Bell, S;
(2013)
An exploration of the dynamic longitudinal association between hazardous alcohol use and mental health.
Doctoral thesis , UCL (University College London).
Abstract
This thesis is an examination of the association between alcohol use and mental health. Typically, research on alcohol use and mental health has concentrated on clinical disorders such as alcohol dependency and major depression. Less attention has been paid to drinking patterns as risk factors for, or consequences of, poor mental health. This thesis aimed to explore the relationship between hazardous patterns of alcohol consumption (such as ‘binge’ drinking) and mental health longitudinally - taking into account both directions of causality whilst also modelling a reciprocal relationship over time (i.e. alcohol use and mental health influencing changes in each other). The main purpose of this work was to compare competing models of causation to conclude which “best fits” – i.e. whether hazardous alcohol use leads to poor mental health, whether poor mental health leads to engaging in hazardous alcohol consumption, or a combination of both. Data from three existing sources was drawn upon to achieve these goals: the Whitehall II study of British Civil Servants, the Birmingham Untreated Heavy Drinkers (BUHD) project and the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) two-wave survey of participants from the Czech Republic, Russia and Poland. All datasets have repeated measures of a number of alcohol related variables and standardised mental health scales. Questions pertaining to basic demographic and other lifestyle variables are also available. Using dynamic modelling techniques, no significant effects were observed for any measure of alcohol consumption (weekly units and frequency of heavy drinking days) on changes in mental health, however, mental health was found to impact upon changes in drinking behaviours suggesting that mental health is the dominant underlying process in the relationship between alcohol use and mental health (no evidence was found for a reciprocal relationship/feedback loop over time).
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