Impacts of age of onset of substance use disorders on risk of adult incarceration among disadvantaged urban youth: a propensity score matching approach

Do Substances Used in Adolescence Predict the Persistence of Substance Use Disorders in Adulthood? A 15-Year Study of Youth After Detention

PURPOSE

Investigate if the type of substance use disorder (SUD) in adolescence predicts SUDs in adulthood and examine sex and racial/ethnic differences in the persistence of SUDs.

METHODS

Data are from the Northwestern Juvenile Project, a 15-year longitudinal study of 1829 youth randomly sampled from detention in Chicago, IL (1995-1998). Interviewers assessed SUDs using structured diagnostic interviews.

RESULTS

Compared with females without an SUD at detention, females with cannabis alone, comorbid alcohol and cannabis, or SUDs other than alcohol and cannabis at detention had higher odds of having an SUD 5 years later (25%, 32%, and 36% vs. 15%, adjusted odds ratio [AOR] = 1.94, 95% confidence interval [CI] 1.11-3.40; AOR = 2.76, 95% CI 1.58-4.83; AOR = 3.46, 95% CI 1.56-7.66, respectively). Males and females with SUDs other than alcohol and cannabis at detention had greater odds of having an SUD 15 years later, compared with those without an SUD at detention (males: 36% vs. 14%, AOR = 2.98, 95% CI 1.14-7.83; females: 29% vs. 8%, AOR = 4.77, 95% CI 1.85-12.30). Among youth with an SUD at detention, males were more likely than females to have an SUD 15 years later (AOR = 1.84, 95% CI 1.03-3.29); non-Hispanic White and Hispanic males were more likely to persist than Black males (AOR = 3.32, 95% CI 1.50-7.35; AOR = 2.32, 95% CI 1.04-5.18, respectively).

DISCUSSION

The type of SUD during adolescence matters. Youth with SUDs such as cocaine and opioids fared the worst. Healthcare providers must collaborate with correctional officials to increase service provision.

Suicide While Locked Up in Texas: Risk Factors for Death by Suicide in Custody

In the United States, suicide is a leading cause of death in prisons and jails, with incarcerated individuals being nine times more likely to die by suicide than the general population. Identifying vulnerabilities at each stage of custody (prebooking, jail, prison) and factors that increase suicide risk can improve prevention efforts. A hierarchical binary logistic regression was conducted on data from the Texas Justice Initiative's Deaths in Custody Report. Variables included race/ethnicity, sex, age at death, days in custody, classification of crime as violent or nonviolent, and custody type of prebooking, jail, or prison. Among main effects, when compared to suicide rates in prison, jail suicide deaths were over three and a half times more likely (OR = 3.61), and the period of prebooking emerged as a period of staggering risk of suicide death, with suicides being over 5,000% more likely than at other stages of custody (OR = 50.86). When interactions were entered, Latinx individuals were at a particularly increased risk of suicide death (OR = 10.46), likelihood of suicide death decreased with each year of age (OR = .89), nonviolent offenders were just under three and a half times more likely to die by suicide when compared to violent offenders (OR = 3.45), and each stage of custody was shown to affect the relationship between age-related rates of suicide in different ways. Results call for further investigation into suicide among understudied populations in corrections, such as Latinx individuals, juveniles in the prison system, and nonviolent offenders, to identify the groups at the highest risk of premature death in correctional systems.

Who gets screened and who tests positive? Drug screening among justice-involved youth in a midwestern urban county

BACKGROUND

Given high rates of substance use among justice-involved youth, justice systems have attempted to monitor use through drug screening (DS) procedures. However, there is discretion in deciding who is screened for substance use, as not every youth who encounters the system is screened. The aim of the current study was to examine factors associated with selection for and results of oral DS among justice-involved youth assigned to probation to better inform potential DS policy. Electronic court records from 4,668 youth with first-incident records assigned to probation in a midwestern urban county's juvenile justice system between 2011 and 2016 were included in the analytical sample. Race/ethnicity, gender, age, number of charges and charge type for the current incident were included as independent variables.

RESULTS

Multivariable hierarchical logistic regression analyses indicated that males were more likely to be assigned to DS (aOR = 0.40, 95%CI [0.34, 0.46]), and more likely to test positive for use (aOR = 0.43, 95% CI [0.34, 0.54]) than females. As age increased, youth were less likely to be assigned to DS (aOR = 0.91, 95% CI [0.87, 0.94]), with non-significant differences in DS results. Greater number of charges were associated with a higher likelihood of being assigned to DS (aOR = 1.55, 95% CI [1.43, 1.68]). Youth with violent offenses were more likely to be assigned to DS than those with other offense types (property offenses, drug offenses, statutory offenses, disorderly conduct, and all other offenses), but less likely to test positive for use.

CONCLUSIONS

Many factors were associated with differences in DS, but these factors were not always associated with differential DS results. Demographic or charge-based decisions may not be appropriate for DS assignment.

Pathways from prenatal cocaine exposure to adult substance use and behavior

This is a report from the most recent adult follow-up of the longest running cohort study of prenatal cocaine exposure (PCE), in which women were enrolled prenatally and offspring were assessed in infancy, childhood, adolescence, and young adulthood. In previous studies, PCE was linked to offspring behavior problems such as early substance use and externalizing behavior problems. The current analyses examine pathways from PCE to behavioral outcomes in offspring at the 25-year assessment. Prenatal cocaine exposure was moderate in this cohort; most women decreased or discontinued use after the first trimester. During the first and third trimesters, 38% and 11% used cocaine, respectively. This represents the most common pattern of PCE in non-treatment samples. At this phase, the adult offspring were, on average, 27.3 years old (range = 25-30), had 13.4 years of education, 83% were employed, 55% were Black, and 55% were female. Offspring who were exposed to cocaine during the first trimester were significantly more likely to use marijuana in the past year, report more arrests, and have poorer scores on a decision-making task, controlling for other prenatal substance exposure, demographic, and socioeconomic factors. In mediation analyses, there were indirect pathways from PCE to current marijuana use through early initiation of marijuana use and 21-year marijuana use, and through 15-year status offenses and 21-year marijuana use. There was also an indirect pathway from PCE to lifetime arrests through early initiation of marijuana use and 21-year Conduct Disorder, although the direct pathway from PCE to arrests also remained significant. These findings are consistent with those from previous phases and are an indication that there are detrimental associations with PCE that persist across developmental stages and into adulthood.

Duration of stay and rate of subsequent criminal conviction and hospitalisation for substance use among young people admitted to a short-term residential program

INTRODUCTION

This study examined the association between program duration and rate of criminal conviction and hospitalisation for substance use up to 15 years later among young people admitted to a short-term residential program for drug and alcohol use.

METHODS

Data were derived from linked administrative records of all clients referred to a modified therapeutic community for young people from January 2001 to December 2016 in New South Wales, Australia (n = 3059). Cox proportional hazards regression analyses examined the rate of conviction (separately for any offence, violent offence, non-violent offence and administrative offence) and hospitalisation for substance use, up to 15 years post-program among young people who attended treatment for 1-29 days, 30-59 days, 60-89 days and 90-120 days.

RESULTS

Thirty days or more in treatment was independently associated with a lower rate of conviction for any offence and a non-violent offence, as well as hospitalisation for substance use, while 60 days or more was associated with a lower rate of conviction for a violent and administrative offence, relative to those who spent 1-29 days in the program. Additional months in the program were also associated with reduced rates of conviction and hospitalisation, although 90-120 days appeared to confer no additional benefits than 60-89 days.

DISCUSSION AND CONCLUSIONS

At least 60 days may be the minimum duration needed for short-term, therapeutic community programs to reduce the risk of conviction across all crime types and hospitalisation for substance use.

Associations of alternative cannabis product use and poly-use with subsequent illicit drug use initiation during adolescence

RATIONALE

Specific cannabis products may differentially increase risk of initiating non-cannabis illicit drug use during adolescence.

OBJECTIVE

To determine whether ever- and poly-use of smoked, vaporized, edible, concentrate, or blunt cannabis products are associated with subsequent initiation of non-cannabis illicit drug use.

METHODS

High school students from Los Angeles completed in-classroom surveys. The analytic sample (N = 2163; 53.9% female; 43.5% Hispanic/Latino; baseline M age = 17.1 years) included students who reported never using illicit drugs at baseline (spring, 11th grade) and provided data at follow-up (fall and spring, 12th grade). Logistic regression models assessed associations between use of smoked, vaporized, edible, concentrate, and blunt cannabis at baseline (yes/no for each product) and any non-cannabis illicit drug use initiation-including cocaine, methamphetamine, psychedelics, ecstasy, heroin, prescription opioids, or benzodiazepines-at follow-up.

RESULTS

Among those who never used non-cannabis illicit drugs at baseline, ever cannabis use varied by cannabis product (smoked = 25.8%, edible = 17.5%, vaporized = 8.4%, concentrates = 3.9%, and blunts = 18.2%) and patterns of use (single product use = 8.2% and poly-product use = 21.8%). After adjustment for baseline covariates, odds of illicit drug use at follow-up were largest for baseline ever users of concentrates (aOR [95% CI] = 5.74[3.16-10.43]), followed by vaporized (aOR [95% CI] = 3.11 [2.41-4.01]), edibles (aOR [95% CI] = 3.43 [2.32-5.08]), blunts (aOR [95% CI] = 2.66[1.60-4.41]), and smoked (aOR [95% CI] = 2.57 [1.64-4.02]) cannabis. Ever use of a single product (aOR [95% CI] = 2.34 [1.26-4.34]) or 2 + products (aOR [95% CI] = 3.82 [2.73-5.35]) were also associated with greater odds of illicit drug initiation.

CONCLUSIONS

For each of five different cannabis products, cannabis use was associated with greater odds of subsequent illicit drug use initiation, especially for cannabis concentrate and poly-product use.

Parent-child Relations, Religiousness, and Adolescent Substance Use Disorders

Research has shown that parent-child relationships and religiousness are negatively associated with substance use among adolescents, but few studies have addressed their relationship with substance use disorders (SUDs). This study explored whether high quality parent-child relations are negatively associated with the risk of an SUD among adolescents, especially when religiousness is high. The data used to assess this inquiry were from 4 years (2016–2019) of the U.S. National Survey on Drug Use and Health (NSDUH). SUDs in the past year were based on a set of questions consistent with criteria enumerated in the DSM-IV. Latent measures of parent-child relations and religiousness were also constructed. The results of an augmented inverse probability weighting (AIPW) model furnished empirical evidence in support of the notion that the lowest risk of an SUD occurred among those reporting high quality parent-child relations and high religiousness, even after adjusting for a substantial number of selection factors.

Flexibly modeling age trends in the prevalence of co-occurring patterns of substance use and mental health disorders using time-varying effects and latent class analysis

Background: Substance use disorders (SUDs) and mental health disorders may change and co-occur in complex patterns across adult ages, but these processes can be difficult to capture with traditional statistical approaches.Objective: To elucidate disorder prevalence and comorbidities across adult ages by using time-varying effect models (TVEMs), latent class analysis (LCA), and modeling latent class prevalences as complex functions of age.Methods: Data were drawn from participants who are 18-65 years old in the National Epidemiologic Survey on Alcohol and Related Conditions III (n = 30,999; 51% women) and a subsample who reported a past-year post-traumatic stress disorder (PTSD), mood, anxiety, or SUD based on DSM-5 diagnoses (n = 11,279). TVEM and LCA were used to examine age trends and comorbidity patterns across ages.Results: SUD prevalence peaked at age 23 (31%) and decreased thereafter, while mental health disorder prevalence was stable (20%-26% across all ages). The prevalence of five classes of individuals based on specific combinations of mental health and SUDs varied by age: the Alcohol Use Disorder class had the highest prevalence at age 26, whereas the Mood and Anxiety Disorder classes peaked around age 63. Interestingly, the Poly-Disorder class prevalence was greatest at age 18 but decreased sharply across young adulthood; however, the prevalence of the other high comorbidity class, PTSD with Mood or Anxiety Disorder, remained fairly constant across age, peaking at age 44.Conclusions: Multimorbid mental health disorders (excluding SUDs) persist in prevalence across adult ages. LCA, TVEM, and their integration together hold substantial potential to advance addiction research.

Preschool blood lead levels, language competency, and substance use in adolescence

BACKGROUND

Elevated lead levels in children are a persistent public health problem, particularly in urban areas in the United States, yet few prospective studies have examined the association of childhood lead levels with substance use in adolescence.

OBJECTIVES

To determine the association of early lead levels with adolescent substance use and whether childhood IQ, language skills, and externalizing (aggressive and disruptive) behavior mediate the association, controlling for confounding biological and environmental factors.

METHODS

The participants (N = 265) were a subsample of a prospective birth cohort study on the developmental effects of prenatal cocaine exposure in the Midwest United States. Blood lead levels (BLL) were assessed at age 4, IQ at age 11, language skills and externalizing behavior at age 12, and substance (alcohol, tobacco, marijuana) use and substance use-related problems at age 15. Biologic assays (hair, urine, bloodspots), along with self-report, were utilized to determine adolescent substance use. Path analyses were conducted to examine the direct and indirect associations of BLL with adolescent substance use.

RESULTS

The children's mean BLL at 4 years of age was 7.07 (SD = 4.12) μg/dL. Approximately 31% of adolescents used tobacco or marijuana, 40% used alcohol, and 23% reported experiencing substance use-related problems at age 15.7 (SD = 0.28). Elevated BLL was related to a higher likelihood of substance use. Childhood language skills fully mediated the relationship of BLL with substance use-related problems. IQ was related to neither substance use nor substance use-related problems.

DISCUSSION

Elevated BLL in preschool years is a risk factor for adolescent substance use and related problems. Early screening and intervention for language impairment may reduce substance use-related problems.

Chronic tobacco smoking, impaired reward-based decision-making, and role of insular cortex: A comparison between early-onset smokers and late-onset smokers

INTRODUCTION

The literature suggests that tobacco smoking may have a neurotoxic effect on the developing adolescent brain. Particularly, it may impair the decision-making process of early-onset smokers (<16 years), by rendering them more prone to impulsive and risky choices toward rewards, and therefore more prone to smoking relapses, in comparison to late-onset smokers (≥16 years). However, no study has ever investigated reward-based decision-making and structural brain differences between early-onset smokers and late-onset smokers.

METHODS

Computerized measures of reward-based decision-making [Cambridge Gambling Task (CGT); 5-trials adjusting delay discounting task (ADT-5)] were administered to 11 early-onset smokers (mean age at regular smoking initiation = 13.2 years), 17 late-onset smokers (mean age at regular smoking initiation = 18.0 years), and 24 non-smoker controls. Voxel-based morphometry (VBM) was utilized to investigate the gray matter (GM) and white matter (WM) volume differences in fronto-cortical and striatal brain regions between early-onset smokers, late-onset smokers, and non-smokers.

RESULTS

Early-onset smokers displayed a riskier decision-making behavior in comparison to non-smokers as assessed by the CGT (p < 0.01, Cohen's f = 0.48). However, no significant differences (p > 0.05) in reward-based decision-making were detected between early-onset smokers and late-onset smokers. VBM results revealed early-onset smokers to present lower GM volume in the bilateral anterior insular cortex (AI) in comparison to late-onset smokers and lower WM volume in the right AI in comparison to late-onset smokers.

CONCLUSION

Impairments in reward-based decision-making may not be affected by tobacco smoking initiation during early adolescence. Instead, lower GM and WM volume in the AI of early-onset smokers may underline a vulnerability to develop compulsive tobacco seeking and smoking behavior during adulthood.

Patterns of Substance Use Disorders and Associated Co-occurring Psychiatric Morbidity among Patients Seen at the Psychiatric Unit of a Tertiary Health Center

BACKGROUND

Understanding the pattern of co-occurring mental illness in patients with substance use disorders (SUDs) is essential in improving the prevention and treatment of substance use-related problems. This study examined the pattern of SUDs, the associated co-occurring psychiatric morbidities, and associated factors among patients with SUDs managed at a tertiary health center.

METHODS

The records of patients who presented with SUDs between 2010 and 2019 were examined. Socio-demographics of interest were extracted from case files. Substance use diagnoses, as well as associated co-occurring mental illness, were extracted and entered into SPSS software. Bivariate analyses including the risk of developing co-occurring mental disorder were calculated.

FINDINGS

For most patients, the initiation of substance use was before the age of 21 years, while the onset of SUDs was between 21-30 years. Cannabis use disorders (CUDs), alcohol use disorders (AUDs), and nicotine use disorders (NUDs) were the commonest SUDs. Compared with those with CUDs, non-users of cannabis were significantly less likely to develop co-occurring mental illness [odds ratio (OR) = 0.25, 95% confidence interval (CI) =0.13-0.42, P = 0.001]. Those with tramadol use disorders (OR = 2.13, 95% CI = 1.03-4.41, P = 0.040) and those without pentazocine use disorders (P = 0.003) were more likely to have a comorbid mental illness. Patients with AUDs (P = 0.001), CUDs (P = 0.001), NUDs (P = 0.001), and tramadol use disorders (P = 0.045) were significantly more likely to be multiple substance users.

CONCLUSION

Results suggest an association between SUDs and co-occurring mental illness, though differences in these associations were noticed across the categories of substances. This emphasizes a holistic approach to prevention and care of patients presenting with SUDs.

Causal inference with observational data: the need for triangulation of evidence

The goal of much observational research is to identify risk factors that have a causal effect on health and social outcomes. However, observational data are subject to biases from confounding, selection and measurement, which can result in an underestimate or overestimate of the effect of interest. Various advanced statistical approaches exist that offer certain advantages in terms of addressing these potential biases. However, although these statistical approaches have different underlying statistical assumptions, in practice they cannot always completely remove key sources of bias; therefore, using design-based approaches to improve causal inference is also important. Here it is the design of the study that addresses the problem of potential bias - either by ensuring it is not present (under certain assumptions) or by comparing results across methods with different sources and direction of potential bias. The distinction between statistical and design-based approaches is not an absolute one, but it provides a framework for triangulation - the thoughtful application of multiple approaches (e.g. statistical and design based), each with their own strengths and weaknesses, and in particular sources and directions of bias. It is unlikely that any single method can provide a definite answer to a causal question, but the triangulation of evidence provided by different approaches can provide a stronger basis for causal inference. Triangulation can be considered part of wider efforts to improve the transparency and robustness of scientific research, and the wider scientific infrastructure and system of incentives.

A Bad Start: The Combined Effects of Early Onset Substance Use and ADHD and CD on Criminality Patterns, Substance Abuse and Psychiatric Comorbidity among Young Violent Offenders

Substance abuse, conduct disorder (CD) and attention deficit/hyperactivity disorder (ADHD) are all known risk factors for developing aggressive behaviors, criminality, other psychiatric comorbidity and substance use disorders (SUD). Since early age of onset is important for aggravating the impact of several of these risk factors, the aim of the present study was to investigate whether young adult violent offenders with different patterns of early onset externalizing problems (here: substance use < age 15, ADHD, CD) had resulted in different criminality profiles, substance use problem profiles and psychiatric comorbidity in young adult age. A mixed-method approach was used, combining a variable-oriented approach (with Kruskal Wallis tests) and a person-oriented approach (with Configural frequency analysis). Overall, this combined approach indicated that persons with combined ADHD+CD and persons with CD + early onset of substance use had a more varied history of violent crimes, a more comprehensive history of aggressive behaviors in general, and more psychiatric comorbidity, as well as more varied SUD and destructive substance abuse in adult age, than persons without ADHD, CD or early SU. Results are in line with previous variable-oriented research, but also indicate that individuals in this group with heavy problem aggregation early in life have a wider spectrum of problems in young adult age. Importantly, among these young violent offenders, problem aggregation was the overwhelming norm, and not the exception, as in studies of the general population. This emphasizes the need for early coordinated interventions, but also that treatment within correctional facilities in adult age needs to be comprehensive and take individual patterns of comorbidity into account.

Recovery in Special Emphasis Populations

Special emphasis populations in the current context can be defined as groups experiencing health disparities resulting in elevated risk to health, safety, and well-being from drinking alcohol. Individuals from marginalized minority populations often encounter barriers to accessing and receiving effective alcohol treatment due to social inequities and disadvantaged life contexts, which also may adversely affect recovery from alcohol use disorder (AUD). Recovery from AUD often involves the adoption of a stable non-drinking lifestyle (sobriety), increased health and well-being, and increased social connection. Although there has been considerable work on AUD epidemiology among special emphasis populations, little research exists directly examining recovery among racial/ethnic minority populations and/or sexual and gender minority populations. The current narrative review hopes to spark scholarly interest in this critically neglected area. This article opens with a review of special emphasis populations and their alcohol-related risks. Next, definitions of recovery, Alcoholics Anonymous, and culturally adapted recovery models for racial/ethnic minority populations are explored. This is followed by a discussion of factors that may particularly influence recovery among marginalized minority populations. This narrative review concludes with a discussion of research priorities for promoting health equity through studies focused on understanding and supporting recovery from AUD among marginalized minority populations.

Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder

AIMS

This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD.

METHODS

We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated.

RESULTS

Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD.

CONCLUSIONS

ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.

Psychiatric comorbidities in alcohol use disorder

Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate. In this Series paper, we examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan. Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous. Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.

Capacity of juvenile probation officers in low-resourced, rural settings to deliver an evidence-based substance use intervention to adolescents

Substance use is a major public health problem with a host of negative outcomes. Justice-involved youth have even higher risks and lack access to evidence-based interventions, particularly in rural communities. Task-shifting, or redistribution of tasks downstream to an existing workforce with less training, may be an innovative strategy to increase access to evidence-based interventions. Initial findings are presented from a services research trial conducted primarily in rural communities in which an existing workforce, juvenile probation/parole officers (JPOs), were randomized either to learn and deliver contingency management (CM) or to continue delivering probation services as usual (PAU). This study used the prevailing version of CM for adolescents, that is, family-based with behavior modification and cognitive behavioral components. Data included JPOs' self-reports, as well as audio-recorded youth/family sessions with JPOs rated by expert and trained observational coders. Data also included ratings from a comparison study in which therapists were trained and supervised by experts to deliver CM to justice-involved youth/families. Results showed JPOs can feasibly incorporate CM into their services. When adherence of CM JPOs was compared against CM therapists, JPOs delivered significantly more cognitive behavioral components of CM and similar levels of behavior modification components of CM. These findings suggest that JPOs can be leveraged to provide evidence-based substance use interventions like CM in similar, or even greater, capacities to clinically trained therapists. This task-shifting approach could dramatically expand service access for these high-risk youth, particularly in rural areas where substance use services are limited or nonexistent. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Linking parental incarceration and family dynamics associated with intergenerational transmission: A life-course perspective

Children experiencing parental incarceration face numerous additional disadvantages, but researchers have often relied on these other co-occurring factors primarily as controls. In this article, we focus on the intimate links between crime and incarceration, as well as on the broader family context within which parental incarceration often unfolds. Thus, parents' drug use and criminal behavior that precedes and may follow incarceration periods may be ongoing stressors that directly affect child well-being. We also use our analyses to foreground mechanisms associated with social learning theories, including observations and communications that increase the child's risk for criminal involvement and other problem outcomes. These related family experiences often channel the child's own developing network ties (peers, romantic partners) that then serve as proximal influences. We explore these processes by drawing on qualitative and quantitative data from a study of the lives of a sample of respondents followed from adolescence to young adulthood, as well as on records searches of parents' incarceration histories. Through our analyses, we find evidence that 1) some effects attributed to parental incarceration likely connect to unmeasured features of the broader family context, and b) together parental incarceration and the broader climate often constitute a tightly coupled package of family-related risks linked to intergenerational continuities in criminal behavior and other forms of social disadvantage.

Linking parental incarceration and family dynamics associated with intergenerational transmission: A life-course perspective

Children experiencing parental incarceration face numerous additional disadvantages, but researchers have often relied on these other co-occurring factors primarily as controls. In this article, we focus on the intimate links between crime and incarceration, as well as on the broader family context within which parental incarceration often unfolds. Thus, parents' drug use and criminal behavior that precedes and may follow incarceration periods may be ongoing stressors that directly affect child well-being. We also use our analyses to foreground mechanisms associated with social learning theories, including observations and communications that increase the child's risk for criminal involvement and other problem outcomes. These related family experiences often channel the child's own developing network ties (peers, romantic partners) that then serve as proximal influences. We explore these processes by drawing on qualitative and quantitative data from a study of the lives of a sample of respondents followed from adolescence to young adulthood, as well as on records searches of parents' incarceration histories. Through our analyses, we find evidence that 1) some effects attributed to parental incarceration likely connect to unmeasured features of the broader family context, and b) together parental incarceration and the broader climate often constitute a tightly coupled package of family-related risks linked to intergenerational continuities in criminal behavior and other forms of social disadvantage.

Explaining continuity in substance use: The role of criminal justice system involvement over the life course of an urban African American prospective cohort

BACKGROUND

African Americans are disproportionately burdened by substance use consequences and criminal justice system involvement, yet their interrelationship over the life course is not well understood. This study aimed to assess how substance use, crime, and justice system involvement may influence one another from adolescence to midlife.

METHODS

Data come from a community cohort of urban African Americans first assessed in childhood and followed up into midlife (n = 1242, 606 males, 636 females). We draw on interview data and local, state, and federal criminal records. Participants were assessed at ages 6, 16, 32, and 42, with additional record retrieval at age 52. Utilizing structural equation modeling, we estimate pathways between substance use, criminal behavior, and arrests over time by gender.

RESULTS

For males, significant paths were found between childhood behavioral problems and adolescent substance use, delinquency, and police interactions. For females, a significant path was found between childhood behavioral problems and only adolescent delinquency. We observed continuity between substance use and between arrest constructs from adolescence through midlife for men only. Direct paths were found between substance use and later arrests for both males and females. Paths were also observed between arrests and later substance use for both genders.

CONCLUSIONS

Findings of reciprocal relationships highlight the critical need to break the cycle of substance use and crime and point to specific times in the life course when intervention is necessary. Findings introduce the potential role of the criminal justice system as a key intervention agent in redirecting substance use careers.

Prenatal cocaine exposure: Direct and indirect associations with 21-year-old offspring substance use and behavior problems

BACKGROUND

Prenatal cocaine exposure (PCE) has been linked to child/adolescent behavior problems and substance use in several longitudinal cohort studies. It is unclear whether these effects extend into adulthood and influence young adult behavior problems and substance use and, if so, whether they are mediated by childhood and adolescent experiences.

METHODS

These data are from an ongoing longitudinal study of individuals born to women who were recruited early in pregnancy. Trimester-specific data on prenatal drug exposure were obtained. Caregivers and offspring were assessed at delivery and at 1, 3, 7, 10, 15, and 21 years postpartum. This report is from age 21, when 225 offspring (52% females; 54% African American, 46% Caucasian) reported on behavior problems, emotion regulation, and substance use.

RESULTS

There were significant direct associations between PCE and early initiation of marijuana, 21-year emotion regulation problems, arrest history, and Conduct Disorder. The relation between PCE and young adult internalizing behavior was mediated by adolescent mood symptoms. The association between PCE and 21-year marijuana use was mediated by early initiation of marijuana use.

CONCLUSIONS

PCE has both direct and indirect long-term associations with young adult development. Using statistical models that considered the complex interrelationships among PCE and adult outcomes, we demonstrated that the direct effects of PCE on young adult emotion regulation problems, arrest history, and Conduct Disorder are not completely explained by earlier adolescent behavior. Moreover, the analyses suggesting mediated pathways from PCE to young adult problems identify crucial variables to target interventions for exposed children and adolescents.

Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders

Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low-income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural "imbalance" between frontal/regulatory and cortical-subcortical circuits, leading to further heightened impulsive and reward-driven behaviors. Exercise increases growth and brain-derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the "naïve" or underdeveloped connections between neurological reward and regulatory processes in adolescence from the "bottom up" and "offset" reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly "assisted" exercise, which we have shown increases neural activity in cortical-subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.

Early onset cigarette smokers exhibit greater P300 reactivity to smoking-related stimuli and report greater craving

Adolescence is a period during which a number of critical neuromaturation processes occur and the vulnerability for developing nicotine dependence is extremely high. Thus, early-onset (EO; age < 16 years old), relative to late-onset (LO; age ≥ 16 years old), tobacco smoking may be uniquely deleterious for developmentally immature systems that regulate neural signaling reactivity. This study investigated how age of tobacco smoking onset affects neurophysiological measures of smoking cue reactivity and reported craving in adult smokers. EO smokers (EOS; n = 8; 4 females), LO smokers (LOS; n = 10; 5 females), and healthy non-smokers (HNS; n = 10; 5 females) participated in an event-related potential (ERP) cue reactivity study with tactile and image stimuli. Participants handled neutral objects during one interval and smoking-related objects during a second interval. After each interval, they viewed smoking-related, neutral, or arousing images using an oddball paradigm. P300 ERPs and craving for tobacco were recorded during each session. P300 amplitudes were significantly higher in central midline (Cz) channel to smoking, but not neutral or arousing, images after handling smoking objects. Specifically, Cz P300 smoking amplitudes were significantly greater in EOS, relative to LOS and HNS, and associated with greater craving at baseline. There were no other group differences in mood or craving. EOS exhibited greater P300 reactivity to smoking-related stimuli, relative to LOS, suggesting a more sensitized neural response. EO smoking during early neuromaturation may alter neurophysiological signaling involved in responding to smoking-related stimuli, which could impact the outcome of smoking cessation interventions.

Typologies of adverse childhood experiences and their relationship to incarceration in U.S. military veterans

Numerous studies have reported that adverse childhood experiences (ACEs) are associated with negative psychosocial outcomes in adulthood, but no study has examined the different typologies of ACEs and the relationship of these with adult incarceration in military veterans. The current study used latent class analysis to examine the existence of different childhood maltreatment and household dysfunction typologies in a sample of U.S. military veterans identified through the National Epidemiological Survey on Alcohol and Related Conditions-III ((NESARC-III)). A total of 60.73% of veterans reported one or more ACEs. Four latent classes were identified and were named Low adversities, Moderate maltreatment with high household substance use, Severe maltreatment with moderate household dysfunction and Severe multi-type adversities. Relative to the Low adversities class, the three maltreatment/dysfunction classes had significantly elevated odds ratios (1.72-2.29) for adult incarceration, when controlling for sociodemographic characteristics and alcohol and drug use. The results point to the importance of examining childhood risk factors for incarceration and suggest that a certain sub-group of military personnel who are about to transition into the civilian life may need additional support to adjust and live successful lives.

Early onset tobacco cigarette smokers exhibit deficits in response inhibition and sustained attention

BACKGROUND

Initiation of cigarette smoking during adolescence coincides with structural and cognitive neuromaturation. Thus, early onset smokers (EOS; initiated <16 years old) may be at unique risk of altered development of executive function relative to late onset smokers (LOS; initiated >16 years old). This study quantified the effects of age of smoking onset on response impulsivity and inhibitory control using a novel smoking Go/NoGo task (Luijten et al., 2011).

METHODS

Nicotine deprived adult EOS (n = 10) and LOS (n = 10) and adult healthy non-smokers (HNS; n = 10) were shown smoking-related and neutral images with either a blue (Go) or yellow (NoGo) frame. Participants were instructed to respond to blue-framed Go trials quickly and accurately, and withhold responding for yellow-framed NoGo trials.

RESULTS

EOS made more Go response accuracy errors (p ≤ 0.02) and failed more frequently to inhibit responses to NoGo trials (p < 0.02) than LOS and HNS. EOS also made more errors in inhibiting responses to smoking-related (p ≤ 0.02) and neutral (p ≤ 0.02) NoGo trials. EOS reported greater baseline craving for cigarette smoking than LOS (p < 0.04), and craving was significantly associated with greater omission errors (p ≤ 0.04).

CONCLUSIONS

EOS exhibited greater difficulty than LOS in responding accurately to Go stimuli and withholding responses to both smoking and neutral NoGo stimuli, indicating greater response impulsivity, poor attention, and deficits in response inhibition. These findings suggest that EO smoking, in particular, contributes to diminished task-related attention and inhibitory control behaviors in adulthood and provide support for the tobacco-induced neurotoxicity of adolescent cognitive development (TINACD) theory (DeBry and Tiffany, 2008).

Firearms, alcohol and crime: convictions for driving under the influence (DUI) and other alcohol-related crimes and risk for future criminal activity among authorised purchasers of handguns

Firearm violence frequently involves alcohol, but there are no studies of misuse of alcohol and risk for future violence among firearm owners. We examined the association between prior convictions for alcohol-related crimes, chiefly driving under the influence (DUI), and risk of subsequent arrest among 4066 individuals who purchased handguns in California in 1977. During follow-up through 1991, 32.8% of those with prior alcohol-related convictions and 5.7% of those with no prior criminal history were arrested for a violent or firearm-related crime; 15.9% and 2.7%, respectively, were arrested for murder, rape, robbery or aggravated assault. Prior alcohol-related convictions were associated with a fourfold to fivefold increase in risk of incident arrest for a violent or firearm-related crime, a relative increase greater than that seen for age, sex or prior violence. Prior convictions for alcohol-related crime may be an important predictor of risk for future criminal activity among purchasers of firearms.

Substance Use among Youth with Currently and Formerly Incarcerated Parents

Parental incarceration impacts millions of children in the U.S. and has important consequences for youths' adjustment. Children of incarcerated parents are at risk for a host of negative psychosocial outcomes, including substance abuse problems. Using data from a statewide survey of youth behavior, the effect of both present and past parental incarceration on youths' report of their substance use behaviors was examined. Both present and past parental incarceration was significantly associated with use of alcohol, tobacco, marijuana, and prescription drugs, as well as substance abuse and dependence. Implications for practice and research are discussed.

The Relationship between Trauma, Arrest, and Incarceration History among Black Americans: Findings from the National Survey of American Life

Prior research indicates an association between exposure to trauma (e.g., being victimized) and perpetration of crime, especially in the context of chronic victimization. This study examines the relationship between trauma exposure, posttraumatic stress disorder (PTSD), and history of arrest and incarceration among a representative sample of black Americans from the National Survey of American Life (N = 5,189). One-third had a history of arrest, and 18 percent had a history of incarceration. Frequency of trauma exposure was associated with involvement with the criminal justice system. Relative to never experiencing trauma, experiencing ≥4 traumas was associated with elevated odds of arrest (odds ratio [OR] = 4.03), being jailed (OR = 5.15), and being imprisoned (OR = 4.41), all p <.01. PTSD was also associated with likelihood of incarceration among those with a history of trauma (OR = 2.18, p <.01). Both trauma exposure and trauma-associated psychopathology are associated with increased likelihood of arrest and incarceration in adulthood among black Americans.

Histórico e Fatores Associados à Criminalidade e Violência entre Dependentes de Crack

Resumo Este estudo buscou avaliar o histórico, envolvimento recente e fatores associados a violência e criminalidade entre dependentes de crack em tratamento em Comunidades Terapêuticas (CTs). Foram entrevistados 72 indivíduos, maiores de 18 anos, que estavam em tratamento em CTs do interior de Minas Gerais. Os participantes responderam ao Addiction Severity Index versão 6 (ASI6), Teste de Triagem do Envolvimento com Álcool, Cigarro e Outras Substâncias (ASSIST) e questionário sociodemográfico. Os resultados mostraram que a maioria tinha histórico de detenções e esteve recentemente envolvido com violência e atividades ilegais, como roubo, furto, tráfico de drogas e agressões. A regressão de Poisson mostrou que o maior nível de instrução teve um efeito protetor, enquanto problemas com emprego, psiquiátricos e prisão na adolescência estavam associados a crimes nos últimos seis meses. Um programa de reinserção ocupacional e educacional durante o tratamento e após a alta das CTs pode ser uma abordagem protetora para crimes.

Substance abuse and criminal activities following traumatic brain injury in childhood, adolescence, and early adulthood

OBJECTIVE

Use a longitudinal birth cohort to evaluate the association of traumatic brain injury at ages 0 to 5, 6 to 15, and 16 to 21 years with drug and alcohol abuse and engagement in criminal activities.

MAIN MEASURES

Follow-up over 21 to 25 years using self-report of drug and alcohol use, arrests, and violent and property offenses. Outcomes were assessed for 2 levels of severity (inpatient, hospitalized; outpatient, seen by general practitioner or at emergency department).

PARTICIPANTS

Members of the Christchurch Health and Development Study, a longitudinal birth cohort.

SETTING

Christchurch, New Zealand.

RESULTS

Adjusted for child and family factors, compared with noninjured individuals, inpatients injured at 0 to 5 years or 16 to 21 years were more likely to have symptoms consistent with drug dependence. All inpatient groups had increased risk of arrest, with the age groups of 0 to 5 and 6 to 15 years more likely to be involved in violent offenses and the age group of 0 to 5 years more likely to engage in property offenses. Outpatient group had an increased risk of violent offenses for first injury 0 to 5 years, arrests and property offenses for injury 6 to 15 years, and increased risk of arrests and violent offenses for injury 16 to 21 years of age. However, when alcohol dependence and drug dependence were added as an additional covariate, traumatic brain injury was no longer associated with criminal behavior for the age group of 0 to 5 years.

CONCLUSIONS

Traumatic brain injury is associated with increased criminal behavior and may represent a risk factor for offending. However, early substance use is a mediating factor for those injured early in life.

Psychosocial adversity, delinquent pathway and internalizing psychopathology in juvenile male offenders

The main aim of the present study was to investigate the presence of a set of risk factors relating to childhood life events and other psychosocial factors that may be associated with criminal indicators and with the prevalence of internalizing psychopathology in a sample of adolescent offenders. Fifty male adolescents in the custody of the Portuguese Juvenile Justice System participated in the study (M=15.8 years of age). The Adolescent Psychopathology Scale - Short Form (APS-SF) was administered in a structured interview format, and the sociodemographic, family and criminal data questionnaire was filled in by the justice professional after consulting the adolescent's file. Forty-six percent of all subjects had previous delinquent behavior. About 32% of the boys had committed violent offenses and 88% acted with peers. Also, the persistence of the delinquent behavior (50% of the offenders), coupled with the increase in the severity of the crimes committed (38% of the sample), suggests that these adolescents were at risk for serious and chronic delinquency at the time of the intervention. About 32% of the participants reported posttraumatic stress disorder symptoms, 20% had suicide ideation, and a lower percentage reported other internalizing problems. Institutionalization, maltreatment and conduct problems in childhood, and family risk factors (parental conflict, absence of a father figure, lack of parental control and family substance addiction) were related with the report of internalizing problems. Moreover, the increase in the severity of criminal offenses and living in a correctional facility were associated with higher levels of posttraumatic stress, interpersonal problems, anxiety and depression. This study draws attention to the importance of assessing indicators of psychopathology and of psychosocial risk in intervention programs with young offenders, but also to the need of family focused interventions in order to help prevent recidivism.

Are all biases missing data problems?

Estimating causal effects is a frequent goal of epidemiologic studies. Traditionally, there have been three established systematic threats to consistent estimation of causal effects. These three threats are bias due to confounders, selection, and measurement error. Confounding, selection, and measurement bias have typically been characterized as distinct types of biases. However, each of these biases can also be characterized as missing data problems that can be addressed with missing data solutions. Here we describe how the aforementioned systematic threats arise from missing data as well as review methods and their related assumptions for reducing each bias type. We also link the assumptions made by the reviewed methods to the missing completely at random (MCAR) and missing at random (MAR) assumptions made in the missing data framework that allow for valid inferences to be made based on the observed, incomplete data.

Childhood trauma, PTSD, and problematic alcohol and substance use in low-income, African-American men and women

Previous studies demonstrate that PTSD mediates the relationship between childhood trauma and alcohol and substance use disorders and that PTSD and alcohol/substance use comorbidity is greater in men than in women. We sought to replicate and extend these findings in a predominantly low-income, African-American sample recruited from a public hospital. We administered measures of childhood trauma, PTSD symptoms, problematic alcohol use, and problematic substance use to 803 men and 2084 women. We examined rates of comorbidity in men and women. Next, two bootstrap analyses were used to test whether PTSD is a mediator between childhood trauma and problematic alcohol use and between childhood trauma and problematic substance use. Finally, two bootstrap analyses were used to test whether gender would moderate the indirect effect of PTSD in both the alcohol and substance use models. Results showed that although men and women reported similar overall PTSD symptom frequency, men were more likely than women to report PTSD comorbid with alcohol and/or substance use problems. In addition, PTSD partially mediated the relationship between childhood trauma and problematic alcohol use and between childhood trauma and problematic substance use. The indirect effects of PTSD on the relationship between childhood trauma and problematic alcohol use and between childhood trauma and problematic substance use were greater in men. This study demonstrates the important interplay of gender, childhood trauma, PTSD, and alcohol and substance use. Mental health providers should consider childhood trauma histories and diagnostic comorbidities when treatment planning.

DAT1 and Alcohol Use: Differential Responses to Life Stress during Adolescence

Stressful life events can impact both substance use initiation and the quantity of substances consumed by adolescents; however, the effect of stress on substance use may be contingent on other factors including social support, peers, and genotype. DAT1, a polymorphic dopamine transporter gene, is one such factor that may be responsible for differential susceptibility to cumulative life pressures. Data from the National Longitudinal Study of Adolescent Health was utilized to determine whether adolescents with the 10-repeat allele are more likely to respond to life stresses by engaging in alcohol use than those without the allele. Respondents' self-reports of key stressors were used to create a composite life stress scale. The interaction of this measure with the number of 10-repeat DAT1 alleles was evaluated in series of logistic regression models. A significant interaction emerged between stressful life experiences and DAT1 for alcohol use among females, but this pattern was not seen in males. Females with the 10-repeat allele appear to be more sensitive to life stress as compared to those without the allele. It appears that variation in the DAT1 gene may help explain why some women are more likely to consume alcohol when confronted with stress. It however does not appear to condition the reaction of men, in terms of alcohol use, to stress.

Comparative Effectiveness of California's Proposition 36 and Drug Court Programs Before and After Propensity Score Matching

California's voter-initiated Proposition 36 (Prop 36) program is often unfavorably compared to drug courts, but little is empirically known about the comparative effectiveness of the two approaches. Using statewide administrative data, analyses were conducted on all Prop 36 and drug court offenders with official records of arrest and drug treatment. Propensity score matching was used to create equivalent groups, enabling comparisons of success at treatment discharge, recidivism over 12 months post-treatment entry, and magnitude of behavioral changes. Significant behavioral improvements occurred for both Prop 36 and drug court offenders, but while more Prop 36 offenders were successful at discharge, more recidivated over 12 months. Core programmatic differences likely contributed to differences in outcomes. Policy implications are discussed.

Age of Substance Use Onset as a Predictor of Early Adult Substance Dependence and Offending in Male and Female Delinquents

This study was designed first, to test whether sex moderated the effect of substance use onset on early adult substance dependence and offending and second, to identify the factors responsible for this effect. Structured equation modeling with 1,281 adjudicated delinquents (1,104 males, 177 females) from the Pathways to Desistance study revealed that sex moderated the onset–substance dependence and onset–offending relationships. Whereas age of substance use onset predicted early adult substance dependence in both males and females, it only predicted early adult offending in males. Out of six putative mediators, only one, adolescent moral disengagement, satisfied the criteria for mediated moderation. Mediation of the moderated onset–offending relationship was the result of moral disengagement correlating with both age of substance use onset and early adult offending in male but not female delinquents. Moral disengagement displayed similar patterns of correlation in the onset–substance dependency relationship but failed to satisfy all criteria for mediated moderation.

Effects of prenatal cocaine/polydrug exposure on substance use by age 15

OBJECTIVE

Examined effects of prenatal cocaine exposure (PCE) on tobacco, alcohol, marijuana and cocaine use by age 15.

METHODS

Adolescent (n=358; 183 PCE, 175 non-prenatally cocaine exposed; NCE) drug use was assessed using urine, hair, and/or blood spot samples and self-report (Youth Risk Behavior Surveillance System; YRBSS) at ages 12 and 15. Logistic regression assessed effects of PCE on drug use controlling for other drug exposures, environment and blood lead levels (BLL).

RESULTS

Adjusted percentages of drug use (PCE vs. NCE) were: tobacco 35% vs. 26% (p<.04), marijuana 33% vs. 23% (p<.04), alcohol 40% vs. 35% (p<.01), and any drugs 59% vs. 50% (p<.005). PCE adolescents were twice as likely to use tobacco (OR=2.02, 95% CI=1.05-3.90, p<.04), 2.2 times more likely to use alcohol (OR=2.16, 95% CI=1.21-3.87, p<.01) and 1.8 times more likely to use marijuana (OR=1.81, 95% CI=1.02-3.22, p<.04) than NCE adolescents. A race-by-cocaine-exposure interaction (p<.01) indicated PCE non-African American adolescents had greater probability of tobacco use (65%) than NCE non-African American youth (21%). PCE was associated with any drug use (OR=2.16, CI=1.26-3.69, p<.005), while higher BLL predicted alcohol use (p<.001). Violence exposure was a predictor of tobacco (p<.002), marijuana (p<.0007) and any drug (p<.04).

CONCLUSIONS

PCE and exposure to violence increased the likelihood of tobacco, marijuana or any drug use by age 15, while PCE and higher early BLL predicted alcohol use. Prevention efforts should target high risk groups prior to substance use initiation.

Improving Our Ability to Evaluate Underlying Mechanisms of Behavioral Onset and Other Event Occurrence Outcomes: A Discrete-Time Survival Mediation Model

The purpose of this article is to introduce and describe a statistical model that researchers can use to evaluate underlying mechanisms of behavioral onset and other event occurrence outcomes. Specifically, the article develops a framework for estimating mediation effects with outcomes measured in discrete-time epochs by integrating the statistical mediation model with discrete-time survival analysis. The methodology has the potential to help strengthen health research by targeting prevention and intervention work more effectively as well as by improving our understanding of discretized periods of risk. The model is applied to an existing longitudinal data set to demonstrate its use, and programming code is provided to facilitate its implementation.

Emerging adulthood themes, role transitions and substance use among Hispanics in Southern California

INTRODUCTION

Hispanic emerging adults appear to be at especially high risk for substance use but little is known about their risk and protective factors. A crucial next step to reducing substance use among this priority population may involve understanding how transition-to-adulthood themes are associated with substance use. Intervention and prevention programs could also benefit from information about which if any specific transitions undergone in emerging adulthood are associated with substance use.

METHODS

Hispanic emerging adults (aged 18 to 24) completed surveys indicating their identification with transition-to-adulthood themes, role transitions in the past year, and use of alcohol and marijuana. Logistic regression models were used to examine the associations between transition-to-adulthood themes and past-month binge drinking and marijuana use, controlling for age and gender. Separate logistic regression models explored the association between each individual role transition and past-month binge drinking and marijuana use, controlling for age and gender and using a Bonferonni correction.

RESULTS

Among the participants (n=1,390), 41% were male, the average age was 21, 24% reported past-month marijuana use and 34% reported past-month binge drinking. Participants who felt emerging adulthood was a time of focusing on others were less likely to report marijuana use and binge drinking. Among the 24 transitions, five were significantly associated with past-month marijuana use and 10 were significantly associated with past-month binge drinking.

CONCLUSION

Findings suggest transition-to-adulthood themes as well as specific changes experienced by emerging adults are meaningful for Hispanics and should be explored in prevention and intervention programs in the future. Future research should determine what specific mechanisms are making these transitional processes risk factors for substance use.

The Mental Health, Substance Use, and Delinquency among Truant Youths in a Brief Intervention Project: A Longitudinal Study

The relationship between substance use, mental health disorders, and delinquency among youth is well documented. What has received far less attention from researchers is the relationship between these issues among truant youth, in spite of studies that document truants are a population at-risk for negative outcomes. The present study bridges this gap by (1) examining psychosocial functioning and delinquency among truants, and (2) assessing the efficacy of a Brief Intervention (BI) in reducing delinquent behavior over time. To meet these objectives, data were collected from 183 truant youth enrolled in an ongoing NIDA-funded BI project. Informed by a developmental damage perspective, a structural equation model was formulated and estimated. Interim results provide overall support for the model, and suggest the BI may be a promising, innovative intervention for truant youth. Service delivery implications and directions for future analyses are discussed.

Do family dinners reduce the risk for early adolescent substance use? A propensity score analysis

The risks of early adolescent substance use on health and well-being are well documented. In recent years, several experts have claimed that a simple preventive measure for these behaviors is for families to share evening meals. In this study, we use data from the 1997 National Longitudinal Study of Youth (n = 5,419) to estimate propensity score models designed to match on a set of covariates and predict early adolescent substance use frequency and initiation. The results indicate that family dinners are not generally associated with alcohol or cigarette use or with drug use initiation. However, a continuous measure of family dinners is modestly associated with marijuana frequency, thus suggesting a potential causal impact. These results show that family dinners may help prevent one form of substance use in the short term but do not generally affect substance use initiation or alcohol and cigarette use.

Risco de persistência na conduta infracional em adolescentes: estudo exploratório

A literatura internacional é consistente em apontar fatores de risco fortemente associados à persistência do comportamento infracional em adolescentes. O conhecimento tem servido de base para o desenvolvimento de instrumentos de avaliação de risco de reincidência infracional, com o propósito principal de adequar a medida judicial, o tipo e o nível de intervenção às necessidades do adolescente. O presente estudo teve como objetivo realizar uma investigação exploratória da performance do instrumento Youth Level of Service/Case Management Inventory, fundamentado nos fatores de risco associados à persistência da conduta infracional, em amostra composta de quarenta adolescentes em conflito com a lei, no interior do Estado de São Paulo. Realizada a coleta de dados inicial, após um período de 6 a 12 meses foi feito levantamento no Cartório da Infância e Juventude para verificar registro de novas infrações. Análises estatísticas mostraram a boa capacidade preditiva do instrumento. Outros resultados e limitações do estudo são apresentados e discutidos.