Journal Article Reviews.

ADOLESCENT COGNITION AND SUBSTANCE USE Morin JG, Afzali MH, Bourque J, Stewart SH, Séguin JR, O’Leary-Barrett M, and Conrod PJ. A population-based analysis of the relationship between substance use and adolescent cognitive development. AJP. Published online October 2018. Studies have shown a relationship between alcohol and cannabis misuse and cognitive functioning, but the results are mixed. The authors aimed at determining the relationship between adolescent cognition and substance use over time. Data from the Co-Venture study (a longitudinal study on the efficacy of a drug and alcohol prevention program) were used. In September 2012 or 2013, participating 7th graders in the Montreal area [n 5 3826; 53% male; mean (SD) age 5 12.7 y (0.5); 58% European] completed an annual web-based testing for 4 years to assess cognition (spatial working memory, delayed recall memory, perceptual reasoning, and inhibitory control) and substance use (Detection of Alcohol and Drug Problems in Adolescents questionnaire). Cannabis use at least 33/week was observed in 0.69%, 0.91%, 2.47%, and 3.81% of participants during 7th, 8th, 9th, and 10th grade, respectively, whereas alcohol use at least 33/week was observed in 0.31%, 0.34%, 0.36%, and 0.90% of participants during 7th, 8th, 9th, and 10th grade, respectively. After controlling for covariates (socioeconomic status, ethnicity, and family intactness), results showed that cannabis use was associated with poorer working memory (b 5 0.51, SE 5 0.25, p 5 0.04), perceptual reasoning (b 5 20.25, SE 5 0.08, p 5 0.001), and inhibition (b 5 1.19, SE 5 0.48, p , 0.01) during the same period. Further impairment in inhibition a year later was predicted by increases in cannabis use (b5 1.05, SE 5 0.41, p 5 0.01). Alcohol use was associated with lower spatial working memory (b 5 0.09, SE 5 0.05, p , 0.05), lower perceptual reasoning scores (b 5 20.06, SE 5 0.02, p , 0.01), and poorer inhibition (b 5 0.27, SE 5 0.09, p , 0.01) during the same period. Lagged effects were not observed for alcohol. The authors concluded that cannabis use is associated with more significant concurrent and lasting effects than alcohol use in adolescent cognitive functions. The results have implications on making policies that protect youths from substance use. J.H.S. ADOLESCENT DEPRESSION AND RISK BEHAVIORS Bai S, Zeledon LR, D’Amico EJ, Shoptaw S, Avina C, LaBorde AP, et al. Reducing health risk behaviors and improving depression in adolescents: a randomized controlled trial in primary care clinics. J Pedi Psych. October 2018. Health risk behaviors (HRBs) occur frequently with adolescent depression. The effectiveness of addressing multiple HRBs in primary care (PC) to reduce depressive symptoms has not been well studied. The aims of this study were to determine whether a PC intervention would decrease adolescent HRBs and improve depression and to determine associations between HRBs and depression. Adolescents (age: 16.06 6 1.45 years, 43% male) from 2 PC clinics with possible/probable past-year depression ascertained by the Composite International Diagnostic Interview or with current depression [on the Center for Epidemiologic Studies Depression Scale (CES-D) or Diagnostic Interview Schedule for Children (DISC)] but on no psychotropic medications and with at least 1 targeted HRB (smoking, substance use, unsafe sex, and obesity risk) were randomized to receive the HEALTHY TEENS intervention [HT: combination of motivational strategies and cognitive-behavioral approach, modeling, and coaching delivered by psychotherapist case managers (CMs) for 10 1-hour weekly sessions delivered in PC clinics or offices near PC; n 5 95] or enhanced usual care (UC1: providing information on depression treatment to PC clinicians; n 5 92). HT participants continued to receive UC1. Youth and parent assessments were performed at baseline, 6 months, and 12 months, with the adolescent completing self-report questionnaires. The primary outcome was the HRB index [HRBI (0–4); sum of HRBs]. A secondary outcome was the CES-D score. There were no significant group differences (HT vs UC1) in age, sex, baseline HRBI (1.42 6 0.94 vs 1.396 1.07), DISC criteria depressive disorder (51% vs 52%), and CES-D “severe” score (34% vs 29%), although there were more Latino/Hispanic participants in the UC1 group (p 5 0.05). The average attendance in HT was 3.69 sessions (SD 5 3.19); 30.5% attended no sessions. Participants in site A (CMs were integrated in the PC clinic) had better attendance than site B (mean [SD]: 4.18[3.14] vs 2.63 [3.10], p 5 0.028). Analysis showed no significant group differences at 6 and 12 months, although there were fewer HRBs over time for all participants (12-month adjusted odds ratio 5 0.32, 95% confidence interval [CI] 0.15–0.72, p 5 0.006) and improved depression at