Childhood economic strains in predicting substance use in emerging adulthood: mediation effects of youth self-control and parenting practices

Parental substance use disorders and psychiatric conditions in offspring: A Swedish population-based cohort study with over 1,000,000 individuals

BACKGROUND

Exposure to parental substance use problems has been associated with offsprings poor health and adverse social outcomes. In this study, we examined the association between exposure to parental substance use disorder (SUD) during childhood, and adolescence and offspring psychiatric conditions in young adulthood.

METHOD

This was a register-based cohort study comprising 562,095 males and 531,130 females born between 1981 and 1990 in Sweden. Parental SUD was captured between the offspring's birth and eighteenth birthday. Cox regression models were used to estimate the Hazard Ratio (HR) of psychiatric conditions from age 18 years to a maximum age of 35 years, from January 1, 1999 to December 31, 2016.

RESULTS

About 4% of the study population was exposed to parental SUD during childhood and adolescence. The HR of psychiatric diagnosis was higher in males (1.80, 95% CI = 1.77-1.85) and females (1.56, 95% CI = 1.51-1.60) who were exposed to parental SUD, compared to those who were not; after adjusting for year of birth, domicile, origin, relative poverty, and other parental psychiatric diagnoses. The risks of psychiatric conditions were higher among males and females exposed to parental SUD during childhood compared to during adolescence.

CONCLUSION

Exposure to parental SUD during childhood and adolescence was associated with an increased risk of psychiatric conditions in early adulthood for both males and females. Neither origin, poverty, municipality, or other parental psychiatric diagnoses fully explained the association. These risks seemed to be somewhat higher among males, and among those exposed during childhood when compared to during adolescence.

Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia

El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.

Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6-18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.

Association between poverty exposure during childhood and adolescence, and drug use disorders and drug-related crimes later in life

AIMS

To examine whether poverty exposure in childhood/adolescence increases the risk of later drug use disorder and drug crime conviction.

DESIGN, SETTING AND PARTICIPANTS

A national cohort study encompassing 634 284 individuals born between 1985 and 1990, residing in Sweden between 5 and 18 years of age, followed-up from January 2004 to December 2016, starting from the age of 19 years until the first visit to inpatient/outpatient care with a diagnosis of a drug use disorder or a drug crime offence.

MEASUREMENTS

The exposure variable was 'trajectories of poverty' based on household income, assessed through group-based trajectory analysis. Cox regression analysis was used to obtain hazard ratios for drug use disorders and drug crime convictions using age as the underlying time scale.

FINDINGS

We identified five trajectories of childhood/adolescence poverty: (1) 'moving out of poverty in childhood' (8.7%); (2) 'never poverty' (68.9%); (3) 'moving into poverty in adolescence' (11.0%); (4) 'moving out of poverty in adolescence' (5.4%); and (5) 'chronically poor' (5.9%). Compared with the 'never poor' group, almost all trajectory groups had higher risks for drug use problems. Young males 'moving into poverty in adolescence' had the highest risks of drug use disorder [hazard ratio (HR) = 1.48, 95% confidence interval (CI) = 1.40-1.57] and drug crime conviction (HR = 1.50, 95% CI = 1.38-1.62), after adjusting for calendar year, domicile, origin, psychiatric diagnosis and parental psychiatric diagnosis. The results were similar in females moving into poverty in adolescence (HR = 1.63, 95% CI = 1.52-1.76 and HR = 1.89, 95% CI = 1.74-2.05 for drug use disorders and drug crime, respectively).

CONCLUSION

In Sweden, poverty exposure early in life seems to increase the risk of drug use problems in adulthood. These associations are not explained fully by domicile, origin or other psychiatric disorders. Young males and females moving into poverty in adolescence are at highest risk.

Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism

Applying a social determinants of health framework, this review brings attention to evidence from social sciences and neuroscience on the role of selected social factors in individual and population-level vulnerability to substance use and substance use disorders (SUDs). The understanding that social vulnerability to substance use and SUDs is multifaceted and occurs across different levels of influence (individual, interpersonal, community, and societal) is underscored. We propose that socially based stressors play a critical role in creating vulnerability to substance use and SUDs, and as such, deserve greater empirical attention to further understand how they "get under the skin." Current knowledge from social sciences and neuroscience on the relationships among vulnerability to substance use resulting from stressors, exposure to socially toxic childhood environments, and racism and discrimination are summarized and discussed, as are implications for future research, practice, and policy. Specifically, we propose using a top-down approach to the examination of known, yet often unexplored, relationships between vulnerability to substance use and SUDs, related inequities, and potential differential effects across demographic groups. Finally, research gaps and promising areas of research, practice, and policy focused on ameliorating social vulnerabilities associated with substance use and SUDs across the lifespan are presented. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.

Parenting and Self-Control Across Early to Late Adolescence: A Three-Level Meta-Analysis

Self-control plays a significant role in positive youth development. Although numerous self-control challenges occur during adolescence, some adolescents control themselves better than others. Parenting is considered a critical factor that distinguishes adolescents with good self-control from those with poor self-control, but existing findings are inconsistent. This meta-analysis summarizes the overall relationship between parenting and self-control among adolescents aged 10 to 22 years. The analysis includes 191 articles reporting 1,540 effect sizes (N = 164,459). The results show that parenting is associated with adolescents' self-control both concurrently (r = .204, p < .001) and longitudinally (r = .157, p < .001). Longitudinal studies also reveal that adolescents' self-control influences subsequent parenting (r = .155, p < .001). Moderator analyses show that the effect sizes are largely invariant across cultures, ethnicities, age of adolescents, and parent and youth gender. Our results point to the importance of parenting in individual differences in adolescent self-control and vice versa.

Economic Circumstances in Childhood and Subsequent Substance Use in Adolescence - A Latent Class Analysis: The youth@hordaland Study

The aim of the present study was to investigate the association between longitudinal registry-based data on family income during childhood and self-reported substance use in adolescence, including potential alcohol- or drug problems. Data from the Norwegian population-based youth@hordaland-survey was employed, and the analyzed included n = 8,983 adolescents aged 16–19 years. This information was linked to registry-based information about childhood family income for seven consecutive years prior to adolescents’ participation in the youth@hordaland-survey. Latent class analyses (LCA) were used to examine associations between patterns of family economic circumstances in childhood and subsequent substance use in adolescence. Based on the LCA, we identified four distinct patterns of family economic circumstances: a ‘never poor’ (89.3%) group, followed by two groups characterized by moving in (3.0%) or out (4.6%) of poverty, and a final ‘chronically poor’ (3.1%) group. Several findings were of interest: the chronically poor reported less daily snus use, fewer had tried alcohol, were less likely to report frequent intoxication, and less prone to have potential alcohol- or drug-related problems compared to all other groups. They were also less likely to have tried any illicit drug compared to those moving in or out of poverty. Finally, the chronically poor reported more daily smoking than the never poor group, but less daily smoking than the moving out of poverty group. The never poor group was less likely to have tried any illicit drugs compared to the groups moving into or out of poverty, and less likely to smoke daily compared to the moving out of poverty group. In other words, the present study somewhat surprisingly suggested lower substance use among the chronically poor adolescents compared to other adolescents on several of the measures of substance use.

Contributions of Research based on the PSID Child Development Supplement

The Child Development Supplement to the PSID (PSID-CDS) began in 1997 with a cohort of 2,394 households including 3,586 children. Since that auspicious start, three waves of the first cohort were collected - 1997, 2002-03, and 2007-08 - and a new cohort was interviewed in 2014. To date more than 400 journal articles, chapters, books, and dissertations that used the data have been collected in the PSID bibliography. This paper brings together founders and early adopters to summarize important contributions to the child development, time use, media, and health literatures. The purpose of this paper is not a detailed literature review but an overview of the literature and knowledge base to which PSID-CDS researchers have contributed. It points out unique methodological and measurement contributions, summarizes the motivation for research on parental investments in children, reviews findings regarding healthy child development, and examines the role of neighborhoods in children's lives.

Adolescents from upper middle class communities: Substance misuse and addiction across early adulthood

In this prospective study of upper middle class youth, we document frequency of alcohol and drug use, as well as diagnoses of abuse and dependence, during early adulthood. Two cohorts were assessed as high school seniors and then annually across 4 college years (New England Study of Suburban Youth younger cohort [NESSY-Y]), and across ages 23-27 (NESSY older cohort [NESSY-O]; ns = 152 and 183 at final assessments, respectively). Across gender and annual assessments, results showed substantial elevations, relative to norms, for frequency of drunkenness and using marijuana, stimulants, and cocaine. Of more concern were psychiatric diagnoses of alcohol/drug dependence: among women and men, respectively, lifetime rates ranged between 19%-24% and 23%-40% among NESSY-Os at age 26; and 11%-16% and 19%-27% among NESSY-Ys at 22. Relative to norms, these rates among NESSY-O women and men were three and two times as high, respectively, and among NESSY-Y, close to one among women but twice as high among men. Findings also showed the protective power of parents' containment (anticipated stringency of repercussions for substance use) at age 18; this was inversely associated with frequency of drunkenness and marijuana and stimulant use in adulthood. Results emphasize the need to take seriously the elevated rates of substance documented among adolescents in affluent American school communities.

Examining the Contemporaneous, Short-Term, and Long-Term Effects of Secondary Exposure to Violence on Adolescent Substance Use

The relationship between secondary exposure to violence-defined as witnessing violence in the home, community, or school-and adolescent substance use is well-documented. Yet, multi-wave empirical studies examining this relationship are sparse. In addition, studies have only begun to examine whether this relationship varies by the situational components of the violent event. Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), this study examines the contemporaneous, short-term, and long-term effects of secondary exposure to violence on substance use, and whether witnessing violence in which a weapon is present has a different impact on adolescent substance use than does witnessing violence without a weapon. Hierarchical logistic regression models on a racially and ethnically diverse sample of 1670 youth (51.5% female) residing in 79 neighborhoods indicated that: (1) the effects of secondary exposure to violence on alcohol and marijuana use were enduring, albeit attenuated, over time; (2) the effect of secondary exposure to violence on illicit drug use was suppressed in the short-term but significant in the long-term; (3) witnessing violence without a weapon was salient for alcohol and marijuana use at all time points; and (4) witnessing violence with a weapon impacted illicit drug use in the long-term. The results suggest that addressing the consequences of secondary exposure to violence requires prolonged intervention efforts and that the study of secondary exposure to violence requires a more nuanced approach that accounts for situational aspects of the violent event.

The influence of childhood welfare participation on adulthood substance use: evidence from the National Longitudinal Study of Adolescent to Adult Health

BACKGROUND

The associations between early life-socioeconomic status and health, specifically substance use, are well substantiated. The vulnerabilities associated with adversity in childhood, particularly poverty, can have a cumulative effect on an individual's risk and resilience throughout the life course. While several studies substantiate the relationship between substance use and welfare participation, less known is the impact of and prevalence of behavioral health problems later in life among young adults who were welfare recipients before age 18.

OBJECTIVE

This article explores whether childhood welfare participation before the age of 18 years influences substance use until young adulthood (24-34 years).

METHODS

This study used Add Health data with sample sizes ranging from 12,042 to 12,324 respondents, and propensity score matching methods to balance the samples and account for selection bias. Matched data were then used to run a series of regression models.

RESULTS

Those who participated in welfare before the age of 18 years had a significant lower probability of remaining substance-free until young adulthood (marijuana-free by 30%, p < 0.001; and other illicit substances-free by 16%, p < 0.05). However, no significant between-group differences were found on any of the alcohol-related variables.

CONCLUSIONS

Findings highlight long-term behavioral health risks, especially substance use, faced by young adults who participated in welfare before the age of 18 years. Acknowledging the vulnerabilities associated with welfare participation and living in poverty could help increase the effectiveness of program and treatment efforts. The prevention of long-term behavioral health disorders hinges on early diagnosis and intervention.

Childhood self-control predicts smoking throughout life: Evidence from 21,000 cohort study participants

Objective: Low self-control has been linked with smoking, yet it remains unclear whether childhood self-control underlies the emergence of lifetime smoking patterns. We examined the contribution of childhood self-control to early smoking initiation and smoking across adulthood. Methods: 21,132 participants were drawn from 2 nationally representative cohort studies; the 1970 British Cohort Study (BCS) and the 1958 National Child Development Study (NCDS). Child self-control was teacher-rated at age 10 in the BCS and at ages 7 and 11 in the NCDS. Participants reported their smoking status and number of cigarettes smoked per day at 5 time-points in the BCS (ages 26–42) and 6 time-points in the NCDS (ages 23–55). Both studies controlled for socioeconomic background, cognitive ability, psychological distress, gender, and parental smoking; the NCDS also controlled for an extended set of background characteristics. Results: Early self-control made a substantial graded contribution to (not) smoking throughout life. In adjusted regression models, a 1-SD increase in self-control predicted a 6.9 percentage point lower probability of smoking in the BCS, and this was replicated in the NCDS (5.2 point reduced risk). Adolescent smoking explained over half of the association between self-control and adult smoking. Childhood self-control was positively related to smoking cessation and negatively related to smoking initiation, relapse to smoking, and the number of cigarettes smoked in adulthood. Conclusions: This study provides strong evidence that low childhood self-control predicts an increased risk of smoking throughout adulthood and points to adolescent smoking as a key pathway through which this may occur.

Children in nonparental care: health and social risks

Approximately 2.3 million children in the United States live separately from both parents; 70-90% of those children live with a relative. Compared with children living with one or both parents, children in nonparental care are in poorer health, are at heightened risk for experiencing disruptions and instability in caregiving, and are vulnerable to other social antecedents of child health (e.g., neglect, poverty, maltreatment). Given the significant impact of adversity in childhood on health across the lifespan, which is increased among children in nonparental care, it is informative to consider the health risks of children living in nonparental care specifically. Research examining the contributions of poverty, instability, child maltreatment, and living in nonparental care, including meta-analyses of existing studies, are warranted. Longitudinal studies describing pathways into and out of nonparental care and the course of health throughout those experiences are also needed. Despite these identified gaps, there is sufficient evidence to indicate that attention to household structure is not only relevant but also essential for the clinical care of children and may aid in identifying youth at risk for developing poor health across the lifespan.

Cigarette Use by Turkish Adolescents and Its Links to Strain, Depression, and Anger

In this study of Turkish adolescents and cigarette smoking, we applied general strain theory, conceptualizing smoking as a coping strategy for various types of strain and negative emotions associated with strain. Our secondary data were collected via a survey prepared (in English, by the Icelandic Center for Social Research and Analysis, later translated into Turkish) for the Youth in Europe Project fighting drug use by urban European students. The present data came from students in the populous Bagcilar district of Istanbul, Turkey, where in 2008, 10th-grade students completed the questionnaire. Our final sample included 1,949 students. Logistic regression showed cigarette smoking (both lifetime and 30-day) to be associated with strain arising from school, from negative life events, and from violent victimization. Smoking also appeared linked to negative affect, specifically anger and depression. Gender was observed to moderate a link between lifetime cigarette smoking and anger.

Translating Developmental Neuroscience to Substance Use Prevention

Several preventive interventions have demonstrated efficacy in reducing substance use. However, opportunities exist to further improve prevention approaches. The application of recent advances in developmental neuroscience can inform the design, implementation, and evaluation of substance use prevention programs. This paper first briefly describes the developmental integration of the prefrontal cortex with emotion and motivation centers of the brain, and the implications of this process for substance use vulnerability. Discussed next are specific examples of how developmental neuroscience can inform prevention timing, development, and evaluation. Contextual considerations are then suggested including a critical role for schools in substance misuse prevention. Finally, current theoretical and methodological challenges to the translation of developmental neuroscience to substance use prevention are discussed.

Modeling the association between lifecourse socioeconomic disadvantage and systemic inflammation in healthy adults: The role of self-control

OBJECTIVE

We sought to identify pathways connecting lifecourse socioeconomic status (SES) with chronic, low-grade inflammation, focusing on the explanatory roles of self-control, abdominal adiposity, and health practices.

METHODS

Participants were 360 adults aged 15-55 who were free of chronic medical conditions. They were roughly equally divided between low and high current SES, with each group further divided between low and high early-life SES. Structural equation modeling (SEM) was used to identify direct and indirect pathways linking early-life and current SES with low-grade, chronic inflammation in adulthood, as manifest by serum interleukin-6 and C-reactive protein. Low SES was hypothesized to relate to inflammation by reducing self-control, which in turn was hypothesized to facilitate lifestyle factors that potentiate inflammation (smoking, alcohol use, sedentary behavior, and weight gain).

RESULTS

Analyses revealed that self-control was pivotal in linking both early-life and current SES to inflammation. Low early-life SES was related to a harsher family climate, and in turn lower adult self-control, over and above the effects of current SES. Controlling for early-life SES, low current SES was associated with perceived stress and, in turn, diminished self-control. Results showed that lower self-control primarily operated through higher abdominal adiposity to associate with greater inflammation.

CONCLUSIONS

The findings suggest a mechanistic scenario wherein low SES in early life or adulthood depletes self-control and, in turn, fosters adiposity and inflammation. These pathways should be studied longitudinally to elucidate and potentially ameliorate socioeconomic disparities in health.