Major Depressive Disorder as a Driver of Dual Systems Model Development During Adolescence and Emerging Adulthood Among Justice-Involved Youth: Is Salience Age-Graded?

The dual systems model is a psychological framework centered on differential development of sensation-seeking and impulse control during adolescence and emerging adulthood with implications for understanding antisocial behavior. However, there is a dearth of research which has examined mental illness as a driver of differential development of these constructs. This study examined major depressive disorder as a risk factor for elevated sensation-seeking and diminished impulse control and tested to determine whether the salience differed by age. The Pathways to Desistance data were analyzed. Mixed effects models examined the direct effect of major depressive disorder on dual systems outcomes and test for moderation by age. Findings indicated that major depressive disorder at baseline was associated with increased sensation-seeking and diminished impulse control. Relationships did not differ in salience based on age. Results suggest that treatment effective for addressing depression may have relevance for mitigating the impact of the disorder on cognition.

Major depressive disorder as a moderator of the relationship between heavy-episodic drinking and anxiety symptoms.

BACKGROUND: Major depressive disorder and heavy-episodic drinking are risk factors for the development of anxiety. However, the interactive effect between these constructs for predicting anxiety symptoms remains understudied. AIMS: This study sought to examine how major depressive disorder moderates the relationship between heavy-episodic drinking frequency and the development of anxiety symptoms in adolescence and emerging adulthood among a sample of justice-involved youth, with expectations that the salience of this relationship may differ based on life-course stage. METHODS: Several waves of the Pathways to Desistance study were analyzed. Poisson regression with robust standard errors was used to test the direct and interactive effects of major depressive disorder and heavy-episodic drinking frequency on anxiety symptoms at follow-up in adolescence and emerging adulthood separately. RESULTS: Results indicated that there was a significant negative interaction between major depressive disorder and heavy-episodic drinking frequency for predicting anxiety scores in both adolescence and emerging adulthood, though the results for adolescence were more robust. CONCLUSIONS: These results suggest youth without major depressive disorder that engage in heavy-episodic drinking may be a priority population for treating anxiety issues, but that ceiling effects may limit the impact of the behavior on anxiety on youth with major depressive disorder.

Using trajectory modeling of spatio-temporal trends to illustrate disparities in COVID-19 death in flint and Genesee County, Michigan.

COVID-19's rapid onset left many public health entities scrambling. But establishing community-academic partnerships to digest data and create advocacy steps offers an opportunity to link research to action. Here we document disparities in COVID-19 death uncovered during a collaboration between a health department and university research center. We geocoded COVID-19 deaths in Genesee County, Michigan, to model clusters during two waves in spring and fall 2020. We then aggregated these deaths to census block groups, where group-based trajectory modeling identified latent patterns of change and continuity. Linking with socioeconomic data, we identified the most affected communities. We discovered a geographic and racial gap in COVID-19 deaths during the first wave, largely eliminated during the second. Our partnership generated added and immediate value for community partners, including around prevention, testing, treatment, and vaccination. Our identification of the aforementioned racial disparity helped our community nearly eliminate disparities during the second wave.

Validating a geospatial healthfulness index with self-reported chronic disease and health outcomes.

Leveraging community engagement from past research may yield frameworks on which to build new inquiries. We previously integrated community voice into the development of a healthfulness index to increase awareness of social determinants of health in the built environment and inform deployment of public health interventions in the Flint (Michigan, USA) Center for Health Equity Solutions. Here we combine the healthfulness index with self-reported chronic disease and health outcomes (n = 12,279) from a community-based healthcare entity, the Genesee Health Plan. The healthfulness index purports to predict how health-promoting a neighborhood is based on many spatially varying characteristics; by linking our health plan data to this index, we validate the effectiveness of the healthfulness index. After geocoding all enrollees and joining their healthfulness scores, we conducted a series of logistic regressions to compare the relationship between self-reported outcomes and healthfulness. Matching the two intervention projects of our center (revolving around healthy eating & physical activity in project 1 and mental health sustainment & substance use prevention in project 2), our analyses also focused on classes of outcomes related to a) cardiovascular disease and b) mental health. In only select cases, higher (better) healthfulness scores from each project were independently associated with better cardiovascular and mental health outcomes, controlling for age, race, and sex. Generally, however, healthfulness did not add predictive strength to the association between health and sociodemographic covariates. Even so, the use of composite healthfulness indices to describe the health-promoting or degrading qualities of a neighborhood could be valuable in identifying differences in health outcomes. Future researchers could further explore healthcare claims datasets to increase understanding of the links between healthfulness and health outcomes. This and future work will be valuable in advocacy toward additional healthfulness indices to aid other communities in enriching understanding between the built environment and health.

The Role of ADHD in Predicting the Development of Violent Behavior Among Juvenile Offenders: Participation Versus Frequency.

Past research has identified attention-deficit/hyperactivity disorder (ADHD) as a risk factor for engagement in violent offending. Despite the link between the disorder and violent offending, this risk factor has yet to be examined as a predictor of heterogeneity in the development of violent offending among juvenile offenders. It is likely that the impulsivity, genetic link, and generally chronic disorder course which are characteristics of the disorder play roles in predicting violent offending, which is consistent with both self-control theory and general developmental theory related to early life deficits and life-course persistent offending. Past research has also elucidated a developmental trajectory model of violent offending, which is utilized by the present research. The present research examines ADHD as a risk factor predicting trajectory group assignment. The Pathways to Desistance data followed 1,354 juvenile offenders for 84 months following conviction for a serious offense. Using multinomial logistic regression, this study extends past research on the development of violent offending among juvenile offenders by examining ADHD as a risk factor predicting assignment to violent offending trajectory groups. Results indicate that meeting criteria for ADHD at baseline predicted membership to all trajectory groups relative to the Abstaining group when all covariates were included. This increase in risk is highest for the trajectory group characterized by the highest frequency of violent offending. This indicates the relevance of identifying and treating ADHD among juvenile offenders to best mitigate risk of violent recidivism throughout adolescence and early adulthood.

The Relevance of Victimization Experiences for Predicting the Development of Threat Symptoms During Adolescence and Early Adulthood.

The "threat" portion of the threat/control override symptom constellation is characterized by the belief by an individual that others seek to do them harm. There has yet to be an examination of the link between perceived threat symptomatology and the experience of victimization, despite the fact that both constructs are linked to the perpetration of violent behavior. Furthermore, there has yet to be research which examines the heterogeneity in developmental patterns of threat symptomatology. The present research utilized the Pathways to Desistance data to model the developmental heterogeneity in perceived threat symptomatology across adolescence and early adulthood using group-based trajectory modeling. A series of multinomial logistic regression models were then estimated to examine the relevance of victimization experiences for predicting trajectory group assignment. A five-group model of development during adolescence and early adulthood best fit the threat symptom data. Victimization experienced prior to age 16 predicted assignment to all groups in the model characterized by presentation of threat symptoms at some point during the study. Victimization experienced between ages 16 and 23 predicted assignment to the High Chronic group and marginally predicted assignment to the Accelerating group. These results indicate that victimization does indeed predict the presentation of perceived threat symptomatology. This indicates that presentation of threat symptoms may be indicative of a history of victimization. Proper screening of those presenting threat symptoms may help to better orient treatment plans for modalities centered on victimization experiences. Future research should investigate the possibility that threat symptoms mediate the relationship between victimization and violent behavior.

The Impact of PTSD-Linked Strain Sensitivity on Violent Offending: Differences in Effects During Adolescence Versus Early Adulthood.

OBJECTIVES: Investigate the relevance of post-traumatic stress disorder (PTSD)-linked strain sensitivity associated with exposure to violence for predicting violence outcomes among juvenile offenders during adolescence and early adulthood. METHODS: This study uses the Pathways to Desistance data and to test relevant relationships. Two series of negative binomial regression models were estimated to test hypotheses, one corresponding to each period of the life course. RESULTS: Results indicated that witnessed violence interacted with PTSD status in adolescence, indicating that individuals afflicted with PTSD demonstrated heightened sensitivity to this strain, manifested in increased violent offending. CONCLUSIONS: Results indicate that witnessed violence may act as a trigger during adolescence, resulting in juvenile offenders with PTSD responding with violence. This may have treatment implications for individuals suffering from PTSD.

Early Life Poly-Victimization and Differential Development of Anxiety as Risk Factors for the Continuity of Substance Dependence in Adulthood.

Background: Abuse of psychoactive substances may lead to physical and/or physiological dependence on said substances. While a great deal of research has focused on risk factors predicting onset, there has been little research focused on risk factors influencing continued dependence on substances in adulthood following onset early in life. Purpose/Objectives: The present study examined poly-victimization and developmental patterns of anxiety as predictors of continued substance dependence problems. Methods: The Pathways to Desistance data were used in the present study. A subset of this sample was used in analyses comprising 261 juvenile offenders who reported lifetime drug and/or alcohol dependence at baseline. Firth logistic regression was used to estimate the impact that covariates had on the odds that individuals in this subsample had continued substance dependence in adulthood. Results: Results indicated that increased poly-victimization score pertaining to direct victimization at baseline was associated with increased odds of continued substance dependence problems in adulthood. Further, presentation of high and chronic anxiety symptomatology during adolescence was associated with increased risk for continued dependence. Conclusions/Importance: Drug dependent adolescents who demonstrate chronic anxiety and/or have experienced polyvictimization are at-risk for continuity of dependent in adulthood. Youth should be screened for these issues and targeted with treatment.

PTSD as a Risk Factor for the Development of Violence Among Juvenile Offenders: A Group-Based Trajectory Modeling Approach.

Violent offending is a public health problem disproportionately perpetrated by adolescents. Posttraumatic stress disorder (PTSD) has been identified as a risk factor that increases an individual's odds of engaging in violent behavior. Juvenile offenders are a population indicated to be at high risk of the development and perpetuation of violent behavior across the life course. Despite the fact that PTSD also has a high prevalence among juvenile offenders, there has yet to be any research examining PTSD as a risk factor for violent offending among juvenile offenders. Furthermore, very little research has examined the development specifically of violent offending across adolescence among juvenile offenders. Using group-based trajectory modeling (GBTM), this research found four distinct violence trajectories that juvenile offenders followed through adolescence (Abstaining, Moderate Stable, Desisting, High Chronic). Using multinomial logistic regression, PTSD was found to more than double the risk of assignment to all three trajectory groups that demonstrated violent behavior at some point in adolescence relative to the Abstaining reference group. This research adds to the limited research conducted on the development of violent behavior through adolescence among juvenile offenders using the GBTM method. Furthermore, results indicate that PTSD is a risk factor for the perpetration of violent behavior. These results suggest that juvenile offenders may desist from violence even after high rates of violence have already been achieved and that screening of trauma victims may be important for providing juvenile offenders suffering from PTSD with proper treatment to mitigate risk of violent behavior.

Post-traumatic stress disorder and having antisocial peers in adolescence are risk factors for the development of antisocial personality disorder.

Antisocial personality disorder is a mental illness that is a major public health concern. Both post-traumatic stress disorder and association with antisocial peers have been found to be associated with increased risk for diagnosis of antisocial personality disorder. Despite this, past research has yet to examine the interrelatedness of these three constructs from a developmental perspective. This study sought to examine the effect of post-traumatic stress disorder in adolescence on the risk for antisocial personality disorder diagnosis in adulthood and the relevance of differences in developmental patterns of degree of association with antisocial peers in adolescence as an additional risk factor. The Pathways to Desistance data were used in analyses, comprising the longitudinal responses of 1,354 juvenile offenders who had recently been adjudicated for a serious offense prior to baseline measurement. Logistic regression was used to examine these relationships. Ever meeting criteria for post-traumatic stress disorder in adolescence significantly increased the odds of developing antisocial personality disorder in adulthood. This effect was no longer significant upon inclusion of variables pertaining to association with antisocial peers. Implications are discussed.

Developmental Trajectories of Opioid Use Among Juvenile Offenders: An Epidemiological Examination of Group Characteristics and Criminological Risk Factors.

AIMS: Investigate patterns of change and continuity in opioid use among juvenile offenders during adolescence and early adulthood. Identify demographic characteristics of trajectory groups of opioid users. Examine the relevance of risk factors for predicting assignment to opioid use trajectory groups. METHODS: The Pathways to Desistance sample, consisting of longitudinal data of 1,134 juvenile offenders, was utilized in analyses. Using group-based trajectory modeling, patterns of opioid use were identified. χ2 tests provide information about the significant differences in gender, race, and socioeconomic status composition among the subgroups. Multinomial logistic regression were estimated to identify the relevance of risk factors for predicting assignment to subgroups. RESULTS: A four-group model best fit the opioid use data (Abstaining, Low Accelerating, High Accelerating, Desisting). Race significantly delineated group membership at the bivariate level. Risk factor analysis indicated that lower self-control assessed at baseline predicted elevated risk of assignment to the Low Accelerating and High Accelerating groups. Higher frequency of marijuana use at baseline and a lifetime history of having experienced victimization was associated with assignment to the Desisting group. CONCLUSIONS: Chronic opioid use exists at elevated prevalence among juvenile offenders. Adolescents in the criminal justice system with low self-control should be targeted for intervention.

Heterogeneity in the Development of Drug Use Versatility: Risk Factors for Polydrug Use throughout the Life-Course.

BACKGROUND: Polydrug use is a major public health issue associated with numerous undesirable physical and mental health outcomes. While past research has identified risk factors for polydrug use and elevated drug use variety, there has yet to be any research which seeks to examine this phenomenon from a developmental perspective. There also has yet to be any research which examines the impact of risk factors for predicting differential development. OBJECTIVES: Identify developmental subgroups of polydrug use. Identify risk factors predicting heterogeneity in development. METHODS: The Pathways to Desistance data were used in this research. The present study used group-based trajectory modeling to elucidate general developmental patterns of drug use variety and sought to identify risk factors predicting the heterogeneity in the development of this outcome using multinomial logistic regression among a sample of juvenile offenders. RESULTS: A six group model best fit the drug use variety count data. Several risk factors were identified which predicted assignment to the most problematic developmental subgroup, including: low self-control, low religiosity, and history of victimization at baseline. White participants were more likely to engage in any level of drug use. Conclusions/Importance: These results indicate that juvenile offenders are at-risk for chronic issues with polydrug use and more general engagement in polydrug use. Public health and criminal justice professionals should work together to develop and implement psychosocial interventions for targeting risk factors associated with accelerating and chronic polydrug use.

Racial Disparities in Community Mental Health Service Use Among Juvenile Offenders.

PURPOSE: Investigate differences in community mental health service utilization by race among a sample of juvenile offenders in the time surrounding adjudication for a serious offense. It was predicted that racial minority youth would demonstrate lower utilization of these services. METHODS: The Pathways to Desistance data were used in analyses. This consisted of the responses of 1354 juvenile offenders. Wave 1 of the data was used in analyses. Logistic regression models were used to examine the relevance of racial identification and control covariates for predicting odds of receiving community mental health services during the prior 6 months. RESULTS: Results indicate that Black youth had lower odds of receiving all types of community mental health services, relative to White participants. Hispanic juvenile offenders had lower odds of receiving several types of services also, relative to White juvenile offenders. DISCUSSION: Findings indicate that minority justice-involved youth utilize community mental health services in the time surrounding adjudication at lower rates than White juvenile offenders do, a net of all effects. This may be indicative of additional barriers to service use and possible institutionalized racism which restrict mandating of services which may reduce mental health symptom severity and risk for recidivism among minority juvenile offenders.

The development of anxiety symptomatology among juvenile offenders: the roles of maternal substance abuse and unemployment.

This research examined the development of anxiety across adolescence and early adulthood among a sample of juvenile offenders comprising males and females. In addition, despite the understanding of maternal substance abuse and maternal unemployment as risk factors predicting development of anxiety, this research examined the interaction between these two characteristics for doing so. Analyses used group-based trajectory modelling to provide descriptive representation of general developmental patterns of anxiety. Next, a series of multinomial logistic regression models were estimated to examine the effects of baseline covariates on the relative risk of assignment to the elucidated trajectory groups. A three-group model best fit the data, comprising low, moderate, and high anxiety trajectory groups. Results from the regression models indicate that the interaction between maternal unemployment and maternal substance abuse history significantly increased the risk of assignment to the high anxiety group.