Developmental Trajectories of Religious Service Attendance: Predictors of Nicotine Dependence and Alcohol Dependence/Abuse in Early Midlife.

This longitudinal study assesses the associations between developmental trajectories of religious service attendance from mean age 14 to mean age 43 and nicotine dependence and alcohol dependence/abuse at mean age 43 (N = 548). Six trajectories of religious service attendance were identified. As compared with belonging to weekly stable trajectory group, a higher probability of belonging to the weekly/none decreasing, occasional stable, and non-attendance trajectory group was significantly associated with a higher likelihood of nicotine dependence. In addition, as compared with belonging to weekly stable trajectory group, a higher probability of belonging to the weekly/none decreasing, weekly/occasional decreasing, occasional stable, and non-attendance trajectory group was significantly associated with a higher likelihood of alcohol dependence/abuse. These findings are consistent with the hypothesis that religious service attendance protects against nicotine dependence and alcohol dependence/abuse in early midlife.

Adolescent risk and protective factors predicting triple trajectories of substance use from adolescence into adulthood.

OBJECTIVES: Since the number of individuals who use substances in the United States has markedly increased every year, substance use is a significant public health concern. The current study examines the possible risk and protective factors associated with triple comorbid trajectories of longitudinal alcohol, tobacco, and cannabis use from age 14 to 36. METHODS: A community sample of 674 participants (53% African Americans and 47% Puerto Ricans; 60% females) were recruited from the Harlem Longitudinal Development Study. Multinomial logistic regression analyses were conducted to examine the associations between the risk (low self-control, peer drug use) and protective (parent-child attachment, family church attendance) factors at age 14 and membership in the triple trajectory groups derived from a multivariate growth mixture model. RESULTS: Low self-control and peer drug use were associated with an increased likelihood of being a member in the triple comorbid trajectory groups compared to the reference group (i.e., low alcohol, no tobacco, and no cannabis use). On the other hand, parent-child attachment and family church attendance were associated with a decreased likelihood of being a member in the triple comorbid trajectory groups compared to the reference group. CONCLUSIONS: Treatment programs for adolescents who use substances may be more helpful if their parents and/or friends could also participate together with the adolescent, rather than only the adolescent participates in the treatment programs. Further research is needed to gain a greater understanding of the conceptual nature of the relationship between earlier risk and protective factors and later substance use patterns.

Longitudinal Smoking Patterns: Do They Predict Symptoms of ADHD in Adults?

Objective: The objective of this study was to assess whether comparisons of longitudinal smoking trajectories predict differences in symptoms of ADHD in adults. Method: Participants were interviewed 7 times between 14 and 43 years of age. ADHD symptoms at outcome were assessed with the World Health Organization ADHD Self-Report Scale. Bivariate and multivariate linear regression analyses assessed the associations between the trajectories of smoking and ADHD symptoms. Results: The multivariate analysis (R2 = .12) indicated that compared with being nonsmokers, the probability of being in the heavy/continuous group (standardized regression coefficient [SRC] = .17, p < .01) and in the late starter group (SRC = .11, p < .05) were significantly associated with adult ADHD symptoms. Conclusion: Longitudinal smoking patterns were associated with ADHD symptoms in adults. Chronic smoking jeopardizes both physical health and the ability to fulfill adult roles as employees, family members, and friends. Smoking cessation in adolescence may lessen the likelihood of ADHD symptoms in adulthood.

Single and dual diagnoses of major depressive disorder and posttraumatic stress disorder predicted by triple comorbid trajectories of tobacco, alcohol, and marijuana use among urban adults.

Background: The adverse consequences of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) affect a significant portion of the US population every year (i.e., 15 million for MDD; 8 million for PTSD) and are of public health concern. The current study examines tobacco, alcohol, and marijuana use as possible longitudinal predictors of MDD and/or PTSD. Methods: A community sample of 674 participants (53% African Americans and 47% Puerto Ricans; 405 females and 269 males) were recruited from the Harlem Longitudinal Development Study. We used Mplus software to obtain the triple trajectories of tobacco, alcohol, and marijuana use from mean age 14 to 36. Logistic regression analyses were then conducted to examine the associations between those triple trajectory groups and a single diagnosis of MDD or PTSD as well as a dual diagnosis of MDD with PTSD at age 36. Results: The observed percentages of MDD, PTSD, and the comorbidity of MDD and PTSD were 17%, 8%, and 5%, respectively. The heavy use of all 3 substances group was associated with an increased likelihood of having MDD (adjusted odds ratio [AOR] = 3.14, P < .01), PTSD (AOR = 3.91, P < .05), and MDD with PTSD (AOR = 6.64, P < .01), as compared with the tobacco and alcohol use group. Conclusions: Treatment programs to quit or reduce the use of tobacco, alcohol, and marijuana may help decrease the prevalence of MDD and PTSD. This could lead to improvements in individualized treatments for patients who use tobacco, alcohol, and marijuana and who have both MDD and PTSD.

Sexual risk behaviors in African American and Puerto Rican women: Impulsivity and self-control.

Millions of people are living with the human immunodeficiency virus (HIV). African American and Hispanic/Latino communities suffer the most severe burden of HIV in the US. The ultimate goal of this study was to better understand risk factors for this infection: Do impulsivity and self control operate independently or synergistically with respect to HIV sexual risk behaviors in women? An enhanced understanding of these risk factors may better inform future interventions. Among the total of 343 female participants, half were African American and the other half were Latina. Data in this study were collected in the area of New York City during 2014-2016, when the mean age of the participants was 39 years. Linear regression analyses were used to examine the associations of impulsivity and self control with HIV sexual risk behaviors. Impulsivity and self control were independently associated with most of the HIV sexual risk behaviors examined. In addition, the interaction terms between impulsivity and low self control were all significantly associated with each of the sexual risk behaviors. Prevention programs should consider incorporating the roles of impulsivity and self control simultaneously as related to HIV risk behaviors.

Season of birth: A predictor of ADHD symptoms in early midlife.

OBJECTIVE: In this longitudinal study, we applied linear regression analyses to examine season of birth as related to symptoms of attention deficit/hyperactivity disorder (ADHD) in early midlife. METHOD: We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. FINDINGS: The findings indicate that, as compared with participants who were born in the summer, those who were born in the spring (Beta = 0.34; t-statistic = 3.59; p < 0.001) had significantly more ADHD symptoms. In addition, exposure to maternal cigarette smoking in adolescence significantly intensified (p < 0.01) the association between season of birth and ADHD symptoms in early midlife. CONCLUSION: These findings suggest that exposure to greater maternal maladaptive behaviors, such as cigarette smoking, may result in a greater vulnerability to other environmental risk factors, such as season of birth.

Trajectories of cannabis use beginning in adolescence associated with symptoms of posttraumatic stress disorder in the mid-thirties.

BACKGROUND: Posttraumatic stress disorder (PTSD) symptoms are related to a number of adverse consequences such as substance use and general medical conditions. The present longitudinal study seeks to find the longitudinal patterns of cannabis use as precursors of PTSD symptoms. Such information will serve as a guide for intervention programs for PTSD. METHODS: Growth mixture modeling was conducted to identify the cannabis use trajectory groups using a community sample of 674 participants (53% African Americans, 47% Hispanics of Puerto Rican decent; 60% females) from the Harlem Longitudinal Development Study. Logistic regression analyses were performed to examine the association between earlier trajectories of cannabis use (ages 14 to 36) and later symptoms of PTSD (at age 36) for the full model including the entire sample (N = 674) as well as the reduced model including only participants who had experienced a traumatic event (n = 205). RESULTS: Five trajectory groups of cannabis use were obtained. The chronic use group (full model: adjusted odds ratio [AOR] = 4.68, P < .01; reduced model: AOR = 4.27, P < .05), the late quitting group (full model: AOR = 6.18, P < .01; reduced model: AOR = 6.67, P < .01), and the moderate use group (full model: AOR = 3.97, P < .01; reduced model: AOR = 3.32, P < .05) were all associated with an increased likelihood of having PTSD symptoms at age 36 compared with the no use group. CONCLUSIONS: The findings provide information that PTSD symptoms in the mid-30s can possibly be reduced by decreasing membership in the chronic cannabis use trajectory group, the late quitting trajectory group, and the moderate cannabis use trajectory group.

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.

The association between alcohol use trajectories from adolescence to adulthood and cannabis use disorder in adulthood: a 22-year longitudinal study.

BACKGROUND: Due to the increasing prevalence of cannabis use disorder (CUD), the impact of cannabis use on public health may be significant. OBJECTIVE: The present study seeks the possible precursors (e.g., alcohol use) of CUD in order to minimize the potential negative consequences of CUD such as impaired coordination and performance. METHOD: The Harlem Longitudinal Development Study included 674 participants (53% African Americans, 47% Puerto Ricans), with 60% females (n=405) from a six wave survey. We used a growth mixture model to obtain the trajectories of alcohol use from the mean ages of 14 to 36. To examine the associations between alcohol use trajectories and CUD, we used logistic regression analyses with the indicator of CUD as the dependent variable and the indicator of membership in each trajectory group as the independent variables. RESULTS: A three alcohol use trajectory group model was selected. Male gender, higher frequency of cannabis use in adolescence, and a lower educational level were associated with an increased likelihood of having CUD. Membership in the increasing alcohol use group (OR=27.44, p < .01; AOR=15.54, p < .01) and the moderate alcohol use group (OR=10.40, p < .05; AOR=8.63, p < .05) were associated with an increased likelihood of having CUD compared with the membership in the no or low alcohol use group. CONCLUSIONS: The findings of our study support the hypothesis that addressing alcohol use at an early age could impact later CUD.

Psychosocial Factors Related to the Intergenerational Transmission of Externalizing Behaviors in Early Midlife.

BACKGROUND: To study the intergenerational transmission of externalizing behaviors. METHODS: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from mothers at mean age 40 and from their children from adolescence (mean age = 14, SD = 2.8) to early midlife (mean age = 43, SD = 2.8) at seven time points. Structural equation modeling (SEM) was used to study the psychosocial factors as related to externalizing behaviors in early midlife. RESULTS: First, maternal externalizing behaviors were indirectly associated with the offspring's externalizing behaviors through the offspring's substance use in adolescence, the offspring's partner's smoking patterns, and the offspring's marital conflict. Second, maternal cigarette smoking was indirectly associated with the offspring's externalizing behaviors through the offspring's substance use in adolescence, the offspring's partner's cigarette smoking, and the offspring's marital conflict. Third, maternal marital conflict had an indirect effect on the offspring's externalizing behaviors, mediated by offspring marital conflict. CONCLUSIONS: The finding that externalizing behaviors can be transmitted from parent to child informs the need for family-based interventions that are appropriate to adolescents.

Lack of Preventive Health Behaviors in the Early Forties: The Role of Earlier Trajectories of Cigarette Smoking From Adolescence to Adulthood.

OBJECTIVE: To study the degree to which individuals in different trajectories of cigarette smoking from adolescence to the early forties are similar or different in terms of lack of preventive health behaviors (e.g., underuse of preventive health services, unhealthy eating habits) in early midlife. METHODS: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from adolescence to early midlife (mean age = 43 years, standard deviation [SD] = 2.8) at seven time points. Using growth mixture modeling, we statistically identified the number of smoking trajectories. Logistic regression analysis was used to study the relationship between the probabilities of participants' smoking trajectory group membership and lack of preventive behaviors in early midlife. RESULTS: Five trajectory groups of cigarette smokers were identified. With controls, as compared with the nonsmoker trajectory group, higher probabilities of belonging to the heavy/continuous smoker trajectory group and the late starter trajectory groups were significantly associated with a higher likelihood of lack of preventive health behaviors (adjusted odds ratio [AOR] = 3.49 and 4.02 respectively). In addition, as compared to the quitter/decreaser trajectory group, higher probabilities of belonging to the heavy/continuous smoker trajectory group and the late starter trajectory group were also significantly associated with a higher likelihood of lack of preventive health behaviors (AOR = 3.51 and 4.04 respectively). CONCLUSIONS: Intervention programs may consider focusing on heavy/continuous smokers and late starters in programs designed to promote adequate use of preventive health services and healthy general lifestyles in early midlife.

Compulsive buying and quality of life: An estimate of the monetary cost of compulsive buying among adults in early midlife.

The aims of this study were to examine the associations between compulsive buying and quality of life and to estimate the monetary cost of compulsive buying for a cohort of men and women at mean age 43. Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. Linear regression analyses showed that compulsive buying was significantly associated with quality of life, despite controlling for relevant demographic and psychosocial factors. The estimated monetary cost of compulsive buying for this cohort was significant. The fact that the monetary cost of CB is not trivial suggests that individuals are both consciously and unconsciously plagued by their CB. The findings are important for interventionists and clinicians for cost-effective intervention and treatment programs.

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.

Substance Use and the Number of Male Sex Partners by African American and Puerto Rican Women.

BACKGROUND: In the United States (US), there are 19 million new sexually transmitted disease (STD) infections each year. Untreated STDs can lead to serious long-term adverse health consequences, especially for young women. Centers for Disease Control and Prevention estimates that undiagnosed and untreated STDs cause at least 24,000 women in the US each year to become infertile. This clearly is a public health issue of great concern for young women. MATERIALS AND METHODS: The current cross-sectional study included a community sample consisting of 343 female participants (50% African Americans, 50% Puerto Ricans) at their mean age of 39 years. Regression analyses were conducted to examine the associations of time-varying factors within-person (e.g., substance use) and fixed effects factors between-persons (e.g., race/ethnicity) with the number of male sexual partners. RESULTS: Alcohol use (b=0.14, p<0.01), cannabis use (b=1.10, p<0.01), marital status - unmarried (b=-0.16, p<0.05), and race/ethnicity - African American (b=-0.20, p<0.01) were significantly related to having a higher number of male sex partners in the past year. CONCLUSIONS: From a public health perspective, treatment and prevention programs for sexual risk behavior focused on substance use as well as socio-cultural factors (i.e., marital status, race/ethnicity) may be more effective than programs focused only on substance use.

ADHD, Conduct Disorder, Substance Use Disorder, and Nonprescription Stimulant Use.

OBJECTIVE: To assess whether the relationship of an ADHD diagnosis by adolescence to nonprescription stimulant use in adulthood is direct or indirect, via Conduct Disorder (CD) and/or Substance Use Disorder (SUD). METHOD: Data were obtained from multiple waves of interviews and questionnaires completed by 551 community-based participants when they were between the mean ages of 14.1 and 36.6 years. RESULTS: The results of the structural equation model (SEM) supported both a direct association between early ADHD and later nonprescription stimulant use ( B = .18, z = 2.74) and the relationship from ADHD to later nonprescription stimulant use ( B = .01, z = 1.72) via CD and SUD. CONCLUSION: The longitudinal data supporting these paths suggest that efforts to prevent and treat the misuse of nonprescription stimulants may be more effective if attention is paid to those with a history of ADHD, as well as to those who also had CD and SUD.

Adolescent predictors of alcohol use in adulthood: A 22-year longitudinal study.

BACKGROUND AND OBJECTIVES: The excessive consumption of alcohol is a major issue in the United States and elsewhere. It is associated with a number of adverse health consequences, as well as difficulty in relationships and employment. Therefore, the present longitudinal study investigates the direct and indirect adolescent predictors of alcohol use in adulthood. METHODS: Among the 674 participants (53% African Americans, 47% Puerto Ricans), 60% were females (n = 405). Mplus software was used to perform structural equation modeling. RESULTS: Parental problems with alcohol use in the participants' late adolescence were related to low parent-child attachment in late adolescence, which in turn, was related to self delinquency in late adolescence. This was related to peer delinquency in emerging adulthood, which in turn, was associated with alcohol use in emerging adulthood and in adulthood. Low parent-child attachment in late adolescence was also related to low satisfaction with school in late adolescence, which in turn, was related to self delinquency in late adolescence. This was associated with alcohol use in emerging adulthood, which in turn, was associated with alcohol use in adulthood. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: One of the key implications of this study is that an impaired low parent-child attachment relationship is a determinant of children's engagement in delinquent behavior and ultimately the use of alcohol in adult life. Implications for social interventions from the findings of the current study were also discussed. (Am J Addict 2016;25:549-556).

Tobacco and alcohol use among adolescents in South Africa: shared and unshared risks.

OBJECTIVE: Tobacco and alcohol use by adolescents are major public health concerns in South Africa. However, the extent to which key psychosocial risk factors for tobacco use and alcohol use by adolescents in South Africa are shared or unshared is unclear. This study sought to examine the shared and unshared risk factors for tobacco and alcohol use among adolescents in Johannesburg. METHOD: Participants comprised 736 males and females aged 12-17 years who were recruited via a household survey conducted during 2004. The participants were interviewed using a questionnaire comprising measures of personal, family (parental bonding and family legal drug use) and contextual (school and neighbourhood) factors. Separate multiple logistic regression analyses were conducted to predict lifetime alcohol use and lifetime tobacco use from variables within each domain (personal, family and contextual), controlling for demographic factors. RESULTS: Personal, family (parental bonding) and contextual factors (school factors) were primarily shared risk factors for tobacco and alcohol use, while family legal drug use and neighbourhood factors were largely unshared. CONCLUSIONS: Interventions addressing personal, parenting and schooling factors are likely to have an impact on preventing both tobacco and alcohol use, whereas interventions focused on ameliorating family drug use and neighbourhood factors may need to be more substance-specific.

Psychosocial Factors Related to Underuse of Medical Services.

In this longitudinal study, we applied structural equation modeling (SEM) to examine the historical, predisposing, enabling/barrier, and need factors as related to the underuse of medical services during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. The findings supported a mediational model: A mutually affectionate parent-child relationship in early adolescence was inversely related to underuse of medical services in early midlife via the mediational roles played by later predisposing factors (i.e., depressive mood and cigarette smoking), need factor (i.e., physical health problems), barriers (i.e., financial difficulty), and enabling factors (i.e., social support for health services in early midlife). In addition, satisfaction with medical services in the neighborhood had an association with less underuse of medical services in early midlife. Family therapy focused on an increase in the affectionate relationship between the adolescents and his/her parents and cognitive-behavioral treatment of depressive mood may lead to a decrease in the underuse of medical services.

Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder.

OBJECTIVE: To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. METHOD: A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. RESULTS: Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. CONCLUSIONS: In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder.