BACKGROUND: Given the negative consequences of early alcohol use for health and social functioning, it is essential to detect children at risk of early drinking. The aim of this study is to determine predictors of early alcohol use that can easily be detected in Preventive Child Healthcare (PCH).METHODS: We obtained data from the first two waves on 1261 Dutch adolescents who participated in TRAILS (TRacking Adolescents' Individual Lives Survey) at ages 10-14 years and from the PCH records regarding ages 4-10 years. Early adolescence alcohol use (age 10-14 years) was defined as alcohol use at least once at ages 10-12 years (wave 1) and at least once in the previous 4 weeks at ages 12-14 years (wave 2). Predictors of early alcohol use concerned parent and teacher reports at wave 1 and PCH registrations, regarding the child's psychosocial functioning, and parental and socio-demographic characteristics.RESULTS: A total of 17.2% of the adolescents reported early alcohol use. Predictors of early alcohol use were teacher-reported aggressive behaviour [odds ratios (OR); 95% confidence interval (CI): 1.86; 1.11-3.11], being a boy (OR 1.80, 95%-CI 1.31-2.56), being a non-immigrant (OR 2.31, 95%CI 1.05-5.09), and low and middle educational level of the father (OR 1.71, 95%CI 1.12-2.62 and OR 1.77, 95%CI 1.16-2.70, respectively), mutually adjusted.CONCLUSION: A limited set of factors was predictive for early alcohol use. Use of this set may improve the detection of early adolescence alcohol use in PCH.doi: 10.1093/eurpub/cku072
Alcohol use among adolescents has become a major public health concern over the past decade. This alcohol use is associated with various other problems, therefore it is important to detect at-risk adolescents as a starting point for interventions. The main aim of this thesis is to identify determinants of adolescent alcohol use. Furthermore, determinants of multiple health risk behaviors were studied. The studies described in this thesis were embedded within the TRAILS (TRacking Adolescents’ Individual Lives Survey) study. TRAILS is a large prospective cohort study of the psychological, social and psychical development of children into adulthood. The TRAILS study started in 2001 when the children were aged 10-12 years. The results of this thesis show that parenting is a determinant for adolescent alcohol use. Furthermore, Self-control, aggressive behavior, alcohol use of friends and various socio-demographic characteristics were predictive for alcohol use. Low self-control does not increase the risk of alcohol use, but does increase the risk of alcohol abuse and multiple health risk behaviors. Although some aspects of parenting were found to be predictive for adolescent alcohol use, the effects were small. The results show that in future research on determinants for alcohol use by adolescents a distinction should be made between specific patterns of alcohol use and that the association with other health risk behaviors should be studied. The same holds true for the development of preventive intervention programs. Further increase of the cooperation between schools and Preventive Child Healthcare may increase the efficiency of these programs.
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Previous research shows that automatic tendency to approach alcohol plays a causal role in problematic alcohol use and can be retrained by Approach Bias Modification (ApBM). ApBM has been shown to be effective for patients diagnosed with alcohol use disorder (AUD) in inpatient treatment. This study aimed to investigate the effectiveness of adding an online ApBM to treatment as usual (TAU) in an outpatient setting compared to receiving TAU with an online placebo training. 139 AUD patients receiving face-to-face or online treatment as usual (TAU) participated in the study. The patients were randomized to an active or placebo version of 8 sessions of online ApBM over a 5-week period. The weekly consumed standard units of alcohol (primary outcome) was measured at pre-and post-training, 3 and 6 months follow-up. Approach tendency was measured pre-and-post ApBM training. No additional effect of ApBM was found on alcohol intake, nor other outcomes such as craving, depression, anxiety, or stress. A significant reduction of the alcohol approach bias was found. This research showed that approach bias retraining in AUD patients in an outpatient treatment setting reduces the tendency to approach alcohol, but this training effect does not translate into a significant difference in alcohol reduction between groups. Explanations for the lack of effects of ApBM on alcohol consumption are treatment goal and severity of AUD. Future ApBM research should target outpatients with an abstinence goal and offer alternative, more user-friendly modes of delivering ApBM training.
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Alcoholgebruiksstoornis (AUD) is een groot probleem. Alleen al in de USA zijn er 15 miljoen mensen met een AUD en meer dan 950.000 Nederlanders drinkt overmatig. Wereldwijd is 3-8% van het aantal sterfgevallen en 5% van alle ziektes en letsels toe te schrijven aan AUD. Zorg staat voor uitdagingen. Zo krijgt meer dan de helft van de AUD-patiënten binnen een jaar na behandeling een terugval. Een oplossing hiervoor is de inzet van Cue-Exposure-Therapy (CET). Daarbij worden cliënten blootgesteld aan triggers d.m.v. objecten, mensen en omgevingen die zucht opwekken. Om op een realistische, veilige en gepersonaliseerde manier deze triggers te ervaren, wordt Virtual Reality ingezet (VRET). Op die manier worden coping-vaardigheden getraind om verlangen naar alcohol tegen te gaan. De effectiviteit van VRET is (klinisch) bewezen. De komst van AR-technologieën roept echter de vraag op om mogelijkheden van Augmented-Reality-Exposure-Therapy (ARET) te onderzoeken. ARET geniet dezelfde voordelen als VRET (zoals een realistische veilige ervaring). Maar omdat AR virtuele-componenten in de echte omgeving integreert, waarbij het lichaam zichtbaar is, roept het vermoedelijk een ander type ervaring op. Dit kan de ecologische validiteit van CET in de behandeling vergroten. Daarnaast is ARET goedkoper te ontwikkelen (minder virtuele elementen) en hebben cliënten/klinieken gemakkelijker toegang tot AR (via smartphone/tablet). Bovendien worden nieuwe AR-brillen ontwikkeld, die nadelen zoals een te klein smartphone-scherm oplossen. Ondanks de vraag vanuit behandelaars, is ARET nog nooit ontwikkeld en onderzocht rondom verslaving. In dit project wordt het eerste ARET-prototype ontwikkeld rondom AUD in de behandeling van alcoholverslaving. Het prototype wordt ontwikkeld op basis van Volumetric-Captured-Digital-Humans en toegankelijk gemaakt voor AR-brillen, tablets en smartphones. Het prototype wordt gebaseerd op RECOVRY, een door het consortium ontwikkelde VRET rondom AUD. Een prototype-test onder (ex)AUD-cliënten zal inzicht geven in behoeften en verbeterpunten vanuit patiënt en zorgverlener en in het effect van ARET in vergelijk met VRET.
Alcohol use disorder (AUD) is a major problem. In the USA alone there are 15 million people with an AUD and more than 950,000 Dutch people drink excessively. Worldwide, 3-8% of all deaths and 5% of all illnesses and injuries are attributable to AUD. Care faces challenges. For example, more than half of AUD patients relapse within a year of treatment. A solution for this is the use of Cue-Exposure-Therapy (CET). Clients are exposed to triggers through objects, people and environments that arouse craving. Virtual Reality (VRET) is used to experience these triggers in a realistic, safe, and personalized way. In this way, coping skills are trained to counteract alcohol cravings. The effectiveness of VRET has been (clinically) proven. However, the advent of AR technologies raises the question of exploring possibilities of Augmented-Reality-Exposure-Therapy (ARET). ARET enjoys the same benefits as VRET (such as a realistic safe experience). But because AR integrates virtual components into the real environment, with the body visible, it presumably evokes a different type of experience. This may increase the ecological validity of CET in treatment. In addition, ARET is cheaper to develop (fewer virtual elements) and clients/clinics have easier access to AR (via smartphone/tablet). In addition, new AR glasses are being developed, which solve disadvantages such as a smartphone screen that is too small. Despite the demand from practitioners, ARET has never been developed and researched around addiction. In this project, the first ARET prototype is developed around AUD in the treatment of alcohol addiction. The prototype is being developed based on Volumetric-Captured-Digital-Humans and made accessible for AR glasses, tablets and smartphones. The prototype will be based on RECOVRY, a VRET around AUD developed by the consortium. A prototype test among (ex)AUD clients will provide insight into needs and points for improvement from patient and care provider and into the effect of ARET compared to VRET.
Alcohol Use Disorder (AUD) involves uncontrollable drinking despite negative consequences, a challenge amplified in festivals. ARise is a project using Augmented Reality (AR) to prevent AUD by helping festival visitors refuse alcohol and other substances. Based on the first Augmented Reality Exposure Therapy (ARET) for clinical AUD treatment, ARise uses a smartphone app with AR glasses to project virtual humans that tempt visitors to drink alcohol. Users interact in a safe and personalized way with these virtual humans through phone, voice, and gesture interactions. The project gathers festival feedback on user experience, awareness, usability, and potential expansion to other substances.Societal issueHelping treatment of addiction and stimulate social inclusion.Benefit to societyMore people less patients: decrease health cost and increase in inclusion and social happiness.Collaborative partnersNovadic-Kentron, Thalamusa
