title: Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes.
abstract: OBJECTIVE
  To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent.
  
  
  METHODS
  We analysed data on a representative sample of Slovak adolescents 8502 adolescents (mean age 13.21, 49.4 % boys) from the 2014 Health Behaviour in School-aged Children cross-sectional study. We assessed the associations of alcohol and energy drinks consumption with negative outcomes and their potential synergy, as measured by the synergy index (SI).
  
  
  RESULTS
  Adolescents consuming both alcohol and energy drinks were at higher risk of negative behavioural outcomes than their peers who drank only alcohol or energy drinks or were non-consumers. Consumers of alcohol and energy drinks were highly prone to be involved in fighting-the joint association of alcohol and energy drinks consumption was greater than sum of its associations separately in relation to fighting (SI 1.49; 95 % confidence interval 1.03-2.16).
  
  
  CONCLUSIONS
  Preventive strategies should aim at increasing awareness of negative behavioural outcomes-especially aggressive behaviour associated with alcohol and energy drinks consumption among young adolescents.
authors.affiliation: Department of Health Psychology, Faculty of Medicine, Graduate School Kosice Institute for Society and Health, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia. jana.holubcikova@upjs.sk.|Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia. jana.holubcikova@upjs.sk.
authors.forename: Jana
authors.initials: J
authors.lastname: Holubcikova
authors.affiliation: Department of Health Psychology, Faculty of Medicine, Graduate School Kosice Institute for Society and Health, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.|Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.|Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.
authors.forename: Peter
authors.initials: P
authors.lastname: Kolarcik
authors.affiliation: Department of Health Psychology, Faculty of Medicine, Graduate School Kosice Institute for Society and Health, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.|Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.|Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Madarasova Geckova
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Clinical Educational Bases in Associated Hospitals, P. J. Safarik University, Kosice, Slovakia.
authors.forename: Eva
authors.initials: E
authors.lastname: Joppova
authors.affiliation: Department of Health Psychology, Faculty of Medicine, Graduate School Kosice Institute for Society and Health, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.|Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.|Department of Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
authors.affiliation: Department of Health Psychology, Faculty of Medicine, Graduate School Kosice Institute for Society and Health, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.|Department of Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D061215:Energy Drinks / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D000066553:Problem Behavior; D012306:Risk; D057566:Self Report; D018154:Slovakia
keywords: Alcohol; Energy drinks; Negative behavioural outcomes; Young adolescents