Fishbein Diana H, Novak Scott P, Ridenour Ty A, Thornburg Vanessa, Hammond Jane, Brown Jaki
Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania.
RTI International, Research Triangle Park, North Carolina.
J Stud Alcohol Drugs. 2016 May;77(3):431-40. doi: 10.15288/jsad.2016.77.431.
Prior studies of the association between neurocognitive functions and marijuana use among adolescents are mostly cross-sectional and conducted in adolescents who have already initiated marijuana use. The current study used a longitudinal design on a preadolescent, substance-naive sample. We sought to identify demographic factors associated with neurocognitive functions and the complement of neurocognitive function characteristics that predict marijuana initiation in adolescents.
Substance-naive adolescents (n = 465) ages 10-12 years (51% male) were recruited from a community with high levels of adolescent marijuana use and prospectively followed to ages 12-15. Tasks measuring neurocognitive functions were administered and audio-assisted interviews were conducted. Two types of models were estimated for each outcome: forced-entry models and another using stepwise selection via bidirectional elimination with varying tolerance levels to account for selection misspecification.
About 10% (n = 49) initiated marijuana use over the study period. Child's age, academic achievement, and parental education were associated with baseline neurocognitive functions; namely, positive emotion attributions and lower impulsivity. Facial recognition-particularly misattribution of sad faces-was the strongest predictor of marijuana initiation, including in the stepwise model (partial OR = 1.3, 95% CI [1.03, 1.63], p < .05) that resulted in the best-fitting model.
Prediction of marijuana initiation was improved in stepwise models compared with forced-entry models. Emotion perception appears to be an early developmental risk factor that is prospectively associated with marijuana initiation; as expected, other neurocognitive functions did not play an interactive role. Future studies of the interrelationships between emotion perception and the myriad other factors implicated in marijuana initiation, including neurocognitive functions not measured here, will provide a more comprehensive understanding of risk for marijuana initiation.
先前关于青少年神经认知功能与大麻使用之间关联的研究大多为横断面研究,且研究对象是已经开始使用大麻的青少年。本研究采用纵向设计,以青春期前未使用过任何物质的样本为对象。我们试图确定与神经认知功能相关的人口统计学因素,以及预测青少年开始使用大麻的神经认知功能特征组合。
从青少年大麻使用率较高的社区招募了年龄在10 - 12岁(51%为男性)、未使用过任何物质的青少年(n = 465),并对其进行前瞻性追踪至12 - 15岁。实施了测量神经认知功能的任务并进行了音频辅助访谈。针对每个结果估计了两种类型的模型:强制进入模型和另一种通过双向消除、采用不同容忍水平的逐步选择模型,以考虑选择错误设定。
在研究期间,约10%(n = 49)的青少年开始使用大麻。儿童的年龄、学业成绩和父母教育程度与基线神经认知功能相关;即积极情绪归因和较低的冲动性。面部识别——尤其是对悲伤面孔的错误归因——是开始使用大麻的最强预测因素,在逐步模型中也是如此(偏优势比 = 1.3,95%置信区间[1.03, 1.63],p <.05),该模型是拟合效果最佳的模型。
与强制进入模型相比,逐步模型对开始使用大麻的预测效果更好。情绪感知似乎是一个早期发展风险因素,与开始使用大麻存在前瞻性关联;正如预期的那样,其他神经认知功能并未起到交互作用。未来关于情绪感知与开始使用大麻所涉及的众多其他因素(包括此处未测量的神经认知功能)之间相互关系的研究,将更全面地理解开始使用大麻的风险。