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Bares CB, Sharma V, Lopez-Quintero C. Socio-demographic Correlates of Electronic Cigarette and Cannabis Co-use Among Naïve and Tobacco Adolescent Users. JOURNAL OF PREVENTION (2022) 2023; 44:457-475. [PMID: 37038010 PMCID: PMC11101152 DOI: 10.1007/s10935-023-00729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/12/2023]
Abstract
The increasing co-use of e-cigarette and cannabis among youth has become a public health challenge. The present analyses aimed to identify prevalence and correlates of past-month co-use of e-cigarettes and cannabis among adolescents with and without prior tobacco use. For this panel study, 5 years of cross-sectional data (2014-2018) were used from 8th, 10th-, and 12th-grade adolescents in the Monitoring the Future study, a nationally representative survey of U.S. students. We examined prevalence and correlates of e-cigarettes and cannabis co-use among adolescents who had ever used tobacco (n = 15,136) and among those who had never used tobacco (n = 56,525). Adolescents who had ever used tobacco showed significantly higher rates of e-cigarettes and cannabis co-use compared to adolescents who had never used tobacco (17.1% vs. 2.2%, p < 0.01). Results from adjusted multinomial regression models showed that overall, Black and Hispanic adolescents tobacco users were less likely than Whites to co-use e-cigarettes and cannabis. Black adolescents who had used tobacco previously were more likely than Whites to have used cannabis exclusively. Black and Hispanic tobacco-naïve adolescents were more likely than Whites to have used cannabis exclusively, while Black tobacco-naïve adolescents were less likely to use e-cigarettes exclusively or co-use e-cigarettes and cannabis. Overall, males and twelve graders were more likely than males and eight graders to use or co-use cannabis or e-cigarettes, respectively. Among lifetime tobacco users, higher levels of parental education were associated with co-use of cannabis and e-cigarettes. Racial/ethnic-specific patterns of e-cigarette and cannabis co-use depends on adolescents' prior experience with tobacco. The higher rates of use and co-use of e-cigarettes and cannabis among prior tobacco users suggest that targeted interventions are needed for this group. Identified socio-demographic groups at higher risk of co-use of e-cigarettes and cannabis need to be further studied.
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Affiliation(s)
- Cristina B Bares
- School of Social Work, University of Michigan, 1080 South University, Ann Arbor, MI, 48109, USA.
| | - Vinita Sharma
- School of Public and Population Health, Boise State University, Boise, ID, 83725, USA
| | - Catalina Lopez-Quintero
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
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Pocuca N, Chadi N, Vergunst F, Parent S, Côté SM, Boivin M, Tremblay RE, Séguin JR, Castellanos-Ryan N. Prospective Polysubstance use Profiles Among Adolescents with Early-onset Cannabis Use, and their Association with Cannabis Outcomes in Emerging Adulthood. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-01005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Ceyhun HA. Psychiatric symptoms, current use of tobacco, alcohol, illicit drug, and poly-substance among medical students in Eastern Turkey. J Ethn Subst Abuse 2022; 21:1-28. [PMID: 36271892 DOI: 10.1080/15332640.2022.2135656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study aims to investigate the prevalence and patterns of substance use among medical students and to examine associated psychiatric symptoms. It has been observed that depression and psychoticism scores have a significant effect on smoking, and interpersonal sensitivity-hostility-paranoid ideation scores have a significant effect on drinking. It has been shown that interpersonal sensitivity and depression scores are more predictive of mono-and poly-substance use. Revealing the relationship between tobacco, alcohol, poly-substance use, and psychiatric symptoms in the medical school sample shows the importance of practices aimed at increasing students' awareness of their psychiatric symptoms and providing access to psychiatric services.
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Lee CA, Smith DC, Lanker A, Clary KL. Sensitivity and specificity of the CRAFFT to identify heavy cannabis use: Evidence from a large statewide adolescent sample. Addict Behav 2021; 122:107006. [PMID: 34174550 DOI: 10.1016/j.addbeh.2021.107006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM Screening adolescents at risk for cannabis use disorders is critical. The CRAFFT is a screening tool designed to address both alcohol and drug use among youth. Current study tests the psychometric properties of the CRAFFT and attempts to modify one of the screening items to compare the efficiency. DESIGN We examined the ideal cut-off point of the CRAFFT for identifying persons with heavy cannabis use and compared the utility of the original and revised CRAFFT. PARTICIPANTS Sample (N = 132,555) averaged 16.19 (±1.21) years of age; 51.0% were female, 59.7% were White, 15.2% were Latino/Latina, and 6.7% were African-American. Majority resided in non-rural area and 34.5% were receiving free or reduced lunch at school. MEASUREMENTS Heavy cannabis use was defined as using cannabis 10 or more times in the past 30 days. Sensitivity, specificity, the area under the receiver operating characteristic curve, and Youden value were analyzed to determine the ideal cut-off point. FINDINGS Maximum overall predictive accuracy was at a cutoff score of 2 or higher when using the original CRAFFT questions. At a cutoff score of 2, sensitivity was 82.0%, specificity was 83.7%, with an AUC of 0.880. On the contrary, when an alternative CAR question was used, maximum predictive accuracy was at a cutoff score of 1 or higher when predicting heavy cannabis use. At a cutoff score of 1, sensitivity was 92.7%, specificity was 75.5%, with an AUC of 0.900. CONCLUSIONS The results provide evidence that the CRAFFT is a promising brief diagnostic instrument for heavy cannabis use among youth. Modification to Car item may have potential in reducing disparities in sensitivity among different racial ethnic groups, as well as those who with low socioeconomic status.
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Affiliation(s)
- Carol A Lee
- University of Illinois at Urbana-Champaign, School of Social Work, 1010 W. Nevada St. Urbana, IL 61801, United States.
| | - Douglas C Smith
- University of Illinois at Urbana-Champaign, School of Social Work, 1010 W. Nevada St. Urbana, IL 61801, United States
| | - Angus Lanker
- University of Illinois at Urbana-Champaign, School of Social Work, 1010 W. Nevada St. Urbana, IL 61801, United States
| | - Kelly L Clary
- Texas State University, School of Social Work, 712 N. Comanche St., San Marcos, TX 78666, United States
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Pacheco-Colón I, Salamanca MJ, Coxe S, Hawes SW, Gonzalez R. Exercise, Decision-Making, and Cannabis-Related Outcomes among Adolescents. Subst Use Misuse 2021; 56:1035-1044. [PMID: 33829950 DOI: 10.1080/10826084.2021.1906279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Poor decision-making may represent a risk factor for adverse cannabis-related outcomes, whereas exercise has been linked to better executive functioning and substance use outcomes. This study examines the associations between self-reported exercise and cannabis use (CU) outcomes over 6 months among adolescents, and whether these are mediated by exercise-related effects on decision-making. Method: Participants were 387 adolescents aged 15-18 who completed two assessments 6 months apart. Self-reported past 6-month hours/week of exercise were assessed at baseline. At the 6-month follow-up, participants completed measures assessing past 6-month CU frequency, presence of CU disorder (CUD), and CU-related problems, as well as risky decision-making tasks (Iowa Gambling Task, Game of Dice Task, Cups Task), which were used to derive a latent construct of decision-making. We used prospective mediation to examine the role of decision-making in the relationship between exercise and CU outcomes. Results: More self-reported exercise at baseline predicted greater CU frequency at the 6-month follow-up, but did not predict the presence of a CUD, or cannabis-related problems. After controlling for confounds, baseline exercise did not predict better decision-making at follow-up. Decision-making did not predict CU outcomes, and indirect effects of decision-making were not significant. Conclusions: Contrary to hypotheses, adolescents reporting more exercise at baseline also reported higher CU frequency in our sample. This association may be explained by factors like sample characteristics or sports types, but more research is needed to explore this. Results did not support a mediating role for decision-making in the associations between exercise and CU outcomes.Supplemental data for this article can be accessed online at https://doi.org/10.1080/10826084.2021.1906279.
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Affiliation(s)
- Ileana Pacheco-Colón
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Maria J Salamanca
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Stefany Coxe
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Samuel W Hawes
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Raul Gonzalez
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
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Prevalence and correlates of youth poly-substance use in the COMPASS study. Addict Behav 2020; 107:106400. [PMID: 32222564 DOI: 10.1016/j.addbeh.2020.106400] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/03/2020] [Accepted: 03/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Youth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming. DESIGN Cross-sectional sample taking part in a cohort study. SETTING Canadian high schools (AB, BC, ON, QC) PARTICIPANTS: 74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019. MEASUREMENTS Self-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures. RESULTS Of the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use. CONCLUSIONS The evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.
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Wheeler PB, Stevens-Watkins D, Dogan JN, McCarthy D. Polysubstance use among frequent marijuana users: an examination of John Henryism Active Coping, psychiatric symptoms, and family social support among African American incarcerated men. J Ethn Subst Abuse 2020; 21:553-569. [PMID: 32697626 DOI: 10.1080/15332640.2020.1793861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Incarcerated African American men who use marijuana are vulnerable to polysubstance use, which is associated with greater risk for negative health and psychosocial outcomes than marijuana use alone. It is imperative to understand risk and protective factors for polysubstance use among this vulnerable population to inform the development of culturally tailored substance use interventions. The current study examined the association between John Henryism Active Coping (JHAC), family social support, psychiatric symptoms, and polysubstance use among African American incarcerated men who frequently use marijuana. Results indicated that higher John Henryism Active Coping (JHAC) is associated with decreased likelihood of engaging in polysubstance use, while psychiatric symptoms are associated with increased likelihood of polysubstance use. Incorporating elements of JHAC into concurrent mental health and substance use treatment may reduce risk for overdose and reincarceration among African American incarcerated men upon release into the community.
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Affiliation(s)
- Paris B Wheeler
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Jardin N Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
| | - Daniel McCarthy
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky
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Crummy EA, O'Neal TJ, Baskin BM, Ferguson SM. One Is Not Enough: Understanding and Modeling Polysubstance Use. Front Neurosci 2020; 14:569. [PMID: 32612502 PMCID: PMC7309369 DOI: 10.3389/fnins.2020.00569] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/08/2020] [Indexed: 12/19/2022] Open
Abstract
Substance use disorder (SUD) is a chronic, relapsing disease with a highly multifaceted pathology that includes (but is not limited to) sensitivity to drug-associated cues, negative affect, and motivation to maintain drug consumption. SUDs are highly prevalent, with 35 million people meeting criteria for SUD. While drug use and addiction are highly studied, most investigations of SUDs examine drug use in isolation, rather than in the more prevalent context of comorbid substance histories. Indeed, 11.3% of individuals diagnosed with a SUD have concurrent alcohol and illicit drug use disorders. Furthermore, having a SUD with one substance increases susceptibility to developing dependence on additional substances. For example, the increased risk of developing heroin dependence is twofold for alcohol misusers, threefold for cannabis users, 15-fold for cocaine users, and 40-fold for prescription misusers. Given the prevalence and risk associated with polysubstance use and current public health crises, examining these disorders through the lens of co-use is essential for translatability and improved treatment efficacy. The escalating economic and social costs and continued rise in drug use has spurred interest in developing preclinical models that effectively model this phenomenon. Here, we review the current state of the field in understanding the behavioral and neural circuitry in the context of co-use with common pairings of alcohol, nicotine, cannabis, and other addictive substances. Moreover, we outline key considerations when developing polysubstance models, including challenges to developing preclinical models to provide insights and improve treatment outcomes.
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Affiliation(s)
- Elizabeth A Crummy
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Timothy J O'Neal
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Britahny M Baskin
- Graduate Program in Neuroscience, University of Washington, Seattle, WA, United States.,Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Susan M Ferguson
- Center for Neurobiology of Addiction, Pain, and Emotion, University of Washington, Seattle, WA, United States.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, United States.,Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, United States
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Nestor LJ, Behan B, Suckling J, Garavan H. Cannabis-dependent adolescents show differences in global reward-associated network topology: A functional connectomics approach. Addict Biol 2020; 25:e12752. [PMID: 30957353 DOI: 10.1111/adb.12752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/05/2019] [Accepted: 03/11/2019] [Indexed: 12/11/2022]
Abstract
Adolescence may be a period of increased vulnerability to the onset of drug misuse and addiction due to changes in developing brain networks that support cognitive and reward processing. Cannabis is a widely misused illicit drug in adolescence which can lead to dependence and alterations in reward-related neural functioning. Concerns exist that cannabis-related alterations in these reward networks in adolescence may sensitize behaviour towards all forms of reward that increase the risk of further drug use. Taking a functional connectomics approach, we compared an acutely abstinent adolescent cannabis-dependent (CAN) group with adolescent controls (CON) on global measures of network topology associated with anticipation on a monetary incentive delay task. In the presence of overall superior accuracy, the CAN group exhibited superior global connectivity (clustering coefficient, efficiency, characteristic path length) during monetary gain anticipation compared with the CON group. Additional analyses showed that the CAN group exhibited significantly greater connectivity strength during monetary gain anticipation across a subnetwork that included mesocorticolimbic nodes involving both interhemispheric and intrahemispheric connections. We discuss how these differences in reward-associated connectivity may allude to subtle functional alterations in network architecture in adolescent cannabis-dependence that could enhance the motivation for nondrug reward during acute abstinence.
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Affiliation(s)
- Liam J. Nestor
- Neuropsychopharmacology UnitImperial College London London UK
- School of Psychology and Institute of NeuroscienceTrinity College Dublin Dublin Ireland
- Department of PsychiatryUniversity of Cambridge Cambridge UK
| | - Brendan Behan
- School of Psychology and Institute of NeuroscienceTrinity College Dublin Dublin Ireland
| | - John Suckling
- Department of PsychiatryUniversity of Cambridge Cambridge UK
| | - Hugh Garavan
- School of Psychology and Institute of NeuroscienceTrinity College Dublin Dublin Ireland
- Department of PsychiatryUniversity of Vermont Burlington Vermont USA
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Zuckermann AM, Williams G, Battista K, de Groh M, Jiang Y, Leatherdale ST. Trends of poly-substance use among Canadian youth. Addict Behav Rep 2019; 10:100189. [PMID: 31193263 PMCID: PMC6525276 DOI: 10.1016/j.abrep.2019.100189] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Poly-substance use, increasingly understood as a behaviour with uniquely adverse consequences, is on the rise among Canadian youth. High levels of e-cigarette vaping and the recent legalization of recreational cannabis use may result in an acceleration of this trend. The aim of this work was to characterise changes in youth poly-substance use over time, generate baseline data for future investigations, and highlight areas of interest for policy action. METHODS Descriptive statistics and regression models explored patterns and trends in concurrent use of multiple substances (alcohol, cigarettes, cannabis, and e-cigarettes) among Canadian high school students taking part in the COMPASS prospective cohort study during Y2 (2013/2014; n = 45,298), Y3 (2014/2015, n = 42,355), Y4 (2015/2016; n = 40,436), Y5 (2016/2017; n = 37,060), and Y6 (2017/2018; n = 34,879). RESULTS Poly-substance use increased significantly over time, with over 50% of students who used substance reporting past-year use of multiple substances by 2017/2018. Male and Indigenous students were significantly more likely to report poly-substance use than female and white students respectively. E-cigarette vaping doubled from Y5 to Y6 and was included in all increasingly prevalent substance use combinations. CONCLUSIONS Youth poly-substance use, rising since 2012/2013, saw a particularly steep increase after 2016/2017. Differential effects were observed for distinct demographic subpopulations, indicating tailored interventions may be required. E-cigarette vaping surged in parallel with the observed increase, suggesting a key role for this behaviour in shaping youth poly-substance use.
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Affiliation(s)
- Alexandra M.E. Zuckermann
- University of Waterloo, School of Public Health and Health Systems, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
- Public Health Agency of Canada, Applied Research Division, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Gillian Williams
- University of Waterloo, School of Public Health and Health Systems, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
| | - Katelyn Battista
- University of Waterloo, School of Public Health and Health Systems, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
| | - Margaret de Groh
- Public Health Agency of Canada, Applied Research Division, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Ying Jiang
- Public Health Agency of Canada, Applied Research Division, 785 Carling Ave, Ottawa, ON K1A 0K9, Canada
| | - Scott T. Leatherdale
- University of Waterloo, School of Public Health and Health Systems, 200 University Avenue, Waterloo, ON N2L 3G1, Canada
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Decision-Making as a Latent Construct and its Measurement Invariance in a Large Sample of Adolescent Cannabis Users. J Int Neuropsychol Soc 2019; 25:661-667. [PMID: 31043184 PMCID: PMC6688949 DOI: 10.1017/s1355617719000341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Relative to the vast literature that employs measures of decision-making (DM), rigorous examination of their psychometric properties is sparse. This study aimed to determine whether three measures of DM assess the same construct, and to measure invariance of this construct across relevant covariates. METHOD Participants were 372 adolescents at risk of escalation in cannabis use. DM was assessed via four indices from the Cups Task, Game of Dice Task (GDT), and Iowa Gambling Task (IGT). We used confirmatory factor analysis to assess unidimensionality of the DM construct, and moderated nonlinear factor analysis (MNLFA) to examine its measurement invariance. RESULTS The unidimensional model of DM demonstrated good fit. MNLFA results revealed that sex influenced mean DM scores, such that boys had lower risk-taking behaviors. There was evidence of differential item functioning (DIF), such that IQ and age moderated the IGT intercept and GDT factor loading, respectively. Significant effects were retained in the final model, which produced participant-specific DM factor scores. These scores showed moderate stability over time. CONCLUSIONS Indices from three DM tasks loaded significantly onto a single factor, suggesting that these DM tasks assess a single underlying construct. We suggest that this construct represents the ability to make optimal choices that maximize rewards in the presence of risk. Our final DM factor accounts for DIF caused by covariates, making it comparable across adolescents with different characteristics. (JINS, 2019, 25, 661-667).
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Vaughn MG, Salas-Wright CP, Jackson DB. The complex genetic and psychosocial influences on polysubstance misuse. Curr Opin Psychol 2019; 27:62-66. [DOI: 10.1016/j.copsyc.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/07/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
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