An analysis of within-subject and population level risk related to substance use and mental health outcomes among adolescents in the PATH study
An analysis of within-subject and population level risk related to substance use and mental health outcomes among adolescents in the PATH study
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DOI：
10.1016/j.drugalcdep.2020.108385
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发表时间：
2021-01-01
影响因子：
4.2
通讯作者：
Cavazos-Rehg, Patricia A.
中科院分区：
文献类型：
--
作者：
Li, Xiao;Borodovsky, Jacob T.;Cavazos-Rehg, Patricia A.
导言：本研究的目的是了解青少年药物使用模式如何导致消极的心理健康结果。方法：使用了参加人群健康与烟草评估(PATH)研究前三波的青少年(基线年龄为12-17岁，第一波)的数据。结果：在受试者内和受试者间的分析中，其他违禁药物(如阿片类药物、可卡因、非医疗用处方药)的使用与内化问题呈正相关(受试者内估计，AOR：1.65，95%CI=1.36-2.01；受试者间估计，AOR：1.53，95%CI=1.32~1.78；饮酒与外化问题正相关(受试者内估计，AOR：1.66，95%CI=1.43~1.93；受试者间估计，AOR：1.67，95%CI=1.48~1.89)。此外，受试者内部分析表明，酒精、大麻和其他非法药物与内化和外化问题并存的几率增加(从大麻，AOR：1.18，-酒精，AOR：1.58)。讨论：通过受试者内和被试之间的比较，本研究证明了青少年药物使用与内化和外化问题之间的关联。结果表明，不仅需要进行个人水平评估和早期干预，而且还需要制定和实施公共卫生政策，以预防或减轻青少年使用药物的负面影响，以促进这一高危群体改善心理健康结果。
Introduction: The objective of this study was to understand how adolescent substance use patterns may lead to negative mental health outcomes.Methods: Data from adolescents (12-17 years old at baseline, Wave 1) who participated in the first 3 waves of the Population Assessment of Health and Tobacco (PATH) study were used. Self-reported data on past 30-day substance use and internalizing/externalizing problems were used to conduct within-subject (fixed-effects model) and population-averaged (GEE model) analyses.Results: In both within-subject and between-subject analyses, the use of other illicit drugs (e.g., opioids, cocaine, prescription drugs for non-medical use) was positively associated with internalizing problems (within-subject estimate, AOR: 1.65, 95 % CI = 1.36-2.01; between-subject estimate, AOR: 1.53, 95 % CI = 1.32-1.78) and alcohol use was positively associated with externalizing problems (within-subject estimate, AOR: 1.66, 95 % CI = 1.43-1.93; between-subject estimate, AOR: 1.67, 95 % CI = 1.48-1.89). Additionally, within-subject analysis suggested that alcohol, marijuana, and other illicit drugs were associated with increased odds of comorbid internalizing and externalizing problems (ranging from marijuana, AOR: 1.18, - alcohol, AOR: 1.58).Discussion: Using within-subject and between-subject comparisons, this study demonstrated associations between adolescent substance use and internalizing and externalizing problems. Results suggest not only the need for individual level assessment and early intervention, but also the development and implementation of public health policy aimed at preventing or mitigating the negative effects of substance use in adolescence to promote improved mental health outcomes for this at-risk group.