Barry Caroline M, Jagtiani Ashna, Livingston Melvin D, Talavera-Brown Sierra, LaBounty Hannah, Atkinson Eugena, Skinner Juli R, Komro Kelli A
Rollins School of Public Health, Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA, United States.
Cherokee Nation Behavioral Health, Cherokee Nation Health Services, Tahlequah, OK, United States.
Front Child Adolesc Psychiatry. 2024;3. doi: 10.3389/frcha.2024.1390793. Epub 2024 Nov 18.
This study examines the impacts of anxiety and depressive symptoms on subsequent initiation of alcohol use, cannabis use, and prescription opioid misuse among diverse adolescents attending high schools on or near a Tribal reservation in a rural Great Plains region of the U.S.
In collaboration with Emory University and a Great Plains Tribal nation's behavioral health organization, a community randomized trial of 20 high schools was conducted to prevent substance misuse. Surveys administered at four time points (fall and spring of 10th and 11th grade) included the GAD-7, PHQ-8, and items assessing lifetime alcohol use, cannabis use, prescription opioid misuse, and covariates (age, gender, race, and food insecurity). The analytic sample included students with data at two or more time points ( = 455) from control schools ( = 10). Approximately half of the sample identified as American Indian only or American Indian/White only, and 36%-39% as White only.
Adjusted generalized estimating equations showed that every 5-point increase in anxiety symptoms was associated with 1.28 and 1.29 times the odds of initiating alcohol and cannabis use respectively the following semester. Similarly, every 5-point increase in depressive symptoms was associated with 1.25, 1.34, and 1.38 times the odds of initiating alcohol use, cannabis use, and prescription opioid misuse respectively the following semester.
Results show a consistent 25%-38% increased odds of certain types of substance use initiation following increases in anxiety and depressive symptoms among adolescents. Findings underscore the need for targeted prevention and intervention to address mental health issues among a historically marginalized population. Addressing mental health concerns earlier may mitigate later substance use risks and sequelae for rural and American Indian youth.
本研究考察了焦虑和抑郁症状对美国大平原农村地区部落保留地或其附近高中就读的不同青少年随后开始饮酒、使用大麻和滥用处方阿片类药物的影响。
与埃默里大学和一个大平原部落国家的行为健康组织合作，对20所高中进行了一项社区随机试验，以预防药物滥用。在四个时间点（十年级和十一年级的秋季和春季）进行的调查包括广泛性焦虑障碍量表（GAD-7）、患者健康问卷-8（PHQ-8），以及评估终生饮酒、使用大麻、滥用处方阿片类药物和协变量（年龄、性别、种族和粮食不安全状况）的项目。分析样本包括来自对照学校（n = 10）的有两个或更多时间点数据的学生（n = 455）。大约一半的样本仅确定为美洲印第安人或仅为美洲印第安人/白人，36%-39%仅确定为白人。
调整后的广义估计方程显示，焦虑症状每增加5分，与下学期开始饮酒和使用大麻的几率分别增加1.28倍和1.29倍相关。同样，抑郁症状每增加5分，与下学期开始饮酒、使用大麻和滥用处方阿片类药物的几率分别增加1.25倍、1.34倍和1.38倍相关。
结果表明，青少年焦虑和抑郁症状增加后，某些类型物质使用开始的几率持续增加25%-38%。研究结果强调了针对历史上被边缘化人群解决心理健康问题进行有针对性预防和干预的必要性。尽早解决心理健康问题可能会减轻农村和美洲印第安青年日后的物质使用风险和后遗症。
