RESUMO
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.
Assuntos
Alcoolismo , Tabagismo , Adolescente , Adulto , Alcoolismo/epidemiologia , Humanos , Estudos Longitudinais , Tabagismo/epidemiologia , Tabagismo/terapiaRESUMO
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.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Negro ou Afro-Americano , Transtorno Depressivo Maior/epidemiologia , Hispânico ou Latino , Uso da Maconha/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , Razão de Chances , Fatores de Risco , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
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.
Assuntos
Comportamento do Adolescente/psicologia , Fumar Maconha/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/psicologia , Fatores Etários , Feminino , Hispânico ou Latino/psicologia , Humanos , Estudos Longitudinais , Masculino , Modelos Psicológicos , Cidade de Nova Iorque/epidemiologia , Adulto JovemRESUMO
Few studies have examined the socio-cultural determinants of alcohol and drug misuse trajectories among adult Latinas. To assess the associations between socio-cultural determinants and alcohol and drug misuse, we used a longitudinal design to follow a sample of adult Latina mother-daughter-dyads (N = 267) for ten years, and collected four waves of data. They were adult Latinas of Caribbean, South and Central American descent. Specifically, this study investigated the effects of the following factors: (1) Individual Determinants (e.g., socioeconomic conditions, mental health, and medical status); (2) Cultural Determinants (e.g., acculturation to US culture); (3) Interpersonal Determinants (e.g., interpersonal support, relationship stress, mother-daughter attachment, intimate partner violence); (4) Community Determinants (e.g., neighborhood related stress); and (5) Institutional Determinants (e.g., religious involvement, involvement with the criminal justice system). Using hierarchical modeling, we found that taking prescribed medication on a regular basis for a physical problem, religious involvement, and mother-daughter attachment were negatively associated with drug misuse, while involvement in criminal activity was positively associated with drug misuse. Regarding alcohol misuse, results showed that age at arrival in the United States, number of years in the United States, and religious involvement were negatively associated with alcohol misuse, while involvement in criminal activity was positively associated with alcohol misuse. Based on our findings, explicit implications are provided for culturally relevant interventions.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Relações Mãe-Filho/etnologia , Religião e Psicologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Adulto , Idoso , Alcoolismo/etnologia , Região do Caribe/etnologia , América Central/etnologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , América do Sul/etnologia , Estados Unidos/etnologia , Adulto JovemRESUMO
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.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Abuso de Maconha/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Comorbidade , Feminino , Inquéritos Epidemiológicos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , Prevalência , Fatores de Risco , Adulto JovemRESUMO
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.
Assuntos
Mães/psicologia , Comportamento Problema/psicologia , Adolescente , Adulto , Conflito Familiar/psicologia , Feminino , Humanos , Masculino , Fumar/psicologia , Adulto JovemRESUMO
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.
Assuntos
Fumar Cigarros/psicologia , Comportamentos Relacionados com a Saúde , Serviços Preventivos de Saúde , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , New York , Fatores de Risco , Adulto JovemRESUMO
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.
Assuntos
Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
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).
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Apego ao Objeto , Relações Pais-Filho , Psicologia do Adolescente , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Delinquência Juvenil/psicologia , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , Fatores de Risco , Autorrelato , Adulto JovemRESUMO
OBJECTIVES: To study the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unemployment status at mean age 43. METHODS: We gathered longitudinal data on a prospective cohort taken from a community sample (N = 548). Forty-nine percent of the original participants were females. Over 90% of the participants were white. The participants were followed from adolescence to early midlife. The mean ages of participants at the follow-up interviews were 14.1, 16.3, 22.3, 27.0, 31.9, 36.6, and 43.0, respectively. We used the growth mixture modeling (GMM) approach to identify the trajectories of marijuana use over a 29-year period. RESULTS: Five trajectories of marijuana use were identified: chronic users/decreasers (8.3%), quitters (18.6%), increasing users (7.3%), chronic occasional users (25.6%), and nonusers/experimenters (40.2%). Compared with nonusers/experimenters, chronic users/decreasers had a significantly higher likelihood of unemployment at mean age 43 (adjusted odds ratio = 3.51, 95% confidence interval = 1.13-10.91), even after controlling for the covariates. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The results of the associations between the distinct trajectories of marijuana use and unemployment in early midlife indicate that it is important to develop intervention programs targeting chronic marijuana use as well as unemployment in individuals at this stage of development. Results from this study should encourage clinicians, teachers, and parents to assess and treat chronic marijuana use in adolescents.
Assuntos
Fumar Maconha/epidemiologia , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: The study assesses the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, children living at home, and spouse/partner marijuana use at age 43. METHOD: This study used a longitudinal design. The sample participants (N = 548) were first studied at mean age 14 and last studied at mean age 43. RESULTS: Six trajectories of marijuana use were identified: chronic/heavy users (3.6 %), increasing users (5.1 %), chronic/occasional users (20 %), decreasers (14.3 %), quitters (22.5 %), and nonusers/experimenters (34.5 %). With three exceptions, as compared with being a nonuser/experimenter, a higher probability of belonging to the chronic/heavy, the increasing, or the chronic/occasional user trajectory group was significantly associated with a greater likelihood of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, not having children who lived at home, and having a spouse/partner who used marijuana at early midlife. In addition, compared with being a quitter, a higher probability of belonging to the chronic/heavy user trajectory group was significantly associated with a higher likelihood of unconventional behavior, sensation seeking, emotional dysregulation, alcohol dependence/abuse, and spouse/partner marijuana use. Implications for intervention are presented. CONCLUSIONS: Trajectories of marijuana use, especially chronic/heavy use, increasing use, and chronic/occasional use, are associated with unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, having children who lived at home, and spouse/partner marijuana use at age 43. The importance of the findings for prevention and treatment programs are discussed.
Assuntos
Transtornos Relacionados ao Uso de Álcool/psicologia , Cannabis , Desenvolvimento Humano , Abuso de Maconha/psicologia , Fumar Maconha/psicologia , Tabagismo/psicologia , Adolescente , Adulto , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Abuso de Maconha/classificação , Abuso de Maconha/epidemiologia , Fumar Maconha/epidemiologia , New York/epidemiologia , Tabagismo/epidemiologia , Adulto JovemRESUMO
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.
Assuntos
Distúrbios do Início e da Manutenção do Sono/psicologia , Fumar/psicologia , Adolescente , Adulto , Negro ou Afro-Americano , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Porto Rico , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fumar/epidemiologiaRESUMO
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.
Assuntos
Comportamento do Adolescente/etnologia , Consumo de Bebidas Alcoólicas/etnologia , Fumar/etnologia , Adolescente , Criança , Feminino , Humanos , Masculino , Fatores de Risco , África do Sul/etnologiaRESUMO
BACKGROUND AND OBJECTIVES: Unemployment (5.5% as of 2015) is a serious social and economic problem in our society. Since marijuana use is an important factor related to unemployment, identifying the trajectory of the use of marijuana may aid intervention programs and research on unemployment. METHODS: Six hundred seventy-four participants (53% African-Americans, 47% Puerto Ricans) were surveyed (60% females) from ages 14 to 36. The first data collection was held when the participants were students attending schools in the East Harlem area of New York City. RESULTS: We found that the chronic marijuana use (OR = 4.07, p < .001; AOR = 2.58, p < .05) and the late marijuana quitter (OR = 2.91, p < .05) trajectory groups were associated with an increased likelihood of unemployment compared with the no marijuana use trajectory group. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The results suggest that those who use marijuana chronically are at greater risk for being unemployed. Consequently, these individuals should have access to and participate in marijuana cessation treatment programs in order to reduce their risk of unemployment. Unemployment intervention programs should also consider focusing on the cessation of the use of marijuana to decrease the likelihood of later unemployment.
Assuntos
Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Abuso de Maconha/etnologia , Cidade de Nova Iorque , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Although the "stage theory" suggests that marijuana use occurs after the initiation of tobacco smoking, substantial evidence exists that they often occur concurrently, and that the use of marijuana may influence the use of tobacco. METHODS: This study uses trajectory analysis to examine the relationship between marijuana use beginning in adolescence and adult tobacco dependence in a 5-wave longitudinal study (mean ages in each wave: 14, 19, 24, 29, and 32). The sample consisted of 816 participants (52% African Americans, 48% Puerto Ricans), of whom 60% were females. Logistic regression analyses were conducted to predict later tobacco dependence from earlier trajectories of marijuana use. RESULTS: A higher Bayesian posterior probability (BPP) for the chronic marijuana use trajectory group (odds ratio [OR]=10.93, P<.001; adjusted OR [AOR]=10.40, P<.001), for the increasing marijuana use trajectory group (OR=6.94, P<.001; AOR=6.73, P<.001), and for the moderate marijuana use trajectory group (OR=3.13, P<.001; AOR=3.18, P<.001) was associated with an increased likelihood of being dependent on tobacco compared with the BPP of the no or low marijuana use trajectory group. CONCLUSIONS: The results underscore the value of considering multiple patterns of marijuana use within a person-centered approach. Thus, it would be appropriate for marijuana cessation programs to incorporate the prevention, assessment, and cessation of tobacco use in their health promotion strategies.
Assuntos
Comportamento do Adolescente/psicologia , Fumar Maconha/epidemiologia , Tabagismo/epidemiologia , Adolescente , Adulto , Teorema de Bayes , Feminino , Humanos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: We modeled triple trajectories of tobacco, alcohol, and marijuana use from adolescence to adulthood as predictors of antisocial personality disorder (ASPD) and generalized anxiety disorder (GAD). METHODS: We assessed urban African American and Puerto Rican participants (n = 816) in the Harlem Longitudinal Development Study, a psychosocial investigation, at 4 time waves (mean ages = 19, 24, 29, and 32 years). We used Mplus to obtain the 3 variable trajectories of tobacco, alcohol, and marijuana use from time 2 to time 5 and then conducted logistic regression analyses. RESULTS: A 5-trajectory group model, ranging from the use of all 3 substances (23%) to a nonuse group (9%), best fit the data. Membership in the trajectory group that used all 3 substances was associated with an increased likelihood of both ASPD (adjusted odds ratio [AOR] = 6.83; 95% CI = 1.14, 40.74; P < .05) and GAD (AOR = 4.35; 95% CI = 1.63, 11.63; P < .001) in adulthood, as compared with the nonuse group, with control for earlier proxies of these conditions. CONCLUSIONS: Adults with comorbid tobacco, alcohol, and marijuana use should be evaluated for use of other substances and for ASPD, GAD, and other psychiatric disorders. Treatment programs should address the use of all 3 substances to decrease the likelihood of comorbid psychopathology.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtorno da Personalidade Antissocial/epidemiologia , Transtornos de Ansiedade/epidemiologia , Fumar Maconha/epidemiologia , Uso de Tabaco/epidemiologia , Adolescente , Adulto , Fatores Etários , Comorbidade , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Cidade de Nova Iorque/epidemiologia , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
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.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/etnologia , Grupos Minoritários/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Psicologia , Porto Rico/etnologia , Fatores Sexuais , Fatores Socioeconômicos , Adulto JovemRESUMO
INTRODUCTION: This longitudinal study examined the association between trajectories of cigarette smoking and unemployment across a 29-year time period from mean age 14 to mean age 43. METHODS: Participants came from a community-based random sample of residents in 2 upstate New York counties. Data were collected at 7 timepoints. RESULTS: Using growth mixture modeling, 5 trajectory groups of cigarette smokers were identified. The trajectory groups were as follows: heavy/continuous smokers, occasional smokers, late-starting smokers, quitters/decreasers, and nonsmokers. Multivariate logistic regression analysis was used to study the relationship between the participant's trajectory group membership and unemployment in the fifth decade of life. The association was determined with controls for age, gender, current cigarette use, current alcohol use, current marijuana use, physical diseases, occupation, educational level, past unemployment experience, socioeconomic status measures of family of origin, depressive mood, and self-control from adolescence through the early 40s. The findings indicate that patterns of adolescent and young adult cigarette smoking have implications for later unemployment. Overall, the results showed that people who fell into the categories of heavy/continuous smokers (adjusted odds ratio [AOR] = 3.84) and occasional smokers (AOR = 4.03) were more likely to be unemployed at mean age 43 when compared with nonsmokers. There was no significant difference between the quitters/decreasers and the nonsmokers with respect to unemployment. CONCLUSIONS: Intervention programs designed to deal with unemployment should consider focusing on heavy/continuous and occasional cigarette smokers as risk factors for unemployment.
Assuntos
Fumar/epidemiologia , Fumar/tendências , Desemprego/tendências , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Feminino , Seguimentos , Previsões , Humanos , Estudos Longitudinais , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/tendências , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: There is limited research on the correlates of cigarette smoking in women in late midlife. OBJECTIVES: The present study examined the associations between risk factors in several psychosocial domains and current cigarette smoking among women in their mid-60s. These domains included risks in personal attributes, family relationships, negative life events, financial stressors, contextual factors, and problematic alcohol use. METHODS: Data were from a cohort of women originally living in two upstate New York counties (N = 511) in late midlife (mean age = 65). Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The results supported our hypotheses. The cumulative psychosocial risk index was significantly associated with a greater likelihood of cigarette smoking [A.O.R. = 1.53; 95% C.I. (1.3-.181); p < .001] after controlling for age and educational level. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: It is important to reduce the number of psychosocial risk factors faced by women in their 60s in order to reduce the likelihood of continued cigarette smoking.
Assuntos
Envelhecimento/psicologia , Fumar/psicologia , Idoso , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Saúde da MulherRESUMO
BACKGROUND AND OBJECTIVES: We examined the association between the conjoint developmental trajectories of body mass index (BMI) and marijuana use from age 24 to age 32 and short sleep duration. METHODS: The participants included 158 African American male, 267 African American female, 166 Puerto Rican male, and 225 Puerto Rican female young adults (N=816). Using Mplus, we obtained the conjoint trajectories of BMI and marijuana use. Logistic regression analyses examined the association between the conjoint trajectories and short sleep duration. RESULTS: Five conjoint trajectory groups were extracted: normal BMI and no or low marijuana use, obese and no or low marijuana use, morbidly obese and some marijuana use, normal BMI and high marijuana use, and obese and high marijuana use. Those in the obese and no or low marijuana use group, the morbidly obese and some marijuana use group, and the obese and high marijuana use group were more likely to report shorter sleep duration than those with normal BMI and no or low marijuana use group. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This study highlights the significance of examining joint trajectories over several developmental stages. In treating short sleep duration, we propose focusing on treating obesity, and also treating marijuana use if applicable.