Stable Anxiety and Depression Trajectories in Late Adolescence for Oral Contraceptive Users.

Background: The use of oral contraceptives (OCs) has been associated with increased incidences of anxiety and depression, for which adolescents seem to be particularly vulnerable. Rather than looking at singular outcomes, we examined whether OC use is associated with depressive and anxiety symptom trajectories from early adolescence into early adulthood. Materials and Methods: Data from 178 girls were drawn from the Research on Adolescent Development and Relationships (RADAR-Y) younger cohort study. We used assessments on 9 waves from age 13 until 24. Developmental trajectories of ratings on the Reynolds Adolescent Depression Scale (RADS-2) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were compared between never and ever users of OCs. Results: Never users showed increases in depressive and anxiety symptoms in late adolescence, whereas OC users showed a stable level of symptoms throughout adolescence. This effect remained after adjusting for baseline differences between groups in romantic relationships, sexual debut, educational level, smoking, drinking, and drug use. Age of OC use onset did not significantly predict symptom development. Conclusions: OC use in adolescence was related to an altered developmental trajectory of internalizing symptoms, in which OC users did not show an increase in depressive and anxiety symptoms in late adolescence, whereas never users did. The question remains whether this altered symptom trajectory can be considered a protective effect of OC use on psychopathology. Additional research is needed to improve our understanding of the long-term consequences of OC use on mental health.

GWAS of lifetime cannabis use reveals new risk loci, genetic overlap with psychiatric traits, and a causal influence of schizophrenia.

Cannabis use is a heritable trait that has been associated with adverse mental health outcomes. In the largest genome-wide association study (GWAS) for lifetime cannabis use to date (N = 184,765), we identified eight genome-wide significant independent single nucleotide polymorphisms in six regions. All measured genetic variants combined explained 11% of the variance. Gene-based tests revealed 35 significant genes in 16 regions, and S-PrediXcan analyses showed that 21 genes had different expression levels for cannabis users versus nonusers. The strongest finding across the different analyses was CADM2, which has been associated with substance use and risk-taking. Significant genetic correlations were found with 14 of 25 tested substance use and mental health-related traits, including smoking, alcohol use, schizophrenia and risk-taking. Mendelian randomization analysis showed evidence for a causal positive influence of schizophrenia risk on cannabis use. Overall, our study provides new insights into the etiology of cannabis use and its relation with mental health.

Genome-wide association meta-analysis of age at first cannabis use.

BACKGROUND AND AIMS: Cannabis is one of the most commonly used substances among adolescents and young adults. Earlier age at cannabis initiation is linked to adverse life outcomes, including multi-substance use and dependence. This study estimated the heritability of age at first cannabis use and identified associations with genetic variants. METHODS: A twin-based heritability analysis using 8055 twins from three cohorts was performed. We then carried out a genome-wide association meta-analysis of age at first cannabis use in a discovery sample of 24 953 individuals from nine European, North American and Australian cohorts, and a replication sample of 3735 individuals. RESULTS: The twin-based heritability for age at first cannabis use was 38% [95% confidence interval (CI) = 19-60%]. Shared and unique environmental factors explained 39% (95% CI = 20-56%) and 22% (95% CI = 16-29%). The genome-wide association meta-analysis identified five single nucleotide polymorphisms (SNPs) on chromosome 16 within the calcium-transporting ATPase gene (ATP2C2) at P < 5E-08. All five SNPs are in high linkage disequilibrium (LD) (r2  > 0.8), with the strongest association at the intronic variant rs1574587 (P = 4.09E-09). Gene-based tests of association identified the ATP2C2 gene on 16q24.1 (P = 1.33e-06). Although the five SNPs and ATP2C2 did not replicate, ATP2C2 has been associated with cocaine dependence in a previous study. ATP2B2, which is a member of the same calcium signalling pathway, has been associated previously with opioid dependence. SNP-based heritability for age at first cannabis use was non-significant. CONCLUSION: Age at cannabis initiation appears to be moderately heritable in western countries, and individual differences in onset can be explained by separate but correlated genetic liabilities. The significant association between age of initiation and ATP2C2 is consistent with the role of calcium signalling mechanisms in substance use disorders.

Genetic vulnerability to schizophrenia is associated with cannabis use patterns during adolescence.

BACKGROUND: Previously reported comorbidity between schizophrenia and substance use may be explained by shared underlying risk factors, such as genetic background. The aim of the present longitudinal study was to investigate how a genetic predisposition to schizophrenia was associated with patterns of substance use (cannabis use, smoking, alcohol use) during adolescence (comparing ages 13-16 with 16-20 years). METHOD: Using piecewise latent growth curve modelling in a longitudinal adolescent cohort (RADAR-Y study, N = 372), we analyzed the association of polygenic risk scores for schizophrenia (PRS; p-value thresholds (pt) < 5e-8 to pt < 0.5) with increase in substance use over the years, including stratified analyses for gender. Significance thresholds were set to adjust for multiple testing using Bonferroni at p ≤ 0.001. RESULTS: High schizophrenia vulnerability was associated with a stronger increase in cannabis use at age 16-20 (PRS thresholds pt < 5e-5 and pt < 5e-4; pt < 5e-6 was marginally significant), whereas more lenient PRS thresholds (PRS thresholds pt < 5e-3 to pt < 0.5) showed the reverse association. For smoking and alcohol, no clear relations were found. CONCLUSIONS: In conclusion, our findings support a relation between genetic risk to schizophrenia and prospective cannabis use patterns during adolescence. In contrast, no relation between alcohol and smoking was established.

Longitudinal associations between social anxiety symptoms and cannabis use throughout adolescence: the role of peer involvement.

There appear to be contradicting theories and empirical findings on the association between adolescent Social Anxiety Disorder (SAD) symptoms and cannabis use, suggesting potential risk as well as protective pathways. The aim of this six-year longitudinal study was to further examine associations between SAD symptoms and cannabis use over time in adolescents from the general population, specifically focusing on the potential role that adolescents' involvement with their peers may have in these associations. Participants were 497 Dutch adolescents (57 % boys; M age = 13.03 at T1), who completed annual self-report questionnaires for 6 successive years. Cross-lagged panel analysis suggested that adolescent SAD symptoms were associated with less peer involvement 1 year later. Less adolescent peer involvement was in turn associated with lower probabilities of cannabis use as well as lower frequency of cannabis use 1 year later. Most importantly, results suggested significant longitudinal indirect paths from adolescent SAD symptoms to cannabis use via adolescents' peer involvement. Overall, these results provide support for a protective function of SAD symptoms in association with cannabis use in adolescents from the general population. This association is partially explained by less peer involvement (suggesting increased social isolation) for those adolescents with higher levels of SAD symptoms. Future research should aim to gain more insight into the exact nature of the relationship between anxiety and cannabis use in adolescents from the general population, especially regarding potential risk and protective processes that may explain this relationship.

Early onset of cannabis use: does personality modify the relation with changes in perceived parental involvement?

BACKGROUND: The present study examined (1) the association between changes in perceived parental control and support from age 13 to 15 and early onset of cannabis use (before age 16), and (2) whether personality modifies the association between a decline in perceived parental control and support and early onset of cannabis use. METHOD: Objectives were studied using data (three waves covering two years) from 444 Dutch adolescents participating in the Research on Adolescent Development and Relationships (RADAR) study. Adolescents had a mean age of 13 years at baseline, and reported at each wave about perceived parental control and support. Big Five personality traits and past year cannabis use were also measured by self-report. Joint latent growth curve-discrete-time survival analyses were used to answer the research questions. RESULTS: Early onset of cannabis use was reported by 19.4% of the sample. Overall, a decline in perceived parental control or support from age 13 to age 15 was unrelated to the risk of early onset of cannabis use. In adolescents with low levels of emotional stability and extraversion, a stronger decline in perceived parental control was associated with an increased risk of early cannabis use. CONCLUSIONS: Experiencing a decline in parental control from age 13 to 15 is associated with early onset of cannabis use in adolescents characterized by low emotional stability and low extraversion.

Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study.

In this study, we prospectively examined developmental trajectories of five anxiety disorder symptom dimensions (generalized anxiety disorder, panic disorder, school anxiety, separation anxiety disorder, and social anxiety disorder) from early to late adolescence in a community sample of 239 adolescents, assessed annually over 8 years. Latent growth modeling indicated different developmental trajectories from early into late adolescence for the different anxiety disorder symptoms, with some symptoms decreasing and other symptoms increasing over time. Sex differences in developmental trajectories were found for some symptoms, but not all. Furthermore, latent class growth analysis identified a normal developmental profile (including a majority of adolescents reporting persistent low anxiety disorder symptoms over 8 years) and an at-risk developmental profile (including a minority of adolescents reporting persistent high anxiety disorder symptoms over 8 years) for all of the anxiety disorder symptom dimensions except panic disorder. Additional analyses longitudinally supported the validity of these normal and at-risk developmental profiles and suggested differential associations between different anxiety disorder symptom dimensions and developmental trajectories of substance use, parenting, and identity development. Taken together, our results emphasize the importance of examining separate dimensions of anxiety disorder symptoms in contrast to a using a global, one-dimensional approach to anxiety.

If parents establish a no-smoking agreement with their offspring, does this prevent adolescents from smoking? Findings from three Dutch studies.

Data from three studies were used to investigate whether the establishment of a no-smoking agreement is related to lower odds of adolescent smoking. The prevalence of a no-smoking agreement was first explored by using a national sample involving 4,501 Dutch adolescents. Second, data from a longitudinal study among 595 early adolescents and their parents were used to test whether establishing a no-smoking agreement prevents adolescents from smoking. Third, the authors tested among 856 early- and mid-adolescents and their parents, whether in addition to the establishment of a no-smoking agreement, the frequency and quality of communication on smoking issues had an effect on adolescent smoking. The findings do not support that establishing a no-smoking agreement is an effective deterrent with regard to adolescent smoking. Parents who want to prevent smoking might consider focusing their efforts on establishing a good quality of communication on smoking issues whereas parents who just talk a lot about smoking issues without considering the quality of their communication might do more harm than good.

Developmental trajectories of adolescent anxiety disorder symptoms: a 5-year prospective community study.

OBJECTIVE: This study prospectively examined the developmental trajectories of anxiety disorder symptoms in a large sample of adolescents from the general population. METHOD: Two cohorts of early and middle adolescents (1,318 junior high and high school students) completed the Screen for Child Anxiety Related Emotional Disorders during 5 consecutive years. The Screen for Child Anxiety Related Emotional Disorders is a questionnaire that measures self-rated child and adolescent anxiety symptoms that map onto DSM-IV-TR anxiety disorders. At the first wave of measurement, the early and middle adolescent cohorts were an average of 12 and 16 years of age, respectively. Age and sex differences in the developmental trajectories of adolescent anxiety disorder symptoms over time were examined by means of latent growth modeling. RESULTS: Over the course of 5 years, there was a slight decrease in the panic disorder, school anxiety, and separation anxiety disorder symptoms for all of the adolescents, with the exception of social phobia symptoms, which remained fairly stable over time. Adolescent girls showed a slight increase of generalized anxiety disorder symptoms over time, whereas these symptoms decreased among adolescent boys. CONCLUSIONS: This study replicates and extends earlier findings on the developmental trajectories of anxiety symptoms during adolescence. By using individually focused, trajectory-based analyses rather than group score differences, this study extends earlier findings and advances our understanding of age and sex differences in the development of adolescent anxiety symptoms.

Parental support and control and early adolescent smoking: a longitudinal study.

The aim of this study is to examine the role of parental support and control on young adolescent smoking initiation, increase, continuation, and cessation. Longitudinal data gathered every 6 months over a one-year period were collected in Utrecht, The Netherlands, for 1,012 adolescents in 2000. Logistic regressions demonstrated that low parental control predicted adolescent smoking initiation but neither support nor control predicted adolescent smoking increase or continuation. Parental smoking status was important in adolescent smoking continuation and cessation. Suggestions based on these findings are made for prevention programs. A limitation is that the study only utilized adolescent reports.

Parental anti-smoking socialization. associations between parental anti-smoking socialization practices and early adolescent smoking initiation.

This longitudinal study of 600 families concentrates on the influence of parental anti-smoking socialization by examining both (a) the effects of eight indicators of anti-smoking socialization on adolescent smoking and (b) the influence of parental smoking on the effectiveness of their anti-smoking socialization. Robust differences between smoking and non-smoking parents demonstrated that both kinds of families hold different norms and attitudes about adolescent smoking and how to deal with it. In terms of effective anti-smoking socialization, it appeared that parental involvement on a more abstract level, such as feeling confident one has influence on the smoking behaviour of one's child and having knowledge whether one's child and his or her friends smoke, seemed important in preventing early adolescent smoking, while concrete communication or house rules about smoking were not.

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general adolescent population.

OBJECTIVE: This study examined the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large sample of adolescents from the general population. METHOD: In 2001, 1,340 junior high and high school adolescents in the Netherlands completed the SCARED. The SCARED is a questionnaire that purports to measure five child and adolescent anxiety symptom dimensions. The factor structure of the SCARED was investigated by means of confirmatory factor analyses that were conducted for males and females, early (10-13 years) and middle (14-18 years) adolescent groups, and for Dutch and ethnic minorities. Analyses of variance were carried out to compare mean scores for the various groups. RESULTS: The five-factor structure of the SCARED not only had the best fit for the general adolescent population but also for the age, gender, and ethnic groups. It was also found that the SCARED scores of the adolescent subgroups differed from one another in agreement with previous studies on adolescent anxiety disorder symptoms. CONCLUSIONS: The findings of this study support the claim that the SCARED has a five-factor structure. The usefulness of the SCARED was also demonstrated.

Lifetime parental smoking history and cessation and early adolescent smoking behavior.

BACKGROUND: Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. METHODS: A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. RESULTS: Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. CONCLUSIONS: Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.