Chenshu Zhang

Developmental trajectories of cigarette smoking from adolescence to the early thirties : Personality and behavioral risk factors

The purpose of this study was to identify distinct trajectories of cigarette smoking from ages 14 to 32, and to examine adolescent personality factors that distinguish trajectories of smoking behavior. Participants (N = 975) were randomly selected and followed prospectively since 1975. Follow-up data on cigarette use and personality and behavioral attributes were collected at five points in time, using structured interviews given in private by trained interviewers. Of these subjects, 746 comprised the cohort used in this study. Growth mixture modeling identified five smoking trajectory groups: nonsmokers, occasional smokers, late starters, quitters, and heavy/continuous smokers. Adolescent personality and behavioral risk factors such as lower ego integration, more externalizing behavior, and lower educational aspirations distinguished the trajectory groups. No gender differences were noted. The findings supported the hypotheses indicating multiple distinct trajectory groups of smoking behavior. Smoking behavior appeared in early adolescence and most often continued into adulthood. Emotional difficulties (i.e., lower ego integration), externalizing behavior, and lower educational aspirations in early adolescence were associated both with smoking at an early age and with continuing to smoke into the thirties. To be more effective, smoking prevention programs should target personality and behavioral variations before smoking becomes habitual, particularly focused on characteristics reflecting behavioral problems as manifested in emotional difficulties, externalizing behavior, and low educational aspirations in early adolescence. The implications for research, prevention, and treatment are discussed.

The Association Between Earlier Marijuana Use and Subsequent Academic Achievement and Health Problems: A Longitudinal Study

In this prospective longitudinal study, the authors investigated the association between marijuana use over a period of 13 years and subsequent health problems at age 27. A community sample of 749 participants from upstate New York was interviewed at mean ages of 14, 16, 22, and 27 years. Marijuana use over time was significantly associated with increased health problems by the late twenties, including respiratory problems, general malaise, neurocognitive problems, and lower academic achievement and functioning. Effective prevention and intervention programs should consider the wide range of adverse physiological and psychosocial outcomes associated with marijuana use over time.

Association between attention-deficit/hyperactivity disorder in adolescence and substance use disorders in adulthood

OBJECTIVES To determine whether attention-deficit/hyperactivity disorder (ADHD) in adolescence is related to substance use disorders (SUDs) in adulthood and whether conduct disorder (CD) mediates this relationship. DESIGN A prospective design incorporating 5 assessments in participants spanning the mean ages of 14 to 37 years. Two baseline assessments were taken at ages 14 and 16 years, and 3 outcome assessments were taken between ages 27 and 37 years. SETTING United States. PARTICIPANTS A community sample of individuals initially drawn from upstate New York in 1975 and observed to a mean age of 37 years. INTERVENTIONS The Diagnostic Interview Schedule for Children was used to assess ADHD and CD and the University of Michigan Composite International Diagnostic Interview was used to assess SUDs. MAIN OUTCOME MEASURE A diagnosis of SUDs given to participants in adulthood. RESULTS The odds ratios for ADHD and CD in adolescence as related to SUDs in adulthood were 1.9 and 3.5, respectively. The association between ADHD and SUDs, however, was indirect because CD served as a mediator between ADHD and SUDs. CONCLUSIONS Pediatricians should focus on adolescent ADHD when it progresses to CD because CD is a major predictor of SUDs in adulthood.

Cigarette Smoking and Depressive Symptoms: A Longitudinal Study of Adolescents and Young Adults

Cigarette smoking and depressive symptoms have been shown to be related in previous research. This paper examined the relationship between cigarette smoking and depressive symptoms in a longitudinal sample of 688 adolescents and young adults through surveys conducted over 13 yr. The results indicate that a history of earlier cigarette smoking in adolescence predicts later depressive symptoms in the late twenties. The study also suggests that depressive symptoms during adolescence predict cigarette smoking in the late twenties but not above and beyond prior smoking. These results help clarify and expand current knowledge on the links between cigarette smoking and depression. The results point to several clinical implications for treatment of both cigarette smoking and depressive symptoms among both adolescents and young adults.

Adolescent ADHD and Adult Physical and Mental Health, Work Performance, and Financial Stress

OBJECTIVE: There is a scarcity of longitudinal studies of adolescents with attention-deficit/hyperactivity disorder (ADHD) followed until adulthood. We studied the relationship between ADHD in adolescence and impaired general physical health, impaired general mental health, antisocial personality disorder, impaired work performance, and high financial stress in adulthood. METHODS: A prospective design incorporated 6 assessments of participants spanning mean ages from 14 to 37 years. Two baseline assessments were taken between ages 14 and 16 years, and 5 outcome assessments were taken at mean age 37 years. Participants were assessed with structured interviews and questionnaires. The participants were from a community sample of individuals initially drawn in 1975 and followed to a mean age of 37 years in 2009. RESULTS: The adjusted odds ratios and 95% confidence intervals (CIs) for ADHD in adolescence as related to internal stress in adulthood were 1.82 (95% CI = 1.01–3.25; P < .05) for impaired general physical health, 2.36 (95% CI = 1.23–4.51; P < .01) for impaired general mental health, and 3.28 (95% CI = 1.51–7.13; P < .01) for antisocial personality disorder. The adjusted odds ratios and 95% CIs for ADHD in adolescence as related to external stress were 2.46 (95% CI = 1.37–4.43; P < .01) for impaired work performance and 3.33 (95% CI = 1.70–6.55; P < .001) for high financial stress. CONCLUSIONS: Clinicians should focus on early diagnosis and treatment of adolescent ADHD because it is a major predictor of an array of physical, mental, work, and financial problems in adulthood.

Pathways from Adolescent Parent-Child Conflict to Substance Use Disorders in the Fourth Decade of Life

This 24-year community longitudinal study provides important information regarding parent-child conflict in adolescence (mean ages 14-16), vulnerable personality attributes and peer deviance in the twenties (mean age 22), and marital conflict and partners illicit drug use in the late twenties and early thirties (mean ages 27-32) as related to a later diagnosis of substance use disorders (SUDs) in the thirties (mean ages 32-37). A community-based sample was interviewed between 1975 and 2007. Results based in structural equation modeling indicated that a weak parent-child bond was related to the development of drug-conducive personality traits, which was associated with the selection of drug-using peers and partners, which in turn, predicted SUDs. Both peer deviance and partners illicit drug use had the greatest effects on SUDs. The findings should aid in formulating prevention and treatment programs targeting specific risk factors in adolescents, young adults, and adults.

Antisocial behavior at age 37: developmental trajectories of marijuana use extending from adolescence to adulthood.

This investigation studied the association between developmental trajectories of marijuana use extending from adolescence to age 32 and later antisocial behavior at age 37. Semi-parametric group-based modeling and logistic regression analyses were used to analyze the data. Five distinct trajectories of marijuana use were identified: never-users, quitters/decreasers, occasional users, chronic users, and increasing users. Being either a chronic user or an increasing marijuana user was associated with an increase in the risk of exhibiting antisocial behavior in adulthood. Both chronic and increasing use of marijuana may serve as predictors of adult antisocial behavior. Treatment programs to prevent antisocial behavior across the life course should include a component to address earlier and concurrent marijuana use.

Maternal Cigarette Smoking during Pregnancy and Child Aggressive Behavior

This studys objective was to examine the association between maternal smoking during pregnancy and childhood aggressive behavior in African-American and Puerto Rican children, as well as the relationship between maternal unconventional behavior, low maternal affection, and offspring aggression. Participants consisted of African-American and Puerto Rican children (N = 203; mean age = 8.6, SD = 0.87) and their mothers living in an inner city community. An interview consisting of a structured questionnaire was administered to the mothers and their children. Scales with adequate psychometric properties were adapted from previous validated measures. They included maternal smoking during pregnancy, maternal education, unconventionality, and warmth. Controlling for demographic factors, maternal unconventional behavior, and low maternal warmth, maternal smoking during pregnancy was associated with having offspring who were aggressive. Maternal unconventionality and warmth were independently related to childhood aggression. Although causal limitations are noted, it may be that a decrease in smoking during pregnancy is associated with a reduction in aggression in the offspring.

Adolescent Pathways to Adult Smoking: Ethnic Identity, Peer Substance Use, and Antisocial Behavior

African-Americans and Puerto Ricans were interviewed during adolescence, in their early twenties, and then again in their mid-twenties. Results indicated that earlier adolescent smoking, family conflict, and weak ethnic identity were significantly related to antisocial behavior, which in turn was related to associating with friends who smoked and/or used illegal drugs, and ultimately, to their own smoking. Results further indicate that early interventions in the development of tobacco use should focus on decreasing parental and adolescent smoking and parent-child conflict. If intervention occurs at a later time point, the emphasis should be on increasing ethnic identity and decreasing antisocial behavior. (Am J Addict 2010;00:1-9).

Longitudinal precursors of young adult light smoking among African Americans and Puerto Ricans.

INTRODUCTION Studies have consistently documented the importance of examining light smoking among African American and Latino adolescent and adult smokers. Little is known, however, about the psychosocial antecedents of adolescent and young adult light smoking in these racial/ethnic minority groups. METHODS This study examined the longitudinal interrelationships and pathways leading to light smoking among African Americans (n = 288) and Puerto Ricans (n = 262). Specifically, we assessed parental factors, perceived discrimination, peer smoking, personality factors, and light smoking in late adolescence as precursors to light smoking among African American and Puerto Rican young adults. RESULTS The results of structural equation modeling showed that a history of greater parental smoking, less parental educational attainment, and more perceived discrimination were each mediated by peer smoking and the youths maladaptive personality and behavior in late adolescence. The youths maladaptive personality and behavioral characteristics and light smoking in late adolescence, in turn, predicted light smoking in young adulthood. There were no significant racial/ethnic or gender differences in the pathways to light smoking. DISCUSSION Findings highlight the longitudinal pathways to light smoking among African Americans and Puerto Ricans. The results suggest that effective prevention and cessation programs must address peer and parental social influences, perceived discrimination, and especially, emotional and behavioral problems in late adolescence to reduce light smoking among late adolescents and young adults in these racial/ethnic groups.