Abstract
No known studies have investigated co-occurrence of psychopathology problems in adolescents with biologic and/or environmental susceptibility, including prenatal drug exposure. This study identified comorbidity patterns of psychopathology problems by utilizing data from urban, primarily African American, youth, majority of whom were at heightened risk for exposure to drugs in utero. The roles of Research Domain Criteria (RDoC)-informed behavioral constructs of the Negative Valence (irritability) and Social Process Systems (social disinhibition) as antecedents of the comorbidity patterns were further examined. Lastly, the predictive validity of the identified patterns was evaluated in relation to emerging adulthood outcomes. Participants were 358 urban adolescents, primarily African Americans, drawn from a 21-year prospective birth-cohort study of the effects of prenatal drug exposure. Psychopathology problems were assessed at age 15. Irritability and social disinhibition were self-reported at age 12. Emerging adulthood outcomes were measured at age 21. Latent class modeling indicated four patterns: Normative (57%), substance-use (SU; 24%), mental-health-problems-without-substance-use (MH; 11%), and substance-use-and-other-mental-health-problems (SUMH; 7%). Higher irritability increased the odds of developing the MH pattern, whereas higher social disinhibition increased the odds of developing the SU pattern. The odds of manifesting the SUMH pattern were higher for children with higher irritability. For children with higher social disinhibition, the odds of manifesting the SUMH pattern were higher at a trend level. Adolescent comorbidity patterns were differentially associated with problematic tobacco and marijuana use and clinically relevant mental health problems in emerging adulthood, and completion of high school education. Peri-pubertal identification of individual differences in irritability and social disinhibition may mitigate the emergence of adolescent psychopathology, which could influence emerging adulthood adjustment in this at-risk population.
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Availability of Data
The data for this manuscript can be made available for research purposes under Data Use Agreements with Case Western Reserve University. The source of the data is Case Western Reserve University and its affiliated hospital University Hospitals Cleveland Medical Center. Researchers interested in gain access to the data may contact Dr. Sonia Minnes at slk2@case.edu. It can take some months to negotiate data use agreements and gain access to the data. The corresponding author will assist with any reasonable replication attempts for two years following publication.
Code Availability
Code for latent class analyses and validation analyses is available upon email request to the corresponding author.
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Acknowledgements
The authors would like to thank all our families who participated in our research for 21 years. We would also like to thank Dr. Lynn T. Singer for her initiation of the 21-year longitudinal study.
Funding
This research was supported by a National Institute on Drug Abuse Grant R01-07957. This manuscript was also made possible by the Richard R. Zdanis Research Fellowship Award, Case Western Reserve University, Cleveland, Ohio.
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Dr. June-Yung Kim conceptualized the paper, performed the statistical analyses, and wrote the initial and final draft. Dr. Sonia Minnes designed the study and provided input on the conceptualization of the paper and interpretation of the data. Dr. Meeyoung O. Min provided the input on the conceptualization of the paper, statistical analyses, and interpretation of the data. Dr. Ty A. Ridenour provided input on the interpretation of the data. All authors contributed to critical revision of the manuscript for important intellectual content and read and approved the final manuscript.
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June-Yung Kim, Sonia Minnes, and Meeyoung O. Min declare that they have no conflict of interest. Ty A. Ridenour’s spouse owns the intellectual property of the Assessment of Liability and EXposure to Substance use and Antisocial behavior (ALEXSA).
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The study was approved by the Institutional Review Board of the participating hospital (University Hospitals Cleveland Medical Center, Ohio). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
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Parents and/or caregivers provided signed written informed consent. Written assent was obtained from youth.
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The authors affirm that all participants provided informed consent/assent for the findings in aggregate form to be published.
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Kim, JY., Minnes, S., Min, M.O. et al. Co-occurrence of Psychopathology Problems in At-Risk Adolescents. J Psychopathol Behav Assess 44, 1110–1125 (2022). https://doi.org/10.1007/s10862-022-09980-w
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DOI: https://doi.org/10.1007/s10862-022-09980-w