Personality traits and health‐risk behaviours in university students

Relations between personality and health‐risk behaviours in university undergraduates were examined using multiple measures of personality across multiple samples (N = 1151). Big Five personality variables, at both factor and facet levels, were used to predict three specific health‐risk behaviours: (a) tobacco consumption, (b) alcohol consumption and (c) speeding in an automobile. Our findings showed that low Conscientiousness and low Agreeableness were uniformly associated with this cluster of potentially health damaging behaviours. Extraversion was additionally associated with alcohol use. Interaction effects were found between Conscientiousness and Agreeableness on smoking and (for men only) on drinking. Other personality variables not centrally related to the Big Five, such as Risk‐Taking (high) and Integrity (low), were also implicated in the present health‐risk behaviours. Copyright © 2009 John Wiley & Sons, Ltd.     

Stages of change for health-related behaviours in 18 year-old Australians

Abstract

This study investigated the validity of a Stages of Change algorithm with respect to independent measures of physical activity and fitness. dietary intake and alcohol consumption in 18 year-old Ausmlian men (n = 301) and women (n = 282). Stage of Change categories were related to fat and fibre intakes in men and fibre intake in women as well as hit and vegetable intakes in men and women. Physical activity and fitness for men and women also showed significant linear associations with Stage of Change categories. Alcohol consumption was significantly associated with Stage of Change categories for men but not for women although recorded alcohol consumption was very variable for women. However, the algorithm was valid for both men and women when drinking alcohol consistent with national guidelines on safe drinking was used. In summary, with reference to actual health behaviours, the Stages of Change algorithm was valid for young men and women for diet. physical activity and alcohol drinking. Independent behavioural data were not available for smoking behaviours. Using the algorithm, there were significant associations in men between prccontemplation status for diet and drinking and diet and physical activity, in women between diet and smoking and in both men and women between drinking and smoking. Covariance between precontemplation status for different health behaviours therefore suggests the need for multimodal interventions.     

Multiple health risk behaviours and posttraumatic stress disorder symptoms among university students from 22 countries

The goal of the study was to investigate multiple health risk behaviours in relation to PTSD symptoms in a sample of university students from 22 countries. Using anonymous questionnaires, data were collected from 16804 undergraduate university students (mean age 20.8, SD?=?2.8) from 23 universities in 22 countries in Africa, Asia, Caribbean and South America. Results indicate that overall, 20.9% of the university students screened positive for PTSD, and the overall mean of health risk behaviours (range from 1–10) was 2.7 for university students from all countries. Logistic regression adjusted for sociodemographic characteristics and social support found that each of the ten individual health risk behaviours was significantly associated with PTSD symptoms. In addition, logistic regression with multiple health risk behaviours found a steady increase from 1 (Odds Ratio (OR): 1.37, CI 1.05–1.77) to 5 or more (OR: 3.57, CI 2.75–4.64) health risk behaviours in association with PTSD symptoms, adjusted for age, gender, economic family background and social support.     

Concurrent tobacco use and risky drinking in South Africa: Results from the South African National Health and Nutrition Examination Survey

The aim of this study was to examine socio-demographic and psychosocial correlates of concurrent tobacco use and risky drinking. We analysed data from the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) 2011–2012. The sample included 14 764 adolescents and adults aged 15 years and older. They responded to questions on tobacco and alcohol use, psychosocial, and socio-demographic indicators. Results indicate that 9.6% (16.8% among men and 3.5% among women) of South Africans were involved in concurrent tobacco use and risky drinking, 18.2% in current tobacco use only, and 20.3% in risky drinking only. In covariate adjusted analysis, being 25 to 64 years, being male, belonging to the coloured population group, residing in urban areas, having experienced three or more traumatic events, and poor self-rated health were associated with concurrent tobacco use and risky drinking. Findings suggest socio-demographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use in South Africa.     

Parental involvement and health risk behaviours among school-going adolescents in six African countries

The aim of this study was to assess the association between parental involvement (support and monitoring) and health risk behaviours among adolescents in six African countries. Data were from the cross-sectional Global School-Based Student Health Survey (GSHS) which sampled a total of 16 587 adolescents (mean age 14.6 years, SD = 1.6) from 2009 to 2013. In multivariable regression analyses, adjusted for relevant variables, higher levels of parental involvement were negatively associated with substance use (smoking, other tobacco use, drunkenness and illicit drug use) and violence (being bullied, in a physical fight), injury and truancy. Only high-level parental involvement was associated with use of contraception at most recent sex. Interventions for reducing various health risk behaviours should consider the positive impact of parental involvement.     

The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of South African secondary school learners

Poor mental health in adolescents has shown associations with engagement in other risk behaviours. However, evidence of this association in Sub-Saharan Africa, particularly South Africa, is lacking. This study examines the associations between pertinent risk behaviours and feelings of sadness or hopelessness amongst a nationally representative sample of South African school going adolescents. Data was analysed from the South African Youth Risk Behaviour Survey 2011 (n=10,997), a cross-sectional national survey among grades 8–11 school learners. Logistic regression examined the association of demographic, substance use, violent behaviour, sexual activity and suicidal plans and attempts with the primary outcome, feelings of sadness or hopelessness. Having feelings of sadness or hopelessness was significantly associated with more senior grades, being bullied (AOR:1.67, 95% CI: 1.42–1.96), being assaulted by a partner (1.33 [1.05–1.68]), forced sex (1.78 [1.37–2.32]); gang membership (1.32 [1.06–1.65]), binge drinking (1.37 [1.14–1.65]), ever having sex (1.23 [1.02–1.47]), having ≥1 partner/s in preceding three months (1.25 [1.02–1.53]), having made a plan to attempt suicide (2.50 [1.95–3.21]) and suicide attempt (1.49 [1.21–1.85]). Adolescents in South Africa are experiencing a multiple burden of risk. Health promotion strategies targeting adolescent mental health and risk behaviours need to be developed and implemented in a timely and comprehensive manner.     

The relationship between self-concept and a healthy lifestyle in adolescence: an exploratory model

A gender-based model has been designed to study the relationships that exist among self-concept dimensions and some health-promoting behaviours (consumption of healthy food and participation in sports) and health-risk behaviours (consumption of tobacco, alcohol, cannabis and unhealthy food). The model was employed on a representative sample of 1,038 adolescents from the Valencian Community, aged between 15 and 18 years old (528 girls and 510 boys, M age= 16.3; SD= .92). Path analysis with the Lisrel VIII program maximum likelihood method was used. The results show the model's good fit to the data with regard to both the boys (chi 2 /gl= 2.57; RMSR= .04; RMSEA= 0.5; GFI= .98; NNFI= .91; CFI= .97; CN= 350.10) and the girls (chi 2 /gl= 3.28; RMSR= .04; RMSEA= 0.6; GFI= .98; NNFI= .87; CFI= .95; CN= 284.42). For the two sexes, behavioural conduct, social acceptance and close friendship emerged as good predictors of health-risk behaviours. Athletic competence had an indirect influence on health behaviours, with participation in sports being a mediating variable in that relationship.     

Stages of change for health-related behaviours in 18 year-old Australians

Abstract This study investigated the validity of a Stages of Change algorithm with respect to independent measures of physical activity and fitness. dietary intake and alcohol consumption in 18 year-old Ausmlian men (n = 301) and women (n = 282). Stage of Change categories were related to fat and fibre intakes in men and fibre intake in women as well as hit and vegetable intakes in men and women. Physical activity and fitness for men and women also showed significant linear associations with Stage of Change categories. Alcohol consumption was significantly associated with Stage of Change categories for men but not for women although recorded alcohol consumption was very variable for women. However, the algorithm was valid for both men and women when drinking alcohol consistent with national guidelines on safe drinking was used. In summary, with reference to actual health behaviours, the Stages of Change algorithm was valid for young men and women for diet. physical activity and alcohol drinking. Independent behavioural data were not available for smoking behaviours. Using the algorithm, there were significant associations in men between prccontemplation status for diet and drinking and diet and physical activity, in women between diet and smoking and in both men and women between drinking and smoking. Covariance between precontemplation status for different health behaviours therefore suggests the need for multimodal interventions.     

The direct and indirect benefits of dispositional mindfulness on self-esteem and social anxiety

This study investigated the long‐term health effects of combat stress reaction (CSR) among Israeli CSR casualties (112) and control veterans (184) of the 1973 Yom Kippur war. Posttraumatic stress disorder (PTSD), physical symptoms, and adverse health practices were examined 18 years after the war. The relationship between CSR, PTSD, physical symptoms and adverse health practices was examined via hierarchical linear regression. Findings indicate that although CSR was positively associated with more current physical symptoms and adverse health practices in univariate analyses, these associations were not significant once demographic differences between the groups were controlled. In contrast, current PTSD symptoms were positively associated with current physical symptoms (p < 0.001) and showed a trend association with adverse health practices (p = 0.06). PTSD was the most powerful predictor of current physical symptoms and appears to mediate the association between CSR and physical symptoms almost two decades after the war. Both combat stress reaction and the results of the study were discussed in the light of the theory of Conservation of Resources (COR).     

Global positive expectancies in adolescence and health-related behaviours: longitudinal models of latent growth and cross-lagged effects

Constructs representative of global positive expectancies (GPE) such as dispositional optimism and hope have been theoretically and empirically linked to many positive mental and physical health outcomes. However such expectancies' health implications for adolescents, as well as their trajectory over time, are less well understood than for adult populations. This study tested whether GPE predict the key indicators of adolescents' future physical health status, their health-related behaviours. A prospective longitudinal study design was employed whereby a diverse population-based cohort (N?=?744; mean age at baseline?=?12) completed three surveys over approximately 18 months. Rigorous tests of causal predominance and reciprocal effects were conducted through latent growth and cross-panel structural equation models. Results showed GPE systematically decreased during the course of the study, yet higher initial levels of GPE predicted less alcohol drinking, healthier food choice and greater physical activity over time. GPE's protective relationships towards health protective behaviours (vs. health risk behaviours that also included tobacco smoking) appear more independent from depressive symptomatology, and the primary findings were robust across socio-demographic groups.     

Examining Spouse/Partner Presence as a Moderator in the Relationship Between Mental Health Symptoms and Alcohol Use in OEF/OIF Veterans

Veterans from the conflicts in Afghanistan (Operation Enduring Freedom; OEF) and Iraq (Operation Iraqi Freedom; OIF) have reported elevated rates of alcohol consumption, and greater depression and posttraumatic stress disorder (PTSD) symptoms are associated with increased alcohol use. Presence of a spouse/partner, which has been associated with reduced drinking, may buffer the relationship between mental health symptoms and alcohol consumption. To examine this hypothesis, the current study utilized baseline survey data from OEF/OIF veterans (N = 325) enrolled in a brief alcohol intervention. Spouse/partner presence moderated the relationship between depression symptoms and alcohol consumption such that depression was positively associated with drinking for veterans without a spouse/partner. Exploratory analyses indicated that the relationship between depression and alcohol use may be particularly salient for veterans without a spouse/partner and a lower number of deployments. Spouse/partner presence did not moderate the relationship between PTSD symptoms and alcohol consumption. Implications of the findings are discussed.     

Effects of tobacco use on non-adherence to antiretroviral therapy among HIV-positive patients in South Africa

This study aimed to estimate the relationship between tobacco use and non-adherence to antiretroviral therapy (ART) in a South African sample. Participants were 1 963 HIV patients who attended a primary care clinic in Pretoria (female = 68.5%; black African = 99.5%; median age = 37.0 years; tobacco users only = 8.6%, problem drinkers only = 14.9%, and tobacco users and problem drinkers = 10.5%). In adjusted logistic regression analysis, tobacco use only was not significantly associated with non-adherence to ART. Alcohol use only (OR: 1.72; CI: 1.26, 2.36) and tobacco use and problem drinking (OR: 2.31; CI: 1.60, 3.33) were highly associated with non-adherence to ART.     

Association between tobacco use,depression, and anxiety: A cross-national study among university students from 30 low- and middle-income countries

This study aimed to investigate the association between tobacco use and depression and anxiety in a cross-national study among university students from 30 predominantly low- and middle-income countries. Self-report survey data were collected from 23 073 university students (58.0% female), with a mean age of 20.8 years (SD = 2.5). Following logistic regression analyses, tobacco using university students were more likely to have depressive symptoms and anxiety (posttraumatic stress symptoms = PTSS) than non-tobacco using students. Gender stratified analysis found associations between tobacco use and depressive symptoms were stronger among women than men. The associations between tobacco use and anxiety (PTSD) symptoms were stronger among men than women. In this large cross-national study, current tobacco use was significantly associated with depression and anxiety (PTSD) symptoms. Tobacco use prevention efforts can help alleviating mental health problems among university students.     

Adverse developmental experiences and risky health behaviours among black South African university students

This study examined the relationship between adverse developmental experiences (ADEs) and risky health behaviours among a cross-sectional sample of black South African students (n = 393; females = 58%, M_age = 20.5 years, SD = 2.9). Binary logistic regression was used to model the association between categories of ADEs and risky health behaviours. Findings suggest individual ADEs to significantly predict risky health behaviours. The highest singular ADEs reported were being treated like a child (62%), parents being overprotective (59%), and being driven to be perfectionistic (58%). There was no indication of a general trend of ordered associations between the number of ADEs and risky health behaviours.     

The Relationship of Adverse Childhood Experiences to PTSD,Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation‐based Native Americans. In 2011, data were collected from Native American (N = 288; 15–24 years of age) tribal members from a remote plains reservation using an anonymous web‐based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post‐traumatic stress disorder (PTSD) symptoms, depression symptoms, poly‐drug use, and suicide attempt. Seventy‐eight percent of the sample reported at least one ACE and 40 % reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37 %), poly‐drug use (51 %), PTSD symptoms (55 %), and depression symptoms (57 %). To address these findings culturally appropriate childhood and adolescent interventions for reservation‐based populations must be developed, tested and evaluated longitudinally.     

Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among U.S. Iraq War Veterans

The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003–2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation = 1.0 year) after the initial (i.e., “index”) Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.     

Religious perceptions of alcohol consumption and drinking behaviours among religious and non-religious groups

Evidence indicates that religious involvement is associated with lower levels of alcohol consumption. However, mechanisms underlying the specific effects of religion on alcohol behaviours are still not entirely clear. This study examined potential differences in religious perceptions of alcohol consumption (RePAC) among Christian, Buddhist, Muslim, and non-religious individuals, and between Catholic and Baptist Christian denominations. We also assessed whether these perceptions were associated with quantity and frequency of drinking. Participants (N?=?495; 79% female) aged 18 and above completed self-report measures of alcohol consumption and religious perceptions of alcohol use. Findings indicated that non-religious individuals and Buddhists reported higher RePAC scores (i.e., more favourable attitudes toward alcohol use), followed by Christians and then Muslims. Drinking quantity was more strongly associated with RePAC for Buddhists and Christians than the same association for non-religious participants. These results provide preliminary evidence linking religious perceptions of alcohol to drinking behaviours across religious affiliations.     

Resisting temptation: alcohol specific self-efficacy mediates the impacts of compensatory health beliefs and behaviours on alcohol consumption

Awareness of health risks linked with excessive alcohol consumption appears to have little influence on how much some people drink. Compensatory health beliefs (CHBs), in which the consequences of unhealthy behaviour are considered to be neutralised by additional healthy behaviours, are one way of justifying poor health choices. Currently, the role of CHBs within the context of drinking behaviour is not well understood. This research examined associations between alcohol specific compensatory health beliefs (ACH-Beliefs) and behaviours (ACH-Behaviours), alcohol consumption and alcohol specific self-efficacy (ASE), via an online survey completed by 249 participants, aged 18 + years (63.1% female; M age = 41.62 years; SD = 14.80). Higher ACH-Beliefs were associated with increases in ACH-Behaviours. While both predicted alcohol consumption, a greater proportion of variance was explained by ACH-Behaviours. ASE was a significant mediator of those relationships, suggesting that those with higher ASE may be better equipped to regulate drinking behaviour. Recommendations for future research include measuring both CHBs and behaviours within an experimental design, and further investigation of related cognitions such as compensatory behaviour intentions. Alcohol misuse interventions may wish to consider the potential roles of CHBs and behaviours in facilitating maladaptive coping strategies, and how addressing these may reduce harms.     

Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial

Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion interventions to reduce this problem. We tested the efficacy of such an intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk-reduction intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants' intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mean age = 12.4 years), with 96.7% retained at 12-month follow-up. Generalised estimating equations revealed that averaged over the follow-ups, a greater percentage of health-promotion intervention participants than HIV/STD control participants met 5-a-Day fruit and vegetable and physical activity guidelines. The intervention also increased health-promotion knowledge, attitude and intention, but did not decrease substance use or substance-use attitude and intention. The findings suggest that theory based and contextually appropriate interventions may increase health behaviours among young adolescents in sub-Saharan Africa.