Consumo de alcohol y contextos de desarrollo en la adolescencia
espanolLos patrones de consumo de alcohol en Espana se han modificado en los ultimos anos, y aunque el consumo de alcohol per capita ha ido descendiendo ligeramente en las ultimas decadas, su prevalencia actual entre los adolescentes y las mujeres es alta. Se ha constatado que el consumo abusivo de alcohol en la adolescencia se asocia a numerosas consecuencias negativas, como la continuidad en su consumo y el de otras drogas en la adultez, los problemas academicos, las relaciones sexuales de riesgo, los accidentes de trafico, las actividades pre delictivas, diversos trastornos emocionales, lesiones cerebrales graves y neurodegeneracion. El alcohol es uno de los principales factores de riesgo de mortalidad y morbilidad en la poblacion mundial y esta implicado en mas de 60 problemas de salud. Para realizar una prevencion efectiva del consumo de alcohol en la adolescencia se hace necesario entender que factores lo explican, incluyendo los relativos a los contextos familiares, de los iguales y los escolares. Son escasas las investigaciones realizadas al respecto en paises latinos o mediterraneos con un diseno longitudinal. Por ello, este estudio pretende analizar que cambios se producen en el consumo de alcohol a lo largo de la adolescencia media y explorar con que caracteristicas de los contextos de desarrollo esta asociado. Asimismo, describir una tipologia de adolescentes en funcion de dicho consumo y de otras caracteristicas personales o contextuales, asi como identificar predictores de dicha clasificacion. Metodo. Se ha usado un diseno longitudinal de tres oleadas, con una muestra de 525 adolescentes (49,7% chicas) de Educacion Secundaria Obligatoria (ESO) de todas las provincias y habitats de Andalucia. Las variables objeto de estudio se han evaluado con un autoinforme administrado al alumnado en sus aulas, cuyas propiedades psicometricas han sido previamente verificadas. En el analisis de datos se han utilizado tecnicas univariantes, bivariantes y multivariantes exploratorias. 12 Resultados. Se ha encontrado un aumento significativo en el consumo de alcohol durante la adolescencia media. Destacan las diferencias segun la edad y el curso, las diferencias de genero en el incremento del consumo de alcohol a lo largo de la adolescencia y una tendencia a la equiparacion del consumo entre chicos y chicas. Por otra parte, se ha hallado que, de las variables antecedentes estudiadas, las mas estrechamente asociadas con el consumo de alcohol son las referidas a las barreras y apoyos percibidos por el alumnado para su compra y consumo, la permisividad de los amigos y el hermano, y la percepcion de la peligrosidad de embriagarse. Finalmente, se ha obtenido una clasificacion del alumnado (en el tiempo 3) en cuatro clases relevantes: dos tienden a agrupar a los sujetos que raras veces o nunca consumen alcohol (56% del alumnado) y otras dos a los que consumen alcohol alguna vez al mes y semanalmente (41% del alumnado) Las dos primeras clases se caracterizan por elementos positivos de los contextos de desarrollo (familia, escuela e iguales) con indicios de colaboracion entre la familia y la escuela. A ambas clases se asocia de manera mas estrecha como caracteristicas antecedentes el no comprar ni consumir alcohol, mostrar una alta percepcion del riesgo inherente al embriagarse y percibir una baja permisividad de los iguales ante el consumo de alcohol. Por su parte, la clase que agrupa al alumnado que consume alcohol alguna vez al mes esta preferentemente compuesta por chicas de 15 anos de habitat semiurbano, con baja percepcion de riesgo de emborracharse, percepcion positiva de su familia y de los iguales en el ambito escolar, y un bajo rendimiento academico. Y por ultimo, en la clase que agrupa al alumnado que consume alcohol semanalmente predominan los chicos de 4o de ESO, con baja percepcion de riesgo de emborracharse y con una valoracion negativa de los contextos familia y escuela. A estas clases se asocia de manera mas estrecha las caracteristicas antecedentes de resultar muy facil comprar y beber alcohol. Discusion. A partir de un estudio longitudinal se ha obtenido una tipologia de los adolescentes en funcion de su consumo de alcohol, sus contextos de desarrollo y otras caracteristicas, identificando antecedentes de cada clase obtenida. Esta novedosa informacion puede ser utilizada en el diseno de programas de prevencion del consumo de alcohol y de promocion de la salud mas efectivos. EnglishIntroduction. Patterns of alcohol consumption in Spain have changed in recent years, and although consumption per capita has been declining slightly over the last few decades, the current prevalence among adolescents and women is high. It has been established that alcohol abuse in adolescence is associated with a number of negative consequences, such as continued consumption of alcohol and other drugs in adulthood, academic problems, risky sexual behaviour, traffic accidents, pre!criminal activities, various emotional disorders, serious brain damage and neurodegeneration. Alcohol is one of the principal risk factors for mortality and morbidity in the world's population and is involved in more than 60 health problems. To carry out effective prevention of alcohol consumption in adolescence, it is necessary to understand what factors explain it, including those relating to the contexts of family, peers and school. Very little research with a longitudinal design has been carried out on this subject in Latin or Mediterranean countries. Therefore, this study aims to analyse what changes take place in alcohol consumption throughout middle adolescence and to explore with which characteristics of the contexts of development it is associated. The intention is also to describe a typology of adolescents based on this consumption and of other personal or contextual characteristics, as well as identifying predictors for each type resulting from this classification. Method. A longitudinal design consisting of three waves was used, with a sample of 525 adolescents (49.7% girls) in Compulsory Secondary Education (CSE) from all the provinces and habitats in Andalusia. Those variables which are the object of the study were assessed by means of a self report with psychometric properties which have been previously verified. This was administered to the pupils in their classrooms. Exploratory univariate, bivariate and multivariate techniques were used in the data analysis. Results. A significant increase in alcohol consumption was found during middle adolescence. Among the findings that stood out were differences according to age and school year, as well as gender differences in the rise in alcohol consumption throughout adolescence and a tendency towards similar consumption between boys and girls. At the same time, it was found that, of the variables studied, those most closely associated with alcohol consumption are those which relate to the obstacles and aids to purchasing and consuming alcohol as perceived by the children, the permissiveness of friends and siblings, and awareness of the dangers of getting drunk. Finally, classification of the schoolchildren into four main classes was obtained (during the third wave) two tend to group together those subjects who rarely or never drink alcohol (56% of the children) while the other two include those who drink alcohol every month and every week (41% of the children) The first two classes are characterised by positive elements in the contexts of development (family, school and peers) with evidence of collaboration between family and school. The antecedent characteristics most closely associated with both these classes are not buying or consuming aicohol, showing a high level of awareness of the risks inherent in getting drunk and perceiving low permissiveness among peers towards the consumption of alcohol. On the other hand, the class which groups together those children who drink alcohol every month is composed mainly of fifteen year old girls from a semi urban habitat with a low level of awareness of the risks of getting drunk, positive perception of their family and peers in the school environment, and low academic performance. Lastly, the class which groups together those children who consume alcohol every week is predominantly made up of boys in the 4th year of CSE, with a low level of awareness of the risks of getting drunk and a negative evaluation of school and family contexts. The antecedent characteristics of having easy access to buying and drinking alcohol are more closely associated with these classes. Discussion. Using a longitudinal study as the starting point, a typology of adolescents was obtained based on their alcohol consumption, contexts of development and other characteristics, with antecedents being identified for each class obtained. This new information may be used in the design of more effective alcohol consumption prevention and health promotion programmes.