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首次涉及司法的青少年中大麻使用的预测因素:一项队列研究。

Predictors of cannabis use among first-time justice-involved youth: A cohort study.

机构信息

University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA, 94110, USA.

Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI, 02903, USA.

出版信息

Drug Alcohol Depend. 2021 Aug 1;225:108754. doi: 10.1016/j.drugalcdep.2021.108754. Epub 2021 May 21.

Abstract

BACKGROUND

Justice-involved youth use cannabis at higher rates than their same-aged peers increasing likelihood of adverse behavioral health consequences and continued legal involvement. This study examined individual level predictors of early onset use cannabis use (<13 years of age) and cannabis use initiation in the 12 months following first court contact.

METHODS

Participants were 391 first-time justice-involved youth (56.9 % male; M = 14.6 years; 32.1 % White, 11.1 % Black, 14.7 % Other/Multi-racial, 42.2 % Latinx) and an involved caregiver (87.2 % female; M = 41.0 years). Baseline assessments captured individual level factors; cannabis use was assessed every four months post-baseline for 12 months. Primary analyses involved multivariable modified Poisson regressions and survival analysis.

RESULTS

In multivariable models, youth who reported lifetime cannabis use (n = 188, 48.1 %) were older, reported alcohol use and positive cannabis use expectancies. Greater self-control and self-concept were associated with lower likelihood of lifetime cannabis use. Youth who initiated cannabis during the 12-month follow-up (n = 30, 14.8 %) tended to be older, White/non-Latinx, and to report more psychiatric symptoms (posttraumatic stress, externalizing, internalizing, and affect dysregulation), delinquent behavior, lower levels of self-control, poorer self-concept, greater drug use intentions and positive cannabis expectancies. In the multivariable survival analysis, affect dysregulation, internalizing symptoms, and more positive cannabis expectancies remained independently and positively associated with cannabis initiation.

CONCLUSIONS

There is a critical and unique window of opportunity to prevent cannabis use initiation among first-time justice-involved youth. Research is needed to determine whether brief interventions that aim to modify expectancies about cannabis use reduce rates of cannabis initiation in this underserved population.

摘要

背景

与同龄人相比,涉及司法程序的青少年使用大麻的比率更高,这增加了他们出现不良行为健康后果和继续卷入法律程序的可能性。本研究考察了个体层面的预测因素,包括在首次与法庭接触后的 12 个月内,较早开始使用大麻(<13 岁)和首次使用大麻的情况。

方法

参与者为 391 名首次涉及司法程序的青少年(56.9%为男性;平均年龄为 14.6 岁;32.1%为白人,11.1%为黑人,14.7%为其他/多种族裔,42.2%为拉丁裔)和一位相关的照顾者(87.2%为女性;平均年龄为 41.0 岁)。基线评估收集了个体层面的因素;在基线后每四个月评估一次大麻使用情况,为期 12 个月。主要分析包括多变量修正泊松回归和生存分析。

结果

在多变量模型中,报告有终生大麻使用史的青少年(n=188,48.1%)年龄较大,报告有酒精使用和积极的大麻使用预期。更高的自我控制和自我概念与较低的终生大麻使用可能性相关。在 12 个月的随访期间开始使用大麻的青少年(n=30,14.8%)年龄较大,为白人/非拉丁裔,报告有更多的精神症状(创伤后应激、外化、内化和情绪失调)、犯罪行为、较低的自我控制水平、较差的自我概念、更强的药物使用意图和积极的大麻预期。在多变量生存分析中,情绪失调、内化症状和更积极的大麻预期仍然与大麻使用的开始独立且呈正相关。

结论

对于首次涉及司法程序的青少年来说,现在有一个关键且独特的机会窗口来预防大麻的使用。需要研究是否可以通过针对改变大麻使用预期的简短干预措施,降低这一弱势群体的大麻使用开始率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4bf/8282753/8d52861e9381/nihms-1713010-f0001.jpg

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