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Chang KK, Rogge RD, Starr LR. Characterizing Life Stress Exposure Among Sexual Minority Adolescents: Temporality, Content, And Mediating Role in Mental Health Disparities. Res Child Adolesc Psychopathol 2024; 52:851-863. [PMID: 38214850 DOI: 10.1007/s10802-023-01165-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/13/2024]
Abstract
Though sexual minority adolescents face a wide array of deleterious stressors, few studies have examined the role of specific types of stress exposure (i.e., chronic vs. episodic, interpersonal vs. non-interpersonal) on mental health disparities. This study utilizes a contextual threat-based assessment to (a) compare levels of stress exposure types between sexual minority and non-sexual minority adolescents, and (b) examine stress type as a mediator between sexual orientation and two outcomes: depressive symptoms and emotion dysregulation. Data comes from a longitudinal sample (14-17 years-old, N = 241; 17.6% sexual minority; 54% assigned female at birth; 73.9% White), with two time-points (T1 and T2) utilized. Sexual minority adolescents reported higher chronic interpersonal stress, but no differences in non-interpersonal chronic or episodic stress, relative to non-sexual minority adolescents. Chronic interpersonal stress exposure mediated the link between membership in an oppressed group (i.e., sexual minority teens) and the primary outcomes (emotion dysregulation and depressive symptoms) at both T1 and T2. Findings demonstrate the utility of contextual threat-based assessments within sexual minority research.
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Affiliation(s)
- Katharine K Chang
- Department of Psychology, University of Rochester, Rochester, NY, USA.
| | - Ronald D Rogge
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Lisa R Starr
- Department of Psychology, University of Rochester, Rochester, NY, USA
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Lai RY, Su MH, Lin YF, Chen CY, Pan YJ, Hsiao PC, Chen PC, Huang YT, Wu CS, Wang SH. Relationship between mood disorders and substance involvement and the shared genetic liabilities: A population-based study in Taiwan. J Affect Disord 2024; 345:168-176. [PMID: 37879417 DOI: 10.1016/j.jad.2023.10.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/16/2023] [Accepted: 10/22/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND This study explored the phenotypic association of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BPD), with a range of substance involvement, including lifetime experience and age at initiation of tobacco, alcohol, and betel nut use. Additionally, we elucidated polygenic risk score (PRS) association. METHODS In total, 132,615 community participants were recruited from the Taiwan Biobank. Genome-wide genotyping data were available for 106,806 unrelated individuals, and the PRS for MDD and BPD was calculated. The significance of mood disorders and PRSs associated with substance involvement were evaluated using a linear/logistic regression model with adjustment for potential confounders. Sex differences were assessed. RESULTS MDD and BPD were associated with regular alcohol consumption, drinking cessation, tobacco smoking, smoking cessation, betel nut chewing, and earlier onset of drinking. BPD was associated with an earlier onset of smoking. MDD PRS was associated with regular alcohol use (odds ratio [OR] per standard deviation increase in PRS = 1.03, p = 0.018), alcohol cessation (OR = 1.05, p = 0.03), regular tobacco use (OR = 1.08, p < 0.0001), and betel nut chewing (OR = 1.06, p < 0.0001), whereas BPD PRS was not associated with substance use. Phenotypic association strengths between MDD/BPD and regular drinking/smoking and the polygenic association between MDD PRS and regular smoking were larger in females than in males. LIMITATIONS Retrospective self-reported MDD/BPD diagnoses and substance involvement. CONCLUSIONS Mood disorders were associated with a range of substance involvement. Shared genetic architecture contributed to the co-occurrence of MDD and substance involvement. These findings may help design prevention and cessation strategies for substance use.
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Affiliation(s)
- Rou-Yi Lai
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Mei-Hsin Su
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Psychiatry, Virginia Institute for Psychiatric Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Yen-Feng Lin
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chia-Yen Chen
- Biogen, Cambridge, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Yi-Jiun Pan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Chang Hsiao
- College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pei-Chun Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Yen-Tsung Huang
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Yunlin branch, Douliu, Taiwan
| | - Shi-Heng Wang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan.
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Xu C, Wang S, Su BB, Ozuna K, Mao C, Dai Z, Wang K. Associations of adolescent substance use and depressive symptoms with adult major depressive disorder in the United States: NSDUH 2016-2019. J Affect Disord 2024; 344:397-406. [PMID: 37844780 DOI: 10.1016/j.jad.2023.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/16/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Few studies have focused on the associations of adolescent substance use and depressive symptoms with adult major depressive disorder (MDD). METHODS Data from 168,859 adults, among which, 15,959 had experienced MDD in the past year, as indicated by a major depressive episode (MDE) marked by MDD symptoms, were from the 2016-2019 National Surveys on Drug Use and Health. Weighted multivariable logistic regression (MLR) analyses were used to determine the associations. RESULTS The overall MDD prevalence was 7.2 %, whereas the prevalence for adults without early onset depressive symptoms prior to age 18 was 4.6 %. Variable cluster analysis revealed that adolescent use of alcohol, cigarettes, marijuana, cocaine, hallucinogen use, and inhalants prior to age 18 were in one cluster. MLR analyses showed that the presence of depressive symptoms prior to age 18 was the major risk factor for MDD, while adolescent use of alcohol, marijuana, and inhalants prior to age 18 were associated with increased odds of MDD (p < 0.05) both in the whole data and the subset of adults without depressive symptoms prior to age 18. Adolescent use of cocaine prior to age 18 were associated with MDD only in the whole data, whereas adolescent smokeless tobacco use was associated with MDD only in those without depressive symptoms prior to age 18. CONCLUSIONS These findings highlight the comorbid early substance use and depressive symptoms during adolescence with adult MDD. Intervention strategies should simultaneously address early-onset substance use and depressive symptoms prior to age 18.
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Affiliation(s)
- Chun Xu
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA.
| | - Silas Wang
- Department of Statistics & Data Science, Dietrich College of Humanities and Social Sciences, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Brenda Bin Su
- Department of Pediatrics - Allergy and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Kaysie Ozuna
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - ChunXiang Mao
- Department of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Zheng Dai
- Health Affairs Institute, Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV, USA.
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Shaw ZA, Handley ED, Warmingham JM, Starr LR. Patterns of life stress and the development of ruminative brooding in adolescence: A person-centered approach. Dev Psychopathol 2023:1-13. [PMID: 37589100 PMCID: PMC10873479 DOI: 10.1017/s0954579423000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Research links life stressors, including acute, chronic, and early life stress, to the development of ruminative brooding. However, singular forms of life stress rarely occur in isolation, as adolescents typically encounter stressors that vary on important dimensions (e.g., types, timings, quantities) across development. The current study employs latent profile analysis (LPA) to identify natural clusters of life stress that, over time, may be differently associated with ruminative brooding. Evaluations of episodic, chronic, and early life stress were conducted with community-recruited mid-adolescents (N = 241, Mage = 15.90 years, 53% female) and their parents using the UCLA Life Stress Interview and lifetime adversity portions of the Youth Life Stress Interview. Analyses identified four distinct patterns: low stress, high peer stress, moderate home / family stress, and multifaceted / high school stress. Adolescents in the high peer stress and moderate home / family stress profiles were at highest risk for developing a brooding style over time. Despite high overall levels of stress, teens in the multifaceted / high school stress profile were at not at elevated risk for developing a brooding style. Findings demonstrate the utility of person-centered approaches to identify patterns of stress exposure that heighten risk for brooding over time.
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Affiliation(s)
- Zoey A Shaw
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Jennifer M Warmingham
- Department of Pediatrics, Columbia University, Irving Medical Center, New York, NY, USA
| | - Lisa R Starr
- Department of Psychology, University of Rochester, Rochester, NY, USA
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DeLaney EN, Williams CD, Jones SCT, Hood KB, Cage J, Coston BE, Hawn SE, Santana A, Dick DM. Sexual Victimization and Mental Health Among LGBQ + College Students: Examining Social Support and Trauma-Related Drinking as Mediators. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-00997-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Physical Activity and Depression in Adolescents: Evidence from China Family Panel Studies. Behav Sci (Basel) 2022; 12:bs12030071. [PMID: 35323390 PMCID: PMC8945286 DOI: 10.3390/bs12030071] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/21/2022] [Accepted: 03/03/2022] [Indexed: 02/06/2023] Open
Abstract
Depression in adolescents is a major public health disorder. The relationship between physical activity and risk of depression in adolescents was examined using three waves of data from the China Family Panel Studies in 2020. The risk of depression was significantly higher among adolescents who reported lower frequency and shorter duration of physical exercise than those who reported physical exercise more frequently and for a longer duration. The risk of depression was significantly higher among adolescents who reported intense physical exercise than those who reported little or no intense physical exercise. The amount of time spent on housework by adolescents is inversely associated with depression. These results provide somewhat stronger evidence for an activity−depression link than previous studies and suggest a differential role for different types of physical activity, such as exercise and housework. The overall model predicting depression in adolescents (LR chi-squared = 95.974, p < 0.001, Nagelkerke R-square = 0.183) was statistically significant. To effectively control depression in adolescents, the government, schools and parents need to act together to guide adolescents towards participation in appropriate physical activities. The appropriate level of physical activity is for adolescents to experience breathing, rapid heartbeat, and slight perspiration.
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The Role of Internalizing Mental Health Problems in Substance Use Trajectories for Minority Adolescents. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00298-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Cheng HG, Edwards AC. Major depressive symptoms and escalation of drinking among new drinkers in the United States: Variations across sex and age groups. Addict Behav 2021; 122:107017. [PMID: 34146797 DOI: 10.1016/j.addbeh.2021.107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Heavy episodic drinking is common in the United States (US) and causes substantial burden to individuals and the society. The transition from first drinking to first heavy drinking episode is a major milestone in the escalation of drinking. There is limited evidence about whether major depressive symptoms predict the progression from drinking to heavy drinking and potential variations across age, sex, and depressive symptoms. In this study, we aim to estimate the association between history of major depressive symptoms and the risk of first heavy drinking episode among new drinkers in the US. METHODS Study population was US non-institutionalized civilian new drinkers 12 years of age and older who had their first drink during the past 12 months drawn from the National Survey on Drug Use and Health. History of major depressive symptoms and alcohol drinking behaviors were assessed via audio-computer-assisted self-interviews. Logistic regressions and structural equation modeling were used for analysis. RESULTS Depressed mood and/or anhedonia predicted the transition from the first drink to a heavy drinking episode among underage female new drinkers, whereas null associations were found among males and female new drinkers who had their first drink at 21 and later. Among new drinkers with depressed mood and/or anhedonia, low mood or energy positively predicted the progression to a heavy drinking episode among late-adolescent boys, but negatively among late-adolescent girls; neurovegetative symptoms positively predicted the progression to a heavy drinking episode among young adult new drinkers. CONCLUSIONS The relationships linking major depressive symptoms and the transition from drinking to first heavy drinking episode vary across age, sex, and depressive symptoms.
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Shaw ZA, Conway CC, Starr LR. Distinguishing Transdiagnostic versus Disorder-Specific Pathways between Ruminative Brooding and Internalizing Psychopathology in Adolescents: A Latent Variable Modeling Approach. Res Child Adolesc Psychopathol 2021; 49:1319-1331. [PMID: 33914186 DOI: 10.1007/s10802-020-00714-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 12/01/2022]
Abstract
Rumination is correlated with diverse types of internalizing problems, but the extent to which it relates to a higher-order internalizing spectrum versus disorder-specific pathology is unclear. Using a quantitative model of the internalizing dimension, we compared the strength of transdiagnostic versus diagnosis-specific pathways from brooding-the most depressogenic component of rumination-to major depressive disorder (MDD) in adolescents. Community-recruited mid-adolescents (N = 241, Mage = 15.90 years, 53% female) completed semi-structured interviews of anxiety and depressive conditions and a self-report brooding measure. Confirmatory factor analysis revealed good fit for a one-factor model of internalizing conditions. Results revealed a large, significant factor correlation between brooding and the internalizing factor (r = 0.55), with some evidence for a more modest specific link between brooding and the unique component of the MDD diagnosis (r = 0.17; approximately one-third as large as the transdiagnostic pathway). These cross-sectional associations were generally consistent across two assessment waves separated by 19 months. We concluded that brooding is better conceptualized as a common characteristic of all internalizing problems in adolescence, rather than a specific feature of MDD. Preregistered hypotheses, data analysis code, and correlation matrices for this study are posted at https://osf.io/dax7u/ .
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Affiliation(s)
- Zoey A Shaw
- Department of Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY, 14627-0266, USA.
| | | | - Lisa R Starr
- Department of Psychology, University of Rochester, 491 Meliora Hall, Box 270266, Rochester, NY, 14627-0266, USA
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10
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Kuo PC, Huang JH, Wu SC, Chen WJ. Associations of parental and peer cross-substance use with 12-17-year-old adolescents' problematic alcohol use: A parent-child dyadic gender analysis. Drug Alcohol Depend 2021; 221:108611. [PMID: 33639568 DOI: 10.1016/j.drugalcdep.2021.108611] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/05/2021] [Accepted: 01/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescent alcohol use was found to be influenced by parental and peer alcohol use. Drinking behaviors also differed by gender. However, previous studies mainly focused on adolescents' substance use in relation to the same substance use among their salient others. Hence, this study investigated the cross-substance relationships of alcohol and tobacco use of parents and peers with adolescents' problematic alcohol use, separately by gender. METHODS Data were derived from 4445 adolescents aged 12-17 years from the 2014 National Survey of Substance Use, a nationally representative survey in Taiwan. Problematic alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Multivariate multinomial logistic regression was used, stratified by gender. RESULTS For males, maternal (adjusted odds ratio [aOR] = 1.73) and peer (aOR = 2.57) alcohol use was related to social drinking (AUDIT < 2); paternal (aOR = 3.58), maternal (aOR = 2.18), peer alcohol use (aOR = 5.37), and their own tobacco use (aOR = 4.72) were related to problem drinking (AUDIT ≥ 2). For females, maternal (aOR = 2.26) and peer (aOR = 2.84) alcohol use was related to social drinking; maternal (aOR = 2.35) and peer tobacco use (aOR = 3.48), and paternal (aOR = 4.56) and peer alcohol use (aOR = 3.36) were linked to problem drinking. CONCLUSIONS Both male and female adolescents' alcohol use was associated with their peer alcohol use, and gender differences were found in relation to their parental and peer substance use. Specifically, the parental role-modeling of smoking was only significant in mother-daughter dyads. These findings could inform multifaceted adolescent alcohol prevention programs, tailoring for males and females and also targeting their parental and peer substance use.
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Affiliation(s)
- Pei-Chun Kuo
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Jiun-Hau Huang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei J Chen
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
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11
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Calarco CA, Lobo MK. Depression and substance use disorders: Clinical comorbidity and shared neurobiology. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:245-309. [PMID: 33648671 DOI: 10.1016/bs.irn.2020.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mood disorders, including major depressive disorder (MDD), are the most prevalent psychiatric illnesses, and pose an incredible burden to society, both in terms of disability and in terms of costs associated with medical care and lost work time. MDD has extremely high rates of comorbidity with substance use disorders (SUD) as many of the same neurobiological circuits and molecular mechanisms regulate the reward pathways disrupted in both conditions. MDD may induce SUDs, SUD may contribute to MDD development, or underlying vulnerabilities and common life experience may confer risk to developing both conditions. In this chapter we explore theories of MDD and SUD comorbidity, the neurobiological underpinnings of depression, overlapping cellular and molecular pathways for both conditions, and current treatment approaches for these comorbid conditions.
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Affiliation(s)
- Cali A Calarco
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Mary Kay Lobo
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States.
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Starr LR, Hershenberg R, Shaw ZA, Li YI, Santee AC. The perils of murky emotions: Emotion differentiation moderates the prospective relationship between naturalistic stress exposure and adolescent depression. Emotion 2020; 20:927-938. [PMID: 31246045 PMCID: PMC6933107 DOI: 10.1037/emo0000630] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Negative emotion differentiation (NED) refers to the ability to identify and label discrete negative emotions. Low NED has been previously linked to depression and other indices of low psychological well-being. However, this construct has rarely been explored during adolescence, a time of escalating depression risk, or examined in the context of naturalistic stressors. Further, the association between NED and depression has never been tested longitudinally. We propose a diathesis-stress model wherein low NED amplifies the association between stressful life events (SLEs) and depression. A sample of 233 community-recruited midadolescents (Mage 15.90 years, 54% female) completed diagnostic interviews and reported on mood and daily stressors 4 times per day for 7 days. SLEs were assessed using a semistructured interview with diagnosis-blind team coding based on the contextual threat method. Follow-up interviews were conducted 1.5 years after baseline. Low NED was correlated with depression but did not predict prospective changes in depression as a main effect. Confirming predictions and supporting a diathesis-stress model, low NED predicted (a) within-subjects associations between daily hassles and momentary depressed mood, (b) between-subjects associations between SLE severity and depression, and (c) prospective associations between SLE severity and increases in depression at follow-up. Results were specific to negative (vs. positive) emotion differentiation. Results suggest that low NED is primarily depressogenic in the context of high stress exposure. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Lisa R Starr
- Department of Clinical and Social Sciences in Psychology
| | | | - Zoey A Shaw
- Department of Clinical and Social Sciences in Psychology
| | - Y Irina Li
- Department of Clinical and Social Sciences in Psychology
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13
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Interpersonal childhood adversity and stress generation in adolescence: Moderation by HPA axis multilocus genetic variation. Dev Psychopathol 2019; 32:865-878. [DOI: 10.1017/s0954579419001123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractResearch suggests that childhood adversity (CA) is associated with a wide range of repercussions, including an increased likelihood of interpersonal stress generation. This may be particularly true following interpersonal childhood adversity (ICA) and for youth with high hypothalamic-pituitary-adrenal (HPA) axis-related genetic risk. In the current study, we applied a multilocus genetic profile score (MGPS) approach to measuring HPA axis-related genetic variation and examined its interaction with ICA to predict interpersonal stress generation in a sample of adolescents aged 14–17 (N = 241, Caucasian subsample n = 192). MGPSs were computed using 10 single nucleotide polymorphisms from HPA axis-related genes (CRHR1, NRC31, NRC32, and FKBP5). ICA significantly predicted greater adolescent interpersonal dependent stress. Additionally, MGPS predicted a stronger association between ICA and interpersonal dependent (but not independent or noninterpersonal dependent) stress. No gene–environment interaction (G×E) effects were found for noninterpersonal CA and MGPS in predicting adolescent interpersonal dependent stress. Effects remained after controlling for current depressive symptoms and following stratification by race. Findings extend existing G×E research on stress generation to HPA axis-related genetic variation and demonstrate effects specific to the interpersonal domain.
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Wu Q, Slesnick N. Interruption of dysfunctional mother-child reciprocal influences associated with family therapy. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:753-763. [PMID: 31045402 PMCID: PMC6776693 DOI: 10.1037/fam0000536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examined the prospective associations among maternal substance use, depressive symptoms, and children's behavioral problems in a family systems therapy (ecologically based family therapy [EBFT]) condition and an individual treatment condition. Participants included 183 mothers with a substance use disorder who had at least 1 biological child in their care. Mothers were randomly assigned to the EBFT condition (n = 123) or an individual treatment condition (n = 60). Maternal substance use, depressive symptoms, and child behavioral problems were assessed at baseline and at 3, 6, and 12 months postbaseline. Autoregressive cross-lagged models were estimated to compare whether the cross-lagged paths among the 3 variables differed from zero in each treatment condition. Findings revealed that for individual treatment, strong reciprocal relationships were observed between maternal substance use and maternal depressive symptoms, and between maternal substance use and child behavioral problems. Conversely, in the EBFT group, fewer reciprocal relationships were observed, and instead, maternal depressive symptoms predicted more future child behavioral problems. These findings suggest an interruption in the dysfunctional reciprocal transmission of problem behaviors between mothers and children over time in the family therapy condition. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in interrupting the dysfunctional family dynamics that contribute to maternal substance using behaviors and child behavioral problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Qiong Wu
- Department of Family and Child Sciences, College of Human
Sciences, Florida State University. Address: 322 Sandels Building, 120 Convocation
Way, Tallahassee, FL 32306
| | - Natasha Slesnick
- Department of Human Sciences, The Ohio State University.
Address: Campbell Hall Room 135, 1787 Neil Ave., Columbus, OH 43210
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Serotonergic multilocus genetic variation moderates the association between major interpersonal stress and adolescent depressive symptoms: Replication and candidate environment specification. J Psychiatr Res 2019; 117:55-61. [PMID: 31279244 DOI: 10.1016/j.jpsychires.2019.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/17/2019] [Accepted: 06/27/2019] [Indexed: 12/18/2022]
Abstract
Serotonin-linked genetic risk and stressful life event (SLE) interaction research has been criticized for using single genetic variants with inconsistent replicability. A recent study showed that a multilocus genetic profile score (MGPS) capturing additive risk from five serotonin-linked polymorphisms moderated the association between major interpersonal SLEs and depression, but no subsequent replication attempts have been reported. Moreover, major interpersonal SLEs have been suggested as "candidate environments" for this MGPS, but it has never been demonstrated that gene-environment interactions (G × Es) for major interpersonal SLEs are significantly stronger than for other contexts. Adolescents (N = 241) completed contextual-threat life stress interviews and clinical interviews assessing depressive symptoms, and provided DNA. MGPS intensified the major interpersonal stress-depression association; the interaction accounted for 4% of depressive symptom variance. Genetic moderation was statistically unique to major interpersonal stress versus other environments. Extending previous findings, results support an MGPS approach and underscore the cruciality of the G × E candidate environment.
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Conway CC, Li YI, Starr LR. Trait anhedonia is a transdiagnostic correlate of internalizing problems during adolescence. JOURNAL OF RESEARCH IN PERSONALITY 2019. [DOI: 10.1016/j.jrp.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Singh N, Minaie MG, Skvarc DR, Toumbourou JW. Impact of a Secondary School Depression Prevention Curriculum on Adolescent Social-Emotional Skills: Evaluation of the Resilient Families Program. J Youth Adolesc 2019; 48:1100-1115. [DOI: 10.1007/s10964-019-00992-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 02/06/2019] [Indexed: 01/13/2023]
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Assari S, Mistry R, Caldwell CH, Zimmerman MA. Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents. Front Psychol 2018; 9:2135. [PMID: 30505287 PMCID: PMC6250838 DOI: 10.3389/fpsyg.2018.02135] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 10/16/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends' drug use on adolescents' depressive symptoms and marijuana use. Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender. Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents. Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, United States
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
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HPA-axis multilocus genetic variation moderates associations between environmental stress and depressive symptoms among adolescents. Dev Psychopathol 2018; 31:1339-1352. [DOI: 10.1017/s0954579418000779] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractResearch suggests that genetic variants linked to hypothalamic-pituitary-adrenal (HPA)-axis functioning moderate the association between environmental stressors and depression, but examining gene–environment interactions with single polymorphisms limits power. The current study used a multilocus genetic profile score (MGPS) approach to measuring HPA-axis–related genetic variation and examined interactions with acute stress, chronic stress, and childhood adversity (assessed using contextual threat interview methods) with depressive symptoms as outcomes in an adolescent sample (ages 14–17, N = 241; White subsample n = 192). Additive MGPSs were calculated using 10 single nucleotide polymorphisms within HPA-axis genes (CRHR1, NR3C2, NR3C1, FKBP5). Higher MGPS directly correlated with adolescent depressive symptoms. Moreover, MGPS predicted stronger associations between acute and chronic stress and adolescent depressive symptoms and also moderated the effect of interpersonal, but not noninterpersonal, childhood adversity. Gene–environment interactions individually accounted for 5%–8% of depressive symptom variation. All results were retained following multiple test correction and stratification by race. Results suggest that using MGPSs provides substantial power to examine gene–environmental interactions linked to affective outcomes among adolescents.
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Childhood adversity moderates the influence of proximal episodic stress on the cortisol awakening response and depressive symptoms in adolescents. Dev Psychopathol 2018; 29:1877-1893. [PMID: 29162191 DOI: 10.1017/s0954579417001468] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Childhood adversity (CA) is known to predict sensitization to proximal stressors. Researchers have suggested that disruptions in hypothalamus-pituitary-adrenal axis functioning may be a biological mechanism. If so, CA may predict altered associations between proximal life stress and markers of cortisol secretion. We examined whether CA moderates associations between recent episodic stress and (a) the cortisol awakening response (CAR), and (b) depressive symptoms, in 241 adolescents aged 14-17 years (cortisol n = 196). Salivary cortisol was sampled at 0, 30, and 60 min postawakening for 2 days. The CAR was calculated as the area under the curve with respect to increase and waking cortisol. CA and episodic stress were assessed using contextual-threat-method-coded objective interviews. CA significantly interacted with episodic stress to predict both the CAR and depression. Among those with low CA, episodic stress predicted increased CAR but did not predict depression. For adolescents with high CA, episodic stress predicted lower CAR and higher depression. These interactions were found only for independent (uncontrollable, fateful) events, and not for dependent (self-generated) stress. Increased allostatic load resulting from CA exposure may interfere with adolescents' ability to optimally regulate their CAR in relation to recent stress, contributing to increased depression risk.
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Abstract
Depression, as a heterogeneous collection of disorders, is likely to include subgroups that are more genetic in origin. In common with other neuropsychiatric disorders such as schizophrenia, Alzheimer's disease and Huntington's disease, earlier age at onset in depression is associated with higher genetic loading and poorer long-term outcome. Adolescents and young adults with depression are also at high risk of developing a bipolar illness. This article reviews depressive illnesses that occur for the first time in adolescence and young adulthood. Case studies are used to discuss atypical presentations and the evolving concept of bipolar-spectrum disorders.
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Gaete J, Rojas G, Fritsch R, Araya R. Association between School Membership and Substance Use among Adolescents. Front Psychiatry 2018; 9:25. [PMID: 29479322 PMCID: PMC5812301 DOI: 10.3389/fpsyt.2018.00025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/22/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Substance use among adolescents is a major problem worldwide, producing many health and economic consequences. Even though there are well-known personal, familial, and social factors associated with drug use, less is known about the effect of school-related factors. School membership is a recognized variable affecting academic performance among students; however, its effect on substance use is less understood. AIMS The primary aim of this study was to explore the association between school membership and cigarette, alcohol, and cannabis use among a representative sample of secondary students from municipal state-funded schools in Santiago of Chile, and secondly, to test the hypothesis that depressive or anxiety symptoms mediate this association. METHODS A total of 2,508 students from 22 state-funded schools in Santiago, Chile, answered a questionnaire. This instrument included an abbreviated version of the psychological sense of school membership (PSSM), questions regarding the use of alcohol, tobacco, and cannabis and scales of psychological functioning (depression, anxiety, self-concept, and problem-solving). The association analyses were performed using adjusted regression models for each outcome using all independent variables while controlling for gender and age. For the mediation effect, a combination of ordinary least square and logistic regression analyses was conducted. RESULTS There was an association between a strong PSSM and low risk for smoking (OR 0.57; 95% CI 0.46-0.72), drinking (0.65; 95% CI: 0.51-0.83), and cannabis use (0.52; 95% CI 0.37-0.74). We also found that depressive and anxiety symptoms do not fully mediate the association between school membership and any substance use, and 73% of this effect in the case of smoking, 80% in the case of drinking, and 78.5% in the case of cannabis use, was direct. CONCLUSION This is the first study in Latin America exploring the association between school membership and substance use among secondary students. School membership seems to be an important and independent factor to be included in preventive interventions. Therefore, these results support future research aiming to test interventions at increasing the sense of school membership to prevent substance use among adolescents. CLINICAL TRIAL REGISTRATION ISRCTN19466209. Retrospectively registered.
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Affiliation(s)
- Jorge Gaete
- Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.,Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Graciela Rojas
- Departamento de Psiquiatría y Salud Mental, Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago, Chile.,Millennium Institute for Research in Depression and Personality, Santiago, Chile
| | - Rosemarie Fritsch
- Departamento de Psiquiatría y Salud Mental, Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago, Chile
| | - Ricardo Araya
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Lowe SR, Sampson L, Young MN, Galea S. Alcohol and Nonmedical Prescription Drug Use to Cope With Posttraumatic Stress Disorder Symptoms: An Analysis of Hurricane Sandy Survivors. Subst Use Misuse 2017; 52:1348-1356. [PMID: 28394737 DOI: 10.1080/10826084.2017.1280832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Postdisaster increases in substance use have been attributed to use of substances to cope with emotional reactions. However, no study to our knowledge has explored disaster survivors' substance use to cope with posttraumatic stress disorder (PTSD) symptoms. OBJECTIVE We investigated the prevalence and correlates of alcohol use and nonmedical prescription drug use (NMPDU) to cope with PTSD symptoms in two population-based samples of adult residents of New York City neighborhoods affected by Hurricane Sandy. METHOD Participants completed structured interviews at either 13-16 or 25-28 months postdisaster (combined N = 914). Participants with PTSD symptoms, assessed via the Posttraumatic Stress Checklist for DSM-5, indicated whether they coped with their symptoms through alcohol use or NMPDU, via items adapted from the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models explored correlates of substance use coping, including demographic characteristics, lifetime and hurricane-related exposures, and psychiatric symptoms in the combined sample. RESULTS Over a third of participants in the combined sample (n = 311, 34.0%) reported PTSD symptoms, and of these, 12.8% used alcohol to cope and 9.2% endorsed NMPDU to cope. Older age and being a parent living with a child under 18 years old at the time of the hurricane were associated with a lower likelihood, and more severe depression symptoms with a higher likelihood, of alcohol use coping. Conclusions/Importance: Although preliminary, the results provide evidence for the use of substances to cope with postdisaster PTSD symptoms, and that age, parent status, and depression symptoms are associated with alcohol use coping.
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Affiliation(s)
- Sarah R Lowe
- a Department of Psychology , Montclair State University, Montclair , New Jersey , USA
| | - Laura Sampson
- b Department of Epidemiology , Boston University, Boston , Massachusetts , USA
| | - Megan N Young
- a Department of Psychology , Montclair State University, Montclair , New Jersey , USA
| | - Sandro Galea
- b Department of Epidemiology , Boston University, Boston , Massachusetts , USA
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Effects of Adolescent Universal Substance Misuse Preventive Interventions on Young Adult Depression Symptoms: Mediational Modeling. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:257-68. [PMID: 25795013 DOI: 10.1007/s10802-015-9995-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression symptoms are associated with impairments in functioning and have substantial health and economic consequences. Universal substance misuse prevention programs have shown effects on non-targeted mental health-related symptoms, but long-term effects are understudied. This cluster randomized controlled trial examined effects of both the LifeSkills Training (LST) and Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14) interventions, delivered during seventh grade, on age 22 young adult depression symptoms. The study was conducted in US rural Midwestern communities with a randomly-selected sample from a larger study (N = 670). Experimental conditions were LST+SFP 10-14, LST-only, and a control condition. Effects on age 22 depression symptoms were hypothesized as mediated through effects on age 21 relationship problems and illicit use of substances. Structural equation modeling with manifest and latent variables was conducted to test hypotheses; the intervention conditions were combined and compared with the control condition because analyses indicated a comparable pattern of effects between intervention conditions. Significant indirect intervention effects were found on age 22 depression symptoms via effects on the mediating variables (indirect effect: β = -0.06, 95 % CI [-0.10, -0.01], p = 0.011). Effect sizes for the young adult variables were between d = 0.17 and 0.29, which can be considered small, but nontrivial, especially in the context of public health benefits. Results support scaled-up implementation of school-based and family-focused universal substance misuse preventive interventions.
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Hernandez L, Cancilliere MK, Graves H, Chun TH, Lewander W, Spirito A. Substance Use and Depressive Symptoms among Adolescents Treated in a Pediatric Emergency Department. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015; 25:124-133. [PMID: 27152065 DOI: 10.1080/1067828x.2014.889633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study examined associations between substance use and depressed mood by gender and type of substance used (no use, alcohol, marijuana or both alcohol and marijuana) in a sample of 713 adolescents (Mage = 15.3) recruited from a Pediatric Emergency Department (PED). Adolescents who reported any marijuana use had higher overall depressed mood scores compared to all other adolescents. When examined by gender, females with both alcohol and marijuana use reported the highest overall depressed mood symptoms. These results suggest the usefulness of screening and identification of depressive symptoms among adolescents presenting to a PED for substance use-related problems.
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Affiliation(s)
- Lynn Hernandez
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
| | | | - Hannah Graves
- Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
| | - Thomas H Chun
- Departments of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University
| | - William Lewander
- Departments of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
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Felton JW, Kofler MJ, Lopez CM, Saunders BE, Kilpatrick DG. The emergence of co-occurring adolescent polysubstance use and depressive symptoms: A latent growth modeling approach. Dev Psychopathol 2015; 27:1367-83. [PMID: 26439081 PMCID: PMC6363005 DOI: 10.1017/s0954579414001473] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study tests competing models of the relation between depression and polysubstance use over the course of adolescence. Participants included a nationwide sample of adolescents (N = 3,604), ages 12 to 17 at study Wave 1, assessed annually for 3 years. Models were tested using cohort-sequential latent growth curve modeling to determine whether depressive symptoms at baseline predicted concurrent and age-related changes in drug use, whether drug use at baseline predicted concurrent and age-related changes in depressive symptoms, and whether initial levels of depression predicted changes in substance use significantly better than vice versa. The results suggest a transactional model such that early polysubstance use promotes early depressive symptoms, which in turn convey elevated risk for increasing polysubstance use over time, which in turn conveys additional risk for future depressive symptoms, even after accounting for gender, ethnicity, and household income. In contrast, early drug use did not portend risk for future depressive symptoms. These findings suggest a complicated pattern of interrelations over time and indicate that many current models of co-occurring polysubstance use and depressive symptoms may not fully account for these associations. Instead, the results suggest a developmental cascade, in which symptoms of one disorder promote symptoms of the other across intrapersonal domains.
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27
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STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use. AIDS Behav 2015; 19:1478-90. [PMID: 25863467 DOI: 10.1007/s10461-015-1062-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
African Americans face disproportionate sexually transmitted infection including HIV (STI/HIV), with those passing through a correctional facility at heightened risk. There is a need to identify modifiable STI/HIV risk factors among incarcerated African Americans. Project DISRUPT is a cohort study of incarcerated African American men recruited from September 2011 through January 2014 from prisons in North Carolina who were in committed partnerships with women at prison entry (N = 207). During the baseline (in-prison) study visit, participants responded to a risk behavior survey and provided a urine specimen, which was tested for STIs. Substantial proportions reported multiple partnerships (42 %), concurrent partnerships (33 %), and buying sex (11 %) in the 6 months before incarceration, and 9 % tested positive for an STI at baseline (chlamydia: 5.3 %, gonorrhea: 0.5 %, trichomoniasis: 4.9 %). Poverty and depression appeared to be strongly associated with sexual risk behaviors. Substance use was linked to prevalent STI, with binge drinking the strongest independent risk factor (adjusted odds ratio: 3.79, 95 % CI 1.19-12.04). There is a continued need for improved prison-based STI testing, treatment, and prevention education as well as mental health and substance use diagnosis.
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28
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Conway CC, Hammen C, Brennan PA. Adolescent precursors of adult borderline personality pathology in a high-risk community sample. J Pers Disord 2015; 29:316-33. [PMID: 25248011 PMCID: PMC5653280 DOI: 10.1521/pedi_2014_28_158] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Longitudinal studies of the exact environmental conditions and personal attributes contributing to the development of borderline personality disorder (BPD) are rare. Furthermore, existing research typically examines risk factors in isolation, limiting our knowledge of the relative effect sizes of different risk factors and how they act in concert to bring about borderline personality pathology. The present study investigated the prospective effects of diverse acute and chronic stressors, proband psychopathology, and maternal psychopathology on BPD features in a high-risk community sample (N = 700) of youth followed from mid-adolescence to young adulthood. Multivariate analyses revealed significant effects of maternal externalizing disorder history, offspring internalizing disorder history, family stressors, and school-related stressors on BPD risk. Contrary to expectations, no interactions between chronically stressful environmental conditions and personal characteristics in predicting borderline personality features were detected. Implications of these findings for etiological theories of BPD and early screening efforts are discussed.
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Affiliation(s)
- Christopher C. Conway
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Constance Hammen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Memarzia J, St Clair MC, Owens M, Goodyer IM, Dunn VJ. Adolescents leaving mental health or social care services: predictors of mental health and psychosocial outcomes one year later. BMC Health Serv Res 2015; 15:185. [PMID: 25934411 PMCID: PMC4494644 DOI: 10.1186/s12913-015-0853-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 04/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND UK service structure necessitates a transition out of youth services at a time of increased risk for the development and onset of mental disorders. Little is currently known about the mental health and psychosocial outcomes of leaving services at this time. The aim of this study was to determine predictors of mental health and social adjustment in adolescents leaving mental health or social care services. METHODS A cohort (n = 53) of 17 year olds were interviewed and assessed when preparing to leave adolescent services and again 12 months later. Their mental health and psychosocial characteristics were compared to a same-age community sample group (n = 1074). RESULTS At discharge 34 (64%) met DSM IV criteria for a current psychiatric diagnosis and only 3 (6%) participants met operational criteria for successful outcomes at follow-up. Impairments in mental health, lack of employment, education or training and low preparedness were associated with poor outcomes. CONCLUSIONS The findings suggest the current organisation of mental health and care services may not be fit for purpose and even unwittingly contribute to persistent mental illness and poor psychosocial outcomes. A redesign of services should consider a model where the timing of transition does not fall at the most hazardous time for young people, but is sufficiently flexible to allow young people to move on when they are personally, socially and psychologically most able to succeed. Assessment of a young person's readiness to transition might also be useful. A youth focused service across the adolescent and early adult years may be better placed to avoid young people falling through the service gap created by poor transitional management.
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Affiliation(s)
- Jessica Memarzia
- Developmental Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
- NIHR CLAHRC East of England (EoE), Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
| | - Michelle C St Clair
- Developmental Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
- Department of Psychology, University of Bath, Bath, BA2 7AY, England.
| | - Matt Owens
- Developmental Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
- Mood Disorders Centre, Psychology, University of Exeter, Exeter, UK.
| | - Ian M Goodyer
- Developmental Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
| | - Valerie J Dunn
- Developmental Lifecourse Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
- NIHR CLAHRC East of England (EoE), Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, England.
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Charlson FJ, Baxter AJ, Dua T, Degenhardt L, Whiteford HA, Vos T. Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010. Epidemiol Psychiatr Sci 2015; 24:121-40. [PMID: 25497332 PMCID: PMC6998140 DOI: 10.1017/s2045796014000687] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 01/08/2023] Open
Abstract
AIMS Mortality-associated burden of disease estimates from the Global Burden of Disease 2010 (GBD 2010) may erroneously lead to the interpretation that premature death in people with mental, neurological and substance use disorders (MNSDs) is inconsequential when evidence shows that people with MNSDs experience a significant reduction in life expectancy. We explore differences between cause-specific and excess mortality of MNSDs estimated by GBD 2010. METHODS GBD 2010 cause-specific death estimates were produced using the International Classification of Diseases death-coding system. Excess mortality (all-cause) was estimated using natural history models. Additional mortality attributed to MNSDs as underlying causes but not captured through GBD 2010 methodology is quantified in the comparative risk assessments. RESULTS In GBD 2010, MNSDs were estimated to be directly responsible for 840 000 deaths compared with more than 13 million excess deaths using natural history models. CONCLUSIONS Numbers of excess deaths and attributable deaths clearly demonstrate the high degree of mortality associated with these disorders. There is substantial evidence pointing to potential causal pathways for this premature mortality with evidence-based interventions available to address this mortality. The life expectancy gap between persons with MNSDs and the general population is high and should be a focus for health systems reform.
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Affiliation(s)
- F. J. Charlson
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- University of Queensland, School of Population Health, Herston, Queensland, Australia
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - A. J. Baxter
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- University of Queensland, School of Population Health, Herston, Queensland, Australia
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - T. Dua
- World Health Organization, Department of Mental Health and Substance Abuse, Geneva
| | - L. Degenhardt
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
- University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia
- University of Melbourne, Melbourne School of Population and Global Health, Victoria, Australia
| | - H. A. Whiteford
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- University of Queensland, School of Population Health, Herston, Queensland, Australia
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - T. Vos
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
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31
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Externalizing disorders in adolescence mediate the effects of maternal depression on substance use disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:185-94. [PMID: 23975078 DOI: 10.1007/s10802-013-9786-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Maternal depression has been linked to increased risk of substance use disorders (SUDs) in offspring. Cross-sectional studies have identified relationships among maternal depression, externalizing disorders and SUDs, but no longitudinal examination of causality has been undertaken. In order to address this gap in the literature, depression and externalizing disorders at or prior to age 15 were tested as mediators of the relationship between maternal depression and SUDs diagnosed between ages 16 and 20 in a sample of 702 Australian youth (363 women) using path models. Mothers' and fathers' substance diagnoses and earlier onset of substance abuse in youth were controlled for in all analyses. Consistent with previous work, maternal depression predicted SUDs between ages 16 and 20. An indirect effect of maternal depression through youth externalizing disorders diagnosed by age 16 was detected for alcohol and cannabis use disorders, but not drug disorders. Early adolescent depression was not a mediator of the relationship between maternal depression and any of the substance outcomes measured. To our knowledge, this study is the first to examine depression and externalizing disorders in early adolescence as mediators of the effect of maternal depression on psychopathology in later adolescence. Further work is needed to understand how family environment and genetic factors may explain the mediation by externalizing disorders.
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32
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Edwards AC, Heron J, Dick DM, Hickman M, Lewis G, Macleod J, Kendler KS. Adolescent alcohol use is positively associated with later depression in a population-based U.K. cohort. J Stud Alcohol Drugs 2014; 75:758-65. [PMID: 25208193 PMCID: PMC4161696 DOI: 10.15288/jsad.2014.75.758] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 06/06/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alcohol use and internalizing problems are often positively associated during adolescence and adulthood. However, the basis of this relationship remains poorly understood, and longitudinal data collected in population-based samples could improve the development of etiological models. METHOD Using a prospective population-based U.K. cohort, the current study examined the relationship between frequency of drinking during adolescence (ages 13-15, N = 7,100) with problems with depression and anxiety at average age 17 years 10 months (n = 4,292). Analyses were conducted separately by sex and adjusted by the inclusion of potential individual- and familial-level confounders. RESULTS Among boys, drinking frequency was positively associated with later depression but not anxiety. This association was robust to adjustment for covariates/confounders. Among girls, drinking frequency was related to later depression and anxiety in univariable analyses. In multivariable analyses, only the association with depression remained after adjustment for covariates/confounders. RESULTS were comparable across sexes, although the effect size of drinking frequency was higher among boys. CONCLUSIONS Higher adolescent alcohol use, even at sub-clinical levels, is associated with an increased risk of later problems with depression but may not be associated with an aggregate measure of anxiety. Future research should consider the possibility of differential relationships between multiple measures of adolescent alcohol use and distinct internalizing outcomes later in development.
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Affiliation(s)
- Alexis C Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Danielle M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Matt Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, England
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, England
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
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Hill RM, Pettit JW, Lewinsohn PM, Seeley JR, Klein DN. Escalation to Major Depressive Disorder among adolescents with subthreshold depressive symptoms: evidence of distinct subgroups at risk. J Affect Disord 2014; 158:133-8. [PMID: 24655777 PMCID: PMC4052553 DOI: 10.1016/j.jad.2014.02.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 02/03/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND The presence of subthreshold depressive symptoms (SubD) in adolescence is associated with high prospective risk of developing Major Depressive Disorder (MDD). Little is known about variables that predict escalation from SubD to MDD. This study used a longitudinal prospective design in a community sample of adolescents to identify combinations of risk factors that predicted escalation from SubD to MDD. METHODS Classification tree analysis was used to identify combinations of risk factors that improved the sensitivity and specificity of prediction of MDD onset among 424 adolescents with a lifetime history of SubD. RESULTS Of the 424, 144 developed MDD during the follow-up period. Evidence for multiple subgroups was found: among adolescents with poor friend support, the highest risk of escalation was among participants with lifetime histories of an anxiety or substance use disorder. Among adolescents with high friend support, those reporting multiple major life events in the past year or with a history of an anxiety disorder were at highest risk of escalation. LIMITATIONS Study findings may not inform prevention efforts for individuals who first develop SubD during adulthood. This study did not examine the temporal ordering of predictors involved in escalation from SubD to MDD. CONCLUSIONS Adolescents with a history of SubD were at highest risk of escalation to MDD in the presence of poor friend support and an anxiety or substance use disorder, or in the presence of better friend support, multiple major life events, and an anxiety disorder. Findings may inform case identification approaches for adolescent depression prevention programs.
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Affiliation(s)
- Ryan M Hill
- Florida International University, United States.
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Johnson TP, Hughes TL, Cho YI, Wilsnack SC, Aranda F, Szalacha LA. Hazardous drinking, depression, and anxiety among sexual-minority women: self-medication or impaired functioning? J Stud Alcohol Drugs 2013; 74:565-75. [PMID: 23739020 PMCID: PMC3711347 DOI: 10.15288/jsad.2013.74.565] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women. METHOD Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study. RESULTS Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression. CONCLUSIONS Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood.
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Affiliation(s)
- Timothy P. Johnson
- Survey Research Laboratory, University of Illinois at
Chicago, Chicago, Illinois,Correspondence may be sent to Timothy P.
Johnson at the Survey Research Laboratory, University of Illinois at Chicago, 412 S.
Peoria Street, Chicago, IL 60607, or via email at:
| | - Tonda L. Hughes
- Department of Health Systems Science, College of Nursing,
University of Illinois at Chicago, Chicago, Illinois
| | - Young Ik Cho
- Joseph J. Zilber School of Public Health, University of
Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Sharon C. Wilsnack
- Department of Clinical Neuroscience, University of North
Dakota School of Medicine & Health Sciences, Grand Forks, North Dakota
| | - Frances Aranda
- Department of Health Systems Science, College of Nursing,
University of Illinois at Chicago, Chicago, Illinois
| | - Laura A. Szalacha
- Center for Research and Transdisciplinary Scholarship,
The Ohio State University College of Nursing, Columbus, Ohio
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Schlauch RC, Levitt A, Connell CM, Kaufman JS. The moderating effect of family involvement on substance use risk factors in adolescents with severe emotional and behavioral challenges. Addict Behav 2013; 38:2333-42. [PMID: 23584195 DOI: 10.1016/j.addbeh.2013.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 01/28/2013] [Accepted: 02/20/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The current study longitudinally examined the moderating effects of family involvement, which previous research has shown to be a protective factor against adolescents' substance use involvement, on the associations between internalizing and externalizing problems, respectively, and substance use (alcohol, marijuana, and tobacco) and problems in a unique sample of adolescents with severe emotional and behavioral problems. METHOD Adolescents (n=4786) and their parents were assessed at three waves over a 1-year period as part of the SAMHSA funded Comprehensive Community Mental Health Initiative (CMHI). Multilevel growth curve models were estimated using Hierarchical Linear Modeling (HLM) to examine the associations between time-varying internalizing and externalizing problems, respectively, and substance use involvement over time as a function of family involvement at baseline. RESULTS Results supported the hypothesis that family involvement protects against adolescent substance use involvement by buffering the adverse effects of both internalizing and externalizing problems. Specifically, for alcohol use, family involvement buffered the negative effects of high externalizing problems. For tobacco use, family involvement buffered the negative effects of both internalizing and externalizing problems, respectively. For substance use problems, family involvement buffered the effects of only internalizing problems. Family involvement did not moderate effects of emotional and behavioral problems on marijuana use, however, a significant main effect was observed such that family involvement was negatively related to marijuana use. CONCLUSIONS Results suggest that the beneficial effects of family involvement on at-risk adolescents' substance use involvement are dependent on the type of emotional and behavioral problems the adolescent experiences as well as the type of substance the adolescent uses. Implications for family- and adolescent-focused treatment are discussed.
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Gorka SM, Shankman SA, Seeley JR, Lewinsohn PM. The moderating effect of parental illicit substance use disorders on the relation between adolescent depression and subsequent illicit substance use disorders. Drug Alcohol Depend 2013; 128:1-7. [PMID: 22901413 PMCID: PMC3510318 DOI: 10.1016/j.drugalcdep.2012.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 05/25/2012] [Accepted: 07/21/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous research has demonstrated that depression and family history of illicit substance use disorders (ISUDs) are risk factors for the development of ISUDs. However, no study to date has examined whether these risk factors interact to predict onset. In addition, history of parental and sibling ISUDs have been identified as risk factors almost exclusively in healthy individuals and thus, it is unknown whether they confer unique risk among adolescents with a history of depression. METHODS The current study examined these questions using data from the Oregon Adolescent Depression Project (OADP). DSM diagnoses of probands were assessed during 4-waves, first in adolescence (ages 14-18) and subsequently up until age 30. Lifetime DSM diagnoses of ISUDs in biological mothers, fathers, and siblings were obtained. RESULTS Proportional hazards model analyses indicated that there was a significant depression by parental ISUDs interaction. Among probands with parental ISUDs (and not among those without parental ISUDs), depression in adolescence was significantly associated with a shorter time to develop an ISUD. Sibling ISUDs were not associated with onset and did not interact with adolescent depression. CONCLUSION Prevention and intervention efforts targeted at this particularly at-risk group may be effective.
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Affiliation(s)
- Stephanie M. Gorka
- University of Illinois at Chicago Department of Psychology 1007 West Harrison St. (M/C 285) Chicago, IL 60657
| | - Stewart A. Shankman
- University of Illinois at Chicago Department of Psychology 1007 West Harrison St. (M/C 285) Chicago, IL 60657
| | - John R. Seeley
- Oregon Research Institute 1715 Franklin Boulevard Eugene, OR 97403
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A history of chronic morphine exposure during adolescence increases despair-like behaviour and strain-dependently promotes sociability in abstinent adult mice. Behav Brain Res 2013; 243:44-52. [PMID: 23295400 DOI: 10.1016/j.bbr.2012.12.049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 12/20/2012] [Accepted: 12/27/2012] [Indexed: 11/22/2022]
Abstract
A crucial issue in treating opiate addiction, a chronic relapsing disorder, is to maintain a drug-free abstinent state. Prolonged abstinence associates with mood disorders, strongly contributing to relapse. In particular, substance use disorders occurring during adolescence predispose to depression later in adulthood. Using our established mouse model of opiate abstinence, we characterized emotional consequences into adulthood of morphine exposure during adolescence. Our results indicate that morphine treatment in adolescent mice has no effect on anxiety-like behaviours in adult mice, after abstinence. In contrast, morphine treatment during adolescence increases behavioural despair in adult mice. We also show that morphine exposure strain-dependently enhances sociability in adult mice. Additional research will be required to understand where and how morphine acts during brain maturation to affect emotional and social behaviours into adulthood.
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Engstrom M, El-Bassel N, Gilbert L. Childhood sexual abuse characteristics, intimate partner violence exposure, and psychological distress among women in methadone treatment. J Subst Abuse Treat 2012; 43:366-76. [PMID: 22444420 PMCID: PMC5860657 DOI: 10.1016/j.jsat.2012.01.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 01/07/2012] [Accepted: 01/16/2012] [Indexed: 01/04/2023]
Abstract
Traumatic experiences and their biopsychosocial sequelae present complex challenges in substance use treatment. For women with substance use problems, childhood sexual abuse (CSA), intimate partner violence exposure (IPV), posttraumatic stress disorder (PTSD), and overall psychological distress are often co-occurring concerns. To address gaps in knowledge and to strengthen practice regarding these critical issues in substance use treatment, we drew upon cross-sectional and longitudinal data from baseline and 12-month interviews with a random sample of 416 women in methadone treatment to examine relationships between CSA characteristics, particularly the presence of force and involvement of family, IPV, and mental health concerns. Although CSA involving force and family was not associated with IPV as hypothesized, it was associated with increased risk of PTSD and overall psychological distress. The multivariate findings underscore the psychological vulnerabilities associated with CSA involving force and family and suggest that drug use and financial circumstances may be important targets to reduce IPV risk.
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Affiliation(s)
- Malitta Engstrom
- School of Social Service Administration, University of Chicago, IL 60637, USA.
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Wolitzky-Taylor K, Bobova L, Zinbarg RE, Mineka S, Craske MG. Longitudinal investigation of the impact of anxiety and mood disorders in adolescence on subsequent substance use disorder onset and vice versa. Addict Behav 2012; 37:982-5. [PMID: 22503436 DOI: 10.1016/j.addbeh.2012.03.026] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Revised: 02/26/2012] [Accepted: 03/21/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE A large body of epidemiological research indicates that anxiety and mood disorders are highly comorbid with substance use disorders (SUDs). However, longitudinal research regarding their temporal relations is limited. The goal of this study was to assess whether emotional disorders (i.e., anxiety and mood disorders) predict the onset of SUDs, whether SUDs predict the onset of emotional disorders, or both. METHOD The current study used data from baseline assessment (N=627) and four years of follow-up assessments from the NU/UCLA Youth Emotion Project to examine this question. RESULTS In line with the self-medication hypothesis of emotional disorder/SUDs comorbidity, anxiety and unipolar mood disorders at baseline assessment were associated with later onsets of SUDs. In particular, social anxiety disorder (SAD) at baseline predicted onset of alcohol use disorders and PTSD predicted the onset of all SUDs. SUDs did not predict any anxiety or unipolar mood disorders with the exception that alcohol use disorders predicted the onset of obsessive compulsive disorder (OCD). CONCLUSIONS These findings, as well as the clinical implications and future directions for research, are discussed.
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Shrier LA, Walls C, Lops C, Kendall AD, Blood EA. Substance use, sexual intercourse, and condom nonuse among depressed adolescents and young adults. J Adolesc Health 2012; 50:264-70. [PMID: 22325132 PMCID: PMC3279699 DOI: 10.1016/j.jadohealth.2011.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 07/07/2011] [Accepted: 07/07/2011] [Indexed: 12/01/2022]
Abstract
PURPOSE To examine daily- and event-level associations of substance use with occurrence of sex and condom nonuse among depressed youth. METHODS Depressed, sexually active outpatients aged 15-22 years reported alcohol use, marijuana use, and sex on a personal digital assistant for 2 weeks. If they reported sex, participants indicated partner type and condom use. Data were analyzed for participants who reported both substance use and sex events (N = 39) using generalized estimating equations. Daily-level models compared the likelihood of sex and of condom nonuse between days on which participants did or did not use substances. Event-level models examined the likelihood of sex in the 2, 6, and 12 hours after substance use and the likelihood of condom nonuse if substances were used in the preceding 2, 6, and 12 hours. RESULTS Participants reported 307 sex events (180 unprotected) and 391 substance use events on 572 days. Substance use was associated with increased odds of sex on the same day, but not after adjusting for weekend. Depressed youth were less likely to have sex within 2 hours after substance use and more likely to have sex within 12 hours after marijuana use. There was no main effect of substance use on condom nonuse; however, there was a significant interaction such that on weekdays, condom nonuse was less likely when substances were used within 6 hours before sex. CONCLUSIONS The findings from this small, predominantly female sample suggest that contextual factors, not intoxication, influence associations of substance use with sexual behavior in depressed youth.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Trudeau L, Spoth R, Randall GK, Mason WA, Shin C. Internalizing symptoms: effects of a preventive intervention on developmental pathways from early adolescence to young adulthood. J Youth Adolesc 2011; 41:788-801. [PMID: 22160441 DOI: 10.1007/s10964-011-9735-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
Abstract
This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.
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Affiliation(s)
- Linda Trudeau
- Partnerships in Prevention Science Institute, Iowa State University, ISU Research Park, Building 2, Suite 2400, 2625 North Loop Drive, Ames, IA 50010, USA.
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Wu LT, Gersing K, Burchett B, Woody GE, Blazer DG. Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database. J Psychiatr Res 2011; 45:1453-62. [PMID: 21742345 PMCID: PMC3196279 DOI: 10.1016/j.jpsychires.2011.06.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 06/12/2011] [Accepted: 06/17/2011] [Indexed: 11/18/2022]
Abstract
This study examined the prevalence of substance use disorders (SUDs) among psychiatric patients aged 2-17 years in an electronic health records database (N=11,457) and determined patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients at a large university-based hospital and its associated psychiatric clinics were systematically captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control, psychotic, learning, mental retardation, and relational disorders. The prevalence of SUD in the 2-12-year age group (n=6210) was 1.6% and increased to 25% in the 13-17-year age group (n=5247). Cannabis diagnosis was the most prevalent SUD, accounting for more than 80% of all SUD cases. Among patients with a SUD (n=1423), children aged 2-12 years (95%) and females (75-100%) showed high rates of comorbidities; blacks were more likely than whites to be diagnosed with CD, impulse-control, and psychotic diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational, and eating diagnoses. Patients with a SUD used more inpatient treatment than patients without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient psychiatric treatment. Collectively, results add clinical evidence on treatment needs and diagnostic patterns for understudied diagnoses.
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Affiliation(s)
- Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Box 3419, Durham, NC 27710, USA.
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O'Neil KA, Conner BT, Kendall PC. Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention. Clin Psychol Rev 2011; 31:104-12. [DOI: 10.1016/j.cpr.2010.08.002] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 08/06/2010] [Accepted: 08/09/2010] [Indexed: 11/29/2022]
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Marmorstein NR. Longitudinal associations between depressive symptoms and alcohol problems: The influence of comorbid delinquent behavior. Addict Behav 2010; 35:564-71. [PMID: 20171020 DOI: 10.1016/j.addbeh.2010.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 12/08/2009] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Although numerous studies have demonstrated a positive association between depressive symptoms and alcohol problems and related disorders, it remains unclear whether this link can be explained by the joint co-occurrence of these disorders with delinquent behavior. This study examined the longitudinal associations between depressive symptoms and alcohol problems from early adolescence through early adulthood, while accounting for delinquent behavior and the potential interaction effects between delinquent behavior and each of these problems. METHOD The National Longitudinal Study of Adolescent Health sample of 20,728 adolescents, followed for 6 years, was used. Males and females were examined separately. Multilevel modeling was used to predict both initial levels and rate of change in alcohol problems based on levels of depressive symptoms and delinquent behavior (and their interaction), and initial level and rate of change in depressive symptoms based on alcohol problems and delinquent behavior (and their interaction). RESULTS Once delinquent behavior was included in the model, the reciprocal positive associations between alcohol problems and depressive symptoms tended to remain significant. Some interactive effects between delinquent behavior and these problems were found, mainly in females. CONCLUSIONS The reciprocal positive associations between alcohol problems and depressive symptoms over time are not fully due to their joint co-occurrence with delinquent behavior, though delinquent behavior does moderate these links in some cases.
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Vázquez FL. Psychoactive substance use and dependence among Spanish university students: prevalence, correlates, polyconsumption, and comorbidity with depression. Psychol Rep 2010; 106:297-313. [PMID: 20402455 DOI: 10.2466/pr0.106.1.297-313] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In this study, the prevalence of psychoactive substance use and dependence was estimated among students at a Spanish university, together with associated factors, polyconsumption, and comorbidity with depression, using a 554-member sample stratified by sex, degree year, and discipline. 86.5% had consumed some potentially addictive psychoactive substance in the past month, and 10.5% satisfied DSM-IV criteria for dependence on nicotine, alcohol, caffeine, or cannabis. Polyconsumers (90.4%) consumed an average 3.2 different substances. Current depression implied increased likelihood of having consumed tobacco or psychoactive pharmaceutical drugs in the past month, and DSM-IV symptoms of major depressive episode were shown by 8.6% of 58 substance-dependent participants, 8.7% of 540 past-month legal substance consumers, and 12.1% of 140 past-month illegal substance consumers.
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Affiliation(s)
- Fernando L Vázquez
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Campus Universitario Sur, 15782 Santiago de Compostela, Spain.
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Anxiety as a predictor of age at first use of substances and progression to substance use problems among boys. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2010; 38:211-24. [PMID: 19821024 DOI: 10.1007/s10802-009-9360-y] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined associations of generalized and social anxiety with (1) age at first use of tobacco, alcohol, and marijuana and (2) interval from first use to first problem use of each substance. Participants were 503 males who comprised the youngest cohort (first assessed in the first grade) of the Pittsburgh Youth Study, a longitudinal community-based study of boys. Annual assessments of generalized and social anxiety, delinquency, and substance use from first grade through high school were included. Both types of anxiety predicted earlier first use of alcohol and tobacco, and generalized anxiety predicted earlier first use of marijuana. Both types of anxiety predicted the progression from first use to problems related to marijuana. The effect of generalized anxiety tended to be significant above and beyond the effect of delinquency, while the effect of social anxiety on risk for first use of substances was not. Overall, the associations between anxiety and substance use and related problems depend on the class of substance and the type of anxiety.
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Gallerani CM, Garber J, Martin NC. The temporal relation between depression and comorbid psychopathology in adolescents at varied risk for depression. J Child Psychol Psychiatry 2010; 51:242-9. [PMID: 19874429 PMCID: PMC2827636 DOI: 10.1111/j.1469-7610.2009.02155.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study examined the temporal comorbidity of depressive disorders with anxiety, externalizing, and substance use disorders in adolescents who varied in risk for depression. METHODS Participants were 240 adolescents and their mothers who had either a history of depression (high-risk, n = 185) or were lifetime-free of psychiatric disorders (low-risk, n = 55). Children (54.2% females) were first evaluated in 6th grade (mean age = 11.86, SD = .57) with the K-SADS-PL to assess current and lifetime diagnoses, and then annually through 12th grade with the A-LIFE to assess diagnoses since the previous evaluation. RESULTS For girls, the rate of depression was high regardless of prior anxiety, whereas for boys, the odds that those with prior subthreshold anxiety would have subsequent subthreshold depression were 1.5 times those of boys with no prior subthreshold anxiety, controlling for risk. In addition, the odds that girls with prior substance use disorders would have a threshold depressive disorder subsequently were three times those of girls with no prior substance use disorders, controlling for risk. CONCLUSIONS These results highlight the importance of early detection of various forms of psychopathology in youth who then can be targeted for intervention. The prospective paths to comorbidity differed by sex, thus suggesting that interventions need to be constructed with sensitivity to these distinct diagnostic trajectories.
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Marmorstein NR, Iacono WG, Malone SM. Longitudinal associations between depression and substance dependence from adolescence through early adulthood. Drug Alcohol Depend 2010; 107:154-60. [PMID: 19926409 PMCID: PMC2822052 DOI: 10.1016/j.drugalcdep.2009.10.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 05/20/2009] [Accepted: 10/07/2009] [Indexed: 10/20/2022]
Abstract
AIMS The association between depression and substance dependence is poorly understood; examinations of these two disorders over time during key developmental periods can provide insight into how these problems relate to each other. The goal of the present study was to examine longitudinal associations between depression and substance (alcohol and illicit drug) dependence during the period from adolescence through early adulthood. PARTICIPANTS Participants in the Minnesota Twin Family Study, a community-based sample of 1252 youth and their families, were used. Youth were first assessed at age 17; they returned to the study at ages 20 and 24. MEASUREMENTS Major depression and drug and alcohol dependence were assessed via structured interviews. Gender was examined as a possible moderator. FINDINGS The results indicated that both substance dependence and depression showed stability over time--that is, each disorder was associated with increased risk for the same disorder later. Substance dependence between ages 17 and 20 predicted increased risk of depression between ages 20 and 24. These associations did not differ significantly by gender. CONCLUSIONS Substance dependence during late adolescence predicts the subsequent occurrence of major depression.
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Affiliation(s)
- Naomi R. Marmorstein
- Rutgers University, Camden / Department of Psychology / 311 North 5th Street / Camden, NJ 08102 USA
| | - William G. Iacono
- University of Minnesota / Department of Psychology / 75 East River Road / Minneapolis, MN 55455 USA
| | - Stephen M. Malone
- University of Minnesota / Department of Psychology / 75 East River Road / Minneapolis, MN 55455 USA
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Increased prevalence of behavioral risks among adolescent and young adult women with psychological distress in the emergency department. Pediatr Emerg Care 2010; 26:93-8. [PMID: 20094003 DOI: 10.1097/pec.0b013e3181cdb883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mental health problems in adolescents have been recognized as a significant medical concern. They have been associated with risk-taking behaviors during adolescence. OBJECTIVE To determine the prevalence of elevated scores for psychological distress among adolescent girls aged 15 to 21 years who present to a pediatric emergency department (PED) for general medical care and to correlate psychological distress scores with sexual and substance use behaviors. METHODS The study was performed in the PED of an urban general hospital. We enrolled female patients aged 15 to 21 years cared for in the PED. Subjects completed the Center for Epidemiological Studies-Depression Scale 8 (CES-D8); elevated scores were defined as 7 or greater. The survey collected data on demographics, sexual practices, alcohol and drug use, and health care access and utilization. RESULTS Two hundred ninety-nine subjects participated. One hundred forty-one participants (47.7%) had CES-D8 scores of 7 or greater. In multivariate logistic regression, factors associated with increased emotional distress were being white, Hispanic, or of other race; having a recent new sex partner; and recent sex without birth control. Alcohol use in the past 3 months was associated with elevated distress as was having a distant relationship with one's parents/guardians. Those who had never had sex or who had sex in the past but not within the past 3 months were also more likely to have elevated CES-D8 scores compared with those who had sex more recently with the use of birth control. CONCLUSIONS Screening for mental health issues in the emergency department may identify a significant number of adolescent patients in need of further evaluation, especially as half of surveyed patients reported the PED as a usual source of health care.
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