预测成年早期持续性、局限性和延迟性问题性大麻使用：一项纵向研究的结果。
Predicting Persistent, Limited, and Delayed Problematic Cannabis Use in Early Adulthood: Findings From a Longitudinal Study.
机构信息
Duke University, Durham, NC.
Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.
出版信息
J Am Acad Child Adolesc Psychiatry. 2017 Nov;56(11):966-974.e4. doi: 10.1016/j.jaac.2017.08.012. Epub 2017 Sep 21.
OBJECTIVE
To identify risk profiles associated with patterns of problematic cannabis use in early adulthood.
METHOD
Data came from 1,229 participants in the Great Smoky Mountains Study, a prospective 20-year cohort study from 1993 to 2015 that is representative of western North Carolina with yearly assessments conducted from ages 9 and 16 years, and assessments at ages 19, 21, 26, and 30 years. Patterns of problematic cannabis use (i.e., DSM-5 cannabis use disorder or daily use) in early adulthood included the following: nonproblematic use in late adolescence (ages 19-21) and early adulthood (ages 26-30); limited problematic use in late adolescence only; persistent problematic use in late adolescence and early adulthood; and delayed problematic use in early adulthood only. Multinominal logistic regression models examined pairwise associations between these patterns and risk factors in childhood/early adolescence (ages 9-16) and late adolescence (ages 19-21). Risk factors included psychiatric disorders (e.g., anxiety, depressive), other substance use (smoking, alcohol, illicit drugs), and challenging social factors (e.g., low socioeconomic status, family functioning, peers). Sex and race/ethnicity (white, African American, American Indian) interactions were tested.
RESULTS
The persistent pattern (6.7% of sample) was characterized by more anxiety disorders across development and more DSM-5 CUD symptoms during late adolescence compared to the limited pattern (13.3%), which, in turn, had more childhood family instability and dysfunction. The delayed pattern (3.7%) was characterized by more externalizing disorders, maltreatment, and peer bullying in childhood compared to those in nonproblematic users. There were no significant interactions of sex or race/ethnicity.
CONCLUSION
Problematic cannabis use patterns during early adulthood have distinctive risk profiles, which may be useful in tailoring targeted interventions.
目的
确定与早期成年期问题性大麻使用模式相关的风险特征。
方法
数据来自于 1993 年至 2015 年进行的为期 20 年的大烟山研究（Great Smoky Mountains Study）中的 1229 名参与者，该研究是北卡罗来纳州西部的一个代表性的 20 年队列研究，每年在 9 岁和 16 岁时进行评估，并在 19、21、26 和 30 岁时进行评估。早期成年期问题性大麻使用（即 DSM-5 大麻使用障碍或每日使用）模式包括以下几种：青春期晚期（19-21 岁）和成年早期（26-30 岁）非问题性使用；青春期晚期仅有限的问题性使用；青春期晚期和成年早期持续的问题性使用；以及成年早期仅延迟的问题性使用。多项逻辑回归模型检查了这些模式与童年/青春期早期（9-16 岁）和青春期晚期（19-21 岁）的风险因素之间的两两关联。风险因素包括精神疾病（如焦虑、抑郁）、其他物质使用（吸烟、饮酒、非法药物）和挑战性的社会因素（如低社会经济地位、家庭功能、同伴）。测试了性别和种族/民族（白种人、非裔美国人、美洲印第安人）的相互作用。
结果
持续性模式（样本的 6.7%）在整个发展过程中表现出更多的焦虑障碍，并且在青春期晚期与有限模式（13.3%）相比，有更多的 DSM-5 CUD 症状，而后者又表现出更多的儿童期家庭不稳定和功能障碍。延迟模式（3.7%）在儿童时期表现出更多的外化障碍、虐待和同伴欺凌，与非问题使用者相比。性别或种族/民族没有显著的相互作用。
结论
早期成年期问题性大麻使用模式具有独特的风险特征，这可能有助于针对特定人群进行干预。
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