RESUMEN
Marijuana is one of the most commonly used drugs in the United States, and use during adolescence--when the brain is still developing--has been proposed as a cause of poorer neurocognitive outcome. Nonetheless, research on this topic is scarce and often shows conflicting results, with some studies showing detrimental effects of marijuana use on cognitive functioning and others showing no significant long-term effects. The purpose of the present study was to examine the associations of marijuana use with changes in intellectual performance in two longitudinal studies of adolescent twins (n = 789 and n = 2,277). We used a quasiexperimental approach to adjust for participants' family background characteristics and genetic propensities, helping us to assess the causal nature of any potential associations. Standardized measures of intelligence were administered at ages 9-12 y, before marijuana involvement, and again at ages 17-20 y. Marijuana use was self-reported at the time of each cognitive assessment as well as during the intervening period. Marijuana users had lower test scores relative to nonusers and showed a significant decline in crystallized intelligence between preadolescence and late adolescence. However, there was no evidence of a dose-response relationship between frequency of use and intelligence quotient (IQ) change. Furthermore, marijuana-using twins failed to show significantly greater IQ decline relative to their abstinent siblings. Evidence from these two samples suggests that observed declines in measured IQ may not be a direct result of marijuana exposure but rather attributable to familial factors that underlie both marijuana initiation and low intellectual attainment.
Asunto(s)
Inteligencia , Fumar Marihuana , Adolescente , Niño , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
Objective: Recently, use of alternative tobacco products, such as electronic cigarettes (e-cigarettes) and hookah (water-pipe tobacco), has increased among adolescents. It is unknown whether attention-deficit hyperactivity disorder (ADHD) symptoms are associated with initiation of alternative tobacco product use. Methods: Ninth grade high school students who never used any tobacco product at baseline (N = 1,921) participated in a longitudinal survey from 2014 to 2015. Overall symptomatology and inattention (IN) and hyperactivity-impulsivity (HI) ADHD subtypes were assessed at baseline. Past 6-month e-cigarette, hookah, and combustible cigarette use (yes/no) were reported at three semi-annual follow-ups. Repeated measures logistic regression models assessed the association of baseline ADHD symptoms with likelihood of tobacco product initiation across follow-ups. Results: For ADHD main effect estimates, unadjusted odds of reporting e-cigarette, hookah, and combustible cigarette use pooled across follow-up time points were 45%, 33%, and 37% greater, respectively, with each increase in one SD-unit of baseline ADHD symptoms in baseline never-users of tobacco products. ADHD was not associated with hookah or combustible cigarette use after adjusting for other risk factors. After adjustment, e-cigarette use initiation remained associated with overall ADHD (odds ratio, OR [95%confidence interval, 95% CI] = 1.22 [1.04, 1.42]) and HI (OR [95% CI] = 1.26 [1.09, 1.47]) symptoms, but not IN symptoms (OR [95% CI] = 1.13 [0.97, 1.32]). ADHD × Time interactions were not significant, suggesting ADHD increased odds of e-cigarette use initiation but did not alter the shape of use trajectory across follow-up among initiators. Conclusions: Understanding the psychosocial mechanisms underlying the pathway from ADHD to e-cigarette use may advance tobacco product use etiologic theory and prevention practice in the current era in which e-cigarette use is popular among youth.
Asunto(s)
Conducta del Adolescente/psicología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Sistemas Electrónicos de Liberación de Nicotina , Fumar/psicología , Adolescente , Femenino , Humanos , Conducta Impulsiva , Modelos Logísticos , Estudios Longitudinales , Masculino , Estudios Prospectivos , Factores de RiesgoRESUMEN
Although lower socioeconomic status has been linked to increased youth substance use, much less research has determined potential mechanisms explaining the association. The current longitudinal study tested whether alternative (i.e., pleasure gained from activities without any concurrent use of substances) and complementary (i.e., pleasure gained from activities in tandem with substance use) reinforcement mediate the link between lower socioeconomic status and youth substance use. Further, we tested whether alternative and complementary reinforcement and youth substance use gradually unfold over time and then intersect with one another in a cascading manner. Potential sex differences are also examined. Data were drawn from a longitudinal survey of substance use and mental health among high school students in Los Angeles. Data collection involved four semiannual assessment waves beginning in fall 2013 (N = 3395; M baseline age = 14.1; 47% Hispanic, 16.2% Asian, 16.1% multiethnic, 15.7% White, and 5% Black; 53.4% female). The results from a negative binomial path model suggested that lower parental socioeconomic status (i.e., lower parental education) was significantly related to an increased number of substances used by youth. The final path model revealed that the inverse association was statistically mediated by adolescents' diminished engagement in pleasurable substance-free activities (i.e., alternative reinforcers) and elevated engagement in pleasurable activities paired with substance use (i.e., complementary reinforcers). The direct effect of lower parental education on adolescent substance use was not statistically significant after accounting for the hypothesized mediating mechanisms. No sex differences were detected. Increasing access to and engagement in pleasant activities of high quality that do not need a reinforcement enhancer, such as substances, may be useful in interrupting the link between lower parental socioeconomic status and youth substance use.
Asunto(s)
Padres , Refuerzo en Psicología , Clase Social , Trastornos Relacionados con Sustancias/psicología , Adolescente , Conducta del Adolescente , Femenino , Actividades Humanas/psicología , Humanos , Estudios Longitudinales , Los Angeles , Masculino , Modelos Psicológicos , Trastornos Relacionados con Sustancias/economíaRESUMEN
BACKGROUND AND OBJECTIVES: We conducted a review of the prevalence and co-occurrence of 12 types of addictions in US ethnic/racial groups and discuss the implications of the results for genetic research on addictions. METHODS: We utilized MEDLINE and PsycINFO databases to review the literature on alcohol, tobacco, marijuana, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We present results for each addiction based on total US prevalence, prevalence within ethnic groups, and co-occurrence of addictions among ethnic groups when available. RESULTS: This review indicates very little research has examined the interrelationships of addictive behaviors among US ethnic groups. The studies that exist have focused nearly exclusively on comorbidity of substances and gambling behaviors. Overall findings suggest differences among US ethnic groups in prevalence of addictions and in prevalence of addiction among those who use substances or engage in gambling. Almost no ethnic group comparisons of other addictive behaviors including eating/food, internet, love, sex, exercise, work, and shopping were identified in the literature. CONCLUSIONS: Despite large-scale research efforts to examine alcohol and substance use disorders in the United States, few studies have been published that examine these addictive behaviors among ethnic groups, and even fewer examine co-occurrence and comorbidity with other addictions. SCIENTIFIC SIGNIFICANCE: Even with the limited studies, these findings have implications for genetic research on addictive behaviors. We include a discussion of these implications, including issues of population stratification, disaggregation, admixture, and the interplay between genetic and environmental factors in understanding the etiology and treatment of addictions. (Am J Addict 2017;26:424-436).
Asunto(s)
Etnicidad/psicología , Trastornos Relacionados con Sustancias/epidemiología , Conducta Adictiva/epidemiología , Investigación Genética , Humanos , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
Distress tolerance-the capacity to withstand distressing states-is implicated in the etiology of regular smoking. The present study extends past research by examining whether relations between perceived distress tolerance and smoking-related factors: (1) differ across subdimensions of distress tolerance (Tolerance, Appraisal, Regulation, Absorption); (2) extend across measures of dependence, negative reinforcement smoking, and craving; and (3) are incremental to depressive and anxiety symptoms. Results showed that global distress tolerance was associated with measures of dependence, negative reinforcement, and craving even after controlling for affective symptomatology. Subdimensions of distress tolerance were not uniquely related to smoking outcomes in unadjusted or adjusted models. These findings suggest that: (a) distress tolerance is uniquely implicated in smoking over and above affective symptomatology; and (b) specific subdimensions of distress tolerance do not provide more information about smoking-related characteristics than global dimensions; and
Asunto(s)
Ansiedad/psicología , Depresión/psicología , Motivación/fisiología , Estrés Psicológico/psicología , Tabaquismo/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Fumar/psicología , Cese del Hábito de Fumar/psicología , Adulto JovenRESUMEN
The social self-control scale (SSCS), which taps provocative behavior in social situations, was compared with five potentially overlapping measures (i.e., temperament-related impulsivity, psychomotor agitation-related self-control, perceived social competence, and rash action in response to negative and positive affectively charged states) as correlates of tobacco use and other drug use among a sample of 3,356 ninth-grade youth in Southern California high schools. While there was a lot of shared variance among the measures, the SSCS was incrementally associated with both categories of drug use over and above alternate constructs previously implicated in adolescent drug use. Hence, SSC may relate to adolescent drug use through an etiological pathway unique from other risk constructs. Given that youth who tend to alienate others through provocative social behavior are at risk for multiple drug use, prevention programming to modify low SSC may be warranted.
Asunto(s)
Autocontrol , Adolescente , Conducta del Adolescente , California , Humanos , Instituciones Académicas , Trastornos Relacionados con Sustancias , Uso de TabacoRESUMEN
IMPORTANCE: Exposure to nicotine in electronic cigarettes (e-cigarettes) is becoming increasingly common among adolescents who report never having smoked combustible tobacco. OBJECTIVE: To evaluate whether e-cigarette use among 14-year-old adolescents who have never tried combustible tobacco is associated with risk of initiating use of 3 combustible tobacco products (ie, cigarettes, cigars, and hookah). DESIGN, SETTING, AND PARTICIPANTS: Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, mean age = 14.1 years) and at a 6-month follow-up (spring 2014, 9th grade) and a 12-month follow-up (fall 2014, 10th grade). Ten public high schools in Los Angeles, California, were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and completed follow-up assessments at 6 or 12 months (N = 2530). At each time point, students completed self-report surveys during in-classroom data collections. EXPOSURE: Student self-report of whether he or she ever used e-cigarettes (yes or no) at baseline. MAIN OUTCOMES AND MEASURES: Six- and 12-month follow-up reports on use of any of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes or no); (2) combustible cigarettes (yes or no), (3) cigars (yes or no); (4) hookah (yes or no); and (5) number of combustible tobacco products (range: 0-3). RESULTS: Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever users (n = 222) than never users (n = 2308) at the 6-month follow-up (30.7% vs 8.1%, respectively; difference between groups in prevalence rates, 22.7% [95% CI, 16.4%-28.9%]) and at the 12-month follow-up (25.2% vs 9.3%, respectively; difference between groups, 15.9% [95% CI, 10.0%-21.8%]). Baseline e-cigarette use was associated with greater likelihood of use of any combustible tobacco product averaged across the 2 follow-up periods in the unadjusted analyses (odds ratio [OR], 4.27 [95% CI, 3.19-5.71]) and in the analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR, 2.73 [95% CI, 2.00-3.73]). Product-specific analyses showed that baseline e-cigarette use was positively associated with combustible cigarette (OR, 2.65 [95% CI, 1.73-4.05]), cigar (OR, 4.85 [95% CI, 3.38-6.96]), and hookah (OR, 3.25 [95% CI, 2.29-4.62]) use and with the number of different combustible products used (OR, 4.26 [95% CI, 3.16-5.74]) averaged across the 2 follow-up periods. CONCLUSIONS AND RELEVANCE: Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal.
Asunto(s)
Conducta del Adolescente , Sistemas Electrónicos de Liberación de Nicotina , Fumar/epidemiología , Productos de Tabaco/estadística & datos numéricos , Adolescente , Recolección de Datos , Femenino , Estudios de Seguimiento , Estimulantes Ganglionares/administración & dosificación , Humanos , Los Angeles/epidemiología , Masculino , Nicotina/administración & dosificación , Oportunidad Relativa , Factores de Riesgo , Autoinforme , EstudiantesRESUMEN
PURPOSE: Adolescent involvement in cyberbullying is common and involves several roles (witness, perpetrator, or victim). Whether different cyberbullying roles are differentially associated with substance use is unknown. The present study examined the associations of adolescent cyberbullying involvement with use and polyuse of various substances. METHODS: A longitudinal cohort of students in Los Angeles, California (N = 2,768) completed surveys at baseline (10th grade, 2014, mean age = 15.5 years) and 12-month follow-up (11th grade, 2015). Five mutually exclusive cyberbullying roles were identified at baseline-no involvement; witness only; witness and victim; witness and perpetrator; and witness, victim, and perpetrator. Past 6-month use of nine substances and poly-use of multiple substances were assessed at baseline and follow-up. RESULTS: Most students (52.2%) were involved in >1 cyberbullying roles. Relative to no involvement, all cyberbullying roles, including witnessing only, were associated with increased odds of using most substances and polysubstance use at follow-up, after adjusting for sociodemographics and baseline substance use (odds ratios: 1.44 [95% confidence interval: 1.18-1.76] to 5.24 [2.73-10.05]). Relative to the witness-only role, students involved in all three roles were at greater odds of using several substances at follow-up (odds ratios: 1.47 [95% confidence interval: 1.05-2.05] to 2.96 [1.60-5.50]). CONCLUSIONS: Cyberbullying involvement, even witnessing, may be associated with future substance use in adolescence. All cyberbullying roles warrant consideration in understanding and preventing youth substance use.
Asunto(s)
Conducta del Adolescente/psicología , Víctimas de Crimen/psicología , Ciberacoso/psicología , Trastornos Relacionados con Sustancias/etiología , Adolescente , Víctimas de Crimen/estadística & datos numéricos , Ciberacoso/clasificación , Ciberacoso/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Los Angeles/epidemiología , Masculino , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Greater diversification of nicotine products, marijuana products, and prescription drugs have contributed to increasing trends in adolescent poly-product use-concurrent use of 2 or more drugs-within these drug classes (e.g., nicotine use via e-cigarettes, hookah, cigars). Extant work suggests that poly-product drug use disparities may be disproportionately heightened among youth from lower socioeconomic status (SES) backgrounds, however, it is unknown whether indicators of objective SES or subjective SES differentially increase risk of poly-product use including these newly emerging drugs. This study examined associations of parental education and subjective social status (SSS: perceptions of social standing compared to society [societal SSS] or school [school SSS]) with poly-product use of nicotine products, marijuana products, and prescription drugs among adolescents (Nâ¯=â¯2218). Lower parental education and school SSS were associated with increased odds of past or current single, dual, or multiple product use of nicotine, marijuana, and prescription drugs. Findings suggest that risk for poly-product use of emerging drugs are higher for adolescents who endorse lower perceived social standing relative to peers at school and who were from a lower parental SES background.
Asunto(s)
Consumidores de Drogas , Disparidades en el Estado de Salud , Uso de la Marihuana/tendencias , Mal Uso de Medicamentos de Venta con Receta/tendencias , Vapeo/tendencias , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Factores SocioeconómicosRESUMEN
AIMS: To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid-adolescence. DESIGN: Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12-month follow-up). Additional analyses tested whether sex and socio-economic status moderated this association. SETTING: Ten high schools in Los Angeles, CA, USA, 2013-15. PARTICIPANTS: Students (n = 3396, 53.5% female, mean [standard deviation (SD)] age at wave 1 baseline = 14.1 (0.42) years). MEASUREMENTS: Self-reported conduct problems (11-item questionnaire), alternative reinforcement (44-item questionnaire) and use of alcohol, marijuana and combustible cigarettes during the past 6 months (yes/no) and the past 30 days (nine-level ordinal response based on days used in past 30 days). RESULTS: Significant associations of wave 1 conduct problems with wave 3 marijuana use during the past 6 months (ß = 0.25) and past 30 days (ß = 0.26) were mediated by wave 2 diminished alternative reinforcement (ßindirect effect : 6 months = 0.013, 30 days = 0.017, Ps < 0.001). Associations of conduct problems with alcohol or combustible cigarette use were not mediated by alternative reinforcement. All associations did not differ by sex and socio-economic status. CONCLUSIONS: Diminished alternative reinforcement may be a modifiable mechanism linking early adolescent conduct problems and subsequent marijuana use that could be targeted in prevention programs to offset the adverse health and social sequelae associated with comorbid conduct problems and marijuana use in early-mid adolescence.
Asunto(s)
Conducta del Adolescente/psicología , Fumar Cigarrillos/epidemiología , Trastorno de la Conducta/epidemiología , Uso de la Marihuana/epidemiología , Refuerzo en Psicología , Consumo de Alcohol en Menores/estadística & datos numéricos , Adolescente , Fumar Cigarrillos/psicología , Trastorno de la Conducta/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Uso de la Marihuana/psicología , Consumo de Alcohol en Menores/psicología , Estados Unidos/epidemiologíaRESUMEN
PURPOSE: Although evidence suggests that anhedonia-a reduced ability to experience pleasure in response to rewarding stimuli-may predict weight gain during adolescence, it remains unclear whether changes in anhedonia during adolescence are associated with changes in body mass index (BMI). This study examines longitudinal associations between changes in anhedonia and developmental trajectories of BMI during adolescence. METHODS: Self-report measures of anhedonia and BMI were collected at five semiannual assessments among students from 10 high schools in Los Angeles, CA, area (N = 3,396) followed up from the 9th grade to the 11th grade. Four BMI trajectories were identified using growth mixture modeling: (1) stable normative weight; (2) overweight to normative weight (i.e., decreasing BMI); (3) overweight to chronically obese (increasing BMI); and (4) normative weight to overweight (increasing BMI). Latent growth curve modeling estimated baseline level and changes in anhedonia. A multinomial logistic regression model tested associations of baseline level and slope of anhedonia with the four BMI trajectory groups. RESULTS: Compared with the stable normative BMI trajectory group, each 1-unit standard deviation increase in anhedonia slope increased the odds of membership in the overweight to chronically obese group (odds ratio [OR] [95% confidence interval {CI}] = 1.29 [1.09-1.49], p < .001) and in the normative weight to overweight group (OR [95% CI] = 1.28 [1.04-1.53], p = .006), and decreased the odds of membership in the overweight to normative weight group (OR [95% CI] = .78 [.57-.95], p = .01). CONCLUSIONS: Across a 2-year period of high school, the rate of change in anhedonia is associated with certain BMI trajectories linked with poorer metabolic health. Increasing anhedonia may be an important risk factor to consider in adolescent obesity prevention.
Asunto(s)
Anhedonia/fisiología , Índice de Masa Corporal , Obesidad Infantil/prevención & control , Adolescente , Peso Corporal , Femenino , Humanos , Estudios Longitudinales , Masculino , AutoinformeRESUMEN
OBJECTIVE: To examine whether reduced substance-free enjoyable activity (i.e., 'alternative reinforcers') is a mediating mechanism linking lower socioeconomic status and adolescent substance use risk. METHOD: High school students in Los Angeles, CA (N = 2,553, 2013-2014, M age baseline = 14.1) were administered three semiannual surveys. Socioeconomic status was measured by highest parental education reported at Wave 1 (the beginning of 9th grade). Three elements of alternative reinforcement at Wave 2 (six-month follow-up) were assessed as mediators: ratings of frequency of engagement, level of enjoyment, and frequency × enjoyment product scores of substance-free typically pleasant activities (like participation in sports teams or school clubs). Study outcomes included prior six-month alcohol, marijuana, tobacco, and other substance use at Wave 3 (twelve-month follow-up). Logistic regression models adjusting for alternative reinforcers and substance use from the preceding wave as well as other co-factors were used to examine the association of Wave 1 parental education with Wave 3 substance use and mediation by Wave 2 alternative reinforcement. RESULTS: Lower parental education at Wave 1 was associated with a greater likelihood of reporting alcohol (ß = -0.122, 95% CI = -0.234, -0.009) and marijuana (ß = -0.168, 95% CI = -0.302, -0.034) use at Wave 3. The inverse association between parental education and substance use was statistically mediated by each element of diminished alternative reinforcement at Wave 2. Lower parental education at Wave 1 was associated with lower alternative reinforcement at Wave 2, which in turn was associated with greater likelihood of alcohol (range of ßindirect effects : -0.007 [95% CI = -0.016, -0.001] to -0.01 [95% CI = -0.018, -0.004]) and marijuana (ßs: -0.011 [95% CI = -0.022,-0.002] to -0.018 [95% CI = -0.035, -0.005]) use at Wave 3. Parental education was not associated with use of combustible tobacco products or other drugs at Wave 3 adjusting for Wave 1 combustible tobacco and other drug use, respectively (ps ≥ 0.061). CONCLUSION: Diminished access to and engagement in substance-free enjoyable activity may in part underlie socioeconomic disparities in adolescent alcohol and marijuana use risk. Increasing substance-free enjoyable activities may be useful in substance abuse prevention in socioeconomically disadvantaged youth.
Asunto(s)
Recreación/psicología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/economía , Adolescente , Conducta del Adolescente/psicología , Alcoholismo/epidemiología , Alcoholismo/psicología , Escolaridad , Femenino , Humanos , Los Angeles/epidemiología , Masculino , Abuso de Marihuana/epidemiología , Abuso de Marihuana/psicología , Padres/psicología , Grupos Raciales/psicología , Grupos Raciales/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Encuestas y Cuestionarios , Uso de Tabaco/epidemiología , Uso de Tabaco/psicologíaRESUMEN
The present study tested the hypothesis that teens who engage in conduct problems are more likely to use substances because they engage in fewer alternative reinforcing (i.e., pleasurable) substance-free activities and more complementary reinforcing substance-associated activities. In a cross-sectional, correlational design, 9th grade students (N = 3,383; mean age = 14.6 years) in Los Angeles, California, U.S.A. completed surveys in 2013 measuring conduct problems (e.g., stealing, lying, getting in fights); alternative and complementary reinforcement; use of a number of licit, illicit, and prescription drugs; and other cofactors. Conduct problems were positively associated with past 6-month use of any substance (yes/no) among the overall sample and past 30-day use frequency on a composite index that included 6 substances among past 6-month users. These associations were statistically mediated by diminished alternative reinforcement and increased complementary reinforcement when adjusting for relevant covariates. Conduct problems were associated with lower engagement in alternative reinforcers and increased engagement in complementary reinforcers, which, in turn, were associated with greater likelihood and frequency of substance use. Most mediational relations persisted adjusting for demographic, environmental, and intrapersonal cofactors and generalized to alcohol, cigarette, and marijuana use, although, complementary reinforcers did not significantly mediate the relation of conduct problems with alcohol use frequency. These results point to diminished alternative reinforcement and increased complementary reinforcement as mechanisms linking conduct problems and adolescent substance use. Interventions that increase access to and engagement in a diverse set of alternative substance-free activities and deter activities that complement use may prevent substance use in adolescents who engage in conduct problems. (PsycINFO Database Record
Asunto(s)
Trastorno de la Conducta/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Conducta del Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Modelos Psicológicos , Refuerzo en Psicología , Factores SexualesRESUMEN
AIM: The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. METHODS: Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. FINDINGS: Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. CONCLUSIONS: Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems.
Asunto(s)
Depresión/complicaciones , Trastornos Mentales/complicaciones , Problema de Conducta/psicología , Trastornos Relacionados con Sustancias/etiología , Adolescente , Depresión/psicología , Femenino , Humanos , Los Angeles , Masculino , Trastornos Mentales/psicología , Factores de Riesgo , Instituciones Académicas , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
AIMS: This study explored whether the density of family history (FH) of substance use disorders relates to post-treatment substance use outcomes in adolescents, with the primary aim of determining whether FH exerts a relatively stronger influence on longer-term outcomes. METHOD: The present investigation examined adolescents (ages 12-18, n=366) from two independent samples who were treated for alcohol/substance use disorder (ASUD) and re-assessed during the eight years following treatment with identical methodology. Primary substance use outcomes were assessed at 1, 2, 4, 6, and 8 years post-treatment and included total drinks, days using marijuana, and days using other drugs. RESULTS: In hierarchical linear models there were significant FH density×linear time interactions for total drinks (z=12.75, p<0.001) and marijuana use days (z=4.39, p<0.001); greater FH density predicted more total drinks and more marijuana use days, with both associations becoming stronger over time. The increasing linkage between FH and other drug use was not significant over time. CONCLUSIONS: Findings are consistent with previous research indicating that the risk associated with FH increases over time, especially in relation to quantity/frequency measures of alcohol and marijuana use. By extending these findings to an adolescent clinical sample, the current study highlights that FH density of alcohol and drug dependence is a risk factor for poorer long-term outcomes for adolescent-onset ASUD youth as they transition into adulthood. Future work should explore the mechanisms underlying greater post-treatment substance use for adolescents/young adults with greater FH density.
Asunto(s)
Conducta del Adolescente , Trastornos Relacionados con Alcohol/terapia , Salud de la Familia , Adolescente , Trastornos Relacionados con Alcohol/epidemiología , California/epidemiología , Femenino , Humanos , Masculino , Fumar Marihuana/epidemiología , Factores de Riesgo , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: Smoking reinforcement expectancies-expectations that smoking modulates mood-can be powerful motivators to smoke, resulting in increased nicotine dependence. The impact of smoking reinforcement expectancies on nicotine dependence may be particularly strong in individuals with increased mood or anxiety symptoms because they may be more likely to act on expectancies with smoking behavior in order to offset their affective symptoms. This study examined levels of emotional symptom dimensions as moderators of the relation between positive and negative smoking reinforcement expectancies and nicotine dependence severity in a community sample. METHOD: In a cross-sectional design, 317 daily cigarette smokers (215 men) completed self-report measures of smoking reinforcement expectancies, mood and anxiety symptoms, and nicotine dependence. RESULTS: Increasing levels of negative affect and anxiety symptoms strengthened associations between negative reinforcement smoking expectancies and nicotine dependence severity (moderation effects; (ßs > .13; ps < .03) but did not moderate relations between positive reinforcement expectancies and dependence. Anhedonia did not moderate relations involving either positive or negative reinforcement smoking expectancies. CONCLUSIONS: Distinct components of anxiety and depressive symptoms interact differently with smoking reinforcement expectancies. Emotional symptoms characterized by excesses in aversive (but not deficits in appetitive) functioning may amplify tendencies to compulsively act on negative reinforcement expectancies by smoking. Cessation treatments that target negative reinforcement expectancies may be particularly salient for emotionally distressed smokers.
Asunto(s)
Ansiedad/psicología , Depresión/psicología , Refuerzo en Psicología , Fumar/psicología , Tabaquismo/psicología , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumar/epidemiología , Encuestas y Cuestionarios , Tabaquismo/epidemiologíaRESUMEN
AIMS: This report was designed to test the hypothesis that family history of smoking (FH) would moderate the effects of positive and negative smoking expectancies on initiation in a college sample. DESIGN: Secondary analysis of a study of college freshmen never-smokers (n=196; 46% male) who completed a baseline interview and quarterly online follow-up assessments for 15 months. FINDINGS: Analyses indicated that FH moderated the effect of negative outcome expectancies (p=.003) but not the effects of expectancies for positive or negative reinforcement on the probability of smoking initiation. Stronger negative expectancies were associated with a decreased risk of initiation for family history positive but not family history negative participants. CONCLUSIONS: Findings are consistent with previous tobacco research indicating that FH+adolescents have more negative expectancies about cigarette smoking. This suggests that adolescents observing negative consequences or receiving negative messages from their parents about cigarettes may be less likely to experiment with smoking.
Asunto(s)
Familia/psicología , Refuerzo en Psicología , Fumar/psicología , Estudiantes/psicología , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Fumar/epidemiología , Encuestas y Cuestionarios , Universidades , Adulto JovenRESUMEN
This study reports on a prospective test of the Acquired Preparedness Model, which posits that impulsivity influences cigarette smoking through the formation of more positive and fewer negative expectancies about smoking effects. College freshman never-smokers (n = 400; 45% male) completed a baseline interview and quarterly online follow-up assessments for 15 months after baseline. Structural equation modeling indicated that the effects of the impulsivity components of sensation seeking and negative urgency on risk of smoking initiation were mediated by expectancies for positive and negative reinforcement from smoking, respectively. Expectancies about negative consequences from smoking predicted initiation but did not mediate the effects of sensation seeking or negative urgency. Findings are consistent with the Acquired Preparedness Model and suggest that heightened impulsivity is associated with heightened expectancies for reinforcement from smoking, and thus with greater risk for smoking initiation.