Substance use and eating patterns of female adolescent students

Introduction: The problems of smoking and/or drinking among female adolescents come to the front as a serious social problem, as the rate of occurrence of these behaviors among female adolescents is on the increase. Substance use disorders and eating disorders frequently co-occur in the presence of other psychiatric disorders. Although this co-occurrence suggests the possibility of shared factors in the etiology of these two problems, research to date has not established such links. Regardless of the meaning of the association, the reality that substance use disorders and eating disorders frequently co-occur has important implications for assessment, treatment, and future research, especially for female adolescents.

Objectives: The first objective of this research was to estimate the rates of smoking and drinking problems among female adolescent students and the second was to examine their association with psychopathologies and eating behaviors.

Methods: We surveyed 861 female adolescents, 405 students in the 8th grade of one middle school and 456 students in the 10th grade from two high schools in Wonju, South Korea. Each student completed a questionnaire that consisted of demographic data, parental monitoring, her attitude toward her parents (CATP), her own attitude toward alcohol, tobacco, and foods, BMI, and the difference between perceived and ideal body images (DoBI). The TFEQ (Three Factor Eating Questionnaire) for eating patterns and the self-report version of SDQ (Strengths and Difficulties Questionnaire-self report) for psychopathology were also administered.

Results: 1) For the 8th graders, the prevalence of smoking and drinking were 8.6% and 18.4%, respectively. These prevalences were 14% and 48.3% correspondingly in the 10th graders (Table 1). 2) Female adolescents with smoking and/or drinking habits, except for the 10th graders with smoking, showed inattention-hyperactivity and conduct problems more frequently than the students without substance use habits. 3) The 10th graders who reported drinking had eating patterns characterized by dietary restraints, and the 8th graders with drinking problems showed disinhibition of eating patterns (Table 2). 4) The female adolescents with a high score in the difference between perceived and ideal body image showed inattention-hyperactivity and emotional problems more frequently (Table 3).

Conclusions: From these results, we suggest that middle-school girls may start smoking to reduce their weight. The lower the disinhibition score is, the higher the risk of smoking and drinking. For the high-school girls, the lower the dietary restraint score is, the higher the risk of drinking. In conclusion, smoking and drinking behaviors are closely related to externalizing problems such as inattention-hyperactivity and conduct problems and eating behavior is mainly related to drinking rather than smoking. The association of eating behavior and drinking is likely correlated through the medium of various psychopathologies.