Effect of a selective personality-targeted prevention program on 7-year illicit substance related outcomes: A secondary analysis of a cluster randomized controlled trial.

BACKGROUND: This study evaluated the efficacy of the selective personality-targeted PreVenture program in reducing cannabis and stimulant use over a 7-year period spanning adolescence and early adulthood. METHODS: A cluster randomized controlled trial was conducted in 14 Australian schools. Schools were randomized to PreVenture, a brief personality-targeted selective intervention, comprising two 90-minute facilitator-led sessions delivered one week apart, or a control group (health education as usual). Only students who scored highly on one of four personality traits (anxiety sensitivity, negative thinking, impulsivity, sensation seeking) were included. Students completed online self-report questionnaires between 2012 and 2019: at baseline; post-intervention; 1-, 2-, 3-, 5.5- and 7-years post-baseline. Outcomes were past 6-months cannabis use, stimulant use (MDMA, methamphetamine or amphetamine) and cannabis-related harms. RESULTS: The sample comprised 438 adolescents (Mage=13.4 years; SD=0.47) at baseline. Retention ranged from 51% to 79% over the 7-years. Compared to controls, the PreVenture group had significantly reduced odds of annual cannabis-related harms (OR=0.78, 95% CI=0.65-0.92). However, there were no significant group differences in the growth of cannabis use (OR=0.84, 95% CI=0.69-1.02) or stimulant use (OR=1.07, 95% CI=0.91-1.25) over the 7-year period. CONCLUSIONS: PreVenture was effective in slowing the growth of cannabis-related harms over time, however owing to missing data over the 7-year trial, replication trials may be warranted to better understand the impact of the PreVenture intervention on cannabis and stimulant use among young Australians. Alternative implementation strategies, such as delivering the intervention in later adolescence and/or providing booster sessions, may be beneficial.

The Role of Executive Function at 6 Years in the Association between Behavioral Inhibition at 5 Years and Anxiety at 7 Years.

EF skills play a central role in the etiology and maintenance of anxiety, but it is unclear whether they act as moderators or mediators in the relation between early behavioral inhibition (BI) and later anxiety. The current study tested two models by examining whether two executive functions (EF) skills (cognitive flexibility and working memory) assessed at age 6 acted as moderators or mediators in the relation between BI at 5 years and anxiety symptoms at 7 years. The sample consisted of 422 children from the Quebec Longitudinal Study of Child Development. We tested the moderation model, main and interaction effects using hierarchical multiple regression analyses and the mediation model with the product of coefficients test. Results showed that higher BI at 5 years predicted high anxiety at 7 years only at low levels of cognitive flexibility or working memory at 6 years. This suggests that high levels of cognitive flexibility or working memory at 6 years may act as protective factors. In contrast, neither cognitive flexibility nor working memory at age 6 acted as mediators in the association between BI at 5 years and anxiety at 7 years. Results support the hypothesis that goal-driven cognitive control processes act as moderators and promote adaptive functioning by dampening the effect of early BI on later anxiety.

Longitudinal Study of Early Adversity and Disturbing Dream Frequency: Moderating Role of Early Negative Emotionality.

Although disturbing dreams are prevalent in youth and are associated with psychopathology, little is known about their developmental course and risk factors. We aimed to examine the association between early social environment and subsequent disturbing dream frequency across adolescence as moderated by early negative emotionality. Measures of children's early social environment and negative emotionality were collected from the mothers of 410 children (5-42 months old) and measures of disturbing dream frequency directly from the children (13-18 years old). Preliminary steps identified subgroups of families with distinct profiles of social environment using latent variable mixture modeling, and captured changes in disturbing dream frequency using latent growth modeling. Regression and moderation analyses were conducted to test the study objectives. Results showed that the diverse family patterns were best captured by two profiles reflecting adverse and positive social environments and that overall disturbing dream frequency decreased during adolescence. Moderation analyses showed that when early negative emotionality was higher, DD frequency was not only more elevated in an adverse environment, but lower in a positive environment. These results indicate that the development of disturbing dreams is most strongly associated with a combination of individual and environment factors. Our study adds to the literature by refining our conception of individual traits and disturbing dream development and has implications for the prevention of bad dreams, nightmares, and associated psychopathologies.

Emotion Dysregulation Is Associated With Increased Problem Cannabis Use Among Emerging Adults During COVID-19.

OBJECTIVE: Emerging adulthood (18-25 years) is associated with peak prevalence of cannabis use. Although population-based longitudinal studies have found little change in cannabis use among emerging adults during COVID-19, research examining changes among vulnerable subgroups is lacking. The present study examined the association between emotion dysregulation at 23 years and change in cannabis use frequency and problem cannabis use among a large sample of emerging adults, from before to during the COVID-19 pandemic. METHOD: Longitudinal data were analyzed from 1,226 emerging adults (59% female; n = 738 reported cannabis use) who completed online surveys before the pandemic (2019; age 21) and 1 year into COVID-19 (2021; age 23) as part of the Québec Longitudinal Study of Child Development. RESULTS: There was no significant overall within-person change in cannabis use outcomes during COVID-19 among the emerging adult sample. However, emotional clarity (a dimension of emotion dysregulation) at 23 years significantly moderated change in problem cannabis use during COVID-19. Namely, low emotional clarity at 23 years was associated with increased problem cannabis use (B = 0.79, 95% CI [0.23, 1.34]), whereas high emotional clarity at 23 years was associated with decreased problem cannabis use (B = -0.68, 95% CI [-1.27, -0.09]) during COVID-19, among men only. CONCLUSIONS: Findings highlight the need to consider changes in cannabis use during COVID-19 among emerging adults with elevated emotion dysregulation (and particularly, low emotional clarity among men) and reiterate the need for supports and targeted interventions to reduce cannabis use and decrease associated harms as society emerges from COVID-19.

A thorough investigation of the bifactor model of psychopathology in a representative birth cohort: Testing internal and predictive validity to inform models of comorbidity.

This study used symptom dimensions reflecting DSM-V internalizing, externalizing, eating disorders, and substance use (SU) and related problems to thoroughly investigate the structure of psychopathology in mid-adolescence (15 and 17 years, N = 1,515, 52% female). Compared to other hierarchical configurations (unidimensional, correlated factors, or higher-order model), a bifactor model of psychopathology wherein all first-order symptom dimensions loaded onto a second-order general psychopathology factor (P factor) and one of three, second-order specific internalizing, externalizing, or SU factors, best captured the structure of the psychopathology in mid-adolescence. This bifactor model was then used to predict several distinct mental health disorders and alcohol use disorder (AUD) at 20 years, via a structural equation model (SEM). The P factor (bifactor model) was associated with all but one outcome (suicidal ideation without an attempt), at 20 years. Controlling for the P factor, there were no additional, positive, temporal cross-associations (i.e., between mental health (mid-adolescence) and AUD at 20 years, or between SU (mid-adolescence) and mental health problems at 20 years). These results are bolstered by findings from a well-fitting correlated factors model. Namely, when mid-adolescent psychopathology was modeled using an adjusted correlated factors model, associations with outcomes at 20 years were largely masked, with no significant partial, temporal cross-associations. Thus, collectively, findings indicate that comorbidity between SU and mental health in youth may be largely attributable to an underlying liability to experience both problems (i.e., P factor). Ultimately, results support targeting the common liability to psychopathology in the prevention of later mental health problems and AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Transactional associations between vocabulary and disruptive behaviors during the transition to formal schooling.

This study investigated the transactional relations between vocabulary and disruptive behaviors (DB; physical aggression and opposition/rule breaking/theft and vandalism), during the transition to formal schooling, using a community sample of 572 children. Cross-lagged panel model analyses were used to examine bidirectional relationships, comparing physical aggression to non-aggressive DB. Transactional associations between vocabulary and DB were observed, coinciding with school entry. Lower vocabulary in preschool (60mo.) was predictive of higher physical aggression scores in kindergarten. In turn, higher physical aggression in kindergarten was predictive of lower vocabulary in 1st grade. For non-aggressive DB, recurrent associations were found. Lower verbal skills in preschool (42mo.) and kindergarten predicted higher non-aggressive DB scores later in preschool and in 1st grade respectively. In turn, higher non-aggressive DB in kindergarten predicted lower vocabulary scores in 1st grade. In contrast to transactional paths from vocabulary to DB, transactional paths from DB to vocabulary observed after the transition to elementary school remained significant after controlling for comorbid hyperactivity, impulsivity and inattention behaviors, suggesting these links were specific to aggressive and non-aggressive DB. Practical implications for prevention are discussed.

Prenatal paternal anxiety symptoms predict child DHEA levels and internalizing symptoms during adrenarche.

Introduction: This study examined (1) whether measures of paternal anxious and depressive symptoms collected prenatally and during a follow-up assessment when the child was in middle childhood, predict child neuroendocrine outcomes, and (2) whether neuroendocrine outcomes are intermediate factors between paternal mental health and child cognitive/behavioral outcomes. Middle childhood coincides with increased autonomy as the child transitions into grade school, and with adrenarche, as the maturing adrenal gland increases secretion of dehydroepiandrosterone (DHEA) and its sulfated metabolite (DHEA-S), hormones that are implicated in corticolimbic development which regulate emotions and cognition. Methods: Participants were recruited from a subsample of a large prospective birth cohort study (3D study). We conducted a follow-up study when children were 6-8 years old (N = 61 families, 36 boys, 25 girls). Parental symptoms of anxiety, stress and depression were assessed via validated self-report questionnaires: prenatally using an in-house anxiety questionnaire, the Perceived Stress Scale (PSS) and the Center for Epidemiologic Studies Depression (CES-D), and at the follow up, using the Beck Anxiety and Beck Depression Inventories. Children provided salivary hormone samples, and their pituitary gland volume was measured from structural Magnetic Resonance Imaging (MRI) scans. Child behaviors were measured using the Strengths and Difficulties Questionnaire and cognitive outcomes using the WISC-V. Multiple regression analyses were used to test whether paternal mental health symptoms assessed prenatally and during childhood are associated with child neuroendocrine outcomes, adjusting for maternal mental health and child sex. Indirect-effect models assessed whether neuroendocrine factors are important intermediates that link paternal mental health and cognitive/behavioral outcomes. Results: (1) Fathers' prenatal anxiety symptoms predicted lower DHEA levels in the children, but not pituitary volume. (2) Higher prenatal paternal anxiety symptoms predicted higher child internalizing symptoms via an indirect pathway of lower child DHEA. No associations were detected between paternal anxiety symptoms measured in childhood, and neuroendocrine outcomes. No child sex differences were detected on any measure. Conclusion: These results highlight the often-overlooked role of paternal factors during pregnancy on child development, suggesting that paternal prenatal anxiety symptoms are associated with child neuroendocrine function and in turn internalizing symptoms that manifest at least up to middle childhood.

Effect of Selective Personality-Targeted Alcohol Use Prevention on 7-Year Alcohol-Related Outcomes Among High-risk Adolescents: A Secondary Analysis of a Cluster Randomized Clinical Trial.

Importance: Alcohol consumption is one of the leading preventable causes of burden of disease worldwide. Selective prevention of alcohol use can be effective in delaying the uptake and reducing harmful use of alcohol during the school years; however, little is known about the durability of these effects across the significant transition from early adolescence into late adolescence and early adulthood. Objective: To examine the sustained effects of a selective personality-targeted alcohol use prevention program on alcohol outcomes among adolescents who report high levels of 1 of 4 personality traits associated with substance use. Design, Setting, and Participants: A cluster randomized clinical trial was conducted to assess the effectiveness of the selective personality-targeted PreVenture program on reducing the growth of risky alcohol use and related harms from early to late adolescence and early adulthood. Participants included grade 8 students attending 14 secondary schools across New South Wales and Victoria, Australia, in 2012 who screened as having high levels of anxiety sensitivity, negative thinking, impulsivity, and/or sensation seeking. Schools were block randomized to either the PreVenture group (7 schools) or the control group (7 schools). The primary end point of the original trial was 2 years post baseline; the present study extends the follow-up period from July 1, 2017, to December 1, 2019, 7 years post baseline. Data were analyzed from July 22, 2021, to August 2, 2022. Interventions: The PreVenture program is a 2-session, personality-targeted intervention designed to upskill adolescents to better cope with their emotions and behaviors. Main Outcomes and Measures: Self-reported monthly binge drinking, alcohol-related harms, and hazardous alcohol use measured by the Alcohol Use Disorders Identification Test-Concise consumption screener. Results: Of 438 participants (249 male [56.8%]; mean [SD] age, 13.4 [0.5] years) from 14 schools, 377 (86.2%) provided follow-up data on at least 2 occasions, and among those eligible, 216 (54.0%) participated in the long-term follow-up. Compared with the control condition, the PreVenture intervention was associated with reduced odds of any alcohol-related harm (odds ratio [OR], 0.81 [95% CI, 0.70-0.94]) and a greater mean reduction in the frequency of alcohol-related harms (ß = -0.22 [95% CI, -0.44 to -0.003]) at the 7.0-year follow-up. There were no differences in the odds of monthly binge drinking (OR, 0.80 [95% CI, 0.56-1.13]) or hazardous alcohol use (OR, 0.87 [95% CI, 0.59-1.27]) at the 7.0-year follow-up. Exploratory analyses at the 5.5-year follow-up showed that compared with the control condition, the PreVenture intervention was also associated with reduced odds of monthly binge drinking (OR, 0.87, [95% CI, 0.77-0.99]) and hazardous alcohol use (OR, 0.91 [95% CI, 0.84-0.99]), but this was not sustained. Conclusions and Relevance: This study demonstrated that a brief selective personality-targeted alcohol use prevention intervention delivered in the middle school years can have sustained effects into early adulthood. Trial Registration: anzctr.org.au Identifier: ACTRN12612000026820.

Longitudinal associations throughout adolescence: Suicidal ideation, disturbing dreams, and internalizing symptoms.

OBJECTIVE/BACKGROUND: Many studies have reported associations between disturbing dream occurrence and internalizing symptoms in adults, but the extent to which such associations also characterize adolescents remains unknown. The main goal of the present longitudinal study was to evaluate the strength and stability of the associations between disturbing dream frequency, suicidal ideation, and internalizing symptoms from ages 13 to 18. METHODS: Participants (N = 434) drawn from two longitudinal birth cohort studies on child development in the province of Quebec, Canada, completed annual self-reports of disturbing dream frequency, suicidal ideation, and levels of depression and anxiety. RESULTS: Two separate cross-lagged panel models for symptoms of depression and anxiety were conducted with both models showing similar results. In early adolescence, high levels of and higher change in disturbing dream frequency were associated with increased odds of reporting later suicidal ideation, whereas in mid to late adolescence, increased odds of reporting suicidal ideation at age 17 was associated with increased disturbing dream frequency at age 18. Across adolescence, increased levels of depression and anxiety were associated with increased odds of reporting later suicidal ideation and increased disturbing dream frequency. CONCLUSIONS: These findings support previous literature suggesting that disturbing dream frequency, depression, and anxiety, are risk factors for suicidal ideation throughout adolescence. The present longitudinal study allows for a refinement of our conceptualization of disturbing dream and their relation to suicide and internalizing symptoms throughout adolescence and suggests that the collection of information on disturbing dream and internalizing symptoms during early adolescence may help screen adolescents for suicide risk.

The moderating role of sex and self-, teacher-, and father-reported ADHD hyperactivity-impulsivity symptoms, on the association between early adolescent internalizing symptoms and substance use.

AIMS: Internalizing symptoms are theorized to lead to substance use (SU) via a tendency to use substances to cope with or self-medicate negative feelings and emotions; however, empirically, this association is mixed, pointing to the existence of moderating factors. The present study aimed to examine how self-, teacher-, and father-reported attention-deficit/hyperactivity disorder hyperactivity-impulsivity symptoms (ADHD-HI) and sex, moderated the association between self-reported internalizing symptoms and SU, in early adolescence. METHODS: Cross-sectional data obtained at 13 years of age, drawn from the Quebec Longitudinal Study of Child Development (N = 1,424; 53 % female). Alcohol, cigarette, and cannabis use, and internalizing and ADHD-HI symptoms were assessed. RESULTS: There was a significant three-way interaction between internalizing, ADHD-HI, and sex, for cigarette use, with Bayes factor (BF) indicating very strong evidence for an effect (BF = 48.40). While the three-way interaction for cannabis use did not reach statistical significance (self-report: p <.066; father-report: p <.053), BF indicated substantial evidence for an effect (self-report: BF = 3.54; father-report: BF = 9.08). Further analyses revealed internalizing was associated with cigarette and cannabis use only among females with high ADHD-HI symptoms (cigarette use: ß = 0.15, SE = 0.04, 95 %CI [0.07, 0.22]; cannabis use (self-reported ADHD-HI): ß = 0.14, SE = 0.06, 95 %CI [0.04, 0.25]; cannabis use (father-reported ADHD-HI): ß = 0.21, SE = 0.10, 95 %CI [0.01, 0.41]). CONCLUSIONS: Findings aid in clarifying the inconsistent relationship between internalizing symptoms and SU among adolescent females by underscoring the moderating role of ADHD-HI. Further, findings also support a growing body of literature which highlights the need for both self- and adult-informants (i.e., teacher and parent) in assessing ADHD-HI symptoms in females.

Transition from preschool to school: Children's pattern of change in morning cortisol concentrations.

Many studies show a general increase in stress hormones at the exposure to school entry, but inconsistencies among them due to small samples with varying methodologies and very few time-points, preclude robust conclusions. The current study aimed to describe the pattern of morning cortisol concentration in children across the transition from preschool to school by examining whether we could identify a response to the school entry, but also an anticipatory stress response (pre-entry) and a stress adaptation response (post-entry). We further tested the robustness of this pattern across several characteristics. Participants were 384 children recruited from two cohorts of the 3D pregnancy study, and followed across their transition from preschool to kindergarten. Children's morning salivary cortisol samples were collected over five time-points: twice before school entry, once at school entry and twice after school entry (one sample per time-point). Although no anticipatory stress response was observed two weeks before school entry, latent growth curve models showed that most children's morning cortisol concentrations increased during the first two weeks of school, and was not associated with any sociodemographic characteristics, supporting the hypothesis that school entry is a normative environmental stressor. In contrast, two months after school entry, some children showed stress adaptation whereas others showed a prolonged stress response to school entry. This between-children variance could not be explained by any specific sociodemographic characteristic. This study showed that the morning stress response rises at school entry and is sustained for at least two weeks in most children. However, the observed variability in the stress adaptation response remains to be elucidated and linked to functional correlates.

Transactional longitudinal relations between accuracy and reaction time on a measure of cognitive flexibility at 5, 6, and 7 years of age.

Whereas accuracy is used as an indicator of cognitive flexibility in preschool-age children, reaction time (RT), or a combination of accuracy and RT, provide better indices of performance as children transition to school. Theoretical models and cross-sectional studies suggest that a speed-accuracy tradeoff may be operating across this transition, but the lack of longitudinal studies makes this transition difficult to understand. The current study explored the longitudinal and bidirectional associations between accuracy and RT on the DCCS (mixed block) at 5, 6, and 7 years of age using cross-lagged panel analyses. The study also examined the roles of working memory and language, as potential longitudinal mediators between RT at Time X and accuracy at Time X + 1, and explored the role of inhibitory control. The sample consisted of 425 children from the Quebec Longitudinal Study of Child Development. Results show lagged associations from slower RT to greater improvements in accuracy between 5 and 6 years and between 6 and 7 years. Further, higher accuracy at 6 years predicted faster RT at 7 years. Only working memory acted as a partial mediator between RT at 5 years and accuracy at 6 years. These results provide needed longitudinal evidence to support theoretical claims that slower RT precedes improved accuracy in the development of cognitive flexibility, that working memory may be involved in the early stage of this process, and that accuracy and reaction time become more efficient in later stages of this process.

Changes in emerging adults' alcohol and cannabis use from before to during the COVID-19 pandemic: Evidence from a prospective birth cohort.

OBJECTIVE: Prospective research is needed to better-understand changes in substance use from before to during the coronavirus disease (COVID-19) pandemic, among emerging adults (18-25 years), a high-risk group for substance use. METHOD: N = 1,096 (weighted sample N = 1,080; 54% female) participants enrolled in the Québec Longitudinal Study of Child Development, who completed prepandemic (2019; 21 years) and COVID-19 (mid-March to mid-June 2020) surveys. COVID-19-related and preexisting factors were examined as moderators of change in substance use. RESULTS: Full sample analyses revealed decreased binge drinking (p < .001, Bayes factor [BF] = 22, Cohen's f² = 0.02), but no changes in alcohol and cannabis use. Stratified analyses revealed emerging adults who reported < monthly use prepandemic increased their alcohol use (p < .001, BF > 150, f² = 0.05) and binge drinking (p < .001, BF = 27, f² = 0.01), but not their cannabis use. Conversely, emerging adults who reported >monthly use prepandemic decreased their binge drinking (p < .001, BF > 150, f² = .12) and cannabis use (p < .001, BF > 150, f² = .06), but did not change their alcohol use frequency. Several factors moderated change in substance use, including employment loss (p = .005, BF > 39, f² = .03) and loneliness (p = .018, BF > 150, f² = .10) during COVID-19. CONCLUSIONS: Changes in alcohol and cannabis use frequency among emerging adults in the first 3 months of COVID-19 largely differed according to prepandemic substance use, COVID-19-related factors, and preexisting factors. While some youth with preexisting vulnerabilities (e.g., more frequent substance use prepandemic) remained stable or decreased their substance use during COVID-19, emerging adults who experienced employment loss, loneliness, and financial concerns during COVID-19 increased their substance use, highlighting the need for increased supports for vulnerable populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations of childhood sociability and responsibility with cannabis use trajectories during adolescence: results from a prospective population-based birth cohort study.

This study aims to identify distinct trajectories of cannabis use during adolescence and examine whether Sociability (ability to relate to others) and Responsibility (ability to integrate a community setting) during childhood are associated with these trajectories, accounting for individual and familial confounders. Population-based cohort study (1998-2019): 1511 children from the Quebec Longitudinal Study of Child Development were followed between ages 5 months and 19 years. We identified developmental trajectories of adolescent cannabis use (assessed biyearly between ages 12 and 19 years) using a group-based trajectory model. We performed multinomial regression analyses to estimate the association between childhood Sociability and Responsibility assessed yearly between ages 6 and 12 years, and cannabis use trajectories. At 19 years, 62.8% (807/1286) of adolescents had used cannabis at least once in their lifetime, 44.2% had used at least once in the past 12 months (504/1140), and 6.8% were reporting daily use (77/1140). We identified three cannabis use trajectories: nonusers (n = 577, 38.2%), late users (n = 690, 45.7%; mean age of initiation: 16.2 ± 1.6), and early users (n = 244, 16.2%; mean age of initiation: 14.1 ± 1.3). Compared with Nonusers, children with low Sociability had a lower risk for late (OR, 0.43; 95 CI 0.27; 0.68) and early (OR, 0.22; 95 CI 0.12; 0.41) cannabis use. Children with low Responsibility were at higher risk of being Early users (OR, 2.23; 95 CI 1.13; 4.37) but not Late users (OR, 1.20; 95 CI 0.71; 2.03). Understanding the multiple dimensions of social skills and their association with cannabis use trajectories may help improve the effectiveness of evidence-based prevention strategies.

A three-factor model of common early onset psychiatric disorders: temperament, adversity, and dopamine.

Commonly comorbid early onset psychiatric disorders might reflect the varying expression of overlapping risk factors. The mediating processes remain poorly understood, but three factors show some promise: adolescent externalizing traits, early life adversity, and midbrain dopamine autoreceptors. To investigate whether these features acquire greater predictive power when combined, a longitudinal study was conducted in youth who have been followed since birth. Cohort members were invited to participate based on externalizing scores between 11 to 16 years of age. At age 18 (age 18.5 ± 0.6 y.o.), 52 entry criteria meeting volunteers had a 90-min positron emission tomography scan with [18F]fallypride, completed the Childhood Trauma Questionnaire, and were assessed with the Structured Clinical Interview for DSM-5. The three-factor model identified those with a lifetime history of DSM-5 disorders with an overall accuracy of 90.4% (p = 2.4 × 10-5) and explained 91.5% of the area under the receiver operating characteristic curve [95% CI: .824, 1.000]. Targeting externalizing disorders specifically did not yield a more powerful model than targeting all disorders (p = 0.54). The model remained significant when including data from participants who developed their first disorders during a three-year follow-up period (p = 3.5 × 10-5). Together, these results raise the possibility that a combination of temperamental traits, childhood adversity, and poorly regulated dopamine transmission increases risk for diverse, commonly comorbid, early onset psychiatric problems, predicting this susceptibility prospectively.

Trajectories of adolescent poly-substance use and their long-term social and economic outcomes for males from low-income backgrounds.

Substance abuse is a significant public health concern that disproportionately burdens males and low-income communities. This study examined (1) longitudinal profiles of male adolescent poly-substance use and (2) their association with social and economic participation across early adulthood. Drawing on a cohort of males (n = 890) from low-income neighborhoods, we used group-based multi-trajectory modeling to identify profiles of poly-substance use (alcohol, tobacco, cannabis, illicit drugs) from age 13-17 years. Regression models were used to link substance use profiles to high school graduation, criminal convictions, personal and household earnings, welfare receipt and partnership from age 19-37 years, obtained from administrative records. Child IQ, family adversity and behavioral problems were adjusted for. Four poly-substance use profiles were identified: abstinent (n = 128, 14.4%), late-onset (n = 412, 46.5%), mid-onset (n = 249, 28.1%), and early-onset (n = 98, 11.1%). Relative to the late-onset (reference) group, participants in the early-onset profile were 3.0 times (95%CI = 1.68-5.53) more likely to have left school without a diploma, 2.7 times (95% CI = 1.56-4.68) more likely to have a criminal conviction by age 24 years, earned 10,185 USD less (95% CI = - 15,225- - 5144) per year at age 33-37 years and had 15,790 USD lower (95% CI = - 23,378- - 8218) household income at age 33-37 years, a 1.3 times (95%CI = 1.15-1.57) higher incidence of annual welfare receipt and a 24% (95% CI = 5-40) lower incidence of marriage/cohabitation from age 18-35 years. We show that adolescent-onset poly-substance use by age 13 is associated with poor social and economic outcomes. Delaying the onset of substance use and reducing exposure to additional substance classes has potential for high societal cost savings.

The 7-Year Effectiveness of School-Based Alcohol Use Prevention From Adolescence to Early Adulthood: A Randomized Controlled Trial of Universal, Selective, and Combined Interventions.

OBJECTIVE: Alcohol use is a leading cause of burden of disease among young people. Prevention strategies can be effective in the short-term; however little is known about their longer-term effectiveness. The aim of this study was to examine the sustainability of universal, selective, and combined alcohol use prevention across the critical transition period from adolescence into early adulthood. METHOD: In 2012, a total of 2190 students (mean age, 13.3 years) from 26 Australian high schools participated in a cluster randomized controlled trial and were followed up for 3 years post baseline. Schools were randomly assigned to deliver the following: (1) universal Web-based prevention for all students (Climate Schools); (2) selective prevention for high-risk students (Preventure); (3) combined universal and selective prevention (Climate Schools and Preventure [CAP]); or (4) health education as usual (control). This study extends the follow-up period to 7-years post baseline. Primary outcomes were self-reported frequency of alcohol consumption and binge drinking, alcohol-related harms, and hazardous alcohol use, at the 7-year follow-up. RESULTS: At 7-year follow-up, students in all 3 intervention groups reported reduced odds of alcohol-related harms compared to the control group (odds ratios [ORs] = 0.13-0.33), and the Climate (OR = 0.04) and Preventure (OR = 0.17) groups reported lower odds of hazardous alcohol use. The Preventure group also reported lower odds of weekly alcohol use compared to the control group (OR = 0.17), and the Climate group reported lower odds of binge drinking (OR = 0.12), holding mean baseline levels constant. CONCLUSION: This study demonstrated that both universal and selective preventive interventions delivered in schools can have long-lasting effects and reduce risky drinking and related harms into adulthood. No added benefit was observed by delivering the combined interventions. CLINICAL TRIAL REGISTRATION INFORMATION: The CAP Study: Evaluating a Comprehensive Universal and Targeted Intervention Designed to Prevent Substance Use and Related Harms in Australian Adolescents; https://www.anzctr.org.au/; ACTRN12612000026820.

Longitudinal Trajectories of Food Insecurity in Childhood and Their Associations With Mental Health and Functioning in Adolescence.

Importance: Household food insecurity has been associated with mental health problems in children independently of family income and other confounders. It is unclear whether food insecurity during childhood is also associated with mental health and functioning during adolescence. Objective: To evaluate longitudinal trajectories of household food insecurity during the first 13 years of life, characteristics associated with these trajectories, and the associations of the trajectories with externalizing, internalizing, substance use, and social adjustment problems at 15 years of age. Design, Setting, and Participants: This cohort study included participants from the Québec Longitudinal Study of Child Development, a cohort of 2120 children born in Québec, Canada, in 1997 and 1998 and followed up annually or biannually from 5 months to 15 years of age (1998-2013). Data were analyzed from November 2020 to October 2021. Exposures: When children were aged 1.5, 4, 8, 10, 12, and 13 years, mothers reported whether a family member experienced hunger because the family had run out of food or money to buy food in the past 12 months. Main Outcomes and Measures: Group-based trajectory modeling was used to identify differential exposure to food insecurity from 1.5 to 13 years according to logit functions of age. At 15 years of age, adolescents completed validated questionnaires assessing externalizing, internalizing, substance use, and social adjustment problems. Associations between trajectories of food insecurity and outcomes were assessed using linear regressions. Results: A total of 2032 individuals were included in the analyses of trajectories of food insecurity (1026 [50.5%] male) and 1441 in the analysis of the association with outcomes at 15 years of age (752 [52.2%] female). Two trajectories of food insecurity were identified between 1.5 and 13 years of age: high risk (73 children [3.6%]) and low risk (1959 children [96.4%]). At 5 months, the high-risk and low-risk groups differed in household characteristics including income insufficiency (58 [80.6%] vs 405 [21.0%]), single parenthood (21 [29.2%] vs 135 [6.9%]), and parental history of depression (mothers: 30 [43.5%] vs 411 [21.7%]; fathers: 12 [32.4%] vs 209 [13.5%]). The high-risk trajectory from 1.5 to 13 years of age was associated with cannabis use (ß, 0.47; 95% CI, 0.12-0.81), peer bullying (ß, 0.43; 95% CI, 0.08-0.77), and dropout potential (ß, 0.38; 95% CI, 0.03-0.68) at 15 years of age after adjustment for sex, household income insufficiency, and parental mental health. Conclusions and Relevance: In this cohort study, few children experienced a persistent high risk of food insecurity, which was associated with psychosocial problems later in adolescence after adjustment for confounders including low income. Early identification of risk for food insecurity may guide the delivery of tailored interventions to improve functioning in adolescence.

Depression and anxiety symptoms in young adults before and during the COVID-19 pandemic: evidence from a Canadian population-based cohort.

BACKGROUND: Concerns have been raised that the COVID-19 pandemic could increase risk for adverse mental health outcomes, especially in young adults, a vulnerable age group. We investigated changes in depression and anxiety symptoms (overall and severe) from before to during the pandemic, as well as whether these changes are linked to COVID-19-related stressors and pre-existing vulnerabilities in young adults followed in the context of a population-based cohort. METHOD: Participants (n = 1039) from the Quebec Longitudinal Study of Child Development reported on their depression (Centre for Epidemiological Studies Depression Scale, short form) and anxiety (General Anxiety Disorder-7 Scale) symptoms and completed a COVID-19 questionnaire during the first wave of the COVID-19 pandemic in the summer of 2020 (age 22 years). Assessments at age 20 (2018) were used to estimate pre-pandemic depression and anxiety symptom severity. RESULTS: While mean levels of depression and anxiety symptoms did not change from before to during the first wave of the COVID-19 pandemic (e.g., the mean of depressive symptoms was 9.30 in 2018 and 9.59 in 2020), we observed a slight increase in rates of severe depression (scores ≥ 21) from before (6.1%) to during (8.2%) the pandemic. Most COVID-19-related variables (e.g., loss of education/occupation, frequent news-seeking) - except living alone - and most pre-existing vulnerabilities (e.g., low SES, low social support) were not associated with changes in depression or anxiety symptoms. However, results varied as a function of pre-pandemic levels of depression and anxiety: depression and anxiety symptoms increased among adults with the lowest levels of symptoms before the pandemic, while they decreased among those with the highest levels of symptoms, possibly reflecting a regression to the mean. CONCLUSIONS: Depression and anxiety symptoms in young adults from Québec in Summer 2020 were mostly comparable to symptoms reported in 2018. Most COVID-19-related stressors and pre-existing vulnerabilities were not associated with changes in symptoms, except living alone and pre-existing symptoms of depression and anxiety. However, the increased rate of severe depression warrants further investigation.