Commentary on Salom et al. (2015): Examining the developmental underpinnings of comorbid mental health and substance use outcomes in young adults.
Commentary on Salom et al. (2015): Examining the developmental underpinnings of comorbid mental health and substance use outcomes in young adults.
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对 Salom 等人的评论。
DOI：
10.1111/add.12810
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Skinner,Martie
中科院分区：
文献类型：
--
作者：
Herrenkohl,Todd;Skinner,Martie
研究表明，父母滥用和滥用酒精可以预测青少年和年轻成年子女的相同行为[1，2]。父母饮酒与青少年后来的内化症状和心理困扰之间也存在关系[1]。此外，与青少年中物质使用和心理健康问题同时发生有关的研究结果表明，这些问题可以而且经常重叠，并且它们不仅受到父母饮酒的影响，而且还受到家庭支持水平低和家庭内其他相关风险因素的影响[3]。在年轻成人样本中，类似的共同发生的问题是否存在特别突出的风险还不太清楚，Salom和同事[4]在他们的两代纵向研究中对这些问题进行了出色的研究。研究结果显示，在21岁的年轻人中测量的共病（共病）心理健康和酒精使用问题之间存在相对较强的发展联系，并预测（在14岁时测量）母亲吸烟和青少年饮酒，吸烟频率以及注意力和思维问题。母亲的温暖度低，但不是家庭冲突的措施，也预测21岁时的合并症。这些发现以及其他类似的发现对于推进预防和干预计划至关重要，因为它们有助于隔离可延展的目标，以制定普遍和更有针对性的风险降低策略[5]。在讨论他们的结果时，Salom和同事[4]评论了我和同事早些时候发表的一项研究，该研究对800名20多岁的年轻人进行了跟踪调查[6]-这项研究与他们的研究没有什么不同，因为我们调查了年轻人共病结果的发展基础，特别关注家庭。我们发现，在儿童晚期（10-12岁）和青春期（13-14岁和15-18岁）测量的家庭冲突实际上比我们分析中的其他变量（包括家庭参与和父母的家庭管理实践）更能预测共病的心理健康和药物使用问题（27岁的年轻人）。Salom及其同事注意到我们的研究结果似乎存在差异，他们认为家庭冲突对我们来说是一个重要的预测因素，而不是他们，因为我们早期的研究关注的风险因素较少，并且没有包括母亲温暖和青少年行为的措施。这是一个合理的解释，但差异可能存在其他原因。例如，我们所说的“家庭冲突”并不一致。在Salom等人的研究中，家庭冲突标签是指三个结构松散的措施-一个，多项目规模的“开放的家庭沟通”;和两个，其他单一项目（是/否）的母亲报告的措施，父母的生活安排和关系暴力的历史。在我们以前的工作中，同样的标签指的是几个青年报告，基于年龄（缩放）的家庭成员如何“相处”的指标，无论他们是把事情说出来，互相批评还是经常争论或大喊大叫。这是一个重要的区别，不仅因为相同的标签使用不同，而且因为两项研究中的变量之间存在假定的独立性，这些变量更可能反映了一系列因素，这些因素也同时发生并影响青年发展，并延伸到成年人的功能。因此，我们并不认为我们的研究结果是相反的，我们认为它们同样指向了年轻人因与父母和兄弟姐妹经历不支持和敌对关系而受到的伤害。在回顾这两项研究时，我们对共患病的测量也明显不同。For ...
Research shows that parents’ misuse and abuse of alcohol is predictive of the same behavior in their adolescent and young adult children [1, 2]. A relationship also exists between parents’ alcohol use and later internalizing symptoms and psychological distress in adolescents [1]. Moreover, findings related to the co-occurrence of substance use and mental health problems among adolescents show that these problems can and often do overlap, and that they are influenced not just by parents’ drinking but also low levels of family support and other related risk factors within the family [3]. Whether there are particularly salient risks for similar co-occurring problems in young adult samples is less well understood, and Salom and colleagues [4] have performed an excellent job of attending to these issues in their two-generation longitudinal study. Results of the study show a relatively strong developmental link between co-occurring (comorbid) mental health and alcohol use problems measured in young adults at age 21 and predictors (measured at age 14) of maternal smoking and adolescent drinking, smoking frequency and attention and thought problems. Low maternal warmth, but not measures of family conflict, also predicted comorbidity at age 21. These findings, and others like them, are critical for advancing prevention and intervention programs because they help to isolate malleable targets for universal and more targeted risk reduction strategies [5]. In discussing their results, Salom and colleagues [4] comment on a study that colleagues and I published earlier on 800 youth followed into their late 20s [6]—a study not unlike theirs, in that we investigate the developmental underpinnings of comorbid outcomes in young adults, with a particular focus on the family. We found that family conflict, measured in late childhood (ages 10–12) and adolescence (13–14 and 15–18), was actually more predictive of comorbid mental health and substance use problems (in young adults at age 27) than were other variables in our analyses, including measures of family involvement and parents’ family management practices. Noting what appears to be a discrepancy in our studies’ findings, Salom and colleagues suggest that family conflict was a significant predictor for us, but not them, because our earlier study focused on fewer risk factors and did not include measures of maternal warmth and adolescent behavior. This is a plausible explanation, yet differences may exist for other reasons. For example, what we call ‘family conflict’is not consistent. In the study by Salom et al., the family conflict label refers to three loosely structured measures—one, a multi-item scale of ‘open family communication’; and two, other single-item (yes/no) mother-report measures of parents’ living arrangement and a history of relationship violence. In our previous work, the same label refers to several youth-report, age-based (scaled) indicators of how family members ‘get along’, whether they talk things out, criticize one another or frequently argue or shout. This is an important distinction not only because the same label is used differently, but also because there is an assumed independence among variables in both studies that more probably reflect a constellation of factors that also co-occur and impinge upon youth development, and adult functioning by extension. Rather than seeing our findings, therefore, as being in contrast, we see them as pointing similarly at the damage inflicted on young people that comes from having experienced unsupportive and hostile relationships with parents and siblings. Upon review of the two studies, it is also apparent that our measures of comorbidity differ. For …