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Journal Article•DOI•

Perceived parental alcohol problems, internalizing problems and impaired parent - child relationships among 71 988 young people in Denmark.

Veronica Pisinger1, Kim Bloomfield2, Janne Schurmann Tolstrup1•
University of Southern Denmark1, Aarhus University2
01 Nov 2016-Addiction (Wiley-Blackwell)-Vol. 111, Iss: 11, pp 1966-1974
TL;DR: Boys and girls in secondary education in Denmark who report perceived parental alcohol problems have significantly higher odds of internalizing problems and poorer parent-child relationships compared with young people without perceived parents' alcohol problems.
Abstract: Aims To test the hypothesis that young people with perceived parental alcohol problems have poorer parent–child relationships and more emotional symptoms, low self-esteem, loneliness and depression than young people without perceived parental alcohol problems. Design Cross-sectional analysis using data from the Danish National Youth Study 2014, a web-based national survey. Setting Denmark. Participants A total of 71.988 high school and vocational school students (aged 12–25, nested in 119 schools and 3.186 school classes) recruited throughout 2014. Measurements Outcome variables included internalizing problems such as emotional symptoms, depression, self-esteem, loneliness and aspects of the parent–child relationship. The main predictor variable was perceived parental alcohol problems, including the severity of the perceived problems and living with a parent with alcohol problems. Control variables included age, sex, education, ethnicity, parents’ separation and economic problems in the family. Findings Boys and girls with perceived parental alcohol problems had statistically significant higher odds of reporting internalizing problems (e.g. frequent emotional symptoms: odds ratio (OR)= 1.58 for boys; 1.49 for girls) and poor parent–child relationships (e.g. lack of parental interest: OR = 1.92 for boys; 2.33 for girls) compared with young people without perceived parental alcohol problems. The associations were not significantly stronger for mother's alcohol problems or if the young person lived with the parent with perceived alcohol problems. Conclusion Boys and girls in secondary education in Denmark who report perceived parental alcohol problems have significantly higher odds of internalizing problems and poorer parent–child relationships compared with young people without perceived parental alcohol problems.

Summary (2 min read)

Jump to: [Introduction] – [Methods and material] – [Ethics] – [Results] and [Discussion]

Introduction

  • Globally, it has been estimated that alcohol causes almost five percent of diseases and injuries, while nearly four percent of all deaths are attributable to alcohol, making it one of the leading risk factors for death and disability (1).
  • European men and women have a high annual alcohol intake, averaging 10.9 liters of pure alcohol per capita (2).
  • Therefore many face an increased risk of more than 60 alcohol-related diseases (3).
  • Children of parents with severe alcohol problems have been found to be at increased risk of adverse mental health outcomes, including internalizing problems (such as depression and anxiety) and externalizing problems (such as aggressive and antisocial behavior) (4-20).
  • Most previous studies are based on data from help-seeking adults or children of parents in treatment, while the results of general population studies have been mixed (21).

Methods and material

  • The Danish National Youth Study 2014 Data comes from the Danish National Youth Study 2014, a national survey of 75,858 high school and vocational school students.
  • In spring 2014 all of Denmark’s 137 general high schools and the 12 largest vocational schools were invited to participate.
  • School participant proportion was 87% among high schools and 83% among vocational schools.
  • Since the target group was young people, participants older than 25 years of age (N=782) and those with missing data on parental alcohol problems (N=3.088) were excluded, leaving the total study population at 71,988 respondents.
  • Teachers facilitated the survey by giving students a code that gave access to the electronic survey.

Ethics

  • The study was approved by the Danish Data Protection Agency.
  • An overall measure indicating whether participants perceived any parent to have alcohol problems (yes/no) was constructed and a measure was coded to distinguish between perceived mothers’, fathers’, stepparents’, or both parents’ alcohol problems.
  • Participants were asked how often within the last six months they had felt a) low, b) nervous, or c) irritable or had been in a bad mood, with the possible responses: “almost daily”, “more than once a week”, “about once a week”, “about once every month”, or “seldom or never”.
  • Two variables for difficult communication with mother and difficult communication with father were dichotomized into Yes for the answers “very difficult”, “difficult” or “I don’t have parents to talk to” and No for the answers “very easy” and “easy”.
  • All analyses were stratified by sex and adjusted for age, ethnicity, education, parents’ separation and financial strains in the family as potential confounders.

Results

  • The total study population included 71,988 young people in high schools and vocational schools (table 1).
  • Girls with perceived parental alcohol problems had about two and a half times higher odds of reporting depression compared to girls without perceived parental alcohol problems.
  • Parent with the alcohol problem and whether they are in the household Among boys, perceived fathers’, mothers’, step-parents’, and both parents’ alcohol problems were significantly associated with higher odds of experiencing frequent emotional symptoms compared to boys who did not perceive their parents to have alcohol problems (table 4).
  • Furthermore, the chi-square test did not find perceived parental alcohol problems among both parents’ to be significantly different from perceived fathers’ alcohol problems among boys (p=0.23), but did so among girls (p=0.008).
  • Sensitivity analyses Sensitivity analyses for all outcomes showed that for each category boys and girls with perceived parental alcohol problems had statistically significant higher odds of being in a higher ordered category.

Discussion

  • The present study has examined associations between having parents with alcohol problems among 71,988 boys and girls attending high schools and vocational schools in Denmark.
  • No differences in the association between frequent emotional symptoms and perceived mothers’ and fathers’ alcohol problems were found for either boys or girls.
  • Studies that have controlled for parental mental illness showed inconsistent results regarding whether parental alcohol problems were associated with mental health problems in children (5,17,21,25,32).
  • Other limitations include the measures used in this study.
  • The authors results suggest that, in contrast to other young people, those with parents who have alcohol problems represent a vulnerable group with poor parent-child relationships and more internalizing problems.

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This coversheet template is made available by AU Library
Version 1.0, October 2016
Coversheet
This is the accepted manuscript (post-print version) of the article.
Contentwise, the post-print version is identical to the final published version, but there may be
differences in typography and layout.
How to cite this publication (APA)
Please cite the final published version:
Pisinger, V. S. C., Bloomfield, K., & Tolstrup, J. (2016). Perceived parental alcohol problems,
internalizing problems and impaired parent — child relationships among 71 988 young people in
Denmark. Addiction, 111(11), 1966–1974. doi:10.1111/add.13508
Publication metadata
Title:
Perceived parental alcohol problems, internalizing problems and
impaired parent — child relationships among 71 988 young people
in Denmark
Author(s):
Pisinger, V. S. C., Bloomfield, K., & Tolstrup, J
Journal:
Addiction
DOI/Link:
http://dx.doi.org/10.1111/add.13508
Document version:
Accepted manuscript (post-print)
1
Perceived parental alcohol problems, internalizing problems and
impaired parent-child relationships among 71,988 young people
in Denmark
Veronica S. C. Pisinger, Kim Bloomfield, Janne S. Tolstrup
1. Author: Veronica S. C. Pisinger
Research Assistant, Master of Public Health
National Institute of Public Health, University of Southern Denmark
2. Author: Kim Bloomfield
Professor, Dr. P.H., Master of Public Health
Centre for Alcohol & Drug Research, Copenhagen Division, University of Aarhus, Denmark
3. Author (corresponding): Janne S. Tolstrup
Professor, DM Sci, PhD, Master of Human Biology
National Institute of Public Health, University of Southern Denmark
Email: jst@si-folkesundhed.dk
Word count: 3.562
Declaration: Nothing to declare
2
Abstract
Aims: To test the hypothesis that young people with perceived parental alcohol problems
have poorer parent-child relationships and more emotional symptoms, low self-esteem,
loneliness, and depression than young people without perceived parental alcohol problems.
Design: Cross-sectional analysis using data from the Danish National Youth Study 2014, a
web-based national survey.
Setting: Denmark
Participants: 71.988 high school and vocational school students (aged 12-25, nested in 119
schools and 3.186 school classes) recruited throughout 2014.
Measurements: Outcome variables included internalizing problems such as emotional
symptoms, depression, self-esteem, loneliness and aspects of the parent-child relationship.
The main predictor variable was perceived parental alcohol problems, including the severity
of the perceived problems and living with a parent with alcohol problems. Control variables
included age, sex, education, ethnicity, parents’ separation and economic problems in the
family.
Findings: Boys and girls with perceived parental alcohol problems had statistically
significant higher odds of reporting internalizing problems (OR= 1.58 for boys; 1.49 for girls)
and poor parent-child relationships (e.g. lack of parental interest: OR= 1.96 for boys; 2.29 for
girls) compared to young people without perceived parental alcohol problems. The
associations were not significantly stronger for mother’s alcohol problems or if the young
person lived with the parent with perceived alcohol problems.
Conclusion: Boys and girls in secondary education in Denmark who report perceived
parental alcohol problems had significantly higher odds of internalizing problems and poorer
parent-child relationships compared to young people without perceived parental alcohol
problems.
3
Introduction
Globally, it has been estimated that alcohol causes almost five percent of diseases and
injuries, while nearly four percent of all deaths are attributable to alcohol, making it one of
the leading risk factors for death and disability (1). European men and women have a high
annual alcohol intake, averaging 10.9 liters of pure alcohol per capita (2). Therefore many
face an increased risk of more than 60 alcohol-related diseases (3). Heavy drinking also has
psychological and social implications that go beyond the individual alcohol user. Children of
parents with alcohol problems are especially at risk of experiencing negative effects.
Children of parents with severe alcohol problems have been found to be at
increased risk of adverse mental health outcomes, including internalizing problems (such as
depression and anxiety) and externalizing problems (such as aggressive and antisocial
behavior) (4-20). However, most previous studies are based on data from help-seeking adults
or children of parents in treatment, while the results of general population studies have been
mixed (21).
Because not all children of parents with alcohol problems experience negative
outcomes, it is plausible that the variability of how the family environment and parent-child
relationship are affected by the parents’ alcohol problems may explain later mental health
outcomes. It has been found that parental alcohol problems can lead to negative parent-child
relationships in early adulthood, including poor parent-child communication, lack of trust in
parents, and reversed responsibility family roles (16,23).
There has been insufficient research into the effects of mothers’ and fathers’
alcohol problems as experienced by their children and research results have been inconsistent
(5,24-26). Some studies have found that mothers’ alcohol problems lead to a higher risk of
mental health problems in children than fathers’ alcohol problems (5,9,27). Furthermore,
some studies suggest that fathers’ alcohol problems may be a stronger risk factor for
externalizing problems among children, while mothers’ alcohol problems are more strongly
associated with internalizing problems (4,5,8).
The aim of the present study was to test the hypothesis that young people with
perceived parental alcohol problems have poorer parent-child relationships and more
internalizing problems, such as frequent emotional symptoms, low self-esteem, loneliness
and depression than young people without perceived parental alcohol problems. We also
tested whether having a mother with alcohol problems, living with the parent with alcohol
4
problems, or feeling insecure, being yelled at or scolded because of parents’ alcohol problems
were more strongly associated with frequent emotional symptoms.
Citations
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A meta-analysis on interparental conflict, parenting, and child adjustment in divorced families: Examining mediation using meta-analytic structural equation models.

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Rianne van Dijk1, Inge E. van der Valk1, Maja Deković1, Susan Branje1•
Utrecht University1
01 Jul 2020-Clinical Psychology Review
TL;DR: A meta-analysis to identify post-divorce family processes to explain child functioning found that parental support, hostility, structuring, intrusiveness, and role diffusion indeed served as mediating mechanisms underlying the persistent link between interparental conflict and children's internalizing and externalizing problems.
Abstract: Every year, parental divorce becomes the reality of many families. The aim of this meta-analysis was to identify post-divorce family processes to explain child functioning. Both direct and indirect associations between interparental conflict, parenting, and child adjustment were examined. After a systematic search for articles published before October 2019, we coded 2257 correlations in 115 samples of N = 24,854 divorced families. Analyses consisted of: (1) Performing multiple three-level meta-analyses to calculate the bivariate correlations between interparental conflict, parenting (i.e., support, hostility, structuring, intrusiveness, parent-child relationship quality, parent-child conflict, and role diffusion) and child psychosocial adjustment. (2) Testing four meta-analytic structural equation models in which parenting dimensions were examined as potential mediators. First, results showed that correlations between interparental conflict, parenting, and child adjustment were mostly significant, in the expected direction, and of small effect size. Second, parental support, hostility, structuring, intrusiveness, and role diffusion indeed served as mediating mechanisms underlying the persistent link between interparental conflict and children's internalizing and externalizing problems. This was not true for dyadic parent-child processes. Third, our findings hinted towards a stronger impact of negative versus positive parenting behaviors, and parental role diffusion was considered a particular risk in the context of post-divorce interparental conflict.

69 citations

Journal Article•DOI•
Ambient ozone exposure and depressive symptoms in adolescents: Results of the GINIplus and LISA birth cohorts.

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Tianyu Zhao1, Iana Markevych1, Marie Standl, Gerd Schulte-Körne1, Tamara Schikowski, Dietrich Berdel, Sibylle Koletzko1, Carl-Peter Bauer2, Andrea von Berg, Dennis Nowak1, Joachim Heinrich3, Joachim Heinrich1 •
Ludwig Maximilian University of Munich1, Technische Universität München2, University of Melbourne3
01 Mar 2019-Environmental Research
TL;DR: This study does not support the hypothesis that ambient ozone exposure might increase the prevalence of depressive symptoms in German adolescents and needs to be replicated in other samples due to a lack of similar studies.
Abstract: Background Depression has been associated with air pollution, as reported by animal and epidemiological studies. However, the relationship between ozone exposure and depression, especially among adolescents, is scarcely investigated. Objectives The study aimed to analyze associations between ozone exposure and depressive symptoms among German adolescents. Methods The analyses were based on 2827 adolescents aged 15 from Munich and Wesel areas of the GINIplus and LISA birth cohorts. The depressive symptoms were assessed by the Depression Screener for Teenagers (DesTeen). Long-term ozone exposure was estimated by optimal interpolation techniques and assigned to home addresses. Nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter Results The prevalence of depressive symptoms ranged from 10.9% to 13.8% depending on regions. Overall, long- and short-term exposure to ozone were not statistically significantly associated with depressive symptoms. However, subgroup analysis showed inconsistent significant protective associations for short-term exposure to ozone lag 0 day (same day) and depressive symptoms in Wesel (OR = 0.76, 95% CI: (0.59, 0.98)), but not in Munich (OR = 1.00, 95% CI: (0.83, 1.21)). Conclusions Our study does not support the hypothesis that ambient ozone exposure might increase the prevalence of depressive symptoms in German adolescents. Nevertheless, due to a lack of similar studies, these results need to be replicated in other samples.

20 citations

Journal Article•DOI•
Self-injury and suicide behavior among young people with perceived parental alcohol problems in Denmark: a school-based survey.

[...]

Veronica Pisinger1, Keith Hawton2, Keith Hawton3, Janne Schurmann Tolstrup1•
University of Southern Denmark1, Oxford Health NHS Foundation Trust2, Warneford Hospital3
01 Feb 2018-European Child & Adolescent Psychiatry
TL;DR: It is shown that young people with parental alcohol problems have higher odds of self-injury, suicide ideation, and suicide attempts, whereas no gender differences were found for suicidal ideation and suicide Attempts.
Abstract: The aim of this study was to test the hypothesis that young people who perceive their parents to have alcohol problems are more likely to self-injure, have suicide ideation, and to attempt suicide than young people without parental alcohol problems. We also tested whether the association between parental alcohol problems and self-injury, suicide ideation, and suicide attempt among young people differed depending on the gender of the child and the parent. Data came from the Danish National Youth Study 2014, a web-based national survey. A total of 75,853 high school and vocational school students participated. Self-injury, suicidal ideation, and suicide attempts were outcomes and the main exposure variables were perceived parental alcohol problems, gender of the parent with alcohol problems, cohabitation with a parent with alcohol problems, and severity of the parents’ alcohol problems. Young people with parental alcohol problems had higher odds of self-injury [boys: OR = 1.59 (95% CI 1.40–1.82); girls: OR = 1.84 (95% CI 1.69–1.99)], suicidal ideation [boys: OR = 1.81 (95% CI 1.59–2.06); girls: OR 1.74 (95% CI 1.59–1.89)], and suicide attempt [boys: OR = 2.10 (95% CI 1.63–2.71); girls: OR = 2.09 (95% CI 1.80–2.42)] compared to young people without parental alcohol problems. Girls with parental alcohol problems had higher odds of self-injury than boys with parental alcohol problems, whereas no gender differences were found for suicidal ideation and suicide attempts. Also no differences were found depending on the gender of the parent with alcohol problems. This study shows that young people with parental alcohol problems have higher odds of self-injury, suicide ideation, and suicide attempts.

12 citations

Cites background from "Perceived parental alcohol problems..."

  • ...Parental alcohol problems have been associated with poor parent–child communication [15, 16], reversed responsibility roles and disrupted routines [17, Abstract The aim of this study was to test the hypothesis that young people who perceive their parents to have alcohol problems are more likely to self-injure, have suicide ideation, and to attempt suicide than young people without parental alcohol problems....

    [...]

Journal Article•DOI•
Associations between parenting and substance use, meal pattern and food choices: A cross-sectional survey of 13,269 Norwegian adolescents.

[...]

Siri Håvås Haugland1, Lindsey Coombes2, Tonje Holte Stea1•
University of Agder1, Oxford Brookes University2
30 Mar 2019-Preventive medicine reports
TL;DR: Overall, parenting was associated with a range of lifestyle outcomes among adolescents, and family-strengthening interventions may have an impact on multiple public health domains.
Abstract: Identifying factors that affect adolescent lifestyle behaviors is essential in order to develop effective generic prevention approaches. This study aimed to investigate the association between parental monitoring, parental emotional support, parental-adolescent conflict and adolescent substance use, meal pattern and food choices. The study included data from 13,269 Norwegian adolescents aged 13–16 years collected in 2016. Multivariable logistic regression models adjusted for gender, age and parental education were applied. Results show that low parental monitoring was associated with increased substance use (Odds ratios (OR) ranging from 2.8; 95% Confidence intervals (CI) 2.1–3.6 to OR 3.8; 95% CI, 2.7–5.3) and irregular meal patterns (1.7; 1.3–2.1 to 2.6; 2.1–3.3), low fish intake (1.3;1.0–1.7), and high intake of sugar-sweetened beverages, diet beverages and energy drinks (1.4;1.1–1.7 to 2.1;1.6–2.8). Low parental emotional support was associated with increased substance use (1.8;1.5–2.1 to 2.5;1.9–3.2), irregular meal patterns (2.0; 1.8–2.3 to 2.1;1.9–2.3), low intake of vegetables, fruits and fish (1.3; 1.1–1.5 to 1.5; 1.3–1.7) and high intake of salty snacks, candy, cakes, sugar-sweetened beverages, diet beverages and energy drinks (1.4; 1.2–1.6 to 2.1;1.7–2.5). Finally, high parent-adolescent conflict was associated with increased substance use (2.3; 2.0–2.7 to 2.7; 2.3–3.1), irregular meal patterns (1.6 ;1.5–1.8 to 1.9;1.7–2.1), low intake of fruits and fish (1.3; 1.1–1.5 to 1.5; 1.3–1.7) and high intake of salty snacks, candy, cakes, sugar-sweetened beverages, diet beverages and energy drinks (1.5; 1.3–1.7 to 2.1; 1.8–2.5). Overall, parenting was associated with a range of lifestyle outcomes among adolescents. Family-strengthening interventions may have an impact on multiple public health domains.

11 citations

Cites background from "Perceived parental alcohol problems..."

  • ...However, findings also suggest that adolescent perception of parenting behavior is highly relevant to adolescent lifestyle and health (Pisinger et al., 2016; Aas et al., 1996), and may also have a greater predictive value over parental report in relation to adolescent lifestyle behavior (Abar et…...

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Problematic familial alcohol use and adolescents’ heavy drinking: can conditions in school compensate for the increased risk of heavy drinking among adolescents from families with problematic alcohol use?

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Gabriella Olsson1, Sara Brolin Låftman1, Bitte Modin1•
Stockholm University1
01 Jul 2019-International journal of adolescence and youth
TL;DR: The results showed that problematic alcohol consumption in the family was associated with a higher likelihood of heavy drinking among adolescents, and the association was weaker in schools with a strong student focus, indicating a compensatory effect of conditions in school.
Abstract: The aim of the present study is to assess the association between problematic alcohol consumption in the family and youth alcohol consumption and to explore the extent to which this association is ...

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Cites background from "Perceived parental alcohol problems..."

  • ...on more severe (and often clinical) cases of parental alcohol problems (Pisinger et al., 2016)....

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  • ...Yet, most studies on parental alcohol problems and related effects have been on more severe (and often clinical) cases of parental alcohol problems (Pisinger et al., 2016)....

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Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.

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Jürgen Rehm, Colin Mathers, Svetlana Popova1, Svetlana Popova2, Montarat Thavorncharoensap3, Montarat Thavorncharoensap4, Yot Teerawattananon3, Jayadeep Patra2 •
University of Toronto1, Centre for Addiction and Mental Health2, Health Intervention and Technology Assessment Program3, Mahidol University4
27 Jun 2009-The Lancet
TL;DR: The burden of mortality and disease attributable to alcohol, both globally and for ten large countries, is quantified and concludes that alcohol consumption is one of the major avoidable risk factors, and actions to reduce burden and costs associated with alcohol should be urgently increased.
Abstract: Summary Alcohol consumption has been identified as an important risk factor for chronic disease and injury. In the first paper in this Series, we quantify the burden of mortality and disease attributable to alcohol, both globally and for ten large countries. We assess alcohol exposure and prevalence of alcohol-use disorders on the basis of reviews of published work. After identification of other major disease categories causally linked to alcohol, we estimate attributable fractions by sex, age, and WHO region. Additionally, we compare social costs of alcohol in selected countries. The net effect of alcohol consumption on health is detrimental, with an estimated 3·8% of all global deaths and 4·6% of global disability-adjusted life-years attributable to alcohol. Disease burden is closely related to average volume of alcohol consumption, and, for every unit of exposure, is strongest in poor people and in those who are marginalised from society. The costs associated with alcohol amount to more than 1% of the gross national product in high-income and middle-income countries, with the costs of social harm constituting a major proportion in addition to health costs. Overall, we conclude that alcohol consumption is one of the major avoidable risk factors, and actions to reduce burden and costs associated with alcohol should be urgently increased.

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The predictive validity of multiple-item versus single-item measures of the same constructs

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Lars Bergkvist1, John R. Rossiter2•
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01 May 2007-Journal of Marketing Research
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Abstract: This study compares the predictive validity of single-item and multiple-item measures of attitude toward the ad (AAd) and attitude toward the brand (ABrand), which are two of the most widely measured constructs in marketing. The authors assess the ability of AAd to predict ABrand in copy tests of four print advertisements for diverse new products. There is no difference in the predictive validity of the multiple-item and single-item measures. The authors conclude that for the many constructs in marketing that consist of a concrete singular object and a concrete attribute, such as AAd or ABrand, single-item measures should be used.

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The Predictive Validity of Multiple-Item Versus Single-Item Measures of the Same

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Lars Bergkvist, John R. Rossiter
01 Jan 2007

1,884 citations

Journal Article•DOI•
The relation between different dimensions of alcohol consumption and burden of disease - an overview

[...]

Juergen Rehm1, Juergen Rehm2, Juergen Rehm3, Dolly Baliunas2, Dolly Baliunas3, Guilherme Borges, Kathryn Graham4, Kathryn Graham3, Kathryn Graham5, Hyacinth Irving3, Tara Kehoe3, Charles D. H. Parry6, Charles D. H. Parry7, Jayadeep Patra3, Svetlana Popova3, Svetlana Popova2, Vladimir Poznyak8, Michael Roerecke3, Michael Roerecke2, Robin Room9, Robin Room10, Andriy V. Samokhvalov3, Benjamin Taylor3, Benjamin Taylor2 •
Dresden University of Technology1, University of Toronto2, Centre for Addiction and Mental Health3, Curtin University4, University of Western Ontario5, University of Cape Town6, Medical Research Council7, World Health Organization8, Turning Point Alcohol and Drug Centre9, University of Melbourne10
01 May 2010-Addiction
TL;DR: Findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries, and a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes.
Abstract: Aims As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. Methods Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses. Results Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose-response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. Conclusions Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol-disease relationships.

1,034 citations

Journal Article•DOI•
The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a meta-analysis.

[...]

Arin M. Connell1, Sherryl H. Goodman•
Emory University1
01 Sep 2002-Psychological Bulletin
TL;DR: In this paper, a meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children, with all average effect sizes being small in magnitude.
Abstract: In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).

853 citations

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Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights. If you believe that this document breaches copyright please contact us providing details, and the authors will remove access to the work immediately and investigate your claim. You may not further distribute the material or use it for any profit-making activity or commercial gain •