Paths to postsecondary education enrollment among adolescents with and without childhood attention-deficit/hyperactivity disorder (ADHD): A longitudinal analysis of symptom and academic trajectories.

We examined developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms, standardized achievement, and school performance for adolescents with and without ADHD who did and did not enroll in postsecondary education (PSE; N = 749; 79% boys; 63% White, 17% non-Hispanic Black, 10% Hispanic, and 10% other ethnicities). In a multisite study (recruitment based in New York, North Carolina, Pennsylvania, California, and Quebec), participants were originally enrolled between 1994 and 1998 at ages 7 to 9.9 and followed up through 2012 (Mage = 25 at final follow-up). Adolescents who eventually enrolled in PSE had less severe symptoms, but differences were modest and trajectories were similar over time. For all adolescents, standardized achievement trajectories declined up to two thirds of a standard deviation from ages 9 to 17. By the end of high school, the average GPA of adolescents with ADHD was three quarters of a point higher for those who eventually enrolled in PSE compared to those who did not. Overall, school performance mattered more than academic achievement for understanding eventual enrollment of adolescents with ADHD.

Personality and Alcohol Use across College: Examining Context-Dependent Pathways toward Alcohol Problems.

BACKGROUND: College life is characterized by marked increases in alcohol consumption. Extraversion and neuroticism are associated with alcohol use problems in college and throughout adulthood, each with alcohol use patterns consistent with an externalizing and internalizing pathway respectively. Students higher in extraversion drink more frequently and consume more alcohol, while neuroticism is paradoxically not consistently associated with elevated alcohol use. OBJECTIVE: This study examined whether students higher in neuroticism may drink the day before stressors, namely tests and assignment deadlines. METHOD: Multilevel generalized linear models were performed using data from a longitudinal study of first-time, first-year undergraduates assessing alcohol use across four years of college, with daily diary bursts each semester. RESULTS: Students higher in extraversion had heavier alcohol use and greater alcohol use problems in their fourth year of college. Neuroticism was not associated with drinking behaviors or with drinking before a test or assignment, but was associated with greater fourth year alcohol problems. Students lower in extraversion who reduced heavy drinking the day before academic events had fewer alcohol use problems at the fourth year of college relative to students higher in extraversion. CONCLUSIONS: Students higher in extraversion appear to exhibit a continuity of established alcohol use patterns from adolescence, predisposing them to a more hazardous trajectory of college alcohol use. Characteristics of low extraversion may afford some protection from alcohol-positive college culture. High neuroticism appears associated with a hazardous trajectory of college alcohol use, but continued research into situational factors of alcohol use in high neuroticism is warranted.

Mental Health of Students Reporting Food Insecurity during the Transition to University.

Purpose: The present study examined differences in mental health and well-being between students with and without suspected food insecurity during their transition to university.Methods: We drew on existing data from 4 samples of first-year undergraduates enrolled at 3 large universities in 3 provinces (Alberta n = 199, Québec n = 299, and Ontario n = 461 and n = 510). Students completed online surveys assessing a wide range of health-related behaviours and indicators, and students were classified as food secure or insecure based on their responses to screening questions.Results: Mental health (depression, anxiety, low satisfaction with life) was consistently poorer in students classified as food insecure across all samples. The magnitude of mental health deficit was comparable to socioeconomic disadvantage associated with food insecurity.Conclusions: Students experiencing food insecurity are disproportionately launching their university careers with poorer mental health, revealing a critical point of intervention for these socioeconomically higher-risk students.

Peer Information and Substance Use Decision Making in Street-Involved Youth.

In the context of adolescent substance use, peers are a primary source of both influence and information. Substance-related peer information sharing is a relatively understudied phenomenon, particularly in street-involved youth. We recruited 84 youth from a community drop-in center to complete a survey assessing substance use and peer influence on drug use. A subset of youth completed a semi-structured interview assessing factors related to peer information sharing around drug use. Results showed that peer influence was highly relevant to drug use patterns in street-involved youth. Trust in the person supplying information, personal and peer experience, and salience of information played important roles in youths' assessments of drug-related information exchanged with peers. Implications for improving community information dissemination strategies are discussed.

Health trajectories of children with severe obesity attending a weight management program.

PURPOSE: The objective of the present study is to examine physical and mental health trajectories of change in youth with severe obesity attending a tertiary care weight management program. It was predicted that younger children would show favourable changes in body mass index (BMI), markers of cardiovascular health, quality of life, and mental health. METHODS: This 2-year longitudinal study examined health trajectories of children referred to a weight management program at a Canadian paediatric tertiary care centre from November 2010 to December 2013. Participants were 209 of 217 consecutive referred paediatric patients (families) aged 3 to 17 years who met criteria for severe obesity and consented to participate. To maximize generalizability of results, there were no exclusion criteria. Primary outcomes were children's quality of life and BMI. Secondary outcomes included anxiety, depression, and non-high-density lipoprotein cholesterol levels. RESULTS: The findings suggest an improvement in mental health, quality of life, and cardiometabolic health of children and adolescents of all ages over the 2 years of programming. These positive findings were consistent across gender, age, and distance to the program. BMI trajectory changes varied across age cohorts such that younger children showed more favourable outcomes. The retention rate over the 2 years was high at 82.9%. CONCLUSIONS: This is the first study to show improvements in both physical and mental health outcomes beyond 1 year in a tertiary care setting with a high-risk population of children and youth with severe obesity. Findings highlight the need to examine both mental and physical health outcomes beyond 1 year.

Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD.

INTRODUCTION: Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for smoking cigarettes, but there is little longitudinal research on the array of smoking characteristics known to be prognostic of long-term smoking outcomes into adulthood. These variables were studied into early adulthood in a multisite sample diagnosed with ADHD combined type at ages 7-9.9 and followed prospectively alongside an age- and sex-matched local normative comparison group (LNCG). METHODS: Cigarette smoking quantity, quit attempts, dependence, and other characteristics were assessed in the longitudinal Multimodal Treatment Study of Children with ADHD (MTA) eight times to a mean age of 24.9 years: ADHD n = 469; LNCG n = 240. RESULTS: In adulthood, the ADHD group had higher rates of daily cigarette smoking, one or more quit attempts, shorter time to first cigarette of the day, and more severe withdrawal than the LNCG. The ADHD group did not appear to have better smoking cessation rates despite a higher proportion quitting at least once. Smoking quantity and nicotine dependence did not differ between groups. The ADHD group reported younger daily smoking onset and faster progression from smoking initiation to daily smoking across assessments. Finally, ADHD symptom severity in later adolescence and adulthood was associated with higher risk for daily smoking across assessments in the ADHD sample. CONCLUSIONS: This study shows that ADHD-related smoking risk begins at a young age, progresses rapidly, and becomes resistant to cessation attempts by adulthood. Prevention efforts should acknowledge the speed of uptake; treatments should target the higher relapse risk in this vulnerable population. IMPLICATIONS: Although childhood ADHD predicts later smoking, longitudinal studies of this population have yet to fully characterize smoking behaviors into adulthood that are known to be prognostic of long-term smoking outcome. The current study demonstrates earlier and faster progression to daily smoking among those with a childhood ADHD diagnosis, as well as greater risk for failed quit attempts. Prevention efforts should address speed of smoking uptake, while treatments are needed that address smoking relapse risk. The current study also demonstrates ADHD symptom severity over development increases daily smoking risk, implicating the need for continuous ADHD symptom management.

Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study.

BACKGROUND: Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. METHODS: Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. RESULTS: In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. CONCLUSIONS: Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.

The Rise and Fall of Depressive Symptoms and Academic Stress in Two Samples of University Students.

Self-reported depressive experiences are common among university students. However, most studies assessing depression in university students are cross-sectional, limiting our understanding of when in the academic year risk for depression is greatest and when interventions may be most needed. We examined within-person change in depressive symptoms from September to April. Study 1 (N = 198; 57% female; 72% white; Mage = 18.4): Depressive symptoms rose from September, peaked in December, and fell across the second semester. The rise in depressive symptoms was associated with higher perceived stress in December. Study 2 (N = 267; 78.7% female; 67.87% white; Mage = 21.25): Depressive symptoms peaked in December and covaried within persons with perceived stress and academic demands. The results have implications for understanding when and for whom there is increased risk for depressive experiences among university students.

Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.

OBJECTIVE: Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5-75%). This study documents how information source (parent vs. self-report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm-based) influence reported ADHD persistence rates in adulthood. METHOD: Five hundred seventy-nine children were diagnosed with DSM-IV ADHD-Combined Type at baseline (ages 7.0-9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self-reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. RESULTS: Persistence rates were higher when using parent rather than self-reports, structured interviews rather than rating scales (for self-report but not parent report), and a norm-based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver-Operating Characteristics (ROC) analyses revealed that sensitivity and specificity were optimized by combining parent and self-reports on a rating scale and applying a NB threshold. CONCLUSION: The interview format optimizes young adult self-reporting when parent reports are not available. However, the combination of parent and self-reports from rating scales, using an 'or' rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood.

Fully convolutional neural network for removing background in noisy images of uranium bearing particles.

A fully convolutional neural network (FCN) was developed to supersede automatic or manual thresholding algorithms used for tabulating SIMS particle search data. The FCN was designed to perform a binary classification of pixels in each image belonging to a particle or not, thereby effectively removing background signal without manually or automatically determining an intensity threshold. Using 8000 images from 28 different particle screening analyses, the FCN was trained to accurately predict pixels belonging to a particle with near 99% accuracy. Background eliminated images were then segmented using a watershed technique in order to determine isotopic ratios of identified particles. A comparison of the isotopic distributions of an independent data set segmented using the neural network with a commercially available automated particle measurement (APM) program developed by CAMECA was performed. This comparison highlighted the necessity for effective background removal to ensure that resulting particle identification is not only accurate, but preserves valuable signal that could be lost due to improper segmentation. The FCN approach improves the robustness of current state-of-the-art particle searching algorithms by reducing user input biases, resulting in an improved absolute signal per particle and decreased uncertainty of the determined isotope ratios.

A Person-Centered Analysis of Risk Factors that Compromise Wellbeing in Emerging Adulthood.

The transition to adulthood is a major life course transition that can pose risk to wellbeing. Research is needed to identify patterns of risk for compromised wellbeing, in order to best identify supports for individuals during this potentially vulnerable transition. The purpose of this study was to identify profiles of risk in an emerging adulthood sample, and to relate these profiles to mental health and subjective and academic wellbeing. Undergraduate emerging adults (N = 903, 82 % female), aged 18-25 years (M = 21.14, SD = 1.75), completed a series of questionnaires about risk factors, mental health, and academic variables. Results from a latent profile analysis identified four distinct risk profiles: Low Risk (76 %), Low Social Support Risk (4 %), Financial Risk (11 %), and Multiple Risk (8 %). The risk profiles were subsequently related to mental health and subjective and academic wellbeing outcomes, using a pseudo-class draws approach. Analyses indicated that the risk-pattern profiles differed in several ways across outcomes. Implications for targeted interventions are discussed.

Compliance Trends in a 14-Week Ecological Momentary Assessment Study of Undergraduate Alcohol Drinkers.

High compliance is a priority for successful ecological momentary assessment (EMA) research, but meta-analyses of between-study differences show that reasons for missed prompts remain unclear. We examined compliance data from a 14-week, 182-survey EMA study of undergraduate alcohol use to test differences over time and across survey types between participants with better and worse compliance rates, and to evaluate the impact of incentives on ongoing participation. Participants were N = 196 students (65.8% female; Mage = 20.6). Overall compliance was 76.5%, declining gradually from 88.9% to 70% over 14 weeks. Declines were faster in participants with lower overall compliance, but we found no demographic, personality, mental health, or substance use differences between participants with better versus worse compliance rates. Compliance varied by survey type, and unannounced bonus incentives did not impact compliance rates. Participants completed fewer surveys the week after winning a gift card. We offer recommendations for designing future EMA studies.

Impact of Legalization on Cannabis Use, Attitudes, and Purchasing Preferences: A Repeated Cross-Sectional Survey of Canadian Young Adults.

Objective: The Government of Canada legalized recreational cannabis use in October of 2018 with the implementation of the Cannabis Act. The act aimed to reduce the illicit cannabis market, improve consumer health outcomes, and reduce youth access to cannabis. However, little is known about the attitudes and behaviors of young adults, who have been shown to have a high prevalence of cannabis use, towards cannabis after legalization. Method: In this descriptive study, we examined cannabis use, attitudes, and purchasing preferences among Canadian university-attending young adults both before and after the legalization of cannabis. Participants were recruited from a large Canadian university from 2017 to 2021. Results: Our findings showed that there was an increase in cannabis use immediately following legalization that subsequently decreased in later years. Additionally, attitudes about the legalization of cannabis became more favorable in later years (following legalization), particularly among those who did not use cannabis. Most young adults were also keen to purchase cannabis from a government-owned store before legalization. However, with the exception of past-month consumers, this preference decreased substantially following legalization. Conclusions: The current research adds to the knowledge base about changes in cannabis-related attitudes and use after legalization and focuses on a key population - young adults.

Uncovering the metabolite complexity and variability of cultivated hemp (Cannabis sativa L.): A first phytochemical diversity mapping in Greece.

The high value of fiber-type Cannabis sativa L. (hemp) due to its phytochemicals has yet to be fully recognized and leveraged. Besides cannabidiol (CBD), which is the most prevalent non-psychoactive cannabinoid, hemp contains numerous other cannabinoids with unexplored bioactivities, in addition to various compound classes. Previous works have aimed to correlate chemical profiles of C. sativa inflorescences with important parameters, mostly based on experiments under controlled conditions. However, mapping studies that explore the phytochemical diversity of hemp in a more realistic context are crucial to guide decisions at multiple levels, especially in areas where hemp cultivation was recently re-authorized, including Mediterranean countries. In this work, a powerful strategy was followed to map the phytochemical diversity of cultivated hemp in Greece, being the first study of its kind for this environment. A panel of 98 inflorescence samples, covering two harvesting years, eleven geographical regions and seven commonly used EU varieties, were studied using a combination of targeted and untargeted approaches. Quantitative results based on UPLC-PDA revealed relatively constant CBD/THC (total) ratios, while profiling by LC-HRMS effectively probed the phytochemical variability of samples, and led to the annotation of 88 metabolites, including a multitude of minor cannabinoids. Multivariate analysis substantiated a strong effect of harvesting year in sample discrimination and related biomarkers were revealed, belonging to fatty acids and flavonoids. The effect of geographical region and, especially, variety on chemical variation patterns was more intricate to interpret. The results of this work are envisioned to enhance our understanding of the real-world phytochemical complexity of C. sativa (hemp), with a view to maximized utilization of hemp for the promotion of human well-being.

Who sleeps best? Longitudinal patterns and covariates of change in sleep quantity, quality, and timing across four university years.

This study tracked change over time in sleep quantity, disturbance, and timing, and sleep's covariations with living situation, stress, social support, alcohol use, and grade point average (GPA) across four years of university in 186 Canadian students. Women slept longer as they moved through university, and men slept less; rise times were later each year. Students reported sleeping fewer hours, more sleep disturbances, and later rise times during years with higher stress. In years when students lived away from home, they reported more sleep disturbances, later bedtimes, and later rise times. Living on campus was associated with later bedtimes and rise times. Alcohol use was higher and GPA was lower when bedtimes were later. The implications of these observed patterns for understanding the correlates and consequences of university students' sleep are discussed.

Stress and Mood Associations With Smartphone Use in University Students: A 12-Week Longitudinal Study.

The current study used device-logged screen-time records to measure week-to-week within-person associations between stress and smartphone use in undergraduate students (N = 187; mean age = 20.1 years). The study was conducted during fall 2020 and focused on differences across types of app used and whether accumulated screen use each week predicted end-of-week mood states. Participants uploaded weekly screenshots from their iPhone "Screen Time" settings display and completed surveys measuring stress, mood, and COVID-19 experiences. Results of multilevel models showed no week-to-week change in smartphone hours of use or device pickups. Higher stress levels were not concurrently associated with heavier smartphone use, either overall or by type of app. Heavier smartphone use in a given week did not predict end-of-week mood states, but students who tended to spend more time on their phones in general reported slightly worse moods-a between-persons effect potentially reflecting deficits in well-being that are present in students' off-line lives as well. Our findings contribute to a growing scholarly consensus that time spent on smartphones tells us little about young people's well-being.

Social cognition in youth with a first-degree relative with schizophrenia: A systematic scoping review.

Social-cognitive deficits are present in individuals at familial high-risk (FHR) for schizophrenia and may play a role in the onset of the illness. No literature review has examined the social-cognitive profiles of youth at FHR who are within the peak window of risk for developing schizophrenia, which could provide insight on the endophenotypic role of social cognition. This systematic scoping review (1) summarizes the evidence on social-cognitive deficits in youth at FHR, (2) explores brain correlates, and (3) describes social-cognitive deficits and prodromal symptom associations. We searched PsycInfo and PubMed for studies investigating social cognition in FHR youth aged 35 or younger and included 19 studies (FHR=639; controls=689). Studies report that youth at FHR have difficulty recognizing negative emotions, particularly fear. Youth at FHR also have difficulty performing complex theory of mind tasks. Abnormality in corticolimbic and temporoparietal regions are observed in youth at FHR during social-cognitive tasks, but results are inconsistent. Finally, there is evidence for negative associations between prodromal symptoms and performance on emotion regulation and theory of mind tasks, but the research is scarce. This review highlights the need for studies on youth at FHR using longitudinal designs and extensive social-cognitive, brain imaging and clinical measures.

Association Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.

Importance: Possible associations between stimulant treatment of attention-deficit/hyperactivity disorder (ADHD) and subsequent substance use remain debated and clinically relevant. Objective: To assess the association of stimulant treatment of ADHD with subsequent substance use using the Multimodal Treatment Study of ADHD (MTA), which provides a unique opportunity to test this association while addressing methodologic complexities (principally, multiple dynamic confounding variables). Design, Setting, and Participants: MTA was a multisite study initiated at 6 sites in the US and 1 in Canada as a 14-month randomized clinical trial of medication and behavior therapy for ADHD but transitioned to a longitudinal observational study. Participants were recruited between 1994 and 1996. Multi-informant assessments included comprehensively assessed demographic, clinical (including substance use), and treatment (including stimulant treatment) variables. Children aged 7 to 9 years with rigorously diagnosed DSM-IV combined-type ADHD were repeatedly assessed until a mean age of 25 years. Analysis took place between April 2018 and February 2023. Exposure: Stimulant treatment of ADHD was measured prospectively from baseline for 16 years (10 assessments) initially using parent report followed by young adult report. Main Outcomes and Measures: Frequency of heavy drinking, marijuana use, daily cigarette smoking, and other substance use were confidentially self-reported with a standardized substance use questionnaire. Results: A total of 579 children (mean [SD] age at baseline, 8.5 [0.8] years; 465 [80%] male) were analyzed. Generalized multilevel linear models showed no evidence that current (B [SE] range, -0.62 [0.55] to 0.34 [0.47]) or prior stimulant treatment (B [SE] range, -0.06 [0.26] to 0.70 [0.37]) or their interaction (B [SE] range, -0.49 [0.70] to 0.86 [0.68]) were associated with substance use after adjusting for developmental trends in substance use and age. Marginal structural models adjusting for dynamic confounding by demographic, clinical, and familial factors revealed no evidence that more years of stimulant treatment (B [SE] range, -0.003 [0.01] to 0.04 [0.02]) or continuous, uninterrupted stimulant treatment (B [SE] range, -0.25 [0.33] to -0.03 [0.10]) were associated with adulthood substance use. Findings were the same for substance use disorder as outcome. Conclusions and Relevance: This study found no evidence that stimulant treatment was associated with increased or decreased risk for later frequent use of alcohol, marijuana, cigarette smoking, or other substances used for adolescents and young adults with childhood ADHD. These findings do not appear to result from other factors that might drive treatment over time and findings held even after considering opposing age-related trends in stimulant treatment and substance use.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

People prefer to diversify across different types of prosocial behaviour.

People have multiple opportunities to act prosocial any given day but only limited resources to do so (e.g. time, effort and money they are willing to invest). We test whether people prefer to diversify their prosocial efforts across different types of help: casual help, direct help, indirect help and emotional support. In two daily diary studies (total N = 711), we examine whether previous prosocial behaviour affects subsequent prosocial behaviour for the same or other types of prosocial behaviour. We found that day-to-day prosocial behaviours reflected a diversified helping pattern. Participants were less likely to help the same way (i.e. the same type of prosocial behaviour) on subsequent days and more likely to help in different ways (i.e. a different type of prosocial behaviour). This tendency did not extend to casual help in Study 2, implying that the next day reduction in doing the same type of prosocial behaviour is limited to prosocial behaviours that are at least somewhat effortful or time consuming.