Article

Transitions from first substance use to substance use disorders in adolescence: is early onset associated with a rapid escalation?

Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Street 46, D-01187 Dresden, Germany.
Drug and alcohol dependence (Impact Factor: 3.6). 10/2008; 99(1-3):68-78. DOI: 10.1016/j.drugalcdep.2008.06.014
Source: PubMed

ABSTRACT Early substance use (SU) in adolescence is known to be associated with an elevated risk of developing substance use disorders (SUD); it remains unclear though whether early SU is associated with more rapid transitions to SUD.
To examine the risk and speed of transition from first SU (alcohol, nicotine, cannabis) to SUD as a function of age of first use.
N=3021 community subjects aged 14-24 years at baseline were followed-up prospectively over 10-years. SU and SUD were assessed using the DSM-IV/M-CIDI.
(1) The conditional probability of substance-specific SU-SUD transition was the greatest for nicotine (36.0%) and the least for cannabis (18.3% for abuse, 6.2% for dependence) with alcohol in between (25.3% for abuse; 11.2% for dependence). (2) In addition to confirming early SU as a risk factor for SUD we find: (3) higher age of onset of any SU to be associated with faster transitions to SUD, except for cannabis dependence. (4) Transitions from first cannabis use (CU) to cannabis use disorders (CUD) occurred faster than for alcohol and nicotine. (5) Use of other substances co-occurred with risk and speed of transitions to specific SUDs.
Type of substance and concurrent use of other drugs are of importance for the association between age of first use and the speed of transitions to substance use disorders. Given that further research will identify moderators and mediators affecting these differential associations, these findings may have important implications for designing early and targeted interventions to prevent disorder progression.

0 Bookmarks
 · 
248 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated the age of onset of substance use among 536 students with mild academic disabilities and 906 students without academic disabilities, and the extent to which emotional, conduct, and hyperactivity problems explain the differences between these two groups. Using discrete-time survival analysis, the results of this study showed that students with a mild academic disability were not at higher risk for the onset of daily smoking, and were at a significantly lower risk for the onset of weekly alcohol use and cannabis use. Though students with a mild academic disability displayed higher scores on conduct, emotional, and hyperactivity problems compared with their counterparts without an academic disability, this was not reflected in an increased risk for early onset substance use.
    Learning Disabilities Research and Practice 11/2014; 29(4). DOI:10.1111/ldrp.12041
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To construct a virtual space of common adolescent psychiatric disorders, spanned by factors reflecting major psychopathological dimensions, and locate psychiatric disorders in that space; examine whether the major psychopathological dimensions can be hierarchically organized; and determine the distribution of the latent scores of individuals in the space spanned by those dimensions. Method Exploratory factor analyses of data from the National Comorbidity Survey Adolescent Supplement (NCS-A) using the psychiatric diagnoses as indicators were used to identify the latent major psychopathological dimensions. The loadings of the disorders on those dimensions were used as coordinates to calculate the distance among disorders. The distribution of individuals in the space was based on the latent scores on the factors reflecting the major psychopathological conditions. Results A model with three correlated factors provided an excellent fit (Comparative Fit Index [CFI]=0.97, Tucker-Lewis Index [TLI]=0.95, the root mean squared error of approximation [RMSEA]=0.008) for the structure of disorders and a 4-factor model could be hierarchically organized, ultimately yielding a general psychopathology factor. Distances between disorders ranged from 0.079 (between social phobia and generalized anxiety disorder [GAD]) and 1.173 (between specific phobia and conduct disorder [CD]). At the individual level, there were 546 distinct liabilities observed (22% of all 2,455 potential liabilities). Conclusion A novel way of understanding psychiatric disorders in adolescents is as existing in a space with a limited number of dimensions with no disorder aligning along one single dimension. These dimensions are hierarchically organized, allowing for analyses at different levels of organization. Furthermore, individuals with psychiatric disorders present with a broad range of liabilities, reflecting the diversity of their clinical presentations.
    Journal of the American Academy of Child & Adolescent Psychiatry 10/2014; DOI:10.1016/j.jaac.2014.10.007 · 6.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Adolescence is a period of developmental flux when brain systems are vulnerable to influences of early substance use, which in turn relays increased risk for substance use disorders. Our study intent was to assess adolescent regional cerebral blood flow (rCBF) as it relates to current and future alcohol use. The aim was to identify brain-based predictors for initiation of alcohol use and onset of future substance use disorders.

Preview

Download
5 Downloads
Available from