Nelson Sarah E, Van Ryzin Mark J, Dishion Thomas J
Harvard Medical School.
University of Oregon Child and Family Center.
Dev Psychopathol. 2015 Feb;27(1):253-77. doi: 10.1017/S0954579414000650. Epub 2014 Jul 14.
Substance use trajectories were examined from early adolescence to young adulthood among a diverse sample of 998 youths. Analysis of longitudinal data from ages 12 to 24 identified distinct trajectories for alcohol, marijuana, and tobacco use. Modeling revealed 8 alcohol, 7 marijuana, and 6 tobacco use trajectories. Analyses assessed risk for substance use problems in early adulthood within each trajectory, as well as overlap among alcohol, marijuana, and tobacco use trajectories. Findings confirmed that adolescents with early- and rapid-onset trajectories are particularly vulnerable to the development of problematic substance use in early adulthood. However, analyses also identified an escalating high school onset trajectory for alcohol and for marijuana use that was equally prognostic of problem use in adulthood. Moreover, tobacco use in early adolescence was associated with developing high-risk marijuana and alcohol use patterns. Random assignment to the Family Check-Up intervention was found to reduce risk for membership in the high-risk marijuana use trajectories, suggesting that family-based approaches delivered during adolescence can prevent escalations to problematic substance use. These findings suggest the importance of developmental heterogeneity and equifinality in considering prevention for alcohol and drug use.
在998名青少年的多样化样本中，研究了从青春期早期到青年期的物质使用轨迹。对12至24岁的纵向数据进行分析，确定了酒精、大麻和烟草使用的不同轨迹。建模显示有8种酒精使用轨迹、7种大麻使用轨迹和6种烟草使用轨迹。分析评估了每个轨迹中成年早期物质使用问题的风险，以及酒精、大麻和烟草使用轨迹之间的重叠情况。研究结果证实，具有早期和快速发作轨迹的青少年在成年早期特别容易出现物质使用问题。然而，分析还发现了酒精和大麻使用的高中发作轨迹不断升级，这同样预示着成年后的问题使用。此外，青春期早期使用烟草与发展高风险的大麻和酒精使用模式有关。研究发现，随机分配到家庭检查干预措施可降低加入高风险大麻使用轨迹的风险，这表明在青春期实施的基于家庭的方法可以预防物质使用升级为问题使用。这些发现表明，在考虑预防酒精和药物使用时，发展异质性和等效性的重要性。
