Early Adolescent Substance Use Research Articles

A case study in developmental discontinuity: PROSPER Interventions and adolescent substance use trajectories shape young adult substance use and mental health problems.

The loss of John Schulenberg reverberates across the developmental and prevention sciences. In honor of his many contributions, this paper applies his ideas of developmental continuity and discontinuity to understand the process by which PROSPER delivered universal prevention programs (delivered in Grades 6 and 7) affect young adult outcomes. Guided by these developmental models, we deconstructed adolescent substance use initiation trajectories into two discrete phases-early and late adolescence, demarcated by substance use initiation levels at the end of 9th grade. We evaluated the effects of PROSPER interventions on these phases, and in turn, the effects of adolescent substance use initiation on young adult antisocial behavior, alcohol and drug use consequences, and depression symptoms. This sample included 1,984 young adults who participated in the PROSPER intervention trial in Grade 6 (two cohorts, 2002 and 2003), followed over 8 adolescent measurement occasions (Fall and Spring of Grade 6; Spring of Grades 7-12). Young adult outcomes were averaged across three waves (collected at ages 20, 23, and 25). PROSPER interventions were associated with reduced substance use initiation in early adolescence, but not escalation during late adolescence. In turn, substance use in both early and late adolescence was uniquely associated with young adult antisocial behavior, depression symptoms, and substance use consequences. PROSPER interventions were associated with young adult antisocial behavior and problematic substance use via reduced risk for early initiation status. Findings are discussed in terms of developmental continuity and discontinuity.

Progression of Comorbid Depression and Substance Use among Racially Diverse Adults.

Comorbidity of depression and substance abuse is common and a major public health burden. Studies of this form of comorbidity in racial and ethnic minoritized (REM) populations are minimal and have mixed findings. The present study examined the effect of general risk factors (family bonding, supervision, involvement, peer delinquency), depression risk factors (caregiver depression), and substance use risk factors (adult family members, sibling, and peer substance use) in early adolescence (~ ages 13-14) on comorbid depression and substance use in later adolescence (~ ages 15-17) and adulthood (~ ages 29-31) and continuity in comorbidity from adolescence to adulthood. Longitudinal data on 1000 Black (n = 680) Hispanic (n = 170) and White (n = 150) individuals came from the Rochester Youth Development Study. Participants were interviewed 14 times over 17 years beginning in 1988. General risk factors predicted comorbidity across racial/ethnic groups. Substance specific risk predicted comorbidity among Black and Hispanic individuals whereas depression specific risk was predictive among White individuals. Adolescent comorbidity predicted comorbidity in adulthood across race. These findings highlight the importance of substance use intervention for racial and ethnic minoritized individuals and mental health risk factors in Whites. The continuity of comorbidity from adolescence to adulthood highlights the importance of targeting adolescents for intervention to prevent long-term manifestation of this form of comorbidity and its associated consequences.

Fear of Deportation and Hispanic Early Adolescent Substance Use: a Moderated Mediation Model of Stress and Hope.

Reports of deportation can create a state of chronic fear in children living in mixed-status immigrant families over their own or a loved one's potential deportation. One indicator of health disparities among youth is elevated rates of alcohol, tobacco, and other drug use (ATOD). Yet little is known about the effects of fear of deportation (FOD) on ATOD or what might promote resilience. We explore the associations between FOD and ATOD use, how stress mediates this relationship, and whether hope moderates the mediated pathway from FOD to ATOD. Participants were 200 first- and second-generation 7th grade Hispanic youth (49% female) assessed across three waves of data. A moderated mediation model tested the indirect effect of FOD on ATOD through stress and whether hope moderated these associations. FOD was measured by the Family Fear of Deportation Scale. Snyder's Children's Hope Scale measured hope. Stress was measured by a short version of Pediatric Psychological Stress Measure. ATOD was adapted from the Monitoring the Future project. FOD was not directly associated with ATOD use. However, this path was fully mediated by stress. Hope significantly moderated the path from FOD to stress such that a one unit increase in hope completely offset the effects of FOD on stress. Hope did not moderate the path from stress to ATOD use. Interventions that increase awareness of deportation trauma, alleviate stress, and promote hope may help prevent, delay initiation into, and/or decrease ATOD among Hispanic first- and second-generation youth.

Measure of Socialization of American Indian Children (MOSAIC): Understanding the roots of ethnic-racial identity.

The Measure of Socialization of American Indian Children (MOSAIC) was created as part of a larger study developing a family-based and culturally grounded substance use prevention program for young American Indian (AI) adolescents. The MOSAIC was designed to measure ethnic-racial socialization (ERS) for use with AI families to support better understanding of the roots of ethnic-racial identity among AI youth and their relationship to risk for substance use in early adolescence. This study was conducted in partnership with a Lakota reservation community. Community partners and advisors provided guidance on the creation of an item pool, which also drew extensively from the existing literature on ERS in other populations. The MOSAIC was pilot tested with a small sample of parents (N = 19) and then tested with a development sample of participants (N = 197) taking part in the larger study. A series of factor analyses were conducted with data from this development sample to explore associations among items and alignment with proposed dimensions. Four dimensions emerged, related to socialization practices to support spirituality, language, pride, and preparation for bias. The original MOSIAC measure was refined based on these analyses and prepared for testing in an independent sample. Dimensions of ERS common to measures developed for other populations emerged as relevant for AI families, with adaptations to reflect the unique context of this population. Further work is needed to confirm the structure of the MOSAIC in both this AI community and with other diverse indigenous populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Substance familiarity in middle childhood and adolescent substance use

BackgroundChildhood familiarity with (knowledge of) substances is a potentially important, currently understudied adolescent substance use risk factor. We aimed to describe changes in childhood familiarity with substances and to test whether baseline familiarity predicts early adolescent substance use. MethodsUtilizing the Substance Use Module of the longitudinal cohort study, Adolescent Brain Cognitive Development (ABCD; US youth aged 9–10 years followed for 10 years) through Data Release 4 (n=7896; individuals who completed all six assessments in the first three years), we conducted longitudinal mixed models and survival analyses to describe changes in familiarity and to determine the adjusted odds of substance use by age 13 based on number of familiar substances at baseline. ResultsThe sample consisted of 3754 females and 4142 males, aged 9–10 at baseline, with majority White individuals (68.9%). Unconditional time models indicated age significantly predicted familiarity (B=0.08, p<0.001; R2=0.288) with ~3.59 familiar substances at 9 years increasing to ~7.43 substances at 13 years. Family history, home use, peer use, and neighborhood availability predicted familiarity, accounting for 1% of additional variance (R2=0.299; ∆R2=0.011). For each additional familiar substance at baseline, adjusted odds of future use increased 1.28 times (95% CI 1.22, 1.34). ConclusionsThis is the first study to characterize substance familiarity in this age range as a predictor of future substance use. Familiarity increases with age (age being the most predictive indicator). Familiarity at age 9–10 predicts early adolescent substance use. As such, childhood familiarity may represent an easily implemented screening tool for at-risk youth.

Pandemic-Related Changes in the Prevalence of Early Adolescent Alcohol and Drug Use, 2020–2021: Data From a Multisite Cohort Study

PurposeEvaluate changes in early adolescent substance use from May 2020 to May 2021 during the coronavirus disease 2019 pandemic using data from a prospective nationwide cohort: the Adolescent Brain Cognitive Development Study. MethodsIn 2018–2019, 9,270 youth aged 11.5–13.0 completed a prepandemic assessment of past-month alcohol and drug use, then up to seven during-pandemic assessments between May 2020 and May 2021. We compared the prevalence of substance use among same-age youth across these eight timepoints. ResultsPandemic-related decreases in the past-month prevalence of alcohol use were detectable in May 2020, grew larger over time, and remained substantial in May 2021 (0.3% vs. 3.2% prepandemic, p <.001). Pandemic-related increases in inhalant use (p = .04) and prescription drug misuse (p < .001) were detectable in May 2020, shrunk over time, and were smaller but still detectable in May 2021(0.1%-0.2% vs. 0% pre-pandemic). Pandemic-related increases in nicotine use were detectable between May 2020 and March 2021 and no longer significantly different from prepandemic levels in May 2021 (0.5% vs. 0.2% prepandemic, p = .09). There was significant heterogeneity in pandemic-related change in substance use at some timepoints, with increased rates among youth identified as Black or Hispanic or in lower-income families versus stable or decreased rates among youth identified as White or in higher-income families. DiscussionAmong youth ages 11.5–13.0 years old, rates of alcohol use remained dramatically reduced in May 2021 relative to prepandemic and rates of prescription drug misuse and inhalant use remained modestly increased. Differences remained despite the partial restoration of prepandemic life, raising questions about whether youth who spent early adolescence under pandemic conditions may exhibit persistently different patterns of substance use.

Associations between early childhood adversity and behavioral, substance use, and academic outcomes in childhood through adolescence in a U.S. longitudinal cohort

BackgroundChildhood adversity is strongly associated with adolescent substance use, but few epidemiologic studies have investigated early childhood adversity (ECA) before age 5. This study investigated pathways by which ECA is associated with adolescent alcohol and cannabis use and high school completion through childhood behavioral and academic mediators and their reciprocal effects. MethodsData were from the National Longitudinal Survey of Youth 1979-Child/Young Adult Cohort which surveyed children born 1984–1999 and followed through 2016 (n = 5521). Outcomes included alcohol and cannabis use frequency at ages 15–18, and high school completion by age 19. ECA at ages 0–4 was a cumulative score of maternal heavy drinking/drug use, low emotional support, low cognitive stimulation, and household poverty. Multilevel path models were conducted with ECA, childhood mediators (behavioral (externalizing and internalizing problems) and academics (reading and math scores), accounting for demographics and confounders. ResultsECA was indirectly associated with adolescent cannabis frequency through mediators of externalizing/internalizing problems, low academics, and early cannabis onset before age 14. ECA was also indirectly associated with alcohol frequency via the same mediators, but not early alcohol onset. Greater behavioral problems elevated substance use risk; whereas, low academics reduced risk. Reciprocal effects were evident between childhood behavioral problems and cannabis frequency to high school completion. ConclusionAdversity from birth to age 4 is associated with childhood behavioral problems and lower academics, which increased adolescent alcohol and cannabis use and lowered high school completion. Early childhood interventions with parents and preschools/daycare may reduce early onset and adolescent substance use.

A longitudinal study of protective factors against substance use in early adolescence. An ecological approach.

Adolescent substance use has been widely related to different individual, school, family and community factors. Yet, the number of studies with all these variables together in a model from an ecological perspective is still low, and they rarely used a longitudinal design. The aim of this study was to explore, from an ecological perspective, the prospective impact of different individual, school, family and neighbourhood factors on adolescent substance use. This was a longitudinal study with a one-year follow up. There were 881 participants (Mage=12.57; 48.1% females) at wave 1, of which 686 (Mage=13.51; 51.8% females) were followed-up at wave 2. Validated questionnaires were used for data collection. Regression analyses showed that higher substance use was predicted by high family socio-economic status cross-sectionally and longitudinally, and it was related to low neighbourhood socio-economic status cross-sectionally only. Participants who disliked school and had a poor academic performance were more likely to use substances, both cross-sectionally and longitudinally. The inclusion of families in substance use prevention programmes could be a key component in these interventions. Moreover, promotion of a positive school climate could protect adolescents from using substances.

Substance Abuse and Oral Health of Adolescence

Substance abuse is a rising health trend that affects countries worldwide.It is associated with financial, social, medical, oral and economic effects that can affect the user, community and the society. Some substances have been used in the history of mankind for religious, cultural, recreational and medicinal purposes. Substance abuse among adolescents is increasing with possible associated factors like peer influence, availability and affordability of substances, favourable parental attitude to substance use, parental substance use problems, parental approval of substance use in early adolescence, family structure, locality of residence, social bonding, boredom, type of school, and adventurous personality. Oral health conditions among substance abusers may be attributed to the direct impact of the chemical qualities and nature of the illicit substances on oral tissues, decreased saliva production, concentration, personal preference, the frequency and amount of consumption of the abused substanceand the substance abuser associated oral health risk behaviours.

A cross-national comparison of the linkages between family structure histories and early adolescent substance use

Family structure can influence adolescent health with cascading implications into adulthood. Life course theory emphasizes how this phenomenon is dynamic across time, contextualized in policy systems, and grounded in processes of selection and socialization. This study used data from the U.S. (National Longitudinal Survey of Youth 1979 Child and Young Adults, n = 6,236) and U.K. (Millennium Cohort Study, n = 11,095) to examine associations between a single mother family structure between ages 0–14 and early adolescent substance use at age 14 across time and place, using inverse probability of treatment weighting to explore how results varied by selection into family structure. In both countries, single parenthood, regardless of its timing during childhood, consistently predicted adolescent substance use when samples were re-weighted to resemble the overall population. However, when samples were re-weighted so that their background characteristics resembled those of actual single parent families, there was little evidence that single parenting posed risks, suggesting that single parenting might matter less for adolescents who are likely to experience it (and vice versa). In addition, more generous welfare policy in the U.K. than in the U.S. did not appear to have ameliorated the observed role of single parenting in adolescent substance use. Findings supported a model of disadvantage saturation, where single parenting has little additional impact over the myriad other disadvantages that single parent families tend to experience, rather than a model of cumulative disadvantage, where single parenting compounds or adds to other disadvantages. Policy and interventions might more valuably focus on these other disadvantages than on family structure.

33.1 Early Adolescent Substance Use During the Pandemic in the ABCD Study

33.1 Early Adolescent Substance Use During the Pandemic in the ABCD Study

1.101 Familiarity With Substances of Abuse and Adolescent Substance Use

Adolescent substance use is a complex problem associated with several adverse health consequences. Familiarity with (knowledge of) substances of abuse in childhood is a potentially important, currently understudied substance use risk factor. We described changes in familiarity with substances of abuse during childhood and tested whether baseline familiarity predicts early adolescent substance use.

Racial differences in early adolescent substance use: Child abuse types and family/peer substance use as predictors

This study examined the associations among child abuse types, family/peer substance use, and adolescent substance use, as well as testing whether these associations vary by race. The sample was derived from the Longitudinal Studies of Child Abuse and Neglect (N = 562). Child sexual abuse, family substance use, and peer substance use were associated with a higher likelihood of adolescent substance use. Sexual abuse was more strongly associated with substance use in Black youth than in White youth. Conversely, greater peer substance use had a stronger association with substance use in White youth than in Black youth.

An Exploration of Intra-individual Mechanisms for the Association Between Childhood Conduct Problems and Early Adolescent Substance Use

An Exploration of Intra-individual Mechanisms for the Association Between Childhood Conduct Problems and Early Adolescent Substance Use

Early Adolescent Substance Use Before and During the COVID-19 Pandemic: A Longitudinal Survey in the ABCD Study Cohort

PurposeEvaluate changes in early adolescent substance use during the coronavirus disease 2019 (COVID-19) pandemic using a prospective, longitudinal, nationwide cohort. MethodsParticipants were enrolled in the Adolescent Brain Cognitive Development Study. A total of 7,842 youth (mean age = 12.4 years, range = 10.5–14.6) at 21 study sites across the U.S. completed a three-wave assessment of substance use between May and August 2020. Youth reported whether they had used alcohol, nicotine, cannabis, or other substances in the past 30 days. Data were linked to prepandemic surveys that the same youth had completed in the years 2018–2020, before the advent of the COVID-19 pandemic. ResultsPast-30-day substance use remained stable in the 6 months since stay-at-home orders were first issued in U.S. states/counties; was primarily episodic (1–2 days in the past month); and was typically limited to a single substance. Using pretest/posttest and age-period designs, we found that compared to before the pandemic, fewer youth were using alcohol and more youth were using nicotine or misusing prescription drugs. During the pandemic, youth were more likely to use substances when they were more stressed by pandemic-related uncertainty; their family experienced material hardship; their parents used alcohol or drugs; or they experienced greater depression or anxiety. Neither engagement in social distancing nor worry about COVID-19 infection was associated with substance use. Several risk factors were stronger among older (vs. younger) adolescents. ConclusionsAmong youth in early adolescence, advent of the COVID-19 pandemic was associated with decreased use of alcohol and increased use of nicotine and misuse of prescription drugs.

The roles of child maltreatment and fathers in the development of substance use in an at-risk sample of youth: A longitudinal study

BackgroundDespite ample cross-sectional evidence linking child maltreatment and father involvement to adolescent substance use, little is known about the longitudinal impact of child maltreatment and father involvement in the developmental course of substance use from early adolescence to late adolescence. ObjectiveThe primary aim of the study was to examine the long-term effects of childhood maltreatment (i.e., maltreatment type, perpetrator identity) and the quality and quantity of father involvement on developmental trajectories of substance use among high-risk youth. Participants and settingData were drawn from the Longitudinal Studies of Child Abuse and Neglect. Study participants included 681 U.S. adolescents who had experienced or were at risk for child maltreatment. MethodsLatent Growth Poisson Modeling was conducted to examine developmental trajectories of substance use at ages 12, 14, 16, and 18. ResultsChild emotional abuse and greater quantity of father involvement were associated with a higher initial number of substances used, while higher quality of father-child relationships was associated with a lower initial number of substances used. Emotional abuse and greater quantity of father involvement were associated with slower increases in the number of substances used over time. ConclusionsThe findings suggest that engaging fathers and promoting nurturing parenting and positive parent-adolescent interactions may be important for programs and policies aimed to prevent early adolescent substance use initiation. Furthermore, early identification of emotional abuse among adolescents could help to prevent initial polysubstance use onset.

Peer Victimization Exposure and Subsequent Substance Use in Early Adolescence: The Role of Sleep Problems.

While sleep problems are positively associated with both peer victimization and substance use, previous studies largely have ignored the indirect role sleep problems may play in this association. This three-wave longitudinal study aimed to determine whether sleep problems might link peer victimization to subsequent substance use. Participants were 986 youth (53.7% female, Mage = 12.32 [SD = 0.54 years], 55.6% White, 24.4% Latinx, 22.8% African American/Black, 11.1% Multiracial/Multiethnic, 13.4% Asian/Pacific Islander, and 6.4% Native American) from three U.S. public middle schools. A structural equation model controlling for multiple potential confounds revealed an indirect effect of peer victimization on substance use through sleep problems. Multiple group analyses indicated that the indirect effect was larger for females than for males. Effects did not differ across school socioeconomic level. The results provide further support to include peer victimization when considering factors that may influence adolescent sleep issues and subsequent substance use.

Bullying and Substance Use in Early Adolescence: Investigating the Longitudinal and Reciprocal Effects Over 3 Years Using the Random Intercept Cross-Lagged Panel Model.

Bullying and substance use among adolescents have been increasingly studied in the field of developmental psychology, but research to date has primarily investigated the cross-sectional relationship and, to a lesser extent, the long-term impact of bullying on substance use. Grounded in the General Theory of Crime, this study focused on the longitudinal reciprocal relationships between bullying and substance use (i.e., smoking and alcohol consumption) during early to mid-adolescence, which is a critical developmental phase. We aimed to investigate the hypothesis of a reinforcing downward spiral at the within-person level. Moreover, we intended to examine gender differences in the expected longitudinal relationships. Our analyses are based on self-report data for bullying and substance use collected from 1,495 adolescents (746 males; Mage at T1 = 12.42, SD = 0.58) at three waves between 2017 and 2019. We applied the random intercept cross-lagged panel model to separate within-person from between-person effects. At the between-person level, the mutual association between bullying and substance use, previously demonstrated in cross-sectional studies, was confirmed. At the within-person level, results provide evidence of a significant age-dependent change in bullying and substance use from 13 to 14 years old, where the significant increase in bullying could be attributed to females but not to males. We also found a gender-independent significant positive effect of bullying at 12 years old on substance use at 13 years, but not vice versa. Thus, the hypothesis of a reinforcing downward spiral, shown by significant positive reciprocal effects, did not find support. According to the General Theory of Crime, our findings underline that bullying can be considered a context-related factor inasmuch as it pushes adolescents to smoke and drink, which are both expressions of low levels of self-control, which need to be considered in intervention programs to effectively prevent unhealthy and risky behaviors in adolescence.

Age of Substance Use Initiation and Sexual Violence Victimization among Female Adolescents.

Objective: In this study, I examined the association between age of substance use initiation and sexual violence (SV) among adolescent girls. Methods: Data were drawn from the 2017 Youth Risk Behavior Survey, and the sample included 7526 girls. Logistic regression was used to estimate the relationship between age of initiation of alcohol use, marijuana use and cigarette smoking, and SV, assessed by forced sexual intercourse and experiencing SV. Results: A dose-response association was observed between age of substance use initiation and SV. Across all 3 substance use variables and for both SV outcomes, those who initiated substance use before age 15 were more likely to experience SV than those who initiated at or after age 15, who, in turn, had a higher likelihood of experiencing SV than those who had never initiated substance use. Conclusion: Early initiation of substance use may be a meaningful marker of risk for SV victimization in later adolescence. SV prevention programs could use early initiation of substance use to identify adolescents who are at increased risk for SV and provide them with targeted interventions. To be more effective, primary prevention of SV may need to begin targeting substance use in early adolescence.

Examining the internalizing pathway to substance use frequency in 10 cultural groups

Use of alcohol, tobacco, and drugs (i.e., substance use) is a leading cause of global health burden for 10-to-24-year-olds, according to the World Health Organization’s index of number of years of life lost, leading international health organizations to prioritize the prevention of substance use before it escalates in adolescence. Pathways defined by childhood externalizing symptoms and internalizing symptoms identify precursors to frequent substance use toward which interventions can be directed. However, these pathways are rarely examined beyond the United States and Europe. We investigated these pathways in our sample of 1083 children from 10 cultural groups followed from ages 8–14. We found that age-10 externalizing symptoms predicted more frequent mother-reported age-13 and self-reported age-14 substance use. We also found that a depressive pathway, marked by behavioral inhibition at age 8 and subsequent elevation in depressive symptoms across ages 8–12 predicted more frequent substance use at age 13 and 14. Additionally, we found a combined externalizing and internalizing pathway, wherein elevated age-9 depressive symptoms predicted elevated externalizing symptoms at age-10 which predicted greater peer support for use at age-12, which led to more frequent substance use at age-13 and -14. These pathways remained significant within the cultural groups we studied, even after controlling for differences in substance use frequency across groups. Additionally, cultures with greater opportunities for substance use at age-12 had more frequent adolescent substance use at age-13. These findings highlight the importance of disaggregating between- and within-culture effects in identifying the etiology of early adolescent substance use.