Faculty Bibliography

Heavy cannabis use is associated with a wide array of physical, mental, and functional problems. Therefore, cannabis use disorders (CUDs) may be a major public health concern. Given the adverse health consequences of CUDs, the present study seeks to find possible precursors of CUDs. The current study consisted of 5 waves of data collection from the Harlem Longitudinal Development Study. Among 816 participants, about half are African Americans (52%), and the other half are Puerto Ricans (48%). We used Mplus to obtain the triple trajectories of alcohol use, tobacco use, and depressive symptoms. Logistic regression analyses were then conducted to examine the associations between the trajectory groups and CUDs. The 5 trajectory groups were (1) moderate alcohol use, high tobacco use, and high depressive symptoms (MHH; 12%); (2) moderate alcohol use, high tobacco use, and low depressive symptoms (MHL; 26%); (3) moderate alcohol use, low tobacco use, and low depressive symptoms (MLL; 18%); (4) low alcohol use, no tobacco use, and high depressive symptoms (LNH; 11%); and (5) low alcohol use, no tobacco use, and low depressive symptoms (LNL; 33%). The MHH, MHL, MLL, and LNH trajectory groups were associated with an increased likelihood of having CUDs compared to the LNL trajectory group after controlling for a number of confounding factors (e.g., CUDs in the late 20s). The findings of the current longitudinal study suggest that treatments designed to reduce or quit drinking as well as smoking and to relieve depressive symptoms may reduce the prevalence of CUDs. (PsycINFO Database Record

Millions of people are living with the human immunodeficiency virus (HIV). African American and Hispanic/Latino communities suffer the most severe burden of HIV in the US. The ultimate goal of this study was to better understand risk factors for this infection: Do impulsivity and self control operate independently or synergistically with respect to HIV sexual risk behaviors in women? An enhanced understanding of these risk factors may better inform future interventions. Among the total of 343 female participants, half were African American and the other half were Latina. Data in this study were collected in the area of New York City during 2014-2016, when the mean age of the participants was 39 years. Linear regression analyses were used to examine the associations of impulsivity and self control with HIV sexual risk behaviors. Impulsivity and self control were independently associated with most of the HIV sexual risk behaviors examined. In addition, the interaction terms between impulsivity and low self control were all significantly associated with each of the sexual risk behaviors. Prevention programs should consider incorporating the roles of impulsivity and self control simultaneously as related to HIV risk behaviors.

BACKGROUND: Post traumatic stress disorder (PTSD) symptoms are related to a number of adverse consequences such as substance use and general medical conditions. The present longitudinal study seeks to find the longitudinal patterns of cannabis use as precursors of PTSD symptoms. Such information will serve as a guide for intervention programs for PTSD. METHODS: Growth mixture modeling was conducted to identify the cannabis use trajectory groups using a community sample of 674 participants (53% African Americans, 47% Hispanics of Puerto Rican decent; 60% females) from the Harlem Longitudinal Development Study. Logistic regression analyses were performed to examine the association between earlier trajectories of cannabis use (age 14 to 36) and later symptoms of PTSD (at age 36) for the full model including the entire sample (N = 674) as well as the reduced model including only participants who had experienced a traumatic event (n = 205). RESULTS: Five trajectory groups of cannabis use were obtained. The chronic use group (full model: Adjusted odds ratio, AOR = 4.68, p<.01; reduced model: AOR = 4.27, p<.05), the late quitting group (full model: AOR = 6.18, p<.01; reduced model: AOR = 6.67, p<.01), and the moderate use group (full model: AOR = 3.97, p<.01; reduced model: AOR = 3.32, p<.05) were all associated with an increased likelihood of having PTSD symptoms at age 36 compared with the no use group. CONCLUSIONS: The findings provide information that PTSD symptoms in the mid 30s can possibly be reduced by decreasing membership in the chronic cannabis use trajectory group, the late quitting trajectory group, and the moderate cannabis use trajectory group.

African Americans have the most severe burden of human immunodeficiency virus (HIV) of all racial/ethnic groups in the United States. Also, HIV continues to be a serious threat to the health of the Hispanic/Latino community. For prevention purposes, the present study examined the relationship of both cannabis use and self-control with HIV risk behaviors in a sample of African American and Puerto Rican female adolescents, young adults, and adults. Among the total of 343 female participants, half were African American and the other half were Puerto Rican. Logistic regression analyses were used to examine earlier cannabis use as well as self-control and later HIV risk behaviors. High frequency of cannabis use and high self-control measured at ages 19 to 29 were positively and negatively related to having sexual intercourse with someone they just met at ages 32 to 39. Prevention programs should incorporate the role of cannabis use and low self-control as related to HIV risk behaviors. Our results may have particular utility for designing interventions focused on not only cannabis use (a risk factor) but also self-control (a protective factor) as related to HIV sexual risk behaviors.

BACKGROUND: Due to the increasing prevalence of cannabis use disorder (CUD), the impact of cannabis use on public health may be significant. OBJECTIVE: The present study seeks the possible precursors (e.g., alcohol use) of CUD in order to minimize the potential negative consequences of CUD such as impaired coordination and performance. METHOD: The Harlem Longitudinal Development Study included 674 participants (53% African Americans, 47% Puerto Ricans), with 60% females (n=405) from a six wave survey. We used a growth mixture model to obtain the trajectories of alcohol use from the mean ages of 14 to 36. To examine the associations between alcohol use trajectories and CUD, we used logistic regression analyses with the indicator of CUD as the dependent variable and the indicator of membership in each trajectory group as the independent variables. RESULTS: A three alcohol use trajectory group model was selected. Male gender, higher frequency of cannabis use in adolescence, and a lower educational level were associated with an increased likelihood of having CUD. Membership in the increasing alcohol use group (OR=27.44, p < .01; AOR=15.54, p < .01) and the moderate alcohol use group (OR=10.40, p < .05; AOR=8.63, p < .05) were associated with an increased likelihood of having CUD compared with the membership in the no or low alcohol use group. CONCLUSIONS: The findings of our study support the hypothesis that addressing alcohol use at an early age could impact later CUD.

A quarter of people living with human immunodeficiency virus (HIV) infection in the United States are women. Furthermore, African American and Hispanic/Latina women continue to be disproportionately affected by HIV, compared with women of other races/ethnicities. Cannabis use prior to intercourse may be associated with increased risky sexual behaviors which are highly related to HIV. The ultimate goal of this research is to better understand the relationships between unconventional personal attributes (e.g., risk-taking behaviors) in the late 20s, substance use (e.g., alcohol) in the mid 30s, and cannabis use prior to intercourse in the late 30s using a community sample; such an understanding may inform interventions. This study employing data from the Harlem Longitudinal Development Study includes 343 female participants (50% African Americans, 50% Puerto Ricans). Structural equation modeling indicated that unconventional personal attributes in the late 20s were associated with substance use in the mid 30s (beta=0.32, p<0.001), which in turn, was associated with cannabis use prior to sexual intercourse in the late 30s (beta=0.64, p<0.001). Unconventional personal attributes in the late 20s were also directly related to cannabis use prior to sexual intercourse in the late 30s (beta=0.39, p<0.01). The findings of this study suggest that interventions focused on decreasing unconventional personal attributes as well as substance use may reduce sexual risk behaviors among urban African American and Puerto Rican women. Also, the implications of this study for health care providers and researchers working in HIV prevention are that these precursors may be useful as patient screening tools.

The current study examines the longitudinal patterns of both cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder (GAD) using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicator variables of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid 20s to the mid 30s were used as the independent variables, and the diagnosis of GAD in the mid 30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having GAD as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of GAD.

Background/UNASSIGNED:In the United States (US), there are 19 million new sexually transmitted disease (STD) infections each year. Untreated STDs can lead to serious long-term adverse health consequences, especially for young women. Centers for Disease Control and Prevention estimates that undiagnosed and untreated STDs cause at least 24,000 women in the US each year to become infertile. This clearly is a public health issue of great concern for young women. Materials and Methods/UNASSIGNED:The current cross-sectional study included a community sample consisting of 343 female participants (50% African Americans, 50% Puerto Ricans) at their mean age of 39 years. Regression analyses were conducted to examine the associations of time-varying factors within-person (e.g., substance use) and fixed effects factors between-persons (e.g., race/ethnicity) with the number of male sexual partners. Results/UNASSIGNED:<0.01) were significantly related to having a higher number of male sex partners in the past year. Conclusions/UNASSIGNED:From a public health perspective, treatment and prevention programs for sexual risk behavior focused on substance use as well as socio-cultural factors (i.e., marital status, race/ethnicity) may be more effective than programs focused only on substance use.

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).

Traumatic events are linked with an array of adverse consequences such as substance use. Only a few individuals exposed to traumatic events, however, suffer from post traumatic stress disorder (PTSD) or substance use. The present longitudinal study examined the inter-relationship among victimization, PTSD, and substance use. 674 participants (53% African Americans, 47% Puerto Ricans) were surveyed over five time waves at mean ages 14, 19, 24, 29, and 36. Of the 674, 60% were females. We used Mplus to perform structural equation modeling. Victimization at ages 19, 24, and 29 was directly associated with substance use at age 36 and was also related to PTSD at age 36. PTSD, in turn, was related to substance use at age 36. This study indicates the importance of intervention for those who have been victimized with a focus on PTSD treatment. From a public health perspective, health providers should consider treatment and prevention programs for helping individuals cope with some of the consequences of victimization. This might ultimately reduce substance use.