Search

Objective: The present study examines the network structure and, using Bayesian network analysis, estimates the directional pathways among symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and levels of alcohol and cannabis use. Method: A sample of 1471 adults in the United States, who reported at least one potentially traumatic event, completed the PTSD Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), and the Alcohol/Cannabis Use Disorders Identification Test (AUDIT/CUDIT). A regularized partial correlation network provided estimates of symptoms clusters and connections. Directional pathways within the network were then estimated using a directed acyclic graph (DAG). Results: Symptoms clustered in theoretically consistent ways. Risky behavior demonstrated the highest strength centrality and bridge strength. Neither alcohol nor cannabis use appeared central in the network, and DAG results suggested that MDD and PTSD symptoms are more likely to lead to substance use than the other way around. Conclusions: Results suggest that cannabis use is largely connected to alcohol use. Consistent with prior research, risky behavior appeared to be the primary bridge between substance use and PTSD. The direction of associations between substance use and psychological symptoms requires further attention. [ABSTRACT FROM AUTHOR]

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; others: 4.5%) and seven (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR] = 1.36; 95% CI, 1.07-1.70) and tobacco (RR = 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR = 1.45; 95% CI, 1.07-1.93; tobacco: RR = 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies. [ABSTRACT FROM AUTHOR]

Although stress is often related to substance use, it remains unclear whether substance use is related to individual differences in how adolescents respond to stress. Therefore the present study examined associations between substance use and daily emotional reactivity to stress within a year across adolescence. Adolescents (N = 330; Mage = 16.40, SD = 0.74 at study entry; n = 186 female; n = 138 Latine; n = 101 European American; n = 72 Asian American; n = 19 identifying as another ethnicity including African American and Middle Eastern) completed a longitudinal study, including three assessments between the 10th grade and 3‐years post‐high school. At each assessment, participants reported frequency of alcohol and cannabis use and the number of substances they had ever used. They also completed 15 daily checklists, in which they reported the number of daily arguments and their daily emotion. Multilevel models suggested that more frequent alcohol and cannabis use were related to attenuated positive emotional reactivity to daily stress (i.e., smaller declines in positive emotion on days when they experienced more arguments) for both male and female adolescents. Associations for negative emotional reactivity to stress varied by sex; more frequent alcohol use and use of more substances in one's lifetime were related to greater anxious emotional reactivity to stress among female adolescents, whereas more frequent alcohol and cannabis use and higher lifetime substance use were related to attenuated depressive emotional reactivity to stress among male adolescents. Taken together, substance use was related to emotional reactivity to daily stress within the same year during adolescence, although associations differed by valence and adolescent sex. [ABSTRACT FROM AUTHOR]

The current study aims to fill the existing research gaps by investigating the role of teacher care in protecting African American adolescents in under-resourced neighborhoods from negative outcomes of adverse life events. The study included 638 adolescents from four under-resourced neighborhoods in Chicago's Southside who were assessed to determine the moderating role of caring teachers on the relationship between adverse adolescent experiences and risky sexual behaviors, substance use, bullying perpetration, and violent behaviors. Caring teachers had a significant moderating effect on the association between adverse experiences and both bullying perpetration and violent behaviors. Adolescents who perceived their teachers as caring showed lower tendencies towards bullying and violence, even if they had adverse experiences. These results highlight the crucial role of teacher care in supporting African American adolescents from under-resourced neighborhoods who have experienced adverse life events. It emphasizes educators' role in shaping our youth's future, especially those facing adversity and at a crossroads in their lives. Plain language summary: Despite adverse life events, adolescents who perceived their teachers as caring were less at risk of engaging in bullying and violence. Caring teachers are especially important for African American adolescents in under-resourced neighborhoods. [ABSTRACT FROM AUTHOR]

Background: Family functioning is associated with adolescent drug use, alcohol use, cigarette use, and sexual risk behaviors. Assessing adolescents for family functioning, commonly associated with multiple risk behaviors, may help identify adolescents at risk for adverse health outcomes. This study examined whether a latent family functioning construct, encompassing multiple dimensions of family functioning, was associated with adolescents' substance use and sexual risk behaviors. Method: This study used data harmonization with three intervention trials, including data from 1451 adolescents (M = 13.6, SD = 1.0), to perform a full-information item bifactor analysis on 46 family functioning items from five pre-existing family functioning measures. Regression analysis was used to examine the association between the identified subset of items and the following outcomes: cigarette use, alcohol use, drug use, and condom use. Results: Bifactor analysis identified a 26-item latent family functioning construct. Regression analysis indicated that a 26-item latent family functioning construct was associated negatively with lifetime and past 90-day cigarette use, alcohol use, and drug use. Conclusion: In sum, the multi-dimensional latent family functioning construct may target specific barriers to risk screening in adolescent populations, including time constraint, hesitancy in discussing sensitive health topics, and use culturally appropriate and age-appropriate assessments. [ABSTRACT FROM AUTHOR]

Aim To examine the association between academic orientation and frequent cannabis use among Swedish adolescents in upper secondary school and include pupils from introductory programs (IPs), a large group of adolescents previously overlooked in research on adolescent cannabis use. Methods We used cross-sectional data from two anonymous school surveys carried out in upper secondary school in 2021. The samples consisted of pupils from all academic orientations, and the analysis included 3151 pupils in higher education preparatory programs (HEPs), 1010 pupils in vocational programs (VPs), and 819 pupils in IPs. The association between the exposure academic orientation and the outcome frequent (21+ times) cannabis was analyzed using multi-level mixed-effects Poisson regression. Results Estimates from the first model showed a significant (P  < 0.05) 2.45 times higher risk of frequent cannabis use among pupils in IPs compared with in HEPs [incidence rate ratio (IRR) 2.45, 95% confidence interval (CI) 1.28–4.66] and 82% higher in VPs (IRR 1.82, 95% CI 1.09–3.04) compared with in HEPs. However, the associations between academic orientation and frequent (21+ times) cannabis use were attenuated and no longer significant when socioeconomic status, truancy, school dissatisfaction, and early onset of substance use were adjusted for. Conclusions There was a higher risk of frequent (21+ times) cannabis use among pupils in IPs, and this differential was explained by higher exposure to risk factors in this group. This result is important from a policy perspective as it provides knowledge of a previously neglected risk group for frequent cannabis use. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied minor refugees are a high risk group for trauma-related disorders. Although these disorders pose a risk for unhealthy substance use, research of substance use among young refugees is lacking. Methods: This study investigated substance use in a total of 102 refugees between 16 and 21 years of age who arrived as unaccompanied minors in Germany. Participants were asked about their religious beliefs and substance use within the last three months and prior to leaving their countries of origin. Unhealthy substance use was assessed by drug-specific questionnaires. Results: Overall, 38% of the study participants met the criteria for unhealthy substance use (12% solely for unhealthy tobacco use). According to self-ratings, 21% of the refugees met the criteria for unhealthy alcohol use, 25% for unhealthy tobacco use and 12% for unhealthy cannabis use. Young refugees who had already used drugs in their country of origin were more susceptible to developing unhealthy substance use. Identifying as religious seems to reduce the risk for unhealthy substance use. Conclusion: The results reveal that unaccompanied refugees are highly vulnerable for unhealthy substance use. Special programs for unhealthy substance use prevention are needed for this group. [ABSTRACT FROM AUTHOR]

Background: People who inject drugs (PWID) experience high rates of violence, especially in early childhood, increasing their likelihood of engaging in risky substance use behavior in adulthood. Additionally, complex trauma has been reported among PWID due to witnessing and experiencing an overdose, further highlighting the need to examine the role of multiple experiences of trauma on their vulnerability to substance misuse. Methods: Our study of 350 PWID from rural Kentucky examined differences in polysubstance use between participants who experienced violence earlier (≤15 years old) versus later (≥16 years old) in their childhood. Results: Findings highlighted a direct association between experiences of early childhood violence and polysubstance use in adulthood. Additionally, our sample of PWID who experienced violence early in their childhood reported higher rates of severe substance use disorder and mental health distress. Conclusions: Tailored approaches that incorporate trauma-informed care may help to address the disproportionate rates of substance use and related adverse effects among PWID. [ABSTRACT FROM AUTHOR]

Background: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. Method: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. Results: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). Conclusions: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS. [ABSTRACT FROM AUTHOR]

Throughout the last two decades, research on poly-victimization (PV) has evolved from examinations of a core set of past-year victimization types in youth samples to investigations of a broad range of victimization types experienced during variable time intervals in diverse samples of varying ages. As the concept of PV expands, greater clarity regarding the definition and measurement of PV is needed to advance understanding of its risk and protective factors as well as its associated outcomes. This scoping review aimed to (a) identify approaches used to operationally define and measure PV across studies and (b) synthesize empirical findings concerning risk factors and outcomes associated with PV. A systematic search of peer-reviewed research published before 2022 across 12 databases yielded 98 studies that met inclusion criteria. Study characteristics including the research design, sample type, victimization timeframe, operational definition(s) of PV, measurement of PV, analytic methods, and key findings were synthesized across studies. Findings indicated that the majority of reviewed studies were cross-sectional investigations that utilized categorical measures of lifetime PV in samples of youth. Results also demonstrated that PV is robustly associated with a broad range of predictors, including mental health symptoms and diagnoses as well as family- and community-level factors. PV is also associated with numerous adverse outcomes including depression, anxiety, suicidality, substance use, and delinquency across diverse study types and populations. Future research that examines the conditional effects of PV is needed to identify subgroups of individuals at higher risk of adverse outcomes following PV and modifiable targets for interventions. [ABSTRACT FROM AUTHOR]

Although alcohol use is related to daily affect, findings regarding affect variability—the degree to which individuals exhibit day-to-day fluctuations in affect—and alcohol use have been mixed. The present study assessed whether individuals who use alcohol tend to have higher positive and negative affect variability than individuals who do not, as well as whether higher affect variability is related to more frequent and intense alcohol use among individuals who use alcohol. We also explored whether affect variability differed between individuals who use alcohol and those who concurrently use alcohol and cannabis. College students (N = 1909; M = 20.1, SD = 1.3; 67.7% female; 76.6% white; n = 1147 individuals who use alcohol) completed a 21-day protocol between February-December 2021 in which they reported daily affect, number of drinks consumed, and any cannabis use. As hypothesized, individuals who used alcohol had higher positive and negative affect variability than individuals who did not. Among individuals who used alcohol, individuals with higher negative affect variability drank alcohol more frequently, and both higher positive and negative affect variability were related to more intense alcohol use. No differences emerged between individuals who used alcohol and those who concurrently used alcohol and cannabis. Taken together, higher positive and negative affect variability were related to higher odds of using alcohol and more frequent and intense use among individuals who use alcohol, over and above average affect. Higher affect variability could relate to alcohol use because of difficulties with emotion regulation or heightened sensitivity to the environment. [ABSTRACT FROM AUTHOR]

Objective: Kratom use represents a growing risk for public health. The present study examined demographic and behavioral factors linked with kratom use. Participants: Participants were college students in the United States who participated in the 2019-2020 Healthy Minds Study. Methods: Participants completed survey-based assessment of kratom use and related demographic, behavioral, and mental health variables. Results: Kratom use was linked with being White, male or transgender/gender nonconforming, identifying as a sexual minority, use of alcohol or marijuana, and depressive symptoms. Kratom use was not uniquely linked to exercise or anxiety. Conclusions: The results of the present study can be used to inform initial targeting of efforts to reduce kratom use among college students. [ABSTRACT FROM AUTHOR]

Purpose: Drug use is quite common in transgender women, but the mechanisms of the drug use remain unclear. The purpose of this study was to investigate the mediating role of loneliness in perceived stress and the drug use among transgender women. Methods: A cross-sectional survey was conducted from April to September 2018 in Shenyang and Kunming, China, among 247 transgender women. Chinese Perceived Stress Scale, the Chinese version of 8-item UCLA Loneliness Scale, a drug use questionnaire, and a demographic characteristic questionnaire were included in the survey. Descriptive analysis, logistic regression, and mediation analysis were done using SPSS Statistics version 26.0 and Mplus version 8.3. Results: The mean age of transgender women in the study was 33.04 years (standard deviation=8.14). Around 33.20% (n=82) of transgender women reported ever using one kind of drugs, the most commonly used drugs were rush (79.20%), ice (8.50%), and 5-MeO-DIPT (8.50%). Univariate logistic regression showed that perceived stress (odds ratio [OR]=1.73, 95% bootstrap confidence intervals [CI]=1.27–2.36) and loneliness (OR=1.62, 95% CI=1.23–2.13) had a significant association with drug use, all p [ps] <0.01. The effect of perceived stress on drug use was partially mediated by feeling of loneliness (estimate=0.09, standard error=0.04, p<0.05), the mediating effect (0.09) accounted for 27.27% of the total effect (0.33). Conclusion: Perceived stress can positively predict drug use. Loneliness plays an important role in drug use among transgender women. [ABSTRACT FROM AUTHOR]

Background: Self-Esteem (SE) may be a reason why students use substances. A dysfunctional family may be an issue that leads students to use drugs. There has been limited research on how drug use (DU) is a consequence of family dysfunction. Aims: This study examines the associations between SE and DU and the moderating effects of dimensions of family dysfunction (problem-solving, communications, roles, affective response, affective involvement, behavior control, and general functioning) on this association. Methods: 450 students completed the Psychoactive Substance Use Questionnaire, Family Assessment Device, and Index of Self-Esteem. Results: The results indicated that roles significantly moderated the association between self-esteem and drug use, while the moderation effects of all other family dysfunction dimensions were insignificant. Conclusions: The association between self-esteem and drug use and how roles moderate this association emphasize the need to create awareness in families and schools where these students can easily understand the consequences of their behavior. [ABSTRACT FROM AUTHOR]

Objectives: The study investigated the types of local substances used, the reasons for the use, and ways of reducing such behavior to the barest minimum in the Ilorin South Local Government Area of Kwara State, Nigeria. Methods: A phenomenological and exploratory research design was adopted for the study. The participants were purposively selected. The study adopted Semi-structured interviews to collect the data, and the method of data analysis was qualitative. Results: The study showed that ogogoro (local gin), skushies (a mixture of herbs and ogogoro), gerigemu (a mixture of thorn apple and ogogoro), monkey tail (a mixture of weed and ogogoro), dried pawpaw leaves, asa (a mixture of tobacco and other substances), amongst others were the common locally used substances in the study area. These local substances were used for not being expensive to produce, availability, parents' utilization, peer influence, coping strategies, not seen as illegal, and as sources of energy. Conclusion: There are different types of local substances used in the Ilorin South Local Government Area for various reasons. This paper proffers, amongst others, that there is a need for regulating bodies in charge of drug control to extend their surveillance beyond orthodox to reduce local substance use. [ABSTRACT FROM AUTHOR]

Objectives: We determine the factors related to the attitudes toward substance users and how these factors predict attitudes. Methods: The research was a field study. The control variables were gender and occupation. Health workers, teachers, prison guards, shopkeepers, university students, bartenders, and professional athletes were chosen by lottery method of simple random sampling. 350 people were reached. Fagerström Nicotine Dependence Test, Addiction Profile Index Risk Scanning Scale-Alcohol, and Addictive Material Attitude Scale were used. T-test, ANOVA, Bonferroni post hoc test, analysis of effect size, and linear regression model were used. Results: Gender (1%), marital status (2%), residence (4%), occupation (9%), NUD (2%), risky alcohol use (12%), having people with AUD in the social circle (1%), having a substance user in the social circle (20%), being in a substance use environment (16%); neighborhood characteristics as crime (9%), drug use (5%), illicit drug selling (7%) were found predictors of the attitude. Conclusions: Demographical factors like being single, being a bartender, living with friends; substance-related risk factors; neighborhood characteristics like high crime, substance use, and illicit drug selling were predictors of positive attitude. Identifying the factors explaining the positive attitude will guide the determination of prevention and protection programs for society. [ABSTRACT FROM AUTHOR]

Objective: The present study primarily examines the clinician's perspective on the initiation of substance use among Pakistani adolescents by using bio-psycho-social correlates. Method: Qualitative research design was used to explore the risk and protective factors of substance use. For this purpose, twelve clinical experts i.e., clinical psychologists (N = 6 with HEC-recognized MS Clinical Psychology degree) and psychiatrists (N = 6 with valid PMC) were approached for in-depth interviews. The inclusion of experts with at least five years of experience in dealing with Substance Use Disorders (SUD). Their verbatim was transcribed and thematically analyzed by using NVIVO v.12. Results: The findings of this study revealed three main themes for risky behavior i.e., temperamental factors (self-esteem-related problems, anxiety sensitivity, experimentation, and assertiveness issue), family-level factors (parenting style, family conflict, and genetic transmission), and environmental risk factors (peer influence, role of media, and easy access of substance). In addition, the protective factor of substance use also emerged i.e., religiosity or spirituality along with the appropriate parenting which can overcome the risk tendencies of substance use in adolescents. Conclusion: The study concluded that appropriate parenting can make a bridge between risk factors of substance use. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to (1) identify the percentage of high-risk substance use or substance use disorder (SUD) and (2) examine the factors associated with high-risk substance use or SUD in adults aged 50 years and older receiving mental health treatment with a primary delirium or dementia diagnosis. Method: This study used 7 years (2013–2019) of national administrative data on community mental health center patients aged 50 years and older with a primary delirium or dementia diagnosis receiving treatment in the United States (U.S.). To examine factors associated with the dependent variable (high-risk substance use or SUD), a multivariable binary logistic regression model was utilized. Results: The sample included 77,509 individuals who were mostly aged 65 years and older (69.7%), and did not have co-occurring high-risk substance use or SUD (90.1%). Receiving treatment in a U.S. region other than the Northeast, being younger, male, not non-Hispanic White, and having multiple mental health diagnoses had greater odds of co-occurring high-risk substance use or SUD. Conclusion: One in ten persons in this sample having high-risk substance use or SUD highlights the clinical necessity for screening and subsequent treatment for co-occurring high-risk substance use among persons receiving treatment for a neurocognitive disorder. [ABSTRACT FROM AUTHOR]

Objective: This study investigates tobacco use in Bangladesh among adults using 2017 Global Adult Tobacco Survey (GATS) data, with the aim of identifying prevalence and associated factors to inform targeted policy interventions. Methods: Utilizing GATS-Bangladesh 2017 data for individuals aged 15 and above, a comprehensive analysis was conducted employing various statistical techniques. Chi-square tests and binary logistic regression were employed to discern patterns and significant associations. Results: The prevalence of tobacco use in Bangladesh stood at 19.5%, revealing substantial variations across demographic and socio-economic factors. Males exhibited a significantly higher prevalence (40.4%) than females (0.6%), underscoring the gender disparities. Regional disparities were evident, with Mymensingh showing the highest prevalence at 26%. Various factors, including age, residence, gender, education, occupation, family size, wealth index, smokeless tobacco use, health conditions, and media exposure, displayed significant associations with tobacco use, emphasizing the multifaceted nature of this public health challenge. Conclusion: The findings underscore the imperative for policy interventions that prioritize educational initiatives, targeted interventions for specific demographics, refined communication strategies, and comprehensive health education programs. Notably, the influential role of media and the prevalence of smokeless tobacco use should be integral considerations in the formulation of effective tobacco control policies. Furthermore, the study advocates for longitudinal research to deepen our understanding of dynamic factors influencing tobacco use over time and to assess the effectiveness of implemented interventions. These recommendations aim to guide Bangladesh towards achieving its ambitious goal of becoming "Tobacco Free". [ABSTRACT FROM AUTHOR]

Research has considered the role of social learning in substance use and determined that social influences are powerful determinants of substance initiation. However, the relationships between peer, sibling, and parent behaviors and e-cigarette initiation among early adolescents, and rural youth in particular, have yet to be examined. The present study investigated how peer delinquency, sibling substance use, and parental approval contribute to risk of e-cigarette initiation across middle school while also examining these associations with alcohol use initiation. Adolescents (N = 663) self-reported perceptions of peer delinquency, sibling substance use, parental approval about substance use, and their own e-cigarette and alcohol use. Multilevel survival analyses were conducted to model the risk of initiation and predictors of this risk. Results indicate that the risk of e-cigarette initiation increased by 75% annually as youths progressed through middle school. All social factors were significant predictors of e-cigarette initiation, while perceived peer delinquency and parental approval predicted alcohol initiation. Results emphasize the importance of early intervention for preventing e-cigarette initiation and the influence of peers and parents on alcohol initiation and the influence of peers, siblings, and parents on e-cigarette use. Highlights: This study contributes to our understanding of the risk of e-cigarette and alcohol initiation across middle school in a sample of rural youth. Results suggest that the risk of e-cigarette initiation increased by 75% annually across middle school, but the risk for alcohol initiation remained higher and stable. Findings identified peer delinquency and parental approval as risks for both e-cigarette and alcohol initiation. Sibling substance use was significantly associated with e-cigarette but not alcohol initiation. [ABSTRACT FROM AUTHOR]

Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1–11.8%, I2: 98.0%)), followed by ADHD (2.9% (95% CI 1.2–6.9%, I2 = 94.3%)), ODD (1.9% (95% CI 1.0–3.7%, I2 = 98.4%)), depressive disorder (1.7% (95% CI 1.0–2.9%, I2 = 97.7%)), CD (1.5% (95% CI 0.6–3.8%, I2 = 98.8%)) and ASD (1.4% (95% CI 0.4–5.4%, I2 = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health. [ABSTRACT FROM AUTHOR]

Background: Substance use disorders (SUD) in the perinatal period have risen dramatically over the past 2 decades. Substance use disorders can have deleterious effects on maternal-infant health. Recovery can improve quality of life but can be challenging for women with SUD in the perinatal period. It is important for health care providers to have an understanding of factors associated with maternal substance use and recovery. Objective: The purpose of this qualitative review was to identify factors influencing substance use and recovery in women with SUD in the perinatal period. Methods: A systematic search was conducted using the databases of CINAHL, PsycINFO, and PubMed along with a manual search of Google Scholar. The studies were assessed using criteria from the Joanna Briggs Institute's critical appraisal checklist for qualitative research. Results: Findings from 16 qualitative studies were synthesized. Six descriptive subthemes identifying factors influencing substance use and recovery were revealed: (1) Infant Care, (2) Stigma, (3) Social Settings Involving Substance Use, (4) Internalized Stigma and Mental Health Symptoms, (5) Addiction Concerns, and (6) Coping Abilities. Conclusions: Participants described external and internal factors that influenced their substance use and recovery. The findings suggest health care providers refer women to residential addiction treatment, use destigmatizing language, promote access to peer services, and provide trauma-informed care. [ABSTRACT FROM AUTHOR]

This is a focused review of the most current publications and direct experiences of Military Sexual Trauma (MST) among veteran women and the lasting impact on this population's mental and physical health. This review covers the span of the last 5 years (2018-2023). Additionally, the review seeks to fill a gap in the literature to understand better how and if veteran women who have experienced MST use social media and online talk to form meaningful connections. A total of 13 studies were included in the final review. This review found many studies (5) further investigated the roles of gender, race, and interpersonal relationships in relation to MST experiences. This review did not find any current publications that sought to understand MST experiences that women veterans have shared through social media platforms. This type of online research in the future could help provide valuable new insight into the unique needs of MST survivors. [ABSTRACT FROM AUTHOR]

Background and aims: Population‐level alcohol use data are available from high‐income countries, but limited research has been conducted in sub‐Saharan Africa. This systematic review and meta‐analysis aimed to summarize population‐level alcohol use in sub‐Saharan Africa. Method: Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance‐related disorders' and 'prevalence' and 'sub‐Saharan Africa'. We included general population studies on alcohol use (including any use, high‐risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub‐Saharan African adolescents (10–17) and adults (18+) were extracted. Analyses included life‐time and past 12‐ and 6‐month alcohol use. Results: We included 141 papers. Among adolescents, the life‐time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3–37.1%], 36.2% (CI = 18.4–56.1%) in the past year and 11.3% (CI = 4.5–20.4%) in the past 6 months. Among adolescents, 12‐month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0–27.8%) and 4.1% (CI = 1.4–7.9%), respectively. Among adults, the life‐time prevalence of alcohol use was 34.9% (CI = 17.7–54.1%), 27.1% (CI = 5.0–56.4%) in the past year and 32.2% (CI = 19.8–46.0%) in the past 6 months. Among adults, the 12‐month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0–30.4%) and 4.3% (CI = 0.8–9.8%), respectively. The highest weighted life‐time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6‐month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents. Conclusion: Alcohol use patterns vary across countries and subregions within sub‐Saharan Africa, and comprehensive population‐level data on alcohol use remain scarce in numerous sub‐Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Despite Puerto Ricans having one of the highest rates of substance use among Hispanic groups in the United States, limited research has focused on the impact of perceived discrimination and stress on substance use among older adults. Individuals who experience stressful events are inclined to engage in harmful behaviors as a coping mechanism. Objectives: Based on the propositions of the General Strain Theory, the current study explores the relationship between perceived discrimination, perceived stress, social activities, and the use of alcohol and cigarettes. Methods: Baseline data from the Boston Puerto Rican Health Study collected in 2014 was used to conduct a logistic regression analysis. Results: The findings reveal that while perceived discrimination is significantly linked to both types of substance use, social activities may serve as a protective factor for cigarette use. Conclusion/Importance: Our study findings emphasize the need to examine perceived discrimination as a stressor impacting the health and well-being of Puerto Ricans in later adulthood. Policy implications for reducing substance use and directions for future research are discussed [ABSTRACT FROM AUTHOR]

Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexual compulsivity, and cognitive escape in predicting methamphetamine use among SMM living with HIV. Among 423 SMM living with HIV, we tested a structural equation model examining factors hypothesized to be directly and indirectly associated with methamphetamine use. Analyses were adjusted for demographic covariates and sampling bias. The model showed good fit (CFI = 0.96, RMSEA = 0.01). Heterosexist discrimination was associated with psychological distress (β = 0.39, p < 0.001) and psychological distress was associated with sexual compulsivity (β = 0.33, p < 0.001). Sexual compulsivity was associated with cognitive escape (β = 0.31, p < 0.001), which was associated with methamphetamine use (β = 0.51, p < 0.001). Psychological distress was associated with methamphetamine use via serial indirect effects of sexual compulsivity and cognitive escape (β = 0.05, p < 0.05). Heterosexist discrimination contributed to psychological distress among SMM living with HIV. Psychological distress is linked to methamphetamine use via sexual compulsivity and cognitive avoidance. Interventions seeking to reduce the likelihood that SMM living with HIV use methamphetamine should include coping strategies specific to heterosexism and related psychological distress. [ABSTRACT FROM AUTHOR]

BACKGROUND: After traumatic injury, 13% to 14% of patients use the emergency department (ED) and 11% are readmitted within 30 days. Decreasing ED visits and readmission represents a target for quality improvement. This cohort study evaluates risk factors for ED visits and readmission after trauma, focusing on outpatient follow-up. STUDY DESIGN: We conducted a retrospective chart review of adult trauma admissions from January 1, 2018, to December 31, 2021. Our primary exposure was outpatient follow-up, primary outcome was ED use, and secondary outcome was readmission. Multivariable logistic regression evaluated the association between primary exposure and outcomes, adjusting for factors identified on unadjusted analysis. RESULTS: In total, 2,266 patients met inclusion criteria, with an 11.3% ED visit rate and 4.1% readmission rate. Attending follow-up did not have a significant association with ED visit (odds ratio 0.99, 95% CI 0.99 to 2.01, p = 0.05) or readmission rate (odds ratio 1.68, 95% CI 0.95 to 2.99, p = 0.08). Significant associations with ED use included non-White race, depression, anxiety, substance use disorder, discharge disposition, and being discharged with lines or drains. Significant associations with readmission included depression, anxiety, and discharge disposition. CONCLUSIONS: Emphasizing outpatient follow-up in trauma patients is not an effective target to decrease ED use or readmission. Future studies should focus on supporting patients with mental health comorbidities and investigating interventions to optimally engage with trauma patients after hospital discharge. [ABSTRACT FROM AUTHOR]

Lifestyle medicine leverages six pillars—a predominantly plant-based diet, physical activity, sleep, avoiding risky substance, stress management, and social connection. Facilitating behavior change represents the crux of success with each of these pillars. Positive emotions and positive psychology constructs are shown to drive behavior change in the upward spiral theory of lifestyle change. Moreover, positive psychology interventions serve as additional, independent protective health factors. This paper offers a brief review of the empirical evidence for these roles of positive psychology and makes the case for explicitly adding positive psychology to the foundational lifestyle medicine pillars. [ABSTRACT FROM AUTHOR]

Background: Tobacco is one of the major causes of preventable deaths worldwide. Around the world, tobacco is one of the leading causes of tobacco-related cancer. Objectives: To estimate the proportion of tobacco use among tribal adolescents in Terai-Doars region, and to determine the related risk factors. Methodology: A school based cross-sectional study was conducted among 680 tribal adolescent students of government schools in Teria-Dooars region of West Bengal, from April 2022 to October 2022. After obtaining consent, data on socio-demographics and tobacco consumption were collected. Significance was tested using multivariable logistic regression. Results: The proportion of tobacco consumption among tribal adolescent students was found to be 45.7%. Male (58.1%) and female (28.2%) adolescents were found to be regular consumers. Male adolescents primarily prefer smokeless tobacco, with 58% starting their habit between 12-15 years age. Male adolescents preferred smokeless tobacco, with a significant proportion starting their habit between 12-15 years (58%). High consumption of Khaini (52.6%), Guthka (46.6%), and Cigarette (42.4%) is observed. Age (<0.001), sex (<0.001), religion (0.029), socio-economic level (0.004), and family history (0.003) significantly associated with tobacco consumption. Conclusions: Overall proportion of tobacco use was high among the tribal adolescents, with most starting smoking at an early age. The major risk factor that contributed was the family members' tobacco use. [ABSTRACT FROM AUTHOR]

Background and aims: Substance use treatment (SUT) has shown to be effective in reducing self‐reported offending; however, the association between SUT completion and criminal justice system (CJS) contact has been underexplored, especially in Latin America. This study aimed to estimate the association between SUT completion status and (1) any subsequent CJS contact and (2) CJS contact leading to imprisonment, at 1, 3 and 5 years post‐discharge, in Chile. Design: Retrospective cohort study using multivariable survival analysis based on linked administrative data from 2010 to 2019. Setting: This study took place in Chile, where SUT is available at no cost through Chile's publicly funded health‐care, and is provided in outpatient and inpatient modalities in public and private centres. Participants: A total of 70 854 individuals received their first SUT from 2010 to 2019. They were mainly males (76.3%), and their main substance used at admission was cocaine paste (39.2%). Measurements SUT completion status included completion, late dropout (≥ 3 months) and early dropout (< 3 months). Outcomes were (1) any CJS contact and (2) CJS contact leading to imprisonment after baseline treatment. We estimated the association between treatment completion and CJS contact through flexible parametric Royston−Parmar models while adjusting for several covariates. Findings Those who completed SUT (27.2%) were less likely to have any CJS contact at 5 years post‐SUT compared with those who dropped out late [with a gap of −9.5%, 95% confidence interval (CI) = −8.7, −10.3] and early (−11.2%, 95% CI = −10.1, −12.3). Also, those who completed SUT were less likely to have CJS contact leading to imprisonment at 5 years post‐SUT compared with those who dropped out late (−2.6%, 95% CI = −2.2, −3.1) and early (−4.0%, 95% CI = −3.3, −4.6). These differences were also observed at 1 and 3 years post‐SUT for each outcome. Conclusions: In Chile, completion of substance use treatment appears to be associated with lower probabilities of both any criminal justice system contact and contact leading to imprisonment. [ABSTRACT FROM AUTHOR]

Children involved in the juvenile justice system are more likely to struggle with substance abuse and intellectual disabilities. Substance abuse is a major public health concern among young individuals globally, including juvenile felons. This study examines the relationships and factors that influence juvenile felons' substance abuse, intelligence, and delinquent behaviour. This study applies a descriptive cross-sectional survey design using a purposive sampling technique. The participants included 163 male juveniles from Tamil Nadu, India. The psychological measures used for the study were the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) scale, the Standard Progressive Matrices, and the Australian Self-reported Delinquency Scale. According to the study's findings, intelligence does not have a significant impact on juvenile felons' delinquent behaviour. Furthermore, the study identified repeated offences and runaway behaviour as factors that increase the risk of substance abuse. Juvenile felons' substance abuse significantly influences and predicts their delinquent behaviour. [ABSTRACT FROM AUTHOR]

Background: Cannabis use in young adulthood has been associated with exposure to traumatic events and posttraumatic stress disorder (PTSD). Coping motives for cannabis use represent one mechanism linking PTSD with cannabis problems, yet some individuals with PTSD consider their cannabis use to be medicinal in nature. While a medicinal orientation to cannabis overlaps conceptually with coping motives, it could be associated with unique cannabis outcomes. Objectives: This study examined trauma-related coping motives and medicinal cannabis orientation as mediators of the association between PTSD symptoms and cannabis outcomes in young adults. Method: Data came from an online survey of 212 university students (M age = 19.41; 70.3% Women; 43.4% White) who used cannabis in the past month and endorsed a traumatic life event. Path analyses examined associations of PTSD symptoms with past month cannabis frequency and problems through medicinal cannabis orientation (i.e., number of mental health symptoms that cannabis is used to manage) and trauma-related coping motives. Results: PTSD symptoms were associated with trauma-related coping motives but not with medicinal cannabis orientation. Both trauma-related coping motives and medicinal cannabis orientation were uniquely associated with greater cannabis use frequency, but only trauma-related coping motives were associated with greater cannabis problems. There were significant indirect relationships from PTSD symptoms to cannabis use frequency and problems through trauma-related coping motives but not through medicinal cannabis orientation. Conclusions: Results support unique contributions of trauma-related coping motives and medicinal cannabis orientation to cannabis outcomes and suggest that trauma-related coping motives are specifically implicated in the link between PTSD and cannabis problems. [ABSTRACT FROM AUTHOR]

Background: Cannabis use and misuse is known to be associated with a variety of negative health, academic, and work-related outcomes; therefore, it is important to study the factors that contribute to or moderate its use. Objectives: The aim of this study was to determine whether risky behavior, belongingness and social support as clustering variables play a role in cannabis use frequency. Method: In a university student sample, participant data on risky behavior, belongingness and social support were used to generate vulnerability profiles through cluster analysis (low vulnerability with low risk, low vulnerability with high belonging, moderate vulnerability, and high vulnerability). Using an analysis of variance, the vulnerability profiles were compared with respect to cannabis use frequency and quantity. Through chi-square tests we assessed whether these profiles are overrepresented in certain demographics. Results: The cluster analysis yielded four groups, which differed in their vulnerability for cannabis use. The most vulnerable cluster group had higher cannabis use frequency relative to the two least vulnerable groups. Low income vs. high income was also associated with high vulnerability group membership. International students were overrepresented in the low vulnerability with high belonging group relative to the low vulnerability with low-risk group. The opposite was observed for domestic students. Conclusions: This research adds to the expanding body of literature on cannabis use and misuse in Canada, which may contribute to public health policy and the prevention and treatment of cannabis addiction by providing new insight on who may be at risk. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify and compare risk factors of substance use between heterosexual and LGB adults. Using data from the 2020 National Survey on Drug Use and Health (NSDUH), Chi-square, t-test, and standard multiple regressions were employed to analyze the data. The findings showed that LGB participants had significantly higher experiences with substances and initiated substance use earlier than heterosexual participants. Some risk factors were related to experiences with substance use for both groups (i.e. depression, emotional distress, age of first alcohol and marijuana use), but these factors accounted for more of the variance for LGB participants. Additionally, overall health was uniquely associated with experiences with substance use for LGB participants. These results have important implications for the design of culturally appropriate substance use prevention and intervention services for LGB individuals. [ABSTRACT FROM AUTHOR]

The potential risks associated with administration of psychedelic drugs call for a standardized approach to patient informed consent that addresses factors such as potentially disturbing symptoms and the danger of patient exploitation, authors of a recently published article suggest. The diverse contexts for therapeutic use of these substances and the variety of providers potentially involved in their administration necessitate strong informed consent procedures, the authors explained. The special communication was published online April 10, 2024, in JAMA Psychiatry. [ABSTRACT FROM AUTHOR]

In June 2022, Alabama legalized fentanyl test strips (FTS). In response to this new opportunity to prevent overdoses, Project Linkage, Education, and Prevention (LEAP)—an academic–community partnership providing substance use prevention services—quickly purchased FTS and started distributing them in the Birmingham area. We describe how the Addiction Prevention Coalition, a substance use education and harm reduction provider, distributed 7300 FTS in the first year of legalization via Project LEAP and discuss its efforts to decrease substance use among young people. (Am J Public Health. 2024;114(8):785–788. https://doi.org/10.2105/AJPH.2024.307681) [ABSTRACT FROM AUTHOR]

Community violence (CV) is a serious public health concern. To date, most of the existing research has focused on youth of color living in high-risk environments. The prior literature has shown that CV-exposed youth are at risk for post-traumatic stress symptoms (PTSS), delinquency, and substance use. CV has also been tied to beliefs about violence being an acceptable way of resolving conflict, referred to as the Code of the Streets (COS). It is unclear how the trajectories of other CV-exposed populations may differ from vulnerable youth, including college students who are in a developmental period associated with high-risk for violence exposure. The study objectives were therefore to: 1) examine the relations between CV and delinquency (i.e. gang involvement, arrest, weapon ownership) and illicit substance use, as well as 2) investigate whether there are indirect effects between CV and both delinquency and illicit substance use through PTSS and COS beliefs among college students. The sample included 547 students from two universities (Mage = 20.31, SD = 2.08, Range = 18–28; 80.8% female; 57.8% White). CV was associated with delinquency and illicit substance use. COS beliefs had an indirect effect on the relation between CV and delinquency, but PTSS did not. Conversely, PTSS had an indirect effect on the link between CV and illicit substance use, but COS did not. College students are at risk for CV exposure and adverse outcomes. Interventions addressing PTSS and COS beliefs may be central to mitigating delinquent behaviors and illicit substance use in this population. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aims to explore family dynamics and the economic hardships experienced by families during the COVID-19 pandemic and their associations with adolescents' health risk behaviours (HRBs). Methods: Based on a representative study of adolescents aged 11–16 conducted in Bulgaria during the COVID-19 pandemic and HBSC data from the pre-pandemic period, logistic regression models were applied, assessing cigarette smoking, vaping, alcohol use, drunkenness, and cannabis use. The independent variables included demographics, Family Affluence Scale (FAS III), family structure, ease of communication with parents, and the authors' developed questions on parents' income and economic status change, family conflicts, and missing contact with extended family due to the pandemic. Results: Material status of the family showed increasing differentials in adolescents' HRBs during the pandemic. Parental unemployment, income reduction, and temporary lay-offs were associated with a higher risk of substance use. Family conflicts, missing contact with extended family, and difficulties in communication with the mother were related to a higher risk of substance use. Communication with the father was significantly associated with alcohol use and drunkenness. Boys had lower odds of vaping and higher odds of alcohol use, drunkenness, and cannabis use. Higher age and minority status were associated with an increase in adolescents' HRBs. Conclusions: This study highlights the need for special family-focused interventions in times of health and economic crises. [ABSTRACT FROM AUTHOR]

Internally displaced persons (IDPs) are frequently subjected to traumatic events, making them vulnerable to using substances. This study explores predictors and types of substances used by IDPs, prevalence of substance dependence, and reasons for substance use. Cross-sectional survey data were obtained from 520 IDPs living in camps located in Borno State, Nigeria. The Drug Use Disorders Identification Test (DUDIT) was adapted and administered to the participants. IBM SPSS was used to conduct univariate and multivariate linear regression analyses. More than half (66.2%, n = 344) of the survey participants used at least one substance while a third of them (31.2%, n = 162) used more than one substance. About one in ten respondents met the instrument cut-off for dependence. The most popular substance used was Kolanut (46.5%, n = 242). Popular reasons for substance use were availability of substance, influence from others, and having a disease condition. Education, marital status, employment, and number of substances used were significantly associated with substance dependence. A high prevalence of substance use was found among the IDPs. The study highlights the need for intervention in the substance use problem affecting this vulnerable population. [ABSTRACT FROM AUTHOR]

College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, "other" gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field. [ABSTRACT FROM AUTHOR]

Although the influences of extraversion and neuroticism on the relationship between childhood adversity and substance misuse have been considered in adults, they are not yet clear and have not been examined among adolescent samples. This study sought to investigate the relationship between childhood adversity and adolescent substance misuse, alongside the influences of extraversion and neuroticism, using data from a longitudinal birth cohort study. Statistical analyses were performed on a longitudinal dataset provided by the Christchurch Health and Development Study (CHDS). After controlling for confounds, childhood adversity was a significant predictor of substance use disorder symptoms in adolescence. Moderation analyses showed that experiences of childhood adversity were most strongly associated with adolescent substance use disorder symptoms at higher levels of extraversion and at higher levels of neuroticism. Among adolescents who have experienced childhood adversity, extraversion and neuroticism may be risk factors for substance use disorder. By encouraging professionals to target adolescent substance misuse intervention and prevention approaches towards those who have experienced childhood adversity and are high in extraversion and/or neuroticism, these findings may help to diminish the prevalence of adolescent substance misuse and improve the health of adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research study was to describe and compare the prevalence of substance use behaviors in a sample of transgender and nonbinary young adults by gender subgroup (transgender men, transgender women, nonbinary people), and to examine relationships between substance use behaviors, racism, and antitransgender stigma. Methods: This was an analysis of a cross-sectional sample of 215 transgender and nonbinary young adults recruited from the San Francisco Bay area between January 2019 and July 2021. We used multivariable regression models to examine associations between self-reported experiences of antitransgender stigma, racism, and substance use behaviors. Results: Approximately half of the total sample reported recent heavy episodic drinking (52.8%) and club drug use (50.5%); 19.2% reported daily tobacco use, and 35.7% reported daily marijuana use. There were no gender differences in substance use behaviors. Antitransgender stigma was associated with daily marijuana use, heavy episodic drinking, and club drug use (cocaine, amphetamines, hallucinogens). Black/African American participants were more likely to report daily tobacco use and recent heavy episodic drinking than White participants, and multiracial/multiethnic participants reported greater levels of daily tobacco use compared with White participants. In addition to these main effects, a significant interaction between antitransgender stigma and racism on daily marijuana was found, suggesting risk exacerbation due to intersecting stigmas for participants of color. Conclusion: Findings demonstrate a need for prevention and treatment interventions addressing linkages between antitransgender stigma, racism, and substance use behaviors among transgender and nonbinary young adults. [ABSTRACT FROM AUTHOR]

Aims: To estimate the strength of association between psychiatric disorders and substance use disorders (SUD), and cannabis use and cannabis use disorder (CUD) during early pregnancy. Design: Observational study. Setting: Kaiser Permanente Northern California, USA. Participants: 299 496 pregnancies from 227 555 individuals screened for cannabis use by self‐report and a urine toxicology test at entrance to prenatal care in Kaiser Permanente Northern California during January 2011–December 2021 (excepting year 2020). The sample was 62.5% non‐White, with a mean (standard deviation) age of 31.1 (5.5) years; 6.8% used cannabis; 0.2% had a CUD. Measurements: Exposure variables included electronic health record‐based psychiatric diagnoses of attention deficit hyperactivity, anxiety, bipolar, depressive, personality, posttraumatic stress and psychotic disorders; and alcohol, opioid, stimulant and tobacco use disorders, during the two years prior to pregnancy up to the day before the prenatal substance use screening date. Outcome variables were any cannabis use, frequency of self‐reported cannabis use and CUD during early pregnancy. Findings Psychiatric disorder prevalence ranged from 0.2% (psychotic) to 14.3% (anxiety), and SUD ranged from 0.3% (stimulant/opioid) to 3.8% (tobacco). Psychiatric disorders were associated with cannabis use and CUD, with the strongest association for any use found for bipolar disorder (adjusted odds ratio [aOR] = 2.83; 95% confidence interval [CI] = 2.53–3.17) and the strongest association for CUD found for psychotic disorders (aOR = 10.01, 95% CI = 6.52–15.37). SUDs were associated with cannabis use and CUD, with the strongest association for any use found for tobacco use disorder (aOR = 4.03, 95% CI = 3.82–4.24) and the strongest association for CUD found for stimulant use disorder (aOR = 21.99, 95% CI = 16.53–29.26). Anxiety, bipolar, depressive disorders and tobacco use disorder were associated with greater odds of daily than monthly or less cannabis use. Conclusions: Psychiatric disorders and substance use disorders appear to be associated with elevated odds of any and frequent cannabis use as well as cannabis use disorder during early pregnancy. In most cases, the associations with cannabis outcomes were stronger for substance use disorders than other psychiatric disorders. [ABSTRACT FROM AUTHOR]

Rural adolescents are at a greater risk for substance abuse and other mental health challenges. There is a need for enhanced evidence‐based prevention efforts. This case study evaluated both remote and in‐person instruction of Second Step®, a social‐emotional learning (SEL) curriculum aimed to improve school‐based prevention efforts. Second Step® was implemented in a rural Midwestern middle school from Fall 2020 to Spring 2022. Pre‐ and post‐surveys were given to 7th grade (n = 233) and 8th grade (n = 146) students. To evaluate program implementation, t‐tests were conducted. Post‐survey scores were compared to evaluate remote versus in‐person learning. Seventh grade students showed significant improvement of self‐efficacy in overcoming obstacles, and this was expanded via in‐person instruction. Eighth grade students increased knowledge of identifying and disrupting bullying, and the goal‐setting unit showed more success taught via remote instruction. Second Step® shows promise in increasing self‐efficacy and knowledge of SEL topics. Exploratory results suggest both in‐person and remote implementation should be considered. Practitioner Points: Social‐emotional learning (SEL) should be a component of middle school education as a measure for risky behavior prevention and mental health promotion.The Second Step® program may show promise in increasing confidence and knowledge in skills such as overcoming obstacles, goal setting, identity development, and bullying prevention.Both in‐person and remote implementation have potential for improving social‐emotional skills of middle school students. [ABSTRACT FROM AUTHOR]

It is unknown how the Addictions Neuroclinical Assessment markers—negative affect, sensation seeking, and executive function—contribute to substance use development. This study examined whether associations of negative affect and sensation seeking with substance use vary by executive function. Participants were 167 adolescents (47% female) who participated annually for four years (Mage = 14.07, SDage = 0.54 at Time 1). There were within-person bidirectional associations between higher negative affect and higher substance use for adolescents with lower executive function. Adolescents with higher sensation seeking at age 14 exhibited increasing substance use trajectories from age 14 to 17, regardless of executive function level. Negative affect and substance use influence each other within individuals, whereas sensation seeking predicts substance use between individuals. [ABSTRACT FROM AUTHOR]

Background: Latino/a youth are at increased risk of electronic (e)-cigarette or electronic nicotine delivery systems (ENDS) use; thus, identifying factors impacting initiation is critical. Parenting practices reflecting warmth (e.g., relationship quality) and control (e.g., parental monitoring) and substance use-specific parenting (e.g., reactions to use, parenting self-efficacy) may influence youth substance use. For Latino/a youth, tensions from intergenerational acculturative differences are linked to substance use. We investigated ENDS use-specific parenting as a mediator between general parenting and youth ENDS use, examining whether acculturative gap conflict moderated the association between general and ENDS use-specific parenting. We expected mediation among families experiencing low acculturative gap conflicts. Method: Data were analyzed over two waves from a predominantly White and Latino/a sample of caregiver-child dyads (N = 143) who identified with a culture in addition to or distinct from American. Youth (Mage = 14.9 years, SD = 0.67; 62.9% female) reported relationship quality, parental monitoring, caregiver ENDS attitudes and reactions, acculturative gap conflicts, and ENDS use. Caregivers reported on ENDS use-specific parenting self-efficacy. Two moderated multiple mediator regression models (i.e., relationship quality, parental monitoring) were estimated. Results: Among youth reporting low and mean levels of acculturative gap conflict, ENDS use-specific parenting self-efficacy mediated the association between relationship quality and reduced ENDS use. There was no evidence for an interaction in the parental monitoring model. Conclusions: In families experiencing low levels of acculturative gap conflict, relationship quality may impact ENDS use through caregivers' confidence in their ability to prevent child ENDS use. [ABSTRACT FROM AUTHOR]

Background: Although suicide bereavement is associated with suicide and self-harm, evidence regarding mechanisms is lacking. We investigated whether depression and substance use (alcohol and/or other drugs) explain the association between partner suicide bereavement and suicide. Methods: Linkage of nationwide, longitudinal data from Denmark for the period 1980–2016 facilitated a comparison of 22 668 individuals exposed to bereavement by a partner's suicide with 913 402 individuals bereaved by a partner's death due to other causes. Using causal mediation models, we estimated the degree to which depression and substance use (considered separately) mediated the association between suicide bereavement and suicide. Results: Suicide-bereaved partners were found to have a higher risk of suicide (HRadj = 1.59, 95% CI 1.36–1.86) and of depression (ORadj 1.16, 95% CI 1.09–1.25) when compared to other-bereaved partners, but a lower risk of substance use (ORadj 0.83; 95% CI 0.78–0.88). An increased risk of suicide was found among any bereaved individuals with a depression diagnosis recorded post-bereavement (ORadj 3.92, 95% CI 3.55–4.34). Mediation analysis revealed that depression mediated 2% (1.68%; 95% CI 0.23%–3.14%; p = 0.024) of the association between suicide bereavement and suicide in partners when using bereaved controls. Conclusions: Depression is a partial mediator of the association between suicide bereavement and suicide. Efforts to prevent and optimize the treatment of depression in suicide-bereaved people could reduce their suicide risk. Our findings might be conservative because we did not include cases of depression diagnosed in primary care. Further work is needed to understand this and other mediators. [ABSTRACT FROM AUTHOR]

Objective: To identify the lifetime prevalence and correlates of appearance- and performance-enhancing drugs and substances (APEDS) use among a national sample of US college and university students. Participants: Student participants from the 2020–2021 Healthy Minds Study (N = 7,401; ages 18–30 years). Methods: Lifetime prevalence of five forms of APEDS was estimated. Modified Poisson regression analyses were conducted to determine the sociodemographic correlates of protein and creatine supplement use. Results: Lifetime protein (23.8%) and creatine (7.7%) supplement use were most common among the sample. Older age within young adulthood, male sex, perceiving oneself to be normal weight or somewhat overweight, any athletics participation, and 2–3 or ≥ 5 h/week of exercise were associated with greater likelihood of lifetime protein and creatine supplement use. Conclusions: Awareness and prevention efforts on the potential harms of APEDS use are needed on campuses, particularly among males and those who participate in athletics and high-frequency exercise. [ABSTRACT FROM AUTHOR]

Financial debt and associated stress might increase the risk of substance use problems or exacerbate existing ones. Little evidence is available about the degree of debt stress and its association with substance use. The objective of this study was to examine the associations of the frequency of worry about debt with heavy episodic drinking (HED), daily smoking, e-cigarette use, and cannabis use in the past 30 days. Data were utilized from the 2020/2022 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The surveys employed a web-based panel survey of 6038 adults and collected data on debt-related stress, HED, tobacco smoking, e-cigarettes, and cannabis use in the past 30 days. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. Overall, 18.4% of respondents reported that they were worried about their debt most or all of the time. Accounting for household income, educational status, employment status, and other factors, the results revealed that there was a dose-response relationship between the frequency of worry about debt and substance use including daily smoking, e-cigarette use, and cannabis use in the past 30 days compared to those who were not worried at all about their debt. Sex differences were also found in the association between worry about debt and e-cigarette use. The frequency of worry about debt might have an important role in substance use, which suggests that financial well-being is vital in substance use prevention and harm reduction. [ABSTRACT FROM AUTHOR]