title: Predictors of binge drinking in adolescents: ultimate and distal factors - a representative study.
abstract: BACKGROUND
  As epidemiological surveys have shown, binge drinking is a constant and wide-spread problem behavior in adolescents. It is not rare to find that more than half of all adolescents engage in this behavior when assessing only the last 4 weeks of time independent of the urbanity of the region they live in. There have been several reviews on predictors of substance consumption in adolescents in general, but there has been less high quality research on predictors of binge drinking, and most studies have not been theoretically based. The current study aimed to analyze the ultimate and distal factors predicting substance consumption according to Petraitis' theory of triadic influence. We assessed the predictive value of these factors with respect to binge drinking in German adolescents, including the identification of influence direction.
  
  
  METHODS
  In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was carried out (net sample). The return rate of questionnaires was 88% regarding all students whose teachers or school directors had agreed to participate in the study. In this survey, prevalence of binge drinking was investigated as well as potential predictors from the social/interpersonal, the attitudinal/environmental, and the intrapersonal fields (3 factors of Petraitis). In a multivariate logistic regression analysis, these variables were included after testing for multicollinearity in order to assess their ability to predict binge drinking.
  
  
  RESULTS
  Prevalence of binge drinking in the last 30 days was 52.3% for the surveyed adolescents with a higher prevalence for boys (56.9%) than for girls (47.5%). The two most influential factors found to protect against binge drinking with p < .001 were low economic status and importance of religion. The four most relevant risk factors for binge drinking (p < .001) were life-time prevalence of school absenteeism/truancy, academic failure, suicidal thoughts, and violence at school in the form of aggressive behavior of teachers. The model of Petraitis was partly confirmed for Binge Drinking in German adolescents and the direction of influence factors was clarified.
  
  
  CONCLUSIONS
  Whereas some of the risk and protective factors for binge drinking are not surprising since they are known for substance abuse in general, there are two points that could be targeted in interventions that do not focus on adolescents alone: (a) training teachers in positive, reassuring behavior and constructive criticism and (b) a focus on high risk adolescents either because they have a lack of coping strategies when in a negative mood or because of their low academic achievement in combination with absenteeism from school.
authors.affiliation: Department Medical Psychology and Medical Sociology, Psychiatric University Hospital Erlangen (Friedrich-Alexander-Universität Erlangen-Nürnberg), Schwabachanlage 6, 91054 Erlangen, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Donath
authors.forename: Elmar
authors.initials: E
authors.lastname: Grässel
authors.forename: Dirk
authors.initials: D
authors.lastname: Baier
authors.forename: Christian
authors.initials: C
authors.lastname: Pfeiffer
authors.forename: Stefan
authors.initials: S
authors.lastname: Bleich
authors.forename: Thomas
authors.initials: T
authors.lastname: Hillemacher
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology*; D003625:Data Collection; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D000431:Ethanol