Faculty Bibliography

In this longitudinal study, we applied structural equation modeling (SEM) to examine the psychosocial factors from adolescence to adulthood as related to symptoms of Internet addiction (IA) during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N=548) followed from adolescence to early midlife (mean age=43; SD=2.8). The findings supported a meditational model: adolescent (mean age=16) conflictual parent-child relationship was associated with internalizing problem behaviors at mean age 21 in emerging adulthood (b=0.13, p<0.01), which, in turn, were associated with both alcohol/drug use problems at mean age 27-32 (b=0.24, p<0.001) and affective disorders at mean age 37 (b=0.29, p<0.001), which, ultimately, were associated with symptoms of IA in early midlife (b=0.23, p<0.01; b=0.21, p<0.05, respectively). In addition, alcohol/drug use problems were associated with affective disorders (b=0.22, p<0.05). Among the constructs, alcohol/drug use problems had the greatest total effects on symptoms of IA in early midlife (b=0.28, p<0.001). Findings suggest that family therapy focused on an increase in the affectionate relationship between the adolescent and his/her parents, cognitive-behavioral treatment of internalizing problem behaviors, and effective treatment of individuals who have alcohol/drug use problems may reduce the likelihood of having symptoms of IA in early midlife.

OBJECTIVE: To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. METHOD: A random community-based sample [X age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. RESULTS: Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. CONCLUSIONS: In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder.

Latinos are disproportionately impacted by drinking and driving arrests and alcohol-related fatal crashes. Why, and how, these disparities occur remains unclear. The neighborhood environments that recent Latino immigrants encounter in their host communities can potentially influence health behaviors over time, including the propensity to engage in drinking and driving. This cross-sectional study utilizes a sample of 467 documented and undocumented adult recent Latino immigrants in the United States to answer the following research questions: (a) How do neighborhood-level factors, combined with social support, impact drinking and driving risk behaviors?; and (b) Does acculturative stress moderate the effects of those associations? Results indicate neighborhood-level factors (informal social control and social capital) have protective effects against drinking and driving risk behaviors via the mediating mechanism of social support. Acculturative stress moderated associations between neighborhood informal social control and social support, whereby the protective effects of informal social control on social support were not present for those immigrants with higher levels of acculturative stress. Our findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest that, in the process of developing prevention programs tailored to Latino immigrants, greater attention must be paid to neighborhood-level factors.

BACKGROUND: The study assesses the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, children living at home, and spouse/partner marijuana use at age 43. METHOD: This study used a longitudinal design. The sample participants (N = 548) were first studied at mean age 14 and last studied at mean age 43. RESULTS: Six trajectories of marijuana use were identified: chronic/heavy users (3.6 %), increasing users (5.1 %), chronic/occasional users (20 %), decreasers (14.3 %), quitters (22.5 %), and nonusers/experimenters (34.5 %). With three exceptions, as compared with being a nonuser/experimenter, a higher probability of belonging to the chronic/heavy, the increasing, or the chronic/occasional user trajectory group was significantly associated with a greater likelihood of unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, not having children who lived at home, and having a spouse/partner who used marijuana at early midlife. In addition, compared with being a quitter, a higher probability of belonging to the chronic/heavy user trajectory group was significantly associated with a higher likelihood of unconventional behavior, sensation seeking, emotional dysregulation, alcohol dependence/abuse, and spouse/partner marijuana use. Implications for intervention are presented. CONCLUSIONS: Trajectories of marijuana use, especially chronic/heavy use, increasing use, and chronic/occasional use, are associated with unconventional behavior, sensation seeking, emotional dysregulation, nicotine dependence, alcohol dependence/abuse, having children who lived at home, and spouse/partner marijuana use at age 43. The importance of the findings for prevention and treatment programs are discussed.

The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.

BACKGROUND AND OBJECTIVES: The excessive consumption of alcohol is a major issue in the United States and elsewhere. It is associated with a number of adverse health consequences, as well as difficulty in relationships and employment. Therefore, the present longitudinal study investigates the direct and indirect adolescent predictors of alcohol use in adulthood. METHODS: Among the 674 participants (53% African Americans, 47% Puerto Ricans), 60% were females (n = 405). Mplus software was used to perform structural equation modeling. RESULTS: Parental problems with alcohol use in the participants' late adolescence were related to low parent-child attachment in late adolescence, which in turn, was related to self delinquency in late adolescence. This was related to peer delinquency in emerging adulthood, which in turn, was associated with alcohol use in emerging adulthood and in adulthood. Low parent-child attachment in late adolescence was also related to low satisfaction with school in late adolescence, which in turn, was related to self delinquency in late adolescence. This was associated with alcohol use in emerging adulthood, which in turn, was associated with alcohol use in adulthood. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: One of the key implications of this study is that an impaired low parent-child attachment relationship is a determinant of children's engagement in delinquent behavior and ultimately the use of alcohol in adult life. Implications for social interventions from the findings of the current study were also discussed. (Am J Addict 2016;XX:1-8).

In this longitudinal study, we applied structural equation modeling (SEM) to examine the historical, predisposing, enabling/barrier, and need factors as related to the underuse of medical services during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N = 548) followed from adolescence to early midlife. The findings supported a mediational model: A mutually affectionate parent-child relationship in early adolescence was inversely related to underuse of medical services in early midlife via the mediational roles played by later predisposing factors (i.e., depressive mood and cigarette smoking), need factor (i.e., physical health problems), barriers (i.e., financial difficulty), and enabling factors (i.e., social support for health services in early midlife). In addition, satisfaction with medical services in the neighborhood had an association with less underuse of medical services in early midlife. Family therapy focused on an increase in the affectionate relationship between the adolescents and his/her parents and cognitive-behavioral treatment of depressive mood may lead to a decrease in the underuse of medical services.

OBJECTIVE: Tobacco and alcohol use by adolescents are major public health concerns in South Africa. However, the extent to which key psychosocial risk factors for tobacco use and alcohol use by adolescents in South Africa are shared or unshared is unclear. This study sought to examine the shared and unshared risk factors for tobacco and alcohol use among adolescents in Johannesburg. METHOD: Participants comprised 736 males and females aged 12-17 years who were recruited via a household survey conducted during 2004. The participants were interviewed using a questionnaire comprising measures of personal, family (parental bonding and family legal drug use) and contextual (school and neighbourhood) factors. Separate multiple logistic regression analyses were conducted to predict lifetime alcohol use and lifetime tobacco use from variables within each domain (personal, family and contextual), controlling for demographic factors. RESULTS: Personal, family (parental bonding) and contextual factors (school factors) were primarily shared risk factors for tobacco and alcohol use, while family legal drug use and neighbourhood factors were largely unshared. CONCLUSIONS: Interventions addressing personal, parenting and schooling factors are likely to have an impact on preventing both tobacco and alcohol use, whereas interventions focused on ameliorating family drug use and neighbourhood factors may need to be more substance-specific.

This prospective study examined the longitudinal pathways to the utilization of mental health services among women in their mid-sixties. Earlier educational level, psychological symptoms, cigarette use, and physical diseases and later psychological symptoms were examined as predictors of mental health services utilization. The sample consisted of a prospective cohort of women (N = 511) who were followed from young adulthood (mean age = 32) to late midlife (mean age = 65). Using structural equation modeling, the results supported a mediational model showing that earlier low educational level and greater psychological symptoms predicted increased cigarette smoking. Cigarette smoking predicted later physical diseases and symptoms. Physical diseases and symptoms were related to financial difficulty and later psychological symptoms and, ultimately, the use of mental health services by women in the mid-sixties.

OBJECTIVES: To study the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unemployment status at mean age 43. METHODS: We gathered longitudinal data on a prospective cohort taken from a community sample (N = 548). Forty-nine percent of the original participants were females. Over 90% of the participants were white. The participants were followed from adolescence to early midlife. The mean ages of participants at the follow-up interviews were 14.1, 16.3, 22.3, 27.0, 31.9, 36.6, and 43.0, respectively. We used the growth mixture modeling (GMM) approach to identify the trajectories of marijuana use over a 29-year period. RESULTS: Five trajectories of marijuana use were identified: chronic users/decreasers (8.3%), quitters (18.6%), increasing users (7.3%), chronic occasional users (25.6%), and nonusers/experimenters (40.2%). Compared with nonusers/experimenters, chronic users/decreasers had a significantly higher likelihood of unemployment at mean age 43 (adjusted odds ratio = 3.51, 95% confidence interval = 1.13-10.91), even after controlling for the covariates. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: The results of the associations between the distinct trajectories of marijuana use and unemployment in early midlife indicate that it is important to develop intervention programs targeting chronic marijuana use as well as unemployment in individuals at this stage of development. Results from this study should encourage clinicians, teachers, and parents to assess and treat chronic marijuana use in adolescents. (Am J Addict 2016;XX:1-7).