Social relationships in adolescence and heavy episodic drinking from youth to midlife in Finland and Sweden\xa0\u2014\xa0examining the role of individual, contextual and temporal factors

Noora Berg,Olli Kiviruusu,Taina Huurre,Anne Hammarström,Christopher G Bean,Tomi Lintonen

doi:10.1186/s12889-018-5885-8

Abstract

BackgroundApplying 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.MethodsParticipants 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.ResultsConsistent 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.ConclusionsMicro 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.

Highlights

Applying the Process-Person-Context-Time (PPCT) model of the bioecological theory, this study considers whether proximal processes between the individual and the microsystem during adolescence are associated with heavy episodic drinking (HED), from youth to midlife, and whether the macro level context plays a role in these associations
Men tended to be heavy episodic drinkers more often than women in both countries and Swedish women had a lower level of HED compared to Finnish women, e.g. HED being twice as likely in Finnish women in the two last follow-ups
For Finnish women in the unadjusted model, higher levels of poor family relationships and peer contact were associated with an increased likelihood of HED in all ages, while associations with poor relationships with classmates were not significant

Summary

Introduction

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. Thorough understanding of the complex developmental processes related to alcohol use requires deeper knowledge on the individual, contextual and life course aspects, and especially their interrelations that influence this development [3]. Combining these aspects is not common in previous empirical studies on alcohol use. Bronfenbrenner’s bioecological theory of human development and the Process-Person-Context-Time (PPCT) model [4] provides a useful framework for understanding the complex relations between an individual, their environment, and the passage of time in influencing drinking habits

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Conclusion