Linking Substance Use and Problem Behavior Across Three Generations

Parent-child separation and intergenerational transmission of substance use and disorder: Testing across three generations

There is evidence for intergenerational transmission of substance use and disorder. However, it is unclear whether separation from a parent with substance use disorder (SUD) moderates intergenerational transmission, and no studies have tested this question across three generations. In a three-generation study of families oversampled for familial SUD, we tested whether separation between father (G1; first generation) and child (G2; second generation) moderated the effect of G1 father SUDs on G2 child SUDs. We also tested whether separation between father (G2) and child (G3; third generation) moderated the effect of G2 SUDs on G3 drinking. Finally, we tested whether G1-G2 or G2-G3 separation moderated the mediated effect of G1 SUDs on G3 drinking through G2 SUDs. G1 father-G2 child separation moderated intergenerational transmission. In families with G1-G2 separation, there were no significant effects of father SUD on G2 SUD or G3 drinking. However, in nonseparated families, greater G1 father SUDs predicted heightened G2 SUDs and G3 grandchild drinking. In nonseparated families, G1 father SUDs significantly predicted G2 SUDs, which predicted G3 drinking. However, G2-G3 separation predicted heightened G3 drinking regardless of G2 and G1 SUDs. Parental separation may introduce risk for SUDs and drinking among youth with lower familial risk.

"I've smoked weed with my daughter": Cannabis Use within Families Affected by Parental Opioid Misuse

Youth with parents who use opioids are more likely to engage in early substance use, especially cannabis use. The purpose of this study was to describe the context of cannabis use among families affected by parental opioid misuse. We conducted 25 in-depth interviews with families affected by parental opioid misuse. Participants were parents with a history of opioid misuse and young adults (ages 18-24) who had parents with a history of opioid misuse. Interviews were digitally recorded and professionally transcribed. Data were analyzed inductively using a qualitative content analytic approach. Familial cannabis use was common among young people and their parents. Participants described familial cannabis use as a bonding activity that felt safe and lightened the mood. Additional research is needed to understand the complex role that cannabis use may play in families affected by opioid misuse. Strategies for intergenerational substance use prevention are discussed.

Helping families heal in substance use treatment: A qualitative study about the role of peer support specialists with client families

INTRODUCTION

Peer support specialists (PSS) are people with previous psychiatric illness or substance use disorders who use their experience to support those facing similar hardships. PSS offer a range of beneficial outcomes to both the PSS and clients. The most immediate social connections to those seeking treatment are often their families, yet no PSS studies are inclusive of family involvement. Strong theoretical and empirical support exists for family involvement in addiction treatment, but no studies to date on families in substance use treatment include PSS. This study offers a first look at PSS's experiences with client families. We aimed to describe experiences and attitudes of PSS in working with families of those seeking substance use treatment.

METHODS

This qualitative study included 25 adult PSS with at least 1 year of work experience in substance use treatment and state credentialing board certification. Participants had one interview either in a focus group format or individually. The recruitment and data collection phase lasted from November 2020 to June 2021. The semi-structured interview protocol included six main questions and interviews lasted 60 to 75 min. Upon completion of each interview, the recordings were transcribed and inductively coded. Thematic analysis of the codes identified overarching themes and their implications were described with associated quotes.

RESULTS

Thematic analysis generated three interrelated themes. First, participants described the various ways they often work with the families of their clients, which seemed to be dependent on the age of the client. Second, participants identified the negative aspects of working with families such as family drama, stress, and co-dependency issues. Last, the third theme identified the ways in which PSS assist families in healing from the effects of addiction. The themes identify a complicated and conflicting approach to work with families. Overall, it seemed PSS were operating on their own experiences or suggestions given by supervisors to guide them with no training on how to approach families.

CONCLUSIONS

This study highlights a deficit in PSS training on their role with families, family intervention, and the impact of family on substance use treatment for adults and youth. More research needs to establish the PSS role with families and with clients from marginalized backgrounds. Credentialing and national associations that support PSS should develop additional training and education opportunities related to working with families for PSS, supervisors, and organizational leadership who employ PSS for substance use treatment.

Cannabis Use and Parenting Practices among Young People: The Impact of Parenting Styles, Parental Cannabis-Specific Rules, and Parental Cannabis Use

Cannabis is the most commonly used illicit drug. Its use typically starts in adolescence, and parents play a key role in young people’s cannabis use. Our study aimed to examine and compare the effects of parenting styles, parental cannabis-specific rules, and parental cannabis use on young people’s cannabis use. The research sample consisted of 839 students from various secondary education programs in Slovenia, aged 14 to 21. Associations between the young people’s lifetime cannabis use and their experience of parenting practices were assessed using logistic regression, with demographic, socioeconomic, educational, health, and risk behaviors controlled in a multivariate model. Maternal authoritative parenting (in comparison with permissive parenting), strict maternal, cannabis-specific rules, and parental cannabis non-use statistically significantly reduced the likelihood of young people’s cannabis use. Its strongest predictor was parental cannabis use, followed by the mother’s specific cannabis-use rules and maternal parenting style. The findings of our study can contribute to the development of public health policies to more effectively prevent cannabis use among adolescents and emerging adults, including by designing prevention programs aimed at strengthening parents’ general and cannabis-specific practices and competences.

Socioeconomic Differences in Lifetime and Past 30-Day E-Cigarette, Cigarette, and Dual Use: A State-Level Analysis of Utah Youth

Socioeconomic disparities in combustible cigarette use are well established among youth in the United States and lead to substantial health effects. Given the noteworthy rise in electronic cigarette (e-cigarette) use among youth in recent years, health professionals have expressed concern that e-cigarette use will follow similar socioeconomic patterns. The current study examined this question using a 2019 state-representative sample of youth in grades 6, 8, 10, and 12 from Utah (N = 78,740). Logistic regression models estimated associations between neighborhood- and individual-level factors with lifetime and past 30-day e-cigarette, combustible cigarette, and dual use across 267 neighborhoods. After controlling for individual-level sociodemographic factors, results indicated that youth living in higher-poverty neighborhoods were at a significantly increased risk of lifetime e-cigarette, combustible cigarette, and dual use. Additionally, youth living in households with higher levels of education were at a significantly lower risk of lifetime and past 30-day e-cigarette, cigarette, and dual use. Results suggest that e-cigarettes may follow a similar pattern of socioeconomic disparities among youth as combustible cigarettes. Additionally, most youth using combustible cigarettes also used e-cigarettes, suggesting that any potential harms from e-cigarettes may exacerbate existing socioeconomic disparities in health effects from combustible cigarette use. Research should continue to examine individual- and neighborhood-level socioeconomic disparities in youth e-cigarette, combustible cigarette, and dual use.

Fathers' alcohol consumption and risk of substance-related disorders in offspring

BACKGROUND

Few studies have assessed how children are affected by parental alcohol consumption without clinically diagnosed alcohol problems, especially in relation to more long-term and severe consequences. The aim is to investigate how fathers' alcohol use is related to the risk for substance-related disorders in offspring.

METHOD

A prospective cohort study of 64 710 Swedish citizens whose fathers were conscripted for compulsory military training at ages 18-20 in 1969/70. Information on fathers' alcohol consumption, frequency of intoxication and apprehended for drunkenness, was collected during conscription. Offspring was followed for substance-related disorders from age 12 to end of follow up in 2009.

RESULTS

All measures of fathers' alcohol use were significantly and positively associated with risk for substance-related disorders in offspring. The associations were to a large extent explained by other risk factors in childhood. In the fully adjusted model, those with fathers in the highest alcohol consumption quintile still had a 63% higher risk (HR=1.63 CI 1.26-2.12) of substance-related disorders compared to those whose fathers' reported abstinence. The highest risk was found among offspring to fathers with alcohol-related disorders or that had been apprehended for drunkenness, with a more than two-fold increased risk for substance-related disorders.

CONCLUSIONS

Despite the lower risk found among offspring to fathers with sub-clinical drinking when compared to those with alcohol-related disorders, the former group accounts for a much larger proportion of all cases of substance-related disorders in the population, prompting universal prevention efforts targeting the level of total alcohol consumption in society.

Maternal trajectories of cannabis use and young adult cannabis and nicotine dependence

INTRODUCTION

The goals of this study were to model maternal patterns of cannabis use from one year pre-pregnancy to 16 years postpartum and to determine if different patterns of maternal cannabis use predicted offspring substance use at age 22.

METHODS

Women were recruited from a prenatal clinic between 1982 and 1984. Maternal cannabis use was assessed by trained interviewers twice during pregnancy, at delivery, 8 and 18 months, 3, 6, 10, 14, and 16 years postpartum. At age 22, substance use and dependence were measured in offspring. Growth mixture models of maternal cannabis use were calculated and adult offspring substance use outcomes were regressed onto maternal cannabis trajectory classes (n = 551).

RESULTS

There were five distinct patterns of maternal cannabis use. Offspring of mothers who were chronic cannabis users were more likely to use cannabis (p < 0.001) and develop CUD (p < 0.05) than offspring whose mothers did not use cannabis. Offspring of chronic cannabis users were also more likely to be nicotine dependent by age 22 than offspring whose mothers did not use cannabis (p < 0.01) and than offspring whose mothers were decreasingly likely to use over time (p < 0.01).

CONCLUSIONS

Integrated variable- and person-centered analyses revealed long-term and meaningful patterns of cannabis use and desistance. Chronic maternal cannabis use is a risk factor for regular and dependent cannabis use and for dependent tobacco use among young adult offspring. These findings have implications for maternal-child health given the increasing prevalence of cannabis use among women.

Parent ENDS use predicts adolescent and young adult offspring ENDS use above and beyond parent cigarette use

PURPOSE

Prior research has showed that parent combustible cigarette use predicts cigarette use among their offspring. This study used prospective longitudinal data from parents and offspring to test whether parent electronic nicotine delivery system (ENDS) use predicted a higher probability of ENDS use among their offspring.

METHODS

Data were drawn from the Seattle Social Development Project - The Intergenerational Project (SSDP-TIP). Analyses included 295 families; 7% of parents were Native American/Alaskan Native, 18% were Asian American, 28% were African American, and 47% were European American. Multilevel modeling (in 2020) of data collected in 2015, 2016, and 2017 tested associations between parent self-reported ENDS use and concurrent self-reported ENDS use among offspring ages 10-25 years (53% female). Parent combustible cigarette use was controlled. Analyses also examined the role of parent and offspring perceptions of the safety of ENDS in predicting offspring ENDS use.

RESULTS

About 12% of offspring and 8% of parents reported past-month ENDS use. Parent ENDS use predicted a higher probability of child ENDS use (Odds Ratio 5.68, p = .01), even after controlling parent past month cigarette use. Beyond parent nicotine product use, offspring perceptions of ENDS safety - but not parent perceptions of ENDS safety - contributed independently to offspring probability of past-month ENDS use.

CONCLUSIONS

It is important for parents, health providers, and policymakers to focus on preventing ENDS use among offspring of parents who use ENDS.

Problematic alcohol use in Mexican students: Transmission from parents to children

Introduction. Studies in various countries have shown that adolescents with a history of parental use of alcohol have a greater risk of presenting alcohol problems of their own, including binge drinking, driving under the influence of alcohol, and alcohol dependence. A few studies in Mexico have also found this association, but these have been carried out with non-representative populations. Objective. To examine the association between a history of parental alcohol use and binge drinking, and parental use and possible dependence on alcohol, in a national sample of junior high and high school students in Mexico. Method. A descriptive correlational study was carried out based on a secondary analysis of the National Survey of Student Drug Use (Encuesta Nacional de Consumo de Drogas en Estudiantes, ENCODE), which questioned 114,364 respondents. The association was evaluated with an estimate of prevalence ratios (PR). Results. Students whose mothers or both parents used alcohol had a greater risk for binge drinking (PR [mother] = 2.12, p #abr# .001; PR [both parents] = 2.18, p #abr# .001) and possible alcohol dependence (PR [mother] = 5.43, p #abr# .001; PR [both parents] = 5.14, p #abr# .001). Those whose fathers alone used alcohol had a lower risk for binge drinking (PR = 1.35, p #abr# .001) and for possible dependence (PR = 1.83, p #abr# .001). Discussion and conclusion. This study shows differences in the effects of problematic alcohol use by parents: use by the mother or by both parents implies a greater risk of binge drinking and possible dependence for their children. This finding should be considered in the design of interventions to prevent binge drinking.

Multisystemic Therapy - Building Stronger Families (MST-BSF): Substance misuse, child neglect, and parenting outcomes from an 18-month randomized effectiveness trial

BACKGROUND

Parental substance misuse impacts millions of children globally and is a major determinant of repeat maltreatment and out-of-home placement. There is little published research on family-based, comprehensive treatment models that simultaneously address parental substance misuse and child maltreatment.

OBJECTIVE

This study reports outcomes from a randomized clinical trial examining the effectiveness of the Multisystemic Therapy - Building Stronger Families (MST-BSF) treatment model with families involved with Child Protective Services due to physical abuse and/or neglect plus parental substance misuse.

PARTICIPANTS AND SETTING

Ninety-eight families who had an open case with Child Protective Services in two areas of the state of Connecticut participated.

METHOD

Families referred by the Connecticut Department of Children and Families were randomly assigned to MST-BSF or Comprehensive Community Treatment (CCT). Both interventions were delivered by community-based therapists. Outcomes were measured across 5 assessments extending 18 months post-baseline.

RESULTS

Intent-to-treat analyses showed that MST-BSF was significantly more effective than CCT in reducing parent self-reported alcohol and opiate use and in improving child-reported neglectful parenting. Although means were in predicted directions, new incidents of abuse across 18 months did not differ between groups. The study features high recruitment and engagement rates for a population experiencing multiple involvements with child protection.

CONCLUSION

The outcomes of this study support the effectiveness of MST-BSF, an intensive family- and ecologically- based treatment, for significantly reducing parental alcohol and opiate misuse and child neglect. These findings help in our understanding of how best to address the understudied issue of interventions for child neglect.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.

Estimating perceived parental substance use disorder: Using register data to adjust for non-participation in survey research

AIMS

To estimate the prevalence of parental substance use disorder (PSUD) in the general population based on young adults' reports adjusted for non-participation using register-based indicators of PSUD.

DESIGN

A national sample survey study combined with a retrospective register-based study. Setting Denmark. Participants 10,414 young people (aged 15-25 years) invited to two national sample surveys in 2014 and 2015 (5,755 participants and 4,659 non-participants).

MEASUREMENTS

A crude prevalence of PSUD was calculated based on participants' reports. Parental data from medical, mortality, prescription, and treatment registers (from the young adults' birth until the time of the surveys) were used to estimate a register-based prevalence of PSUD for both participants and non-participants. Differences between participants and non-participants were analysed using bivariate comparisons. Inverse probability weighting was used to adjust for bias due to non-participation. The crude prevalence of PSUD based on survey data was adjusted using the ratio of incidence proportion of the register-based PSUD compared with the survey-based PSUD.

FINDINGS

A total of 731 (12.7%) of the 5,755 survey participants reported PSUD. Register-based PSUD was more common among non-participants (856/4,659; 18.4%) compared with participants (738/5,755; 12.8%, OR = 1.53, 95% CI 1.38-1.70). The adjusted estimate of the survey-based PSUD increased by 2.5 percentage points, from 12.7% to 15.2%.

CONCLUSIONS

In the absence of register data, youth-reported PSUD is likely to underestimate the number of young people experiencing PSUD.

Exploring the evidence for epigenetic regulation of environmental influences on child health across generations

Environmental exposures, psychosocial stressors and nutrition are all potentially important influences that may impact health outcomes directly or via interactions with the genome or epigenome over generations. While there have been clear successes in large-scale human genetic studies in recent decades, there is still a substantial amount of missing heritability to be elucidated for complex childhood disorders. Mounting evidence, primarily in animals, suggests environmental exposures may generate or perpetuate altered health outcomes across one or more generations. One putative mechanism for these environmental health effects is via altered epigenetic regulation. This review highlights the current epidemiologic literature and supporting animal studies that describe intergenerational and transgenerational health effects of environmental exposures. Both maternal and paternal exposures and transmission patterns are considered, with attention paid to the attendant ethical, legal and social implications.

Friends' childhood adversity and long-term implications for substance misuse: a prospective Swedish cohort study

BACKGROUND AND AIMS

Although an individual's childhood adversity is predictive of later substance misuse, the effect of adversity within an individual's friendship network has not been established. The current study aims to estimate the strength of the association between exposure to childhood adversity among individuals' friends at the onset of adolescence, relative to individuals' own exposure to childhood adversity, and hospitalization for substance misuse between young adulthood and retirement.

DESIGN

Prospective cohort study.

SETTING

Stockholm, Sweden.

PARTICIPANTS

Individuals born in 1953, living in Stockholm in 1963, and who nominated three best friends in the 6th grade school class (n = 7180; females = 3709, males = 3471), followed to 2016.

MEASUREMENTS

The outcome was hospitalization with a main or secondary diagnosis attributed to substance misuse, reflected in Swedish inpatient records (ages 19-63 years). Five indicators of childhood adversity (ages 0-12 years) were operationalized into composite measures for individuals and their friends, respectively. Friendships were identified using sociometric data collected in the school class setting (age 13 years).

FINDINGS

Individuals' own childhood adversity does not predict childhood adversity among friends (P > 0.05). Childhood adversity among friends is independently associated with an increased risk of an individual's later substance misuse [hazard ratio (HR) = 1.17, 95% confidence interval (CI) = 1.09-1.24], independently of an individual's own childhood adversity (HR = 1.47, 95% CI = 1.34-1.61). However, childhood adversity among friends does not moderate the association between individuals' own childhood adversity and later substance misuse.

CONCLUSIONS

Within a birth cohort of individuals born in 1950s Stockholm, Sweden, childhood adversity among an individual's friends appears to predict the individual's substance misuse in later life independently of an individual's own exposure to childhood adversity.

The intergenerational transmission of harsh parenting, substance use, and emotional distress: Impact on the third-generation child

The current study evaluated the intergenerational transmission of harsh parenting, substance use, and emotional distress across generations and the association with child aggression. The study included 218 Generation 1 (G1) mothers and fathers, their adolescent (Generation 2; G2) who participated from middle adolescence through adulthood, and the 3rd-generation (G3) child between ages 3-5 years and 6-10 years. G1 behavior was examined when G2 was 16 and 18 years old; G2 alcohol problems and marijuana use were assessed when G2 was 19 and 21 years old. G2 emotional distress and harsh parenting were examined when the G3 child was between 3 and 5 years old. Finally, G3 aggression was assessed between 6 and 10 years old. Results showed continuity of G1 behavior when G2 was in adolescence to G2 behavior in adulthood. G1 alcohol problems and G1 harsh parenting were both associated with G3 aggression through G2 alcohol problems, G2 emotional distress, and G2 harsh parenting. Results suggest that G1 problem behavior as experienced by G2 adolescents in the family of origin plays an important role in G2 alcohol problems in emerging adulthood, which leads to G2 emotional distress and G2 harsh parenting in adulthood, which is related to G3 aggression in the early elementary school years. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Evaluating the effect of retail marijuana legalization on parent marijuana use frequency and norms in U.S. States with retail marijuana legalization

OBJECTIVES

To examine post-retail marijuana legalization (RML) change in marijuana use frequency and pro-marijuana norms among parents.

METHODS

The Intergenerational Study, a longitudinal panel of parents (N = 668) and children, followed participants from 2002 to 2018, when parents were 27 and 43 years old, respectively. Three quarters of participants (74%) lived in an RML state and 142 (21%) had used marijuana in the 8 years prior to RML. Piecewise growth modelling compared pre- and post-RML slopes of use frequency and pro-marijuana norms.

RESULTS

Frequency of use and pro-marijuana norms increased following legalization in both RML and non-RML states, though norms rose significantly faster in RML states. Growth in use was primarily driven by new users of marijuana. There were no differences in frequency of marijuana use or pro-marijuana norms by race/ethnicity, gender, or education.

CONCLUSIONS

An increase in marijuana use frequency associated with RML among parents poses risk to both parents' well-being and the health of their children. A faster pace of increase in pro-marijuana norms in RML states may signal continued increases in use in the future.

Parent hazardous drinking and their children's alcohol use in early and mid-adolescence: prospective cohort study

BACKGROUND

Why adolescents' drinking is associated with their parents' drinking remains unclear. We examined associations in a prospective cohort study, adjusting for socio-demographic characteristics and family factors.

METHODS

We recruited 1927 children from grade 7 classes (mean age 13 years), and one of their parents, in three Australian states, contacted participants annually from 2010 to 2014, and analysed data from assessments at ages 13, 14, 15 and 16 years. We used the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) subscale to identify hazardous drinking in parents (score ≥5) and children (score ≥3) and constructed mixed-effect logistic regression models, accounting for clustering within school and adjusting for likely confounders. We evaluated the sensitivity of estimates by imputing missing values assuming the data were missing at random vs. missing not at random.

RESULTS

Parent hazardous drinking predicted mid-adolescent hazardous drinking, e.g. 15 years olds whose parents [adjusted odds ratio (aOR) 2.00; 95% confidence interval 1.51-2.64] or parents' partners (aOR 1.94; 1.48-2.55) were hazardous drinkers had higher odds of being hazardous drinkers at age 16. The magnitude of univariate associations changed little after adjusting for covariates, and sensitivity analyses confirmed the robustness of the association, across a wide range of assumptions about the missing data.

CONCLUSIONS

The associations between parents' and their adolescent children's hazardous drinking are unlikely to be due to confounding by socio-demographic and family factors. Parents should be encouraged, and supported by public policy, to reduce their own alcohol consumption in order to reduce their children's risk of becoming hazardous drinkers.

Marijuana Legalization and Youth Marijuana, Alcohol, and Cigarette Use and Norms

INTRODUCTION

Rates of adolescent substance use have decreased in recent years. Knowing whether nonmedical marijuana legalization for adults is linked to increases or slows desirable decreases in marijuana and other drug use or pro-marijuana attitudes among teens is of critical interest to inform policy and promote public health. This study tests whether nonmedical marijuana legalization predicts a higher likelihood of teen marijuana, alcohol, or cigarette use or lower perceived harm from marijuana use in a longitudinal sample of youth aged 10-20 years.

METHODS

Data were drawn from the Seattle Social Development Project-The Intergenerational Project, an accelerated longitudinal study of youth followed both before (2002-2011) and after nonmedical marijuana legalization (2015-2018). Analyses included 281 youth surveyed up to 10 times and living in a state with nonmedical marijuana legalization between 2015 and 2018 (51% female; 33% white, 17% African American, 10% Asian/Pacific Islander, and 40% mixed race or other).

RESULTS

Multilevel modeling in 2019 showed that nonmedical marijuana legalization predicted a higher likelihood of self-reported past-year marijuana (AOR=6.85, p=0.001) and alcohol use (AOR 3.38, p=0.034) among youth when controlling birth cohort, sex, race, and parent education. Nonmedical marijuana legalization was not significantly related to past-year cigarette use (AOR=2.43, p=0.279) or low perceived harm from marijuana use (AOR=1.50, p=0.236) across youth aged 10-20 years.

CONCLUSIONS

It is important to consider recent broad declines in youth substance use when evaluating the impact of nonmedical marijuana legalization. States that legalize nonmedical marijuana for adults should increase resources for the prevention of underage marijuana and alcohol use.

The Effects of Parental School Exclusion on Offspring Drug Use: An Intergenerational Path Analysis

PURPOSE

To determine whether and how exclusionary school punishment experienced by parents affects the drug use of their offspring.

METHODS

Using panel data of 360 parent-child dyads from the Rochester Youth Developmental Study and its intergenerational component, the Rochester Intergenerational Study, we conduct path analysis to evaluate the adequacy of a theoretical model that explicates the intergenerational pathways from parental school exclusion to offspring drug use.

RESULTS

Parents who were suspended or expelled during adolescence are more likely to drop out of school, which, in turn, leads to parental adult drug use, economic hardship, and ineffective parenting of their children. As a result, their offspring are likely to hold attitudes/beliefs favoring drug use and have reduced bonding to school, which, ultimately, contribute to offspring drug use.

CONCLUSIONS

Exclusionary school disciplinary practices not only result in a number of adverse collateral consequences within one generation of respondents, the negative effects of such experiences are also felt by the next generation. Therefore, exclusionary school punishment should only be used as a last resort. Whenever possible, disciplinary practices in school need to involve inclusionary efforts to re-integrate students into the larger school community.

Paternal and maternal prescription opioid use and misuse: General and specific risks for early adolescents' substance use

BACKGROUND

Parent substance use is a risk factor early adolescents' substance use. Theoretical models of deviance and general substance use risk may not apply to risk-transmission pathways involving parents' prescription opioid misuse (POM) and child outcomes. Thus, we examined predictions of children's alcohol, tobacco, and marijuana (ATM) use in early adolescence, from parental POM, delinquency, depressive symptoms, and ATM use.

METHOD

Children (n = 216; 121 female) participated from early childhood to ages 11-12 or 13-14 years with their 111 fathers and 136 mothers. At all available waves, self-reports were collected on each parents' POM, ATM, prescription opioid use (POU), depressive symptoms, and delinquent behavior, and children's ATM use.

RESULTS

Poisson regressions were run separately by parent, controlled for child age and gender and paternal age at child's birth, and accounted for clustering of children in families. Child ATM use was predicted by paternal POM, but the effect was better explained by paternal ATM use, which was a stronger effect in families with higher father-child residential contact. In contrast and unexpectedly, mothers' POU but not POM predicted child ATM use, and the effect was not explained by the significant predictions from maternal ATM use and delinquency.

CONCLUSION

Fathers' POM and mothers' POU predicted child ATM use by early adolescence. Findings generally were consistent with parent-child risk-transmission processes described for other substances. Resident fathers' substance use and multiple maternal risk factors are worthy foci for prevention of the intergenerational transmission of substance use.

Parents' Perceptions of Adolescent Exposure to Marijuana Following Legalization in Washington State

OBJECTIVE

Parents in Washington State face new challenges related to the non-medical marijuana legislation that was passed in 2012. We asked parent focus group participants about changes they have observed in their environment, how their children are exposed to marijuana, and how this exposure might affect youth marijuana use.

METHOD

We conducted 6 focus groups with parents of youth ages 8 to 15 (N = 54). Parents were recruited from the Seattle Social Development Project, a multi-ethnic, longitudinal panel study that originated in Seattle in 1985. Thematic content analysis was used to analyze qualitative data.

RESULTS

Parents agreed that they did not want their children using marijuana, and were concerned that their children were exposed to marijuana more often and in many different contexts. Parents said they now need to monitor their children's environment more carefully, especially the other adults that spend time around their children. Edible marijuana products were particularly concerning for parents, as they offer a new set of challenges for parents in monitoring their children's exposure to and use of marijuana. Parents were concerned that marijuana exposure would increase risk of marijuana use in adolescents.

CONCLUSIONS

Parents' experiences in Washington State provide valuable lessons for social work practitioners, policymakers and those developing preventive interventions. Prevention efforts and public health messaging should begin before legalization takes effect to support parents in preparing for changes in their social and physical environments, and should seek to incorporate parenting strategies to monitor and intervene when children are exposed to marijuana.

Intergenerational congruence in adolescent onset of alcohol, tobacco, and marijuana use

We examined alcohol, tobacco, and marijuana (ATM) use onset across early to late adolescence in a sample of fathers and their offspring. We tested a theory of developmental congruence in polysubstance use, or the extent to which fathers' ATM use onset in early adolescence increased risk for earlier ATM onset by their offspring. Average rates of adolescent ATM use onset were also compared across generations, which may reflect intergenerational discontinuity and secular trends. Children (n = 223, 44% boys) and their fathers (n = 113; originally recruited as boys at neighborhood risk for delinquency) contributed repeated prospective self-reports of their ATM use across adolescence (as late as age 18 years). Mothers' ATM use (retrospective) through age 18 years was available for 205 children. Data were analyzed using discrete-time survival mixture analysis. Compared with their fathers, boys and girls showed later onset for tobacco use, and girls showed later onset alcohol use. Developmental congruence was partially supported: Children showed earlier ATM use onset if their fathers were assigned to the early adolescent polysubstance use onset class, compared to the late-adolescent predominantly alcohol and tobacco onset class; mothers' ATM use in adolescence attenuated this effect. Consistent with national secular trends, rates of adolescent onset tobacco and alcohol use declined across generations, whereas marijuana use onset did not. However, there was intergenerational transmission of risk for early polysubstance use onset. Prevention that delays early substance use may have early life span effects as well as transgenerational implications. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Men's misuse of prescription opioids from early to middle adulthood: An examination of developmental and concurrent prediction models

OBJECTIVE

The prevalence of misuse of prescription opioids across adulthood and the associations of such misuse with symptoms of psychopathology and use of other substances were examined for an at-risk community sample of men.

METHOD

For a longitudinal study of boys (N = 206) followed to adulthood, misuse of prescription opioids was assessed on 13 occasions from ages 20-21 years to 37-38 years. Prediction of misuse was examined from prospectively assessed risk factors in 3 models: (a) parental substance use during the men's adolescence; (b) the men's own risk behaviors in adolescence-delinquent behavior, depressive symptoms, and use of tobacco, alcohol, marijuana, and opioids; and (c) within- and between-individual effects of the men's risk behaviors during adulthood.

RESULTS

Opioid misuse was reported by 29% of men. After accounting for effects of age and considered individually, parent marijuana use and all of the adolescent and adult risk factors (except adolescent depressive symptoms) were significant between-individual predictors of opioid misuse. Furthermore, within-individual prediction was significant for adult delinquency and alcohol use after accounting for increases in opioid misuse with age. When risk factors were tested simultaneously, men's adult delinquency and use of marijuana and tobacco remained significant between-individual predictors, whereas no parental or adolescent risk factors remained significant in these models.

CONCLUSION

Both adolescent and adult risk factors were examined that predicted adult opioid misuse. Preventing adolescent problem behavior and using such histories to inform screening for misuse risk in adulthood may reduce the burden of the opioid crisis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Intergenerational marijuana use: A life course examination of the relationship between parental trajectories of marijuana use and the onset of marijuana use by offspring

Prior research documents intergenerational (IG) continuity in marijuana use, with most work adopting a life course perspective. Incorporating a methodology that allows for the measurement of "patterns of behavior" instead of singular aspects of parent marijuana use (e.g., age of onset or frequency at any one age or ages), we investigated the simultaneous effects of parental age of onset, frequency, and duration of marijuana use across 3 periods of the life course (i.e., adolescence, emerging adulthood, and adulthood) on the timing of first marijuana use among offspring. Using prospective data from 2 companion studies, the Rochester Youth Development Study and the Rochester Intergenerational Study, we used group-based trajectory models to estimate trajectories (or patterns) of parental marijuana use spanning ages 14 to 31 among a birth cohort of 462 parents. We then examined the relationship between parental trajectories of marijuana use and the timing of the onset of marijuana use through age 25 among firstborn offspring. Both late-onset persistent use by parents and increasing chronic use spanning adolescence to adulthood by parents were associated with an increased likelihood of onset of marijuana use among offspring. The results underscore the importance of patterns of marijuana use for IG continuity in contrast to singular measures (e.g., age of onset among parents), which can obfuscate important IG patterns of continuity. Prevention and intervention programs should consider the entire history of parent use to better identify children most at risk for the onset of marijuana use in adolescence and emerging adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

An intergenerational investigation of the associations between parental marijuana use trajectories and child functioning

Diverse patterns of life-course marijuana use may have differential health impacts for the children of users. Data are drawn from an intergenerational study of 426 families that included a parent, their oldest biological child, and (where appropriate) another caregiver who were interviewed 10 times from 2002 to 2018; the current study used data from 380 families in waves 6-10. Analyses linked parent marijuana use trajectories estimated in a previous publication (Epstein et al., 2015) to child marijuana, alcohol, and nicotine use; promarijuana norms; internalizing; externalizing; attention problems; and grades using multilevel modeling among children ages 6 to 21. Four trajectories had been found in the previous study: nonuser, chronic, adolescent-limited, and late-onset. Results indicate that children of parents in the groups that initiated marijuana use in adolescence (chronic and adolescent-limited) were most likely to use substances. Children of parents in the late-onset group, where parents initiated use in young adulthood, were not at increased risk for substance use but were more likely to have attention problems and lower grades. Results held when parent current marijuana use was added to the models. Implications of this work highlight the importance of considering both current use and use history in intergenerational transmission of marijuana use, and the need to address parent use history in family based prevention. Prevention of adolescent marijuana use remains a priority. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

General and Specific Predictors of Comorbid Substance Use and Internalizing Problems from Adolescence to Age 33

The current study examines the continuity in comorbidity between substance use and internalizing mental health problems from adolescence to adulthood and investigates the general and specific predictors of comorbidity across development. Participants were drawn from the Seattle Social Development Project (N = 808), a gender-balanced, ethnically diverse longitudinal panel. Structural equation modeling was used to examine risk factors for comorbid substance use and internalizing problems in family and peer social environments; substance use- and mental health-specific social environments (family tobacco, alcohol, and marijuana use; family history of depression); and individual risk factors (behavioral disinhibition). Latent factors were created for comorbid substance use and mental health problems at ages 13-14 and comorbidity of substance abuse and dependence symptoms and mental health disorder symptoms at ages 30-33 and included indicators of anxiety, depression, alcohol, tobacco, and marijuana problems. Comorbid problems in adolescence predicted later comorbidity of disorders in adulthood. In addition, family tobacco environment and behavioral disinhibition predicted adolescent comorbidity, while family history of depression was associated with adult comorbidity. Finally, family and peer substance use in adolescence predicted substance use (alcohol, tobacco, and marijuana) both in adolescence and adulthood. The pattern of results suggests that comorbidity in adolescence continues into adulthood and is predicted by both general and behavior-specific environmental experiences during adolescence. Findings clarify the etiology of comorbid internalizing and substance use problems and suggest potential preventive intervention targets in adolescence to curb the development of comorbidity in adulthood.

The Role of Integrated Care in a Medical Home for Patients With a Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe preventable birth defects and intellectual and/or developmental disabilities resulting from prenatal alcohol exposure. The American Academy of Pediatrics has a previous clinical report in which diagnostic criteria for a child with an FASD are discussed and tools to assist pediatricians with its management can be found. This clinical report is intended to foster pediatrician awareness of approaches for screening for prenatal alcohol exposure in clinical practice, to guide management of a child with an FASD after the diagnosis is made, and to summarize available resources for FASD management.

Concurrent and Prospective Associations Between Substance-Specific Parenting Practices and Child Cigarette, Alcohol, and Marijuana Use

PURPOSE

The current study aimed to understand whether substance-specific parenting practices predicted the probability of child alcohol, cigarette, or marijuana use beyond known family factors like family management and parental substance use and norms.

METHODS

Data were drawn from the Intergenerational Project, which used an accelerated longitudinal design and included 383 families surveyed seven times between 2002 and 2011. Analyses included 224 families with children ages 10-18 years (49% female). Multilevel models tested both concurrent and lagged (predictors at time t - 1, outcomes at time t) associations between child past year use of alcohol, cigarettes, and marijuana and time-varying measures of substance-specific parenting practices, including permitting child use of alcohol or cigarettes; family rules about alcohol, cigarette, and drug use; and child involvement in family member alcohol or cigarette use (getting, opening, or pouring alcoholic drinks; getting or lighting cigarettes for family members). Demographic controls were included.

RESULTS

Child involvement in family member substance use predicted an increased probability of child substance use both concurrently and 1 year later, even when controlling parent substance use, pro-substance norms, and family management. Family rules about substance use and parent provision of alcohol or cigarettes were not consistently related to child alcohol, cigarette, or marijuana use.

CONCLUSIONS

Family-based preventive interventions to reduce youth substance use should continue to focus on family management and include messaging discouraging parents from allowing children to get, open, or pour drinks or get or light cigarettes for family members.

Assessing Associations in Substance Use across Three Generations: From Grandparents to Sons and from Sons to Their Children

The Three Generational Study (3GS) began in the early 90s and involves the third generation (G3) offspring of second generation (G2) fathers who were originally recruited in 1984 as part of the Oregon Youth Study (OYS) in mid childhood (ages 9-10 years) along with their first- generation (G1) parents. As boys, the G2 fathers lived in higher delinquency neighborhoods of a medium-sized Pacific Northwestern United States city. The OYS-3GS examines questions concerning socially mediated intergenerational transmission versus discontinuity (or moderation) of antisocial behavior, substance use, and related problem behaviors. Questions address influences of the grandparents, or Generation 1 (G1), on their sons in G2 and in turn of these sons and their partners on their own children in G3. In this article, we present an overview of the study design-and underlying theory-related to general and outcome-specific transmission pathways. We then summarize key issues and findings to date related to the current main focus of the study regarding intergenerational associations in substance use.

Social class, social mobility and alcohol-related disorders in Swedish men and women: A study of four generations

Objectives

To investigate whether and how social class and social mobility in grandparents and parents predict alcohol-related disorders (ARDs) in males and females aged 12+ years, and whether intergenerational social prediction of ARDs varies across time periods.

Methods

The study sample included four successive generations (G) of Swedish families from the Uppsala Birth Cohort Multigenerational Study: G0 born 1851–1912; G1 born 1915–1929; G2 born 1940–1964 and G3 born 1965–1989. Two study populations were created, each consisting of grandparents, parents and offspring: population I ‘G0-G1-G2’ (offspring n = 18 430) and population II ‘G1-G2-G3’ (offspring n = 26 469). Registers and archives provided data on ancestors’ socio-demographic factors and ARD history, together with offspring ARD development between 1964–2008. Cox regression models examined the hazard of offspring ARD development according to grandparental social class and grandparental-to-parental social trajectories, controlling for offspring birth year, grandmother’s and mother’s marital status and parental ARDs.

Results

Disadvantaged grandparental social class predicted increased ARD risk in offspring in population I, although the effect attenuated and became non-significant in males after adjusting for parental characteristics (adjusted hazard ratio (HR) = 1.80 (95%CI; 1.07, 3.03) in females, HR = 1.32 (95%CI; 0.93, 1.89) in males). In population II, no increase in ARD risk by grandparental social was evident. In both populations, males were at the highest ARD risk if both parents and grandparents belonged to disadvantaged social class (population I: HR = 1.82 (95%CI; 1.22–2.72); population II: HR = 1.68 (95%CI; 1.02–2.76)).

Conclusions

Intergenerational social patterning of ARDs appears to be time-contextual and gender-specific. The role of grandparental social class in developing ARDs in grandchildren seems to decline over time, while persistent grandparental-to-parental social disadvantage remains associated with higher ARD risk in males. When targeting higher risk groups, continuity of familial social disadvantage, particularly among males, should be considered.

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.

Understanding the interplay of individual and social-developmental factors in the progression of substance use and mental health from childhood to adulthood

This study examines the interplay between individual and social-developmental factors in the development of positive functioning, substance use problems, and mental health problems. This interplay is nested within positive and negative developmental cascades that span childhood, adolescence, the transition to adulthood, and adulthood. Data are drawn from the Seattle Social Development Project, a gender-balanced, ethnically diverse community sample of 808 participants interviewed 12 times from ages 10 to 33. Path modeling showed short- and long-term cascading effects of positive social environments, family history of depression, and substance-using social environments throughout development. Positive family social environments set a template for future partner social environment interaction and had positive influences on proximal individual functioning, both in the next developmental period and long term. Family history of depression adversely affected mental health functioning throughout adulthood. Family substance use began a cascade of substance-specific social environments across development, which was the pathway through which increasing severity of substance use problems flowed. The model also indicated that adolescent, but not adult, individual functioning influenced selection into positive social environments, and significant cross-domain effects were found in which substance-using social environments affected subsequent mental health.

Predictors of Adult Marijuana Use Among Parents and Nonparents

The current study examined predictors of marijuana use among adults, including subsamples of adults who are actively parenting (i.e., have regular face-to-face contact with a child) and those who have no children. Participants were a community sample of 808 adults and two subsamples drawn from the full group: 383 adults who were actively parenting and 135 who had no children. Multilevel models examined predictors of marijuana use in these three groups from ages 27 to 39. Becoming a parent was associated with a decrease in marijuana use. Regular marijuana use in young adulthood (ages 21-24), partner marijuana use, and pro-marijuana attitudes increased the likelihood of past-year marijuana use among all participants. Being a primary caregiver (among parents) was associated with less marijuana use. Overall, predictors of marijuana use were similar for all adults, regardless of parenting status. Study results suggest that the onset of parenthood alone may be insufficient to reduce adult marijuana use. Instead, preventive intervention targets may include changing adult pro-marijuana attitudes and addressing marijuana use behaviors of live-in partners. Lastly, universal approaches targeting parents and nonparents may be effective for general adult samples.

Associations Between Parental and Grandparental Marijuana Use and Child Substance Use Norms in a Prospective, Three-Generation Study

PURPOSE

Using prospective longitudinal data from three generations, this study seeks to test whether and how parent and grandparent marijuana use (current and prior) predicts an increased likelihood of child cigarette, alcohol, and marijuana use.

METHODS

Using multilevel modeling of prospective data spanning three generations (n = 306 families, children ages 6-22), this study tested associations between grandparent (G1) and parent (G2) marijuana use and child (G3) past-year cigarette, alcohol, and marijuana use. Analyses tested whether G3 substance-related norms mediated these associations. Current G1 and G2 marijuana use was examined, as was G2 high school and early adult use and G1 marijuana use when G2 parents were in early adolescence. Controls included G2 age at G3 birth, G2 education and depression, and G3 gender.

RESULTS

G2 current marijuana use predicted a higher likelihood of G3 alcohol and marijuana use but was not related to the probability of G3 cigarette use. G3's perceptions of their parents' norms and G2 current marijuana use both contributed independently to the likelihood of G3 alcohol and marijuana use when included in the same model. G3 children's own norms and their perceptions of friends' norms mediated the link between G2 current marijuana use and G3 alcohol and marijuana use.

CONCLUSIONS

Results are discussed in light of the growing trend toward marijuana legalization. To the extent that parent marijuana use increases under legalization, we can expect more youth to use alcohol and marijuana and to have norms that favor substance use.

The Relationships of Parental Alcohol Versus Tobacco and Marijuana Use With Early Adolescent Onset of Alcohol Use

OBJECTIVE

This study examined whether the use of tobacco and marijuana by fathers or mothers predicted onset of alcohol use in their offspring over and above effects of parental alcohol use.

METHOD

The present study included 146 children of 93 parents (90 fathers and 85 mothers). The fathers were originally recruited as boys to the Oregon Youth Study, a study of community, familial, and individual risk factors for delinquency.

RESULTS

Only mothers' but not fathers' alcohol use was associated with children's age at onset. Children's age at onset was predicted by mothers' tobacco use and by the interaction of fathers' marijuana use and alcohol use. These effects were observed when controlling for parental education, child's gender, and also child's antisocial behavior-a general developmental risk factor for substance use onset in adolescence.

CONCLUSIONS

Mothers' substance use played a major role in childhood onset of alcohol use, yet the role of maternal substance use as a risk factor for their children has previously received less attention than the role of paternal substance use. Also, findings imply that it may be important to identify children of polysubstance-using parents for targeted prevention programs.

Families Affected by Parental Substance Use

Children whose parents or caregivers use drugs or alcohol are at increased risk of short- and long-term sequelae ranging from medical problems to psychosocial and behavioral challenges. In the course of providing health care services to children, pediatricians are likely to encounter families affected by parental substance use and are in a unique position to intervene. Therefore, pediatricians need to know how to assess a child's risk in the context of a parent's substance use. The purposes of this clinical report are to review some of the short-term effects of maternal substance use during pregnancy and long-term implications of fetal exposure; describe typical medical, psychiatric, and behavioral symptoms of children and adolescents in families affected by substance use; and suggest proficiencies for pediatricians involved in the care of children and adolescents of families affected by substance use, including screening families, mandated reporting requirements, and directing families to community, regional, and state resources that can address needs and problems.

Explaining Adolescent Drug Use in Adjacent Generations: Testing the Generality of Theoretical Explanations

We tested the assumption that theories of drug use are able to account for behavior across varying contexts and populations by examining whether control, learning, and elaborated theories provide similar explanations for adolescent drug use in adjacent generations. We used data from the Rochester Youth Development Study and Rochester Intergenerational Study which followed a sample of adolescents starting at age 14 and their oldest biological child. Cross-generational analysis between theoretical variables measured at age 14 and drug use measured at approximately ages 15 and 16 were used. Regression models testing for each theoretical framework found that in general, they appear to operate similarly in adjacent generations. We conducted 14 tests of equality for pairs of coefficients across the generations; no statistically significant differences are observed. Overall, these theories offer general explanations for adolescent drug use with respect to risk and protective factors for parents and their children. Theoretical and policy implications are discussed.

Family process and youth internalizing problems: A triadic model of etiology and intervention

Despite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic modelof family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.

Does parental drinking influence children's drinking? A systematic review of prospective cohort studies

AIMS

To evaluate evidence of the capacity for causal inference in studies of associations between parental and offspring alcohol consumption in the general population.

METHODS

A systematic search for, and narrative analysis of, prospective cohort studies of the consequences of drinking, except where assessed prenatally only, or with clinically derived instruments. Primary outcome measures were alcohol use or related problems in offspring, which were collected at least 3 years after exposure measures of parental drinking. The systematic review included 21 studies comprising 26,354 families or parent-child dyads with quantitative effect measures available for each study. Criteria for capacity of causal inference included (1) theory-driven approach and analysis; (2) analytical rigour; and (3) minimization of sources of bias.

RESULTS

Four of the 21 included studies filled several, but not all, criteria and were assessed to have some capacity for causal inference. These four studies found some evidence that parental drinking predicted drinking behaviour in adolescent offspring. The remaining 17 studies had little or no such capacity.

CONCLUSIONS

There is a fairly large and consistent literature demonstrating that more parental drinking is associated with more drinking in offspring. Despite this, existing evidence is insufficient to warrant causal inferences at this stage.

Disorders of cognitive and emotional development in children of mothers with substance abuse and psychiatric disorders

Aims

The aim of this study was to investigate whether the mother's substance abuse, psychiatric problems and socioeconomic situation are related to 1) disorders of psychological development, 2) behavioural and emotional disorders, and 3) mood disorders and neurotic, stress-related and somatoform disorders in children aged 0–12 years.

Data & Methods

The research is based on data on all children born in Finland in 1997 who have not died before their first birthday (n=58 761). These children were followed until their 12th birthday. Information from national registers covering health and social care, education, relationship status, age and receipt of income support were analysed using cross-tabulation with χ2-tests and logistic regression analysis.

Results

Based on the register data of children, 1.4% (n = 798) had a mother with substance abuse problems only, 3.2% (n = 1854) had a mother with psychiatric disorders only, and 1.1% (n = 652) had a mother with both substance abuse and psychiatric disorders. Among children with mothers with substance abuse, psychiatric disorders or both, the risks of all categories of psychiatric diseases studied were significantly higher than in the comparison group. It was a bigger risk for the child to have a mother with both substance abuse and psychiatric disorders than either of these alone.

Conclusion

The mother's substance abuse and her other psychiatric disorders are significant risk factors for her children's psychiatric development, even when the socioeconomic factors are taken into account. Children of mothers with both substance abuse and psychiatric disorders are at a particularly high risk.

DSM-5 ASD moves forward into the past

The fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) (APA in diagnostic and statistical manual of mental disorders, Author, Washington, 2013) has decided to merge the subtypes of pervasive developmental disorders into a single category of autism spectrum disorder (ASD) on the assumption that they cannot be reliably differentiated from one another. The purpose of this review is to analyze the basis of this assumption by examining the comparative studies between Asperger's disorder (AsD) and autistic disorder (AD), and between pervasive developmental disorder not otherwise specified (PDDNOS) and AD. In all, 125 studies compared AsD with AD. Of these, 30 studies concluded that AsD and AD were similar conditions while 95 studies found quantitative and qualitative differences between them. Likewise, 37 studies compared PDDNOS with AD. Nine of these concluded that PDDNOS did not differ significantly from AD while 28 reported quantitative and qualitative differences between them. Taken together, these findings do not support the conceptualization of AD, AsD and PDDNOS as a single category of ASD. Irrespective of the changes proposed by the DSM-5, future research and clinical practice will continue to find ways to meaningfully subtype the ASD.

Asperger's disorder will be back

This review focuses on identifying up-to-date number of publications that compared DSM-IV/ICD-10 Asperger's disorder (AspD) to Autistic Disorder/High-functioning Autism (AD/HFA). One hundred and twenty-eight publications were identified through an extensive search of major electronic databases and journals. Based on more than 90 clinical variables been investigated, 94 publications concluded that there were statistically significant or near significant level of quantitative and/or qualitative differences between AspD and AD/HFA groups; 4 publications found both similarities and differences between the two groups; 30 publications concluded with no differences between the two groups. Although DSM-5 ASD will eliminate Asperger's disorder. However, it is plausible to predict that the field of ASD would run full circle during the next decade or two and that AspD will be back in the next edition of DSM.

Heterogeneity in men's marijuana use in the 20s: adolescent antecedents and consequences in the 30s

Adolescent psychopathology is commonly connected to marijuana use. How changes in these adolescent antecedents and in adolescent marijuana use are connected to patterns of marijuana use in the 20s is little understood. Another issue not clearly understood is psychopathology in the 30s as predicted by marijuana use in the 20s. This study sought to examine these two issues and the associations with marijuana disorder diagnoses using a longitudinal data set of 205 men with essentially annual reports. Individual psychopathology and family characteristics from the men's adolescence were used to predict their patterns of marijuana use across their 20s, and aspects of the men's psychopathology in their mid-30s were predicted from these patterns. Three patterns of marijuana use in the 20s were identified using growth mixture modeling and were associated with diagnoses of marijuana disorders at age 26 years. Parental marijuana use predicted chronic use for the men in adulthood. Patterns of marijuana use in the 20s predicted antisocial behavior and deviant peer association at age 36 years (controlling for adolescent levels of the outcomes by residualization). These findings indicate that differential patterns of marijuana use in early adulthood are associated with psychopathology toward midlife.

General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: replication in two samples

BACKGROUND

This paper presents two replications of a heuristic model for measuring environment in studies of gene-environment interplay in the etiology of young adult problem behaviors.

METHODS

Data were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10-18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25).

RESULTS

Results from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder.

CONCLUSIONS

Organizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence.

A 5-year follow-up study of adolescents who sought treatment for substance misuse in Sweden

Previous studies have shown that substance misuse in adolescence is associated with increased risks of hospitalizations for mental and physical disorders, convictions for crimes, poverty, and premature death from age 21 to 50. The present study examined 180 adolescent boys and girls who sought treatment for substance misuse in Sweden. The adolescents and their parents were assessed independently when the adolescents first contacted the clinic to diagnose mental disorders and collect information on maltreatment and antisocial behavior. Official criminal files were obtained. Five years later, 147 of the ex-clients again completed similar assessments. The objectives were (1) to document the prevalence of alcohol use disorders (AUD) and drug use disorders (DUD) in early adulthood; and (2) to identify family and individual factors measured in adolescence that predicted these disorders, after taking account of AUD and DUD in adolescence and treatment. Results showed that AUD, DUD, and AUD + DUD present in mid-adolescence were in most cases also present in early adulthood. Prediction models detected no positive effect of treatment in limiting persistence of these disorders. Thus, treatment-as-usual provided by the only psychiatric service for adolescents with substance misuse in a large urban center in Sweden failed to prevent the persistence of substance misuse. Despite extensive clinical assessments of the ex-clients and their parents, few factors assessed in mid-adolescence were associated with substance misuse disorders 5 years later. It may be that family and individual factors in early life promote the mental disorders that precede adolescent substance misuse.

Influences on Boys' Marijuana Use in High School: A Two-Part Random Intercept Growth Model

This study examined differences in predictors of marijuana use versus quantity of marijuana use across the high school years, using annual assessments from the Oregon Youth Study (OYS) and a two-part model for semicontinuous data. The OYS is a community sample of at-risk boys followed from age 10 years. In order to capture dynamic prediction effects, change scores of predictors, as well as baseline scores, were included. Baseline predictors predominantly showed associations with the intercepts but not with the slopes of growth models. Change scores for parental monitoring, peer substance use, and antisocial behavior and deviant associations were associated with both parts of the model. Findings highlight the importance of looking at marijuana use compared to quantity of marijuana use.

Intergenerational continuity of substance use

Guided by rigorous methodology and a life-course perspective, the goal of this research is to address a gap in current knowledge on whether, when, and how strongly intergenerational continuity of substance use exists when examining age-equivalent and developmentally specific stages of the life course. Annual self-reported substance use measures were analyzed from a prospective, longitudinal, and nationally representative sample that originally consisted of 1,725 respondents and their families, who were then interviewed over a 27-year period from 1977 to 2004. Findings from multilevel random-intercept regression models provide support for intergenerational continuity when substance use occurs in emerging adulthood but not when limited to adolescence. Implications, limitations, and future research directions are discussed.