Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave. NE, Suite 401, Seattle, WA, 98115, USA.
Prev Sci. 2019 Jul;20(5):705-714. doi: 10.1007/s11121-018-0959-5.
The current study examines the continuity in comorbidity between substance use and internalizing mental health problems from adolescence to adulthood and investigates the general and specific predictors of comorbidity across development. Participants were drawn from the Seattle Social Development Project (N = 808), a gender-balanced, ethnically diverse longitudinal panel. Structural equation modeling was used to examine risk factors for comorbid substance use and internalizing problems in family and peer social environments; substance use- and mental health-specific social environments (family tobacco, alcohol, and marijuana use; family history of depression); and individual risk factors (behavioral disinhibition). Latent factors were created for comorbid substance use and mental health problems at ages 13-14 and comorbidity of substance abuse and dependence symptoms and mental health disorder symptoms at ages 30-33 and included indicators of anxiety, depression, alcohol, tobacco, and marijuana problems. Comorbid problems in adolescence predicted later comorbidity of disorders in adulthood. In addition, family tobacco environment and behavioral disinhibition predicted adolescent comorbidity, while family history of depression was associated with adult comorbidity. Finally, family and peer substance use in adolescence predicted substance use (alcohol, tobacco, and marijuana) both in adolescence and adulthood. The pattern of results suggests that comorbidity in adolescence continues into adulthood and is predicted by both general and behavior-specific environmental experiences during adolescence. Findings clarify the etiology of comorbid internalizing and substance use problems and suggest potential preventive intervention targets in adolescence to curb the development of comorbidity in adulthood.
当前的研究考察了物质使用和内化心理健康问题从青春期到成年的连续性，并调查了跨发展的共病的一般和特定预测因素。参与者来自西雅图社会发展项目（N=808），这是一个性别平衡、种族多样化的纵向小组。结构方程模型被用来检验家庭和同伴社会环境中物质使用和内化问题共病的风险因素；物质使用和心理健康特定的社会环境（家庭烟草、酒精和大麻使用；家庭抑郁史）；以及个体风险因素（行为抑制不足）。在 13-14 岁和 30-33 岁时，创建了共病物质使用和心理健康问题以及物质滥用和依赖症状和精神健康障碍症状共病的潜在因素，并包括焦虑、抑郁、酒精、烟草和大麻问题的指标。青春期的共病问题预测了成年后的共病障碍。此外，家庭烟草环境和行为抑制不足预测了青春期的共病，而家庭抑郁史与成年期的共病有关。最后，青春期的家庭和同伴物质使用预测了青少年和成年期的物质使用（酒精、烟草和大麻）。结果模式表明，青春期的共病会延续到成年期，并且受到青春期一般和特定行为环境经验的预测。研究结果阐明了共患内化和物质使用问题的病因，并提出了青春期可能的预防干预目标，以遏制成年期共病的发展。
