Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-26T17:52:24.656Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender differences in emotional and behavioral disorders and service use among adolescent smokers: A nationwide Israeli study

Published online by Cambridge University Press:  15 April 2020

G. Shoval ,
I. Mansbach-Kleinfeld ,
I. Farbstein ,
R. Kanaaneh ,
A. Valevski ,
A. Apter ,
A. Weizman  and
G. Zalsman
G. Shoval*
Affiliation:
Adolescent Day Unit, Geha Mental Health Center, 1, Helsinki street, P.O. Box 102, 49100Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
I. Mansbach-Kleinfeld
Affiliation:
Mental Health Services, Ministry of Health, Jerusalem, Israel
I. Farbstein
Affiliation:
Child and Adolescent Psychiatry, Ziv Hospital, Safed, Israel
R. Kanaaneh
Affiliation:
Child and Adolescent Psychiatry, Ziv Hospital, Safed, Israel
A. Valevski
Affiliation:
Adolescent Day Unit, Geha Mental Health Center, 1, Helsinki street, P.O. Box 102, 49100Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
A. Apter
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Schneider Center for Children in Israel, Petach Tiqva, Israel
A. Weizman
Affiliation:
Adolescent Day Unit, Geha Mental Health Center, 1, Helsinki street, P.O. Box 102, 49100Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
G. Zalsman
Affiliation:
Adolescent Day Unit, Geha Mental Health Center, 1, Helsinki street, P.O. Box 102, 49100Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, USA
*
*Corresponding author. Tel.: +972 3 925 8440; fax: +972 3 925 8276. E-mail address:shovgal@tau.ac.il (G. Shoval).
Get access

Abstract

Marked gender differences have been identified in cigarette smoking. In this study, we aimed to identify the gender-specific emotional and behavioral disorders among adolescent smokers and their consequent utilization of mental health services. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA) Inventory. Levels of emotional and behavioral difficulties were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Mental health services use and smoking habits were also assessed. Among non-smoker adolescents there were significant gender differences in almost all SDQ scales: emotional problems, pro-social, hyperactivity/inattention and conduct problems, whereas in the smoker group there was a difference only in the SDQ emotional problems scale (both self- and maternal-rated, P < 0.001 and P = 0.002, respectively). Only marginal difference was noted between males and females in help-seeking for emotional or behavioral problems. Over 50% of both male and female smokers in the study had untreated mental disorders (non-significant gender difference). The well-established gender differences in psychiatric symptomatology narrowed markedly in adolescent smokers; the typical gender difference in disruptive behaviors was lost in the adolescent smoking population. The implications of these findings are particularly relevant to developing more effective gender-specific programs to prevent youth smoking, to facilitate quitting and prepare primary care practitioners to identify mental disorders and behavioral problems in adolescents with a smoking history.

Keywords

SmokingDepressionAdolescentServicesSubstance abuseGender
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 7 , September 2013 , pp. 397 - 403
Copyright
Copyright © European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders text revision (DSM-IV-TR). IV-TR ed.Washington, DC: American Psychiatric Press; 2000.CrossRefGoogle Scholar
Berlin, I, Singleton, EG, Pedarriosse, AM, Lancrenon, S, Rames, A, Aubin, HJ, et al.The modified reasons for smoking scale: factorial structure, gender effects and relationship with nicotine dependence and smoking cessation in French smokers. Addiction 2003;98:1575–1583.CrossRefGoogle ScholarPubMed
Bronisch, T, Hofler, M, Lieb, RSmoking predicts suicidality: findings from a prospective community study. J Affect Disord 2008;108:135–145.CrossRefGoogle ScholarPubMed
Brown, RA, Lewinsohn, PM, Seeley, JR, Wagner, EFCigarette smoking, major depression, and other psychiatric disorders among adolescents. J Am Acad Child Adolesc Psychiatry 1996;35:1602–1610.CrossRefGoogle ScholarPubMed
Clayton, SGender differences in psychosocial determinants of adolescent smoking. J Sch Health 1991;61:115–120.CrossRefGoogle ScholarPubMed
Costello, EJ, Erkanli, A, Federman, E, Angold, ADevelopment of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex. J Clin Child Psychol 1999;28:298–311.CrossRefGoogle ScholarPubMed
Dierker, LC, Avenevoli, S, Merikangas, KR, Flaherty, BP, Stolar, MAssociation between psychiatric disorders and the progression of tobacco use behaviors. J Am Acad Child Adolesc Psychiatry 2001;40:1159–1167.CrossRefGoogle ScholarPubMed
DiFranza, JR, Savageau, JA, Rigotti, NA, Fletcher, K, Ockene, JK, McNeill, AD, et al.Development of symptoms of tobacco dependence in youths: 30-month follow-up data from the DANDY study. Tob Control 2002;11:228–235.CrossRefGoogle ScholarPubMed
DiFranza, JR, Savageau, JA, Fletcher, K, Ockene, JK, Rigotti, NA, McNeill, AD, et al.Measuring the loss of autonomy over nicotine use in adolescents: the DANDY (development and assessment of nicotine dependence in youths) study. Arch Pediatr Adolesc Med 2002;156:397–403.CrossRefGoogle ScholarPubMed
Dirocco, DN, Shadel, WGGender differences in adolescents’ responses to themes of relaxation in cigarette advertising: relationship to intentions to smoke. Addict Behav 2007;32:205–213.CrossRefGoogle Scholar
Eggert, LL, Seyl, CD, Nicholas, LJEffects of a school-based prevention program for potential high school dropouts and drug abusers. Int J Addict 1990;25:773–801.Google ScholarPubMed
Farbstein, I, Mansbach-Kleinfeld, I, Levinson, D, Goodman, R, Levav, I, Vograft, I, et al.Prevalence and correlates of mental disorders in Israeli adolescents: results from a national mental health survey. J Child Psychol Psychiatry 2010;51:630–639.CrossRefGoogle ScholarPubMed
Flisher, AJ, Kramer, RA, Hoven, CW, King, RA, Bird, HR, Davies, M, et al.Risk behavior in a community sample of children and adolescents. J Am Acad Child Adolesc Psychiatry 2000;39:881–887.CrossRefGoogle Scholar
Goodman, RThe extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999;40:791–799.CrossRefGoogle ScholarPubMed
Goodman, R, Ford, T, Richards, H, Gatward, R, Meltzer, HThe development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 2000;41:645–655.CrossRefGoogle ScholarPubMed
Hoffman, BR, Sussman, S, Unger, JB, Valente, TWPeer influences on adolescent cigarette smoking: a theoretical review of the literature. Subst Use Misuse 2006;41:103–155.CrossRefGoogle ScholarPubMed
Hu, TW, Lin, Z, Keeler, TETeenage smoking, attempts to quit, and school performance. Am J Public Health 1998;88:940–943.CrossRefGoogle ScholarPubMed
Hughes, JR, Keely, J, Naud, SShape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004;99:29–38.CrossRefGoogle ScholarPubMed
Kerr, DC, Owen, LD, Capaldi, DMThe timing of smoking onset, prolonged abstinence, and relapse in men: a prospective study from ages 18 to 32 years. Addiction 2011.Google ScholarPubMed
Leaf, PJ, Alegria, M, Cohen, P, Goodman, SH, Horwitz, SM, Hoven, CW, et al.Mental health service use in the community and schools: results from the four-community MECA study. Methods for the epidemiology of child and adolescent mental disorders study. J Am Acad Child Adolesc Psychiatry 1996;35:889–897.CrossRefGoogle ScholarPubMed
Leventhal, AM, Waters, AJ, Boyd, S, Moolchan, ET, Lerman, C, Pickworth, WBGender differences in acute tobacco withdrawal: effects on subjective, cognitive, and physiological measures. Exp Clin Psychopharmacol 2007;15:21–36.CrossRefGoogle ScholarPubMed
Malmberg, K, Edbom, T, Wargelius, HL, Larsson, JOPsychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers. Acta Paediatr 2011.CrossRefGoogle ScholarPubMed
Mansbach-Kleinfeld, I, Farbstein, I, Levinson, D, Apter, A, Erhard, R, Palti, H, et al.Service use for mental disorders and unmet need: results from the Israel survey on mental health among adolescents. Psychiatr Serv 2010;61:241–249.CrossRefGoogle ScholarPubMed
Mansbach-Kleinfeld, I, Levinson, D, Farbstein, I, Apter, A, Levav, I, Kanaaneh, R, et al.The Israel survey of mental health among adolescents: aims and methods. Isr J Psychiatry Relat Sci 2010;47:244–253.Google ScholarPubMed
Mansbach-Kleinfeld, I, Apter, A, Farbstein, I, Levine, S, Ponizovsky, AA population-based psychometric validation study of the Strengths and Difficulties Questionaire - Hebrew version. Front Psychiatry 2010;1:1–12.Google Scholar
Mansbach-Kleinfeld, I, Palti, H, Ifrah, A, Levinson, D, Farbstein, IMissed chances: primary care practitioners’ opportunity to identify, treat and refer adolescents with mental disorders. Isr J Psychiatry Relat Sci 2011;48:150–156.Google ScholarPubMed
Merikangas, KR, He, JP, Burstein, M, Swanson, SA, Avenevoli, S, Cui, L, et al.Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 2010;49:980–989.CrossRefGoogle Scholar
Merikangas, KR, He, JP, Brody, D, Fisher, PW, Bourdon, K, Koretz, DSPrevalence and treatment of mental disorders among US children in the 2001-2004 NHANES. Pediatrics 2010;125:75–81.Google ScholarPubMed
Moolchan, ET, Ernst, M, Henningfield, JEA review of tobacco smoking in adolescents: treatment implications. J Am Acad Child Adolesc Psychiatry 2000;39:682–693.CrossRefGoogle ScholarPubMed
Nichter, M, Nichter, M, Vuckovic, N, Quintero, G, Ritenbaugh, CSmoking experimentation and initiation among adolescent girls: qualitative and quantitative findings. Tob Control 1997;6:285–295.CrossRefGoogle ScholarPubMed
Perkins, KA, Donny, E, Caggiula, ARSex differences in nicotine effects and self-administration: review of human and animal evidence. Nicotine Tob Res 1999;1:301–315.CrossRefGoogle ScholarPubMed
Pirie, PL, Murray, DM, Luepker, RVSmoking prevalence in a cohort of adolescents, including absentees, dropouts, and transfers. Am J Public Health 1988;78:176–178.CrossRefGoogle Scholar
Richardson, CG, Memetovic, J, Ratner, PA, Johnson, JLExamining gender differences in emerging tobacco use using the adolescents’ need for smoking scale. Addiction 2011;106:1846–1854.CrossRefGoogle ScholarPubMed
Riggs, PD, Mikulich, SK, Whitmore, EA, Crowley, TJRelationship of ADHD, depression, and non-tobacco substance use disorders to nicotine dependence in substance-dependent delinquents. Drug Alcohol Depend 1999;54:195–205.CrossRefGoogle ScholarPubMed
Robinson, JD, Cinciripini, PM, Tiffany, ST, Carter, BL, Lam, CY, Wetter, DWGender differences in affective response to acute nicotine administration and deprivation. Addict Behav 2007;32:543–561.CrossRefGoogle ScholarPubMed
Sawyer, MG, Arney, FM, Baghurst, PA, Clark, JJ, Graetz, BW, Kosky, RJ, et al.The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being. Aust N Z J Psychiatry 2001;35:806–814.CrossRefGoogle ScholarPubMed
Schmid, HPredictors of cigarette smoking by young adults and readiness to change. Subst Use Misuse 2001;36:1519–1542.CrossRefGoogle ScholarPubMed
Sourander, A, Multimaki, P, Santalahti, P, Parkkola, K, Haavisto, A, Helenius, H, et al.Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study. J Am Acad Child Adolesc Psychiatry 2004;43:1250–1258.Google ScholarPubMed
Tabenkin, H, Gross, RThe role of the primary care physician in the Israeli health care system as a “gatekeeper”--the viewpoint of health care policy makers. Health Policy 2000;52:73–85.CrossRefGoogle ScholarPubMed
Thorner, ED, Jaszyna-Gasior, M, Epstein, DH, Moolchan, ETProgression to daily smoking: is there a gender difference among cessation treatment seekers? Subst Use Misuse 2007;42:829–835.CrossRefGoogle Scholar
Tishby, O, Turel, M, Gumpel, O, Pinus, U, Lavy, SB, Winokour, M, et al.Help-seeking atititudes among Israeli adolescents. Adolescence 2001;36:249–264.Google ScholarPubMed
Tucker, JS, Ellickson, PL, Klein, DJSmoking cessation during the transition from adolescence to young adulthood. Nicotine Tob Res 2002;4:321–332.Google ScholarPubMed
Upadhyaya, HP, Deas, D, Brady, KT, Kruesi, MCigarette smoking and psychiatric comorbidity in children and adolescents. J Am Acad Child Adolesc Psychiatry 2002;41:1294–1305.CrossRefGoogle ScholarPubMed
Verhulst, FC, Achenbach, TM, Ferdinand, RF, Kasius, MCEpidemiological comparisons of American and Dutch adolescents’ self-reports. J Am Acad Child Adolesc Psychiatry 1993;32:1135–1144.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.