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Lemmer D, Moessner M, Arnaud N, Baumeister H, Mutter A, Klemm SL, König E, Plener P, Rummel-Kluge C, Thomasius R, Kaess M, Bauer S. The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial. J Med Internet Res 2024; 26:e54478. [PMID: 38656779 PMCID: PMC11079770 DOI: 10.2196/54478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers. OBJECTIVE This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people. METHODS This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability. RESULTS No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems. CONCLUSIONS Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults. TRIAL REGISTRATION German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.
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Affiliation(s)
- Diana Lemmer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany
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Gresko SA, Rieselbach M, Corley RP, Hopfer CJ, Stallings MC, Hewitt JK, Rhee SH. Subjective effects as predictors of substance use disorders in a clinical sample: A longitudinal study. Drug Alcohol Depend 2023; 249:110822. [PMID: 37331303 PMCID: PMC10851615 DOI: 10.1016/j.drugalcdep.2023.110822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND The literature on the association between subjective effects (SEs; i.e., how an individual perceives their physiological and psychological reactions to a drug) and substance use disorders (SUDs) is largely limited to community samples. The present study addressed the following aims in a clinical sample: whether SEs predict general versus substance-specific SUD in adolescence and adulthood after controlling for conduct disorder symptoms (CDsymp); whether SEs predict SUDs across drug classes; whether SEs predict change in SUD from adolescence to adulthood; and whether there are racial/ethnic differences in associations. METHODS Longitudinal analyses were conducted using data from a sample of 744 clinical probands recruited from residential and outpatient SUD treatment facilities in CO during adolescence (Mage = 16.26) and re-assessed twice in adulthood (Mages = 22.56 and 28.96), approximately seven and twelve years after first assessment. SEs and CDsymp were assessed in adolescence. SUD severity was assessed at adolescence and twice during adulthood. RESULTS SEs assessed in adolescence robustly predicted general SUD for legal and illegal substances in adolescence and adulthood, whereas CDsymp predicted SUD primarily in adolescence. Higher positive and negative SEs in adolescence were associated with greater SUD severity after controlling for CDsymp, with similar magnitudes. Results indicated cross-substance effects of SEs on SUD. We found no evidence for racial/ethnic differences in associations. CONCLUSIONS We investigated the progression of SUD in a high-risk sample with greater odds of sustained SUD. In contrast to CDsymp, both positive and negative SEs consistently predicted general SUD across substances in adolescence and adulthood.
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Affiliation(s)
- Shelley A Gresko
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States.
| | - Maya Rieselbach
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, United States
| | - Christian J Hopfer
- Institute for Behavioral Genetics, University of Colorado Boulder, United States; University of Colorado Denver Medical School, United States
| | - Michael C Stallings
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States
| | - John K Hewitt
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder, United States; Institute for Behavioral Genetics, University of Colorado Boulder, United States
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Tein JY, Wang FL, Oro V, Kim H, Shaw D, Wilson M, Lemery-Chalfant K. The role of early intervention for adolescent mental health and polydrug use: Cascading mediation through childhood growth in the general psychopathology (p) factor. Dev Psychol 2023; 59:1484-1495. [PMID: 37199932 PMCID: PMC10524853 DOI: 10.1037/dev0001543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This study is a secondary data analysis that extends knowledge about the effects of the early childhood Family Check-Up (FCU) intervention to trajectories of general psychopathology problems (p factor) across early and middle childhood, and effects on adolescent psychopathology and polydrug use. The Early Steps Multisite study (ClinicalTrials.gov Identifier NCT00538252) is a randomized controlled trial of the FCU and consists of a large, racially and ethnically diverse sample of children who grew up in low-income households in Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia (n = 731; 49% female; 27.6% African American, 46.7% European American, 13.3% Hispanic/Latinx). To represent a comorbid presentation of internalizing and externalizing problems, we fit a bifactor model that included a general psychopathology (p) factor at eight ages in early childhood (ages 2-4), middle childhood (ages 7.5-10.5), and adolescence (age 14). Latent growth curve modeling was conducted to examine trajectories of the p factor across ages within the developmental periods of early and middle childhood. The effects of FCU on the reductions in growth in the childhood p factor had cascading effects on adolescent p factor (i.e., within-domain effect) and polydrug use (i.e., across-domain effect). Findings underscore the utility of the early FCU in preventing a host of maladaptive adolescent outcomes across diverse settings and populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Anker JJ, Thuras P, Shuai R, Hogarth L, Kushner MG. Evidence for an alcohol-related "harm paradox" in individuals with internalizing disorders: Test and replication in two independent community samples. Alcohol Clin Exp Res 2023; 47:713-723. [PMID: 37115410 PMCID: PMC10416809 DOI: 10.1111/acer.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Internalizing (anxiety and mood) disorders (INTD) commonly co-occur (are "comorbid") with alcohol use disorder (AUD). The literature suggests that excessive alcohol use aimed at coping with INTD symptoms is, at best, a partial explanation for the high comorbidity rates observed. We hypothesized that individuals with INTD experience greater susceptibility to developing AUD symptoms due to the partially shared neurobiological dysfunctions underlying both conditions. We probe this hypothesis by testing the prediction that, after accounting for the volume of alcohol intake, individuals with INTD experience higher levels of alcohol-related symptoms. METHODS Data from the National Epidemiological Survey on Alcohol-Related Conditions (NESARC) Wave 3 were used for the primary analyses, and NESARC Wave 1 data were used for independent replication analyses. Individuals who reported any alcohol use in the prior year were categorized as: (1) never having had an INTD diagnosis ("INTD-Never"); (2) having a remitted INTD diagnosis only ("INTD-Remitted"); or (3) having current INTD diagnosis ("INTD-Current"). Between-group contrasts of alcohol-related symptoms controlled for total alcohol intake (past year), drinking pattern (e.g., binging) and variables previously shown to mark exaggerated AUD symptoms relative to drinking amount (e.g., SES, gender, and family history). RESULTS With all covariates in the model, individuals in the INTD-Current group and the INTD-Remitted group reported significantly greater alcohol-related symptoms than those in the INTD-Never group but did not themselves differ in level of alcohol-related symptoms. These results were replicated in the NESARC 1 dataset. CONCLUSIONS Individuals with INTD experience more alcohol-related symptoms than those who drink at the same level. While considering other explanations, we argue that this "harm paradox" is best explained by the view that INTD confers a neurobiologically mediated susceptibility to the development of AUD symptoms.
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Affiliation(s)
- Justin J. Anker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota – Minneapolis, Minneapolis, Minnesota, USA
| | - Paul Thuras
- Minneapolis VA Medical Center, Minneapolis, Minneapolis, Minnesota, USA
| | | | - Lee Hogarth
- School of Psychology, University of Exeter, Exeter, UK
| | - Matt G. Kushner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota – Minneapolis, Minneapolis, Minnesota, USA
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Defoe IN, Khurana A, Betancourt LM, Hurt H, Romer D. Cascades From Early Adolescent Impulsivity to Late Adolescent Antisocial Personality Disorder and Alcohol Use Disorder. J Adolesc Health 2022; 71:579-586. [PMID: 35934585 PMCID: PMC11184504 DOI: 10.1016/j.jadohealth.2022.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE The behavioral disinhibition model (BDM) posits that a liability toward impulsivity evident by early adolescence underlies the coemergence of antisocial behavior and alcohol use (i.e., problem behaviors) in early-adolescence to mid-adolescence, but that the subsequent development of these problem behaviors (rather than impulsivity itself) predicts the emergence of antisocial personality disorder (APD) and alcohol use disorder (AUD) in late adolescence. The present study was designed to test these predictions of the BDM from early to late adolescence. METHODS We used five-year longitudinal self-report data from the Philadelphia Trajectory Study that was collected from 2006-2012. Mediational analyses were performed using the Random Intercept Cross-lagged Panel Model, which enables the detection of within-person predictions of changes in problem behaviors during adolescence. The sample was ethnically and socioeconomically diverse, including 364 urban US community youth (at baseline: Mage = 13.51(.95); 49.1% female). RESULTS Consistent with the BDM, mediational analyses revealed that changes in early adolescent impulsivity predicted late adolescent APD and AUD criteria, mediated by changes in mid-adolescent alcohol use and conduct problems. DISCUSSION Interventions targeting impulsivity in early adolescence could potentially halt the cascading chain of events leading to both late adolescent APD and AUD by decelerating growth in antisocial behavior and alcohol use during early-adolescence to mid-adolescence. From mid-adolescence to late-adolescence, the consequences of early impulsivity, especially involvement in antisocial behaviors, become a more relevant predictor of both APD and AUD rather than impulsivity itself.
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Affiliation(s)
- Ivy N Defoe
- Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands.
| | - Atika Khurana
- Counseling Psychology and Human Services Department, University of Oregon, Eugene, Oregon
| | - Laura M Betancourt
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hallam Hurt
- Division of Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel Romer
- Annenberg Public Policy Center, The University of Pennsylvania, Philadelphia, Pennsylvania
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Poor sleep quality mediates the relationship between intra-family conflict and mental health problems in Chinese adolescents: a three-wave longitudinal study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Willis BM, Kersh PP, Buchanan CM, Cole VT. Internalizing and externalizing pathways to high-risk substance use and geographic location in Australian adolescents. Front Psychol 2022; 13:933488. [PMID: 35992437 PMCID: PMC9387922 DOI: 10.3389/fpsyg.2022.933488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022] Open
Abstract
One specific instantiation of the storm-and-stress view of adolescence is the idea that “normal” adolescence involves high-risk substance use behaviors. However, although uptake of some substance use behaviors is more common during adolescence than other life stages, it is clear that not all adolescents engage in risky substance use—and among those who do, there is much variation in emotional, behavioral, and contextual precursors of this behavior. One such set of predictors forms the internalizing pathway to substance use disorder, whereby internalizing symptoms in childhood such as negative affect and anxiety set off a chain of consequences culminating in high-risk substance use in late adolescence. However, findings linking internalizing symptoms to substance use are mixed, and it is clear that this link varies across adolescents and contexts. One heretofore unanswered question is whether and how geographic location, specifically whether the adolescent lives in an urban or rural location, moderates this link. The current report is a secondary analysis of data from the Longitudinal Study of Australian Children (LSAC; N = 2,285), in which we examined the link between internalizing symptoms in childhood and initiation of substance use through age 19. Using a multiple event process survival mixture model (MEPSUM), we identified three trajectories of substance use initiation in adolescence: one (65.7% of the sample) characterized by near-complete abstinence until late adolescence, another (27.2%) by earlier initiation of alcohol, nicotine, and cannabis, and another (7.2%) by early initiation of these substances and later initiation of more hazardous drugs such as cocaine and methamphetamine. Although childhood externalizing symptoms increased the risk of being in the second or third class, internalizing symptoms decreased risk when rural and non-rural adolescents were considered together. Few effects of rurality were found, but the negative relationship between internalizing at age 10 and high-risk substance use was only observed among non-rural adolescents. This finding, which was inconsistent with our initial predictions that rurality might confer higher risk for substance use, instead suggests a potentially protective effect of internalizing symptoms for engagement in risky substance use which may differ based on an adolescent’s geographical context.
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Rosa-Justicia M, Saam MC, Flamarique I, Borràs R, Naaijen J, Dietrich A, Hoekstra PJ, Banaschewski T, Aggensteiner P, Craig MC, Sethi A, Santosh P, Sagar-Ouriaghli I, Arango C, Penzol MJ, Brandeis D, Werhahn JE, Glennon JC, Franke B, Zwiers MP, Buitelaar JK, Schulze UME, Castro-Fornieles J. Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits. Eur Child Adolesc Psychiatry 2022; 31:51-66. [PMID: 33147348 DOI: 10.1007/s00787-020-01662-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
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Affiliation(s)
- Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael C Craig
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Arjun Sethi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Paramala Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain.
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A brief video-coaching intervention buffers young children's vulnerability to the impact of caregivers’ depressive symptoms: Examination of differential susceptibility. Dev Psychopathol 2021. [DOI: 10.1017/s0954579421000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractInformed by the National Institute of Mental Health's Research Domain Criteria (RDoC) and developmental psychopathology frameworks, the current study used cortisol area under the curve with respect to ground (AUCg) as an index of differential sensitivity to context, which was expected to predispose young children with elevated vulnerability to adverse caregiving experiences and adaptive sensitivity to intervention effects. Particularly, the study aimed to determine whether improving caregivers’ responsive parenting through the Filming Interactions to Nurture Development (FIND) intervention would buffer children's biologically embedded vulnerability to caregivers’ depressive symptoms. Data were derived from a randomized controlled trial using pretest–posttest design with low-income families of children aged 4 to 36 months (N = 91). Young children's differential sensitivity was measured using cortisol AUCg during a structured stress paradigm. As hypothesized, children whose cortisol AUCg indicated greater sensitivity to social context exhibited more internalizing and externalizing behaviors in relation to caregivers’ elevated depressive symptoms. Critically, the intervention program was effective in attenuating psychopathology symptoms among the more biologically sensitive children. As proven by rigorous statistical tests, the findings of this study partially supported the differential susceptibility hypotheses, indicating both greater vulnerability to adverse conditions and responsiveness to intervention among children with high levels of cortisol AUCg.
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Cheng HG, Edwards AC. Major depressive symptoms and escalation of drinking among new drinkers in the United States: Variations across sex and age groups. Addict Behav 2021; 122:107017. [PMID: 34146797 DOI: 10.1016/j.addbeh.2021.107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Heavy episodic drinking is common in the United States (US) and causes substantial burden to individuals and the society. The transition from first drinking to first heavy drinking episode is a major milestone in the escalation of drinking. There is limited evidence about whether major depressive symptoms predict the progression from drinking to heavy drinking and potential variations across age, sex, and depressive symptoms. In this study, we aim to estimate the association between history of major depressive symptoms and the risk of first heavy drinking episode among new drinkers in the US. METHODS Study population was US non-institutionalized civilian new drinkers 12 years of age and older who had their first drink during the past 12 months drawn from the National Survey on Drug Use and Health. History of major depressive symptoms and alcohol drinking behaviors were assessed via audio-computer-assisted self-interviews. Logistic regressions and structural equation modeling were used for analysis. RESULTS Depressed mood and/or anhedonia predicted the transition from the first drink to a heavy drinking episode among underage female new drinkers, whereas null associations were found among males and female new drinkers who had their first drink at 21 and later. Among new drinkers with depressed mood and/or anhedonia, low mood or energy positively predicted the progression to a heavy drinking episode among late-adolescent boys, but negatively among late-adolescent girls; neurovegetative symptoms positively predicted the progression to a heavy drinking episode among young adult new drinkers. CONCLUSIONS The relationships linking major depressive symptoms and the transition from drinking to first heavy drinking episode vary across age, sex, and depressive symptoms.
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11
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Henderson JL, Wilkins LK, Hawke LD, Wang W, Sanches M, Brownlie EB, Beitchman JH. Longitudinal Emergence of Concurrent Mental Health and Substance Use Concerns in an Ontario School-Based Sample: The Research and Action for Teens Study. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:249-263. [PMID: 34777508 PMCID: PMC8561851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study characterizes patterns of mental health, substance use and their co-occurrence, and identifies developmental trajectories associated with progression from single to concurrent mental health and substance use concerns in an Ontario school-based population. It is a longitudinal extension of the Ontario Student Drug Use and Mental Health Survey, as part of the RAFT collaborative project. METHODS In this study, an Ontario-wide survey was administered to students across three biennial waves starting in grades 7-8 (ages 12-14). We explored how developmental patterns of externalizing, internalizing and co-occurring symptoms were differentially associated with late-adolescent (ages 17-19) problematic substance use. RESULTS On average, students exhibited early (ages 12-14) moderate risk of an internalizing and/or externalizing disorder and approached the low threshold for a diagnostic concern for substance use disorder at age 17-19. The pattern confirmed a potential pathway from early mental health concerns to later adolescent problematic substance use, with rates of co-occurrence increasing with age. Youth with early moderate-to high externalizing and co-occurring internalizing and externalizing symptomology had the highest levels of problematic substance use, with scores indicating high likelihood of a substance use disorder diagnosis. CONCLUSIONS Given the overall pattern of progression, early identification and referral of at-risk youth, especially youth with co-occurring mental health concerns, is of critical importance. Findings support the importance of integrated and co-located mental health and substance use services for youth to more effectively serve a diverse population of youth with varying levels of need.
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Affiliation(s)
- Joanna L Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | | | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Marcos Sanches
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
| | - E B Brownlie
- Centre for Addiction and Mental Health, Toronto, Ontario
| | - Joseph H Beitchman
- Centre for Addiction and Mental Health, Toronto, Ontario
- University of Toronto, Toronto, Ontario
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12
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Ning K, Patalay P, L Maggs J, Ploubidis GB. Early life mental health and problematic drinking in mid-adulthood: evidence from two British birth cohorts. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1847-1858. [PMID: 33765212 PMCID: PMC8429378 DOI: 10.1007/s00127-021-02063-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/10/2021] [Indexed: 01/30/2023]
Abstract
PURPOSE Accumulating evidence suggests that externalising problems are consistently associated with alcohol use behaviours, but findings are inconsistent regarding the role of internalising problems. We investigate whether externalising and internalising problems are associated with problematic drinking in mid-adulthood, and whether potential associations are modified by age, sex and cohort. METHODS The National Child Development Study (NCDS58, n = 17,633) and 1970 British Cohort Study (BCS70, n = 17,568) recruited new-borns in Great Britain in a single week in 1958 and 1970. Mental health was assessed with the Rutter Behaviour Questionnaire at ages 7, 11, and 16 in NCDS58 and ages 5, 10 and 16 in BCS70. Problematic drinking was measured with the CAGE questionnaire at age 33 in NCDS58 and age 34 in BCS70, and the AUDIT scale at age 44/45 in NCDS58 and age 46 in BCS70. Latent scores of externalising and internalising problems were added chronologically into lagged logistic regression models. RESULTS Externalising and internalising problems were associated in opposite directions with problematic drinking in mid-adulthood. Externalising was a risk factor (OR [95% CI] ranging from 1.06 [1.03, 1.10] to 1.11 [1.07, 1.15] for different ages), and internalising was a protective factor (OR [95% CI] ranging from 0.95 [0.92, 0.99] to 0.90 [0.86, 0.94] for different ages). Associations between early life mental health and mid-adulthood problematic drinking did not differ by developmental timing but were stronger in males. CONCLUSION Our study provides new insights on links of externalising and internalising difficulties with alcohol use and has implications for public policy in the UK.
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Affiliation(s)
- Ke Ning
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK.
| | - Praveetha Patalay
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jennifer L Maggs
- College of Health and Human Development, Pennsylvania State University, State College, USA
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
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13
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Patrick ME, Evans-Polce RJ, Parks MJ, Terry-McElrath YM. Drinking Intensity at Age 29/30 as a Predictor of Alcohol Use Disorder Symptoms at Age 35 in a National Sample. J Stud Alcohol Drugs 2021. [PMID: 34100704 DOI: 10.15288/jsad.2021.82.362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The purpose of this longitudinal study was to identify associations of drinking intensity at age 29/30 with symptoms of alcohol use disorder (AUD) at age 35. METHOD Analyses used national longitudinal data from 1,253 individuals (53.5% female) participating in the Monitoring the Future study. Age 29/30 data were collected from 2005 to 2013; age 35 data were collected from 2010 to 2018. Multivariable models regressed age 35 past-5-year AUD symptoms (vs. nondisordered drinking/abstinence) on age 29/30 past-2-week drinking intensity (no/low [0-4] drinking, binge [5-9] drinking, high-intensity [10+] drinking), with key covariates being controlled for. RESULTS At age 35, 32.6% (SE = 1.50) of respondents reported AUD symptoms. AUD symptoms at age 35 were reported by 77.5% (SE = 4.79) of participants who reported age 29/30 high-intensity drinking and 60.6% (SE = 3.95) of participants who reported age 29/30 binge drinking. Age 35 past-5-year abstinence was reported by almost no respondents reporting age 29/30 binge drinking or high-intensity drinking. AUD symptoms at age 35 were significantly more likely for those who reported binge (adjusted multivariable odds ratio [AOR] = 5.61, 95% CI [3.79, 8.30], p < .001) or high-intensity (AOR = 12.26, 95% CI [6.70, 22.41], p < .001) drinking versus no/low drinking at age 29/30. The likelihood of having AUD symptoms was significantly higher for high-intensity than for binge drinkers (AOR = 2.18, 95% CI [1.14, 4.19], p = .019). CONCLUSIONS Nearly 80% of those young adults who reported engaging in high-intensity drinking (10+ drinks in a row) at age 29/30 later reported AUD symptoms at age 35. High-intensity drinking appears to be a strong prospective marker of risk for AUD symptoms among adults in the United States.
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Affiliation(s)
- Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Michael J Parks
- Institute for Translational Research in Children's Mental Health, Minneapolis, Minnesota
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14
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Patrick ME, Evans-Polce RJ, Parks MJ, Terry-McElrath YM. Drinking Intensity at Age 29/30 as a Predictor of Alcohol Use Disorder Symptoms at Age 35 in a National Sample. J Stud Alcohol Drugs 2021; 82:362-367. [PMID: 34100704 PMCID: PMC8328234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/07/2021] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE The purpose of this longitudinal study was to identify associations of drinking intensity at age 29/30 with symptoms of alcohol use disorder (AUD) at age 35. METHOD Analyses used national longitudinal data from 1,253 individuals (53.5% female) participating in the Monitoring the Future study. Age 29/30 data were collected from 2005 to 2013; age 35 data were collected from 2010 to 2018. Multivariable models regressed age 35 past-5-year AUD symptoms (vs. nondisordered drinking/abstinence) on age 29/30 past-2-week drinking intensity (no/low [0-4] drinking, binge [5-9] drinking, high-intensity [10+] drinking), with key covariates being controlled for. RESULTS At age 35, 32.6% (SE = 1.50) of respondents reported AUD symptoms. AUD symptoms at age 35 were reported by 77.5% (SE = 4.79) of participants who reported age 29/30 high-intensity drinking and 60.6% (SE = 3.95) of participants who reported age 29/30 binge drinking. Age 35 past-5-year abstinence was reported by almost no respondents reporting age 29/30 binge drinking or high-intensity drinking. AUD symptoms at age 35 were significantly more likely for those who reported binge (adjusted multivariable odds ratio [AOR] = 5.61, 95% CI [3.79, 8.30], p < .001) or high-intensity (AOR = 12.26, 95% CI [6.70, 22.41], p < .001) drinking versus no/low drinking at age 29/30. The likelihood of having AUD symptoms was significantly higher for high-intensity than for binge drinkers (AOR = 2.18, 95% CI [1.14, 4.19], p = .019). CONCLUSIONS Nearly 80% of those young adults who reported engaging in high-intensity drinking (10+ drinks in a row) at age 29/30 later reported AUD symptoms at age 35. High-intensity drinking appears to be a strong prospective marker of risk for AUD symptoms among adults in the United States.
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Affiliation(s)
- Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Michael J. Parks
- Institute for Translational Research in Children's Mental Health, Minneapolis, Minnesota
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Perrenoud LO, Oikawa KF, Williams AV, Laranjeira R, Fischer B, Strang J, Ribeiro M. Factors associated with crack-cocaine early initiation: a Brazilian multicenter study. BMC Public Health 2021; 21:781. [PMID: 33892673 PMCID: PMC8063477 DOI: 10.1186/s12889-021-10769-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Crack-cocaine dependence is a serious public health issue, related to several psychiatric and psychosocial problems. Crack-cocaine users are usually embedded in a context of great social vulnerability, often associated with violence, poverty, family conflict and easy and early access to alcohol, tobacco and other drugs. METHODS This cross-sectional study enrolled a consecutive sample of 577 patients admitted to 20 therapeutic communities located in Southern Brazil, between September 2012 and September 2013. A structured interview assessed life-time exposure to risk and protective factors for drug use, such as parental monitoring in childhood, deviant behaviors and peer pressure. RESULTS Presence of family conflict (p = 0.002), maltreatment (p = 0.016), and deviant behavior prior to age 15 in a bivariate analysis predicted an earlier age of crack-cocaine initiation, whereas adolescents experiencing parental monitoring during adolescence started use later (p < 0.001). In the multivariate model, perceptions related to ease of access of illicit drugs (marijuana: p = 0.028, 95% CI = - 3.81, - 0.22; crack-cocaine: p < 0.001, 95% CI = - 7.40, - 4.90), and deviant behavior (threatening someone with a gun: p = 0.028, 95% CI = - 2.57, - 0.14) remained independent predictors of early age of crack-cocaine initiation. CONCLUSIONS Early onset of crack-cocaine use seems to be associated with exposure to family conflict, easy access to drugs and deviant behavior. Treatment and preventive programs should take these factors into account when designing and implementing community interventions.
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Affiliation(s)
- Luciane Ogata Perrenoud
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, Rua Prates, 165, 01121000 São Paulo, Brazil
| | - Koki Fernando Oikawa
- Department of Statistics, Brazil University, São Paulo, Brazil, Rua Ibipetuba, 130, SP 03127-180 São Paulo, Brazil
| | - Anna Virginia Williams
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK, 4, Windsor Walk Denmark Hill, SE5 8AF London, UK
| | - Ronaldo Laranjeira
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
| | - Benedikt Fischer
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Applied Research in Mental Health and Addiction, Simon Fraser University (SFU Faculty of Health Sciences, 515 W. Hastings Street, Vancouver, BC V6B 5K3), Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON. M5T 1R8 Canada
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK, 4, Windsor Walk Denmark Hill, SE5 8AF London, UK
| | - Marcelo Ribeiro
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil, Rua Major Maragliano, 241, SP 04017030 São Paulo, Brazil
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD), São Paulo State Secretary of Health, Rua Prates, 165, 01121000 São Paulo, Brazil
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16
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Amiri S, Fathi-Ashtiani M, Sedghijalal A, Fathi-Ashtiani A. Parental divorce and offspring smoking and alcohol use: a systematic review and meta-analysis of observational studies. J Addict Dis 2021; 39:388-416. [PMID: 33648433 DOI: 10.1080/10550887.2021.1886576] [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: 12/14/2022]
Abstract
OBJECTIVE This study was conducted to investigate the relationship between parental divorce and smoking and alcohol consumption in offspring, which is based on a systematic review method and ultimately meta-analysis. Method: In a systematic search, three databases were selected. The manuscripts were searched based on the keywords and the time limit for the search was published manuscripts in English until November 2020. For the relationship between parental divorce and smoking/alcohol use in offspring, one main analysis, and four analyses based on sex, study design, adjusted level, and continents were performed. Result: Forty-three studies were synthesized from the collection of manuscripts. The odds of smoking in offspring whose parents were separated was 1.45 (CI 1.37-1.54) and this odds in men was equal to 1.38 (CI 1.11-1.71; Z = 2.91; p = 0.004; I2 = 81.5%) and in women, 1.78 (CI 1.51-2.10; Z = 6.88; p < 0.001; I2 = 69.6%). The odds of alcohol use in offspring whose parents were separated was 1.43 (CI 1.15-1.77) and this odds in men was equal to 1.69 (CI 1.16-2.47; Z = 2.73; p = 0.006; I2 = 99.6%) and in women 1.79 (CI 1.07-2.99). Discussion: The findings of the present study can be used in health-related policies, prevention, and clinical interventions. This study was a subject with limitations, also.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Azadeh Sedghijalal
- Department of Sociology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Fathi-Ashtiani
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Iranian Academy of Medical Sciences, Tehran, Iran
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17
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Opara I, Weissinger GM, Lardier DT, Lanier Y, Carter S, Brawner BM. Mental Health Burden among Black Adolescents: The Need for Better Assessment, Diagnosis and Treatment Engagement. SOCIAL WORK IN MENTAL HEALTH 2021; 19:88-104. [PMID: 34248423 PMCID: PMC8262091 DOI: 10.1080/15332985.2021.1879345] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N=154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups experienced high amounts of trauma exposure history, recent suicidality, substance use, and depressive symptoms. Nearly one in four adolescents in the out of treatment group met diagnostic criteria for anxiety disorders. Implications include better screening for mental health symptoms to ensure Black adolescent have access to mental health treatment.
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18
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Morales AM, Jones SA, Kliamovich D, Harman G, Nagel BJ. Identifying Early Risk Factors for Addiction Later in Life: A Review of Prospective Longitudinal Studies. CURRENT ADDICTION REPORTS 2020; 7:89-98. [PMID: 33344103 DOI: 10.1007/s40429-019-00282-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose of Review To review prospective longitudinal studies that have identified risk factors for the development of substance use disorders in adulthood from individual differences during childhood and adolescence. Recent Findings Risk factors during childhood and adolescence that have been consistently linked to increased risk for addiction include externalizing and internalizing symptoms, early substance use, and environmental influences, such as parental behavior and exposure to traumatic experiences. Summary Since the etiology of substance use disorders is complex and likely is attributable to many causal pathways, systematic examination of the associations between risk factors will be necessary to understand the mixed findings in the existing literature, to determine which individuals should be targeted for prevention efforts, and to design interventions that address risk factors that are most likely to improve outcomes.
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Affiliation(s)
- Angelica M Morales
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Scott A Jones
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Dakota Kliamovich
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Gareth Harman
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Bonnie J Nagel
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
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19
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Little K, Hawkins MT, Sanson A, O'connor M, Toumbourou JW, Smart D, Vassallo S. Longitudinal Predictors of Alcohol‐Related Harms During the Transition to Adulthood. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00095.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Keriann Little
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Mary T Hawkins
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Ann Sanson
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Meredith O'connor
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - John W Toumbourou
- School of Psychology and Centre for Mental Health and Wellbeing Research, Deakin University,
- Centre for Adolescent Health, Murdoch Children's Research Institute,
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20
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Siennick SE, Widdowson AO, Feinberg ME. Youth with Co-occurring Delinquency and Depressive Symptoms: Do They Have Better or Worse Delinquent Outcomes? J Youth Adolesc 2020; 49:1260-1276. [PMID: 32108301 DOI: 10.1007/s10964-020-01213-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/15/2020] [Indexed: 10/24/2022]
Abstract
Delinquent youth often experience depression, but depression's impact on their future deviance is unclear. Using survey and social network data on a panel of 9th graders (N = 8701; Mage at baseline = 15.6; 48% male; 85% white; 18% eligible for free or reduced-price school lunch) followed throughout high school, this study tested whether depressive symptoms predicted later deviance or deviant peer affiliations among already delinquent youth. A latent class analysis revealed that 4% of respondents showed above-average levels of delinquency but not depressive symptoms, and 3% were above average on both. Compared to the delinquent-only group, the delinquent-depressed group went on to have less deviant friends, and to engage in less deviance themselves. However, peer deviance was not a reliable explanation for the reductions in respondents' own future deviance. Depressive symptoms thus may play a protective role against continued delinquency and substance use among youth who are already delinquent, but it is not because they reduce deviant peer affiliations.
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Affiliation(s)
- Sonja E Siennick
- College of Criminology and Criminal Justice, Florida State University, 112 S. Copeland Street, Tallahassee, FL, 32306, USA.
| | - Alex O Widdowson
- Department of Criminal Justice, University of Louisville, 2301 South Third Street, Louisville, KY, 40292, USA
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 308 Biobehavioral Health, University Park, PA, 16802, USA
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21
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Ning K, Gondek D, Patalay P, Ploubidis GB. The association between early life mental health and alcohol use behaviours in adulthood: A systematic review. PLoS One 2020; 15:e0228667. [PMID: 32069303 PMCID: PMC7028290 DOI: 10.1371/journal.pone.0228667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.
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Affiliation(s)
- Ke Ning
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Dawid Gondek
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
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22
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Meque I, Salom C, Betts KS, Alati R. Predictors of Alcohol Use Disorders Among Young Adults: A Systematic Review of Longitudinal Studies. Alcohol Alcohol 2019; 54:310-324. [PMID: 30942386 DOI: 10.1093/alcalc/agz020] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 02/11/2019] [Accepted: 02/26/2019] [Indexed: 01/13/2023] Open
Abstract
AIMS Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults. METHODS We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains. RESULTS AND CONCLUSION Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.
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Affiliation(s)
- Ivete Meque
- The University of Queensland, Institute for Social Science Research, Level 2 Cycad Building (1018), 80 Meiers Road, Indooroopilly QLD, Brisbane, Australia
| | - Caroline Salom
- The University of Queensland, Institute for Social Science Research, Level 2 Cycad Building (1018), 80 Meiers Road, Indooroopilly QLD, Brisbane, Australia
| | - Kim S Betts
- School of Public Health, Curtin University, Kent Street Bentley Campus, Bentley, WA, Perth, Australia
| | - Rosa Alati
- The University of Queensland, Institute for Social Science Research, Level 2 Cycad Building (1018), 80 Meiers Road, Indooroopilly QLD, Brisbane, Australia.,School of Public Health, Curtin University, Kent Street Bentley Campus, Bentley, WA, Perth, Australia
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23
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Dyer ML, Heron J, Hickman M, Munafò MR. Alcohol use in late adolescence and early adulthood: The role of generalized anxiety disorder and drinking to cope motives. Drug Alcohol Depend 2019; 204:107480. [PMID: 31706711 PMCID: PMC6891250 DOI: 10.1016/j.drugalcdep.2019.04.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The relationship between anxiety and alcohol use is unclear, and moderating factors, such as drinking to cope (DTC) motives, may explain mixed findings. METHODS Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined associations between generalized anxiety disorder (GAD) at age 18 and frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking at ages 18 (unadjusted n = 3462) and 21 (unadjusted n = 2076), in a sample of late adolescent drinkers. Analyses were adjusted for sociodemographic, parental, and adolescent confounders. We also examined whether DTC motives influenced the strength and direction of associations between GAD and alcohol use. RESULTS GAD was positively associated with all alcohol outcomes at baseline (unadjusted OR (95% CI): frequent drinking 1.40 (1.02-1.91); frequent bingeing 1.40 (0.96-2.04); hazardous drinking 1.44 (1.08-1.92); harmful drinking 1.98 (1.22-3.23)). GAD increased the odds of harmful drinking at age 21 (unadjusted OR 1.72, 95% CI 1.09-2.73), but there was no clear evidence of a longitudinal relationship between GAD and the other alcohol use outcomes. There was no clear evidence of a GAD x DTC interaction on alcohol use at ages 18 or 21. Findings were consistent across various multiply imputed datasets. CONCLUSIONS In adolescence, GAD symptoms are associated with frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking. In early adulthood, associations remain for harmful drinking only. DTC motives do not appear to moderate the relationship at either age.
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Affiliation(s)
- Maddy L Dyer
- School of Psychological Science, University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
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24
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Meque I, Dachew BA, Maravilla JC, Salom C, Alati R. Externalizing and internalizing symptoms in childhood and adolescence and the risk of alcohol use disorders in young adulthood: A meta-analysis of longitudinal studies. Aust N Z J Psychiatry 2019; 53:965-975. [PMID: 31035781 DOI: 10.1177/0004867419844308] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Evidence suggests that externalizing and internalizing symptoms are expressed early in life and are associated with problematic drinking in young adulthood. However, few studies have examined their role during childhood and adolescence in predicting alcohol problems later in life. OBJECTIVES To examine the role of childhood and adolescent externalizing and internalizing symptoms in predicting alcohol use disorders in young adulthood. METHODS We searched five electronic databases (PubMed, Scopus, PsycINFO, Web of Sciences and Embase) for studies which diagnosed alcohol use disorders through either the International Classification of Diseases or American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders criteria and followed up children or adolescents into the transition to young adulthood. We performed a meta-analysis and obtained pooled odds ratio estimates with 95% confidence intervals using random-effects models. RESULTS A total of 12 longitudinal studies met eligibility criteria and were included in the meta-analysis. All measured the outcome using Diagnostic and Statistical Manual of Mental Disorders criteria. The majority were of good quality and were conducted in the United States. A total of 19,407 participants (50% female) were included in this meta-analysis. Of these, n = 2337 (12%) had diagnoses of alcohol use disorders/alcohol dependence. Participant ages ranged from birth to 36 years. Internalizing symptoms increased the risk of young adult alcohol use disorders by 21% (odds ratio = 1.21; 95% confidence interval = [1.05, 1.39]), with no strong evidence of publication bias. Subgroup analysis suggested significantly lower heterogeneity than for externalizing studies. Externalizing symptoms increased the risk of alcohol use disorders by 62% (odds ratio = 1.62, 95% confidence interval = [1.39, 1.90]). We found some evidence of publication bias and significant heterogeneity in the studies. CONCLUSION Our findings highlight the contribution of early behavioural problems to the development of alcohol use disorders in young adulthood and the need for timely scrutiny of and intervention on early behavioural problems.
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Affiliation(s)
- Ivete Meque
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Berihun Assefa Dachew
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Joemer C Maravilla
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Caroline Salom
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia
| | - Rosa Alati
- Institute for Social Science Research, The University of Queensland, Brisbane, QLD, Australia.,School of Public Health, Curtin University, Bentley, WA, Australia
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25
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The longitudinal relationship of alcohol problems and depressive symptoms and the impact of externalising symptoms: findings from the Belfast Youth Developmental Study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1231-1241. [PMID: 30903238 DOI: 10.1007/s00127-019-01696-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of the present study was to contribute to the inconsistent literature on the comorbid relationship of alcohol problems and depressive symptoms from late adolescent to emerging adulthood by accounting for their trajectories and their conjoint relationship while controlling for the influence of externalising symptoms. METHODS We utilised data, from a longitudinal school cohort from Northern Ireland (Belfast Youth Developmental Study), over three time points where the participants were 16, 17 and 21 years of age. A total of 3118 participants were included, 1713 females and 1405 males. Second-order latent growth models were applied to examine growth trajectories. Parallel process growth models were used to assess whether growth trajectories of the symptoms were associated. Externalising symptoms were subsequently added as a covariate. RESULTS Alcohol problems among males significantly increased over time but decreased in females. Depressive symptoms initially increased then decreased in both genders. Results indicated associations of the alcohol problems and depression, both initially and with time. Accounting for externalising symptoms only somewhat diminished this effect in males but not in females. An increase of initial levels of depression was associated with a decrease in alcohol problems over time. This association was only true among females. After controlling for externalising symptoms, the relationship was no longer observed. CONCLUSIONS The present study provides further evidence of a significant relationship of alcohol problems and depression in adolescents and further supports a small literature indicating that depression may have protective effects of alcohol problems. Finally, the study shows the importance of accounting for externalising symptoms.
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26
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Grubb LK. Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults. Clin Ther 2019; 41:1669-1680. [PMID: 31462387 DOI: 10.1016/j.clinthera.2019.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 11/29/2022]
Abstract
Opioid use disorder (OUD) is a pediatric and adolescent problem as most young adults (aged <25 years) in treatment programs report initiating use before 25 years of age, and there are lifelong impacts from early substance use necessitating early screening for opioid use and subsequent treatment. Medication-assisted treatment (MAT) is a highly effective intervention for OUD, and there is strong evidence for its use with adolescents; however, most adolescents with OUD are unable to access MAT or remain in MAT long term to achieve substantial recovery. Using case examples drawn from a pediatric and adolescent physician's experiences proving MAT to adolescents and young adults (ages 16-24 years), this article explores the personal and socioeconomic determinants in MAT of OUD in adolescents and young adults and provides suggestions for advocacy areas and resources to improve MAT with this population.
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Affiliation(s)
- Laura K Grubb
- Tufts University School of Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA.
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27
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Blair RJR, White SF, Tyler PM, Johnson K, Lukoff J, Thornton LC, Leiker EK, Filbey F, Dobbertin M, Blair KS. Threat Responsiveness as a Function of Cannabis and Alcohol Use Disorder Severity. J Child Adolesc Psychopharmacol 2019; 29:526-534. [PMID: 31170004 DOI: 10.1089/cap.2019.0004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: Two of the most commonly abused substances by adolescents in the United States are alcohol and cannabis, both of which are associated with adverse medical and psychiatric outcomes throughout the lifespan. Both are assumed to impact the development of emotional processing although findings on the direction of this impact have been mixed. Preclinical animal work and some functional magnetic resonance imaging (fMRI) work with humans have suggested cannabis use disorder (CUD) and alcohol use disorder (AUD) are associated with increased threat responsiveness. However, other fMRI work has indicated CUD/AUD are associated with diminished threat responsiveness. In this study, we report on a study examining the relationship of severity of CUD/AUD and threat responsiveness in an adolescent population. Methods: The study involved 87 (43 male) adolescents with varying levels of CUD/AUD symptomatology (N = 45 above clinical cutoffs for CUD or AUD). They were scanned with fMRI during a looming threat task that involved images of threatening and neutral human faces or animals that appeared to be either looming or receding. Results: Increasing levels of CUD symptomatology were associated with decreased responding to looming stimuli within regions, including rostral frontal and fusiform gyrus as well as the amygdala. There were no relationships with AUD symptomatology. Conclusions: These data indicate that CUD in particular is associated with a decrease in responsiveness to the looming threat cue possibly relating to the putative neurotoxic impact of cannabis abuse.
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Affiliation(s)
- Robert James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Stuart F White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Patrick M Tyler
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Kimberly Johnson
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Laura C Thornton
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Emily K Leiker
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Francesca Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas
| | - Matt Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
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28
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Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies. Addiction 2019; 114:968-982. [PMID: 30891835 PMCID: PMC6563455 DOI: 10.1111/add.14575] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings. DESIGN AND SETTING We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later. PARTICIPANTS Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years. MEASUREMENTS Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders). FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87). CONCLUSIONS Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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29
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Henderson JL, Brownlie EB, McMain S, Chaim G, Wolfe DA, Rush B, Boritz T, Beitchman JH. Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: The Research and Action for Teens study. Early Interv Psychiatry 2019; 13:110-119. [PMID: 28745011 PMCID: PMC6492445 DOI: 10.1111/eip.12458] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 03/20/2017] [Accepted: 04/25/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Concurrent mental health and substance use disorders among youth are associated with functional impairment in developmentally salient domains, yet research on prevention and intervention for this vulnerable population is sparse. This paper describes the rationale and design of the Research and Action for Teens study, an initiative designed to strengthen the evidence base for prevention, screening, treatment and service delivery for youth concurrent mental health and substance use concerns. METHODS Four sub-studies were developed: (1) a cohort study examining the emergence of mental health and substance use concerns from early to mid-adolescence; (2) a screening and diagnosis study validating screening tools with a diagnostic interview; (3) a treatment study examining the feasibility and effectiveness of dialectical behaviour therapy skills training interventions for youth and family members; and (4) a systems study implementing cross-sectoral collaborative networks of youth-serving agencies using a common screening tool. RESULTS Multiple stakeholders, including service providers from youth-serving agencies across sectors, consumer groups and family members participated in an initial consultation, and in the implementation of 4 sub-studies. CONCLUSIONS Collaboration with community stakeholders across sectors and disciplines throughout the research process is challenging but feasible, and is important for the production of applicable knowledge across the continuum of care.
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Affiliation(s)
- Joanna L Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - E B Brownlie
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Shelley McMain
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gloria Chaim
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - David A Wolfe
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Centre for Research & Education on Violence Against Women & Children, University of Western Ontario, London, Ontario, Canada
| | - Brian Rush
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Tali Boritz
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joseph H Beitchman
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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30
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Differential dysfunctions related to alcohol and cannabis use disorder symptoms in reward and error-processing neuro-circuitries in adolescents. Dev Cogn Neurosci 2019; 36:100618. [PMID: 30710868 PMCID: PMC6613939 DOI: 10.1016/j.dcn.2019.100618] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 02/06/2023] Open
Abstract
Alcohol and cannabis are two of the most commonly used substances by adolescents and are associated with adverse medical and psychiatric outcomes. These adverse psychiatric outcomes may reflect the negative impact of alcohol and/or cannabis abuse on neural systems mediating reward and/or error detection. However, work indicative of this has mostly been conducted in adults with Alcohol and/or Cannabis Use Disorder (i.e., AUD and CUD), with relatively little work in adolescent patients. Furthermore, of the work that has been conducted in adolescents, groups were based on categorical diagnoses of AUD and/or CUD, so the relationship between AUD and/or CUD symptom severity in adolescents and neural dysfunction is unclear. We used a Monetary Incentive Delay (MID) task to examine the relationship between AUDIT and/or CUDIT scores and functional integrity of neuro-circuitries mediating reward processing and error detection within 150 adolescents. Our findings indicate that AUDIT score is negatively related to activity in reward processing neuro-circuitry in adolescents. However, CUDIT score is negatively related to activity in brain regions involved in error detection. Each of these relationships reflected a medium effect size (Partial-η2 0.09-0.14). These data suggest differential impacts of AUD and CUD on reward versus error detection neuro-circuitries within the adolescent brain.
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31
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Krohn MD, Larroulet P, Thornberry TP, Loughran TA. The Effect of Childhood Conduct Problems on Early Onset Substance Use: An Examination of the Mediating and Moderating Roles of Parenting Styles. JOURNAL OF DRUG ISSUES 2019; 49:139-162. [PMID: 31462825 PMCID: PMC6713280 DOI: 10.1177/0022042618811784] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the role that effective parenting plays in the relationship between childhood conduct problems and the early onset of drug use. Effective parenting is posited to have a direct protective effect on drug use, a moderating effect on the relationship between conduct problems and early onset, and mediate the relationship between conduct problems and early onset. Two-generational panel data are used to examine these relationships among 263 parent–child dyads. Support is found for the direct protective effect of effective parenting on early onset .and for a partial mediating effect of parenting in the relationship between conduct problems and early onset. There was no support found for parenting moderating the risk that is posed by having childhood conduct problems. Implications for preventing childhood conduct problems from resulting in early onset of drug use through enhancing efforts to help parents cope with such problems are discussed.
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32
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Ye P, Tang W, He J, He H. A GEE-type approach to untangle structural and random zeros in predictors. Stat Methods Med Res 2018; 28:3683-3696. [PMID: 30472921 DOI: 10.1177/0962280218812228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Count outcomes with excessive zeros are common in behavioral and social studies, and zero-inflated count models such as zero-inflated Poisson (ZIP) and zero-inflated Negative Binomial (ZINB) can be applied when such zero-inflated count data are used as response variable. However, when the zero-inflated count data are used as predictors, ignoring the difference of structural and random zeros can result in biased estimates. In this paper, a generalized estimating equation (GEE)-type mixture model is proposed to jointly model the response of interest and the zero-inflated count predictors. Simulation studies show that the proposed method performs well for practical settings and is more robust for model misspecification than the likelihood-based approach. A case study is also provided for illustration.
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Affiliation(s)
- Peng Ye
- School of Statistics, University of International Business and Economics, Beijing, China.,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Wan Tang
- Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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33
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Kimonis ER, Fleming G, Briggs N, Brouwer-French L, Frick PJ, Hawes DJ, Bagner DM, Thomas R, Dadds M. Parent-Child Interaction Therapy Adapted for Preschoolers with Callous-Unemotional Traits: An Open Trial Pilot Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:S347-S361. [DOI: 10.1080/15374416.2018.1479966] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Nancy Briggs
- Mark Wainwright Analytical Centre (Stats Central), The University of New South Wales
| | | | - Paul J. Frick
- Department of Psychology, Louisiana State University
- Learning Sciences Institute of Australia, Australian Catholic University
| | | | | | - Rae Thomas
- Faculty of Health Sciences and Medicine, Bond University
| | - Mark Dadds
- School of Psychology, University of Sydney
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Acion L, Kramer J, Liu X, Chan G, Langbehn D, Bucholz K, McCutcheon V, Hesselbrock V, Schuckit M, Dick D, Hesselbrock M, Kuperman S. Reliability and validity of an internalizing symptom scale based on the adolescent and adult Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:151-160. [PMID: 29870277 PMCID: PMC6481182 DOI: 10.1080/00952990.2018.1476520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND The Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) is an interview that assesses psychiatric symptoms and diagnoses, including substance use disorders and anxiety and mood (i.e., internalizing) disorders. Although the SSAGA is widely used, there exists no overall internalizing characteristics scale based on items drawn from SSAGA's mood and anxiety disorder sections. OBJECTIVES To design and assess a SSAGA-based measurement instrument capturing the overall internalizing dimension that underlies more specific internalizing conditions. METHODS We developed, assessed, and characterized a new scale for measuring internalizing problematic characteristics derived from the SSAGA interview. All samples were drawn from the Collaborative Studies on the Genetics of Alcoholism, a prospective multi-site genetic study of families at high risk for alcohol use disorders. All participants taking part in the study between September 2005 and September 2017 were eligible (n = 904, 52.2% female). RESULTS The scale had adequate internal consistency (ordinal α = 0.85, 95% CI = [0.81, 0.89]). Construct validity was supported by its association with other measures of internalizing characteristics (Internalizing Scale from Achenbach Self Reports; Neuroticism Scale from the Neuroticism-Extraversion-Openness Five-Factor Personality Inventory). Several indices of alcohol, marijuana, and nicotine misuse were also positively associated with Internalizing Scale scores. CONCLUSIONS The Internalizing Scale has very good psychometric properties and can be used in studies that incorporate the SSAGA interview to study the association between internalizing characteristics and problematic alcohol and other substance use. These associations can potentially be utilized to identify individuals at risk for substance problems and to design treatments targeting such individuals.
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Affiliation(s)
- Laura Acion
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Iowa Consortium for Substance Abuse Research and Evaluation, Iowa City, Iowa
- Fundación Sadosky, Buenos Aires, Argentina
| | - John Kramer
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Xiangtao Liu
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Grace Chan
- Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut
| | - Douglas Langbehn
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Kathleen Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Vivia McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut
| | - Marc Schuckit
- Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, California
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Michie Hesselbrock
- Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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35
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Fluharty ME, Heron J, Munafò MR. Longitudinal associations of social cognition and substance use in childhood and early adolescence: findings from the Avon Longitudinal Study of Parents and Children. Eur Child Adolesc Psychiatry 2018; 27:739-752. [PMID: 29058116 PMCID: PMC5973965 DOI: 10.1007/s00787-017-1068-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 10/12/2017] [Indexed: 01/06/2023]
Abstract
Substance use is associated with impaired social cognition. Experimental studies have shown that acute intoxication of alcohol, tobacco, and cannabis decreases the performance in non-verbal, social communication and theory of mind tasks. However, in epidemiological studies the temporal direction of this association has gone relatively unstudied. We investigated both directions of association within an adolescent birth cohort: the association of social cognition with subsequent substance use, and the association of early substance use with subsequent social cognition. We used data from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. Logistic regression indicated that poor childhood non-verbal communication was associated with decreased odds of adolescent alcohol (OR 0.70, 95% 0.54-0.91), tobacco (OR 0.62, 95% CI 0.47-0.83), and cannabis use (OR 0.62, 95% CI 0.46-0.83). Early adolescent substance use was associated with increased odds of poor social communication (alcohol: OR 1.46, 95% CI 0.99-2.14; tobacco: OR 1.95, 95% CI 1.33-2.86) and poor social reciprocity (alcohol: OR 1.57, 95% CI 1.18-2.09; tobacco: OR 1.92, 95% CI 1.43-2.58; cannabis: OR 1.54, 95% CI 1.16-2.05). Overall, the relationship between social cognition and substance use was different in each temporal direction. Poor non-verbal communication in childhood appeared protective against later substance use, while adolescent substance use was associated with decreased social cognitive performance.
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Affiliation(s)
- Meg E Fluharty
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK.
- School of Experimental Psychology, UK Centre for Tobacco and Alcohol Studies, University of Bristol, Bristol, UK.
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol, BS8 1TU, UK.
| | - Jon Heron
- School of Community and Social Medicine, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK
- School of Experimental Psychology, UK Centre for Tobacco and Alcohol Studies, University of Bristol, Bristol, UK
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Georgiou G, Kimonis ER, Fanti KA. What do others feel? Cognitive empathy deficits explain the association between callous-unemotional traits and conduct problems among preschool children. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2018. [DOI: 10.1080/17405629.2018.1478810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Eva R. Kimonis
- School of psychology, The University of New South Wales, Sydney, Australia
| | - Kostas A. Fanti
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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Kendler KS, Gardner CO, Edwards AC, Dick DM, Hickman M, MacLeod J, Heron J. Childhood Risk Factors for Heavy Episodic Alcohol Use and Alcohol Problems in Late Adolescence: A Marginal Structural Model Analysis. J Stud Alcohol Drugs 2018; 79:370-379. [PMID: 29885144 PMCID: PMC6005251 DOI: 10.15288/jsad.2018.79.370] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/19/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study seeks to clarify the nature of the association between five well-studied late childhood predictors and alcohol-related behaviors in adolescence. METHOD We examined, in 7,168 subjects from the Avon Longitudinal Study of Parents and Children (ALSPAC), using linear probability and marginal structural models, the association between parental alcohol problems, peer group deviance, antisocial behavior, and low parental monitoring, and sensation seeking assessed at multiple times from ages 12.5 to 18 years and heavy episodic drinking and alcohol problems at ages 16.5, 17.5, and 20 years. RESULTS Based on the pattern of the attenuation in the association with heavy episodic drinking and alcohol problems from the linear probability to marginal structural models, our five factors were divisible into three groups. For parental alcohol problems, no substantial attenuation was seen. For peer group deviance and antisocial behavior, the associations in the marginal structural models were modestly attenuated (10%-20%). By contrast, for low parental monitoring and sensation seeking, moderate attenuations of 41% and 35%, respectively, were observed. CONCLUSIONS Our results are consistent with the hypothesis that all or nearly all of the association between parental alcohol problems and heavy episodic drinking and alcohol problems in mid to late adolescence is causal. For peer group deviance and antisocial behavior, the large majority of the associations appear to be causal, but confounding influences are also present. However, for low parental monitoring and sensation seeking, our findings suggest that a substantial proportion of the observed association with alcohol outcomes reflects confounding rather than causal influences.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Charles O. Gardner
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Danielle M. Dick
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia
| | - Matt Hickman
- School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom
| | - John MacLeod
- School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom
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Tang W, He H, Wang WJ, Chen DG. Untangle the Structural and Random Zeros in Statistical Modelings. J Appl Stat 2017; 45:1714-1733. [PMID: 30906098 DOI: 10.1080/02664763.2017.1391180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Count data with structural zeros are common in public health applications. There are considerable researches focusing on zero-inflated models such as zero-inflated Poisson (ZIP) and zero-inflated Negative Binomial (ZINB) models for such zero-inflated count data when used as response variable. However, when such variables are used as predictors, the difference between structural and random zeros is often ignored and may result in biased estimates. One remedy is to include an indicator of the structural zero in the model as a predictor if observed. However, structural zeros are often not observed in practice, in which case no statistical method is available to address the bias issue. This paper is aimed to fill this methodological gap by developing parametric methods to model zero-inflated count data when used as predictors based on the maximum likelihood approach. The response variable can be any type of data including continuous, binary, count or even zero-inflated count responses. Simulation studies are performed to assess the numerical performance of this new approach when sample size is small to moderate. A real data example is also used to demonstrate the application of this method.
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Affiliation(s)
- W Tang
- Department of Global Biostatistics & Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA70122, USA
| | - H He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA70122, USA
| | - W J Wang
- Brightech International, LLC, New Jersey, NJ 08873, USA
| | - D G Chen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC27599, USA.,Department of Biostatistics, University of North Carolina at Chapel Hill, NC 27517, USA.,Department of Statistics, University of Pretoria, South Africa
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Halonen JI, Stenholm S, Pulakka A, Kawachi I, Aalto V, Pentti J, Lallukka T, Virtanen M, Vahtera J, Kivimäki M. Trajectories of risky drinking around the time of statutory retirement: a longitudinal latent class analysis. Addiction 2017; 112:1163-1170. [PMID: 28257157 PMCID: PMC5498817 DOI: 10.1111/add.13811] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/07/2016] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Life transitions such as retirement may influence alcohol consumption, but only a few studies have described this using longitudinal data. We identified patterns and predictors of risky drinking around the time of retirement. DESIGN A cohort study assessing trajectories and predictors of risky drinking among employees entering statutory retirement between 2000 and 2011. SETTING AND PARTICIPANTS A total of 5805 men and women from the Finnish Public Sector study who responded to questions on alcohol consumption one to three times prior to (w-3 , w-2 , w-1 ), and one to three times after (w+1 , w+2 , w+3 ) retirement. MEASUREMENTS We assessed trajectories of risky drinking (> 24 units per week among men, > 16 units among women, or an extreme drinking occasion during past year) from pre- to post-retirement, as well as predictors of each alcohol consumption trajectory. FINDINGS Three trajectories were identified: sustained healthy drinking (81% of participants), temporary increase in risky drinking around retirement (12%) and slowly declining risky drinking after retirement (7%). The strongest pre-retirement predictors for belonging to the group of temporary increase in risky drinking were current smoking [odds ratio (OR) = 3.90, 95% confidence interval (CI) = 2.70-5.64], male sex (OR = 2.77, 95% CI = 2.16-3.55), depression (OR = 1.44, 95% CI = 1.05-1.99) and work-place in the metropolitan area (OR = 1.29, 95% CI = 1.00-1.66). Compared with the slowly declining risky drinking group, the temporary increase in risky drinking group was characterized by lower occupational status and education, and work-place outside the metropolitan area. CONCLUSIONS In Finland, approximately 12% of people who reach retirement age experience a temporary increase in alcohol consumption to risky levels, while approximately 7% experience a slow decline in risky levels of alcohol consumption. Male gender, smoking, being depressed and working in a metropolitan area are associated with increased likelihood of increased alcohol consumption.
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Affiliation(s)
| | - Sari Stenholm
- University of Turku, Department of Public Healthand Turku University HospitalTurkuFinland,University of TampereFaculty of Social Sciences (Health Science)TampereFinland
| | - Anna Pulakka
- University of Turku, Department of Public Healthand Turku University HospitalTurkuFinland
| | - Ichiro Kawachi
- Harvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Ville Aalto
- Finnish Institute of Occupational HealthHelsinki/KuopioFinland
| | - Jaana Pentti
- Department of Public Health, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Tea Lallukka
- Finnish Institute of Occupational HealthHelsinki/KuopioFinland
| | | | - Jussi Vahtera
- University of Turku, Department of Public Healthand Turku University HospitalTurkuFinland
| | - Mika Kivimäki
- Finnish Institute of Occupational HealthHelsinki/KuopioFinland,Department of Public Health, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland,Department of Epidemiology and Public HealthUniversity College London Medical SchoolUK
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40
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Serotonin functioning and adolescents' alcohol use: A genetically informed study examining mechanisms of risk. Dev Psychopathol 2017; 30:213-233. [PMID: 28534453 DOI: 10.1017/s095457941700058x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The current study used data from two longitudinal samples to test whether self-regulation, depressive symptoms, and aggression/antisociality were mediators in the relation between a polygenic score indexing serotonin (5-HT) functioning and alcohol use in adolescence. The results from an independent genome-wide association study of 5-hydroxyindoleacetic acid in the cerebrospinal fluid were used to create 5-HT polygenic risk scores. Adolescents and/or parents reported on adolescents' self-regulation (Time 1), depressive symptoms (Time 2), aggression/antisociality (Time 2), and alcohol use (Time 3). The results showed that 5-HT polygenic risk did not predict self-regulation. However, adolescents with higher levels of 5-HT polygenic risk showed greater depression and aggression/antisociality. Adolescents' aggression/antisociality mediated the relation between 5-HT polygenic risk and later alcohol use. Deficits in self-regulation also predicted depression and aggression/antisociality, and indirectly predicted alcohol use through aggression/antisociality. Pathways to alcohol use were especially salient for males from families with low parental education in one of the two samples. The results provide insights into the longitudinal mechanisms underlying the relation between 5-HT functioning and alcohol use (i.e., earlier aggression/antisociality). There was no evidence that genetically based variation in 5-HT functioning predisposed individuals to deficits in self-regulation. Genetically based variation in 5-HT functioning and self-regulation might be separate, transdiagnostic risk factors for several types of psychopathology.
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Bjork JM, Straub LK, Provost RG, Neale MC. The ABCD study of neurodevelopment: Identifying neurocircuit targets for prevention and treatment of adolescent substance abuse. ACTA ACUST UNITED AC 2017; 4:196-209. [PMID: 29038777 DOI: 10.1007/s40501-017-0108-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Substance use disorders (SUD) can be considered developmental disorders in light of their frequent origins in substance initiation during adolescence. Cross-sectional functional magnetic resonance imaging (fMRI) studies of adolescent substance users or adolescents with SUD have indicated aberrations in brain structures or circuits implicated in motivation, self-control, and mood-regulation. However, attributing these differences to the neurotoxicological effects of chronic substance use has been problematic in that these circuits are also aberrant in at-risk children, such as those with prenatal substance exposure, externalizing disorders (such as conduct disorder), or prodromal internalizing disorders such as depression. To better isolate the effects of substance exposure on the adolescent brain, the newly-launched Adolescent Brain Cognitive Development (ABCD) study, funded by the National Institutes of Health, will follow the neurodevelopmental trajectories of over 11,000 American 9/10-year-olds for 10 years, into emerging adulthood. This study will provide a rich open-access dataset on longitudinal interactions of neurodevelopment, environmental exposures, and childhood psychopathology that confer addiction risk. The ABCD twin study will further clarify genetic versus experiential influences (e.g., substance use) on neurodevelopmental and psychosocial outcomes. Neurocircuitry thought to regulate mood and behavior has been directly normalized by administration of psychoactive medications and by cognitive therapies in adults. Because of this, we contend that ABCD project data will be a crucial resource for prevention and treatment of SUD in adolescence because its cutting-edge neuroimaging and childhood assessments hold potential for discovery of additional targetable brain differences earlier in development that are prognostic of (or aberrant in) SUD. The ABCD sample size will also have the power to illuminate how sex differences, environmental interactions and other individual differences interact with neurodevelopment to inform treatment in different groups of adolescents.
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Affiliation(s)
- James M Bjork
- Virginia Commonwealth University, Department of Psychiatry
| | - Lisa K Straub
- Virginia Commonwealth University, Department of Psychiatry
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Kimonis ER, Fanti KA, Anastassiou-Hadjicharalambous X, Mertan B, Goulter N, Katsimicha E. Can Callous-Unemotional Traits be Reliably Measured in Preschoolers? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 44:625-38. [PMID: 26344015 DOI: 10.1007/s10802-015-0075-y] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Callous-unemotional (CU) traits designate an important subgroup of antisocial individuals at risk for early-starting, severe, and persistent conduct problems, but this construct has received limited attention among young children. The current study evaluated the factor structure, psychometric properties, and validity of scores on a comprehensive measure of CU traits, the Inventory of Callous-Unemotional Traits (ICU), in relation to measures of antisocial/prosocial behavior and emotional processing, administered to preschool children. The sample included 214 boys (52 %) and girls (48 %, M age = 4.7, SD = 0.69) recruited from mainstream and high-risk preschools. Confirmatory factor analyses supported a two-factor structure including callous and uncaring dimensions from 12 of the 24 original ICU items. Scores on the parent- and teacher-reported ICU were internally consistent and combined CU scores showed expected associations with an alternate measure of CU traits and measures of empathy, prosocial behavior, conduct problems, and aggression. Preschool children high on CU traits were less accurate, relative to children scoring low, in recognizing facial expressions. They were also less attentionally engaged by images of others in distress when co-occurring conduct problems presented. Findings extend the literature by supporting the psychometric properties of the ICU among young children, and open several avenues for studying early precursors to this severe personality disturbance.
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Khoddam R, Jackson NJ, Leventhal AM. Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for adolescent substance use during the first year of high school? Drug Alcohol Depend 2016; 169:48-55. [PMID: 27771536 PMCID: PMC5140846 DOI: 10.1016/j.drugalcdep.2016.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/06/2016] [Accepted: 10/07/2016] [Indexed: 01/21/2023]
Abstract
AIM The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. METHODS Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. FINDINGS Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. CONCLUSIONS Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems.
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Affiliation(s)
- Rubin Khoddam
- Department of Psychology, University of Southern California, Los Angeles
| | - Nicholas J. Jackson
- Department of Psychology, University of Southern California, Los Angeles,Department of Medicine Statistics Core, University of California, Los Angeles
| | - Adam M. Leventhal
- Department of Psychology, University of Southern California, Los Angeles,Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles
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Aggressive temperament predicts ethanol self-administration in late adolescent male and female rhesus macaques. Psychopharmacology (Berl) 2016; 233:3965-3976. [PMID: 27627910 PMCID: PMC5341689 DOI: 10.1007/s00213-016-4427-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 09/01/2016] [Indexed: 12/27/2022]
Abstract
RATIONALE Anxiety and aggression are associated with ethanol self-administration, but these behaviors can serve as either risk factors for or consequences of heavy drinking in rodents and humans. Baseline levels of aggressive-like and anxious-like behavior in non-human primates have not yet been characterized in relation to future or prior ethanol intake. OBJECTIVE The objective of the study was to test the association between temperament at baseline with future ethanol self-administration in late adolescent male (n = 21) and female (n = 11) rhesus monkeys. METHODS Shortly after entering the laboratory and before exposure to ethanol, the Human Intruder Test (HIT) and the Novel Object Test (NOT) were used to determine baseline anxious-like and aggressive-like behavior in age-matched male and female rhesus monkeys (Macaca mulatta). The monkeys were induced to drink ethanol 4 % (w/v) using a schedule-induced polydipsia procedure, followed by "open-access" ethanol self-administration in which the monkeys were allowed a choice of water or 4 % ethanol (w/v) for 22 h/day for 52 weeks. RESULTS Aggressive monkeys self-administered more ethanol and attained higher blood ethanol concentrations (BECs). No significant differences in ethanol intakes or BECs were found between anxious and non-anxious monkeys or between behaviorally inhibited and non-inhibited monkeys. Baseline aggressive behavior positively correlated with ethanol intake and intoxication. CONCLUSIONS Baseline reactive aggression was associated with higher future ethanol intake and intoxication. While significant sex differences in HIT reactivity were observed, the relationship between aggression and ethanol drinking was observed across sex and is not sex-specific.
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Khoddam R, Leventhal AM. Alternative and complementary reinforcers as mechanisms linking adolescent conduct problems and substance use. Exp Clin Psychopharmacol 2016; 24:376-389. [PMID: 27690501 PMCID: PMC5054745 DOI: 10.1037/pha0000088] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study tested the hypothesis that teens who engage in conduct problems are more likely to use substances because they engage in fewer alternative reinforcing (i.e., pleasurable) substance-free activities and more complementary reinforcing substance-associated activities. In a cross-sectional, correlational design, 9th grade students (N = 3,383; mean age = 14.6 years) in Los Angeles, California, U.S.A. completed surveys in 2013 measuring conduct problems (e.g., stealing, lying, getting in fights); alternative and complementary reinforcement; use of a number of licit, illicit, and prescription drugs; and other cofactors. Conduct problems were positively associated with past 6-month use of any substance (yes/no) among the overall sample and past 30-day use frequency on a composite index that included 6 substances among past 6-month users. These associations were statistically mediated by diminished alternative reinforcement and increased complementary reinforcement when adjusting for relevant covariates. Conduct problems were associated with lower engagement in alternative reinforcers and increased engagement in complementary reinforcers, which, in turn, were associated with greater likelihood and frequency of substance use. Most mediational relations persisted adjusting for demographic, environmental, and intrapersonal cofactors and generalized to alcohol, cigarette, and marijuana use, although, complementary reinforcers did not significantly mediate the relation of conduct problems with alcohol use frequency. These results point to diminished alternative reinforcement and increased complementary reinforcement as mechanisms linking conduct problems and adolescent substance use. Interventions that increase access to and engagement in a diverse set of alternative substance-free activities and deter activities that complement use may prevent substance use in adolescents who engage in conduct problems. (PsycINFO Database Record
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Affiliation(s)
- Rubin Khoddam
- Department of Psychology, University of Southern California
| | - Adam M. Leventhal
- Department of Psychology, University of Southern California,Department of Preventive Medicine, University of Southern California Keck School of Medicine
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Werner KB, Sartor CE, McCutcheon VV, Grant JD, Nelson EC, Heath AC, Bucholz KK. Association of Specific Traumatic Experiences With Alcohol Initiation and Transitions to Problem Use in European American and African American Women. Alcohol Clin Exp Res 2016; 40:2401-2408. [PMID: 27656844 DOI: 10.1111/acer.13220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/18/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND The aims of this study were to (i) characterize racial differences in alcohol involvement and (ii) examine the risk conferred by specific trauma exposures and posttraumatic stress disorder (PTSD) for different stages of alcohol involvement in European American (EA) and African American (AA) women. METHODS Data are from the Missouri Adolescent Female Twins Study (N = 3,787, 14.6% AA; mean age at most recent interview = 24.5 [SD 2.8]). Trauma exposures (e.g., sexual abuse [SA], physical abuse [PA], witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of alcohol initiation, transition to first alcohol use disorder (AUD) symptom, and transition to AUD diagnosis using Cox proportional hazards regression while taking into account other substance involvement, parental characteristics, and commonly co-occurring psychiatric disorders. RESULTS In EA women only, SA was associated with alcohol initiation prior to the age of 14, PA predicted transition from initiation to first AUD symptom, and PA, witnessing injury or death, and SA predicted transition to AUD diagnosis. No association was discovered between trauma exposures or PTSD for any stage of alcohol involvement in AA women. CONCLUSIONS Results reveal trauma experiences as important contributors to all stages of alcohol involvement in EA women only, with different trauma types conferring risk for each stage of alcohol involvement. PTSD was not revealed as a significant predictor of AUD in EA or AA women, suggesting trauma, independent of PTSD, directly contributes to alcohol involvement. Findings highlight the importance of considering racial differences when developing etiologic models of the association of traumatic experiences with alcohol involvement.
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Affiliation(s)
- Kimberly B Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.
| | - Carolyn E Sartor
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Vivia V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Julia D Grant
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Elliot C Nelson
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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Gatta M, Spoto A, Colombo E, Penzo M, Battistella PA. The Dysfunction of Emotional Expression as a Related Factor for Alcohol Misuse in Young Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1184599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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48
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Marmorstein NR. Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:59-68. [PMID: 27512337 PMCID: PMC4975247 DOI: 10.4137/sart.s31438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 11/09/2022]
Abstract
This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents (N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms.
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Lindhiem O, Bennett CB, Hipwell AE, Pardini DA. Beyond Symptom Counts for Diagnosing Oppositional Defiant Disorder and Conduct Disorder? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:1379-87. [PMID: 25788042 DOI: 10.1007/s10802-015-0007-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are among the most commonly diagnosed childhood behavioral health disorders. Although there is substantial evidence of heterogeneity of symptom presentations, DSM diagnoses of CD and ODD are formally diagnosed on the basis of symptom counts without regard to individual symptom patterns. We used unidimensional item response theory (IRT) two-parameter logistic (2PL) models to examine item parameters for the individual symptoms of CD and ODD using data on 6,491 adolescents (ages 13-17) from the National Comorbidity Study: Adolescent Supplement (NCS-A). For each disorder, the symptoms differed in terms of severity and discrimination parameters. As a result, some adolescents who were above DSM diagnostic thresholds for disruptive behavior disorders exhibited lower levels of the underlying construct than others below the thresholds, based on their unique symptom profile. In terms of incremental benefit, our results suggested an advantage of latent trait scores for CD but not ODD.
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Affiliation(s)
- Oliver Lindhiem
- Department of Psychiatry School of Medicine, University of Pittsburgh, 3811 O'Hara St. 537 Bellefield Towers, Pittsburgh, PA, 15213, USA,
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Wills TA, Simons JS, Sussman S, Knight R. Emotional self-control and dysregulation: A dual-process analysis of pathways to externalizing/internalizing symptomatology and positive well-being in younger adolescents. Drug Alcohol Depend 2016; 163 Suppl 1:S37-45. [PMID: 27306730 PMCID: PMC4911542 DOI: 10.1016/j.drugalcdep.2015.08.039] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/22/2015] [Accepted: 08/22/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVES There is little knowledge about how emotional regulation contributes to vulnerability versus resilience to substance use disorder. With younger adolescents, we studied the pathways through which emotion regulation attributes are related to predisposing factors for disorder. METHODS A sample of 3561 adolescents (M age 12.5 years) was surveyed. Measures for emotional self-control (regulation of sadness and anger), emotional dysregulation (angerability, affective lability, and rumination about sadness or anger), and behavioral self-control (planfulness and problem solving) were obtained. A structural model was analyzed with regulation attributes related to six intermediate variables that are established risk or protective factors for adolescent substance use (e.g., academic involvement, stressful life events). Criterion variables were externalizing and internalizing symptomatology and positive well-being. RESULTS Indirect pathways were found from emotional regulation to symptomatology through academic competence, stressful events, and deviance-prone attitudes and cognitions. Direct effects were also found: from emotional dysregulation to externalizing and internalizing symptomatology; emotional self-control to well-being; and behavioral self-control (inverse) to externalizing symptomatology. Emotional self-control and emotional dysregulation had independent effects and different types of pathways. CONCLUSIONS Adolescents scoring high on emotional dysregulation are at risk for substance dependence because of more externalizing and internalizing symptomatology. Independently, youth with better behavioral and emotional self-control are at lower risk. This occurs partly through relations of regulation constructs to environmental variables that affect levels of symptomatology (e.g., stressful events, poor academic performance). Effects of emotion regulation were found at an early age, before the typical onset of substance disorder.
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Affiliation(s)
- Thomas A Wills
- Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, United States.
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermilion, SD, United States.
| | - Steve Sussman
- Preventive Medicine, Psychology, and Social Work, University of Southern California, Los Angeles, CA, United States.
| | - Rebecca Knight
- Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, United States.
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