Violência familiar e consumo de álcool: um cenário de vulnerabilidades em adolescentes escolares.

Abstract

The main objective of this thesis is to evaluate the relationship between family violence suffered in childhood and adolescence (FVCA) and alcohol abuse among school adolescents. Its specific objectives are: a) to present a predictive model of situations of alcohol abuse among school adolescents (Article 1); and (b) to assess the repercussions of family physical violence in childhood and adolescence (FPVCA) on alcohol abuse (AA) among adolescents, exploring whether common metal disorders (CMDs) are mediators of these relationships and whether the paths between FPVCA and AA among adolescents are between boys and girls (Article 2). The research is a subproject of the Longitudinal Study of Nutritional Evaluation of Adolescents (ELANA), which began in 2010 and followed in the subsequent three years two teenage cohorts of two public schools and four private schools in the metropolitan region of Rio de Janeiro. The information was obtained through a self fillable questionnaire. A total of 785 second-year high school students (99.5% of the eligible students) who participated in ELANA's second wave (2011) were interviewed. The Childhood Trauma Questionnaire (CTQ), Conflict Tatics Scale Form (CTS-1), Alcohol Use Disorder Identification Test (AUDIT) and General Health Questionnaire (GHQ) were used to assess the occurrence of family violence suffered in childhood (FVC), family violence adolescents (FVA), the AA and the CMD, respectively. The logit model was used to evaluate prevalence projections in the article that presents a predictive model of situations of alcohol misuse among adolescents. The Path Analysis, via multi-group model, was the analytical strategy to explore the pathways between exposures and outcomes postulated in the Directed Acyclic Diagram (DAG) proposed in article 2. The results of article 1 indicate that 25.5% of adolescents interviewed were classified as suspected cases of alcohol abuse. Being male, aged between 17 and 19 years, not living with the mother, presenting symptoms suggestive of binge eating, having used a strategy of weight reduction in the last 3 months and being a victim of family violence were predictors of alcohol abuse. While the prevalence of alcohol abuse projected by the model in the absence of these characteristics was 8%, in the presence of the same it reaches 68%. The results of the second article indicate that FPVCA are important risk factors for alcohol consumption and for CMD among girls, either directly (FVC) or indirect (FVA). Already among boys, the violence did not lead to these outcomes. In this group, not residing with the mother and being older are the main risk factors for abusive alcohol consumption. It is hoped that the dissemination of the findings of this thesis will contribute to the early detection and tracing of positive AA among adolescents cases and the establishment of interventions that reduce this consumption and so that FFVCA's confrontation gains more space in the public health field, an improvement in the quality of life of adolescents. : Alcohol abuse. Violence. Family violence against children. Family violence against adolescentes. Adolescence. Predictive Model. Pathway analysis.