Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
J Epidemiol Community Health. 2019 Jun;73(6):496-501. doi: 10.1136/jech-2018-211815. Epub 2019 Feb 4.
While compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited.
In this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression.
We found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates.
Low stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.
虽然压力应对能力受损是一般躯体和精神疾病发展的公认风险因素，但个体对压力脆弱性的差异如何具体影响不利健康行为的长期风险知之甚少。
在这项瑞典队列研究中，我们旨在调查青少年晚期的压力应对能力与成年后使用成瘾物质之间的关联。我们纳入了 9381 名男性，他们在兵役体检时接受了心理压力应对能力的测量，随后对他们进行了一项广泛的健康调查（平均年龄 34.0±7.2 岁），其中包括关于物质使用的详细信息。我们使用线性回归来模拟连续结果，使用逻辑回归来模拟二项结果，使用多项逻辑回归来模拟其他分类结果。
我们发现，青少年时期的低压力应对能力会增加所有研究中成瘾行为的风险。在校正了儿童期社会经济信息后，低压力应对能力与成年期当前的经常吸烟（相对风险比：5.85，95%置信区间 4.32 至 7.93）、更高的尼古丁依赖评分（β：0.76，95%置信区间 0.29 至 1.23）、危险饮酒（每周饮酒量超过 14 个酒精当量，OR：1.72，95%置信区间 1.37 至 2.16）、DSM-IV 酒精依赖标准（OR：1.74，95%置信区间 1.35 至 2.25）和药物使用（OR：1.77，95%置信区间 1.51 至 2.08）相关。进一步调整成年期教育程度和职业以及兵役时的其他协变量后，结果基本保持不变。
青少年晚期的低压力应对能力似乎与成年后不利和成瘾的健康行为风险增加有关。
