Is age of onset and duration of stimulant therapy for ADHD associated with cocaine, methamphetamine, and prescription stimulant misuse?

BACKGROUND: To assess whether age of onset and duration of stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) are associated with cocaine, methamphetamine, and prescription stimulant misuse during adolescence. METHODS: Nationally representative samples of US 10th and 12th grade students (N = 150,395) from the Monitoring the Future study were surveyed via self-administered questionnaires from 16 annual surveys (2005-2020). RESULTS: An estimated 8.2% of youth received stimulant therapy for ADHD during their lifetime (n = 10,937). More than one in 10 of all youth reported past-year prescription stimulant misuse (10.4%)-past-year cocaine (4.4%) and methamphetamine (2.0%) use were less prevalent. Youth who initiated early stimulant therapy for ADHD (≤9 years old) and for long duration (≥6 years) did not have significantly increased adjusted odds of cocaine or methamphetamine use relative to population controls (ie, non-ADHD and unmedicated ADHD youth). Youth who initiated late stimulant therapy for ADHD (≥10 years old) and for short duration (<1 year) had significantly higher odds of past-year cocaine or prescription stimulant misuse in adolescence than those initiating early stimulant therapy for ADHD (≤9 years old) and for long duration (≥6 years). Youth who initiated late stimulant therapy for ADHD (≥10 years) for short duration (<1 year) had significantly higher odds of past-year cocaine, methamphetamine, and prescription stimulant misuse versus population controls during adolescence. No differences in past-year cocaine, methamphetamine, and prescription stimulant misuse were found between individuals who only used non-stimulant therapy for ADHD relative to youth who initiated early stimulant therapy (≤9 years old) and for long duration (≥6 years). CONCLUSIONS: An inverse relationship was found between years of stimulant therapy and illicit and prescription stimulant misuse. Adolescents with later initiation and/or shorter duration of stimulant treatment for ADHD should be monitored for potential illicit and prescription stimulant misuse.

Prescription Stimulant Medical and Nonmedical Use Among US Secondary School Students, 2005 to 2020.

Importance: Recent information on the prevalence of prescription stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) and nonmedical use of prescription stimulants (NUPS) at the school-level among US secondary school students is limited. Objective: To investigate the school-level prevalence of and association between stimulant therapy for ADHD and NUPS among US secondary school students. Design, Setting, and Participants: This cross-sectional study used survey data collected between 2005 and 2020 as part of the Monitoring the Future study (data collected annually via self-administered survey in schools from independent cohorts). Participants were from a nationally representative sample of 3284 US secondary schools. The mean (SD) response rates were 89.5% (1.3%) for 8th-grade students, 87.4% (1.1%) for 10th-grade students, and 81.5% (1.8%) for 12th-grade students. Statistical analysis was performed from July to September 2022. Main Outcome and Measure: Past-year NUPS. Results: The 3284 schools contained 231 141 US 8th-, 10th-, and 12th-grade students (111 864 [50.8%, weighted] female; 27 234 [11.8%, weighted] Black, 37 400 [16.2%, weighted] Hispanic, 122 661 [53.1%, weighted] White, 43 846 [19.0%, weighted] other race and ethnicity). Across US secondary schools, the past-year prevalence of NUPS ranged from 0% to more than 25%. The adjusted odds of an individual engaging in past-year NUPS were higher at secondary schools with higher proportions of students who reported stimulant therapy for ADHD, after controlling for other individual-level and school-level covariates. Students attending schools with the highest rates of prescription stimulant therapy for ADHD had approximately 36% increased odds of past-year NUPS compared with students attending schools with no medical use of prescription stimulants (adjusted odds ratio, 1.36; 95% CI, 1.20-1.55). Other significant school-level risk factors included schools in more recent cohorts (2015-2020), schools with higher proportions of parents with higher levels of education, schools located in non-Northeastern regions, schools located in suburban areas, schools with higher proportion of White students, and schools with medium levels of binge drinking. Conclusions and Relevance: In this cross-sectional study of US secondary schools, the prevalence of past-year NUPS varied widely, highlighting the need for schools to assess their own students rather than relying solely on regional, state, or national results. The study offered new evidence of an association between a greater proportion of the student body that uses stimulant therapy and a greater risk for NUPS in schools. The association between greater school-level stimulant therapy for ADHD and other school-level risk factors suggests valuable targets for monitoring, risk-reduction strategies, and preventive efforts to reduce NUPS.

Civic development across the transition to adulthood in a national U.S. sample: Variations by race/ethnicity, parent education, and gender.

Despite a growing understanding about civic development, we know little about whether the developmental course of civic engagement is the same across different types of civic engagement or different groups of youth. To advance developmental science in this area, we documented age-related change in community service, political interest, electoral participation, and political voice across the transition to adulthood by race/ethnicity, parent education, gender, and their interactions. National multicohort probability samples of U.S. high school seniors from the Monitoring the Future study were assessed at baseline (age 18) and followed longitudinally via self-administered mail surveys across 6 follow-up waves to age 29/30. Of the sample (N = 12,557), 51.0% were women, 11.0% were Black, 7.0% were Latinx, 2.3% were Asian, and 75.4% were White. Community service decreased from age 18 to 24, then showed modest recovery. Political interest, electoral participation, and political voice increased steadily from 18 to 24 and less steeply thereafter. Intercepts and (to some extent) slopes varied by race/ethnicity, parent education, gender, and intersections of these factors. Black youth started and remained highest in community service and showed more accelerated growth in political interest and electoral participation. Young women reported higher community service, whereas gender gaps in political engagement trajectories favored young men. Black and Latinx young women stood out as having distinct civic trajectories. The role of parent education varied by race/ethnicity and gender. Diverse civic pathways advance theoretical understanding of civic development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Measuring alcohol use across the transition to adulthood: Racial/ethnic, sexual identity, and educational differences.

BACKGROUND: Patterns of alcohol use change from adolescence to adulthood and may differ based on race/ethnicity, sexual identity, and education. If alcohol use measures do not operate consistently across groups and developmental periods, parameter estimates and conclusions may be biased. OBJECTIVES: To test the measurement invariance of a multi-item alcohol use measure across groups defined by race/ethnicity, sexual identity, and college education during the transition to adulthood. METHODS: Using three waves from the National Longitudinal Study of Adolescent to Adult Health, we tested configural, metric, and scalar invariance of a 3-item alcohol use measure for groups defined by race/ethnicity, sexual identity, and college education at three points during the transition to adulthood. We then assessed longitudinal measurement invariance to test the feasibility of modeling developmental changes in alcohol use within groups defined by these characteristics. RESULTS: Overall, findings confirm notable variability in the construct reliability of a multi-item alcohol use measure during the transition to adulthood. The alcohol use measure failed tests of metric and scalar invariance, increasingly across ages, both between- and within-groups defined by race/ethnicity, sexual identity, and college education, particularly among females. CONCLUSIONS: Measurement testing is a critical step when utilizing multi-item measures of alcohol use. Studies that do not account for the effects of group or longitudinal measurement non-invariance may be statistically biased, such that recommendations for risk and prevention efforts could be misguided.

Alcohol use from adolescence through early adulthood: an assessment of measurement invariance by age and gender.

BACKGROUND AND AIMS: Studies on alcohol use and related constructs rarely test for measurement invariance to assess the reliability and validity of measures of alcohol use across different subpopulations of interest or ages. This failure to consider measurement invariance may result in biased parameter estimates and inferences. This study aimed to test measurement invariance of alcohol use across gender and age using a US nationally representative sample to inform future longitudinal studies assessing alcohol use. DESIGN: The National Longitudinal Study of Adolescent to Adult Health, a school-based, nationally representative longitudinal study conducted in 1994-95, 2001-02 and 2008. SETTING: All regions within the United States; participants were selected via a clustered sample design from 80 high schools that represented the national population. PARTICIPANTS: Youth and young adults aged 13-31 years who had valid data on all three alcohol items within wave: 18 923 from wave 1; 14 315 from wave 3; and 14 785 from wave 4. MEASUREMENTS: Alcohol use measurement models were constructed using past-year general drinking frequency, heavy episodic drinking frequency and average quantity when drinking. Configural (factor structure), metric (factor loadings) and scalar (item intercepts) measurement invariance models were tested by gender and for each year of age from 13 to 31 years. FINDINGS: All models passed the threshold for configural invariance. Comparisons between males and females demonstrated metric (and usually scalar) non-invariance for most ages beyond middle adolescence. Nearly all 1- and 2-year contrasts passed metric invariance. Scalar non-invariance was most prevalent in age comparisons between late adolescence and early adulthood, particularly for tests using 2-year age increments. CONCLUSIONS: Studies that do not account for the effects of gender and age on the measurement of alcohol use may be statistically biased.

Adolescent adaptation before, during and in the aftermath of the Great Recession in the USA.

This study examines the impact of the "Great Recession" (from December 2007 to June 2009) on 8th and 10th graders in the USA, using annual nationally representative data from the Monitoring the Future study. Historical changes in youth adjustment (self-esteem, depressed mood, risk taking, aggression and property crime), school achievement (grade point average [GPA], time spent on homework and educational expectations) and structured and unstructured activities (volunteering, employment, sports and evenings out for fun) were examined between 1991 and 2014. Overall, there were only slight changes in mean levels of adjustment, achievement and most youth activities. However, the percentage of youth working during the school year did decline during the Great Recession. Several longer-term trends were also evident, though not directly tied to the Great Recession. These include an increase in GPA, a decrease in time spent on homework, rising educational expectations and more time spent volunteering. Future work should assess how the shift to unpaid work activities (e.g. volunteering and internships) among youth is impacting the transition from school to work in the contemporary economy, and whether the Great Recession had deleterious impacts for younger children or among youth whose parents lost work or had their homes foreclosed.

Alcohol mixed with energy drink use among u.s. 12th-grade students: prevalence, correlates, and associations with unsafe driving.

PURPOSE: The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. METHODS: Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) after alcohol consumption. RESULTS: Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and white students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors and other substance use. CONCLUSIONS: AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern.

Socioeconomic status and substance use among young adults: a comparison across constructs and drugs.

OBJECTIVE: Little consensus exists regarding the relationship between socioeconomic status (SES) and substance use. This study examined the associations of three indicators of family SES during childhood--income, wealth, and parental education--with smoking, alcohol use, and marijuana use during young adulthood. METHOD: Data were obtained from the national Panel Study of Income Dynamics, a survey of U.S. families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood data drawn from a national sample of young adults, 18-23 years old. Data from the young adults (N = 1,203; 66.1% White; 51.5% female) on their current use of alcohol, cigarettes, and marijuana were used as outcome variables in logistic regressions. Socioeconomic background was calculated from parental reports of education, wealth, and income during the respondent's childhood (birth through age 17 years). RESULTS: Smoking in young adulthood was associated with lower childhood family SES, although the association was explained by demographic and social role covariates. Alcohol use and marijuana use in young adulthood were associated with higher childhood family SES, even after controlling for covariates. CONCLUSIONS: Findings based on three indicators of family background SES--income, wealth, and parental education--converged in describing unique patterns for smoking and for alcohol and marijuana use among young adults, although functional relationships across SES measures varied. Young adults with the highest family background SES were most prone to alcohol and marijuana use.

Differential trends in weight-related health behaviors among American young adults by gender, race/ethnicity, and socioeconomic status: 1984-2006.

OBJECTIVES: We investigated temporal patterns from 1984 to 2006 in 6 weight-related health behaviors by using longitudinal data for multiple cohorts of young adults (aged 19-26 years) from the nationally representative Monitoring the Future Study. METHODS: We used growth curve models to examine historical trends in 6 health behaviors: frequency of eating breakfast, eating green vegetables, eating fruit, exercising, watching television, and sleeping 7 hours each night. Variations across gender, race/ethnicity, and socioeconomic status were investigated. RESULTS: Frequency of exercising was consistently lower among young adult women than young adult men over this 23-year period. Compared with White women, Hispanic women, and women from other race/ethnic groups, Black women showed declines in the frequency of exercise since 1984. In general, young adult women showed a marked increase in the frequency of eating breakfast over this period, although Black women did not show any net gains. CONCLUSIONS: Social disparities in body weight may increase because Black women, Hispanic women, and men with lower socioeconomic status show declining trends in positive weight-related health behaviors compared with White young adults with higher socioeconomic status.

Race/ethnicity, socioeconomic factors, and smoking among early adolescent girls in the United States.

BACKGROUND: This study uses large nationally representative samples of White, Black, Mexican American, Puerto Rican, Other Latina, Asian American, and American Indian 8th-grade girls to examine racial/ethnic differences and similarities in patterns, trends, and socioeconomic correlates of cigarette use. METHODS: The data are drawn from the University of Michigan's Monitoring the Future study. Prevalence and trend data (from 1991 to 2007) in girls' cigarette use were examined by racial/ethnic subgroup. Logistic regression analyses were conducted to determine the extent to which socioeconomic factors predict girls' cigarette use, and whether the relationships between socioeconomic status (SES) and smoking differed across racial/ethnic subgroup. RESULTS: Cigarette use was highest among American Indian girls; at an intermediate level among Mexican American, Puerto Rican, Other Latinas, and White girls; and lowest among Black and Asian American girls. Trend data show that cigarette use has declined for all racial/ethnic subgroups, and that small but consistent racial/ethnic differences in girls' cigarette use have persisted. Generally, girls who did not live in two-parent households, whose parents had lower levels of educational attainment, who attended lower SES schools, and who had more disposable income were more likely than their peers to smoke. That said, however, the relationships between smoking and parental education and school SES were, on average, stronger for White girls than for Black or Hispanic (Mexican American, Other Latina, Puerto Rican) girls. CONCLUSIONS: Future research should seek to understand the mechanisms by which low SES impacts smoking.

Social disparities in BMI trajectories across adulthood by gender, race/ethnicity and lifetime socio-economic position: 1986-2004.

BACKGROUND: The prevalence of obesity and overweight is rapidly increasing in industrialized countries, with long-term health and social consequences. There is also a strong social patterning of obesity and overweight, with a higher prevalence among women, racial/ethnic minorities and those from a lower socio-economic position (SEP). Most of the existing work in this area, however, is based on cross-sectional data or single cohort studies. No national studies to date have examined how social disparities in obesity and overweight differ by age and historical period using longitudinal data with repeated measures. METHODS: We used panel data from the nationally representative Monitoring the Future Study (1986-2004) to examine social disparities in trajectories of body mass index (BMI) over adulthood (age 18-45). Self-reported height and weight were collected in this annual US survey of high-school seniors, followed biennially since 1976. Using growth curve models, we analysed BMI trajectories over adulthood by gender, race/ethnicity and lifetime SEP (measured by parents' education and respondent's education). RESULTS: BMI trajectories exhibit a curvilinear rate of change from age 18 to 45, but there was a strong period effect, such that weight gain was more rapid for more recent cohorts. As a result, successive cohorts become overweight (BMI>25) at increasingly earlier points in the life course. BMI scores were also consistently higher for women, racial/ethnic minority groups and those from a lower SEP. However, BMI scores for socially advantaged groups in recent cohorts were actually higher than those for their socially disadvantaged counterparts who were born 10 years earlier. CONCLUSIONS: Results highlight the importance of social status and socio-economic resources for maintaining optimal weight. Yet, even those in advantaged social positions have experienced an increase in BMI in recent years.