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      Validation of the AUDIT scale and factors associated with alcohol use disorder in adolescents: results of a National Lebanese Study

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          This study objective was to evaluate the prevalence of alcohol use disorder (AUD) and related factors (smoking, internet addiction, social anxiety, child abuse, and bullying) among a representative sample of Lebanese adolescents, and to validate and confirm psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT).


          A cross-sectional study, conducted between January and May 2019, enrolled 1810 adolescents aged between 14 and 17 from schools of all Lebanese districts. From the total number of schools, a proportionate number was selected in each district. AUD was defined as a high AUDIT score (≥8; score range 0–40). A principal component analysis technique to confirm the validity of the construct of the AUDIT scale score was done and a confirmatory analysis to assess the structure of the instrument was conducted. Spearman correlation was used for linear correlation between continuous variables. The Mann-Whitney test was used to compare the means of two groups, while the Kruskal-Wallis test was used to compare three groups or more. A stepwise linear regression was conducted, taking the AUDIT total score as the dependent variable and taking child abuse (psychological, sexual, physical and verbal), cigarette and waterpipe smoking dependence, bullying, social phobia, and internet addiction as independent variables.


          The mean AUDIT score was 6.46 ± 8.44 and high risk of AUD was found in 507 (28.0%) adolescents [95% CI 0.259–0.301]. One factor solution of the AUDIT scale was found after running the factor analysis (α Cronbach = 0.978). Higher AUDIT scores were significantly associated with higher cigarette (Beta = 0.527; p < 0.001) and waterpipe (Beta = 0.299; p < 0.001) dependence, higher childhood sexual abuse (Beta = 0.656; p < 0.001) and neglect (Beta = 0.126; p < 0.001), higher bullying victimization (Beta = 0.236; p < 0.001).


          Alcohol use disorder among Lebanese adolescents seems to be associated with several factors, such as cigarette and waterpipe dependence, parents’ divorce, higher internet addiction, bullying victimization, and childhood sexual abuse and neglect. Parents and healthcare professionals could use this data for early interventions.

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          Most cited references 51

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          Concomitance between childhood sexual and physical abuse and substance use problems. A review.

          This review focuses on the apparent connection between childhood sexual or physical abuse (CSA, CPA) and later substance use problems (SUPs) among adolescents and adults. The rates of CSA among females with SUPs were found to be, on average, nearly two times higher than those found in the general population, and the rates of SUPs among women with CSA histories were found to be similarly elevated. The rates of CSA were not found to be elevated among males with SUPs, but men with histories of CSA were found to be at greater risk for SUPs than men in the general population. Women, girls, and boys with SUPs were found to have elevated rates of CPA relative to the general population, while adult males with SUPs were not found to have elevated rates of CPA. Concomitance rates were not found to vary systematically with regard to either the methodological quality of the studies included nor the year of study publication. Additional descriptive examination of selected studies indicates that among women, childhood abuse is likely to be a factor in the development of SUPs, but that the relationship is mediated by other psychiatric conditions, such as anxiety and depressive disorders.
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            Household crowding index: a correlate of socioeconomic status and inter-pregnancy spacing in an urban setting.

             K Yunis,  M Khogali,   (2004)
            This paper examines the effect of household crowding on inter-pregnancy spacing and its association with socioeconomic indicators, among parous mothers delivered in an urban environment. Cross sectional survey. Sociodemographic data were obtained on 2466 parous women delivering at eight hospitals in Greater Beirut over a one year period. Statistical methodology comprised Pearson chi(2) test and logistic regression analysis. A significant inverse relation was observed between household crowding and socioeconomic status, defined as education and occupation of women and their spouses. Inter-pregnancy spacing increased with higher levels of crowding. Further analysis suggested that this positive association was confounded by maternal demographic characteristics. These data have shown that household crowding, a correlate of low parental socioeconomic status, is associated with longer birth intervals. This association, however, seems to be largely explained by maternal age and parity.
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              The relationship between social anxiety disorder and alcohol use disorders: a critical review.

              Epidemiological studies have demonstrated a significant co-morbidity between social anxiety disorder (SAD) and alcohol use disorders (AUDs). Despite the fact that many studies have demonstrated strong relationships between SAD and AUD diagnoses, there has been much inconsistency in demonstrating causality or even directionality of the relationship between social anxiety and alcohol-related variables. For example, some studies have showed a positive relationship between social anxiety and alcohol-related variables, while others have shown a negative relationship or no relationship whatsoever. In an attempt to better understand the relationship between social anxiety and alcohol, some researchers have explored potential moderating variables such as gender or alcohol expectancies. The present review reports on what has been found with regard to explaining the high co-morbidity between social anxiety and alcohol problems, in both clinical and non-clinical socially anxious individuals. With a better understanding of this complex relationship, treatment programs will be able to better target specific individuals for treatment and potentially improve the efficacy of the treatments currently available for individuals with co-morbid SAD and AUD.

                Author and article information

                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                11 May 2020
                11 May 2020
                : 20
                [1 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Medicine and Medical Sciences, , Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon
                [2 ]INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
                [3 ]GRID grid.411324.1, ISNI 0000 0001 2324 3572, Faculty of Pharmacy, , Lebanese University, ; Hadat, Lebanon
                [4 ]GRID grid.411324.1, ISNI 0000 0001 2324 3572, Faculty of Medicine, , Lebanese University, ; Hadat, Lebanon
                [5 ]Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
                [6 ]GRID grid.497275.a, Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, , Institut d’Epidémiologie et de Neurologie Tropicale, ; GEIST, 87000 Limoges, France
                [7 ]Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
                [8 ]GRID grid.444421.3, ISNI 0000 0004 0417 6142, School of Pharmacy, , Lebanese International University, ; Beirut, Lebanon
                [9 ]GRID grid.444434.7, ISNI 0000 0001 2106 3658, Faculty of Arts and Sciences, , Holy Spirit University of Kaslik (USEK), ; Jounieh, Lebanon
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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                © The Author(s) 2020


                internet addiction, child abuse, smoking, bullying, arabic version, audit scale, alcohol use disorder


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