Kathryn Batts

A clinical validation of the National Survey on Drug Use and Health Assessment of Substance Use Disorders

Alcohol and illicit drug abuse and dependence continue to be of great national concern in the United States, as is true in other nations. The National Survey on Drug Use and Health (NSDUH) provides national annual estimates of substance use and abuse/dependence among the U.S. civilian, noninstitutionalized population aged 12 years or older. We conducted a clinical validation study of the substance use disorder questions of the NSDUH instrument using a sample of 288 adults and adolescents recruited from the community and outpatient substance abuse treatment programs in North Carolina. Using the Structured Clinical Interview for DSM-IV (SCID-IV) for adults and the Pittsburgh Adolescent Alcohol Research Centers Structured Clinical Interview (PAARC-SCID) for adolescents, we computed the psychometric properties of the NSDUH questions. We found the level of agreement between the NSDUH and the SCID/PAARC-SCID interviews to be fair to moderate overall. There was somewhat better agreement for dependence than for abuse and for adults than for adolescents.

Marijuana Use, Recent Marijuana Initiation, and Progression to Marijuana Use Disorder Among Young Male and Female Adolescents Aged 12-14 Living in US Households

Marijuana initiation during adolescence, and early adolescence in particular, is associated with adverse health consequences. Our study used 2005-2014 data from the annual, cross-sectional National Survey on Drug Use and Health to study the prevalence and correlates of marijuana initiation, use, and marijuana use disorder (MUD; abuse or dependence) among 12- to 14-year olds living in civilian US households (n = 84 954). Examined correlates included age, sex, race/ethnicity, poverty status, metropolitan status, year of survey, depression, tobacco use, alcohol use, and fighting at school. Sex differences in the correlates of lifetime use and past year marijuana initiation were tested via interaction. Lifetime prevalence of marijuana use was 5.5%; 3.2% reported past year initiation. About 1 in 6 (16.8%) past year initiates progressed to MUD within 12 months of first use. Although men had higher prevalence of lifetime use than women, past year initiation did not differ by sex. On examining the sex*race/ethnicity interaction effects, findings determined that non-Hispanic black and Hispanic men had higher prevalence estimates of ever using marijuana and incidence of past year initiation as compared with non-Hispanic white men; these race/ethnicity differences were not found among women. Identifying correlates of initiation and progression to MUD among young adolescents is critical to improve prevention and treatment program targets.

Correlates of exposure to potentially traumatic experiences: Results from a national household survey.

Objective: Prior studies have indicated that exposure to potentially traumatic events (PTEs) may increase the risk of poor mental and physical health outcomes. This study’s main goal is to examine the association between PTE exposures and having any past year mental disorder, substance use disorder (SUD), or functional impairment and to explore the moderating effects of age and gender on these associations in a nationally representative sample of civilian adults living in U.S. households. Method: The sample included adults aged 18 or older (n = 5,653) from the 2008–2012 Mental Health Surveillance Study. Results: PTE exposure was significantly associated with having any past year mental disorder and any past year SUD (odds ratio [OR] = 1.85, 95% CI [1.48, 2.32] and OR = 1.59, 95% CI [1.16, 2.18], respectively), as well as lower functioning scores as measured by the abbreviated World Health Organization Disability Assessment Schedule (WHODAS) and the Global Assessment of Functioning scale in models adjusted for sociodemographic characteristics. A single significant interaction (p = .002) indicated that the magnitude of the PTE exposure–WHODAS-measured functional impairment association was stronger among females than males. Conclusions: These findings from a nationally representative study of civilian adults living in U.S. households suggest that PTE exposure may have significant public health implications beyond those associated with the development of posttraumatic stress disorder.