[Show abstract][Hide abstract] ABSTRACT: Objective:
This study identifies and compares outcomes in young adulthood associated with longitudinal patterns of alcohol and marijuana use during adolescence among urban youth.
Data come from a cohort of 678 urban, predominantly Black children followed from ages 6-25 (1993-2012). Analyses are based on the 608 children who participated over time (53.6% male). Longitudinal patterning of alcohol and marijuana use were based on annual frequency reports from grades 8-12 and estimated through latent profile analysis.
We identified four classes of alcohol and marijuana use including Non-Use (47%), Moderate Alcohol Use (28%), Moderate Alcohol/Increasing Marijuana Use (12%) and High Dual Use (13%). A marijuana only class was not identified. Analyses show negative outcomes in adulthood associated with all three adolescent substance use classes. Compared to the non-use class, all use classes had statistically significantly higher rates of substance dependence. Those in the 'High Dual Use' class had the lowest rate of high school graduation. Comparing classes with similar alcohol but different marijuana patterns, the 'Moderate Alcohol/Increasing Marijuana Use' class had a statistically significant increased risk of having a criminal justice record and developing substance use dependence in adulthood.
Among urban youth, heterogeneous patterns of alcohol and marijuana use across adolescence are evident, and these patterns are associated with distinct outcomes in adulthood. These findings suggest a need for targeted education and intervention efforts to address the needs of youth using both marijuana and alcohol, as well as the importance of universal early preventive intervention efforts.
[Show abstract][Hide abstract] ABSTRACT: The trajectory of suicidal ideation across early adolescence may inform the timing of suicide prevention program implementation. This study aimed to identify developmental trajectories of suicidal ideation among an urban cohort of community-residing African Americans (AA) longitudinally followed from middle school through early adulthood (ages 11-19 years). Subtypes based on the developmental course of suicidal ideation from late childhood through mid-adolescence were identified using longitudinal latent class analysis (LLCA) with 581 AA adolescents (52.7% male; 71.1% free or reduced school meals). The developmental trajectories of suicidal ideation were then used to predict suicide attempts in young adulthood. Our LLCA indicated two subtypes (i.e., ideators and nonideators), with 8% of the sample in the ideator class. This trajectory class shows a peak of suicidal ideation in seventh grade and a steady decline in ideation in subsequent grades. Additionally, suicidal ideation trajectories significantly predicted suicide attempt. Results of these analyses suggest the need for suicide prevention approaches prior to high school for AA youth.
Suicide and Life-Threatening Behavior 09/2015; DOI:10.1111/sltb.12191 · 1.40 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study examines the main and interaction effects of known social risk factors for substance use (inadequate parental monitoring and substance using friends) in adolescence and a polygenic score in predicting marijuana and tobacco use in adolescence and young adulthood.
Phenotypic and genetic data were derived from a longitudinal study of a cohort of urban, predominately African American youth. Last year substance-use measures were collected annually from 8th grade through age 22. Participant self-reports of substance-using friends and parent monitoring were obtained yearly from Grades 8 to 12. Using longitudinal latent class analysis, the authors identified parallel developmental trajectories of tobacco and marijuana use and parent monitoring and the proportion of substance-using friends.
Two trajectories were identified for tobacco and marijuana use, characterized by moderate versus little-to-no use. Additionally, 2 latent profiles were found for the social environment profiles: those characterized by higher parent monitoring and a lower proportion of substance-using friends versus lower parent monitoring and a higher proportion of substance-using friends.
We found main and interaction effects for the polygenic score and social environment profile in predicting the longitudinal classes of marijuana and tobacco use. With respect to the interaction effect, membership in the moderate-use classes of marijuana and tobacco use was highest among those in the social environment profile characterized by lower parent monitoring and a higher proportion of substance-using friends. (PsycINFO Database Record
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Journal of Consulting and Clinical Psychology 07/2015; 83(5). DOI:10.1037/a0039537 · 4.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Evidence-based interventions are being disseminated broadly in schools across the USA, but the implementation levels achieved in community settings vary considerably. The current study examined the extent to which teacher and school factors were associated with implementation dosage and quality of the PAX Good Behavior Game (PAX GBG), a universal classroom-based preventive intervention designed to improve student social-emotional competence and behavior. Specifically, dosage (i.e., number of games and duration of games) across the school year and quality (i.e., how well the game is delivered) of PAX GBG implementation across four time points in a school year were examined. Hierarchical linear modeling was used to examine the association between teacher-level factors (e.g., demographics, self-reports of personal resources, attitudes toward the intervention, and workplace perceptions) and longitudinal implementation data. We also accounted for school-level factors, including demographic characteristics of the students and ratings of the schools' organizational health. Findings indicated that only a few teacher-level factors were significantly related to variation in implementation. Teacher perceptions (e.g., fit with teaching style, emotional exhaustion) were generally related to dosage, whereas demographic factors (e.g., teachers' age) were related to quality. These findings highlight the importance of school contextual and proximal teacher factors on the implementation of classroom-based programs.
[Show abstract][Hide abstract] ABSTRACT: Internalizing symptoms during adolescence and beyond is a major public health concern, particularly because severe symptoms can lead to the diagnosis of a number of serious psychiatric conditions. This study utilizes a unique sample with a complex statistical method in order to explore Gene × Environment interactions found in internalizing symptoms during adolescence. Data for this study were drawn from a longitudinal prevention intervention study (
= 798) of Baltimore city school children. Internalizing symptom data were collected using self-report and blood or saliva samples genotyped using Affymetrix 6.0 microarrays. A major depression polygenic score was created for each individual using information from the major depressive disorder Psychiatric Genetics Consortium and used as a predictor in a latent trait–state–occasion model. The major depressive disorder polygenic score was a significant predictor of the stable latent trait variable, which captures time-independent phenotypic variability. In addition, an early childhood stressor of death or divorce was a significant predictor of occasion-specific variables. A Gene × Environment interaction was not a significant predictor of the latent trait or occasion variables. These findings support the importance of genetics on the stable latent trait portion of internalizing symptoms across adolescence.
Development and Psychopathology 05/2015; -1:1-13. DOI:10.1017/S0954579415000401 · 4.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is growing interest in coaching to support teacher implementation of evidence-based interventions; yet, there is limited research examining the tailoring of coaching support to teachers’ needs. This paper examined coaching dosage across one school year, and the relationship between coaching contacts and teacher baseline and end-of-year data. Data came from a randomized controlled trial including 210 teachers in 18 schools implementing the Good Behavior Game (GBG), either as a stand alone or when integrated with a social-emotional learning curriculum. The overarching goal was to determine whether coaches provided varying levels of teacher contacts and how this support related to condition assignment, implementation, and teachers’ beliefs and perceptions data. Growth mixture modeling (GMM) was used to examine the frequency of teacher contacts across the school year. GMM indicated three distinct patterns: about 58 % of teachers received a moderate number of contacts; 27 % received a consistently low number of contacts; and 15 % received high and increasing support. Teachers who received a high degree of support were more often implementing the integrated GBG and reported more negative beliefs and perceptions at the start of the school year than those in the low contact class. Teachers in the low contact class implemented the least number of games and minutes of GBG, but reported better perceptions of organizational health and burnout, at the end of the year. Coaching dosage was unrelated to observer ratings of implementation quality.
School Mental Health 03/2015; 7(1). DOI:10.1007/s12310-015-9145-0
[Show abstract][Hide abstract] ABSTRACT: The present study examines the interaction between a polygenic score and an elementary school-based universal preventive intervention trial. The polygenic score reflects the contribution of multiple genes and has been shown in prior research to be predictive of smoking cessation and tobacco use (Uhl et al., 2014). Using data from a longitudinal preventive intervention study, we examined age of first tobacco use from sixth grade to age 18. Genetic data were collected during emerging adulthood and were genotyped using the Affymetrix 6.0 microarray. The polygenic score was computed using these data. Discrete-time survival analysis was employed to test for intervention main and interaction effects with the polygenic score. We found a main effect of the intervention, with the intervention participants reporting their first cigarette smoked at an age significantly later than controls. We also found an Intervention × Polygenic Score interaction, with participants at the higher end of the polygenic score benefitting the most from the intervention in terms of delayed age of first use. These results are consistent with Belsky and colleagues' (e.g., Belsky, Bakermans-Kranenburg, & van IJzendoorn, 2007; Belsky & Pleuss, 2009, 2013; Ellis, Boyce, Belsky, Bakermans-Kranenburg, & van IJzendoorn, 2011) differential susceptibility hypothesis and the concept of "for better or worse," wherein the expression of genetic variants are optimally realized in the context of an enriched environment, such as provided by a preventive intervention.
Development and Psychopathology 02/2015; 27(1):111-22. DOI:10.1017/S0954579414001333 · 4.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigated the perceived feasibility and pattern of implementation following an online training for teachers delivering an integrated intervention encompassing two school-based universal preventive interventions: Promoting Alternative THinking Strategies (PATHS) curriculum and the PAX Good Behavior Game (GBG). Forty-five teachers from three urban elementary schools completed an online training consisting of didactics and video demonstration and received in-person coaching across a 31-week implementation period. Data from 65 teachers from three schools who received in-person training and coaching provided a benchmark for comparison. Most teachers in the online training + in-person coaching (OLT + IPC) condition reported that the technology was easy to use and that the course was as effective as an in-person workshop. Teachers in the OLT + IPC group reported positive attitudes regarding PATHS and the PAX GBG that generally were not significantly different from attitudes reported by teachers who received in-person training + in-person coaching (IPT + IPC). Importantly, teachers in the OLT + IPC condition achieved a high level of implementation quality similar to that demonstrated by teachers in the IPT + IPC condition. The frequency of intervention delivery by OLT + IPC teachers was also not significantly different than that of IPT + IPC teachers. These findings provide evidence that the internet is a promising component in a training sequence designed to teach teachers to deliver evidence-based preventive interventions.
School Mental Health 12/2014; 6(4):225-236. DOI:10.1007/s12310-014-9124-x
[Show abstract][Hide abstract] ABSTRACT: Despite recent evidence of higher rates of marijuana use among African Americans than Whites, limited research has examined the reasons for this racial disparity. The purpose of this study is to examine how contextual stressors that disproportionately affect African American adolescents are related to marijuana opportunities and use in a sample of primarily low-income urban-dwelling African Americans. Four hundred and seventy African-American children were interviewed annually beginning in first grade as part of a longitudinal field study in Baltimore city. Latent transition analysis was conducted to examine the influence of contextual stress as measured by neighborhood disorder, community violence exposure and racial discrimination on transitions across stages of marijuana involvement in 6th-9th grades. Three-stages of marijuana involvement emerged: no involvement, marijuana opportunities and use and problems. Youth who reported witnessing or being a victim of community violence were significantly more likely to transition from no marijuana involvement to having opportunities to use marijuana (AOR=1.45; 95% CI=1.02, 2.07) and to use and problems (AOR=2.68; 95% CI=1.36, 5.27) compared to youth who did not report exposure to community violence. Higher levels of neighborhood disorder was significantly associated with transitions from no involvement to use and problems (AOR=2.38; 95% CI=1.22, 4.63). Youth who reported experiencing higher levels of racial discrimination were significantly more likely to transition from no marijuana involvement to having opportunities to use marijuana (AOR=2.04; 95% CI=1.41, 2.95). These findings highlight the need to develop interventions focused on contextual factors that disproportionately affect these youth and factors that might promote resilience in these urban environments.
142nd APHA Annual Meeting and Exposition 2014; 11/2014
[Show abstract][Hide abstract] ABSTRACT: African American male high school students have the highest rates of marijuana use among all racial, ethnic, and gender groups, yet there is limited research examining contextual factors salient to the African American community. The purpose of this study was to examine how neighborhood environment measured in 8th grade is related to longitudinal transitions in marijuana use during high school (9th to 12th grades) in a sample of urban African Americans. Four hundred and fifty-two African American children were interviewed annually beginning in 1st grade as part of a longitudinal field study in Baltimore city. Latent transition analysis indicated early in high school posed the greatest risk for initiation and progression of marijuana use. Community violence exposure was associated with an increased likelihood of transitioning from no marijuana use to infrequent use (adjusted odds ratios (AOR) = 2.40, p
Journal of Urban Health 10/2014; 91(6). DOI:10.1007/s11524-014-9909-0 · 1.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
The aim of this study was to examine how patterns of academic and behavior problems in the first grade relate to longitudinal transitions in marijuana use from middle school through entry into high school among African-Americans.
Latent class and latent transition analyses were conducted on a community sample of 458 low-income, urban-dwelling African-Americans.
Two behavior problem classes emerged at school entry; externalizing and attention/concentration. Academic problems co-occurred with both problem behavior classes although more strongly with attention/concentration. Youth in the attention/ concentration problem class were more likely to transition from no marijuana involvement to use and problems beginning in the 7th grade and to use and problems given the opportunity to use marijuana early in high school compared to youth with no problems. Youth in the externalizing behavior problem class were significantly more likely to transition from no involvement to having a marijuana opportunity during the transition to high school compared to youth in the attention/concentration problems class.
These findings highlight the importance of developing prevention programs and providing school services that address the co-occurrence of academic and behavior problems, as well as their subtype specific risks for marijuana involvement, particularly for low-income minority youth who may be entering school less ready than their non-minority peers. These findings also provide evidence for a need to continue to deliver interventions in middle school and high school focused on factors that may protect youth during these critical transition periods when they may be especially vulnerable to opportunities to use marijuana based on their academic and behavioral risk profiles.
[Show abstract][Hide abstract] ABSTRACT: Purpose
The purpose of this study was to examine transitions in gambling participation from late adolescence into emerging adulthood and to identify factors (i.e., gender, race, intervention status, lunch status, conduct disorder, parental monitoring, neighborhood environment, and substance use) that might influence these transitions.
Markov modeling was used to describe the movement between past-year gambling states (i.e., nongambling and gambling) across 5 years. Annual data on the past-year gambling behavior and substance use were collected from 515 young men and women starting at the age of 17 years.
Past-year gambling declined from 51% prevalence at the age of 17 years to 21% prevalence at the age of 22 years. Participants who reported no past-year gambling at a particular annual assessment had more than an 80% probability of also reporting no past-year gambling at the following assessment. Men were 1.07–2.82 times more likely than women to transition from past-year nongambling to gambling year to year, and women were 1.27–5.26 times more likely than men to transition from past-year gambling to nongambling year to year. In addition, gender and past-year tobacco use interacted such that men who used tobacco were most likely (and men who did not use tobacco least likely) to gamble at baseline.
Transition rates between gambling states appear to be relatively stable over time from late adolescence into emerging adulthood; however, men and those who engage in substance use may be at an increased risk of gambling participation.
Journal of Adolescent Health 08/2014; 55(2). DOI:10.1016/j.jadohealth.2014.02.001 · 3.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Risk factors for marijuana use in older adolescents and young adults have focused primarily on family environment and peer affiliation. A growing body of work has examined the relationship between environmental context and young adult substance use. This study builds on previous research linking neighborhood environment to young adult marijuana use by exploring two distinct features of neighborhoods, namely the physical (e.g., broken windows) and social environment (e.g., adults watching youth). Data were obtained from a longitudinal sample of 398 predominately African American young adults living in an urban environment. The data also included observational measures of physical and social order and disorder collected on the young adult's residential block. Exploratory structural equation modeling (ESEM) was utilized to test hypothesized relationships between these two features of the neighborhood environment and past year young adult marijuana use. A two-factor model of neighborhood environment with good fit indices was selected (CFI = 0.97, RMSEA = 0.037). There was a positive and significant direct effect from neighborhood physical disorder to marijuana use (0.219, p < 0.05) controlling for gender, race, and free and reduced price meal (FARPM) status. The direct effect from neighborhood social environment to marijuana use was not significant. These results converge with previous research linking vacant housing with young adult marijuana use but do not provide empirical support for the neighborhood social environment as a determinant of drug taking. Better explication of the social environment is needed to understand its relationship to drug use.
Drug and Alcohol Dependence 07/2014; 16(2). DOI:10.1007/s11121-014-0497-8 · 3.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Many African American adolescents experience racial discrimination, with adverse consequences; however, stability and change in these experiences over time have not been examined. We examined longitudinal patterns of perceived racial discrimination assessed in Grades 7-10 and how these discrimination trajectories related to patterns of change in depressive and anxious symptoms and aggressive behaviors assessed over the same 4-year period. Growth mixture modeling performed on a community epidemiologically defined sample of urban African American adolescents (n = 504) revealed three trajectories of discrimination: increasing, decreasing, and stable low. As predicted, African American boys were more frequent targets for racial discrimination as they aged, and they were more likely to be in the increasing group. The results of parallel process growth mixture modeling revealed that youth in the increasing racial discrimination group were four times more likely to be in an increasing depression trajectory than were youth in the low stable discrimination trajectory. Though youth in the increasing racial discrimination group were nearly twice as likely to be in the high aggression trajectory, results were not statistically significant. These results indicate an association between variation in the growth of perceived racial discrimination and youth behavior and psychological well-being over the adolescent years.
Development and Psychopathology 06/2014; 26(4):1-17. DOI:10.1017/S0954579414000571 · 4.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Opposed to large nationally sponsored health initiatives or biobanks, little is known about gathering genetic samples from young adults participating in academic community-based epidemiologic studies of mental health and substance use, especially samples with a large number of minority participants. This study describes our experience of establishing a genetic arm within a longitudinal study of a cohort of young adults (mean age 29, 75 % African American, 58 % female). In total, 75 % of those interviewed in the most recent wave donated a DNA sample (31.6 % blood and 68.4 % saliva) and over 90 % provided consent for storage and sharing. Current smokers were more likely to donate a sample than nonsmokers (adjusted odds ratio (aOR) = 1.59, 95 % confidence interval (CI) = 1.14, 2.22). The odds of obtaining a saliva sample were increased for those who were former cannabis smokers and who drank more regularly, but decreased among participants with less education and a history with drug use. Fewer minorities (aOR = 0.37, 95 % CI = 0.18, 0.75; p = 0.006) and cannabis users (aOR = 0.46, 95 % CI = 0.27, 0.77) consented to sharing their sample with other investigators. Findings also illustrate there are many study parameters that are important in planning biologic collection efforts. Building strong rapport and trust with subjects, minimizing the burden involved by the respondent to obtain a biological sample, offering a choice to provide blood or saliva, and offering an incentive will increase the likelihood of obtaining a sample and, importantly, increase the opportunity to store and share the sample for the future.
Journal of community genetics 06/2014; 5(4). DOI:10.1007/s12687-014-0191-3