Psychological distress in New Zealand university students and its association with alcohol consumption
Background There is debate on the nature of the association between alcohol use and psychological distress in young people. This study investigates this association among New Zealand university students aged 17-24 years at the time of sampling. Aims 1. To review published research relevant to the topic. 2. To characterise alcohol consumption and how it varies demographically; 3. To describe psychological distress and how it varies demographically; 4. To quantify the association between alcohol consumption and psychological distress. Methods A systematic review of the literature was undertaken, using inclusion criteria of: young people aged 15-30 years, a measure of psychological distress, and a measure of alcohol consumption. For the quantitative study, data were drawn from a 2009 web-based survey of university students across six New Zealand universities (n=2921, response fraction = 54% for women and 46% for men). Measures included modified Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questions and the Kessler-10 scale for psychological distress. Multiple regression analysis was used to estimate the association between alcohol consumption and psychological distress. Analyses were carried out with alcohol consumption as the outcome and repeated with psychological distress as the outcome, adjusting for a range of demographic characteristics. When analysing psychological distress as an outcome, two sets of potential moderators (alcohol-related problems and second-hand effects of alcohol) were also adjusted for. Results 1. In the published literature, interpretation of findings was limited by the poor quality of the research in most cases. Among the strongest studies there was inconsistency in the associations found. Over half (7/13) of the studies found psychological distress to be lowest at moderate levels of consumption and highest in heavy drinkers and at low levels of consumption (including non-drinkers and ex-drinkers). Four studies found no association, and four studies found a positive association between alcohol consumption and psychological distress. 2. Student alcohol consumption was heavy and characterised by infrequent heavy drinking occasions. 3. Psychological distress was common and higher in women than men. 4. In the unadjusted analyses, no association between alcohol consumption and psychological distress was observed. 5. In the adjusted analysis, the level of psychological distress was not associated with alcohol consumption. In the reverse direction, there was a small negative association between level of alcohol consumption and psychological distress, after adjustment for demographic variables and moderating factors, indicating the possibility of a direct effect. There was a larger positive association between alcohol-related problems and non-assaultive second-hand effects, and psychological distress, indicating the possibility of an indirect effect. Conclusions Previously published research did not provide good evidence about the nature of this association. The results of the quantitative study suggest the possibility of an indirect positive effect of alcohol consumption on psychological distress through alcohol-related problems.
Advisor: Connor, Jennie; Kypri, Kypros
Degree Name: Master of Public Health
Degree Discipline: Preventive & Social Medicine
Publisher: University of Otago
Keywords: Alcohol; psychological; distress; New Zealand; University; Students
Research Type: Thesis