Research Findings - Epidemiology and Etiology Research

Monitoring the Future Study

The results from the 2002 annual Monitoring the Future (MTF) survey of 8th, 10th, and 12th grade students in U.S. schools were released in December 2002. The findings indicate that use of marijuana, several other illicit drugs, cigarettes and alcohol decreased from 2001 to 2002. The percentages of 8th and 10th graders using any illicit drug declined and were at their lowest level since 1993 and 1995, respectively. Marijuana use decreased among 10th graders; LSD use was down among students in each grade; and MDMA (Ecstasy) use decreased in each grade, though declines were statistically significant only for 10th graders. Use of most other drugs, including cocaine and heroin, remained stable. No major drug use indicators increased. Cigarette smoking decreased in each grade, expanding on a recent trend. Alcohol use and having "been drunk" were down among 8th and 10th graders, and binge drinking decreased among 10th graders.

Attitudes toward substance use, often seen as harbingers of change in rates of use, were mostly stable, but both perceived risk of harm from using MDMA and disapproval of using this drug increased in each grade. Perceived availability of LSD was down in each grade, and perceived availability of alcohol and cigarettes decreased in grades 8 and 10.

Monitoring the Future, which is conducted by the University of Michigan under a grant from NIDA, has been tracking drug use among seniors for 28 years and among 8th and 10th graders since 1991. The 2002 sample consisted of around 43,700 students in 394 schools in the coterminous U.S.

The changes noted below are statistically significant unless otherwise indicated.

Marijuana

• Among 10th graders, marijuana/hashish use in the past year and past month decreased and daily use in the past month was down. Past year use decreased from 32.7 percent to 30.3 percent; past month use went from 19.8 percent to 17.8 percent, and daily use in the past month declined from 4.5 percent to 3.9 percent.
• For the 8th graders, there has been slow but steady progress toward reduction of marijuana use. The past year marijuana use rate for 8th graders in 2002 -- 14.6 percent -- is the lowest rate seen since 1994, and well below the recent peak of 18.3 percent in 1996.

Cocaine

• Cocaine use remained statistically unchanged from 2001 to 2002 for each grade and recency period. Past year cocaine use was reported by 2.3 percent of 8th graders, 4.0 percent of 10th graders, and 5.0 percent of 12th graders.
• This comes after declines in cocaine use among 10th graders from 2000 to 2001 and among 12th graders between 1999 and 2000.
• Crack use showed a significant increase in past year use among 10th graders, returning to around its 2000 level following a decline in 2001.

Heroin and Other Opiates

• Heroin use by 8th, 10th and 12th graders remained stable from 2001 to 2002 following a decline from 2000 to 2001 among 10th and 12th graders. Past year use rates were around 1 percent in each grade.
• New questions on nonmedical use of Oxycontin and Vicodin in the past year were added in the 2002 survey for each grade, and the findings give some reason for concern.
  • Oxycontin use in the past year without a doctor's orders was reported by 1.3 percent of 8th graders, 3.0 percent of 10th graders, and 4.0 percent of 12th graders.
  • Nonmedical use of Vicodin in the past year was reported by 2.5 percent of 8th graders, 6.9 percent of 10th graders, and 9.6 percent of 12th graders.

Inhalants

• Inhalant use in the lifetime decreased among 8th and 10th graders and past use decreased among 8th graders. Lifetime use went from 17.1 percent in 2001 to 15.2 percent in 2002 among 8th graders and from 15.2 percent to 13.5 percent among 10th graders.
• In 2002, inhalant use among 8th and 10th graders in all recency periods was the lowest seen in the history of the survey and the lowest in about 20 years for seniors.

Hallucinogens

• Hallucinogen use in the lifetime, past year, and past month declined for 12th graders, and past year use was down among 10th graders.
• LSD showed major changes from 2001 to 2002. Rates of use decreased markedly in each grade and recency period. Past year use, for example, declined from 6.6 percent to 3.5 percent among 12th graders, from 4.1 percent to 2.6 percent among 10th graders and from 2.2 percent to 1.5 percent among 8th graders. These are the lowest rates of LSD use in the history of the survey for each grade.

Club Drugs

• Rates of MDMA (Ecstasy) use decreased significantly among 10th graders. For this grade, past year use declined from 6.2 percent to 4.9 percent and past month use went from 2.6 percent to 1.8 percent. Use by 8th and 12th graders also showed signs of decline.

Use of Cigarettes and Smokeless Tobacco

• Cigarette use declined in each grade and several categories of use between 2001 and 2002.
  • Lifetime use - 8th grade - 36.6 percent to 31.4 percent; 10th grade - 52.8 percent to 47.4 percent; 12th grade - 61.0 percent to 57.2 percent.
  • Past month use - 8th grade - 12.2 percent to 10.7 percent; 10th grade - 21.3 percent to 17.7 percent; 12th grade - 29.5 percent to 26.7 percent.
  • Daily use in past month - 10th grade - 12.2 percent to 10.1 percent; 12th - 19.0 percent to 16.9 percent.
• This follows several years of gradual decreases in cigarette smoking that started around 1996 for 8th graders and 1997 for 10th and 12th graders. However, year-to -year declines have not always been statistically significant in all grades, and the decreases seen between 2001 and 2002 are particularly notable.
• Use of bidis in the past year declined among 10th graders from 4.9 percent in 2001 to 3.1 percent in 2002. Use of these small, flavored cigarettes from India was reported by 2.7 percent of 8th graders and 5.9 percent of 12th graders in 2002 based on the past-year reporting period. Use of Kreteks (clove-flavored cigarettes from Indonesia) in the past year was reported by 2.6 percent of 8th graders; 4.9 percent of 10th graders, and 8.4 percent of 12th graders in 2002.
• Lifetime use of smokeless tobacco by 10th graders declined from 19.5 percent in 2001 to 16.9 percent in 2002.

Alcohol Use

• Between 2001 and 2002 significant reductions in alcohol use were observed among 8th and 10th graders in numerous categories of use, including lifetime, past year, and past month. The use rates in 8th and 10th graders are record lows in the history of the survey in those grades.
• Rates of having been drunk in the lifetime and past year decreased for 8th and 10th graders. Among 10th graders, the rate of binge drinking (five or more drinks in a row) in the past two weeks declined, as did the past-month rate of having been drunk.

• Both perceived risk and disapproval of trying marijuana once or twice increased among 10th graders, but among 12th graders perceived risk of smoking marijuana regularly declined.
• Attitudes toward MDMA (Ecstasy) use hardened. Perceived risk of occasional MDMA use increased among 8th graders and perceived risk of trying it once or twice increased among 10th and 12th graders. Disapproval of MDMA use from 2001 to 2002 increased significantly among students in all three grades.
• Perceived risk and disapproval of trying LSD once or twice both increased among 12th graders, but among 10th graders perceived risk of regular LSD use decreased. Notably, perceived availability of LSD declined among students in all three grades.
• Perceived risk of trying inhalants once or twice declined among 8th graders, and perceived risk of regular use of these substances decreased among 10th graders. Seniors are not asked about their attitudes regarding inhalant use.
• Perceived availability of amphetamines decreased among 8th graders.

Substance Dependence, Antisocial Behavior, and Personality

The authors present a biometric model to explain patterns of comorbidity among substance dependence, antisocial behavior, and disinhibitory personality traits, which commonly co-occur. Hierarchical models were fit using data from the Minnesota Twin Family Study. Analyses indicated that a highly heritable externalizing factor accounts for much of the co-occurrence among alcohol dependence, drug dependence, conduct disorder, adolescent antisocial behavior, and disinhibitory personality style. However, variance within each syndrome suggests that both genetic and environmental factors contribute to these distinctions. These findings may help shape strategies for delineating the specific genes and environmental conditions that account for each of these conditions. Krueger, R.F., Hicks, B.M., Patrick C.J., Carlson, S.R., Iacono, W.G., and McGue, M. Etiologic Connections Among Substance Dependence, Antisocial Behavior, and Personality: Modeling the Externalizing Spectrum. Journal of Abnormal Psychology, 111, pp. 411-424, 2002.

Psychiatric Disorders and Substance Abuse Disorders Among Youth in Juvenile Detention

Data are from a large (1829 youth, ages 10-18), random sample of male and female, white, African-American and Hispanic juvenile detainees in Cook County, IL. Among teens in juvenile detention, nearly two thirds of boys and nearly three quarters of girls have at least one psychiatric disorder. These rates dwarf the estimated 15 percent of youth in the general population thought to have psychiatric illness. Even when conduct disorder (common in this population) was excluded, nearly 60 percent of males and more than two-thirds of females met diagnostic criteria for, and also were functionally impaired by, one or more mental or substance use disorder. Half of males and almost half of females had a substance use disorder. Overall, disorders were more prevalent among older youth and females, more than 20 percent of whom had a major depressive disorder. Among boys, non-Hispanic whites had the highest prevalence for most disorders and African Americans the lowest. The exception was separation anxiety disorder, which was more prevalent among African Americans and Hispanics than among whites. Hispanics had higher prevalence than African Americans for panic disorder, obsessive-compulsive disorder and substance use other than alcohol or marijuana disorders. The only categories for which boys had higher prevalence than girls were manic episode, psychotic disorders, any substance abuse disorder, and marijuana use disorder. Longitudinal data are currently being collected on these youth. Teplin, L.A., Abram, K.M., McClleland, G.M., Dulcan, M.K., and Mericle, A.A. Psychiatric Disorders in Youth in Juvenile Detention. Arch. Gen. Psychiatry, 59, pp. 1133-1143, 2002.

Prevalence and Age of Onset for Drug Use in Seven International Sites

Kessler and colleagues present results of analyses of patterns of substance use utilizing data from seven population-based surveys carried out in six countries including the U.S., Canada, Brazil, Mexico, Germany and the Netherlands. All surveys utilized the Composite International Diagnostic Instrument (CIDI) to ascertain drug use. This study compares lifetime prevalence and age of first use for alcohol, cannabis, and other drugs. Alcohol and cannabis are the most widely consumed substances across all sites. Use of cannabis five or more times in a lifetime ranged from 28.8% in the U.S. to 1.7% in Mexico. While prevalence of use of different drugs varied widely from site to site, age of first use was similar across study sites. The authors suggest that this reflects a potentially strong linkage to stages of adolescent development and the influence of social role transitions in early adulthood. Comparisons of data from Mexico City, U.S., and Fresno, California (sample of Mexican-origin respondents including immigrants and U.S. born) revealed that lifetime drug use rates in the Fresno sample are lower than the national U.S. rates, but higher than those for the Mexico City population. The authors conclude that these findings suggest that drug use patterns may change among emigrating populations from low consumption nations as a consequence of international resettlement in nations with higher rates. Vega, W., Aguilar-Gaxiola, S., Andrade, L., Bijl, R., Borges, G., Caraveo-Anduaga, J., DeWit, D., Heeringa, S., Kessler, R.C., Kolody, B., Merikangas, K., Molnar, B., Walters, E., Warner, L., and Wittchen, H. Prevalence and Age of Onset for Drug Use in Seven International Sites: Results from the International Consortium of Psychiatric Epidemiology. Drug and Alcohol Dependence, 68, pp. 285-297, 2002.

The Gateway Hypothesis

Dr. Kandel has edited a book that represents the first systematic discussion of the "Gateway Hypothesis." The volume presents a critical overview of what is currently known about the hypothesis. The authors of the chapters explore the hypothesis from various perspectives ranging from developmental social psychology to prevention and intervention science, animal models, neurobiology, and analytical methodology. Kandel, D.B., Ed. Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. Cambridge, UK: Cambridge University Press, 2002.

Genetic Effects of Antisocial Personality Disorder Associated With Major Depression, Alcohol Dependence, and Marijuana Dependence

This study examined the contribution of genetic effects associated with antisocial personality disorder (ASPD) to the comorbidity of major depression (MD), alcohol dependence (AD), and marijuana dependence (MD) using the Vietnam Era Twin Registry, a general population registry of male veteran twins. A telephone diagnostic interview for DSM-III-R disorders was administered in 1992 to 3360 pairs (1868 MZ and 1492 DZ). Structural equation modeling was performed to estimate additive genetic, shared environmental, and nonshared environmental effects common and specific to each disorder. The heritability estimates for lifetime ASPD, MD, AD, and MJD (marijuana dependence) were 69%, 40%, 56%, and 50%, respectively. Genetic effects on ASPD accounted for 38%, 50%, and 58% of the total genetic variance in risk for MD, AD, and MJD, respectively. After controlling for genetic effects on ASPD, the partial genetic correlations of MD with AD and with MJD were no longer statistically significant. Genetic effects specific to MD and AD and familial effects specific to MJD remained statistically significant. Nonshared environmental contributions to the comorbidity in these disorders were small. The findings indicate that the shared genetic risk between MD and both AD and MJD was largely explained by genetic effects on ASPD, which in turn was associated with increased risk of each of the other disorders. Fu, Q., Heath, A.C., Bucholz, K.K., Nelson, E., Goldberg, J., Lyons, M.J., True, W.R., Jacob, T., Tsuang, M.T., and Eisen, S.A. Archives of General Psychiatry, 59(12), pp.1125-1132, 2002.

Effectiveness of a Universal Drug Abuse Prevention Approach For Youth At High Risk For HOPA Polymorphism Associated With Major Depression, Phobia, and Antisocial Diathesis

This study examined the relationship between thyroid receptor co-activator named HOPA polymorphisms and neuropsychiatric illness in a cohort of Iowa adoptees. Consistent with prior findings, HOPA polymorphisms were associated with an increased risk for major depression and phobia. There was suggestive evidence of gene-by-gene interactive effects (i.e., epistasis) in that the increased psychiatric morbidity was elevated in subjects with alcoholic or antisocial behavior in the biologic father. For example, 80% of females positive for HOPA variants, compared to 41% of females negative for HOPA variants, had this high-risk biologic background. In summary, HOPA polymorphisms may be a moderate risk factor for increased susceptibility to a broad spectrum of neuropsychiatric illness and that the type of illness manifested might be related to a separate genetic diathesis. Philibert, R., Caspers, K., Langbehn, D., Troughton, E.P., Yucuis, R., Sandhu, H.K., Cadoret, R.J. The Association of a HOPA Polymorphism with Major Depression and Phobia. Comprehensive Psychiatry, 43(5), pp. 404-410, 2002.

Prior Violence and Childhood Psychiatric History, But Not Substance Abuse, Predict Violence

The study examined whether scores on the Violence Proneness Scale, history of child and parent psychopathology, and substance abuse, could predict violence at age 19. At age 12-14, biological sons of fathers with and without substance use disorder completed a 13-item Violence Proneness Scale, which was derived by using items from the revised Drug Use Screening Inventory. The occurrence of violent acts was then assessed at a follow-up evaluation when the offspring were 19 years of age. A DSM-III-R axis I psychiatric disorder and a Violence Proneness Scale score of 10 or higher at age 12-14 predicted a violent outcome by age 19. The overall accuracy of prediction was 77%. Sensitivity was 81%, and specificity was 76%. Substance use disorder or psychopathology in the probands or substance use frequency in the children did not contribute to the prediction of violence. Tarter, R.E., Kirisci, L., Vanyukov, M., Cornelius, J., Pajer, K., Shoal, G.D., and Giancola, P.R. American Journal of Psychiatry, 159(9), pp. 1541-1547, 2002.

Poor Self-Control Associated With Escalation of Substance Use

This research tested predictions about the role of temperament and self-control in substance use (tobacco, alcohol, and marijuana) in a sample of 1,526 participants assessed in 6th grade (mean age = 11.5 years) and followed with yearly assessments through 9th grade. Latent growth curve modeling indicated that the rate of growth in substance use was higher among participants who showed increases in poor self-control and lower among participants who showed increases in good self-control. Wills, T.A. and Stoolmiller, M. Journal of Consulting and Clinical Psychology, 70(4), pp. 986-997, 2002.

Adolescent Substance Abuse and Psychiatric Comorbidity

As part of a special journal section on child psychopathology and drug abuse, the authors reviewed published studies using community samples and DSM or ICD classifications to assess rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. They found high rates of comorbidity in community samples; about 60% of youths with substance use, abuse, or dependence have a comorbid psychiatric disorder, with conduct disorder and oppositional defiant disorder the most common. Psychopathology was generally associated with earlier onset of substance use and with substance abuse. The nature of the data limited the authors' ability to explore risk factors, but they feel that current studies show promise for further work in this area. Armstrong, T.D. and Costello, E.J. Community Studies on Adolescent Substance Use, Abuse, or Dependence and Psychiatric Comorbidity. Journal of Consulting and Clinical Psychology, 70, pp. 1224-1239, 2002.

Child Neglect Associated With Increased Risk For Substance Abuse

This article critically reviews the empirical literature pertaining to the prevalence, origins, and consequences of neglectful parenting as it relates to substance abuse. Available evidence indicates that children who experience parental neglect, with or without parental alcohol or drug abuse, are at high risk for substance use disorder (SUD). The effects of parental substance abuse on substance abuse outcome of their children appear to be partly mediated by their neglectful parenting. The discussion concludes with presentation of a developmental multifactorial model in which neglect, in conjunction with other individual and environmental factors, can be integratively investigated to quantify the child's overall liability across successive stages of development as well as to map the trajectory toward good and poor outcomes. Dunn, M.G., Tarter, R.E., Mezzich, A.C., Vanyukov, M., Kirisci, L., and Kirillova, G. Clinical Psychology Review, 22(7), pp. 1063-1090, 2002.

Diminished Cortisol Response Among Offspring of Drug-Dependent Fathers

This report examines the salivary cortisol responses in preadolescent sons and daughters of fathers with and without drug-dependence, and the relative role of family environment. The high-risk boys and girls, relative to offspring of controls, demonstrated a diminished cortisol response in anticipation of a moderate stressor. Girls had significantly higher salivary cortisol concentrations, pre- and post-stressor. No association was found between salivary cortisol responses and measures of the family environment, however. These results suggest that there may be a sex difference in salivary cortisol dynamics in at-risk preadolescent children that is unrelated to current family environment. Hardie, T.L., Moss, H.B., Vanyukov, M.M., Yao, J.K., and Kirillovac, G.P. Psychiatry Research, 112(2), pp. 121-131, 2002.

Substance Use and Abuse By Asian Americans and Pacific Islanders From Four National Epidemiologic Studies

This report analyzed four recent large national surveys to assess the degree of use and abuse of a wide range of psychoactive substances across subgroups of Asian Americans and Pacific Islanders (AAPIs) and in comparison with whites. The surveys analyzed were the 1999 National Household Survey on Drug Abuse, the 1992 National Longitudinal Alcohol Epidemiologic Survey, and the 1995 National Longitudinal Study of Adolescent Health In-School and In-Home surveys. The AAPI sample sizes varied from 900 to more than 4,500 across the four surveys. Results showed that the rates of substance use are lowest for AAPIs. Mixed-heritage AAPIs are at high risk for substance use, with Japanese Americans having the highest substance use rates. Differential rates correspond to the ranking of several acculturation and socioeconomic indices. Results highlight the heterogeneity among AAPIs and point to the importance of studying socioenvironmental and potentially genetic protective factors associated with substance use in mixed-heritage adolescents. Price, R.K., Risk, N.K., Wong, M.M., and Klingle, R.S. Public Health Reports, 117(Suppl 1), pp. S39-S50, 2002.

Long-Term Psychological Sequelae of Smoking Cessation and Relapse

This study examined whether smoking cessation and relapse were associated with changes in stress, negative affect, and smoking-related beliefs. Quitters showed decreasing stress, increasing negative health beliefs about smoking, and decreasing beliefs in psychological benefits of smoking. Quitters became indistinguishable from stable nonsmokers in stress and personalized health beliefs, but quitters maintained stronger beliefs in the psychological benefits of smoking than stable nonsmokers. Relapse was not associated with increases in stress or negative affect. However, relapsers increased their positive beliefs about smoking and became indistinguishable from smokers in their beliefs. Findings suggest that decreased stress and negative beliefs about smoking may help quitters maintain successful cessation, but that declining health risk perceptions may undermine future quit attempts for relapsers. Chassin, L., Presson, C.C., Sherman, S.J., and Kim, K. Health Psychology, 21(5), pp. 438-443, 2002.

Parental Smoking Cessation May Help Decrease Adolescent Smoking

This study examined the relation of parent smoking cessation and adolescent smoking behavior. Participants were 446 adolescents and their parents who completed a computerized measure of implicit attitudes toward smoking and questionnaires assessing smoking, parenting, and explicit attitudes. Parental smoking cessation was associated with less adolescent smoking, except when the other parent currently smoked. Children's reports of parents' antismoking behavior partially mediated the relation between parental smoking and adolescent smoking. Although children's implicit and explicit attitudes were unrelated to parental smoking, mothers' implicit attitudes were related to both their own smoking and their child's smoking. Findings suggest that parental smoking cessation may help lower risk for adolescent smoking - but only if the other parent does not currently smoke. Chassin, L., Presson, C., Rose, J., Sherman, S.J., and Prost, J. Journal of Pediatric Psychology, 27(6), pp. 485-496, 2002.

Child Maltreatment and Adulthood Violence: The Contribution of Attachment and Drug Abuse

This study examined the association between child maltreatment and adult violence in a high-risk sample of women with and without a history of cocaine abuse and the contribution of working models of childhood attachment relationships in understanding this association. Results indicated that whereas childhood physical abuse was associated with adult sexual victimization for cocaine-abusing women, sexual abuse was associated with both partner violence victimization and perpetration for comparison women. Insecure working models of attachment were associated with partner violence victimization for comparison women, independent of the effect of sexual abuse. These findings suggest the importance of research focused on understanding the processes by which child maltreatment may lead to later violence and that examines both childhood and adulthood experiences in understanding pathways to adult violence. Feerick, M.M., Haugaard, J.J., and Hien, D.A. Child Maltreatment, 7(3), pp. 226-240, 2002.

Exploring Why Drug Abuse Epidemics Occur in Different Groups at Different Times: Case Study of Heroin Use Among African Americans in Baltimore City in the 1960s

Agar utilized a broad array of data sources including ethnographic data from drug users, media archives, historical accounts, professional literature from the 1960s and autobiographies to analyze the increase in heroin use and addiction among African Americans in Baltimore City, Maryland, in the 1960s. This study is part of a broader project to develop a theory to explain drug abuse trends with particular temporal and spatial contexts. Agar's approach is to integrate political, socioeconomic and cultural factors within a historical framework and to illustrate the dynamic interaction of factors operating at multiple levels. The authors conclude that a drug abuse "trend" emerges at the convergence of three types of events: (1) rapid change in the distribution and marketing systems, (2) rapid movement of a population into a situation of open marginality and the acute despair that follows, and (3) the forging (or strengthening) of social links between distributors and consumers. With respect to the Baltimore 1960s context, the investigators found that the two most important historical processes behind the 1960s epidemic were the changing distribution/supply system at international and local levels, and the mix of hope and despair that was part of the civil rights movement that impacted the African American community in Baltimore. Agar, M. and Reisinger, H.S. A Heroin Epidemic at the Intersection of Histories: The 1960s Epidemic Among African Americans in Baltimore. Medical Anthropology, 21, pp. 115-156, 2002.

Overview of Measuring Risks and Outcomes in Drug Abuse Research

This paper describes principles and procedures for developing a comprehensive assessment of childhood risk factors and substance abuse outcomes. A conceptual framework is provided, procedures for identifying relevant measurement domains are described, steps necessary in creating an assessment protocol are outlined, selected instruments are described as examples, and resources available for more comprehensively identifying available measures are described. The risks specifically reviewed in this article include family history, childhood maltreatment, peer relationships, and psychopathology. The substance use measures reviewed include substance type, consumption quantity and frequency and substance related problems. Clark, D.B., and Winters, K.C. Measuring Risks and Outcomes in Substance Use Disorders Prevention Research. J of Consulting and Clinical Psychology, 70(6), pp. 1207-1233, 2002.

Correlates of Marijuana Use in Colombian Adolescents: A Focus on the Impact of the Ecological/Cultural Domain

This study examined the influence of ecological/cultural factors and family, personality, and peer factors present during early adolescence that influence marijuana use in late adolescence. A community sample of 2,226 Colombian adolescents living in mixed urban-rural communities and their mothers were interviewed in their homes by trained Colombian interviewers, first in 1995-1996 and then again two years later. The scales used were based on item intercorrelations and grouped into the following categories: (1) adolescent personality, (2) family traits, (3) peer factors, (4) ecological/ cultural variables, and (5) marijuana use. Data were examined using hierarchical regression modeling to determine the relationship between each of the domains and late adolescent marijuana use. The findings supported the family interactional theory of adolescent drug use behavior and found that factors in all of the domains had both a direct effect on late adolescent marijuana use as well as indirect effects mediated through the more proximal domains in the model. Of particular interest was the strength of the influence of the ecological/cultural factors, which far exceeded that observed in similar studies done in the United States. Due to the similarity with findings from studies conducted in the U.S., interventions designed domestically could effectively be directly applied to adolescents in Colombia. The findings also suggest that prevention programs designed specifically to target ecological or cultural factors may have the most profound influence for reducing marijuana use in late adolescence. Brook, D.W., Brook J.S. and Rosen, Z. Correlates of Marijuana Use in Colombian Adolescents: A Focus on the Impact of the Ecological/Cultural Domain. Journal of Adolescent Health, 31, pp. 286-298, 2002.

Early Adolescent Marijuana Use: Risks for the Transition to Young Adulthood

This study assessed the relationship of early adolescent marijuana use to performance of developmental tasks integral to the transition to young adulthood. The tasks concerned intimacy, education, and work and social conformity. African American (N=617) and Puerto Rican (N=531) youths completed questionnaires in their classrooms. Five years later they were individually interviewed. Logistic regression analysis estimated the increased likelihood that early marijuana users would make an inadequate transition to young adult social roles. Analyses examining the association between early marijuana use and twenty outcome variables found significant relationships for ten of them: (a) having lower educational and occupational expectations; (b) being suspended or expelled from school, fired from jobs, 'high' at school or work, collecting welfare; and (c) rebelliousness, not participating in productive activities, not attending church, and being an unmarried parent. Marijuana use was not related to any of the intimate relationship measures. These finding emerged with controls on gender, ethnicity, age, and mother's education. Among African Americans and Puerto Ricans, early marijuana use predicts less adequate performance on some developmental tasks integral to becoming an independent young adult. Marijuana is not a benign drug and is associated with future risks for the individual and society at large. Brook, J.S., Adams, R.E., Balka, E.B. and Johnson, E. Early Adolescent Marijuana Use: Risks for the Transition to Young Adulthood. Psychological Medicine, 32, pp. 79-91, 2002.

Marijuana Use Among the Adolescent Children of High-Risk Drug-Abusing Fathers

This study examines marijuana use among children of male drug abusers. Subjects were 83 African-American and European-American male drug abusers (the majority of whom were injection drug users) and their children. Thirty-one of the fathers were HIV-positive and 52 were HIV-negative. Using logistic regression analyses, we explored cross-sectionally the relationship between four psychosocial domains (i.e., paternal attributes, adolescent problem behaviors, father-adolescent relations, and the environment) and adolescent marijuana use. The father's use of illegal drugs and his failure to cope adaptively predicted adolescent marijuana use, while a close father-child bond were associated with less adolescent marijuana use. Adolescent problem behaviors were associated with an increased likelihood of marijuana use. Furthermore, hierarchical regression analysis demonstrated that the adolescent's problem behavior mediated the associations between the father-adolescent relationship as well as environmental factors with adolescent marijuana use. Reducing the risk factors and enhancing the protective factors within each of the domains could help reduce marijuana use among the adolescent children of drug-abusing fathers. Moreover, if a father is a drug abuser, it is important to help him establish a close bond with his child in order to help attenuate the influence of his drug use on the child's marijuana use. Brook, D.W., Brook, J.S., Richter, L., Whiteman, M. and Arencibia-Mireles, O. Marijuana Use Among the Adolescent Children of High-Risk Drug-Abusing Fathers. The American Journal on Addictions, 11, pp. 95-110, 2002.

Childhood Adversities Associated With Risk for Eating Disorders or Weight Problems During Adolescence or Early Adulthood

A community-based prospective longitudinal study was conducted to investigate the association between childhood adversities and problems with eating or weight during adolescence and early adulthood. A sample of 782 mothers and their offspring were interviewed during the childhood, adolescence, and early adulthood of the offspring. Childhood maltreatment, eating problems, environmental risk factors, temperament, maladaptive parental behaviors and parental psychopathology were assessed during childhood and adolescence. Eating disorders and problems with eating or weight in the offspring were assessed during adolescence and early adulthood. A wide range of childhood adversities were associated with elevated risk for eating disorders and problems with eating or weight during adolescence and early adulthood after the effects of age, childhood eating problems, difficult childhood temperament, parental psychopathology, and co-occurring childhood adversities were controlled statistically. Numerous unique associations were found between specific childhood adversities and specific types of problems with eating or weight, and different patterns of association were obtained among the male and female subjects. Maladaptive paternal behavior was uniquely associated with risk for eating disorders in offspring after the effects of maladaptive maternal behavior, childhood maltreatment, and other co-occurring childhood adversities were controlled statistically. Childhood adversities may contribute to greater risk for the development of eating disorders and problems with eating and weight that persist into early adulthood. Maladaptive paternal behavior may play a particularly important role in the development of eating disorders in offspring. Johnson, J.G., Cohen, P., Kasen, S. and Brook, J.S. Childhood Adversities Associated With Risk for Eating Disorders or Weight Problems During Adolescence or Early Adulthood. American Journal of Psychiatry. 159, pp. 394-400, 2002.

Drug Use and Neurobehavioral, Respiratory, and Cognitive Problems: Precursors and Mediators

To test a model of the early predictors and mediators of drug use and respiratory, neurobehavioral, and cognitive problems in adolescence and young adulthood. Authors prospectively examined self-reported measures of unconventional behavior, peer- and self-drug use and self-reported health problems in a sample of 286 males and 327 females. The sample represented the Northeastern United States at the time the data was first collected in 1975. The participants were assessed in early, middle, and late adolescence, and in young adulthood. Latent variable structural equation models were used to examine the data. Structural equation modeling conducted on the data provided support for the proposed longitudinal model. The findings indicated that adolescent drug use was associated indirectly with respiratory and directly with neurobehavioral and cognitive symptoms in young adulthood. Adolescent drug use during middle and late adolescence served as a mediator between unconventional behavior in early adolescence and health problems in young adulthood. A reduction in adolescent drug use may reduce respiratory and neurobehavioral and cognitive symptoms in young adulthood. This study identifies several points in the biopsychosocial pathways in adolescence leading to later health problems in young adulthood. Brook, J.S., Finch S.J., Whiteman, M. and Brook, D.W. Drug Use and Neurobehavioral, Respiratory, and Cognitive Problems: Precursors and Mediators. Journal of Adolescent Health, 30, pp. 433-441, 2002.

Eating Disorders During Adolescence and the Risk for Physical and Mental Disorders During Early Adulthood

Data from a community-based longitudinal investigation were used to investigate whether adolescents with eating disorders are at an elevated risk for physical and mental disorders during early adulthood. Psychosocial and psychiatric interviews were administered to a representative community sample of 717 adolescents and their mothers from 2 counties in the state of New York in 1983, 1985 to 1986, and 1991 to 1993. In 1983, the mean age of the youths was 13.8 years. Adolescents with eating disorders were at a substantially elevated risk for anxiety disorders, cardiovascular symptoms, chronic fatigue, chronic pain, depressive disorders, limitations in activities due to poor health, infectious diseases, insomnia, neurological symptoms, and suicide attempts during early adulthood after age, sex, socioeconomic status, co-occurring psychiatric disorders, adolescent health problems, body mass index, and worries about health during adulthood were controlled statistically. Problems with eating or weight during adolescence predicted poor health outcomes during adulthood, regardless of whether an eating disorder had been present. Only 22% of the adolescents with current eating disorders had received psychiatric treatment within the past year. Eating disorders during adolescence may be associated with an elevated risk for a broad range of physical and mental health problems during early adulthood. Johnson, J.G., Cohen, P., Kasen, S. and Brook J.S. Eating Disorders During Adolescence and the Risk for Physical and Mental Disorders During Early Adulthood. Archives of General Psychiatry, 59, pp. 545-552, 2002.

Television Viewing and Aggressive Behavior During Adolescence and Adulthood

Television viewing and aggressive behavior were assessed over a 17-year interval in a community sample of 707 individuals. There was a significant association between the amount of time spent watching television during adolescence and early adulthood and the likelihood of subsequent aggressive acts against others. This association remained significant after previous aggressive behavior, childhood neglect, family income, neighborhood violence, parental education, and psychiatric disorders were controlled statistically. Johnson, J.G, Cohen, P., Smailes, E.M., Kasen, S. and Brook, J.S. Television Viewing and Aggressive Behavior During Adolescence and Adulthood. Science, 295, pp. 2468-2471, 2002.

Psychiatric Disorders Associated with Risk for the Development of Eating Disorders During Adolescence and Early Adulthood

Longitudinal data were used to investigate whether anxiety, depressive, disruptive, personality, or substance use disorders are associated with risk for the development of eating disorders during adolescence or early adulthood. Psychiatric disorders were assessed among 726 youths from a random community sample during adolescence and early adulthood. Depressive disorders during early adolescence were associated with elevated risk for the onset of eating disorders, dietary restriction, purging behavior, and recurrent weight fluctuations after preexisting eating problems and other psychiatric disorders were controlled statistically. Disruptive and personality disorders were independently associated with elevated risk for specific eating or weight problems. The present findings suggest that depressive disorders during early adolescence may contribute to the development of eating disorders during middle adolescence or early adulthood. Johnson, J.G., Cohen, P., Kotler, L., Kasen, S. and Brook J.S. Psychiatric Disorders Associated with Risk for the Development of Eating Disorders During Adolescence and Early Adulthood. Journal of Consulting and Clinical Psychology, 70 (5), pp. 1119-1128, 2002.

Childhood Adversities, Interpersonal Difficulties, and Risk for Suicide Attempts During Late Adolescence and Early Adulthood

Data from a community-based longitudinal study were used to investigate the association between childhood adversities, interpersonal difficulties during adolescence, and suicide attempts during late adolescence or early adulthood. A community sample of 659 families from Upstate New York was interviewed in 1975, 1983, 1985 to 1986, and 1991 to 1993. During the 1991-1993 interview, the mean age of the offspring was 22 years. Maladaptive parenting and childhood maltreatment were associated with an elevated risk for interpersonal difficulties during middle adolescence and for suicide attempts during late adolescence or early adulthood after age, sex, psychiatric symptoms during childhood and early adolescence, and parental psychiatric symptoms were controlled statistically. A wide range of interpersonal difficulties during middle adolescence were associated with risk for suicidal behavior after the covariates were controlled. Profound interpersonal difficulties during middle adolescence mediated the association between maladaptive parenting or childhood maltreatment and suicide attempts during late adolescence or early adulthood. Maladaptive parenting and childhood maltreatment may be associated with a risk for severe interpersonal difficulties during adolescence. These interpersonal difficulties may play a pivotal role in the development of suicidal behavior. Youths who are at an elevated risk for suicide may tend to be in need of mental health services that can help them to cope with an extensive history of profound interpersonal difficulties, beginning in childhood and continuing through adolescence. Johnson, J.G., Cohen, P., Gould, M.S., Kasen, S., Brown, J. and Brook, J.S. Childhood Adversities, Interpersonal Difficulties, and Risk for Suicide Attempts During Late Adolescence and Early Adulthood. Archives of General Psychiatry, 59, pp. 741-749, 2002.

Adolescent Life Events as Predictors of Adult Depression

Among adults, life events predict future episodes of major depression as well as a range of anxiety disorders. While studies have begun to examine this issue in adolescents, few studies rely upon prospective epidemiological designs to document relationships between adolescent life events and adult major depression. An epidemiologically-selected sample of 776 young people living in Upstate New York received DSM-based psychiatric assessments and an assessment of life events in 1986. Psychopathology was again assessed in 1992. The current study examined the predictive relationship between life events in 1986 and depression as well as anxiety in 1992, controlling for depression/anxiety in 1986. Adolescent life events predicted an increased risk for major depression diagnosis in adulthood. When analyzed continuously, an association emerged with symptoms of major depression as well as with symptoms of generalized anxiety disorder. However, this association with generalized anxiety disorder was limited to females. Life events in adolescence predict risk for major depression during early adulthood. Pine, D.S., Cohen, P., Johnson, J.G. and Brook, J.S. Adolescent Life Events as Predictors of Adult Depression. Journal of Affective Disorders, 68, pp. 49-57, 2002.

The Longitudinal Relationship Between Drug Use and Risky Sexual Behaviors Among Colombian Adolescents

Community samples representing differing levels of risky sexual behavior and drug use were use to identify the longitudinal relationships between drug use, and risky sexual behaviors and early pregnancy in Colombian adolescents . Cohorts were drawn from higher and lower risk geographic areas as well as from various self-reported ethnic groups. Using regression analyses, controlling for demographic variables, a reciprocal, longitudinal relationship between risky sexual behaviors and drug use was identified. Those adolescents who reported higher levels of drug use at T1 also had more sexual partners and higher frequencies of unprotected sex, and they were also more likely to have experienced early pregnancy at T2. The reverse relationship was true as well. The level of violence experienced by the adolescent emerged as a moderator of some of these relationships. The results suggest that reducing adolescent drug use may also reduce levels of risky sexual behavior and early pregnancy and vice versa. Further, the importance of addressing violence as a risk factor for both problem behaviors is emphasized. Brook, D.W., Brook, J.S., Pahl, T. and Montoya, I., The Longitudinal Relationship Between Drug Use and Risky Sexual Behaviors Among Colombian Adolescents, Archives of Pediatric and Adolescent Medicine, 156, pp. 1101-1107, 2002.

Adolescent Children of Alcoholics Experience Difficulty With the Leaving-Home Transition

The current study examined the extent to which various features of young adults' experiences of leaving home differed for children of alcoholic (COAs) versus nonalcoholic parents. A total of 227 young adults drawn from a high-risk, community sample of COAs and matched controls were interviewed at ages 18-23 years regarding their prior leaving home experiences. COAs showed greater difficulties in negotiating this transition, fewer positive feelings about the transition, and different reasons for leaving home as compared to participants without an alcoholic parent. Moreover, adolescent risk behaviors, family conflict, and family disorganization (assessed prior to this transition) each partly accounted for COAs' risk for difficulty in the leaving home transition. Hussong, A.M. and Chassin, L. Developmental Psychopathology, 14(1), pp. 139-157, 2002.

Children of Opioid- and Alcohol-Dependent Parents

The authors compared families with parental opioid dependence, parental alcohol dependence, and no substance use disorder on several standardized measures. Children of opioid- and alcohol-dependent parents were found to have significantly higher rates of psychopathology, and difficulties in academic, social and family functioning, with problems of the offspring of opioid-dependent parents exceeding those of the alcohol-dependent. Children of opioid dependent parents showed more of a tendency toward disruptive, depressive, and anxiety disorders, while the alcohol group showed more depressive and substance use disorders, compared with controls. Differences in socioeconomic status and family intactness account for some of the group differences; nonetheless, the authors report that these findings are consistent with other literature on high-risk offspring. Wilens, T.E., Biederman, J., Bredin, E., Hahesy, A.L., Abrantes, A., Neft, D., Millstein, R., and Spencer, T.J. A Family Study of High-risk Children of Opioid- and Alcohol-dependent Parents. American Journal of Addictions, 11, pp. 41-51, 2002.