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Yukhnenko D, Blackwood N, Lichtenstein P, Fazel S. Psychiatric disorders and reoffending risk in individuals with community sentences in Sweden: a national cohort study. Lancet Public Health 2023; 8:e119-e129. [PMID: 36669512 PMCID: PMC10914666 DOI: 10.1016/s2468-2667(22)00312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Community sentences are widely used in many countries, often comprising the majority of criminal justice sanctions. Psychiatric disorders are highly prevalent in community-sentenced populations and are thus potential targets for treatment interventions designed to reduce reoffending. We examined the association between psychiatric disorders and reoffending in a national cohort of individuals given community sentences in Sweden, with use of a sibling control design to account for unmeasured familial confounding. METHODS We did a longitudinal cohort study of 82 415 individuals given community sentences between Nov 1, 1991, and Dec 31, 2013, in Sweden using data from population-based registers. We calculated hazard ratios (HRs) for any reoffending and violent reoffending with Cox regression models. We compared community-sentenced siblings with and without psychiatric disorders to control for potential familial confounding. Additionally, we calculated population attributable fractions to assess the contribution of psychiatric disorders to reoffending behaviours. The primary outcomes of the study were any (general) reoffending and violent reoffending. FINDINGS Between Nov 1, 1991, and Dec 31, 2013, those given community sentences who were diagnosed with any psychiatric disorder had an increased reoffending risk in men (adjusted HR 1·59, 95% CI 1·56-1·63 for any reoffending; 1·60, 1·54-1·66 for violent reoffending) and women (1·71, 1·61-1·82 for any reoffending; 2·19, 1·88-2·54 for violent reoffending). Risk estimates remained elevated after adjustment for familial confounding. Schizophrenia spectrum disorders, personality disorders, and substance use disorders had stronger associations with violent reoffending than did other psychiatric disorders. Assuming causality, the adjusted population attributable risk of psychiatric disorders on violent reoffending was 8·3% (95% CI 6·6-10·0) in the first 2 years of community follow-up in men and 30·9% (22·7-39·0) in women. INTERPRETATION Psychiatric disorders were associated with an increased risk of any reoffending and violent reoffending in the community-sentenced population. The magnitude of the association between psychiatric disorders and reoffending varied by individual diagnosis. Substance use disorders had the highest absolute and relative risks. Most of the increased risk for any reoffending in individuals with psychiatric disorders could be attributed to comorbid substance misuse. Given their high prevalence, substance use disorders should be the focus of treatment programmes in community-sentenced populations. FUNDING Wellcome Trust.
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Affiliation(s)
| | - Nigel Blackwood
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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2
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Campisi SC, Ataullahjan A, Baxter JAB, Szatmari P, Bhutta ZA. Mental health interventions in adolescence. Curr Opin Psychol 2022; 48:101492. [PMID: 36347181 DOI: 10.1016/j.copsyc.2022.101492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 01/28/2023]
Abstract
Adolescent mental health (MH) disorders with striking prominence include anxiety, self-harm and depression. The current review aims to highlight high-quality reviews of novel interventions, mainly Cochrane reviews, and/or quality meta-analyses published between 2019 and 2022 on three adolescent mental health challenges. Recent evidence about the effectiveness of psychosocial interventions is encouraging. However, the shift to virtual treatment methods during the pandemic was supported by a relatively thin body of research. Future research and policy in child and youth MH must address the consequences of the pandemic or comparable disruptions on adolescent MH, as well as mitigation strategies. An emphasis on integrated digital, community and school platforms for mental health within child and adolescent health services would benefit from a greater focus on early recognition and prevention.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8, Canada
| | - Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada
| | - Jo-Anna B Baxter
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8, Canada; Cundill Centre for Child and Youth Depression, Centre for Addiction, and Mental Health, 80 Workman Way, Toronto, ON - M6J 1H4. Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8. Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada; Centre of Excellence in Women, and Child Health, Aga Khan University, Stadium Road, PO Box 3500, Karachi, Pakistan. 74800.
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3
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Adzrago D, Wong SW, Wilkerson JM. Effect Modification of Illicit Drug Use on Symptoms of a Major Depressive Episode to Better Understand Binge Drinking by Adolescents and Adults in the United States. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00770-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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4
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Wasserman AM, Shaw-Meadow KJ, Moon TJ, Karns-Wright TE, Mathias CW, Hill-Kapturczak N, Dougherty DM. The externalizing and internalizing pathways to marijuana use initiation: Examining the synergistic effects of impulsiveness and sensation seeking. Dev Psychol 2021; 57:2250-2264. [PMID: 34928672 PMCID: PMC9815474 DOI: 10.1037/dev0001267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Adolescent marijuana use has become increasingly more problematic compared with the past; thus, understanding developmental processes that increase the liability of marijuana use is essential. Two developmental pathways to adolescent substance use have been proposed: an externalizing pathway that emphasizes the expression of aggressive and delinquent behavior, and an internalizing pathway that emphasizes the role of depressive symptoms and negative affect. In this study, we aimed to examine the synergistic role of impulsiveness and sensation seeking in the two risk pathways to determine whether both high and low levels of the traits are risk factors for marijuana use. Our study included 343 adolescents (52% were girls, 78% identified as Hispanic) that oversampled high-risk youth (78% had a family history of substance use disorder), assessed biannually between the ages of 13-16 years old. Moderated mediation analyses revealed that high levels of sensation seeking indirectly predicted marijuana use through higher mean levels of externalizing behavior. The positive relationship between sensation seeking and externalizing behavior was only significant at high levels of impulsiveness. Conversely, low levels of sensation seeking indirectly predicted marijuana use through higher mean levels of internalizing behavior. The negative relationship between sensation seeking and internalizing behavior was only significant at low levels of impulsiveness. Collectively, these results demonstrate that high and low levels of both impulsiveness and sensation seeking confer increased risk of marijuana use, albeit through different mechanisms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - K J Shaw-Meadow
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
| | - T J Moon
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
| | - T E Karns-Wright
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
| | - C W Mathias
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
| | - N Hill-Kapturczak
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
| | - D M Dougherty
- Department of Psychiatry, University of Texas Health Science Center at San Antonio
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5
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An Exploration of Intra-individual Mechanisms for the Association Between Childhood Conduct Problems and Early Adolescent Substance Use. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00701-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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6
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Stiles-Shields C, Archer J, Zhang J, Burnside A, Draxler J, Potthoff LM, Reyes KM, Summersett Williams F, Westrick J, Karnik NS. A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults. Child Psychiatry Hum Dev 2021; 54:639-658. [PMID: 34724134 PMCID: PMC9310430 DOI: 10.1007/s10578-021-01280-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/22/2022]
Abstract
Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.
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Affiliation(s)
- Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Joseph Archer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
| | - Amanda Burnside
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Janel Draxler
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Karen M. Reyes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | | | - Jennifer Westrick
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612, USA
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Peterson SJ, Atkinson EA, Riley EN, Davis HA, Smith GT. Affect-Based Problem Drinking Risk: The Reciprocal Relationship between Affective Lability and Problem Drinking. Alcohol Alcohol 2021; 56:746-753. [PMID: 33822869 DOI: 10.1093/alcalc/agab024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Negative affect has been implicated in risk for the development of problematic drinking behavior. Furthermore, there is evidence for reciprocal relationships between negative affect and problem drinking, such that engagement in problem drinking also predicts increases in negative affect. However, affective models of risk often fail to consider affective lability-the experience of rapidly changing mood. Although affective lability appears to increase risk for problem drinking, it is unknown if this relationship persists above and beyond other affect-related constructs (e.g. depression, anxiety) and if it is reciprocal in nature. Accordingly, we used a longitudinal survey design to examine (a) if affective lability predicts problem drinking above and beyond depression and anxiety and (b) if affective lability and problem drinking demonstrate a reciprocal relationship. METHODS First-year college students (n = 358) participated in a three wave longitudinal study. We constructed a structural equation model (SEM) of a random intercept cross-lagged panel model to test our hypotheses. RESULTS Consistent with our hypotheses, affective lability predicted increases in problem drinking while anxiety and depression did not. Problem drinking and affective lability demonstrated a reciprocal relationship in which increases in one predicted increases in the other at subsequent time points. This relationship was present beyond the predictive effects of anxiety or depression. CONCLUSIONS Affective lability appears to be an important affect-based predictor of problem drinking, and there may be a reciprocal, risk-enhancing relationship between affective lability and problem drinking.Components of negative affect, such as depression or anxiety, have been shown to predict risk for problem drinking, and vice versa. A less considered construct, affective lability, predicted problem drinking while anxiety and depression did not add any predictive power. Problem drinking and affective lability also appeared to demonstrate a reciprocal relationship.
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Affiliation(s)
- Sarah J Peterson
- University of Kentucky, Department of Psychology, 106B Kastle Hall, Lexington, KY 40506, USA
| | - Emily A Atkinson
- University of Kentucky, Department of Psychology, 106B Kastle Hall, Lexington, KY 40506, USA
| | - Elizabeth N Riley
- University of Kentucky, Center for Innovation in Population Health, 364 Healthy Kentucky Building, Lexington, KY 40506, USA
| | - Heather A Davis
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
| | - Gregory T Smith
- University of Kentucky, Department of Psychology, 106B Kastle Hall, Lexington, KY 40506, USA
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8
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Prins SJ, Kajeepeta S, Pearce R, Beardslee J, Pardini D, Cerdá M. Identifying sensitive periods when changes in parenting and peer factors are associated with changes in adolescent alcohol and marijuana use. Soc Psychiatry Psychiatr Epidemiol 2021; 56:605-617. [PMID: 32915245 PMCID: PMC8715643 DOI: 10.1007/s00127-020-01955-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 09/01/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE There are well-established associations between parental/peer relationships and adolescent substance use, but few longitudinal studies have examined whether adolescents change their substance use in response to changes in their parents' behavior or peer networks. We employ a within-person change approach to address two key questions: Are changes in parenting and peer factors associated with changes in adolescent marijuana and alcohol use? Are there sensitive periods when changes in parenting and peer factors are more strongly associated with changes in adolescent marijuana and alcohol use? METHODS We analyzed longitudinal data collected annually on 503 boys, ages 13-19, recruited from Pittsburgh public schools. Questionnaires regarding parental supervision, negative parenting practices, parental stress, physical punishment, peer delinquency, and peer drug use were administered to adolescents and their caretakers. Alcohol and marijuana use were assessed by a substance use scale adapted from the National Youth Survey. RESULTS Reductions in parental supervision and increases in peer drug use and peer delinquency were associated with increases in marijuana frequency, alcohol frequency, and alcohol quantity. Increases in parental stress were associated with increases in marijuana and alcohol frequency. The magnitudes of these relationships were strongest at ages 14-15 and systematically decreased across adolescence. These associations were not due to unmeasured stable confounders or measured time-varying confounders. CONCLUSIONS Reducing or mitigating changes in parenting and peer risk factors in early adolescence may be particularly important for preventing substance use problems as adolescents transition into young adulthood.
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Affiliation(s)
| | | | | | - Jordan Beardslee
- University of California, Irvine, Department of Psychological Science
| | - Dustin Pardini
- School of Criminology & Criminal Justice, Arizona State University
| | - Magdalena Cerdá
- Department of Population Health, NYU School of Medicine, New York, NY
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9
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Gukasyan N, Strain EC. Relationship between cannabis use frequency and major depressive disorder in adolescents: Findings from the National Survey on Drug Use and Health 2012-2017. Drug Alcohol Depend 2020; 208:107867. [PMID: 31958677 PMCID: PMC7039755 DOI: 10.1016/j.drugalcdep.2020.107867] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/04/2020] [Accepted: 01/11/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cannabis use and major depressive disorder (MDD) are common and often co-morbid in adolescents, but the nature and directionality of the relationship between these two conditions remains obscure. METHODS We examined results from the National Survey on Drug Use and Health. Weighted demographics were compared between adolescents with a history of cannabis use (N = 14,873) and never users (N = 73,079). Weighted logistic regression controlling for demographic variables and other substance use was used to determine the relationship between cannabis use frequency and MDD. RESULTS Adolescents with any history of cannabis use had significantly higher rates of lifetime and past year MDD, MDD with severe role impairment, and past year suicide attempt (p < 0.001). Comparing use frequency groups in the adjusted model revealed that heavy users (weekly or greater use) had significantly lower predicted prevalence of lifetime and past year MDD, and past year MDD with severe role impairment compared to light users and those who used cannabis >1 year ago. Rates of reported past year suicide attempt did not differ significantly by cannabis use frequency. CONCLUSIONS Adolescents with any cannabis use history have significantly higher rates of MDD. However, the directionality between frequency of use and MDD is counter to what was expected.
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Affiliation(s)
- Natalie Gukasyan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. 5510 Nathan Shock Drive, Baltimore, MD 21224, United States.
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. 5510 Nathan Shock Drive, Baltimore, MD 21224, United States.
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10
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Russell BS, Hutchison M, Fusco A. Emotion Regulation Outcomes and Preliminary Feasibility Evidence From a Mindfulness Intervention for Adolescent Substance Use. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2018.1561577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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11
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Schleider JL, Ye F, Wang F, Hipwell AE, Chung T, Sartor CE. Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls. Alcohol Clin Exp Res 2018; 43:98-107. [PMID: 30474232 DOI: 10.1111/acer.13913] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence-particularly in girls. However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem-alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls. METHODS Data were drawn from a population-based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self-reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth-report) as covariates. Anxiety and depression severity were included within a single cross-lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior. RESULTS Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated. CONCLUSIONS Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.
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Affiliation(s)
| | - Feifei Ye
- RAND Corporation , Pittsburgh, Pennsylvania
| | - Frances Wang
- Department of Psychiatry , University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison E Hipwell
- Department of Psychiatry , University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tammy Chung
- Department of Psychiatry , University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Carolyn E Sartor
- Department of Psychiatry , Yale University School of Medicine, New Haven, Connecticut
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12
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Hardee JE, Cope LM, Martz ME, Heitzeg MM. Review of Neurobiological Influences on Externalizing and Internalizing Pathways to Alcohol Use Disorder. Curr Behav Neurosci Rep 2018; 5:249-262. [PMID: 31768306 DOI: 10.1007/s40473-018-0166-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose of review Two developmental courses through which alcohol use disorder (AUD) may emerge include externalizing and internalizing pathways. We review recent neuroimaging studies of potential neural risk factors for AUD and link findings to potential behavioral risk factors for AUD. Recent findings There is evidence that early-emerging weakness in prefrontal functioning and later-emerging differences in reward-system functioning contribute to an externalizing risk pathway. Stress may be an important contributor in the internalizing pathway through a blunting of reward-related activation, which may act alone or in combination with heightened emotion-related reactivity. Summary This review highlights areas for future work, including investigation of the relative balance between prefrontal and subcortical circuitry, attention to stages of AUD, and consideration of environmental factors such as stress and sleep. Particularly important is longitudinal work to understand the temporal ordering of associations among brain maturation, behavioral risk, and alcohol use.
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Affiliation(s)
- Jillian E Hardee
- University of Michigan, Department of Psychiatry and Addiction Center, 4250 Plymouth Road, Ann Arbor, MI
| | - Lora M Cope
- University of Michigan, Department of Psychiatry and Addiction Center, 4250 Plymouth Road, Ann Arbor, MI
| | - Meghan E Martz
- University of Michigan, Department of Psychiatry and Addiction Center, 4250 Plymouth Road, Ann Arbor, MI
| | - Mary M Heitzeg
- University of Michigan, Department of Psychiatry and Addiction Center, 4250 Plymouth Road, Ann Arbor, MI
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13
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Fernandez ME, Damme LV, Pauw SD, Costa-Ball D, Daset L, Vanderplasschen W. The moderating role of age and gender differences in the relation between subjective well-being, psychopathology and substance use in Uruguayan adolescents. REVISTA LATINOAMERICANA DE PSICOPATOLOGIA FUNDAMENTAL 2018. [DOI: 10.1590/1415-4714.2018v21n3p486.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to explore the Subjective well-being (SWB) of school-going adolescents in Uruguay (N= 325; Mage= 14.67; SD= 1.62). We investigate age- and gender-specific relationships between psychopathology and substance use on the one hand, and subjective well-being on the other hand. Multivariate linear regression analyses, indicated five significant predictors of SWB: three psychopathology factors (depression-anxiety, social anxiety and dissocial behaviour), and age displayed a negative association, while one psychopathology factor (resilience) showed a positive association. When extending the multivariate linear regression analysis with interaction effects, significant interactions appeared regarding gender and resilience and age and substance use. Our study focuses on the necessity to have evidence-based results in order to plan appropriate preventive interventions with adolescents.
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14
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Elsayed NM, Kim MJ, Fields KM, Olvera RL, Hariri AR, Williamson DE. Trajectories of Alcohol Initiation and Use During Adolescence: The Role of Stress and Amygdala Reactivity. J Am Acad Child Adolesc Psychiatry 2018; 57:550-560. [PMID: 30071976 PMCID: PMC6396321 DOI: 10.1016/j.jaac.2018.05.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/10/2018] [Accepted: 06/11/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Early alcohol use initiation predicts onset of alcohol use disorders in adulthood. However, little is known about developmental trajectories of alcohol use initiation and their putative biological and environmental correlates. METHOD Adolescents (N = 330) with high or low familial loading for depression were assessed annually for up to 6 years. Data were collected assessing affective symptoms, alcohol use, and stress at each assessment. Adolescents also participated in a functional magnetic resonance imaging protocol that included measurement of threat-related amygdala and reward-related ventral striatum activity. RESULTS Latent class analyses identified 2 trajectories of alcohol use initiation. Early initiators (n = 32) reported greater baseline alcohol use and rate of change of use compared with late initiators and/or current abstainers (n = 298). Early initiators reported higher baseline levels of stressful life events (p = .001) and exhibited higher amygdala (p = .001) but not ventral striatum activity compared with late initiators. Early initiators were 15.3 times more likely to have a full drink (p < .0001), 9.1 times more likely to experience intoxication (p < .0001), and 6.7 times more likely to develop an alcohol use disorder by 19 years of age compared with late initiators (p = .003). CONCLUSION Adolescents on a trajectory of early alcohol use initiation have higher levels of stress, have increased threat-related amygdala activity, are more likely to consume a full standard alcoholic drink, are more likely to experience early intoxication, and are at a heightened risk for the onset of an alcohol use disorder.
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Affiliation(s)
| | | | | | | | | | - Douglas E Williamson
- Duke University, the Durham Veterans Affairs Medical Center, Durham, NC, and the University of Texas Health at San Antonio
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15
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Reasons for discontinuation of long-term opioid therapy in patients with and without substance use disorders. Pain 2017; 158:526-534. [PMID: 28192376 DOI: 10.1097/j.pain.0000000000000796] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Several factors may accelerate opioid discontinuation rates, including lack of information about the long-term effectiveness of opioids for chronic pain, heightened awareness about opioid-related adverse events, closer monitoring of patients for opioid-related aberrant behaviors, and greater restrictions around opioid prescribing. Rates of discontinuation may be most pronounced in patients deemed to be at "high risk." The purpose of this study was to compare reasons for discontinuation of long-term opioid therapy (LTOT) between patients with and without substance use disorder (SUD) diagnoses receiving care within a major U.S. health care system. This retrospective cohort study assembled a cohort of Veterans Health Administration patients prescribed opioid therapy for at least 12 consecutive months who subsequently discontinued opioid therapy for at least 12 months. From this cohort, we randomly selected 300 patients with SUD diagnoses and propensity score-matched 300 patients without SUD diagnoses. A comprehensive manual review of patients' medical records ascertained reasons for LTOT discontinuation. Most patients (85%) were discontinued as a result of clinician, rather than patient, decisions. For patients whose clinicians initiated discontinuation, 75% were discontinued because of opioid-related aberrant behaviors. Relative to patients without SUD diagnoses, those with SUD diagnoses were more likely to discontinue LTOT because of aberrant behaviors (81% vs 68%), most notably abuse of alcohol or other substances. This is the first study to document reasons for discontinuation of LTOT in a sample of patients with and without SUD diagnoses. Treatments that concurrently address SUD and chronic pain are needed for this high-risk population.
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Rhew IC, Fleming CB, Stoep AV, Nicodimos S, Zheng C, McCauley E. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort. Addiction 2017; 112:1952-1960. [PMID: 28600897 PMCID: PMC5633491 DOI: 10.1111/add.13907] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/18/2017] [Accepted: 06/02/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Although they often co-occur, the longitudinal relationship between depression and substance use disorders during adolescence remains unclear. This study estimated the effects of cumulative depression during early adolescence (ages 13-15 years) on the likelihood of cannabis use disorder (CUD) and alcohol use disorder (AUD) at age 18. DESIGN Prospective cohort study of youth assessed at least annually between 6th and 9th grades (~ age 12-15) and again at age 18. Marginal structural models based on a counterfactual framework that accounted for both potential fixed and time-varying confounders were used to estimate cumulative effects of depressive symptoms over early adolescence. SETTING The sample originated from four public middle schools in Seattle, Washington, USA. PARTICIPANTS The sample consisted of 521 youth (48.4% female; 44.5% were non-Hispanic White). MEASUREMENTS Structured in-person interviews with youth and their parents were conducted to assess diagnostic symptom counts of depression during early adolescence; diagnoses of CUD and AUD at age 18 was based the Voice-Diagnostic Interview Schedule for Children. Cumulative depression was defined as the sum of depression symptom counts from grades 7-9. FINDINGS The past-year prevalence of cannabis and alcohol use disorder at the age 18 study wave was 20.9 and 19.8%, respectively. A 1 standard deviation increase in cumulative depression during early adolescence was associated with a 50% higher likelihood of CUD [prevalence ratio (PR) = 1.50; 95% confidence interval (CI) = 1.07, 2.10]. Although similar in direction, there was no statistically significant association between depression and AUD (PR = 1.41; 95% CI = 0.94, 2.11). Further, there were no differences in associations according to gender. CONCLUSIONS Youth with more chronic or severe forms of depression during early adolescence may be at elevated risk for developing cannabis use disorder compared with otherwise similar youth who experience fewer depressive symptoms during early adolescence.
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Affiliation(s)
- Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Charles B. Fleming
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Ann Vander Stoep
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Semret Nicodimos
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Cheng Zheng
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Elizabeth McCauley
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Seattle Children’s Hospital, Seattle, WA, USA
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Guo Y, Rousseau J, Renno P, Kehoe P, Daviss M, Flores S, Saunders K, Phillips S, Chin M, Evangelista LS. Feasibility of an emotional health curriculum for elementary school students in an underserved Hispanic community. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2017; 30:133-141. [PMID: 29504643 PMCID: PMC6198665 DOI: 10.1111/jcap.12185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 11/15/2017] [Accepted: 12/17/2017] [Indexed: 01/24/2023]
Abstract
PROBLEM Hispanic children have greater mental health challenges but fewer received mental health services than other ethnic groups. A classroom-based Emotional Health Curriculum (EHC) was developed to address mental health disparities in an underserved Hispanic community. METHODS A quasi-experimental design with one group pre- and post-intervention was used to test the feasibility of an 8-week EHC for one hundred 3rd and 4th grade children in a dual-immersion Spanish-English elementary school. Limited efficacy was measured by changes in depression and anxiety scores reported by children and teachers. Acceptance was evaluated by a child-reported satisfaction survey and a focus group in which the four teachers shared their experiences. Implementation was measured by participation, retention, and fidelity rates. FINDINGS The child-reported depression and anxiety and teacher-reported depression were significantly decreased in at-risk children with the effect size ranging from 0.60 to 1.16 (ps < 0.05). The majority of children (89.7%) enjoyed the EHC and teachers observed that children had acquired skills to manage their emotional distress. The participation, retention, and fidelity rates were 98%, 94%, and 99.13%, respectively. CONCLUSIONS The results provide promising evidence that the EHC has the potential to improve depression and anxiety symptoms in at-risk children.
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Affiliation(s)
- Yuqing Guo
- Sue & Bill Gross School of Nursing, University of California, Irvine, 299D, Berk Hall, Irvine, CA, 92697-3959, Phone: 949-824-9057, Fax: 949-824-0470,
| | - Julie Rousseau
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine CA, 92697-3959,
| | - Patricia Renno
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Semel Institute for Neuroscience & Human Behavior, Rm. 68-229, 760 Westwood Plaza, Los Angeles, CA 90095-1759,
| | - Priscilla Kehoe
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA 92697-3959,
| | - Monique Daviss
- El Sol Science and Arts Academy of Santa Ana, 1010 N. Broadway Street, Santa Ana, CA 92701, Phone: 714-543-0023,
| | - Sara Flores
- El Sol Science and Arts Academy of Santa Ana, 1010 N. Broadway Street, Santa Ana, CA 92701, Phone: 714-543-0023,
| | - Kathleen Saunders
- Sue & Bill Gross School of Nursing, University of California, Irvine, 209, Berk Hall, Irvine, CA, 92697-3959, Phone: 949-824-9694,
| | - Susanne Phillips
- Sue & Bill Gross School of Nursing, University of California, Irvine, 252E Berk Hall, Irvine, CA, 92697-3959, Phone: 949-824-4274,
| | - Mindy Chin
- Sue & Bill Gross School of Nursing, University of California, Irvine, 299C, Berk Hall, Irvine, CA, 92697-3959,
| | - Lorraine S. Evangelista
- Sue & Bill Gross School of Nursing, University of California, Irvine, 299E, Berk Hall, Irvine, CA, 92697-3959, Phone: 949-824-9057,
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Russell BS, Heller AT, Hutchison M. Differences in Adolescent Emotion Regulation and Impulsivity: A Group Comparison Study of School-Based Recovery Students. Subst Use Misuse 2017; 52:1085-1097. [PMID: 28323517 DOI: 10.1080/10826084.2016.1272612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recovery high schools (RHS) vary in organization and operating philosophy, but are designed to support the unique needs of students struggling with substance use disorders (SUD). Previous research on youth risk taking behaviors suggests emotion regulation is a key predictor of outcomes. Specifically, the ability to respond in adaptive rather than maladaptive ways is often associated with challenges of impulsivity, poor distress tolerance, and adolescent substance use. OBJECTIVES The current study considers data from RHS students in order to answer research questions concerning impulsivity and emotion regulation of youth working to change their risk trajectories in comparison to group of typically developing youth. METHODS Participants (n = 114) in the study were composed of students enrolled in 3 RHS programs and a comparison group of similar aged youth (15-20 years) without an identified SUD. Data collection occurred through an anonymous online survey set of four measures of reactivity and impulsivity, emotion regulation, and parent and peer influence, as well as an online version of the Stroop Inhibitory Control Task. RESULTS Participants in the three RHS groups reported decreased emotion regulation abilities, increased impulsivity and increased peer influence when compared to the comparison group; differential effects within RHS are presented. Conclusions/Importance: Results are consistent with the extant literature that difficulty regulating emotions is associated with an increased risk for substance abuse and suggests these difficulties persist in early recovery. Results also suggest the need to better understand how different operating philosophies of programs influence student outcomes and the recovery process.
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Affiliation(s)
- Beth S Russell
- a Department of Human Development & Family Studies , University of Connecticut , Storrs , Connecticut , USA
| | - Anne Thompson Heller
- a Department of Human Development & Family Studies , University of Connecticut , Storrs , Connecticut , USA
| | - Morica Hutchison
- a Department of Human Development & Family Studies , University of Connecticut , Storrs , Connecticut , USA
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Lattie EG, Ho J, Sargent E, Tomasino KN, Smith J, Brown CH, Mohr DC. Teens Engaged in Collaborative Health: The Feasibility and Acceptability of an Online Skill-Building Intervention for Adolescents at Risk for Depression. Internet Interv 2017; 8:15-26. [PMID: 28584734 PMCID: PMC5456272 DOI: 10.1016/j.invent.2017.02.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/23/2017] [Accepted: 02/23/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is an ongoing need for effective and accessible preventive interventions for adolescent depression and substance abuse. This paper reports on a field trial of an online indicated preventive intervention, ProjectTECH, which is based on cognitive-behavioral therapy (CBT) techniques. The study aims to gather information about the feasibility and acceptability of this program. Secondary aims of this study were to examine the impact of the program on depression symptoms, perceived stress, positive affect, and substance use and to compare differences between groups that were led by a peer versus those that were led by a licensed clinician. METHODS High school students (n = 39) were recruited primarily through social media advertisements, and assigned to four groups of 8-12 individuals to collaboratively participate in an 8 week peer network-based online preventive intervention which were led by a trained peer guide or a licensed clinician. Participants were provided with didactic lessons, CBT-based mood management tools, and peer networking features, and completed quantitative and qualitative feedback at baseline, midpoint, end of intervention, and 1 month follow up. RESULTS The program attracted and retained users primarily from social media and was used frequently by many of the participants (system login M = 25.62, SD = 16.58). Participants rated the program as usable, and offered several suggestions for improving the program, including allowing for further personalization by the individual user, and including more prompts to engage with the social network. From baseline to end of intervention, significant decreases were observed in depressive symptoms and perceived stress (p's < .05). Significant increases in positive affect were observed from baseline to midpoint (p < .05) and no changes were observed in substance use, although the rate of substance use was low in this sample. While this study had low power to detect group differences, no consistent differences were observed between participants in a peer-led group and those in a clinician-led group. CONCLUSIONS Results of this study indicates that ProjectTECH, an indicated preventive intervention for high school-aged adolescents, demonstrates both feasibility, acceptability, and short-term, longitudinal psychological benefits for participants. Future iterations of the program may benefit from close attention to user interface design and the continued use of trained peer support guides.
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Affiliation(s)
- Emily G. Lattie
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - Joyce Ho
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - Elizabeth Sargent
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - Kathryn N. Tomasino
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - J.D. Smith
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - C. Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
| | - David C. Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr., 10th Floor, Chicago, IL 60611, USA
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Greenfield BL, Sittner KJ, Forbes MK, Walls ML, Whitbeck LB. Conduct Disorder and Alcohol Use Disorder Trajectories, Predictors, and Outcomes for Indigenous Youth. J Am Acad Child Adolesc Psychiatry 2017; 56:133-139.e1. [PMID: 28117059 PMCID: PMC5314209 DOI: 10.1016/j.jaac.2016.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/29/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to identify separate and joint trajectories of conduct disorder (CD) and alcohol use disorder (AUD) DSM-IV diagnostic symptoms among American Indian and First Nation (Indigenous) youth aged 10 to 18 years, and to characterize baseline profiles and later outcomes associated with joint trajectory group membership. METHOD Data were collected between 2002 and 2010 on three indigenous reservations in the northern Midwest and four Canadian reserves (N = 673). CD and substance use disorder (SUD) were measured using the DSM-IV Diagnostic Interview Schedule for Children-Revised (DISC-R), administered at four time points. RESULTS Using group-based trajectory modeling, three CD and four AUD trajectories were found. Both had a small group with high symptoms, but the largest groups for both had no symptoms (55% and 73%, respectively). CD symptom trajectories began at age 10 years and peaked at age 14; AUD trajectories began at age 12 years and were highest from age 16 on. Eight joint trajectories were identified. Of the sample, 53% fell into the group with no CD or AUD symptoms. Compared to symptomatic groups, this group had greater caretaker warmth, positive school adjustment, less discrimination, and fewer deviant peers, and were less likely to have a caretaker with major depression at baseline. Symptomatic groups had higher odds of high school dropout, sex under the influence, and arrest at age 17 to 20 years. CONCLUSION Despite significant risk factors, a large proportion of Indigenous youth had no CD-SUD symptoms over time. CD-SUD symptoms have multiple development trajectories and are related to early developmental risk and later psychosocial outcomes.
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Hussong AM, Ennett ST, Cox MJ, Haroon M. A systematic review of the unique prospective association of negative affect symptoms and adolescent substance use controlling for externalizing symptoms. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:137-147. [PMID: 28134539 DOI: 10.1037/adb0000247] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This systematic review examines whether negative affect symptoms (i.e., anxiety, depression, and internalizing symptoms more broadly) predict subsequent adolescent substance use after controlling for co-occurring externalizing symptoms. Following PRISMA procedures, we identified 61 studies that tested the association of interest. Findings varied depending on the type of negative affect symptom and to some extent on the substance use outcome. The most consistent associations were evident for depressive symptoms, particularly as predictors of substance use composite scores. No clear association between anxiety and substance use or between internalizing symptoms and substance use was evident, and indeed these associations were as often negative as positive. Mixed findings regarding the depression-substance use association, however, also call for greater attention to potential moderating factors that may help define who, when, and in what context depression serves as an important risk factor for later substance use above and beyond risk associated with externalizing symptoms. (PsycINFO Database Record
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Affiliation(s)
- Andrea M Hussong
- Center for Developmental Science, The University of North Carolina at Chapel Hill
| | - Susan T Ennett
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill
| | - Melissa J Cox
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill
| | - Maleeha Haroon
- Center for Developmental Science and Department of Psychology & Neuroscience, The University of North Carolina at Chapel Hill
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Torikka A, Kaltiala-Heino R, Luukkaala T, Rimpelä A. Trends in Alcohol Use among Adolescents from 2000 to 2011: The Role of Socioeconomic Status and Depression. Alcohol Alcohol 2016; 52:95-103. [PMID: 27507821 DOI: 10.1093/alcalc/agw048] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/25/2016] [Indexed: 01/02/2023] Open
Abstract
AIMS To assess temporal trends of adolescent alcohol use in Finland from 2000 to 2011, according to socio-economic status and depression. METHODS Classroom self-administered questionnaires concerning health, health behaviours and school experiences were administered biennially from 2000-2001 to 2010-2011 to nationwide samples of 14- to 16-year-olds (n = 618,084). Alcohol use was measured as the frequencies of drinking and drunkenness. Socioeconomic status was measured using parental education and unemployment. Depression was measured using a Finnish modification of the Beck Depression Inventory. Cross-tabulations and a logistic regression analysis were applied. RESULTS Over the study period, rates of frequent drinking and frequent drunkenness decreased among both boys and girls. Low levels of parental education and unemployment as well as adolescent depression increased the likelihoods of frequent drinking and drunkenness. Unlike the general decreasing trend observed for alcohol use, the likelihoods of frequent drinking and drunkenness increased among adolescents who were depressed and had unemployed parents with low levels of education. The prevalence of frequent drunkenness was 75.8% among the boys in this group during 2008-2011, whereas the corresponding prevalence was 2.3% for boys without depression and with highly educated, employed parents. The corresponding figures for girls were 41.7% and 1.4%, respectively. CONCLUSIONS The overall decreasing trend in frequent alcohol use was not observed among socioeconomically deprived adolescents with depression. Thus, alcohol prevention programmes should treat these youth as special targets.
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Affiliation(s)
- Antti Torikka
- Kanta-Häme Central Hospital, 13530 Hämeenlinna, Finland
| | - Riittakerttu Kaltiala-Heino
- Department of Adolescent Psychiatry, Tampere University Hospital PO Box 2000, FI-33521 Tampere, Finland, Vanha Vaasa Hospital, Vaasa, and University of Tampere School of Medicine, Tampere, Finland
| | - Tiina Luukkaala
- Science Center, Pirkanmaa Hospital District PO Box 2000, 33521 Tampere, Finland and School of Health Sciences, University of Tampere, FIN-33014, Tampere, Finland
| | - Arja Rimpelä
- School of Health Sciences and PERLA-Tampere Centre for Childhood, Youth and Family Research, University of Tampere, FIN-33014 and Department of Adolescent Psychiatry, Tampere University Hospital PO Box 2000, FI-33521, Tampere, Finland
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Birrell L, Newton NC, Teesson M, Slade T. Early onset mood disorders and first alcohol use in the general population. J Affect Disord 2016; 200:243-9. [PMID: 27148903 DOI: 10.1016/j.jad.2016.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/18/2016] [Accepted: 04/16/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mood disorders and alcohol use are common in the general population and often occur together. This study explored how early onset mood disorders relate to age of first alcohol use in the Australian general population. METHODS Discrete time survival analysis modelled the odds of first alcohol use among those with, versus without, an early onset DSM-IV mood disorders (major depression, dysthymia or bipolar disorder). Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841). RESULTS Early onset mood disorders as an overall class were not significantly related to the odds of first alcohol use in any given year. On examining the different types of mood disorders individually early onset bipolar disorder was a significant predictor of first alcohol use. The analysis then looked at interactions with time and found that after the age of 14 years the presence of an early onset mood disorder significantly increased the odds of first alcohol use by 32%. LIMITATIONS Retrospective recall was used to determine age of onset data which is subject to known biases and replication is recommended in some subgroup analysis due to smaller sample sizes. CONCLUSIONS Mood disorders, particularly bipolar disorder, act as unique risk factors for first alcohol use in the general population and show significant interactions with developmental timing. The findings point to the potential utility of prevention programs that target alcohol use and mood disorders together from early adolescence.
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Affiliation(s)
- Louise Birrell
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Nicola C Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
| | - Tim Slade
- NHMRC Centre of Research Excellence in Mental Health and Substance Use (CREMS), National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia.
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Pardini D, White HR, Xiong S, Bechtold J, Chung T, Loeber R, Hipwell A. Unfazed or Dazed and Confused: Does Early Adolescent Marijuana Use Cause Sustained Impairments in Attention and Academic Functioning? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:1203-17. [PMID: 25862212 DOI: 10.1007/s10802-015-0012-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
There is some suggestion that heavy marijuana use during early adolescence (prior to age 17) may cause significant impairments in attention and academic functioning that remain despite sustained periods of abstinence. However, no longitudinal studies have examined whether both male and female adolescents who engage in low (less than once a month) to moderate (at least once a monthly) marijuana use experience increased problems with attention and academic performance, and whether these problems remain following sustained abstinence. The current study used within-individual change models to control for all potential pre-existing and time-stable confounds when examining this potential causal association in two gender-specific longitudinal samples assessed annually from ages 11 to 16 (Pittsburgh Youth Study N = 479; Pittsburgh Girls Study N = 2296). Analyses also controlled for the potential influence of several pertinent time-varying factors (e.g., other substance use, peer delinquency). Prior to controlling for time-varying confounds, analyses indicated that adolescents tended to experience an increase in parent-reported attention and academic problems, relative to their pre-onset levels, during years when they used marijuana. After controlling for several time-varying confounds, only the association between marijuana use and attention problems in the sample of girls remained statistically significant. There was no evidence indicating that adolescents who used marijuana experienced lingering attention and academic problems, relative to their pre-onset levels, after abstaining from use for at least a year. These results suggest that adolescents who engage in low to moderate marijuana use experience an increase in observable attention and academic problems, but these problems appear to be minimal and are eliminated following sustained abstinence.
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Affiliation(s)
- Dustin Pardini
- Department of Psychiatry, University of Pittsburgh Medical Center, Sterling Plaza, Suite 408, 201 North Craig Street, Pittsburgh, PA, 15213, USA,
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Cerdá M, Prins SJ, Galea S, Howe CJ, Pardini D. When psychopathology matters most: identifying sensitive periods when within-person changes in conduct, affective and anxiety problems are associated with male adolescent substance use. Addiction 2016; 111:924-35. [PMID: 26748766 PMCID: PMC4826797 DOI: 10.1111/add.13304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 12/13/2015] [Accepted: 12/28/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS There is a documented link between common psychiatric disorders and substance use in adolescent males. This study addressed two key questions: (1) is there a within-person association between an increase in psychiatric problems and an increase in substance use among adolescent males and (2) are there sensitive periods during male adolescence when such associations are more evident? DESIGN Analysis of longitudinal data collected annually on boys selected randomly from schools based on a comprehensive public school enrollment list from the Pittsburgh Board of Education. SETTING Recruitment occurred in public schools in Pittsburgh, Pennsylvania, USA. PARTICIPANTS A total of 503 boys assessed at ages 13-19 years, average cooperation rate = 92.1%. MEASUREMENTS Diagnostic and Statistical Manual (DSM)-oriented affective, anxiety and conduct disorder problems were measured with items from the caregiver, teacher and youth version of the Achenbach scales. Scales were converted to t-scores using age- and gender-based national norms and combined by taking the average across informants. Alcohol and marijuana use were assessed semi-annually by a 16-item Substance Use Scale adapted from the National Youth Survey. FINDINGS When male adolescents experienced a 1-unit increase in their conduct problems t-score, their rate of marijuana use subsequently increased by 1.03 [95% confidence interval (CI) = 1.01, 1.05], and alcohol quantity increased by 1.01 (95% CI = 1.0002, 1.02). When adolescents experienced a 1-unit increase in their average quantity of alcohol use, their anxiety problems t-score subsequently increased by 0.12 (95% CI = 0.05, 0.19). These associations were strongest in early and late adolescence. CONCLUSIONS When adolescent boys experience an increase in conduct disorder problems, they are more likely to exhibit a subsequent escalation in substance use. As adolescent boys increase their intensity of alcohol use, they become more likely to develop subsequent anxiety problems. Developmental turning points such as early and late adolescence appear to be particularly sensitive periods for boys to develop comorbid patterns of psychiatric problems and substance use.
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Affiliation(s)
- Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California, Davis, CA, USA
| | - Seth J Prins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Chanelle J Howe
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Dustin Pardini
- School of Criminology and Criminal Justice at Arizona State University, Phoenix, AZ, USA
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Haug S, Núñez CL, Becker J, Gmel G, Schaub MP. Predictors of onset of cannabis and other drug use in male young adults: results from a longitudinal study. BMC Public Health 2014; 14:1202. [PMID: 25416140 PMCID: PMC4247759 DOI: 10.1186/1471-2458-14-1202] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 10/29/2014] [Indexed: 11/23/2022] Open
Abstract
Background The use of cannabis and other illegal drugs is particularly prevalent in male young adults and is associated with severe health problems. This longitudinal study explored variables associated with the onset of cannabis use and the onset of illegal drug use other than cannabis separately in male young adults, including demographics, religion and religiosity, health, social context, substance use, and personality. Furthermore, we explored how far the gateway hypothesis and the common liability to addiction model are in line with the resulting prediction models. Methods The data were gathered within the Cohort Study on Substance Use Risk Factors (C-SURF). Young men aged around 20 years provided demographic, social, health, substance use, and personality-related data at baseline. Onset of cannabis and other drug use were assessed at 15-months follow-up. Samples of 2,774 and 4,254 individuals who indicated at baseline that they have not used cannabis and other drugs, respectively, in their life and who provided follow-up data were used for the prediction models. Hierarchical logistic stepwise regressions were conducted, in order to identify predictors of the late onset of cannabis and other drug use separately. Results Not providing for oneself, having siblings, depressiveness, parental divorce, lower parental knowledge of peers and the whereabouts, peer pressure, very low nicotine dependence, and sensation seeking were positively associated with the onset of cannabis use. Practising religion was negatively associated with the onset of cannabis use. Onset of drug use other than cannabis showed a positive association with depressiveness, antisocial personality disorder, lower parental knowledge of peers and the whereabouts, psychiatric problems of peers, problematic cannabis use, and sensation seeking. Conclusions Consideration of the predictor variables identified within this study may help to identify young male adults for whom preventive measures for cannabis or other drug use are most appropriate. The results provide evidence for both the gateway hypothesis and the common liability to addiction model and point to further variables like depressiveness or practising of religion that might influence the onset of drug use.
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Affiliation(s)
- Severin Haug
- Swiss Research Institute for Public Health and Addiction at Zurich University, Konradstrasse 32, P,O, Box, CH - 8031, Zurich, Switzerland.
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Pang RD, Farrahi L, Glazier S, Sussman S, Leventhal AM. Depressive symptoms, negative urgency and substance use initiation in adolescents. Drug Alcohol Depend 2014; 144:225-30. [PMID: 25280962 PMCID: PMC4253553 DOI: 10.1016/j.drugalcdep.2014.09.771] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/21/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Studies show depressive symptoms are associated with substance use in adolescents, but the mechanism underlying this association is still unclear. This study investigated negative urgency - the disposition to rash action during emotional states - as a factor explaining relations between depressive symptoms and use of several substances. METHODS In this cross-sectional study, 476 adolescents (mean age 14.5 years) completed self-report surveys. Regression models and products of coefficient analyses examined the overall relation of depressive symptoms to substance use and negative urgency as a statistical mediator of this association. RESULTS Depression levels associated with increased likelihood of lifetime use of cigarettes, other forms of tobacco, marijuana, alcohol, inhalants, prescription painkillers, and any substance. Relations between depression levels and lifetime use of alcohol, inhalants, and any substance were accounted for (i.e., statistically mediated) by negative urgency. In adolescents endorsing lifetime use, depression levels associated with younger age of first use of other forms of tobacco and alcohol as well as use frequency of cigarette, alcohol, and composite frequency. Negative urgency accounted for the covariance between depression level and age of first use of alcohol, but did not for other forms of tobacco or frequency of use of any substances. CONCLUSIONS Depression levels are associated with lifetime use of a variety of substances in early adolescence and targeting this risk factor with preventive efforts may be useful in reducing risk. Negative urgency may be an important target for interventions aimed at alcohol and inhalant use.
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Affiliation(s)
- Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar Street, CSC 240, Los Angeles, CA 90033, USA.
| | - Layla Farrahi
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar Street, CSC 240, Los Angeles, CA 90033, USA
| | - Shannon Glazier
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar Street, CSC 240, Los Angeles, CA 90033, USA
| | - Steve Sussman
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar Street, CSC 240, Los Angeles, CA 90033, USA; University of Southern California, Department of Psychology, 3620 South McClintock Ave., SGM 501, Los Angeles, CA 90089, USA; University of Southern California, School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089, USA
| | - Adam M Leventhal
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2250 Alcazar Street, CSC 240, Los Angeles, CA 90033, USA; University of Southern California, Department of Psychology, 3620 South McClintock Ave., SGM 501, Los Angeles, CA 90089, USA
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Keyes KM, Nicholson R, Kinley J, Raposo S, Stein MB, Goldner EM, Sareen J. Age, period, and cohort effects in psychological distress in the United States and Canada. Am J Epidemiol 2014; 179:1216-27. [PMID: 24692432 DOI: 10.1093/aje/kwu029] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although treatment utilization for depression and anxiety symptoms has increased substantially in the United States and elsewhere, it remains unclear whether the underlying population distribution of psychological distress is changing over time. We estimated age, period, and cohort effects using data from 2 countries over more than 20 years, including National Health Interview Surveys from 1997 to 2010 (n = 447,058) and Canadian Community Health Surveys from 2000 to 2007 (n = 125,306). Psychological distress was measured with the Kessler Psychological Distress Scale. By period, both countries showed the highest levels of psychological distress in 2001 and the lowest levels in 2007. By age, psychological distress was highest in adolescence and during the late 40s and early 50s. By cohort, Canadian Community Health Survey results indicated a decreasing cohort effect among those born in 1922-1925 through 1935-1939 (β = -0.36, 95% confidence interval: -0.45, -0.27) and then a continuously increasing cohort effect during the remainder of the 20th century through 1989-1992 (β = 0.49, 95% confidence interval: 0.38, 0.61). The National Health Interview Survey data captured earlier-born cohorts and indicated an increased cohort effect for the earliest born (for 1912-1914, β = 0.44, 95% confidence interval: 0.26, 0.61). In sum, individuals in the oldest and more recently born birth cohorts have higher mean psychological distress symptoms compared with those born in midcentury, underscoring the importance of a broad, population-level lens for conceptualizing mental health.
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