Do traumatic events and substance use co-occur during adolescence? Testing three causal etiologic hypotheses

IF 6.5 1区医学 Q1 PSYCHIATRY Journal of Child Psychology and Psychiatry Pub Date : 2024-04-15 DOI:10.1111/jcpp.13985

Herry Patel, Susan F. Tapert, Sandra A. Brown, Sonya B. Norman, William E. Pelham III

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Abstract

Background

Why do potentially traumatic events (PTEs) and substance use (SU) so commonly co-occur during adolescence? Causal hypotheses developed from the study of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) among adults have not yet been subject to rigorous theoretical analysis or empirical tests among adolescents with the precursors to these disorders: PTEs and SU. Establishing causality demands accounting for various factors (e.g. genetics, parent education, race/ethnicity) that distinguish youth endorsing PTEs and SU from those who do not, a step often overlooked in previous research.

Methods

We leveraged nationwide data from a sociodemographically diverse sample of youth (N = 11,468) in the Adolescent Brain and Cognitive Development Study. PTEs and substance use prevalence were assessed annually. To account for the many pre-existing differences between youth with and without PTE/SU (i.e. confounding bias) and provide rigorous tests of causal hypotheses, we linked within-person changes in PTEs and SU (alcohol, cannabis, nicotine) across repeated measurements and adjusted for time-varying factors (e.g. age, internalizing symptoms, externalizing symptoms, and friends' use of substances).

Results

Before adjusting for confounding using within-person modeling, PTEs and SU exhibited significant concurrent associations (βs = .46–1.26, ps < .05) and PTEs prospectively predicted greater SU (βs = .55–1.43, ps < .05) but not vice versa. After adjustment for confounding, the PTEs exhibited significant concurrent associations for alcohol (βs = .14–.23, ps < .05) and nicotine (βs = .16, ps < .05) but not cannabis (βs = -.01, ps > .05) and PTEs prospectively predicted greater SU (βs = .28–.55, ps > .05) but not vice versa.

Conclusions

When tested rigorously in a nationwide sample of adolescents, we find support for a model in which PTEs are followed by SU but not for a model in which SU is followed by PTEs. Explanations for why PTSD and SUD co-occur in adults may need further theoretical analysis and adaptation before extension to adolescents.

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创伤事件和药物使用会在青春期同时发生吗？检验三种因果病因假设

为什么潜在创伤事件（PTE）和药物使用（SU）在青春期如此常见地同时发生？从研究成人创伤后应激障碍（PTSD）和药物使用障碍（SUD）中得出的因果假设，尚未在患有这些障碍前兆的青少年中进行严格的理论分析或实证检验：PTEs 和 SU。要确定因果关系，就必须考虑到各种因素（如遗传、父母教育、种族/民族），这些因素会将患有 PTEs 和 SU 的青少年与未患有 PTEs 和 SU 的青少年区分开来，而以往的研究往往忽略了这一步骤。

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来源期刊

Journal of Child Psychology and Psychiatry 医学-精神病学

CiteScore

13.80

自引率

5.30%

发文量

169

审稿时长

1 months

期刊介绍： The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.