title: Do causes of stress differ in their association with problem drinking by sex in Korean adolescents?
abstract: Previous studies have focused mainly on whether stress causes present drinking or excessive drinking. However, few studies have been conducted on the relationship between stress and problem drinking in adolescents. The objective of this study was to examine the stress level and the cause of stress related to problem drinking behavior according to sex among Korean youth.
  
  
  
  Data for this study were pooled from cross-sectional data collected annually from 2007 through 2012 from the Korea Youth Risk Behavior Web-based Survey. A representative sample of 442,113 students from 800 randomly selected middle and high schools in Korea were included. Multiple logistic regression models were used in the analysis.
  
  
  
  Both male and female students with extremely high stress were more likely to engage in problem drinking than were students with no stress (odds ratios [OR], 1.73 in males and 1.41 in females). The major causes of stress in male students that were associated with problem drinking were conflict with a teacher, trouble with parents, and peer relationships (ORs, 2.47, 1.72, and 1.71, respectively), whereas there are no statistically significant association between causes of stress and problem drinking among female students. Considering stress level, Male students with extremely high stress level were associated with problem drinking regardless of causes of stress, while Female students who felt extremely high levels of stress were more likely to engage in problem drinking due to stress from a conflict with parents, peer relationships, appearance, and financial difficulty (ORs, 1.53, 1.53, 1.46, and 1.47, respectively).
  
  
  
  Adolescents who engage in problem drinking may be affected by different causes of stress according to sex. Thus, appropriate approaches that reflect sex differences will be helpful to alleviate problem drinking in adolescents and educational authorities need to arrange more effective education program for drinking given positive associations between drinking education and problem drinking.
authors: Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jae-Woo
authors: JW
authors: Choi
authors: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors: Eun-Cheol
authors: EC
authors: Park
authors: Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jae-Hyun
authors: JH
authors: Kim
authors: Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, South Korea. Electronic address: soheepark@yuhs.ac.
authors: So-Hee
authors: SH
authors: Park
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology; D012309:Risk-Taking; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D000066608:Underage Drinking / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Adolescent; Problem drinking; Sex; Stress