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Summary: Study finds some evidence of a positive link between early life anxiety and later alcohol use disorder. However, there was no consistent link between anxiety in childhood and drinking frequency or binge drinking.
Source: University of Bristol
New research led by the University of Bristol has found some evidence that children and adolescents with higher levels of anxiety may be at greater risk of developing alcohol problems. However, the link between anxiety and later binge drinking and later frequency and quantity of drinking was more inconclusive.
The study published in Addiction was carried out by the University’s Tobacco and Alcohol Research Group (TARG) part of the School of Psychological Science and MRC Integrative Epidemiology Unit (MRC IEU).
Many studies have investigated the relationship between anxiety and alcohol use, but the evidence has been unclear. Some studies have found higher anxiety is linked to greater alcohol use, whereas other studies have found anxiety is linked to lower alcohol use, or they have found no association.
The researchers carried out a systematic review of 51 prospective cohort studies from 11 countries [United States, Germany, Finland, UK, Netherlands, Australia, Taiwan, Canada, New Zealand, Sweden, and Norway] to explore whether child and adolescent anxiety is linked to later alcohol use and alcohol use disorders.
Forty-six studies included males and females, four had an all-male sample and one had an all-female sample. Thirty measures assessed anxiety and 40 measures assessed alcohol use. The study sample sizes ranged from 110 to 11,157 participants. Anxiety exposure ages ranged from three to 24 years, and alcohol outcome ages ranged from 11 to 42 years.
The study found some evidence of a link between child and adolescent anxiety and later alcohol use disorders. However, associations of anxiety with later drinking frequency, quantity and binge drinking were more inconsistent.
Maddy Dyer, Ph.D. student in the School of Psychological Science’s Tobacco and Alcohol Research Group, who led the research said: “Our findings indicate that young people with higher anxiety may have a greater risk of developing alcohol problems. Further research is needed to understand why there are differences in associations for alcohol consumption levels versus problematic use, and to establish which individuals with anxiety develop alcohol problems. This could lead to improvements in personalized interventions.”
Funding: The research was funded by the MRC and Alcohol Research UK (MR/L022206/1), MRC Addiction Research Clinical Training programme (MARC), MRC Integrative Epidemiology Unit (IEU), The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), NIHR School of Public Health Research, NIHR Health Protection Research Unit in Evaluation, and NIHR Biomedical Research Centre.
Joint funding was received from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration.
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Source: University of Bristol Media Contacts: Joanne Fryer – University of Bristol Image Source: The image is credited to University of Bristol.
Original Research: Open access “Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta‐analysis of prospective cohort studies”. Maddy L. Dyer Kayleigh E. Easey Jon Heron Matthew Hickman Marcus R. Munafò. Addiction. First published: 19 March 2019 doi:10.1111/add.14575
Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta‐analysis of prospective cohort studies
Background and Aims Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings.
Design and Setting We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta‐analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later.
Participants Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years.
Measurements Ninety‐seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive-compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders).
Findings The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow‐up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta‐analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47–1.87).
Conclusions Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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