Chuang Cheng-Wei I, Chan Connie, Leventhal Adam M
a Department of Preventive Medicine , University of Southern California Keck School of Medicine , Los Angeles , California , USA.
b Department of Psychology , University of Southern California , Los Angeles , California , USA.
J Dual Diagn. 2016;12(1):27-35. doi: 10.1080/15504263.2016.1146557.
Use of drugs and alcohol, including tobacco, is linked to adolescent emotional psychopathology. Given that tobacco use is becoming less common over recent years, its co-use with drugs/alcohol may mark a more severe profile of emotional symptomatology. However, it is unclear whether teens with a lifetime history of using drug/alcohol and tobacco exhibit additional elevations in emotional psychopathology and/or multiple forms of emotional psychopathology compared to teens with lifetime drug/alcohol use without comorbid tobacco use. This cross-sectional study compared emotional disorder symptoms and emotional vulnerability traits among adolescents with varying histories of substance use.
Ninth-grade students enrolled at two schools in Los Angeles, California, were recruited; 575 met eligibility criteria and provided both student assent and parental consent. Students completed self-report measures of emotional pathology, transdiagnostic, and lifetime substance use. Participants were classified into three groupings: (a) no history of substance use (n = 294); (b) lifetime history of drug/alcohol use without tobacco use (n = 166); and (c) lifetime history of drug/alcohol use with concomitant tobacco use (n = 115).
Chi-square results showed that teens with lifetime alcohol/drug use with (vs. without) comorbid tobacco use were more likely to have used 10 of 16 substances assessed in the study. Post-ANOVA pairwise tests revealed that, compared to students with no history of substance use, those with any history of use (alcohol/drugs with and without tobacco use) had higher major depression symptoms and negative affect. Those with lifetime alcohol/drug use with comorbid tobacco use had higher generalized anxiety symptoms and distress, and those with lifetime alcohol/drug use without comorbid tobacco use had higher panic disorder symptoms and anhedonia. There were no significant differences between adolescents with lifetime drug/alcohol use with comorbid tobacco use versus those without tobacco use.
Adolescents with (vs. without) a lifetime history of drug/alcohol use endorse greater emotional symptomatology and trait vulnerabilities, regardless of comorbid lifetime tobacco use. Thus, the extent to which tobacco serves as a gateway to, correlate of, or consequence of other substance use may have little bearing on adolescent emotional health. This study's findings further suggest that emotional vulnerability (in addition to manifest psychopathology) should be considered in adolescent substance use and mental illness prevention.
使用毒品和酒精，包括烟草，与青少年情绪心理病理学有关。鉴于近年来吸烟现象越来越不普遍，吸烟与毒品/酒精共同使用可能标志着更严重的情绪症状表现。然而，与仅有终身毒品/酒精使用史而无烟草使用共病的青少年相比，有终身毒品/酒精和烟草使用史的青少年在情绪心理病理学方面是否有额外的升高和/或多种形式的情绪心理病理学尚不清楚。这项横断面研究比较了有不同物质使用史的青少年的情绪障碍症状和情绪易感性特征。
招募了加利福尼亚州洛杉矶两所学校的九年级学生；575名学生符合资格标准并获得了学生同意和家长同意。学生们完成了情绪病理学、跨诊断和终身物质使用的自我报告测量。参与者被分为三组：（a）无物质使用史（n = 294）；（b）有终身毒品/酒精使用史但无烟草使用史（n = 166）；（c）有终身毒品/酒精使用史且伴有烟草使用史（n = 115）。
卡方检验结果显示，有终身酒精/毒品使用且伴有（与不伴有）烟草使用共病的青少年更有可能使用了研究中评估的16种物质中的10种。方差分析后的两两比较检验显示，与无物质使用史的学生相比，有任何使用史（有和无烟草使用的酒精/毒品使用）的学生有更高的重度抑郁症状和消极情绪。有终身酒精/毒品使用且伴有烟草使用共病的学生有更高的广泛性焦虑症状和痛苦，有终身酒精/毒品使用但无烟草使用共病的学生有更高的惊恐障碍症状和快感缺失。有终身毒品/酒精使用且伴有烟草使用共病的青少年与无烟草使用的青少年之间没有显著差异。
有（与无）终身毒品/酒精使用史的青少年认可更多的情绪症状和特质易感性，无论是否有终身烟草使用共病。因此，烟草作为其他物质使用的入门途径、相关因素或后果的程度可能对青少年情绪健康影响不大。这项研究的结果进一步表明，在青少年物质使用和精神疾病预防中应考虑情绪易感性（除明显的心理病理学外）。
