Although suicidality is a major public health concern, the clinical relevance of behavioural addictions (BAs) with respect to suicide risk remains poorly understood. Guided by the ideation-to-action framework, we examined whether six BAs (gambling disorder, gaming disorder, problematic internet use, problematic pornography use, problematic smartphone use, work addiction) at age 25 were prospectively associated with a) the onset and recurrence of suicidal ideation and suicide attempts at age 28 and b) the likelihood of a suicide attempt versus ideation only. We also assessed whether these associations overlapped with co-occurring risk factors, including substance use disorders (SUDs), other mental health problems (MHPs) and psychological distress (PD). Using a population-based longitudinal design, a non-self-selected sample of 5,611 young Swiss men completed baseline (age 25) and follow-up (age 28) questionnaires. Measurements included BAs, SUDs, MHPs, PD, lifetime suicidality at baseline and 12-month suicidality at follow-up. Logistic regression models tested associations between BAs and suicidality. Overlaps with co-occurring SUDs, MHPs and PDs were quantified using the Karlson–Holm–Breen method. Results revealed that all BAs were significantly prospectively associated with the onset of suicidal ideation or a suicide attempt; only some BAs were associated with the recurrence of ideation (gaming disorder, work addiction, having ≥ 1 BA) or an attempt (gambling disorder). Baseline gambling disorder, problematic pornography use and having ≥ 1 BA were associated with reporting a suicide attempt rather than ideation-only among participants reporting suicidal ideation at follow-up. Adjusting for co-occurring factors attenuated BAs’ associations with onset and recurrence but not for suicide attempts versus ideation only. Overall, BAs showed consistent longitudinal associations with suicidality, with relationships frequently persisting after adjustment for co-occurring risk factors. These findings underscore the clinical relevance of BAs and the importance of systematic screening and prevention efforts within mental health and suicide risk assessment, alongside evidence-based interventions.

Background:Adverse childhood experiences (ACEs) are associated with increased risk for psychopathology and reduced psychosocial functioning across the life course. However, digital selective prevention targeting individuals with a history of ACEs remains scarce. Impairments in emotion regulation and social information processing were confirmed as mechanisms linking ACEs with mental health and potential targets for interventions. This randomised controlled trial evaluated the uptake, efficacy, and differential component effects of the guided FACE app, a theory-based preventive intervention for emerging adults with self-reported ACEs that targets these mechanisms. Methods:Emerging adults (18-24 years) reporting at least one ACE category in a population-based cohort were invited to participate. Of 1514 eligible individuals, 167 (11%) enrolled and were randomised to immediate access to the FACE app or care as-usual with minimal intervention (CAU-MI). The 10-week intervention comprised two transdiagnostic components delivered in a cross-over design: Self- and Emotion Regulation (SER) and Social Skills and Social Information Processing (SSIP). Primary outcomes were resilience and well-being. Secondary outcomes included self-efficacy for managing emotions, social problem-solving, fear of negative evaluation, social avoidance, and self-esteem. Ecological momentary assessments captured real-life affect, burden, resilience, and social distress. Linear mixed models were applied under intention-to-treat and per-protocol principles. Results:Linear mixed models showed significant improvements over time (intervention and CAU-MI) in resilience, self-esteem, self-efficacy for managing emotions, adaptive problem-solving, momentary positive affect. Group × time interaction effects in favour of the app compared to CAU-MI emerged for some more proximal mechanism-related outcomes: self-efficacy for managing emotions, fear of negative evaluation and negative problem orientation but not for resilience and well-being, which were already at normative levels at baseline. Effects were largely maintained at follow-up. Improvements were stronger and more consistent following the SER compared to the SSIP component. Average time of app use was three hours. Conclusions:The FACE app did not improve the primary distal outcomes resilience and well-being beyond the CAU-MI condition. Nevertheless, the FACE app demonstrated modest but consistent improvements in proximal mechanisms associated with ACE-related vulnerability. Findings support the relevance of targeting emotion regulation and social-cognitive processes in digital selective prevention. However, limited uptake highlights challenges in active recruitment of unselected high risk populations and underscores the importance of integrating preventive apps into stepped-care or blended care models. Trial registration:ClinicalTrials.gov NCT05824182.

BackgroundIndividuals with a minority sexual orientation have consistently been found to face a greater risk of mental health problems and problematic substance use than heterosexual individuals. The present study examined whether differences in alcohol use or alcohol use disorder (AUD) symptoms across the spectrum of sexual orientations could be explained by drinking motives (i.e., enhancement, social, coping and conformity motives).MethodA non-self-selective sample of non-abstinent, young Swiss men (N = 5,139; mean age = 25.4, SD = 1.25) completed a self-reporting questionnaire on sexual orientation (on a five-point attraction scale: heterosexual, mostly-heterosexual, bisexual, mostly-homosexual, homosexual), drinking motives, alcohol use indicators (e.g., heavy episodic drinking, Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]), and AUD symptoms. Structural equation modeling was used to test whether drinking motives mediated the associations between dummy-coded sexual orientation (with heterosexual men as the reference) and alcohol use indicators or AUD symptoms.ResultsMostly-heterosexual men exhibited higher scores on alcohol use indicators than heterosexual men, with almost full mediation through their drinking motives, specifically higher enhancement motives. They also reported more AUD symptoms, partially mediated through drinking motives, with comparable contributions from enhancement and coping motives. Homosexual men, however, displayed similar or lower scores for alcohol use indicators and AUD symptoms than heterosexual men, but these differences were not mediated by drinking motives. Indeed, homosexual men exhibited greater coping motives than heterosexual men. No significant results or discernible patterns emerged for bisexual or mostly-homosexual men.DiscussionThese findings highlight the importance of considering the full spectrum of sexual orientations in healthcare and of broadening the focus on drinking motives beyond coping. Understanding the varied motives for alcohol use across the spectrum of sexual orientations facilitates tailored prevention strategies.

Background: Adverse childhood experiences (ACE) are significant transdiagnostic risk factors for impaired psychosocial functioning and mental health conditions throughout life. Most research on ACEs has used composite scores, which precludes specific conclusions about the impact of individual adverse experiences and their frequency of occurrence.Objective: To investigate the association between exposure frequencies of single adverse experiences with psychological distress among emerging adults.Participants and Setting: A total of 2528 emerging Swiss adults aged 18 to 22 years (mean age 19.3) from a random population sample participating in the first wave of a cohort study. Methods: ACE measures were 39 specific experiences for neglect (emotional, physical), abuse (emotional, physical, sexual), witnessing violence, peer maltreatment and parental psychopathology. ANOVA models were used to estimate the associations of exposure frequencies for each adverse experience with psychological distress. Results: Single adverse childhood experiences were strongly associated with psychological distress in emerging adulthood, with considerable differences across experiences and their exposure frequencies. Physical and sexual abuse experiences were associated with psychological distress across all exposure frequencies, including if experienced only rarely. Emotional abuse, emotional neglect and verbal abuse by peers experiences showed associations with psychological distress mainly at higher exposure frequencies. Conclusions: The severe impact of adverse childhood experiences on the mental health of emerging adults varies greatly depending on the specific adverse experience and how often a person had to endure them. Our research underscores the value of analyzing the impact of single adversities and their exposure frequencies alongside dimensional approaches in ACE research. Keywords: Adverse childhood experiences; Emerging adulthood; mental health; Switzerland; psychological distress; peer maltreatment; single adversity approach

Adverse Childhood Experiences (ACEs) are robust predictors of negative mental health outcomes and psycho-social difficulties, yet the psychological mechanisms linking ACEs to later psychopathology remain only partially understood. Drawing on a three-wave longitudinal study of Swiss emerging adults (N = 1934), we conducted longitudinal mediation analyses to examine emotional processing (emotional reactivity, perseverative thinking) and social information processing (threat interpretation bias, rejection sensitivity) as pathways from ACEs to psychopathology. Factor analyses identified three distinct ACE domains: family maltreatment, peer victimization, and sexual abuse. By modelling these domains simultaneously, we accounted for their frequent co-occurrence and isolated their unique contributions. Family maltreatment and peer victimization independently were associated with heightened psychopathology and difficulties with emotional processing and social information processing at Wave 1. Furthermore, both adversity domains also predicted persistent elevations in these domains over time, even after controlling for baseline levels and sociodemographic variables. Longitudinal mediation analyses revealed that family maltreatment and peer victimization both predicted psychopathology via perseverative thinking, threat interpretation bias, and emotional reactivity. Sexual abuse, in contrast, showed weaker or delayed associations with psychopathology and operated primarily through threat interpretation bias. Rejection sensitivity, while associated at the bivariate level, did not mediate longitudinal effects. Findings support and extend McLaughlin's Model of Mechanisms Linking Childhood Trauma to Psychopathology by identifying distinct mediational pathways from specific ACEs to psychopathology. These distinct pathways underscore the relevance of personalized and mechanism-based treatment planning based on the ACEs experienced.

Introduction: Cross-sectional studies have shown that peer influence to use a substance are associated with increased rates of substance use, but there are few longitudinal studies of this relationship or studies investigating whether peer influence to not use substances are associated with decreases in rates of substance use. The present study looks at both directions of influence and compares alcohol with cannabis use. Methods: Two-wave longitudinal study, separated 15.8 months; cross-domain coupling model to disentangle effects of peer influence and peer selection; GEE models to analyse changes in pressure to use and not to use alcohol or cannabis. 6,528 young men from six mandatory military recruitment centres in Lausanne, Windisch and Mels in Switzerland completed at least one questionnaire at baseline (age at baseline: 20.00) or follow-up. Questionnaires were completed outside of the army and independent of recruitment for military or social service. Volume of drinking, heavy episodic drinking, cannabis use frequency, and three items of the misconduct subscale of the Peer Pressure Inventory (pressure to use or not cannabis, pressure to drink or not, and pressure to get drunk or not) were measured. Results: Peer pressure and peer selection operated bidirectionally for alcohol use. For cannabis use, peer selection was about 5-times stronger than peer pressure. Increases in pressure to use a substance were associated with increased substance use and decreases in pressure with decreases in use. Conclusions: Peer pressure continue to operate after adolescence into emerging adulthood, but the strength of effects of peer pressure and peer selection depends on the substance. Peer pressure may have putatively positive effects when pressure is towards non-use of a substance.

Background and Aims:The co-occurrence of behavioral addictions (BAs) and substance use disorders (SUDs) or other mental health problems (MHPs) is well documented. However, there is limited evidence on associations between changes in the severity of BAs, SUDs, and MHPs, or their directions of influence or causation. Methods:A non-self-selecting sample of 5,611 young Swiss men (mean age 25.5 at baseline and 28.3 at follow-up) completed a self-reporting questionnaire on various BAs (gambling, gaming, internet, internet pornography, smartphone, work), SUDs (alcohol, cannabis) and MHPs (major depressive disorder, ADHD, borderline personality disorder, social anxiety disorder). Latent change score models were used to evaluate pairwise, bidirectional associations in symptom severity among different BAs, and between BAs and SUDs or MHPs. Results:Overall, changes in each BA's symptom severity were significantly and positively correlated with changes in the symptom severity of other BAs, alcohol use disorder, and MHPs; for cannabis use disorder, such correlations were only found with gaming and work. Significant bidirectional cross-lagged associations were found between the severity of BAs and MHPs, and between the severity of internet and smartphone addiction and other BAs. For SUDs, cross-lagged pathways were often not significant (e.g., with gambling or pornography) or even negative (between cannabis use disorder and work). Discussion and Conclusions:This study provides strong evidence that BAs and MHPs mutually reinforce each other over time. While this interplay can develop and maintain dysfunction, it may also enable positive change, highlighting the need for a comprehensive theoretical framework and integrated intervention approaches.

Introduction : Depuis quelques années, le concept de consommation excessive, souvent appelé binge, est utilisé pour guider des démarches préventives, notamment pour les dépendances aux substances. Or, la pertinence de ce marqueur précoce n’a jamais été explorée en ce qui a trait à l’hyperconnectivité, phénomène pouvant se traduire par une surutilisation des écrans et mener au développement d’une utilisation problématique d’Internet (UPI). Cette étude souhaite valider et définir ce qui pourrait constituer un épisode de binge Internet. Méthode : L’étude est réalisée auprès de 93 jeunes adultes âgés de 17 à 25 ans. Leur niveau de sévérité d’UPI a été évalué à partir de l’Internet Addiction Test et d’une entrevue clinique basée sur la grille d’évaluation WebAdo. Pour évaluer la pertinence du binge, des analyses de ROC (Receiver Operating Characteristic) ont été effectuées à partir des scores de sévérité. Une analyse linéaire binominale et des tests-t indépendants ont également été conduits pour comparer l’importance des méfaits subis selon les participants ayant vécu ou non un épisode de binge. Résultats : Les analyses de sensibilité et de spécificité indiquent qu’un épisode de binge Internet peut être défini par une utilisation consécutive de plus de 7,5 heures. Ce seuil représente le meilleur ratio pour distinguer les participants à faible risque, de ceux ayant une utilisation problématique d’intensité modérée à sévère. D’autre part, les personnes ayant fait un binge de 7,5 h+ ont rapporté vivre davantage de difficultés familiales, monétaires, physiques et personnelles. Enfin, les jeunes adultes présentant une comorbidité et le temps hebdomadaire passé sur les jeux vidéo ont contribué aux binges de 7,5 h+. Discussion : En considérant des éléments objectifs, ce nouvel indicateur pourrait devenir un marqueur ou une recommandation à ne pas dépasser, favorisant le maintien d‘habitudes saine face aux écrans. Il pourrait également être intégré dans de futures évaluations pour cette problématique.

Background Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP). Methods The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions). Discussion The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood. Trial registration number: NCT05824182.

Single-measurement-point data collection to assess change has increased with studies assessing the impact of the Covid-19 pandemic and of its containment, despite evidence of its lack of validity. Retrospective change is not equivalent to change in repeated self-reported measures giving raise to questions about the validity of the former. This paper purports to investigate inconsistencies between change measures by confronting retrospective change to information from longitudinally self-reported measures from the C-SURF cohort study. The study sample consists of 2,279 young men who participated in C-SURF between 2020 and 2021, and completed between May and June 2021 a survey covering change in alcohol, cigarette, cannabis and other addictive behaviors related to the pandemic. The aforementioned behaviors were assessed longitudinally at two time points using self-reports, and retrospective change since the onset of the Covid-19 crisis was also assessed at the second measurement time. Information from both prospective and retrospective change measures were confronted to identify inconsistent information for each behavior. Additionally, multiple logistic regressions were performed to assess associations between socioeconomic status, impulsivity, depression, and different indicators of motivation to complete the study and inconsistency between both measures for each behavior of interest. Importantly, inconsistent information in at least one of the investigated behaviors was found in about 90% of the participants. Small associations were found between inconsistency and different factors with a consistent effect of impulsivity. In the absence of evidence of the validity of retrospective change measures, studies relying on retrospective change should be interpreted with caution.

Background: Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health. Methods: The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health. Results: A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms. Conclusions: Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

Background and aims: Intense use of smartphones is associated with mental health problems and low well-being. However, little is known about the mental health and well-being of non- and low-level users. This study investigated the possibly non-linear associations between time spent using a smartphone, including non-users, and mental health and well-being among young adults. Methods: Between 2016 and 2018, 5315 young Swiss men (M = 25.45 years old, SD = 1.25) completed a questionnaire assessing smartphone use, daily time spent using a smartphone, mental health and well-being (i.e. depression, social anxiety, attention deficit hyperactivity disorder, life satisfaction, stress) and potential confounding variables (social capital, personality, education). The associations of smartphone use and time spent using a smartphone (linear and quadratic associations) with mental health and well-being were tested using regression models. Results: Non-users (4.3%) reported worse mental health and well-being than smartphone users on all outcomes. Time spent using a smartphone was linearly associated with higher rates of social anxiety, depression, attention deficit hyperactivity disorder and lower levels of life satisfaction. The association with stress was non-linear, with significant linear and quadratic coefficients of time spent using a smartphone. Associations were partially attributable to confounding variables (i.e. social capital, personality, and education). Conclusions: Non-users and intense users of smartphones have lower levels of mental health and well-being than low-level users. Although society and mental health professionals are deeply concerned about the potentially negative consequences of the ever-increasing use of smartphones, the present study suggested that not using a smartphone may also indicate problems.

Abstract Background Adverse childhood experiences increase the risk for psychological disorders and lower psychosocial functioning across the lifespan. However, less is known about the processes through which ACE are linked to multiple negative outcomes. The aim of the FACE epidemiological study is to investigate emotion regulation (emotional reactivity, perseverative thinking and self-efficacy for managing emotions) and social information processing (rejection sensitivity, interpretation biases and social understanding) as potential mechanisms linking adverse childhood experiences and psychosocial functioning in a large population sample of young adults. It is embedded in a larger project that also includes an ecological momentary assessment of emotion regulation and social information processing and informs the development and evaluation of an online self-help intervention for young adults with a history of ACE. Methods The study plans to recruit 5000 young adults aged 18 to 21 from the German-speaking Swiss population. Addresses are provided by Swiss Federal Statistical Office and participants are invited by mail to complete a self-report online survey. If the targeted sample size will not be reached, a second additional sample will be recruited via educational facilities such as universities or teacher training colleges or military training schools. Three follow-ups are planned after 1 year, 2 years and 3 years, resulting in ages 18–24 being covered. The main exposure variable is self-reported adverse childhood experiences before the age of 18, measured at the baseline. Primary outcomes are psychosocial functioning across the study period. Secondary outcomes are social information processing, emotion regulation and health care service use. Statistical analyses include a range of latent variable models to identify patterns of adverse childhood experiences and patterns and trajectories of psychosocial adaptation. Discussion The results will contribute to the understanding of the underlying mechanisms that link ACE with psychosocial functioning which is crucial for an improved insight into risk and resilience processes and for tailoring interventions. Furthermore, the identification of factors that facilitate or hinder service use among young adults with ACE informs healthcare policies and the provision of appropriate healthcare services. Trial registration number: NCT05122988. The study was reviewed and authorized by the ethical committee of Northwestern and Central Switzerland (BASEC number 2021-01204).

Background Clinical interventions for patients after a suicide attempt might include a focus on Reasons for Living (RFL) and/or Reasons for Dying (RFD). The present study examined the longitudinal development of RFL and RFD in patients with and without a suicide-specific intervention - the Attempted Suicide Short Intervention Program (ASSIP). Methods In this secondary analysis of a 2-year follow-up randomized controlled study, participants completed the Suicide Status Form II to assess RFL and RFD, at baseline, as well as at 6-, 12-, 18-, and 24-months follow-up. Growth models and latent class analysis were used to investigate longitudinal developments in RFL and RFD. Regression models were used to test the association between RFL, RFD and suicidal reattempts and ideation. Results Cross-sectionally and longitudinally, RFD, but not RFL, were associated with suicide reattempts and suicidal ideation. The number of RFD decreased significantly across the 24 month period (from 1.90 at t1 to 1.04 at t5 in the control group and from 2.32 at t1 to 0.51 at t5 in the intervention group), and this decrease was stronger (b = −0.02; p = 0.004) in the ASSIP group than in the control group. There was no overall change in RFL. Three latent trajectories of RFD were identified: a decreasing (n = 77), a steady high (n = 17) and a trajectory with first increasing and then decreasing RFD (n = 26). The proportion of patients in the ASSIP intervention was highest in the decreasing trajectory and lowest in the steady high trajectory. Patients in the steady high trajectory were characterized by worse mental health and fewer social obligations (partner, children) at baseline. Conclusion The results confirm the importance of RFD within the suicidal process and show that the number of RFD can be further reduced over the period of 24 months with short interventions such as ASSIP. The relevance of number of RFL in the suicidal process, as protective factor, was not confirmed. In the subgroup of patients whose RFD did not decrease over a long period of time, there is a particularly high risk of suicidal ideation/behavior. Clinical interventions should focus more closely on RFD, their etiology and maintenance.

The association between alcohol use and sensation seeking is well known. Less is known about whether longitudinal changes in alcohol use are associated with changes in sensation seeking and in which direction influence might flow. 5125 men aged 20.0 years old at baseline and 25.4 years old at follow-up responded to the Brief Sensation Seeking Questionnaire, which measures four subscales of experience seeking, boredom susceptibility, thrill- and adventure-seeking, and disinhibition. Alcohol use was measured using volume (drinks per week) and binge drinking (about 60 g or more per occasion). Associations were calculated using cross-lagged panel models and two-wave latent change score models. Correlations between the latent change scores for alcohol use and the sensation-seeking subscales were all positive, being largest for disinhibition (r > 0.3) and much smaller (r ~ 0.1) for the others. Disinhibition was the dominant effect over the entire sensation-seeking scale. Cross-lagged paths were (except for thrill- and adventure-seeking) bidirectional and mostly higher from alcohol use to sensation seeking (e.g., pathvolume-disinhibition = 0.136, and pathdisinhibition-volume = 0.072). Again, effects were highest for disinhibition. Given the bidirectional links between sensation seeking and alcohol use, preventive efforts aiming to achieve stable positive changes in alcohol use and personality should target both simultaneously and focus on disinhibition.

IntroductionSubstance use disorder, depression and sexual minority are well documented risk factors for suicidal behaviour, far less is known about behavioural addictions.ObjectivesFirst, to explore associations between behavioural addictions (gaming, gambling, cybersex, internet, smartphone, work) at age 25 and the incidence and reoccurrence of suicide ideation (SID), suicide attempts (SAT), and suicide attempts among those with suicide ideation (SATID) at age 28. Second, to test whether these associations were impacted by adjusting for cannabis and alcohol use disorder, nicotine dependence, sexual orientation and depression.MethodsBased on two waves of a prospective cohort study of 5,428 young Swiss men, nested models with and without adjustment for risk factors were used to regress SID, SAT and SATID on preceding behavioural addictions.ResultsWithout adjustment, each of the behavioural addictions at age 25 significantly predicted the incidence of SID and SAT at age 28. Gambling and cybersex addiction furthermore predicted SATID. When adjusting for other risk factors, associations with behavioural addictions were reduced, whereas depression and cannabis use disorder were the most important and consistent predictors for the incidence and recurrence of SID, SAT and SATID.ConclusionsAmong young Swiss men, behavioural addictions are important predictors of SID and SAT, however a large part of their association is shared with depression and cannabis use disorder. Treatment for addictive behaviors, especially cannabis use can open the door to larger mental health screening and targeted intervention. Crisis intervention among men presenting addictive behaviours with or without substance may therefore be key to preventing suicidal behaviour.DisclosureNo significant relationships.

Background and aims: It is well documented that individuals with a minority sexual orientation face greater risks of problematic substance use (e.g. heavy episodic drinking, alcohol use disorder) and mental health problems. Far less is known about how that risk varies within this population and their risk of behavioural addictions. This study estimated the risks of problematic substance use, behavioural addiction and poor mental health across the spectrum of sexual orientation. Sample and method: A sample of young Swiss men (N = 5294; mean ag e= 25.5, SD = 1.25; representative of 21 of Switzerland's 26 cantons) completed a self-reporting questionnaire on sexual orientation (attraction, 5-point scale) and criterion variables: problematic substance use (e.g. alcohol, cigarettes, cannabis and other illegal drugs), behavioural addictions (gambling, gaming, cybersex, internet, smartphone, work, exercise) and indicators of mental health (e.g. depression, stress). Curvilinear associations between sexual orientation (heterosexual, mostly-heterosexual, bisexual, mostly-homosexual or homosexual individuals) and criterion variables were explored using fractional polynomial regressions. Results: Although there were differences across criterion variables, in general, the highest risks of problematic substance use, behavioural addictions and mental health problems were estimated for mostly-heterosexual, bisexual or mostly-homosexual men, followed by homosexual men, and with heterosexual men facing the lowest risk. Discussion and conclusion: Aggregating the spectrum of sexual orientations into two or three distinct groups blurs important internal group differences. Outcome-specific explanations beyond minority stress and biphobia are necessary to understand the pathways between sexual orientation and risky behaviours. Considering sexual orientation is important to provide targeted healthcare prevention and interventions.

AIMS OF THE STUDY: In Switzerland, there has been a boom in the market for cannabidiol (CBD) products in recent years. However, little is known on the prevalence,modes of administration and motives for use of CBD products. The aim of the present study was to fill this gap using recent (2019) data from the Cohort Study on Substance Use Risk Factors (C-SURF). METHODS: Between April and December 2019, an unselected sample of 5233 Swiss young men from the French and German-speaking regions (mean age 28.2 years, standard deviation 1.3) completed a self-report questionnaire covering measures of use of CBD products, modes of administration and motives to use of CBD, tetrahydrocannabinol (THC) and cigarettes. Descriptive statistics were used to estimate prevalence of self-reported use, modes of administration and motives to use CBD, whereas logistic regression models were used to test the associations of linguistic region, THC and tobacco use with use of CBD. RESULTS: Lifetime and 12-month prevalence of self-reported use of CBD were 32.4% and 18.5%, respectively. Among past 12-month CBD users, 79.4% used CBD once a month or less often, whereas 20.6% used it more than once a month. The most often reported modes of administration of CBD were in association with tobacco: flowers mixed with tobacco (67.5%), and CBD cigarettes with tobacco (37.1%), while 18.6% used flowers without tobacco. The three most reported reasons for using CBD were: out of curiosity (74.0%), to feel the effects of THC (38.1%) and for well-being and health (37.5%). In multivariable models, CBD use was associated with use of THC (odds ratio [OR] 9.85, 95% confidence interval [CI] 8.28-11.73), cigarettes (OR 2.74, 95% CI 2.28-3.29) ore-cigarettes (OR 1.5795% CI 1.27-1.95), as well as for the linguistic region (French-speaking vs German-speaking region OR 1.3895% CI 1.15-1.65). CONCLUSIONS: Self-reported use of CBD is common among young Swiss men: about one third used CBD in their life and about one in five in the previous 12 months. However, the vast majority of CBD users used it infrequently and out of curiosity. CBD use was particularly prevalent among users of THC and cigarette smokers. CBD was most often used in combination with tobacco, thus exposing users to risks associated with smoking tobacco products.

Abstract Background and Aims There are concerns about the potential impact of the coronavirus disease (COVID-19) pandemic on substance use (SU) and other reinforcing behaviours (ORB). This paper investigates changes in SU and ORB among young men during the COVID-19 crisis (i.e. March–June 2020). Methods Before and during the COVID-19 crisis, 2,344 young Swiss men completed questionnaires covering SU (i.e. alcohol, cigarettes, illegal cannabis), ORB (i.e. gaming, watching TV series, internet pornography) and sociodemographic and work-related characteristics (i.e. deterioration in the work situation, change in working hours, change in working hours from home, healthcare workers’ and other professionals’ contacts with potentially infected people, linguistic region, call up to military or civil protection unit, living situation, age). Results Latent-change score models showed significant decreases of 17% for drinking volume and frequency of heavy episodic drinking, and a significant increase of 75% for time spent gaming and watching TV series. Subgroups showed greater relative increases. French-speaking participants, those who experienced a deterioration in their work situation and healthcare workers in contact with potentially infected people reported increased cigarette use. Those without children increased gaming, whereas those who worked fewer hours, experienced a deterioration in their work situation or were French-speaking did more gaming and watched more TV series. Those who lived alone or were German-speaking watched more internet pornography. Conclusion During the COVID-19 crisis, young Swiss men drank less alcohol and spent more time gaming and watching TV series. Changes in SU and ORB were not homogenous in the young Swiss men population.

Background: The COVID-19 pandemic and its countermeasures may have had a significant impact on the psychological well-being of specific population subgroups. The present study investigated whether sexual minority men (defined here as attracted partly or exclusively to men) from an ongoing cohort study of young Swiss men experienced different psychological impacts, levels of substance use and addictive behaviors, and to which degree pre-existing vulnerabilities and participants experiences during the crisis might explain these differences. Methods: An ongoing cohort sample based on the general population of young Swiss men (mean age = 29.07 years; SD = 1.27) was assessed before and during the COVID-19 crisis for depression, stress, sleep quality, substance use and addictive behaviors. Additionally, during the crisis, we assessed its impact in form of fear, isolation and traumatic experiences. Potential associations between these outcomes and sexual orientation (sexual minority vs. heterosexual) were tested using linear regression models. It was additionally estimated to which degree these associations were attenuated if adjusted for differences in mental health, personality and socioeconomic status before the crisis, as well as the experience of the COVID-19 crisis (infection with the virus and changes to work situation). Results: Compared to heterosexual men, sexual minority men showed higher levels of psychological trauma (b = 0.37 [0.25, 0.49]), fear (b = 0.18 [0.06, 0.30]) and isolation (b = 0.32 [0.20, 0.44]) due to the COVID-19 pandemic as well as higher levels of depression (b = 0.31 [0.20, 0.41]) and lower sleep quality (b = −0.13 [−0.24, −0.02]) during the crisis. These differences were to a large degree explained by higher pre-crisis levels of mental health problems and the personality dimension of neuroticism-anxiety. Sexual minority men showed higher overall levels of substance use and addictive behaviors, but these differences were already present before the crisis. Conclusion: The COVID-19 crisis may have worsened pre-existing vulnerabilities in sexual minority men, leading to its greater psychological impact on them than on heterosexual men. Reducing minority stress due to sexual orientation may help not only to improve mental health among important proportions of the population but also to reduce their vulnerability to crises. Services offering psychological support to sexual minorities may need to be reinforced during crises.