Detection of youth at high risk for substance use disorders: A longitudinal study.

This study extends prior research (D. Clark, J. Cornelius, L. Kirisci, & R. Tarter, 2005) by determining whether variation in the developmental trajectories of liability to substance use disorder (SUD) is contributed by neurobehavioral disinhibition, parental substance use involvement, and demographic variables. The sample, participants in a long-term prospective investigation, consisted of 351 boys, evaluated at ages 10-12, 12-14, 16, 19, and 22, whose parents either had SUD or no adult psychiatric disorder. Neurobehavioral disinhibition in childhood, in conjunction with parental lifetime substance use/SUD, place the child at very high risk for SUD by age 22 if psychosocial maladjustment progresses in severity in early adolescence. These results indicate that monitoring social adjustment during the transition from childhood to mid-adolescence is important for identifying youth at very high risk for succumbing to SUD by young adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental trajectory classes in substance use disorder etiology.

Three trajectory classes culminating in substance use disorder (SUD) were discerned in a longitudinal study of boys from ages 10-12 to 22 years. Neurobehavior disinhibition, parental SUD, socioeconomic status, and affiliation with deviant peers were measured at baseline. Approval of socially nonnormative behavior was measured at ages 10-12, 12-14, 16, and 19 years. Two high-risk trajectories, indicated by increasing approval of antisociality and progressive social maladjustment during adolescence (SUD rate = 72.7%) and stable high level of disturbance (SUD rate = 85%), were identified. Individual characteristics (neurobehavior disinhibition) in conjunction with contextual factors (low socioeconomic status, parental SUD, affiliation with deviant friends) promote approval of antisociality during adolescence and a high rate of SUD by young adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial functioning of adults who experienced substance use disorders as adolescents.

The authors examined whether substance use disorder (SUD) before age 19 was associated with functioning at age 30. Participants (N = 773) were assessed twice during adolescence and at ages 24 and 30. Eight of 14 adult measures were associated with adolescent SUD: education, unemployment, income, risky sexual behavior, suicide attempt, coping, stressful life events, and global adjustment. After adolescent comorbidity and functioning and adult SUD were controlled for, education and unemployment remained associated, and three variables emerged as significant: being a parent (significant only for participants without adult SUD), being currently married, and having decreased life satisfaction (significant only for participants with adult SUD). Adolescent SUD is associated with numerous functioning difficulties at age 30, some of which appear to be related to recurrent SUD, comorbid adolescent disorders, or functioning problems already evident in adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental alcohol involvement and adolescent alcohol expectancies predict alcohol involvement in male adolescents.

Current models of adolescent drinking behavior hypothesize that alcohol expectancies mediate the effects of other proximal and distal risk factors. This longitudinal study tested the hypothesis that the effects of parental alcohol involvement on their children's drinking behavior in mid-adolescence are mediated by the children's alcohol expectancies in early adolescence. A sample of 148 initially 9–11 year old boys and their parents from a high-risk population and a contrast group of community families completed measures of drinking behavior and alcohol expectancies over a 6-year interval. We analyzed data from middle childhood (M age = 10.4 years), early adolescence (M age = 13.5 years), and mid-adolescence (M age = 16.5 years). The sample was restricted only to adolescents who had begun to drink by mid-adolescence. Results from zero-inflated Poisson regression analyses showed that 1) maternal drinking during their children's middle childhood predicted number of drinking days in middle adolescence; 2) negative and positive alcohol expectancies in early adolescence predicted odds of any intoxication in middle adolescence; and 3) paternal alcoholism during their children's middle childhood and adolescents' alcohol expectancies in early adolescence predicted frequency of intoxication in middle adolescence. Contrary to predictions, child alcohol expectancies did not mediate the effects of parental alcohol involvement in this high-risk sample. Different aspects of parental alcohol involvement, along with early adolescent alcohol expectancies, independently predicted adolescent drinking behavior in middle adolescence. Alternative pathways for the influence of maternal and paternal alcohol involvement and implications for expectancy models of adolescent drinking behavior were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between adolescent substance use and young adult internalizing symptoms: Findings from a high-risk longitudinal sample.

The present study examined the role of adolescent substance use and its antecedent behavioral and familial risk factors in the prediction of young adult internalizing symptoms 10 years later, using a community sample of children of alcoholics (n = 194) and demographically matched controls (n = 209). Using growth curve modeling, the authors found that initial levels of adolescent alcohol and drug use (μage = 13) and growth in drug use during adolescence predicted higher levels of internalizing symptoms in young adulthood, even after including in the models shared risk factors for both internalizing symptoms and adolescent substance use. These effects remained significant after including concurrent substance use in adulthood, suggesting that adolescent substance use exerts a long-term impact on young adult internalizing symptoms over and above the effects of persistent substance use over time. The present investigation further revealed that initial levels of alcohol and drug use in adolescence mediate the relation between parental alcoholism and young adult internalizing symptoms. Findings provide evidence for the long-term effects of adolescent substance use on young adult functioning and can help inform both etiological and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in neuropsychological functioning over 10 years following adolescent substance abuse treatment.

Previously, Anderson, Ramo, Cummins, and Brown (2010) described six distinct patterns of alcohol and other drug (AOD) use during the decade following adolescents' treatment for alcohol and other substance use disorders (A/SUD). This time period represents a phase of significant neurodevelopment, and the influence of substance use on the brain is a concern. In the present study, we examined patterns of neuropsychological function over these 10 years in relation to the AOD trajectories identified for youth as they transition into their twenties. Participants were part of a longitudinal research project following adolescents with and without A/SUD who received neuropsychological examinations at baseline and up to 7 times thereafter spanning 10 years (N = 213; 46% female at baseline). Neuropsychological trajectories were significantly related to substance involvement patterns over time on measures of verbal learning and memory (ps = .011 to p = .0002), and verbal attention/working memory (p = .020), with heavier use patterns generally followed by poorer cognition. Heavy use of alcohol alone was independently associated with poorer verbal memory over time. Furthermore, substance withdrawal symptoms during each follow-up time point were related to poorer verbal learning and memory scores (ps     

Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation.

In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delinquency, victimization, and substance use among adolescents with female same-sex parents.

The question of whether parental sexual orientation has an impact on human development has important implications for psychological theories and for legal policy. This study examined associations among family type (same-sex vs. different-sex parents), family and relationship variables, substance use, delinquency, and victimization of adolescents. Participants included 44 adolescents living with female same-sex couples and 44 adolescents living with different-sex couples, matched on demographic characteristics and drawn from a national sample. Analyses indicated that adolescents were functioning well and that their adjustment was not associated with family type. Adolescents whose parents described closer relationships with them reported less delinquent behavior and substance use, suggesting that the quality of parent-adolescent relationships better predicts adolescent outcomes than does family type. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parental drinking problems and adolescent offspring substance use: Moderating effects of demographic and familial factors.

Examined the moderating effects of background and demographic factors and current family situation on the relationship between parental drinking problems and adolescent offspring substance use. Face-to-face interviews were conducted with a random sample of 818 Black and White adolescents (aged 13–17 yrs) and telephone interviews were completed with 1 primary caregiver. Results revealed that neither paternal nor maternal drinking problems consistently predicted substance use among adolescent offspring; however, chaotic and unsupportive family situations were strongly predictive. Hypothesized moderating effects also were found for gender, age, co-occurring parental psychiatric problems, extended family history of drinking problems, current family structure, and caregiver support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family and individual factors associated with substance involvement and PTS symptoms among adolescents in greater New Orleans after Hurricane Katrina.

Objective: This study examined the influence of hurricane impact as well as family and individual risk factors on posttraumatic stress (PTS) symptoms and substance involvement among clinically referred adolescents affected by Hurricane Katrina. Method: A total of 80 adolescents (87% male; 13–17 years old; mean age = 15.6 years; 38% minorities) and their parents were interviewed at the adolescent's intake into substance abuse treatment, 16 to 46 months postdisaster. Independent measures included hurricane impact variables (initial loss/disruption and perceived life threat); demographic and predisaster variables (family income, gender, predisaster adolescent substance use, predisaster trauma exposure, and parental substance abuse); postdisaster family factors (parental psychopathology, family cohesion, and parental monitoring); and postdisaster adolescent delinquency. Results: Hierarchical multivariate regression analyses showed that adolescent substance involvement was associated with higher family income, lower parental monitoring (adolescent report), and more adolescent delinquency. Adolescent-reported PTS symptoms were associated with greater hurricane-related initial loss/disruption, lower family cohesion (adolescent report), and more adolescent delinquency, whereas parent-reported adolescent PTS symptoms were associated with greater parental psychopathology, lower parental monitoring (adolescent report), and lower family cohesion (parent report). Conclusions: The results suggest that hurricane impact was related only to adolescent-reported PTS. However, certain postdisaster family and individual risk factors (low family cohesion and parental monitoring, more adolescent delinquency) were associated both with adolescent substance involvement and with PTS symptoms. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with substance-abusing adolescents after disasters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD.

Children diagnosed with attention-deficit hyperactivity disorder (ADHD; n=142) were prospectively monitored into adolescence (13-18 years old) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD (n=100). Probands reported higher levels of alcohol, tobacco, and illicit drug use than did controls. Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses. Within probands, severity of childhood inattention symptoms predicted multiple substance use outcomes; childhood oppositional defiant disorder/conduct disorder (ODD/CD) symptoms predicted illicit drug use and CD symptoms. Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls. Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Constructive thinking, executive functioning, antisocial behavior, and drug use involvement in adolescent females with a substance use disorder.

The aim of this study was to determine how constructive thinking (CT), executive functioning (EF), and antisocial behavior (ASB) are related to drug use involvement in 282 adolescent females, 14–18 yrs of age, with a substance use disorder (SUD) and in controls. CT was measured using the Constructive Thinking Inventory, EF was measured using a battery of neuropsychological tests, and ASB was measured using the Youth Self-Report Inventory and a psychiatric interview. Females with an SUD demonstrated lower CT and EF scores and higher ASB scores compared with the controls. Low CT and low EF were significantly related to increased drug use involvement even when controlling for age, socioeconomic status, and vocabulary level. ASB partially mediated the relation between CT and drug use involvement, and it fully mediated the relation between EF and drug use involvement. Moreover, ASB moderated the relation between EF and drug use involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent growth trajectories of substance use among pregnant and parenting adolescents.

We examine changes among adolescent girls in substance use during pregnancy and the postpartum period. Three separate latent growth curve analyses assessed the impact of psychosocial, behavioral, and sociodemographic factors on resumption of or change in use of cigarettes, alcohol, and marijuana. The Vulnerable Populations Model for Research and Clinical Practice (Flaskerud & Winslow, 1998) provided the theoretical foundation for this study. This is a secondary analysis of data from a sample of 305 ethnic minority females (245 Latina, 60 African American), aged 13–18 years, who were pregnant at baseline and were participating in an HIV prevention study conducted in inner-city alternative schools in Los Angeles County. Data collected at 4 time points captured changes in substance use from pregnancy through the postpartum period. Baseline predictors included ethnicity/race, partner substance use, childhood abuse history, religiosity, acculturation, depressive symptoms, length of gestation at baseline, and previous substance use. Common predictors of greater resumption and/or greater level of use included greater history of use before pregnancy, partner substance use, childhood abuse, and a longer time since childbirth. African Americans were more likely to be smoking at baseline when they were still pregnant and to use marijuana postpartum; Latinas were more likely to use alcohol over the course of pregnancy and postpartum. Other variables exerted an influence on specific substances. For instance, religiosity impacted cigarette and alcohol use. Findings may assist prenatal care providers to identify and counsel pregnant adolescents at risk for perinatal substance use and to prevent resumption or initiation of substance use after childbirth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent growth modeling of the relationship between depressive symptoms and substance use during adolescence.

To explicate the nature of the relationship between depressive symptoms and substance use, the authors conducted research that incorporated both individual and group approaches and utilized longitudinal data across development. Multiple-group latent growth curve models were used to assess specific dimensions (cross-sectional and longitudinal correlation, within-individual change, and movement off developmental trajectories) of the relationship between depressive symptoms and substance use during adolescence and how this relationship differs by gender. Annual survey data from 8th through 11th grade were provided by 441 girls and 510 boys in the Raising Healthy Children project (E. C. Brown, R. F. Catalano, C. B. Fleming, K. P. Haggerty, & R. D. Abbott, 2005). Levels of depressive symptoms and substance use in early adolescence were positively associated for alcohol, marijuana, and cigarette use for girls, but only for marijuana use for boys. Individual changes in depressive symptoms and substance use across adolescence were positively associated for each type of substance use. Evidence was also found for positive association between episodic expressions of depressive symptoms and alcohol use that fell outside developmental trajectories. Predictive relationships across constructs were not found, with the exception of higher level of depressive symptoms in early adolescence predicting less increase in alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pubertal maturation and early substance use risks among African American children.

Using 2 waves of longitudinal data collected from approximately 870 African American adolescents, this study examined (a) changes in early risk factors for substance use during transition to early adolescence, including perceived prototypes of substance-using peers, willingness and intention to use substances, number of substance-using peers, and youths' own actual substance use; (b) the relationship between pubertal timing and these substance use risks; and (c) the interaction between pubertal timing and peer substance use in predicting the risks. Results showed that, first, risks for substance use increased, particularly among girls, during the transition to early adolescence. Children's prototypic images of substance users became increasingly favorable during this transitional period; a greater number of them were willing and intended to use substances during the transition to early adolescence; and an increased number of early adolescents and their friends began to use substances. Second, these changes were significantly more likely to occur among early maturing girls. Third, early physical maturation interacted with peer substance use to affect these changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disordered eating and substance use in an epidemiological sample: II. Associations within families.

This study investigated familial associations of disordered eating (DE) with substance use and substance use disorders (SU/SUDs) in a community-based sample of 620 adolescent girls, their 310 mothers, and 299 fathers. Female participants completed structured interviews of lifetime anorexia nervosa, bulimia nervosa, binge eating disorder, and SU/SUD; daughters also completed a self-report measure of current DE attitudes and behaviors. Fathers completed interviews assessing lifetime SUD. Evaluation of independent and combined associations of mothers' bulimic eating disturbance (ED) and parents' SUDs with daughters' DE/EDs and SU/SUDs revealed links between mothers' ED and daughters' DE but no relationship between EDs and SU/SUDs across generations. These results suggest that these problems are not cross-transmitted within families and suggest that the addiction model of eating disorders may be simplistic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ecological predictors of substance use in middle school students.

The current study examined important predictors of substance use during early adolescence. The authors hypothesized that adolescents' relationships with key adults (i.e., teachers and parents) influence their choices to use substances indirectly through links with their decisions regarding peer groups. A total of 461 middle school students from an affluent suburban community completed self-report measures of authoritative parenting, perceived social support from teachers, affiliation with rule-breaking and substance-using peers, and frequency of alcohol, cigarette, and drug use. Results of structural equation modeling supported the hypothesized model. Authoritative parenting and teacher support accounted for 31% of the variance in affiliation with deviant peers which, in turn, accounted for 27% of the variance in adolescent substance use; direct paths from parenting and teacher support to substance use were not indicated. Implications for school psychologists' involvement in substance use prevention and intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergence of delinquency and depressed mood throughout adolescence as predictors of late adolescent problem substance use.

Delinquency is a positive predictor of adolescent problem substance use, and depressed mood may increase risk for substance problems. The extent to which effects of delinquency and depressed mood on problem substance use vary depending on when during adolescence the predictors are assessed is unknown. The authors used 5 multigroup path analyses to examine effects of delinquency and depressed mood at ages 11, 12, 13, 14, and 16 years on problem substance use at age 18, and mediation of those effects through alcohol use at age 16 across gender. Participants were 429 rural youths (222 girls and 207 boys) and their families. Indirect positive effects of delinquency on the outcome were observed for boys; direct positive effects of depressed mood were observed for girls. Prevention implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Item response theory modeling of substance use: An index based on 10 drug categories.

This study examined the psychometric characteristics of an index of substance use involvement using item response theory. The sample consisted of 292 men and 140 women who qualified for a Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) substance use disorder (SUD) diagnosis and 293 men and 445 women who did not qualify for a SUD diagnosis. The results indicated that men ha4 a higher probability of endorsing substance use compared with women. The index significantly predicted health, psychiatric, and psychosocial disturbances as well as level of substance use behavior and severity of SUD after a 2-year follow-up. Finally, this index is a reliable and useful prognostic indicator of the risk for SUD and the medical and psychosocial sequelae of drug consumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal association between frequency of substance use and quality of life among adolescents receiving a brief outpatient intervention.

Recognition of the broad consequences of adolescent substance abuse has led to increased emphasis on balancing traditional measures of treatment effectiveness, such as frequency of substance use, with measures of patient functioning and quality of life (QOL). This study evaluated the longitudinal association between frequency of use and QOL among adolescent substance abusers receiving a brief outpatient intervention. Participants were 106 adolescents, aged 13 to 21 years, who met criteria for substance abuse or dependence and completed 4 assessments over a 12 month period. Results of a parallel-process latent growth curve model indicated a moderate longitudinal association, such that reduced frequency of use was associated with QOL improvement. Elaboration of the temporal ordering of this association via a cross-lagged panel model revealed that frequency of substance use predicted subsequent QOL, but that QOL did not predict subsequent frequency of use. Implications pertaining to the assessment of comprehensive outcomes and the setting of treatment expectations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)