ABSTRACT
This study looked at how drinking and losing control affected teenagers' anxiety levels. A review of pertinent theoretical, conceptual, and empirical literature was conducted. The findings showed that alcohol had a considerable impact on teenagers' anxiety levels. The study's conclusion also shows that teenagers' anxiety levels are significantly impacted by a lack of control. The study's conclusions also show that teenage alcohol use might contribute to social issues like fighting or disengagement from peer activities. The study's conclusion also shows that drinking alcohol makes people feel uneasy because it makes them lose their sense of self. The study's findings show that teenage alcohol consumption and loss of control anxiety levels have a substantial combined effect. As a result, it was established that teenage anxiety levels are considerably affected by alcohol usage and loss of control. It was suggested that parents educate their children about the dangers of alcohol drinking in order to minimise their usage.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
The most common psychological disorders that have been found to be comorbid with alcohol-dependence include anxiety (Lechner et al., 2014; Pacek et al., 2013). Research into the relationship between anxiety has generated important albeit mixed findings (Grant et al., 2017; Schmidt et al, 2019). Anxiety and alcohol problems are common and costly among adolescents (Kessler et al., 2019). They can cause huge suffering to individuals and their families, by impacting work, relationships, and health (Whiteford et al., 2015; WHO, 2018). Anxiety and alcohol problems are also costly to society more widely, for example through loss of productivity, and the economic burden on health and social care services (Gustavsson et al., 2017).
Anxiety disorders are psychiatric disorders characterised by excessive fear, maladaptive manifestations of anxiety and related behavioural disturbances (DSM 5, 2019; Raymond et al., 2017). There are 11 types of anxiety disorder that feature in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition): generalised anxiety disorder (GAD), social anxiety disorder (previously social phobia), panic disorder, separation anxiety disorder, specific phobia, selective mutism, agoraphobia, substance/medication-induced anxiety disorder, anxiety disorder due to another medical condition, other specified anxiety disorder, and unspecified anxiety disorder (DSM-5, 2019).Key diagnostic criteria for GAD, for example, are excessive anxiety and uncontrollable worry on most days for a period of six months, about several events and activities, and at least three somatic symptoms such as restlessness, muscle tension, and sleep disturbance (Reynolds & Kamphaus, 2018). There is debate about this categorical classification system; others have advocated a dimensional approach (Insel et al., 2018). If state anxiety, trait anxiety, and each anxiety disorder are considered distinct, their associations with alcohol outcomes may be different.
Prevalence estimates vary according to country, gender, type of anxiety, and duration over which symptoms are counted (Evans et al., 2015). Lifetime and 12-month worldwide prevalence estimates of anxiety disorders range between 5-25% and 3-20%, respectively (Kessler et al., 2019). One systematic review estimated the global average prevalence of anxiety disorders at 7% (5-11%), when adjusting for methodological differences (Baxter et al., 2018). The authors also reported that prevalence estimates were lowest in African cultures at 5% (4-8%) and highest in Euro/Anglo cultures (typically Western European, North American and Australasian populations) at 10% (7-16%) (Baxter et al., 2018).
According to the most recent Adult Psychiatric Morbidity Survey in 2014, around one in six adults surveyed in England (17%) met the criteria for a common mental disorder (CMD) (McManus et al., 2016). CMDs include GAD, depression, specific phobias, social phobia, obsessive compulsive disorder, panic disorder, and CMD not otherwise specified. Prevalence rates were higher in women (one in five) compared to men (one in eight). These rates have increased in women but have remained stable in men, since 2000 (McManus et al., 2016).Because of their high prevalence and chronicity, anxiety disorders are costly to the individual and society more widely.Anxiety disorders account for 15% of disability adjusted life years (DALYs) and years lived with a disability caused by mental and substance use disorders, second only to depression (Whiteford et al., 2013). Anxiety disorders also account for 1.1% of the global burden of disease worldwide (26.8 million DALYs) (Whiteford et al., 2015). Many factors have been reported toinfluence the development and course of anxiety, such as genetics, personality, environment, life events, and treatment (Hovenkamp-Hermelink et al., 2021;Kendler, 2019). For this study, alcohol use and loss of control will be examined.
Alcohol use is also heterogeneous. It can be broadly categorised into three types: level of use, binge drinking, and alcohol use disorders (AUDs). Level of use includes constructs related to frequency and quantity of alcohol use (e.g., units per week). Binge drinking refers to high consumption in a single episode that raises an individual’s risk of harm on that occasion (NHS, 2019). In the UK, binge drinking is classed as more than eight units for men and more than six units for women (NHS,2019). AUD is a chronic, medically diagnosed, severe form of problem drinking (NIH, 2019a). Key diagnostic criteria for AUD include compulsive alcohol consumption, loss of control over drinking, and a negative emotional state when not drinking (NIH, 2019a).Alcohol is one of the world’s most ubiquitous drugs (WHO, 2018). As with anxiety, prevalence estimates vary according to country, gender, age, type of alcohol use, and duration over which symptoms are counted. Globally, one in five adults report heavy episodic drinking (≥7 units) in any month (Peacock et al., 2018). Europe has the highest rates of heavy alcohol consumption (46%), whereas North Africa and the Middle East (15%) have the lowest rates of heavy alcohol consumption (Peacock et al., 2018).Since 2000, hazardous drinking has declined in males but remains higher than in women, and rates of harmful or dependent drinking have remained stable (McManus et al., 2016). The prevalence of alcohol consumption has declined in the last 10 years in England. Reported alcohol use in the previous week has dropped from 65% in 2007 to 58% in 2017 (NHS digital, 2018). Binge drinking rates have dropped from 20% in 2007 to 15% in 2017, a change seen in 16-24- and 25–44-year-olds but not in older age groups (45–64-year-olds and the over 65s) (NHS digital, 2018).
Research suggests anxiety disorders and AUDs are comorbid. People with comorbid internalising and AUDs experience more severe behavioural problems (Salom et al., 2014), greater levels of impairment, and use services at a higher rate (Prior et al., 2017), compared to people with only one disorder. Comorbidity tends to be higher in clinical studies with treatment-seeking samples than in epidemiological studies with community-based samples. For example, research with clinical samples suggests that 16-25% of patients with anxiety disorders also have comorbid alcohol problems, and 30-44% of patients with AUDs experience anxiety or mixed anxiety/depression symptoms (Kushner et al., 2000a). In the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), 33% of individuals who had sought treatment for AUD had at least one independent anxiety disorder, and 15-22% of individuals who had sought treatment for an independent anxiety disorder had a comorbid substance use disorder, primarily AUD (Grant et al., 2014).One explanation for the discrepancy between results with clinical and community samples is that anxiety needs to be severe for it to be associated with alcohol problems (or vice versa) (Sher & Grekin, 2015). Alternatively, there may be limitations associated with treatment-seeking samples such as lack of generalizability to the wider population (Turner et al., 2018), and treatment-seeking biases.
Furthermore, the ability to control and regulate impulses, desires, wishes, emotions, and other behaviors is a core feature of the self (Kim, Richard &Oldehinkel, 2022). In fact, many vital functions of the selfinvolve regulation, such as making decisions, inhibiting and initiating behavior, taking responsibility, and making and carrying out plans (Van Heel et al., 2020). As a result, exerting self-control can improve health (e.g., eating healthier, exercising), decision-making, academic achievement, and job/career performance. For instance, Situ, Li, Dou&Wang (2021) showed that poor self-control has been linked to a failure to set and/or accomplish goals, failure to delay gratification, self-handicapping and procrastination, overeating, gambling, and alcohol and drug abuse. Research has also shown that self-regulation is a particularly important aspect of social relationships. For instance, Situ, Li, Dou & Wang (2021) found that self-control was positively related to a secure attachment style. Higher self-control is also related to better interpersonal accommodation, greater romantic relationship satisfaction, and a greater likelihood of having a constructive response to conflict with a romantic partner (Finkel & Campbell, 2016). Those with greater self-control also show less conflict and more cohesion with family members (Li et al., 2019). In addition, those who exert self-control tend to gain social acceptance from others, whereas those who do not tend to be socially rejected and ostracized by their peers (e.g., Ferrer & Krantz, 2014). These findings suggest that low self-control is a significant risk factor for a wide range of individual and interpersonal difficulties. Low self-control therefore increases susceptibility to a myriad of problems. Self-control appears to diminish with use, however. When one exerts regulatory control on one task, that person will exhibit reduced self-control on a subsequent task due to depleted self-control resources (Paige, Meisel& Colder, 2019). According to the process model of self-control (Inzlicht& Schmeichel, 2012), this effect is driven by two processes, motivation and attention. When people engage in tasks requiring self-control, they experience reduced motivation to exert self-control on subsequent tasks and experience increased motivation to act on impulses. In addition, engaging in self-control reduces attention to cues signaling the need for self-control and increases attention toward cues signaling possible rewards. Despite researchers have reported that alcohol use comorbid with anxiety disorders, there is still a dearth in literature that reported the how alcohol use and loss of control affect the anxiety among adolescents.
1.2 Statement of the Problem
Few observations in psychiatry have been documented as long and as consistently as the association between anxiety (and general negative affect) and the chronic misuse of alcohol (Ankel& Kushner, 2019). Research has shown that up to 50% of individuals receiving treatment for problematic alcohol use also met diagnostic criteria for one or more anxiety disorders (Lees, Mewton, Stapinski, Squeglia, Rae&Teesson, 2019). Alcohol and loss of control are now known to be the most common causes of psychiatric disorders among adolescents, with a lifetime prevalence of approximately 30% and a chronic course into adulthood if not treated (Romer, Reyna & Satterthwaite, 2017). Adolescent alcohol use is a critical public health concern; accordingly, a considerable body of work exists identifying developmentally salient risk and protective factors (Lees et al., 2019). One area receiving increasing attention among adults is the linkage between specific constellations of anxiety psychopathology and alcohol use problems (Romer, Reyna & Satterthwaite, 2017). Despite reports showing that anxiety disorders are among the leading causes of disability and associated with high societal costs, they frequently remain undetected and untreated in primary and mental health care (Ewing, Sakhardande, & Blakemore, 2014). Hence this study will examine the effects of alcohol and loss of control on anxiety level of adolescents.
1.3 Research Question
The following questions guided this study;
1.4 Objectives of the Study
The major aim of the study is to examine the effects of alcohol and loss of control on anxiety level of adolescents. Other specific objectives of the study include;
1.5 RESEARCH HYPOTHESES
Hypothesis One
H0: There is no significant effect of alcohol use on anxiety level of adolescents.
H1: There is a significant effect of alcohol use on anxiety level of adolescents.
Hypothesis Two
H0: There is no significant effect of loss of control on anxiety level of adolescents.
H1: There is a significant effect of loss of control on anxiety level of adolescents.
Hypothesis Three
H0: There is no significant joint effect of alcohol use and loss of control on level of anxiety among adolescents.
H1: There is a significant joint effect of alcohol use and loss of control on level of anxiety among adolescents
1.6 Significance of the Study
This study will be of significance in that it will help the general populace, researchers, psychologists and students to know if social alienation and leisure boredom as factors influencing alcohol use among undergraduates.
The study is restricted to the effects of alcohol and loss of control on anxiety level of adolescents. Participants from this study will be made of secondary school students which will be gotten from three secondary school in Ogun State, Nigeria.
Anxiety: is defined as “a painful or apprehensive uneasiness of mind usually over an impending or anticipated ill” (Merriam-Webster, 2012).
Alcohol use: According Edmonds & Wilcocks (2001), alcohol use is defined as the use of a alcohol at some time in one’s life without the individual developing a specific recurrent pattern.
Loss of Control: Loss of control generally refers to lack of the ability to provide conscious limitation of impulses and behavior as a result of overwhelming emotion.
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