: To compare the effects of consist...
Preprint
Background. Lifetime trajectories of mental ill health are often established during adolescence. Effective interventions to prevent the emergence of mental health problems are needed. In the current study we assessed the efficacy of the CBT informed Climate Schools universal eHealth preventive mental health program, relative to a control. We also e...
Article
Background Alcohol Use Disorder (AUD) is a significant contributor to global disease burden. AUD has a relatively early onset during young adulthood (Teesson et al., 2010). However, compared to AUD in adults, we have relatively little understanding of AUD in adolescents and emerging adults. Methods The RADAR study is a prospective cohort study des...
Article
Objective Alcohol use is a leading cause of burden of disease among young people. Prevention strategies can be effective in the short-term, however little is known about their longer-term effectiveness. The aim of this study was to examine the sustainability of universal, selective and combined alcohol use prevention across the critical transition...
Preprint
Objective: To synthesise international findings on the alcohol-dementia relationship and provide a cross-national comparison of the alcohol-dementia relationship with critical evidence for the relationship between alcohol use and dementia in under-studied populations. Design and setting: Individual participant data meta-analysis of 15 prospective e...
Article
Full-text available
Background: An emerging body of literature has indicated that broad, transdiagnostic dimensions of psychopathology are associated with alterations in brain structure across the life span. The current study aimed to investigate the relationship between brain structure and broad dimensions of psychopathology in the critical preadolescent period when...
Article
Background Early adolescence is a challenging transition period where mental ill-health and experimentation with alcohol and tobacco often increases. Some foods and eating behaviours can be addictive in a way that is comparable to addictive substances. Few studies have examined the prevalence of food addiction in young people, and none have measure...
Article
Background Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be an important predictor of later harms. Previous attempts to conceptualise these trajectories lacked adjustment for known confounders of adolescent drinking, which our study has aimed to address by modelling dynamic changes in...
Article
Background Physical inactivity, poor diet, sedentary recreational screen time, poor sleep, alcohol use and smoking (the “Big 6”) are key lifestyle risk factors for chronic disease. The Big 6 typically emerge during adolescence, co-occur and continue into adulthood. To improve short- and long-term health, early and effective prevention is critical....
Article
Focus of Presentation Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. While enhanced methods for data analysis (e.g. G-methods) and alternative observational d...
Article
This is the first study to investigate the effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of tobacco smoking over a three-year period in adolescence. A cluster randomised controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomised to either the Pre...
Article
Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood. Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspri...
Article
Full-text available
Background: Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pa...
Article
Full-text available
(1) Background: More time spent on social media has been linked to increased alcohol use, with exposure to peer alcohol-related content on social media (content exposure) named as a critical factor in this relationship. Little is currently known about whether early content exposure may have lasting effects across adolescent development, or about th...
Article
Aims To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. Design Prospective longitudinal cohort Setting Secondary schools in New South Wales, Tasmania, and Western Australia. P...
Article
Full-text available
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co‐occurrence in the modal case, heterogeneity of presentation within dis­orders, and instability of diagnosis within patients. This...
Article
Background Suicide plans and attempts rarely occur without prior suicidal ideation but are hard to predict. Early intervention efforts need to focus on subgroups of the population who are more likely to transition from ideation to suicidal plans and attempts. The current study utilised data from a large nationally representative sample to investiga...
Preprint
Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. This review aimed to identify all observational studies employing improved approaches to mitigate confounding i...
Article
Full-text available
Introduction There is a substantial literature finding that moderate alcohol consumption is protective against certain health conditions. However, more recent research has highlighted the possibility that these findings are methodological artefacts, caused by confounding and other biases. While modern analytical and study design approaches can miti...
Article
Full-text available
Much of the knowledge about the relationships among domains of psychopathology is built on the diagnostic categories described in the Diagnostic and Statistical Manual of Mental Disorders ( DSM), and relatively little research has examined the symptom-level structure of psychopathology. The aim of this study was to delineate a detailed hierarchical...
Article
Background: Poor diet, alcohol use, and tobacco smoking have been identified as strong determinants of chronic diseases, such as cardiovascular disease, diabetes, and cancer. Smartphones have the potential to provide a real-time, pervasive, unobtrusive, and cost-effective way to measure these health behaviors and deliver instant feedback to users....
Article
Background and aims Experience of alcohol‐induced memory blackouts in adolescence may be an important risk factor for later harms. This longitudinal study i) modelled trajectories of alcohol‐related blackouts throughout adolescence, ii) explored early‐adolescent predictors of blackout trajectories, and iii) examined the association between blackout...
Article
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...
Article
Full-text available
Purpose: Lifestyle risk factors, such as alcohol use, smoking, high body mass index, poor sleep, and sedentary behavior, represent major public health issues for adolescents. These factors have been associated with increased rates of major depressive disorder (MDD). The purpose of this paper is to investigate critical peaks in the prevalence of MD...
Article
A relationship between alcohol use and aggression is well-established; however, less is known about how these factors develop and influence each other over time. This study examined the immediate and delayed effects of alcohol use on aggression during adolescence. Alcohol use and aggression were measured in a subset of students (n = 1560) from the...
Preprint
Introduction: There is a substantial literature finding that moderate alcohol consumption is protective against certain health conditions. However, more recent research has highlighted the possibility that these findings are methodological artefacts, caused by confounding and other biases. While modern analytical and study design approaches can enh...
Preprint
Categorical mental disorders are being recognized as suboptimal targets in clinical neuroscience due to poor reliability as well as high rates of heterogeneity within, and comorbidity between, mental disorders. As an alternative to the case-control approach, recent studies have focused on the relationship between neurobiology and latent dimensions...
Article
Objectives: Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeli...
Article
Background and aims: Changes in cannabis legalization and availability in Australia necessitate monitoring use and attitudes. We estimated age-period-cohort effects of past-year cannabis use and attitudes towards criminalization and legalization. Design: Analysis of six waves of the Australian National Drug Strategy Household Survey (NDSHS) ever...
Article
Background Parents frequently supply alcohol to their children, often only sips. We investigated whether supply of sips and whole drinks, from parents and other sources, are differentially associated with subsequent drinking outcomes. Methods A cohort of 1,910 adolescents (mean age 12.9yrs) were surveyed annually over seven years from 2010-11. We...
Article
Full-text available
Background: Population estimates of alcohol consumption vary widely among samples of Aboriginal and Torres Strait Islander (Indigenous) Australians. Some of this difference may relate to non-representative sampling. In some communities, household surveys are not appropriate and phone surveys not feasible. Here we describe activities undertaken to...
Article
Aim To compare the long‐term universal outcomes of the Climate Schools program, the selective Preventure program and their combined implementation to standard substance use education in reducing the uptake of alcohol use, engagement in binge drinking and alcohol‐related harms over a 3‐year period. Design A cluster randomized controlled trial. Set...
Article
Background Recent studies suggest that young adult participation in, and volume of, alcohol consumption has decreased. However, the evidence on trends in harmful alcohol consumption in this age group is limited. The current paper aims to examine changes over time in harmful alcohol consumption using a robust, widely employed measure. Methods The l...
Article
Full-text available
Introduction Opioid dependence is a global health priority, currently making the biggest contribution to drug-related deaths. The chronic, long-term persistence of heroin dependence over the life course requires investigation in prospective longitudinal studies, to better understand patterns and predictors of remission and relapse, as well as the i...
Article
Full-text available
Introduction Lifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time (‘the Big 6’), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to...
Article
Background The burden of disease attributable to alcohol and other drug (AOD) use in young people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. Methods Seventy-one se...
Article
Full-text available
Background: Six core behavioural risk factors (poor diet, physical activity, sedentary behaviour, alcohol misuse, smoking and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. Smartphones have the potential to provide a real-time, pervasive, unobtrusive a...