General and Specific Predictors of Comorbid Substance Use and Internalizing Problems from Adolescence to Age 33
- 83 Downloads
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.
KeywordsComorbidity Dual diagnosis Substance use Internalizing disorders Etiology
This research was supported by grants (R01DA024411, R01DA003721, and R01DA09679) from the National Institute on Drug Abuse (NIDA). The funding organization had no role in the design and conduct of the study; collection, analysis, or preparation of data; or preparation, review, or approval of the manuscript. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of NIDA.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures in this study were approved by and in accordance with the ethical standards of the University of Washington institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington: Department of Psychiatry, University of Vermont.Google Scholar
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- Bailey, J. A., Hill, K. G., Oesterle, S., & Hawkins, J. D. (2006). Linking substance use and problem behavior across three generations. Journal of Abnormal Child Psychology, 34, 273–292.Google Scholar
- Bailey, J. A., Hill, K. G., Meacham, M. C., Young, S. E., & Hawkins, J. D. (2011). Strategies for characterizing complex phenotypes and environments: General and specific family environmental predictors of young adult tobacco dependence, alcohol use disorder, and co-occurring problems. Drug and Alcohol Dependence, 118, 444–451.CrossRefPubMedPubMedCentralGoogle Scholar
- Bailey, J. A., Samek, D. R., Keyes, M. A., Hill, K. G., Hicks, B. M., McGue, M., & Hawkins, J. D. (2014). General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: Replication in two samples. Drug and Alcohol Dependence, 138, 161–168.CrossRefPubMedPubMedCentralGoogle Scholar
- Graaf, R. d., Bijl, R. V., Smit, F., Vollebergh, W. A. M., & Spijker, J. (2002). Risk factors for 12-month comorbidity of mood, anxiety, and substance use disorders: Findings from the Netherlands mental health survey and incidence study. The American Journal of Psychiatry, 159, 620–629.CrossRefPubMedGoogle Scholar
- Hawkins, J. D., Smith, B. H., Hill, K. G., Kosterman, R., Catalano, R. F., & Abbott, R. D. (2003). Understanding and preventing crime and violence: Findings from the Seattle social development project. In T. P. Thornberry & M. D. Krohn (Eds.), Taking stock of delinquency: An overview of findings from contemporary longitudinal studies (pp. 255–312). New York, NY: Kluwer Academic/Plenum.CrossRefGoogle Scholar
- Jones, T. M., Hill, K. G., Epstein, M., Lee, J. O., Hawkins, J. D., & Catalano, R. F. (2016). Understanding the interplay of individual and social-developmental factors in the progression of substance use and mental health from childhood to adulthood. Development and Psychopathology Special Issue: Longitudinal Transactional Models of Development and Psychopathology, 28, 721–741.CrossRefGoogle Scholar
- Lee, J. O., Hill, K. G., Guttmannova, K., Bailey, J. A., Hartigan, L. A., Hawkins, J. D., & Catalano, R. F. (2012). The effects of general and alcohol-specific peer factors in adolescence on trajectories of alcohol abuse disorder symptoms from 21 to 33 years. Drug and Alcohol Dependence, 121, 213–219.CrossRefPubMedGoogle Scholar
- McGue, M., Iacono, W. G., Legrand, L. N., Malone, S., & Elkins, I. (2001). Origins and consequences of age at first drink. Associations with substance-use disorders, disinhibitory behavior and psychopathology, and p3 amplitude. Alcoholism: Clinical & Experimental Research, 25, 1156–1165.CrossRefGoogle Scholar
- Merikangas, K. R., Mehta, R. L., Molnar, B. E., Walters, E. E., Swendsen, J. D., Aguilar-Gaziola, S., … Kessler, R. C. (1998). Comorbidity of substance use disorders with mood and anxiety disorders: Results of the international consortium in psychiatric epidemiology. Addictive Behaviors, 23, 893–907.Google Scholar
- Merikangas, K. R., He, J.-p., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in us adolescents: Results from the National Comorbidity Survey replication–adolescent supplement (NCS-A). Journal of the Academy of Child & Adolescent Psychiatry, 49, 980–989.CrossRefGoogle Scholar
- Muthén, L. K., & Muthén, B. O. (2008). Mplus user’s guide (4th ed.). Los Angeles: Muthén & Muthén.Google Scholar
- Oxford, M., Oxford, M. L., Harachi, T. W., Catalano, R. F., & Abbott, R. D. (2001). Preadolescent predictors of substance initiation: A test of both the direct and mediated effect of family social control factors on deviant peer associations and substance initiation. American Journal of Drug and Alcohol Abuse, 27, 599–616.CrossRefPubMedGoogle Scholar
- Robins, L. N., Helzer, J. E., Croughan, J., Williams, J. B. W., & Spitzer, R. L. (1981). NIMH Diagnostic Interview Schedule: Version III (May 1981). Rockville, MD: National Institute of Mental Health.Google Scholar