Department of Psychology, University of Southern California, Los Angeles, CA, USA.
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
Addiction. 2018 Jun;113(6):1139-1148. doi: 10.1111/add.14160. Epub 2018 Feb 7.
To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid-adolescence.
Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12-month follow-up). Additional analyses tested whether sex and socio-economic status moderated this association.
Ten high schools in Los Angeles, CA, USA, 2013-15.
Students (n = 3396, 53.5% female, mean [standard deviation (SD)] age at wave 1 baseline = 14.1 (0.42) years).
Self-reported conduct problems (11-item questionnaire), alternative reinforcement (44-item questionnaire) and use of alcohol, marijuana and combustible cigarettes during the past 6 months (yes/no) and the past 30 days (nine-level ordinal response based on days used in past 30 days).
Significant associations of wave 1 conduct problems with wave 3 marijuana use during the past 6 months (β = 0.25) and past 30 days (β = 0.26) were mediated by wave 2 diminished alternative reinforcement (β : 6 months = 0.013, 30 days = 0.017, Ps < 0.001). Associations of conduct problems with alcohol or combustible cigarette use were not mediated by alternative reinforcement. All associations did not differ by sex and socio-economic status.
Diminished alternative reinforcement may be a modifiable mechanism linking early adolescent conduct problems and subsequent marijuana use that could be targeted in prevention programs to offset the adverse health and social sequelae associated with comorbid conduct problems and marijuana use in early-mid adolescence.
确定行为问题与青少年早期至中期物质使用之间的纵向关联是否由替代强化减少（即无物质活动的参与和享受）所介导。
结构方程模型检验了在第 1 波（基线）行为问题与第 3 波（24 个月随访）物质使用结果之间的关联是否由第 2 波（12 个月随访）替代强化减少所介导。进一步的分析检验了性别和社会经济地位是否调节了这种关联。
美国加利福尼亚州洛杉矶的 10 所高中，2013-2015 年。
学生（n=3396，53.5%为女性，第 1 波基线时的平均[标准差（SD）]年龄为 14.1（0.42）岁）。
自我报告的行为问题（11 项问卷）、替代强化（44 项问卷）以及过去 6 个月内（是/否）和过去 30 天内（基于过去 30 天内使用的天数的九级有序反应）使用酒精、大麻和可燃香烟的情况。
第 1 波行为问题与第 3 波过去 6 个月内大麻使用（β=0.25）和过去 30 天内大麻使用（β=0.26）之间存在显著关联，这些关联由第 2 波替代强化减少所介导（β：6 个月=0.013，30 天=0.017，P<0.001）。行为问题与酒精或可燃香烟使用之间的关联不受替代强化的影响。所有关联在性别和社会经济地位方面没有差异。
替代强化减少可能是一种可改变的机制，将青少年早期的行为问题与随后的大麻使用联系起来，在预防计划中可以针对这种机制，以抵消与青少年早期并发行为问题和大麻使用相关的不良健康和社会后果。
