Stability of morningness/eveningness and changes in sleep and mental health during mid-adulthood.

Objective: A change toward Eveningness in circadian sleep-wake behavior is generally seen from childhood to adolescence, but less is known about circadian changes during adulthood. Circadian changes during mid-adulthood are of high interest, since Eveningness associates with a range of health-related problems, including psychological symptoms and mental disorders. In this study, we examined the circadian stability across 10 years, from 42 to 52 years of age, and how it is associated with sleep and mental health in a Finnish general population cohort follow-up-based (n = 976). Method: Circadian type was assessed at both ages with a widely used item for self-estimated Morningness/Eveningness from the original Horne-Östberg Morningness-Eveningness Questionnaire. Generalized estimating equations were used for analyzing how a change in Morningness/Eveningness was associated with sleep and mental health longitudinally. Results: Our findings indicate that the circadian type is a highly stable trait during mid-adulthood with mainly moderate changes occurring in 42.2% of adults and no circadian change among 57.8% of adults. Most changes occurred within the same circadian type (23.9%), second to changes between moderate circadian types (13.3%). Changes between the Definite Evening-types and Morning-types were very rare (0.5%). Stable Evening-types reported more insufficient sleep, discrepancy between sleep duration on workdays and free days, and depression as compared to stable Morning-types. Moderate changes toward Morningness, comprising mostly those within Morning-types, were associated with reduced distress and psychological symptoms. Conclusions: In conclusion, our findings show high stability of mid-adulthood circadian type. However, changes toward Morningness seem to be associated with improved mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Life-Course Associations Between Smoking and Depressive Symptoms. A 30-Year Finnish Follow-up Study.

INTRODUCTION: Relatively little is known about whether the association between smoking and depressive symptoms changes with age and how the trajectories of smoking and depressive symptoms are intertwined during the life course. In this population-based study, these associations were examined from young adulthood to middle age. METHODS: Participants of a Finnish cohort study (N = 1955) were assessed at the ages of 22, 32, 42, and 52 using questionnaires covering daily smoking (yes/no) and the short 13-item Beck Depression Inventory. Longitudinal latent class and longitudinal latent profile analyses were used to identify life course trajectories of smoking and depressive symptoms. RESULTS: The proportions of daily smokers decreased, while levels of depressive symptoms increased among both females and males from age 22 to 52 years. Smoking was associated with higher levels of depressive symptoms from age 22 to 42 years, while not at 52. Associations among males prevailed when adjusting for education, marital status, and alcohol use. Four life course classes of daily smoking (nonsmokers, decreasing prevalence of smoking, persistent smokers, and increasing prevalence of smoking) and four trajectories of depressive symptoms (low, increasing/moderate, decreasing/moderate, and high) were identified. In males, persistent daily smokers (relative risk ratio (RRR) = 4.5, 95% confidence interval (CI): 2.2 to 9.2) and those in the class with increasing smoking prevalence (RRR = 3.2, 95% CI: 1.1 to 9.1) had an increased risk of belonging to the high depressive symptoms profile. In females these associations were nonsignificant. CONCLUSIONS: Compared to females, the relationship between smoking and depressive symptoms seems more robust among males during adulthood. Specifically, males smoking persistently from young adulthood to middle age have an increased risk of high depressive symptoms trajectory. IMPLICATIONS: This population-based cohort with 30 years of follow-up showed that the life course trajectories of daily smoking and depressive symptoms are associated. Persistent daily smokers and those starting late had an increased risk of belonging to the profile with constantly high levels of depressive symptoms during the life course. However, these associations were statistically significant only in males. Actions should be strengthened, especially in males, to prevent smoking initiation, to help smoking cessation, and to identify and treat depression in smokers with significant depressive symptoms.

Development of Body Dissatisfaction in Women and Men at Different Educational Levels During the Life Course.

BACKGROUND: Our study examines the rarely investigated associations between body dissatisfaction and educational level over the life course in women and men. METHODS: A Finnish cohort (N = 1955) was followed by questionnaires at ages 22, 32, 42, and 52. Body dissatisfaction was measured by asking the respondents to evaluate their appearance using five response options. Analyses were done using logistic regression, while latent class analyses were used to identify classes of body dissatisfaction trajectories over the life course. RESULTS: Body dissatisfaction increased with age in women and men. Among men, body dissatisfaction was related to lower education at the ages of 32 and 42. Also, men with lower education were more likely to maintain a less positive body image over the life course. In women, increasing body dissatisfaction during the life course was associated with lower education. CONCLUSIONS: Differences in body dissatisfaction based on educational level are important to take into account in public health actions aiming to reduce socioeconomic inequalities in health and well-being.

Stress-induced eating and drinking and their associations with weight among women and men during 30-year follow-up.

BACKGROUND: Stress is associated with obesity through several mechanisms, including coping methods used in stressful situations. However, long-term prospective studies investigating stress-induced eating and drinking in parallel and their relationships with weight are scarce. PURPOSE: We examined the prevalence of stress-induced eating and drinking and their associations with body mass index (BMI) among women and men during a 30-year follow-up, as well as BMI trajectories from early adulthood to middle age. METHODS: Participants of a Finnish cohort study were followed by questionnaires at the ages of 22 (N = 1656), 32 (N = 1471), 42 (N = 1334), and 52 (N = 1160). Their coping methods were evaluated by asking how common it was for them to act in certain ways when they encountered stressful situations. We used linear regression analysis to examine the associations between coping methods and BMI, and latent growth models to analyze the BMI trajectories. RESULTS: The prevalence of stress-induced eating was higher among women than men throughout the follow-up, whereas stress-induced drinking was more common among men at 22 and 32 years of age. Stress-induced eating was associated with higher BMI at all ages among women, and from the age of 32 among men. Eating as a persistent coping method over the life course was associated with a higher and faster growth rate of BMI trajectories. Stress-induced drinking was associated with higher BMI in middle age, and with a faster growth of BMI among men. CONCLUSIONS: Effective, appropriate stress management may be one essential factor in preventing weight gain in the adult population.

Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years.

BACKGROUND: Somatic symptoms among adolescents are common, yet little is known about long-term trajectories of somatic symptoms and the factors in adolescence that shape them. We examined individual, family and school-based factors at age 16 as predictors of trajectories of somatic symptoms over 27 years. METHODS: Participants from the Northern Swedish Cohort (n = 1001) responded to questions about individual factors (e.g. health behaviours), family factors (e.g. contact with parents, social and material adversity) and school satisfaction at age 16; as well as 10 somatic symptoms at ages 16, 18, 21, 30 and 43. Teacher assessments at age 16 included overall ability at school and peer relations. Age 16 predictors of somatic symptom trajectory group membership were analysed using multinomial logistic regression. RESULTS: Poor contact with mother and poor school satisfaction were significant predictors of adverse symptom trajectories among both men and women. Low birth weight and low parental academic involvement were contributing factors for women, while smoking and social adversity were more relevant factors for men. CONCLUSIONS: Our findings emphasize the importance of a holistic approach that considers the unique contributions of individual, family and school-based factors in the development of trajectories of somatic symptoms from adolescence to middle age.

Life course associations between smoking and depressive symptoms. A 30-year Finnish follow-up study.

BACKGROUND: While the association between smoking and depressive symptoms has been studied quite extensively, only little is known whether the association changes and how the trajectories of smoking and depressive symptoms are intertwined during the life course. In this population-based study, we examined these associations from young adulthood to middle age. METHODS: Participants of a Finnish cohort study (N = 1955) were addressed at ages 22, 32, 42 and 52 using postal questionnaires including questions of daily smoking and depressive symptoms (the short 13-item Beck Depression Inventory). Linear and logistic regression analyses and longitudinal latent class and profile analyses were used. RESULTS: The percentages of daily smokers decreased, while levels of depressive symptoms increased among both women and men from age 22 to 52 years. Daily smoking was associated with higher levels of depressive symptoms between ages 22 and 42, while not at age 52. Associations among men prevailed also in the adjusted models. Four life course trajectories of daily smoking (non-smokers, quitters, persistent smokers, and late starters) and four depressive symptoms (low, increasing/moderate, decreasing/moderate, and high) were identified. In the adjusted models, persistent daily smokers and late starters had significantly higher risk of belonging to the high depressive symptoms profile in men, but not in women. CONCLUSIONS: Compared to women the associations between daily smoking and depressive symptoms seem more robust among men during adulthood. Especially those men smoking persistently from young adulthood to middle age have an increased risk of high depressive symptoms trajectory during the life course.

Stress, development and mental health study, the follow-up study of Finnish TAM cohort from adolescence to midlife: cohort profile.

PURPOSE: This cohort profile describes the Stress, development and mental health study (TAM), which is a cohort study investigating risk and protective factors as well as longitudinal associations regarding mental health and well-being from adolescence to midlife. This interdisciplinary cohort study operates, for example, in the fields of public health, social medicine, psychiatry and the life course perspective. PARTICIPANTS: In 1981 (n=2242, 98.0% of the target population), 1982 (n=2191, 95.6%) and 1983 (n=2194, 96.7%) during school classes, surveys were conducted to all Finnish-speaking pupils (mostly born 1967) in the Tampere region in Finland. Participants of the school study at age 16 in 1983 (n=2194) comprised the base population for the longitudinal data and were followed-up using postal questionnaires in the years 1989, 1999, 2009 and 2019 at ages 22 (n=1656, 75.5% of the age 16 participants), 32 (n=1471, 67.0%), 42 (n=1334, 60.8%) and 52 (n=1160, 52.9%). FINDINGS TO DATE: The self-reported questionnaires include information on physical and mental health (eg, depression and mood disorders, anxiety disorders), health behaviour and substance misuse (eg, alcohol, tobacco and exercise), socioeconomic conditions, psychosocial resources (eg, self-esteem), social relationships and support, life events, etc. The numerous studies published to date have examined mental health and various factors from several perspectives such as risk and protective factors, individual developmental paths (eg, trajectories) and pathway models (mediation and moderation). FUTURE PLANS: Current and future research areas include, for example, longitudinal associations between mental health (eg, depressive symptoms, self-esteem) and (1) substance use (alcohol and tobacco), (2) family transitions (eg, parenthood, relationship status) and (3) retirement. Next follow-up is planned to be conducted at the latest at age 62 in 2029. Before that it is possible to link the data with cause-of-death register.

Associations between relationship status and mental well-being in different life phases from young to middle adulthood.

The aim of this study was to assess the associations between relationship status and mental well-being in four different phases during the life course, and to identify whether relationship quality moderated these associations. We used a broader concept of relationship status (instead of marital status) and also included the positive dimension of mental health. Participants in a Finnish cohort study were followed up at ages 22 (N = 1,656), 32 (N = 1,471), 42 (N = 1,334), and 52 (N = 1,159). Measures in all study panels covered relationship status (marriage, cohabitation, dating, single and divorced/widowed), Short Beck Depression Inventory (S-BDI), self-esteem (seven items) and relationship quality (six items). Analyses were carried out using linear regression. Compared to marriage, being single or being divorced/widowed were associated with depressive symptoms at every age in men. For women, in turn, being single - but not being divorced/widowed - was associated with depressive symptoms. Among men, being single or being divorced/widowed were also associated with lower self-esteem at age 32, 42 and 52, but in women, only one association between lower self-esteem and being single was found at age 32. Of the age stages, the age 32 is highlighted in men, at which point all relationship statuses were risk factors compared to marriage. There were only few indications of the moderating role of the relationship quality. Compared to marriage, being single or being divorced/widowed were quite consistently associated with poorer mental well-being during the life course, especially among men. For dating and cohabiting the associations were more fragmented depending on age and gender; particularly among women, these relationship statuses tended not to differ from marriage in terms of mental well-being. These observations on mental well-being across five relationship statuses are important in our contemporary society, where the number of marriages is decreasing, and other forms of relationships are becoming more common.

The contribution of drinking culture at comprehensive school to heavy episodic drinking from adolescence to midlife.

BACKGROUND: The school context is associated with adolescent alcohol use, but it is not clear whether this association continues into adulthood. This study examined whether exposure to drunkenness oriented drinking culture in 9th grade school class is associated with individuals' heavy episodic drinking (HED) from adolescence to midlife. METHODS: Participants in the 'Northern Swedish Cohort' study aged 16 years in 1981 were followed-up when aged 18, 21, 30 and 43 (N = 1080). Individual-level factors were HED, positive attitudes towards drunkenness, early initiation of HED and peer-oriented spare-time. School class-level drinking culture was measured as classmate reported HED, positive attitudes, early initiation of HED and peer-oriented spare time. Multilevel log-binomial regression analyses were adjusted for gender, parental socioeconomic background, family structure and HED at age 16. RESULTS: After adjustment for sociodemographic factors several cross-sectional and longitudinal associations were found between class-level indicators of drinking culture and individual HED. After additional adjustment for age 16 HED, most associations attenuated. The risk ratio (95% confidence interval) for engaging in HED at age 43 was 1.58 (1.03-2.42) times higher for those who at age 16 had many classmates reporting positive attitude towards drunkenness. CONCLUSIONS: These findings suggest that drinking culture in school may have a long-lasting impact on drinking habits in adulthood. The associations with HED at follow-ups are likely mediated by HED in adolescence. Studies on alcohol use would benefit from taking into account both individual and contextual factors in a life course perspective.

Longitudinal prospective associations between psychological symptoms and heavy episodic drinking from adolescence to midlife.

AIM: This study examined whether development of psychological symptoms (PS) differed between persons with different longitudinal profiles of heavy episodic drinking (HED) from adolescence to midlife. In addition, the reciprocal associations between PS and HED were studied. METHODS: Participants of a Finnish cohort study in 1983 at age 16 ( N = 2194) were followed up at ages 22 ( N = 1656), 32 ( N = 1471), and 42 ( N = 1334). HED was assessed with frequency of intoxication (16-22 years) and having six or more drinks in a session (32-42 years). Using latent class analysis, the participants were allocated to steady high, increased, moderate, and steady low groups according to their longitudinal profiles of HED. The PS scale (16-42 years) covered five mental complaints. The latent growth curve of PS was estimated in the HED groups for comparisons. In addition, the prospective associations between symptoms and HED were examined using cross-lagged autoregressive models. RESULTS: PS grew from 16 to 32 years, but declined after that, with women having higher level of PS than men. PS trajectory followed a path at highest and lowest level in the steady high and steady low HED groups, respectively. Symptoms predicted later HED, but the association in the opposite direction was not found. CONCLUSIONS: The more the HED trajectory indicated frequent HED, the higher was the level of PS throughout the follow-up. Results support the self-medication hypothesis, suggesting that alcohol is used to ease the burden of PS. More attention should be paid to alcohol use of people with mental symptoms in health services.

Group activity participation at age 21 and depressive symptoms during boom and recession in Sweden: a 20-year follow-up.

BACKGROUND: Organized group activities (e.g. sports or arts clubs) have long been noted as important developmental settings for youth, yet previous studies on the relationships between participation and mental health outcomes have focused on short-term effects among school-aged adolescents. The subsequent period of life, emerging adulthood, has been largely overlooked despite being another important life stage where individuals face new existential challenges and may benefit from group activity participation. The potential for macroeconomic conditions to modify these relationships has also not been considered. METHODS: Participants (n = 1654) comprise two cohorts, born in either 1965 (n = 968) or 1973 (n = 686), from the same middle-sized industrial town in Northern Sweden. Both cohorts completed detailed questionnaires at age 21 (macroeconomic boom for Cohort 65, recession for Cohort 73) and approximately 20 years follow-up (age 43 for Cohort 65, age 39 for Cohort 73). General linear models were used to assess concurrent and prospective associations between regular group activity participation and depressive symptoms, as well as the potential interaction with boom/recession. RESULTS: After controlling for sociodemographic factors, regular group activity participation at age 21 was associated with lower depressive symptoms, both concurrently and at follow-up. Those exposed to recession at age 21 reported higher depressive symptoms at the time but there was no interaction between cohort (boom/recession) and group activity participation. CONCLUSIONS: Regular group activity participation during emerging adulthood is associated with lower depressive symptoms uniformly in times of boom and recession. Beneficial effects of such participation may contribute to better mental health over 20 years.

Poor peer relations in adolescence, social support in early adulthood, and depressive symptoms in later adulthood-evaluating mediation and interaction using four-way decomposition analysis.

PURPOSE: Supportive social relations are associated with good mental health, yet few studies have considered the prospective importance of adolescent peer relations for adult mental health and the potential mechanisms involved. METHODS: Participants (n = 941) were sourced from the Northern Swedish Cohort, a prospective study comprising school students aged 16 years in 1981. Integrating life course epidemiology with four-way decomposition analysis, this paper considers the controlled direct effect of poor peer relations at age 16 years on depressive symptoms at age 43 years, the pure indirect effect mediated by the availability of social support at age 30 years, and potential interactions between the exposure and the mediator. RESULTS: After controlling for gender, baseline depressive symptoms, and parental socioeconomic position, poor peer relations at age 16 years were associated with depressive symptoms at age 43 years, largely irrespective of social support at age 30 years. Nonetheless, poor peer relations in adolescence were associated with poorer social support at age 30 years, and mediation accounted for a modest proportion (pure indirect effect 10%) of the association between poor peer relations at age 16 years and depressive symptoms at age 43 years. CONCLUSIONS: Policies to foster constructive peer relations for adolescents at school are encouraged; such policies may promote both the availability of social support and better mental health across the life course.

Social relationships in adolescence and heavy episodic drinking from youth to midlife in Finland and Sweden - examining the role of individual, contextual and temporal factors.

BACKGROUND: Applying the Process-Person-Context-Time (PPCT) model of the bioecological theory, this study considers whether proximal processes between the individual and the microsystem (social relationships within family, peer group and school) during adolescence are associated with heavy episodic drinking (HED), from youth to midlife, and whether the macro level context (country) plays a role in these associations. METHODS: Participants of two prospective cohort studies from Finland and Sweden, recruited in 1983/1981 at age 16 (n = 2194/1080), were followed-up until their forties using postal questionnaires. Logistic regression analysis was used to examine associations between social relationships at age 16 and HED (at least monthly intoxication or having six or more units of alcohol in one occasion) at ages 22/21, 32/30 and 42/43. Additive interactions between microsystem settings, as well as between settings and country, were also considered. RESULTS: Consistent with the PPCT model, we found individual, contextual and temporal aspects to be associated with drinking habits. Higher levels of poor family relationships were associated with an increased likelihood of HED (ages 22/21 and 32/30) in both Finnish women and men and Swedish men. Higher levels of peer contact were associated with an increased likelihood of HED in both Finnish women (ages 32 and 42) and men (ages 22 and 32), and Swedish men (age 21). In contrast with the other groups, poorer relationships with classmates were associated with an increased likelihood of HED (age 30) for Swedish women only. For women, the combined effect of having both daily peer contact and living in Finland for HED at age 42/43 was statistically distinguishable from a pure additive effect. CONCLUSIONS: Micro and to a lesser extent macro level contexts are associated with heavy episodic drinking well into adulthood. The most relevant processes in the adolescent microsystem occur in family and peer settings. However, long-lasting protective or risk-raising effects between different settings and later HED were not found. Promoting good relationships across different contexts during adolescence may reduce the incidence of HED in adulthood.

Associations between unemployment and heavy episodic drinking from adolescence to midlife in Sweden and Finland.

Background: Unemployment and alcohol use have often been found to correlate and to act as risk factors for each other. However, only few studies have examined these associations at longitudinal settings extending over several life phases. Moreover, previous studies have mostly used total consumption or medical diagnoses as the indicator, whereas subclinical measures of harmful alcohol use, such as heavy episodic drinking (HED), have been used rarely. The aim of this study was to examine the associations between HED and unemployment from adolescence to midlife in two Nordic countries. Methods: Participants of separate cohort studies from Sweden and Finland were recruited at age 16 in 1981/1983 and followed up at ages 21/22, 30/32 and 43/42, (n = 1080/2194), respectively. Cross-lagged autoregressive models were used to determine associations between HED and unemployment. Results: In the Swedish cohort, HED at ages 16 and 30 in men and HED at age 21 in women were associated with subsequent unemployment. In the Finnish cohort, we found corresponding associations at age 16 in women and at age 22 in men. However, the gender differences were not statistically significant. The associations from unemployment to HED were non-significant in both genders, in both cohorts and at all ages. Conclusions: Our results suggest that heavy drinkers are more likely to experience unemployment in subsequent years. The associations from HED to unemployment seem to exist through the life course from adolescence to midlife. More emphasis should be put on reducing alcohol related harms in order to improve labour-market outcomes.

Pathways from problems in adolescent family relationships to midlife mental health via early adulthood disadvantages - a 26-year longitudinal study.

Poor childhood family conditions have a long-term effect on adult mental health, but the mechanisms behind this association are unclear. Our aim was to study the pathways from problematic family relationships in adolescence to midlife psychological distress via disadvantages in early adulthood. Participants of a Finnish cohort study at the age of 16 years old in 1983 were followed up at ages 22, 32 and 42 years old (N = 1334). Problems in family relationships were measured with poor relationship with mother and father, lack of parental support in adolescent's individuation process and poor home atmosphere, and mental health was assessed using Kessler's Psychological Distress Scale (K10). We analyzed the indirect effects of adolescent family relations on mental health at age 42 years old via various disadvantages (somatic and psychological symptoms, relationship/marital status, low education/unemployment and heavy drinking) at ages 22 and 32 years old. Problematic adolescent family relationships were associated with midlife psychological distress in women (0.19; 95% CI 0.11, 0.26) and men (0.13; 95% CI 0.04, 0.21). However, after adjustment for adolescent psychological symptoms, the association was only significant for women (0.12; 95% CI 0.04, 0.20). Poor family relationships were associated with various disadvantages in early adulthood. The association from poor family relationships (16 years old) to psychological distress (42 years old) was in part mediated via psychological symptoms in women (0.03; 95% CI 0.01, 0.04) and men (0.02; 95% CI 0.00, 0.04) and in women also via heavy drinking in early adulthood (0.02; 95% CI 0.00, 0.03). Adolescent family relationships have a role in determining adult mental health. Targeted support addressing psychological well-being and hazardous drinking for adolescents with problematic family relationships might prevent disadvantages in early adulthood, and further prevent poor midlife mental health.

Interpersonal Conflicts and Development of Self-Esteem from Adolescence to Mid-Adulthood. A 26-Year Follow-Up.

This study investigated the association between interpersonal conflicts and the trajectory of self-esteem from adolescence to mid-adulthood. The directionality of effects between self-esteem and interpersonal conflicts was also studied. Participants of a Finnish cohort study in 1983 at age 16 (N = 2194) were followed up at ages 22 (N = 1656), 32 (N = 1471) and 42 (N = 1334) using postal questionnaires. Measures covered self-esteem and interpersonal conflicts including, conflicts with parents, friends, colleagues, superiors, partners, break-ups with girl/boyfriends, and divorces. Participants were grouped using latent profile analysis to those having "consistently low", "decreasing", or "increasing" number of interpersonal conflicts from adolescence to adulthood. Analyses were done using latent growth curve models and autoregressive cross-lagged models. Among both females and males the self-esteem growth trajectory was most favorable in the group with a consistently low number of interpersonal conflicts. Compared to the low group, the group with a decreasing number of interpersonal conflicts had a self-esteem trajectory that started and remained at a lower level throughout the study period. The group with an increasing number of interpersonal conflicts had a significantly slower self-esteem growth rate compared to the other groups, and also the lowest self-esteem level at the end of the study period. Cross-lagged autoregressive models indicated small, but significant lagged effects from low self-esteem to later interpersonal conflicts, although only among males. There were no effects to the opposite direction among either gender. Our results show that those reporting more and an increasing number of interpersonal conflicts have a lower and more slowly developing self-esteem trajectory from adolescence to mid-adulthood. While the result was expected, it does not seem to imply an effect from interpersonal conflicts to low self-esteem. Rather, if anything, our results seem to suggest that those with low self-esteem are more prone to later interpersonal conflicts.

A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage.

AIMS: The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood. METHODS: Finnish cohort study's participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42. RESULTS: Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage. CONCLUSION: Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.

Effects of media exposure on adolescents traumatized in a school shooting.

This study analyzes the impact of the media on adolescents traumatized in a school shooting. Participants were trauma-exposed students (n = 231) and comparison students (n = 526), aged 13-19 years. A questionnaire that included the Impact of Event Scale and a 36-item General Health Questionnaire was administered 4 months after the shooting. Being interviewed was associated with higher scores on the Impact of Event Scale (p = .005), but posttraumatic symptoms did not differ between those who refused to be interviewed and those not approached by reporters. Following a higher number of media outlets did not affect symptoms.