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Compton MT, Frimpong EY, Fu E, Ehntholt A, Chaudhry S, Ferdousi W, Rowan GA, Swetnam H, Radigan M, Smith TE, Rotter M. Associations Between Cumulative Social Adversities and Substance Use Comorbidity in a Statewide Sample of Individuals in Treatment for Mental Illnesses. J Nerv Ment Dis 2023; 211:814-818. [PMID: 37552046 DOI: 10.1097/nmd.0000000000001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
ABSTRACT We sought to investigate associations of cumulative social adversities in four areas (low education, unemployment, homelessness, and criminal/legal involvement) with presence of comorbid alcohol and drug use disorders among individuals in treatment for mental illnesses. Using data from 103,416 adults in mental health treatment, generalized estimating equation modified Poisson models were used to estimate increased risk of having comorbid substance use disorders based on individual and/or cumulative number of social adversities present. Controlling for effects of sex, race/ethnicity, and region (New York City vs . the rest of the State), as well as for the other social adversities, each of four social adversities was associated with presence of substance use comorbidity. Relative to having none of the social adversities, the presence of one, two, three, or four was associated with an increased prevalence ratio (PR) of having substance use comorbidity: 1.44, 2.10, 2.66, and 2.92; all p 's < 0.0001. PRs were greater among female patients, and among Hispanics and those classified as other or multiracial compared with non-Hispanic Whites or non-Hispanic Blacks. Findings indicate substantial associations between four social adversities and presence of substance use comorbidity; the strength of association with the four social adversities is cumulative.
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Affiliation(s)
| | | | - En Fu
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | - Sahil Chaudhry
- New York State Office of Mental Health, Albany, New York
| | | | - Grace A Rowan
- New York State Office of Mental Health, Albany, New York
| | - Hannah Swetnam
- New York State Office of Mental Health, Albany, New York
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Carrà G, Bartoli F, Canestro A, Capogrosso CA, Bebbington PE, Crocamo C. Influence of intrinsic and extrinsic religiosity on youth cannabis use: A structural equation modelling analysis on national survey on drug use and health (NSDUH) 2015-2019. J Psychiatr Res 2023; 166:178-185. [PMID: 37776662 DOI: 10.1016/j.jpsychires.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/11/2023] [Accepted: 09/15/2023] [Indexed: 10/02/2023]
Abstract
Religiosity may reduce the risk of substance use in adults and young people. However, religiosity is a complex construct, variously defined and assessed. We explored the role of different religious components: intrinsic (subjective), extrinsic-personal (service attendance) and extrinsic-social (church-based social activities) in deterring cannabis use among adolescents. Combining several years (2015-2019) of NSDUH data on 68,263 adolescents between 12 and 17 years, a structural equation modelling (SEM) approach was used to evaluate pathways from intrinsic and extrinsic components of religiosity to cannabis use. We analyzed the role of several covariates, including comorbid depression and secular volunteering activities. About 15% of participants said they had used cannabis at some level in the previous year. Some degree of intrinsic and of extrinsic-personal religiosity was reported by 66% and 25% of the sample. 57% were committed to at least one faith-based activity, while 74% reported participation in non-faith-based community activities. The SEM regression model -controlling for putative confounders- showed that both intrinsic and extrinsic-personal religious components reduced the likelihood of cannabis use (Cannabis use coeff.: -0.065, p = 0.001; coeff.: -0.176, p < 0.001, respectively). However, the extrinsic-social component had no effect on refraining from cannabis use, despite involvement in non-faith based volunteering activities was protectively associated. Support for secular volunteering programs may be a cost-effective mechanism for reducing cannabis use. Moreover, whilst promoting religiosity is beyond the scope of any preventive programs, religious practices should be considered relevant protective factors, deserving consideration and support in terms of public health.
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Affiliation(s)
- Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy; Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy
| | - Aurelia Canestro
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy
| | - Chiara A Capogrosso
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy
| | - Paul E Bebbington
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, 20900, Italy.
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Desai R, Jain A, Sultan W, Gandhi Z, Raju AR, Varughese VJ, Jnaneswaran G, Agarwal C, Rizvi B, Mansuri Z, Gupta P, Kumar G, Sachdeva R. Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101465. [PMID: 36295625 PMCID: PMC9609556 DOI: 10.3390/medicina58101465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18−44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015−December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06−1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01−1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55−12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38−2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02−2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Correspondence: or
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19153, USA
| | - Waleed Sultan
- Department of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USA
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, USA
| | - Athul Raj Raju
- Department of Medicine, Karuna Medical College, Chittur-Thathamangalam 678103, Kerala, India
| | - Vivek Joseph Varughese
- Department of Internal Medicine, Government Medical College, Thiruvananthapuram 695011, Kerala, India
| | - Geethu Jnaneswaran
- Department of Medicine, SUT Academy of Medical Sciences, Thiruvananthapuram 695028, Kerala, India
| | - Charu Agarwal
- Department of Medicine, Sri Siddhartha Medical College, Tumakuru 572107, Karnataka, India
| | - Bisharah Rizvi
- Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA 93720, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Puneet Gupta
- Department of Cardiology, Baptist Health Deaconess Madisonville, Madisonville, KY 42431, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
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Espinosa A, Ruglass LM, Conway FN, Jackson KM, White HR. Motives, Frequency, and Consequences of Cannabis Use Among College Students. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221093608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated profiles of cannabis use motives among current cannabis-consuming college students. Then we assessed profile differences in demographic characteristics, social contexts of use, regulatory environment, alcohol use, negative affect, negative consequences, and cannabis use. Participants ( N = 1, 213) were from three universities in states with different cannabis legislation. Six profiles emerged: Low Motives, Low to Moderate Enhance, High Enhance, High Enhance & Social + Moderate Expand, High Enhance & Cope, and High Motives. Profiles differed in social contexts of use, sex, alcohol use, negative affect, and regulatory environment. Profiles endorsing high and multiple motives had higher cannabis use and negative consequences, relative to profiles with low or fewer motives. Profiles characterized by high avoidance motives (i.e., coping) had the highest cannabis use and consequences. Interventions targeting types and intensity of motives for cannabis-use may help reduce use and related consequences among college students who use cannabis.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, New York, NY, USA
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
| | - Lesia M. Ruglass
- Department of Psychology, The City College of New York, New York, NY, USA
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
| | - Fiona N. Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI USA
| | - Helene R. White
- Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, USA
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Bartoli F, Riboldi I, Bachi B, Calabrese A, Moretti F, Crocamo C, Carrà G. Efficacy of Cannabidiol for Δ-9-Tetrahydrocannabinol-Induced Psychotic Symptoms, Schizophrenia, and Cannabis Use Disorders: A Narrative Review. J Clin Med 2021; 10:jcm10061303. [PMID: 33810033 PMCID: PMC8005219 DOI: 10.3390/jcm10061303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 01/17/2023] Open
Abstract
Although cannabis’ major psychoactive component, Δ-9-tetrahydrocannabinol (THC), has been linked to both earlier onset and poorer outcomes of psychotic disorders, Cannabidiol (CBD) seems to have different pharmacological mechanisms and potential therapeutic properties. However, no clinical study has investigated CBD for the treatment of co-occurring psychotic and cannabis use disorders so far, even though its utility seems grounded in a plausible biological basis. The aim of this work is thus to provide an overview of available clinical studies evaluating the efficacy of CBD for psychotic symptoms induced by THC, schizophrenia, and cannabis use disorders. After searching for relevant studies in PubMed, Cochrane Library, and ClinicalTrials.gov, we included 10 clinical studies. Available evidence suggests that CBD may attenuate both psychotic-like symptoms induced by THC in healthy volunteers and positive symptoms in individuals with schizophrenia. In addition, preliminary data on the efficacy of CBD for cannabis use disorders show mixed findings. Evidence from ongoing clinical studies will provide insight into the possible role of CBD for treating psychotic and cannabis use disorders.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
- Correspondence: (F.B.); (G.C.); Tel.: +39-025-799-8644 (F.B.); +39-025-799-8645 (G.C.)
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Bianca Bachi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Angela Calabrese
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Federico Moretti
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy; (I.R.); (B.B.); (A.C.); (F.M.); (C.C.)
- Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, UK
- Correspondence: (F.B.); (G.C.); Tel.: +39-025-799-8644 (F.B.); +39-025-799-8645 (G.C.)
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Hasin D, Walsh C. Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review. J Clin Med 2020; 10:E15. [PMID: 33374666 PMCID: PMC7793504 DOI: 10.3390/jcm10010015] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/10/2020] [Accepted: 12/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. METHODS A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. RESULTS A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. CONCLUSIONS Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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Affiliation(s)
- Deborah Hasin
- New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA
| | - Claire Walsh
- New York State Psychiatric Institute, New York, NY 10032, USA;
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Karriker-Jaffe KJ, Witbrodt J, Mericle AA, Polcin DL, Kaskutas LA. Testing a Socioecological Model of Relapse and Recovery from Alcohol Problems. Subst Abuse 2020; 14:1178221820933631. [PMID: 33192069 PMCID: PMC7594231 DOI: 10.1177/1178221820933631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Abstract
This study tests a socioecological model of relapse and recovery using latent class growth mixture modeling to identify neighborhood, social network and individual-level predictors of alcohol dependence trajectories among a large, longitudinal sample of problem drinkers recruited from substance use treatment settings. We identified four distinct alcohol dependence trajectories: Stable Recovery/Low (Class 1); Relapsing/Rising (Class 2); Late Recovery/Declining (Class 3); and Chronic/High (Class 4). Neighborhood context (poverty and density of bars), social network characteristics (less involvement with Alcoholics Anonymous [AA], continued affiliation with heavy drinkers), and individual predisposing (psychiatric severity) and need (returning to treatment) characteristics each distinguished individuals in the Relapsing/Rising class from individuals in the Stable Recovery/Low class. Social network characteristics (AA involvement and continued affiliation with heavy drinkers) were the primary distinguishing factors for individuals in the Chronic/High class compared to the Late Recovery/Declining class. Study findings can be used to promote recovery and help prevent relapse by: guiding development of community-level interventions to improve social and physical environments; identifying potentially modifiable factors (social network support for sobriety, participation in self-help) to reduce negative consequences among problem drinkers who remain in high-risk neighborhoods; and contributing to ongoing discussions about new and continued licensing of alcohol outlets and regulation of alcohol sales to prevent alcohol problems in high-risk areas and among high-risk people.
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Affiliation(s)
| | - Jane Witbrodt
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Amy A Mericle
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Douglas L Polcin
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
| | - Lee Ann Kaskutas
- Alcohol Research Group, Public Health Institute,
Emeryville, CA, USA
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Heerde JA, Bailey JA, Toumbourou JW, Catalano RF. Longitudinal Associations Between the Adolescent Family Environment and Young Adult Substance Use in Australia and the United States. Front Psychiatry 2019; 10:821. [PMID: 31780972 PMCID: PMC6861438 DOI: 10.3389/fpsyt.2019.00821] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/17/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Harmful alcohol and cannabis use are social concerns associated with a range of negative outcomes. Prior research has identified links between disrupted parent-child attachment and child-adolescent substance use. Materials and Methods: This study used cross-national data from the International Youth Development Study (IYDS; Victoria, Australia and Washington State, USA) to investigate the relationship between early adolescent family environment characteristics, mid-adolescent attachment to parents, and young adult harmful alcohol and cannabis use. The moderating role of state on these relationships was also tested. State-representative samples of students in Grade 7 (age 13, 2002) were recruited and followed longitudinally at ages 14, 15, and 25 (n = 1,945, 53% female, 50% in Victoria). Results: Cross-state differences were evident in levels of family management, parent attitudes favorable to drug use, sibling alcohol and cannabis use, attachment to parents, and past year alcohol and cannabis use. Significantly higher rates of problematic alcohol use were reported by young adults in Victoria (25% vs. 14% in Washington State). Young adults in Washington State reported significantly higher rates of problematic cannabis use (14% vs. 10% in Victoria). Path modeling showed that characteristics of positive family environments (e.g., low conflict) in early adolescence were associated with higher attachment to parents and lower alcohol and cannabis use in mid-adolescence. Sibling substance use and more favorable parent attitudes to drug use were associated with past year alcohol and cannabis use in mid-adolescence. Results showed higher attachment to parents in mid-adolescence did not uniquely predict lower problematic alcohol or cannabis use in young adulthood. No significant cross-state differences in this pattern of associations were found. Discussion: The implications of the current findings suggest that prevention and intervention strategies targeted at reducing problematic substance use into young adulthood may benefit from considering the influence of behavioral norms and attitudes in family relationships.
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Affiliation(s)
- Jessica A. Heerde
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Population Health Studies of Adolescents, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, United States
| | - John W. Toumbourou
- Population Health Studies of Adolescents, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Richard F. Catalano
- Social Development Research Group, School of Social Work, University of Washington, Seattle, WA, United States
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