Longitudinal pathways from unconventional personal attributes in the late 20s to cannabis use prior to sexual intercourse in the late 30s.

A quarter of people living with human immunodeficiency virus (HIV) infection in the United States are women. Furthermore, African American and Hispanic/Latina women continue to be disproportionately affected by HIV, compared with women of other races/ethnicities. Cannabis use prior to intercourse may be associated with increased risky sexual behaviors which are highly related to HIV. The ultimate goal of this research is to better understand the relationships between unconventional personal attributes (e.g., risk-taking behaviors) in the late 20s, substance use (e.g., alcohol) in the mid 30s, and cannabis use prior to intercourse in the late 30s using a community sample; such an understanding may inform interventions. This study employing data from the Harlem Longitudinal Development Study includes 343 female participants (50% African Americans, 50% Puerto Ricans). Structural equation modeling indicated that unconventional personal attributes in the late 20s were associated with substance use in the mid 30s (ß=0.32, p<0.001), which in turn, was associated with cannabis use prior to sexual intercourse in the late 30s (ß=0.64, p<0.001). Unconventional personal attributes in the late 20s were also directly related to cannabis use prior to sexual intercourse in the late 30s (ß=0.39, p<0.01). The findings of this study suggest that interventions focused on decreasing unconventional personal attributes as well as substance use may reduce sexual risk behaviors among urban African American and Puerto Rican women. Also, the implications of this study for health care providers and researchers working in HIV prevention are that these precursors may be useful as patient screening tools.

Joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s predicting generalized anxiety disorder.

The current study examines longitudinal patterns of cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicators of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s were used as the independent variables, and the diagnosis of generalized anxiety disorder in the mid-30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having generalized anxiety disorder as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of generalized anxiety disorder.

Trajectories of Cigarette Smoking Beginning in Adolescence Predict Insomnia in the Mid Thirties.

BACKGROUND: Insomnia is increasingly recognized as a public health concern in modern society. Insomnia diagnoses appear to be increasing and are associated with poor health outcomes. They may cost $100 billion annually in health services. OBJECTIVE: Given the adverse consequences of insomnia such as cardiovascular disease, diabetes, and depression, the present study was designed to examine the relationship of the trajectories of earlier cigarette smoking and later insomnia. The ultimate goal is to reduce the prevalence of insomnia. METHODS: 674 participants (53% African Americans, 47% Puerto Ricans, 60% females) were surveyed at 6 points in time. We employed the growth mixture model to obtain the trajectories of cigarette smoking from age 14 to 32. We used logistic regression analyses to examine the associations between the trajectories of smoking and insomnia. RESULTS: Males were less likely to have insomnia than females (Adjusted odds ratio: AOR = 0.34, p < .05). A higher Bayesian posterior probability (BPP) for the chronic smoking trajectory group (AOR = 2.69, p < .05) and for the moderate smoking trajectory group (AOR = 5.33, p < .01) was associated with an increased likelihood of having insomnia at age 36 compared with the BPP of the no or low smoking trajectory group. CONCLUSIONS: Prevention and treatment programs for individuals who suffer from insomnia should be implemented in parallel with programs for smoking cessation. From a public health perspective, our longitudinal study that examined the association between earlier smoking trajectories and later insomnia suggests that treatments designed to reduce or cease smoking may lessen the occurrence of symptoms of insomnia.

Conjoint trajectories of depressive symptoms and delinquent behavior predicting substance use disorders.

AIMS: This study examines the conjoint trajectories of depressive symptoms and delinquent behavior from adolescence (age 14) into young adulthood (age 24) as predictors of substance use disorders (SUDs) in adulthood (age 32). METHODS: Of the 816 participants, 52% were African Americans, and 48% were Puerto Ricans. After we obtained the conjoint trajectory groups using Mplus, we performed logistic regression analyses using SAS to compare the Bayesian Posterior Probability (BPP) of each of the conjoint trajectory groups with the BPP of the reference conjoint trajectory group to predict SUDs. RESULTS: Four conjoint trajectory groups were obtained. The higher BPPs of both the high depressive symptoms and low delinquent behavior trajectory group (AOR=3.54, p<.05) and the medium depressive symptoms and high delinquent behavior trajectory group (AOR=10.28, p<.001), as compared with the BPP of the low depressive symptoms and low delinquent behavior trajectory group, were associated with an increased likelihood of SUDs in adulthood. These associations were maintained with control on gender, ethnicity, the use of alcohol, cigarettes, and marijuana, socioeconomic status (SES) at age 14, and income and educational level at age 36. CONCLUSIONS: Prevention and treatment of delinquent individuals reporting SUDs might be more effective if their depressive symptoms were also addressed. Similarly, prevention and treatment of depressed individuals reporting SUDs might be more effective if their delinquent behavior was also addressed.

Utilization of mental health services by minority urban adults: psychosocial predictors.

Although most mental disorders have their first onset by young adulthood, there are few longitudinal studies of these problems and related help-seeking behavior. The present study examined some early and current predictors of the use of mental health services among African-American and Puerto Rican participants in their mid-30s. The 674 participants (52.8 % African Americans, 47.2 % Puerto Ricans; 60.1 % women) in this study were first seen in 1990 when the participants attended schools serving the East Harlem area of New York City. A structural equation model controlling for the participants' gender, educational level in emerging adulthood, and age at the most recent data collection showed significant standardized pathways from both ethnicity (ß = -0.28; z = -4.82; p < 0.001) and psychological symptoms (ß = 0.15; z = 2.41; p < 0.05), both measured in emerging adulthood, to smoking in the early 30s. That, in turn, was associated with certain physical diseases and symptoms (i.e., respiratory) in the mid-30s (ß = 0.16; z = 2.59; p < 0.05). These physical diseases and symptoms had a cross-sectional association with family financial difficulty in the mid-30s (ß = 0.21; z = 4.53; p < 0.001), which in turn also had a cross-sectional association with psychiatric disorders (ß = 0.30; z = 5.30; p < 0.001). Psychiatric disorders had a cross-sectional association with mental health services utilization (ß = 0.65; z = 13.25; p < 0.001). Additional pathways from the other domains to mental health services utilization in the mid-30s were also supported by the mediating role of psychiatric disorders. Results obtained from this research offer theoretical and practical information regarding the processes leading to the use of mental health services.

Longitudinal determinants of substance use disorders.

Substance use and substance use disorders (SUDs) have been linked with marital discord. Relatively little is known, however, about the antecedents of SUDs, the mediators of these factors over time, or their associations with the spousal/partner relationship among urban adults. A better understanding of the longitudinal pathways to marital conflict and to SUDs should help prevention and intervention programs target their precursors within the developmental period in which they occur. The present study, therefore, examined the longitudinal predictors of an unsupportive spousal/partner relationship and SUDs among a community sample of urban African American and Puerto Rican adults from East Harlem, NY. Participants (N = 816) completed structured questionnaires at five time waves, from adolescence to adulthood (mean ages = 14, 19, 24, 29, and 32 years). Structural equation modeling examined the effects of earlier environmental and social stressors and intrapersonal and interpersonal factors on later SUDs in adulthood. There was a good fit of the structural equation model (CFI = 0.91; RMSEA = 0.06; and SRMR = 0.06), which revealed three main pathways from adolescence to the spousal/partner relationship and SUDs in adulthood. One pathway linked a weak parent-adolescent attachment relationship with the participant's psychological symptoms in emerging adulthood (p < 0.01), which in turn were related to affiliation with deviant and drug-using peers, also in emerging adulthood (p < 0.001). Peer deviance and drug use were associated with the participant's substance use in young adulthood (p < 0.001), which predicted both an unsupportive spousal/partner relationship (p < 0.05) and SUDs (p < 0.001) later in adulthood. Other pathways highlighted the continuity of psychological symptoms as related to both substance use in young adulthood (p < 0.001) and an unsupportive spousal/partner relationship in adulthood (p < 0.001). Findings showed that the associations of both distal stressors and the parent-adolescent relationship with more proximal intra- and interpersonal problems predicted unsupportive spousal/partner relationships and SUDs among urban adults. Several aspects of the individual's life, at different developmental stages, provide opportunities for interventions to prevent or reduce unsupportive spousal/partner relationships and SUDs.

Developmental trajectories of marijuana use from adolescence to adulthood: personality and social role outcomes.

Longitudinal trajectories of marijuana use from adolescence into adulthood were examined for adverse life-course outcomes among African-Americans and Puerto Ricans. Data for marijuana use were analyzed at four points in time and on participants' personality attributes, work functioning, and partner relations in adulthood using growth mixture modeling. Each of the three marijuana-use trajectory groups (maturing-out, late-onset, and chronic marijuana-users) had greater adverse life-course outcomes than a nonuse or low-use trajectory group. The chronic marijuana-use trajectory group was highly associated with criminal behavior and partners' marijuana use in adulthood. Treatment programs for marijuana use should also directly address common adverse life-course outcomes users may already be experiencing.

Developmental associations between externalizing behaviors, peer delinquency, drug use, perceived neighborhood crime, and violent behavior in urban communities.

This study examines the precursors of violent behavior among urban, racial/ethnic minority adults. Data are from an on-going study of male and female African Americans and Puerto Ricans, interviewed at four time waves, Time 1-Time 4 (T1-T4), from adolescence to adulthood. Structural Equation Modeling was used to analyze the developmental pathways, beginning in mid-adolescence (T1; age = 14.0 years), to violent behavior in adulthood (T4; age = 29.2 years). The variables assessed were: components of externalizing behaviors (i.e., rebelliousness, delinquency; T1, T3); illicit drug use (T2); peer delinquency (T2); perceived neighborhood crime (T4); and violent behavior (T3, T4). Results showed that the participants' externalizing behaviors (rebelliousness and delinquency) were relatively stable from mid-adolescence (T1; age = 14.0 years) to early adulthood (T3; age = 24.4 years). The participants' externalizing behaviors in mid-adolescence also had a direct pathway to peer delinquency in late adolescence (T2; age = 19.1 years). Peer delinquency, in turn, had a direct pathway to the participants' illicit drug use in late adolescence (T2), and to externalizing behaviors in early adulthood (T3). The participants' illicit drug use (T2; age = 19.1 years) had both direct and indirect paths to violent behavior in adulthood (T4). The participants' externalizing behaviors in early adulthood (T3) were linked with violent behavior at T3, and perceived neighborhood crime (T4), both of which had direct pathways to violent behavior in adulthood (T4). The findings suggest developmental periods during which externalizing behaviors, exposure to delinquent peers, illegal drug use, and neighborhood crime could be targeted by prevention and intervention programs in order to reduce violent behavior.

A three-generational study of risk factors for childhood externalizing behavior among African Americans and Puerto Ricans.

This is the first prospective study to examine the precursors of child externalizing behavior across three generations of African Americans and Puerto Ricans. Participants comprised a community cohort of male and female African Americans and Puerto Ricans (N = 366, X⁻ age = 29.4 years), who are part of an ongoing study of drug use and problem behaviors, and who had a child. Data were collected at four time waves, spanning the participants' adolescence to adulthood. Questionnaires were initially self-administered in schools in East Harlem, NY, USA (time 1). Subsequently, structured interviews were conducted by trained interviewers (times 2 and 3), and self-administered via mail (time 4). The independent variables consisted of the participants' prospective reports of their (a) relationships with their parents during adolescence, (b) depressive mood and drug use (adolescence to adulthood), (c) relationship with their oldest child between the ages of 6-13, and (d) perceptions of neighborhood crime and deterioration (in adulthood). The dependent variable was externalizing behavior in the participant's oldest child (X⁻ age = 9.6 years; SD = 2.0). Structural equation modeling showed that the parent-child relationship during participants' adolescence was linked with the participants' depressive mood and drug use which, in turn, were associated with the participants' relationship with their own child, as well as with neighborhood crime and deterioration when participants were adults. The participants' depressive mood, and relationship with their own child, as well as neighborhood crime and deterioration, each had a direct pathway to externalizing behavior in the participant's child. Findings suggest that intervention programs and public policy should address parental attributes, neighborhood factors, and, especially, parenting skills, to reduce risk factors for the intergenerational transmission of externalizing behavior.

Ecology and drug use: universal predictors across time and place.

The interrelation of ecological and psychosocial risk factors and adolescent marijuana use is examined in this three-sample longitudinal data analysis. Participants included (a) white children from the northeast of the USA, (b) African-American and Puerto Rican adolescents from New York City, and (c) adolescents living in Colombia, South America. Adolescents were interviewed in their homes. Independent measures were from the ecological, personality, peer, and family domains. Logistic regression analysis showed that the majority of ecological variables was related to adolescent marijuana use. Hierarchical regression analysis demonstrated that the ecological domain was directly and indirectly related to adolescent marijuana use (via the family, peer, and personality domains). Intervention programs should focus on adolescents' unique ecological settings while targeting universal risk factors (e.g., low ego integration, low parental identification) which predict adolescents' marijuana use. Similarities among the ecological predictors of adolescents' marijuana use in three samples, across time and place, allow a more universal approach to the prevention of substance use.

Earlier violent television exposure and later drug dependence.

This research examined the longitudinal pathways from earlier violent television exposure to later drug dependence. African American and Puerto Rican adolescents were interviewed during three points in time (n = 463). Exposure to violent television programs in late adolescence predicted exposure to violent television programs in young adulthood, which in turn was related to tobacco/marijuana use, nicotine dependence, and later drug dependence. Some policy and clinical implications suggest regulating the times when violent television programs are broadcast, creating developmentally targeted prevention/treatment programs, and recognizing that watching violent television programs may serve as a cue regarding increased susceptibility to nicotine and drug dependence.

Growing up in a violent society: longitudinal predictors of violence in Colombian adolescents.

Although violence and homicide are more prevalent in Colombia, South America than the US, the role of psychosocial factors in the violent behavior of Colombian adolescents remains unclear. The aim of this longitudinal study was to examine the interrelation of domains of personality, familial, peer, and ecological variables associated with violence in a community sample of adolescents from various self-reported ethnic groups in Colombia. The sample consisted of 1,151 male adolescents selected from three Colombian cities. The participants were surveyed using structured interviews at two points in time over a 2-year interval. Data were collected concerning adolescent personal attributes, family characteristics, peer, and ecological factors, including drug availability and the prevalence of violence in the community. The dependent variable was the self-reported frequency of the adolescent's violent behavior. The results supported a model in which violent behavior was correlated independently over time with a number of risk factors from several domains. Evidence for the hypothesized mediated effects of the familial monitoring and bonding domain, the peer domain, the ecological domain, and prior victimization related to personal attributes and contemporaneous violence and the adolescent's violent behavior 2 years later was also found. The findings suggest the use of specific intervention procedures with adolescents to prevent their subsequent violent behavior.

Tobacco use in adolescence: longitudinal links to later problem behavior among African American and Puerto Rican urban young adults.

In this study, the authors assessed the relationship between adolescent tobacco smoking and measures of inner control, deviant behavior, and associating with deviant peers, which are indicators of problem behavior. African American (N = 333) and Puerto Rican (N = 329) early adolescents completed questionnaires in their classrooms in 1990 at Time 1 (T1) and were individually interviewed thereafter when they were late adolescents in 1995 at Time 2 (T2) and as young adults in 2000 at Time 3 (T3). The authors used ordinary least squares regression analysis to assess the comparative association of adolescent smoking patterns at T1 and T2 and the young adult outcomes at T3; they controlled for demographic variables, level of the outcome measure at T2, and marijuana use at T2. The analyses suggested that experimental tobacco smokers demonstrated more problem behaviors than did nonsmokers, and late and continuous smokers demonstrated more problem behaviors as young adults than did experimental smokers and nonusers. These findings may provide a useful guide to a next step that involves translational research.

Correlates of aggression in African American and Puerto Rican children.

The authors examined a cross-sectional interrelationship of psychosocial domains as they relate to aggression in a group of African American and English-speaking Puerto Rican children living in New York City. The population included 80 biological children of African American and Puerto Rican young adults who had been participating in the authors' ongoing longitudinal study, and 77 mothers or mother substitutes (rearing mothers) of those children. The authors performed hierarchical multiple regression analysis. The results indicated that (a) the child's personality and maternal attributes were significantly related to the child's aggression, despite control on all of the other domains and (b) the ethnic identification and discrimination domain was no longer related to the child's aggression with control on the mother-child relationship domain or on the child's personality domain. The findings have implications for clinical practice and public policy.

Early risk factors for violence in Colombian adolescents.

OBJECTIVE: Violence and homicide are more prevalent in Colombia, South America, than in the United States, but the role of psychosocial factors in the violent behavior of Colombian adolescents remains unclear. The objective of the study was to identify personality, familial, peer, and ecological variables associated with violence in Colombian adolescents. METHOD: A survey of adolescents was conducted in 1995-1996. A standard self-report measure was adapted to ensure linguistic and cultural relevance. A total of 2,837 adolescents ages 12-17 years from various self-reported ethnic groups were randomly selected from the community in three Colombian cities: Bogota, Medellin, and Barranquilla. Eighty percent of eligible adolescents agreed to participate. Data were collected concerning the adolescent's personality attributes, family characteristics, peer characteristics, and ecological/cultural factors, including the availability of illicit drugs and the prevalence of violence in the community. The dependent variable was the adolescent's self-reported frequency of violent behavior. RESULTS: Violence directed at the adolescent and the adolescent's own drug use were both more highly correlated with the adolescent's violent behavior than were other risk factors. Significant risk factors of less importance included tolerance of deviance, peer drug use, peer deviance, and exposure to violence on television. CONCLUSIONS: The results supported a model in which violent behavior was correlated independently with a number of risk factors from several domains. The findings point to the use of specific intervention procedures for adolescents to prevent their own subsequent acts of violent behavior.

Earlier marijuana use and later problem behavior in Colombian youths.

OBJECTIVE: The study examined the relationship between earlier adolescent marijuana use and later adolescent behavioral problems. METHOD: A community-based sample of Colombian adolescents was interviewed in 1995-1996 and 1997-1998. The time 2 (T(2)) sample consisted of 1,151 males and 1,075 females. The psychosocial measures assessed adolescent problem behavior, the peer and sibling social network, and ecological/environmental stress and cultural domains. Logistic regression analyses included controls on demographic and time 1 (T(1)) dependent measures. RESULTS: The findings suggest that T(1) adolescent marijuana use was associated with increased risks for T(2) adolescent difficulty at work or school, violent experiences, peer marijuana use, and sibling marijuana problems. CONCLUSIONS: This study provides important evidence in this cohort of the specific relationship between T(1) adolescent marijuana use and T(2) adolescent problem behavior in a society in which drug use, crime, violence, and low educational attainment are pervasive. Similar findings have been shown in previous research with U.S. adolescents. The findings suggest that early adolescent marijuana use is associated with an increase in problem behavior during later adolescence.

The longitudinal relationship between drug use and risky sexual behaviors among colombian adolescents.

OBJECTIVE: To identify the longitudinal relationships between drug use and risky sexual behaviors and early pregnancy in Colombian adolescents. DESIGN: Confidential survey of adolescents, consisting of structured individual interviews, at 2 time points, 2 years apart. A standard self-report questionnaire was adapted to ensure linguistic and cultural relevance. SETTING: Community samples representing differing levels of risky sexual behavior and drug use. Cohorts were drawn from higher- and lower-risk geographic areas and from various self-reported ethnic groups. PARTICIPANTS: Adolescents (N = 2226) randomly selected from 3 major Colombian cities: Bogotá, Medellín, and Barranquilla. MAIN OUTCOME MEASURES: Data were collected concerning adolescent drug use, sexual behaviors, and a history of pregnancy. The youths' drug use included measures of all illegal drugs. RESULTS: By using regression analyses (controlling for demographic variables) a reciprocal longitudinal relationship between risky sexual behaviors and drug use was identified. Those adolescents who reported higher levels of drug use at time 1 also had more sexual partners, had higher frequencies of unprotected sex, and were more likely to have experienced early pregnancy at time 2. The reverse relationship was true as well. The level of violence experienced by the adolescent emerged as a moderator of some of these relationships. CONCLUSIONS: Reducing adolescent drug use may also reduce levels of risky sexual behavior and early pregnancy and vice versa. Furthermore, the importance of addressing violence as a risk factor for both problem behaviors is emphasized.

Correlates of marijuana use in Colombian adolescents: a focus on the impact of the ecological/cultural domain.

To examine the influence of ecological/cultural factors and family, personality, and peer factors present during early adolescence that influence marijuana use in late adolescence. A community sample of 2,226 Colombian adolescents living in mixed urban-rural communities and their mothers were interviewed in their homes by trained Colombian interviewers, first in 1995-1996 and then again 2 years later. The scales used were based on item intercorrelations and grouped into the following categories: (a) adolescent personality, (b) family traits, (c) peer factors, (d) ecological/cultural variables, and (e) marijuana use. Data were examined using hierarchical regression modeling to determine the relationship between each of the domains and late adolescent marijuana use. The findings supported the family interactional theory of adolescent drug use behavior and found that factors in all of the domains had a direct effect on late adolescent marijuana use as well as indirect effects mediated through the more proximal domains in the model. Of particular interest was the strength of the influence of the ecological/cultural factors, which far exceeded that observed in similar studies done in the United States. Owing to the similarity with findings from studies conducted in the United States, interventions designed domestically could effectively be directly applied to adolescents in Colombia. The findings also suggest that prevention programs designed specifically to target ecological or cultural factors may have the most profound influence for reducing marijuana use in late adolescence.