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Mental health comorbidities following peer victimization across childhood and adolescence: a 20-year longitudinal study

Published online by Cambridge University Press:  25 October 2021

Sînziana I. Oncioiu
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
Michel Boivin
Affiliation:
Laval University, Quebec, Canada
Marie-Claude Geoffroy
Affiliation:
McGill University, Montreal, Canada Douglas Mental Health University Institute, Montreal, Canada
Louise Arseneault
Affiliation:
King's College London, London, UK
Cédric Galéra
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
Marie C. Navarro
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France
Mara Brendgen
Affiliation:
University of Quebec in Montreal, Montreal, Canada
Frank Vitaro
Affiliation:
University of Montreal, Montreal, Canada
Richard E. Tremblay
Affiliation:
University of Montreal, Montreal, Canada University College Dublin, Dublin, Ireland
Sylvana M. Côté*
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France University of Montreal, Montreal, Canada
Massimiliano Orri
Affiliation:
Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, Bordeaux, France McGill University, Montreal, Canada Douglas Mental Health University Institute, Montreal, Canada
*
Author for correspondence: Sylvana M. Côté, E-mail: sylvana.cote.1@umontreal.ca

Abstract

Background

Peer victimization is associated with a wide range of mental health problems in youth, yet few studies described its association with mental health comorbidities.

Methods

To test the association between peer victimization timing and intensity and mental health comorbidities, we used data from 1216 participants drawn from the Quebec Longitudinal Study of Child Development, a population-based birth cohort. Peer victimization was self-reported at ages 6–17 years, and modeled as four trajectory groups: low, childhood-limited, moderate adolescence-emerging, and high-chronic. The outcomes were the number and the type of co-occurring self-reported mental health problems at age 20 years. Associations were estimated using negative binomial and multinomial logistic regression models and adjusted for parent, family, and child characteristics using propensity score inverse probability weights.

Results

Youth in all peer victimization groups had higher rates of co-occurring mental health problems and higher likelihood of comorbid internalizing-externalizing problems [odds ratios ranged from 2.06, 95% confidence interval (CI) 1.52–2.79 for childhood-limited to 4.34, 95% CI 3.15–5.98 for high-chronic victimization] compared to those in the low victimization group. The strength of these associations was highest for the high-chronic group, followed by moderate adolescence-emerging and childhood-limited groups. All groups also presented higher likelihood of internalizing-only problems relative to the low peer victimization group.

Conclusions

Irrespective of timing and intensity, self-reported peer victimization was associated with mental health comorbidities in young adulthood, with the strongest associations observed for high-chronic peer victimization. Tackling peer victimization, especially when persistent over time, could play a role in reducing severe and complex mental health problems in youth.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Drs. Côté and Orri are co-senior authors of this paper.

References

Analitis, F., Velderman, M. K., Ravens-Sieberer, U., Detmar, S., Erhart, M., & Herdman, M., … European Kidscreen Group. (2009). Being bullied: Associated factors in children and adolescents 8 to 18 years old in 11 European countries. Pediatrics, 123(2), 569577. doi:10.1542/peds.2008-0323CrossRefGoogle ScholarPubMed
Andrews, G., Slade, T., & Issakidis, C. (2002). Deconstructing current comorbidity: Data from the Australian national survey of mental health and well-being. The British Journal of Psychiatry: The Journal of Mental Science, 181, 306314. doi:10.1192/bjp.181.4.306CrossRefGoogle ScholarPubMed
Angst, J., Sellaro, R., & Ries Merikangas, K. (2002). Multimorbidity of psychiatric disorders as an indicator of clinical severity. European Archives of Psychiatry and Clinical Neuroscience, 252(4), 147154. doi:10.1007/s00406-002-0357-6CrossRefGoogle ScholarPubMed
Arseneault, L. (2018). Annual research review: The persistent and pervasive impact of being bullied in childhood and adolescence: Implications for policy and practice. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 59(4), 405421. doi:10.1111/jcpp.12841CrossRefGoogle ScholarPubMed
Austin, P. C., Grootendorst, P., & Anderson, G. M. (2007). A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: A Monte Carlo study. Statistics in Medicine, 26(4), 734753. doi:10.1002/sim.2580CrossRefGoogle ScholarPubMed
Bogart, L. M., Elliott, M. N., Klein, D. J., Tortolero, S. R., Mrug, S., Peskin, M. F., … Schuster, M. A. (2014). Peer victimization in fifth grade and health in tenth grade. Pediatrics, 133(3), 440447. doi:10.1542/peds.2013-3510CrossRefGoogle ScholarPubMed
Bouman, T., van der Meulen, M., Goossens, F. A., Olthof, T., Vermande, M. M., & Aleva, E. A. (2012). Peer and self-reports of victimization and bullying: Their differential association with internalizing problems and social adjustment. Journal of School Psychology, 50(6), 759774. doi:10.1016/j.jsp.2012.08.004CrossRefGoogle ScholarPubMed
Bowes, L., Maughan, B., Ball, H., Shakoor, S., Ouellet-Morin, I., Caspi, A., … Arseneault, L. (2013). Chronic bullying victimization across school transitions: The role of genetic and environmental influences. Development and Psychopathology, 25(2), 333346. 10.1017/S0954579412001095.CrossRefGoogle ScholarPubMed
Bradshaw, C. P. (2015). Translating research to practice in bullying prevention. American Psychologist, 70(4), 322332. doi:10.1037/a0039114CrossRefGoogle ScholarPubMed
Cantin, S., Brendgen, M., Dussault, F., & Vitaro, F. (2019). Transactional links between adolescents’ and friends’ victimization during the first two years of secondary school: The mediating role of likeability and friendship involvement. Social Development, 28(3), 743757. doi:10.1111/sode.12355CrossRefGoogle Scholar
Caspi, A., Houts, R. M., Ambler, A., Danese, A., Elliott, M. L., Hariri, A., … Moffitt, T. E. (2020). Longitudinal assessment of mental health disorders and comorbidities across 4 decades among participants in the Dunedin birth cohort study. JAMA Network Open, 3(4), e203221e203221. doi:10.1001/jamanetworkopen.2020.3221CrossRefGoogle ScholarPubMed
Cook, C. R., Williams, K. R., Guerra, N. G., Kim, T. E., & Sadek, S. (2010). Predictors of bullying and victimization in childhood and adolescence: A meta-analytic investigation. School Psychology Quarterly, 25(2), 6583. doi:10.1037/a0020149CrossRefGoogle Scholar
Craig, W., Harel-Fisch, Y., Fogel-Grinvald, H., Dostaler, S., Hetland, J., Simons-Morton, B., … Pickett, W. (2009). A cross-national profile of bullying and victimization among adolescents in 40 countries. International Journal of Public Health, 54(Suppl 2), 216224. doi:10.1007/s00038-009-5413-9CrossRefGoogle ScholarPubMed
Danese, A., & Widom, C. S. (2020). Objective and subjective experiences of child maltreatment and their relationships with psychopathology. Nature Human Behaviour, 4, 811818. doi:10.1038/s41562-020-0880-3.CrossRefGoogle ScholarPubMed
Eastman, M., Foshee, V., Ennett, S., Sotres-Alvarez, D., Reyes, H. L. M., Faris, R., & North, K. (2018). Profiles of internalizing and externalizing symptoms associated with bullying victimization. Journal of Adolescence, 65, 101110. doi:10.1016/j.adolescence.2018.03.007CrossRefGoogle ScholarPubMed
Finkelhor, D., Turner, H. A., & Hamby, S. (2012). Let's prevent peer victimization, not just bullying. Child Abuse & Neglect, 36(4), 271274. doi:10.1016/j.chiabu.2011.12.001CrossRefGoogle Scholar
Forbes, M. K., Fitzpatrick, S., Magson, N. R., & Rapee, R. M. (2019). Depression, anxiety, and peer victimization: Bidirectional relationships and associated outcomes transitioning from childhood to adolescence. Journal of Youth and Adolescence, 48(4), 692702. doi:10.1007/s10964-018-0922-6CrossRefGoogle ScholarPubMed
Forbes, M. K., Magson, N. R., & Rapee, R. M. (2020). Evidence that different types of peer victimization have equivalent associations with transdiagnostic psychopathology in adolescence. Journal of Youth and Adolescence, 49(3), 590604. doi:10.1007/s10964-020-01202-4CrossRefGoogle ScholarPubMed
Forte, A., Orri, M., Turecki, G., Galera, C., Pompili, M., Boivin, M., … Geoffroy, M.-C. (2021). Identifying environmental pathways between irritability during childhood and suicidal ideation and attempt in adolescence: Findings from a 20-year population-based study. Journal of Child Psychology and Psychiatry, and Allied Disciplines. doi:10.1111/jcpp.13411CrossRefGoogle ScholarPubMed
Gaffney, H., Ttofi, M. M., & Farrington, D. P. (2019). Evaluating the effectiveness of school-bullying prevention programs: An updated meta-analytical review. Aggression and Violent Behavior, 45, 111133. doi:10.1016/j.avb.2018.07.001CrossRefGoogle Scholar
Geoffroy, M.-C., Boivin, M., Arseneault, L., Renaud, J., Perret, L. C., Turecki, G., … Côté, S. M. (2018). Childhood trajectories of peer victimization and prediction of mental health outcomes in midadolescence: A longitudinal population-based study. CMAJ: Canadian Medical Association Journal = Journal de l'Association Medicale Canadienne, 190(2), E37E43. doi:10.1503/cmaj.170219CrossRefGoogle ScholarPubMed
Goldbach, J. T., Sterzing, P. R., & Stuart, M. J. (2018). Challenging conventions of bullying thresholds: Exploring differences between Low and high levels of bully-only, victim-only, and bully-victim roles. Journal of Youth and Adolescence, 47(3), 586600. doi:10.1007/s10964-017-0775-4CrossRefGoogle ScholarPubMed
Goldbaum, S., Craig, W. M., Pepler, D., & Connolly, J. (2003). Developmental trajectories of victimization. Journal of Applied School Psychology, 19(2), 139156. doi:10.1300/J008v19n02_09CrossRefGoogle Scholar
Gower, A. L., & Borowsky, I. W. (2013). Associations between frequency of bullying involvement and adjustment in adolescence. Academic Pediatrics, 13(3), 214221. doi:10.1016/j.acap.2013.02.004CrossRefGoogle ScholarPubMed
Hanish, L. D., & Guerra, N. G. (2002). A longitudinal analysis of patterns of adjustment following peer victimization. Development and Psychopathology, 14(1), 6989. doi:10.1017/s0954579402001049CrossRefGoogle ScholarPubMed
Hill, L. S., Reid, F., Morgan, J. F., & Lacey, J. H. (2010). SCOFF, the development of an eating disorder screening questionnaire. The International Journal of Eating Disorders, 43(4), 344351. doi:10.1002/eat.20679Google ScholarPubMed
Hoffman, C. Y., Phillips, M. D., Daigle, L. E., & Turner, M. G. (2016). Adult consequences of bully victimization: Are children or adolescents more vulnerable to the victimization experience? Youth Violence and Juvenile Justice, 15(4), 441464. doi:10.1177/1541204016650004.CrossRefGoogle Scholar
Hong, I. K., Wang, W., Pepler, D. J., & Craig, W. M. (2020). Peer victimization through a trauma lens: Identifying who is at risk for negative outcomes. Scandinavian Journal of Psychology, 61(1), 616. doi:10.1111/sjop.12488CrossRefGoogle ScholarPubMed
Jadambaa, A., Thomas, H. J., Scott, J. G., Graves, N., Brain, D., & Pacella, R. (2019). Prevalence of traditional bullying and cyberbullying among children and adolescents in Australia: A systematic review and meta-analysis. The Australian and New Zealand Journal of Psychiatry, 53(9), 878888. doi:10.1177/0004867419846393CrossRefGoogle Scholar
Jetté, M. (2002). Survey Description and Methodology – Part I – Logistics and Longitudinal Data Collections (No. Vol. 2, No. 1). Québec, Canada: Institut de la statistique du Québec.Google Scholar
Kessler, R. C., Adler, L. A., Ames, M., Demler, O. V., Faraone, S., Hiripi, E., … Walters, E. E. (2005a). The world health organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245256. doi:10.1017/S0033291704002892CrossRefGoogle Scholar
Kessler, R. C., Adler, L. A., Gruber, M. J., Sarawate, C. A., Spencer, T., & Van Brunt, D. L. (2007). Validity of the world health organization adult ADHD self-report scale (ASRS) screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research, 16(2), 5265. doi:10.1002/mpr.208CrossRefGoogle Scholar
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the national comorbidity survey replication (NCS-R). Archives of General Psychiatry, 62(6), 617. doi:10.1001/archpsyc.62.6.617CrossRefGoogle Scholar
Klomek, A. B., Marrocco, F., Kleinman, M., Schonfeld, I. S., & Gould, M. S. (2008). Peer victimization, depression, and suicidiality in adolescents. Suicide & Life-Threatening Behavior, 38(2), 166180. doi:10.1521/suli.2008.38.2.166CrossRefGoogle ScholarPubMed
Kretschmer, T., Barker, E. D., Dijkstra, J. K., Oldehinkel, A. J., & Veenstra, R. (2015). Multifinality of peer victimization: Maladjustment patterns and transitions from early to mid-adolescence. European Child & Adolescent Psychiatry, 24(10), 11691179. doi:10.1007/s00787-014-0667-zCrossRefGoogle ScholarPubMed
Ladd, G. W., Ettekal, I., & Kochenderfer-Ladd, B. (2017). Peer victimization trajectories from kindergarten through high school: Differential pathways for children's school engagement and achievement? Journal of Educational Psychology, 109(6), 826841. doi:10.1037/edu0000177.CrossRefGoogle Scholar
Ladd, G. W., Ettekal, I., & Kochenderfer-Ladd, B. (2019). Longitudinal changes in victimized youth's social anxiety and solitary behavior. Journal of Abnormal Child Psychology, 47(7), 12111223. doi:10.1007/s10802-018-0467-xCrossRefGoogle ScholarPubMed
Ladd, G. W., & Kochenderfer-Ladd, B. (2002). Identifying victims of peer aggression from early to middle childhood: Analysis of cross-informant data for concordance, estimation of relational adjustment, prevalence of victimization, and characteristics of identified victims. Psychological Assessment, 14(1), 7496.CrossRefGoogle ScholarPubMed
McDougall, P., & Vaillancourt, T. (2015). Long-term adult outcomes of peer victimization in childhood and adolescence: Pathways to adjustment and maladjustment. The American Psychologist, 70(4), 300310. doi:10.1037/a0039174CrossRefGoogle ScholarPubMed
McLaughlin, K. A., Colich, N. L., Rodman, A. M., & Weissman, D. G. (2020). Mechanisms linking childhood trauma exposure and psychopathology: A transdiagnostic model of risk and resilience. BMC Medicine, 18(1), 96. doi:10.1186/s12916-020-01561-6CrossRefGoogle ScholarPubMed
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., … Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the national comorbidity study-adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980989. doi:10.1016/j.jaac.2010.05.017CrossRefGoogle Scholar
Modecki, K. L., Minchin, J., Harbaugh, A. G., Guerra, N. G., & Runions, K. C. (2014). Bullying prevalence across contexts: A meta-analysis measuring cyber and traditional bullying. The Journal of Adolescent Health, 55(5), 602611. doi:10.1016/j.jadohealth.2014.06.007CrossRefGoogle ScholarPubMed
Moore, S. E., Norman, R. E., Suetani, S., Thomas, H. J., Sly, P. D., & Scott, J. G. (2017). Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis. World Journal of Psychiatry, 7(1), 6076. doi:10.5498/wjp.v7.i1.60CrossRefGoogle ScholarPubMed
Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ (Clinical Research Ed.), 319(7223), 14671468. doi:10.1136/bmj.319.7223.1467CrossRefGoogle ScholarPubMed
Oncioiu, S. I., Orri, M., Boivin, M., Geoffroy, M.-C., Arseneault, L., Brendgen, M., … Côté, S. M. (2020). Early childhood factors associated with peer victimization trajectories from 6 to 17 years of Age. Pediatrics, 145(5), e20192654. doi:10.1542/peds.2019-2654.CrossRefGoogle ScholarPubMed
Orri, M., Boivin, M., Chen, C., Ahun, M. N., Geoffroy, M.-C., Ouellet-Morin, I., … Côté, S. M. (2020). Cohort profile: Quebec longitudinal study of child development (QLSCD). Social Psychiatry and Psychiatric Epidemiology, 56, 883894. doi:10.1007/s00127-020-01972-z.CrossRefGoogle ScholarPubMed
Plana-Ripoll, O., Musliner, K. L., Dalsgaard, S., Momen, N. C., Weye, N., Christensen, M. K., … McGrath, J. J. (2020). Nature and prevalence of combinations of mental disorders and their association with excess mortality in a population-based cohort study. World Psychiatry, 19(3), 339349. doi:10.1002/wps.20802CrossRefGoogle Scholar
Poulin, C., Hand, D., & Boudreau, B. (2005). Validity of a 12-item version of the CES-D used in the national longitudinal study of children and youth. Chronic Diseases in Canada, 26(2–3), 6572.Google ScholarPubMed
Ranta, K., Kaltiala-Heino, R., Pelkonen, M., & Marttunen, M. (2009). Associations between peer victimization, self-reported depression and social phobia among adolescents: The role of comorbidity. Journal of Adolescence, 32(1), 7793. doi:10.1016/j.adolescence.2007.11.005CrossRefGoogle ScholarPubMed
Reijntjes, A., Kamphuis, J. H., Prinzie, P., Boelen, P. A., van der Schoot, M., & Telch, M. J. (2011). Prospective linkages between peer victimization and externalizing problems in children: A meta-analysis. Aggressive Behavior, 37(3), 215222. doi:10.1002/ab.20374CrossRefGoogle ScholarPubMed
Reijntjes, A., Kamphuis, J. H., Prinzie, P., & Telch, M. J. (2010). Peer victimization and internalizing problems in children: A meta-analysis of longitudinal studies. Child Abuse & Neglect, 34(4), 244252. doi:10.1016/j.chiabu.2009.07.009CrossRefGoogle ScholarPubMed
Rijlaarsdam, J., Cecil, C. A. M., Buil, J. M., van Lier, P. A. C., & Barker, E. D. (2021). Exposure to bullying and general psychopathology: A prospective, longitudinal study. Research on Child and Adolescent Psychopathology, 49(6), 727736. doi:10.1007/s10802-020-00760-2CrossRefGoogle ScholarPubMed
Salmivalli, C., Kärnä, A., & Poskiparta, E. (2011). Counteracting bullying in Finland: The KiVa program and its effects on different forms of being bullied. International Journal of Behavioral Development, 35(5), 405411. doi:10.1177/0165025411407457CrossRefGoogle Scholar
Schaefer, J. D., Moffitt, T. E., Arseneault, L., Danese, A., Fisher, H. L., Houts, R., … Caspi, A. (2018). Adolescent victimization and early-adult psychopathology: Approaching causal inference using a longitudinal twin study to rule out noncausal explanations. Clinical Psychological Science: A Journal of the Association for Psychological Science, 6(3), 352371. doi:10.1177/2167702617741381CrossRefGoogle ScholarPubMed
Schoeler, T., Choi, S. W., Dudbridge, F., Baldwin, J., Duncan, L., Cecil, C. M., … Pingault, J.-B. (2019). Multi-polygenic score approach to identifying individual vulnerabilities associated with the risk of exposure to bullying. JAMA Psychiatry, 76(7), 730738. doi:10.1001/jamapsychiatry.2019.0310.CrossRefGoogle ScholarPubMed
Schoeler, T., Duncan, L., Cecil, C. M., Ploubidis, G. B., & Pingault, J.-B. (2018). Quasi-experimental evidence on short- and long-term consequences of bullying victimization: A meta-analysis. Psychological Bulletin, 144(12), 12291246. doi:10.1037/bul0000171CrossRefGoogle Scholar
Schreier, A., Wolke, D., Thomas, K., Horwood, J., Hollis, C., Gunnell, D., … Harrison, G. (2009). Prospective study of peer victimization in childhood and psychotic symptoms in a nonclinical population at age 12 years. Archives of General Psychiatry, 66(5), 527536. doi:10.1001/archgenpsychiatry.2009.23CrossRefGoogle Scholar
Singham, T., Viding, E., Schoeler, T., Arseneault, L., Ronald, A., Cecil, C. M., … Pingault, J.-B. (2017). Concurrent and longitudinal contribution of exposure to bullying in childhood to mental health: The role of vulnerability and resilience. JAMA Psychiatry, 74(11), 11121119. doi:10.1001/jamapsychiatry.2017.2678CrossRefGoogle ScholarPubMed
Smith, P. K., Talamelli, L., Cowie, H., Naylor, P., & Chauhan, P. (2004). Profiles of non-victims, escaped victims, continuing victims and new victims of school bullying. The British Journal of Educational Psychology, 74(Pt 4), 565581. doi:10.1348/0007099042376427CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 10921097. doi:10.1001/archinte.166.10.1092CrossRefGoogle ScholarPubMed
Stapinski, L. A., Bowes, L., Wolke, D., Pearson, R. M., Mahedy, L., Button, K. S., … Araya, R. (2014). Peer victimization during adolescence and risk for anxiety disorders in adulthood: A prospective cohort study. Depression and Anxiety, 31(7), 574582. doi:10.1002/da.22270CrossRefGoogle ScholarPubMed
Stuart, E. A. (2010). Matching methods for causal inference: A review and a look forward. Statistical Science, 25(1), 121. doi:10.1214/09-STS313CrossRefGoogle Scholar
Ttofi, M. M., Farrington, D. P., & Lösel, F. (2012). School bullying as a predictor of violence later in life: A systematic review and meta-analysis of prospective longitudinal studies. Aggression and Violent Behavior, 17(5), 405418. doi:10.1016/j.avb.2012.05.002CrossRefGoogle Scholar
van der Ploeg, R., Steglich, C., Salmivalli, C., & Veenstra, R. (2015). The intensity of victimization: Associations with children's psychosocial well-being and social standing in the classroom. PLoS ONE, 10(10), e0141490. doi:10.1371/journal.pone.0141490.CrossRefGoogle ScholarPubMed
van Geel, M., Vedder, P., & Tanilon, J. (2014). Relationship between peer victimization, cyberbullying, and suicide in children and adolescents: A meta-analysis. JAMA Pediatrics, 168(5), 435442. doi:10.1001/jamapediatrics.2013.4143CrossRefGoogle ScholarPubMed
Weye, N., Momen, N. C., Christensen, M. K., Iburg, K. M., Dalsgaard, S., Laursen, T. M., … Plana-Ripoll, O. (2020). Association of specific mental disorders with premature mortality in the Danish population using alternative measurement methods. JAMA Network Open, 3(6), e206646. doi:10.1001/jamanetworkopen.2020.6646CrossRefGoogle ScholarPubMed
World Health Organization (2001). AUDIT: The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Retrieved from https://apps.who.int/iris/handle/10665/67205.Google Scholar
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