Early Adult Substance Research Articles

Midlife diseases of despair and cardiometabolic risk: testing shared origins in adolescent psychopathology.

Rising midlife mortality in the United States is largely attributable to 'deaths of despair' (deaths from suicide, drug poisonings, and alcohol-related diseases) and deaths from cardiometabolic conditions. Although despair- and cardiometabolic-related mortality are increasing concurrently, it is unclear whether they share common developmental origins. We tested adolescent psychopathology as a potential common origin of midlife diseases of despair and cardiometabolic risk. Participants (N = 4578) were from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative cohort followed from adolescence to early midlife. Adolescent psychopathology included depression, anxiety, eating disorders, PTSD, conduct disorder, and ADHD at ages 11-18. Diseases of despair (suicidality, substance misuse, pain, and sleep problems) and cardiometabolic risk (hypertension, hyperlipidemia, high-risk waist circumference, diabetes, and cardiovascular conditions) were multi-modally measured at ages 33-43. At midlife, adolescents who experienced psychopathology exhibited more indicators of despair-related diseases and cardiometabolic risk (IRRs = 1.67 [1.46-1.87] and 1.13 [1.04-1.21], respectively), even after accounting for demographics, adolescent SES, and adolescent cognitive ability. Associations were evident for internalizing and externalizing conditions, and in a dose-response fashion. In mediation analyses, low education explained little of these associations, but early-adult substance use explained 21.5% of psychopathology's association with despair-related diseases. Midlife despair-related diseases and cardiometabolic risk co-occurred within individuals (IRR = 1.12 [1.08-1.16]). Adolescent psychopathology accounted for 8.3% of this co-occurrence, and 16.7% together with adolescent SES and cognitive ability. Adolescent psychopathology precedes both diseases of despair and cardiometabolic risk. Prevention and treatment of psychopathology may mitigate multiple causes of poor midlife health, reducing premature mortality.

Back to the basics and fast forward to multiculturalism.

This article reviews and comments on the contributions to the special issue, Brief Alcohol Interventions for Young Adults: Strengthening Effects and Disentangling Mechanisms to Build Personalized Interventions for Widespread Uptake, and proposes next steps to strengthen effects and promote widespread uptake. The articles of the special issue were reviewed simultaneously through the lenses of addiction and multicultural sciences to provide further insight into subsequent research that may help to advance the field. The needs of early adults seem to have changed significantly in 30 years. Although significant advances have occurred, many important research questions remain unanswered and many subpopulations continue to be understudied. Common themes discussed in this article emerged from the special issue for potentially improving effects and promoting greater uptake of efficacious interventions. Researchers must pivot to advance understandings concerning early adult substance use interventions among minoritized populations and in the context of intersectionality in order to promote broader uptake. Multicultural psychology may offer novel conceptualizations that would help to diversify early adult interventions as well as help to address gaps in understanding the intervention needs of minoritized early adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Child Maltreatment, Early Adult Substance Use, and Mediation by Adolescent Behavior Problems.

The purpose of the current study was to examine the potential mediating effects of internalizing and externalizing problems at ages 14, 16 and 18 between types of childhood maltreatment and alcohol and marijuana use problems and disorders in young adulthood. Data were from 473 young adults who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Path analysis was conducted to examine pathways between maltreatment type (birth through age 12), internalizing and externalizing problems at three time points during adolescence, and alcohol and marijuana problem use in young adulthood. Findings indicated significant pathways between physical abuse and internalizing problems at 14, which was associated with alcohol-related substance use disorder in adulthood. Externalizing problems and internalizing problems at age 14 mediated the relationship between physical abuse and marijuana-related symptoms in young adulthood. Emotional and sexual abuse were not associated with substance use problems. Implications for practice are discussed.

Substance use behaviors and the timing of family formation during young adulthood.

The impact of substance use on the life course of young adults can be substantial, yet few studies have examined to what extent early adult substance use behaviors are related to the timing of family formation, independent of confounding factors from adolescence. Using panel data from the Monitoring the Future study (N~20,000), the current study examined the associations between three substance use behaviors (i.e., cigarette use, binge drinking, and marijuana use) and the timing of family formation events in young adulthood. Survival analysis and propensity score weighting addressed pre-existing differences between substance users and non-users in the estimation of the timing of union formation (i.e., marriage, cohabitation) and parenthood. Results for young adult substance users showed general patterns of reduced rates of marriage and parenthood, and increased cohabitation during young adulthood. Variations were evident by substance and sex.

Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent attention deficit/hyperactivity disorder and delinquency.

To examine the association between developmental trajectories of inattention, hyperactivity-impulsivity and delinquency through childhood and adolescence (ages 8-16 years) and subsequent binge drinking and marijuana use in early adulthood (age 21 years). Prospective naturalistic follow-up of children with attention deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment-phase assessments occurred at 3, 9 and 14 months after randomization; follow-up assessments occurred at 24 months, 36 months, and 6, 8 and 12 years after randomization. Secondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi-site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care. A total of 579 children with DSM-IV ADHD combined type, aged 7.0 and 9.9 years at baseline (mean = 8.5, SD = 0.80). Ratings of inattention, hyperactivity-impulsivity and delinquency were collected from multiple informants at baseline and through the 8-year follow-up. Self-reports of binge drinking and marijuana use were collected at the 12-year follow-up (mean age 21 years). Trajectories of worsening inattention symptoms and delinquency (and less apparent improvement in hyperactivity-impulsivity) were associated with higher rates of early adult binge drinking and marijuana use, compared with trajectories of stable or improving symptoms and delinquency (of 24 comparisons, all P-values <0.05), even when symptom levels in stable trajectories were high. Worsening inattention symptoms and delinquency during adolescence are were associated with higher levels of early adult substance use; this pattern may reflect a developmental course of vulnerability to elevated substance use in early adulthood.

Age of Substance Use Onset as a Predictor of Early Adult Substance Dependence and Offending in Male and Female Delinquents

This study was designed first, to test whether sex moderated the effect of substance use onset on early adult substance dependence and offending and second, to identify the factors responsible for this effect. Structured equation modeling with 1,281 adjudicated delinquents (1,104 males, 177 females) from the Pathways to Desistance study revealed that sex moderated the onset–substance dependence and onset–offending relationships. Whereas age of substance use onset predicted early adult substance dependence in both males and females, it only predicted early adult offending in males. Out of six putative mediators, only one, adolescent moral disengagement, satisfied the criteria for mediated moderation. Mediation of the moderated onset–offending relationship was the result of moral disengagement correlating with both age of substance use onset and early adult offending in male but not female delinquents. Moral disengagement displayed similar patterns of correlation in the onset–substance dependency relationship but failed to satisfy all criteria for mediated moderation.

GENETIC STUDY: The interaction between the dopamine transporter gene and age at onset in relation to tobacco and alcohol use among 19‐year‐olds

Recent evidence suggests that heterogeneity in the age at onset could explain the inconsistent findings of association studies relating the dopamine transporter (DAT1) gene with alcohol and nicotine consumption. The aim of this study was to examine interactions between two DAT1 polymorphisms and different initiation ages with regard to alcohol and tobacco consumption levels and dependence. Two hundred and ninety-one young adults (135 males, 156 females) participating in the Mannheim Study of Children at Risk were genotyped for the 40-bp variable number of tandem repeats (VNTR) and rs27072 polymorphisms of DAT1. Age at initiation was assessed at age 15 and 19 years. Information about current alcohol and tobacco consumption was obtained at age 19 years using self-report measures and structured interviews. Results suggest that age at onset of intensive consumption moderated the association of the DAT1 gene with early adult substance use and dependence, revealing a DAT1 effect only among individuals homozygous for the 10r allele of the 40-bp VNTR who had started daily smoking or being intoxicated early in life. Equally, carriers of the T allele of the rs27072 polymorphism reporting an early age at first intoxication showed higher current alcohol consumption at age 19 years. In contrast, no interaction between rs27072 and the age at first cigarette with regard to later smoking was observed. These findings provide evidence that the DAT1 gene interacts with an early heavy or regular drug exposure of the maturing adolescent brain to predict substance (ab)use in young adulthood. Further studies are required to confirm these findings.

Early pubertal maturation in the prediction of early adult substance use: a prospective study

To examine whether self-reporting a later stage of pubertal development in early adolescence predicts young adults' use of illicit drugs. Population-based prospective birth cohort study. Follow-up of a cohort of mothers and their children, recruited between 1981 and 1983. Cohort of 2710 young adults who completed a self-report questionnaire about their use of cannabis and amphetamines at the 21-year follow-up. Young adults' use of cannabis and amphetamines were measured at the 21-year follow-up. Stage of pubertal development was assessed at the 14-year follow-up. Potential confounding and mediating variables were assessed between birth and when the child was 14 years. Of 2,710 young adults, 49.9% (47.3 females and 52.7% males) reported that they had used cannabis and 21.0% (18.9% females and 23.3% males) reported that they had used amphetamines and cannabis by 21 years. In multivariate analyses, adolescents with a later stage of puberty were more likely to use cannabis or amphetamines in young adulthood. This association was not confounded by mother's education or child's gender and age. Part of the relationship was explained by the higher frequency of child externalizing behaviour at 14 years. The findings warrant further attention to puberty as a sensitive period in an individual's development. With regard to prevention, there is a need to understand more about the pathways between pubertal development, child behaviour problems and substance use.