Ergenlerde Alkol Tüketiminin Belirleyicileri: Farkındalık Yordayıcı Bir Faktör mü?

Öz

Amaç: Farkındalık ve alkol tüketimi arasındaki ilişki yetişkinlerde açıkça ortaya konmıuşsa da, ergen popülasyonunda yeterince araştırılmamıştır. Bu çalışmanın amacı, ergenler arasındaki alkol tüketiminde bilinçli farkındalığın öngörücü rolünü incelemektir. Yöntem: Çalışmaya bir çocuk ve ergen psikiyatrisi polikliniğine başvuran ve alkol kullandığını bildiren ergenlerden oluşan bir kohort (n = 70) dâhil edilmiştir. Katılımcılar yüz yüze görüşmeler sırasında Çocuk ve Ergen Bilinçli Farkındalık Ölçeği (ÇEBFÖ), Kessler–10 Psikolojik Sıkıntı Ölçeği (K10), İçme Güdüleri Anketi–Gözden Geçirilmiş–Baş Etme Güdüleri (İGA–GG–BG) ve Alkol Kullanım Bozuklukları Tanımlama Testi–Tüketim (AKBTT–T) dahil olmak üzere bir dizi onaylanmış ölçümü tamamlamıştır. Bulgular: Katılımcıların ortalama yaşı 16,99 olup, %54,3'ü erkektir. Kadın cinsiyet İGA–GG–BG skorlarının anlamlı bir negatif yordayıcısı iken (B = –3.936, p = .022), yüksek K10 skorları İGA–GG–BG skorları ile pozitif ilişkilidir (B = .280, p = .002). Ayrıca, hem alkol kullanım süresi (B = .861, p <.001) hem de K10 skorları AKBTT–T skorlarının anlamlı pozitif yordayıcıları olmuştur (B = .066, p =.021). Buna karşılık, daha yüksek ÇEBFÖ skorları, AKBTT–T skorları ile negatif ilişkilidir (B = –.079, p = .029). Tartışma: Bulgular, ergenler arasında alkol tüketiminin azaltılmasında farkındalığın potansiyel rolüne işaret etmektedir. Ayrıca, sonuçlar bu popülasyonda ruh sağlığını teşvik eden ve alkol tüketiminin başlamasını önleyen politikaların uygulanmasının gerekliliğinin altını çizmektedir..

Anahtar Kelimeler

• Ergen
• başa çıkma güdüleri
• Bilinçli farkındalık
• Psikolojik sıkıntı
• Sorunlu alkol kullanımı

Determinants of Alcohol Consumption among Adolescents: Is Mindfulness a Predictor Factor?

Abstract

Objective: While the relationship between mindfulness and alcohol consumption is well-documented in adults, it remains underexplored in adolescent populations. This study aimed to examine the predictive role of mindfulness in alcohol consumption among adolescents. Method: The study included a cohort of adolescents (n = 70) receiving care at a child and adolescent psychiatry outpatient clinic who reported alcohol use. Participants completed a series of validated measures during face-to-face interviews, including the Child and Adolescent Mindfulness Measure (CAMM), the Kessler–10 Psychological Distress Scale (K10), the Drinking Motives Questionnaire–Revised–Coping Motives (DMQ–R–CM), and the Alcohol Use Disorders Identification Test–Consumption (AUDIT–C). Results: The mean participant age was 16.99 years, with 54.3% being male. Female gender was a significant negative predictor of DMQ–R–CM scores (B = –3.936, p = .022), whereas higher K10 scores were positively associated with DMQ–R–CM scores (B = .280, p = .002). Additionally, both the duration of alcohol use (B = .861, p <.001) and K10 scores were significant positive predictors of AUDIT–C scores (B = .066, p =.021). In contrast, higher CAMM scores were negatively associated with AUDIT–C scores (B = –.079, p = .029). Conclusion: The findings indicate the potential role of mindfulness in mitigating alcohol consumption among adolescents. Furthermore, the results underscore the necessity of implementing policies that promote mental health and prevent the initiation of alcohol consumption in this population.

Keywords

• Adolescent
• coping motives
• Mindfulness
• Psychological distress
• Problematic alcohol use

References

1. Yuen WS, Chan G, Bruno R, et al. Adolescent alcohol use trajectories: risk factors and adult outcomes. Pediatrics 2020; 146(4): e20200440.
2. World Health Organization. Alcohol, e-cigarettes, cannabis: concerning trends in adolescent substance use, shows new WHO/Europe report. https://www.who.int/europe/news-room/25-04-2024-alcohol--e-cigarettes--cannabis--concerning-trends-in-adolescent-substance-use--shows-new-who-europe-report (Accessed 08.02.1015).
3. Conegundes LSO, Valente JY, Martins CB, et al. Binge drinking and frequent or heavy drinking among adolescents: prevalence and associated factors. J Pediatr (Rio J) 2020; 96(2): 193–201.
4. Schick MR, Nalven T, Thomas ED, et al. Depression and alcohol use in American Indian adolescents: the influence of family factors. Alcohol Clin Exp Res 2022; 46(1): 141–151.
5. Ai L, Perez E, Asimes A, et al. Binge alcohol exposure in adolescence impairs normal heart growth. J Am Heart Assoc 2020; 9(9): e015611.
6. Alkhouri N, Almomani A, Le P, et al. The prevalence of alcoholic and nonalcoholic fatty liver disease in adolescents and young adults in the United States: analysis of the NHANES database. BMC Gastroenterol 2022; 22(1): 366.
7. Lees B, Meredith LR, Kirkland AE, Bryant BE, Squeglia LM. Effect of alcohol use on the adolescent brain and behavior. Pharmacol Biochem Behav 2020; 192: 172906.
8. de Goede J, van der Mark-Reeuwijk KG, Braun KP, et al. Alcohol and brain development in adolescents and young adults: a systematic review of the literature and advisory report of the Health Council of the Netherlands. Adv Nutr 2021; 12(4): 1379–1410.

9. Merchán-Clavellino A, Salguero-Alcañiz MP, Guil R, Alameda-Bailén JR. Impulsivity, emotional intelligence, and alcohol consumption in young people: a mediation analysis. Foods 2020; 9(1): 71.
10. Buvik K, Tokle R, Bilgrei OR, Scheffels J. Alcohol use in adolescence: a qualitative longitudinal study of mediators for drinking and non-drinking. Drugs (Abingdon Engl) 2022; 29(6): 685–693.
11. Bozic S, Vicendese D, Livingston M, Erbas B. Role of psychological distress on long‐term risky and heavy‐episodic drinking patterns in major cities and rural and remote areas. Aust J Rural Health 2022; 30(1): 25–33.
12. Wolitzky-Taylor K, Sewart A, Zinbarg R, et al. Rumination and worry as putative mediators explaining the association between emotional disorders and alcohol use disorder in a longitudinal study. Addict Behav 2021; 119: 106915.
13. Copeland A, Jones A, Acuff SF, et al. Meaning in life: investigating protective and risk factors for harmful alcohol consumption. Addict Res Theory 2023; 31(3): 191–200.
14. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol (New York) 2003; 10(2): 144–156.
15. de Vibe M, Solhaug I, Rosenvinge JH, et al. Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; Results from a randomized controlled trial. PLoS One 2018; 13(4): e0196053.
16. Enkema MC, McClain L, Bird ER, et al. Associations between mindfulness and mental health outcomes: A systematic review of ecological momentary assessment research. Mindfulness (N Y) 2020; 11: 2455–2469.
17. Korecki JR, Schwebel FJ, Votaw VR, Witkiewitz K. Mindfulness-based programs for substance use disorders: A systematic review of manualized treatments. Subst Abuse Treat Prev Policy 2020; 15(1): 51.
18. Clerkin EM, Sarfan LD, Parsons EM, Magee JC. Mindfulness facets, social anxiety, and drinking to cope with social anxiety: testing mediators of drinking problems. Mindfulness (N Y) 2017; 8: 159–170.
19. Wisener M, Khoury B. Associations between specific mindfulness facets, self-compassion, internally motivated drinking, and alcohol-related problems. Mindfulness (N Y) 2019; 10: 2073–2081.
20. Wisener M, Khoury B. Mindfulness facets, self-compassion, and drinking to cope: how do associations differ by gender in undergraduates with harmful alcohol consumption? J Am Coll Health 2022; 70(6): 1704–1710.
21. Saunders JB, Aasland OG, Babor TF, et al. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐II. Addiction 1993; 88(6): 791–804.
22. Saatcioglu O, Evren C, Cakmak D. Reliability and validity of the alcohol use disorders identification test. Türkiyede Psikiyatri 2002; 4(2–3): 107–113.
23. Bush K, Kivlahan DR, McDonell MB, et al. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med 1998; 158(16): 1789–1795.
24. Gilson KM, Bryant C, Bei B, et al. Validation of the Drinking Motives Questionnaire (DMQ) in older adults. Addict Behav 2013; 38(5): 2196–2202.
25. Cooper ML. Motivations for alcohol use among adolescents: development and validation of a four-factor model. Psychol Assess 1994; 6(2): 117–128.
26. Evren C, Celik S, Aksoy R, Cetin T. Factorial structure, reliability and validity of the Turkish version of the Drinking Motives Questionnaire-Revised in male alcohol dependent inpatients. Dusunen Adam 2010; 23(3): 174–184.
27. Greco LA, Baer RA, Smith GT. Assessing mindfulness in children and adolescents: development and validation of the Child and Adolescent Mindfulness Measure (CAMM). Psychol Assess 2011; 23(3): 606–614.
28. Bilaç Ö, Dikeç G, Akyol CK, et al. Child and Adolescent Mindfulness Measure Turkish validity and reliability study. Turk J Child Adolesc Ment Health 2024; 31(1): 91–95.
29. Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32(6): 959–976.
30. Altun Y, Özen M, Kuloğlu MM. Psikolojik Sıkıntı Ölçeğinin Türkçe uyarlaması: gecerlilik ve güvenilirlik calışması. Anadolu Psikiyatri Dergisi 2019; 20(Suppl.1): 23–31.
31. George D, Mallery P. IBM SPSS Statistics 25 Step by Step, Fifteenth edition. New York: Routledge, 2018.
32. Akbulut Ö, Çapık C. Multivariate statistical analysis and required sample size. J Nursology 2022; 25(2): 111–116.
33. Chang WP, Stuart H, Chen SP. Alcohol use, drug use, and psychological distress in university students: findings from a Canadian campus survey. Int J Ment Health Addict 2022; 20: 2366–2381.
34. Wardell JD, Kempe T, Rapinda KK, et al. Drinking to cope during COVID‐19 pandemic: the role of external and internal factors in coping motive pathways to alcohol use, solitary drinking, and alcohol problems. Alcohol Clin Exp Res 2020; 44(10): 2073–2083.
35. Mohr CD, Umemoto SK, Rounds TW, et al. Drinking to cope in the COVID-19 era: an investigation among college students. J Stud Alcohol Drugs 2021; 82(2): 178–187.
36. D’Aquino S, Callinan S. Drinking to cope as a mediator of the relationship between stress and alcohol outcomes. Drugs (Abingdon Engl) 2024; 31(5): 516–523.
37. Skrzynski CJ, Creswell KG. Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta‐analysis. Addiction 2020; 115(11): 1989–2007.
38. Patrick ME, Evans-Polce RJ, Arterberry BJ, Terry-McElrath Y. Initiation of and escalation to high-intensity drinking in young adults. JAMA Pediatr 2023;177(3): 286–293.
39. Flowers J, Alsup S, Bowen S, et al. Drinking with awareness: mindfulness moderates the relationship between drinking and alcohol-related problems. J Subst Use 2024; 29(6): 1124–1130.
40. Skrzynski CJ, Bryan AD, Hutchison KE. Mindfulness mechanisms in alcohol use: Comparing top-down and bottom-up processes. Psychol Addict Behav 2024; 38(1): 92–100.
41. Cotter EW, Hawthorne DJ, Gerker C, et al. A pilot mindfulness intervention to reduce heavy episodic drinking. J Coll Couns 2021; 24(2): 178–192.
42. Patton KA, Connor JP, Sheffield J, et al. Additive effectiveness of mindfulness meditation to a school-based brief cognitive–behavioral alcohol intervention for adolescents. J Consult Clin Psychol 2019; 87(5): 407–421.
43. Gallo GG, Curado DF, Opaleye ES, et al. Impulsivity and mindfulness among inpatients with alcohol use disorder. Subst Use Misuse 2021; 56(1): 25–32.
44. Wisener M, Khoury B. Specific emotion-regulation processes explain the relationship between mindfulness and self-compassion with coping-motivated alcohol and marijuana use. Addict Behav 2021; 112: 106590.
45. Li P, Mao L, Hu M, et al. Mindfulness on rumination in patients with depressive disorder: a systematic review and meta-analysis of randomized controlled trials. Int J Environ Res Public Health 2022; 19(23): 16101.
46. Carney LM, Park CL, Russell B. Alcohol-related consequences: factor structure and associations with trait mindfulness and drinking motivations. Int J Behav Med 2024; doi: 10.1007/s12529-024-10300-7
47. Dunning D, Tudor K, Radley L, et al. Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials. Evid Based Ment Health 2022; 25:135–142.
48. Peltier MR, Verplaetse TL, Mineur YS, et al. Sex differences in stress-related alcohol use. Neurobiol Stress 2019; 10: 100149.
49. Johannessen EL, Andersson HW, Bjørngaard JH, Pape K. Anxiety and depression symptoms and alcohol use among adolescents-a cross sectional study of Norwegian secondary school students. BMC Public Health 2017; 17: 494.