Dataset Information

Diverging Trends in the Relationship Between Binge Drinking and Depressive Symptoms Among Adolescents in the U.S. From 1991 Through 2018.

ABSTRACT:

Purpose

From 1991 to 2018, binge drinking among U.S. adolescents has precipitously declined; since 2012, depressive symptoms among U.S. adolescents have sharply increased. Binge drinking and depressive symptoms have historically been correlated, thus understanding whether there are dynamic changes in their association informs prevention and intervention.

Methods

Data were drawn from the U.S. nationally representative cross-sectional Monitoring the Future surveys (1991-2018) among school-attending 12th-grade adolescents (N = 58,444). Binge drinking was measured as any occasion of more than five drinks/past 2 weeks; depressive symptoms were measured with four items (e.g., belief that life is meaningless or hopeless), dichotomized at 75th percentile. Time-varying effect modeling was conducted by sex, race/ethnicity, and parental education.

Results

In 1991, adolescents with high depressive symptoms had 1.74 times the odds of binge drinking (95% confidence interval 1.54-1.97); by 2018, the strength of association between depressive symptoms and binge drinking among 12th^-grade adolescents declined 24% among girls and 25% among boys. There has been no significant relation between depressive symptoms and binge drinking among boys since 2009; among girls, the relationship has been positive throughout most of the study period, with no significant relationship from 2016 to 2017.

Conclusions

Diverging trends between depressive symptoms and alcohol use among youth are coupled with declines in the strength of their comorbidity. This suggests that underlying drivers of recent diverging population trends are likely distinct and indicates that the nature of comorbidity between substance use and mental health may need to be reconceptualized for recent and future cohorts.

SUBMITTER: Keyes KM

PROVIDER: S-EPMC7183904 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundMental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018.MethodsData are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students (N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age-period-cohort effects estimated using the hierarchical age-period-cohort models.ResultsAmong girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999-2004.ConclusionsDepressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.