Examining Cohort Effects in Developmental Trajectories of Substance Use.

The current study demonstrates the application of an analytic approach for incorporating multiple time trends in order to examine the impact of cohort effects on individual trajectories of eight drugs of abuse. Parallel analysis of two independent, longitudinal studies of high-risk youth that span ages 10 to 40 across 23 birth cohorts between 1968 and 1991 was conducted. The two studies include the Michigan Longitudinal Study (current analytic sample of n=579 over 12 cohorts between 1980-1991 and ages 10-27) and the Adolescent/Adult and Family Development Project (current analytic sample of n=849 over 11 cohorts between 1968-1978 and ages 10-40). A series of nonlinear, multi-level growth models controlled simultaneously for cohort and age trends in substance use trajectories. Evidence was found for both age and cohort effects across most outcomes as well as several significant age-by-cohort interactions. Findings suggest cohort trends in developmental trajectories of substance use are sample and drug-specific in the adolescent and early to mid-adult years. Thus, studies that do not control for both trends may confound cohort and developmental trends in substance use. For this reason, demonstration of one analytic approach that can be used to examine both time trends simultaneously is informative for future multi-cohort longitudinal studies where change over time is of interest.

Profiling families in conflict: Multigenerational continuity in conflict predicts deleterious adolescent and adult outcomes.

The present study investigated the associations between multigenerational continuity in family conflict and current psychopathology symptoms and social impairment experienced by parents and adolescents. We sampled 246 families from a multigenerational, high-risk, longitudinal study of parents (G1s) and their children (G2s), followed from adolescence (Mage = 14.3 years, 57% female, 71% Caucasian, 26% Hispanic or Latino) to adulthood as well as the children of G2 targets (G3s; Mage = 12.1 years, 47% female, 51% Caucasian, 33% Hispanic or Latino). Family conflict was measured by composite latent variables incorporating mother, father, and adolescent reports in G1-G2 families and incorporating G2 target, G2 target's spouse, and G3 adolescent report in G2-G3 families. Indicators of G2 and G3 impairment including psychopathology symptoms (e.g., internalizing, externalizing, and substance use symptoms) and social role impairment (e.g., marital satisfaction, parenting behavior) were predicted from G1-G2 family conflict, G2-G3 family conflict, and the interaction between G1-G2 and G2-G3 family conflict. Results indicate that G1-G2 family conflict uniquely predicted indicators of G2 and G3 psychopathology, as well as G2 social impairment, even after controlling for more temporally proximal G2-G3 family conflict. Results further indicate that for G2 externalizing, internalizing, and marital functioning outcomes, high G2-G3 family conflict was associated with highest G2 impairment when G1-G2 family conflict was also high. It appears that for many G2 outcomes the interactive effects of multigenerational conflict are associated with greater risk for impairment. (PsycINFO Database Record

Comparing Psychiatric Symptoms among Children of Substance-Abusing Parents With Different Treatment Histories.

It appears that no studies to date have compared the psychiatric functioning of children of substance-abusing parents (COSs) across substance abuse treatment histories (e.g., inpatient, outpatient, residential). Different treatment histories may reflect differences in the severity of drug use, degree of impairment, or drug of choice, which may result in different symptomatology among COSs. Moreover, this information may be important for family-based treatment and prevention planning. In the current study, we examine psychiatric symptoms experienced by children whose parents have different addiction treatment histories. Eighty-one parents in treatment for a substance use disorder who had a 2-8 year old child completed an anonymous, computerized assessment. Respondents reported on their child's symptomatology as well as their own treatment history and current substance use. Overall, children were remarkably similar in psychiatric functioning and demographic characteristics across parent's treatment histories. However, children whose parents had only received medication management or detoxification had significantly higher somatization scores, more social withdrawal, and greater attention problems than children whose parents received outpatient treatment (but not inpatient/residential treatment). Children whose parents had been treated in an inpatient or residential setting had marginally higher attention problems than children whose parents received outpatient treatment (but not inpatient/residential treatment). Differences across treatment histories were reflected in the severity of psychiatric symptomatology in the young children of parents in treatment. However, given the modest size of these differences, prevention and intervention programs with children of substance-abusing parents may not need to be tailored as a function of parental treatment history as recruitment from various treatment centers may provide a sample with similar characteristics and risk profiles.

Future directions in the developmental science of addictions.

This article addresses important future directions for the study of addictions, emphasizing the incorporation of developmental perspectives into how we think about substance use and disorder as unfolding processes over time and context for a heterogeneous group of individuals. These perspectives articulate complexities in the developmental processes that underlie change and continuity in human behavior over time. We consider two key developmental concepts, namely, "time" and "heterogeneity." We argue that a lack of attention to time sampling creates ambiguity in the meaning of time-linked assessments, challenges in discerning which of multiple clocks may govern behavior, and the inability in some instances to distinguish which of multiple etiological processes may be driving behavior within our samples. Moreover, artificial divisions among disorders that commonly co-occur with substance use are a barrier to the further integration of the study and treatment of addictions with that of psychopathology. Similar to recent changes in the study of psychiatric disorders more broadly, we argue that identifying common deficits among commonly comorbid disorders, rather than patterns of comorbidity per se, is key to identifying early emerging risk factors for substance use and disorder, with important implications for identifying risk populations and developmental periods as well as potentially malleable intervention targets. Attention to time sampling in theory-driven research designs and attempts to identify more homogenous groups of individuals who use and eventually abuse substances over time are two examples of ways to better understand some of the complexity underlying the development of addictions.

Understanding the diverse needs of children whose parents abuse substances.

In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children's negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present.

Anxiety disorders in long-term survivors of adult cancers.

BACKGROUND: Little is known about the prevalence of anxiety disorders among long-term survivors of adult cancers. Using data from the National Comorbidity Survey Replication (NCS-R), we compared rates of anxiety disorders between long-term cancer survivors and individuals without a history of cancer. METHODS: A nationally representative sample of 9282 adults participated in a household survey to assess the prevalence of DSM-IV psychiatric disorders, a subset of whom also answered questions about medical comorbidities, including cancer. Long-term survivors were defined as those who received an adult cancer diagnosis at least 5 years before the survey. Multiple logistic regression analyses were used to examine associations between cancer history and anxiety disorders in the past year. RESULTS: The NCS-R sample consisted of 225 long-term cancer survivors and 5337 people without a history of cancer. Controlling for socio-demographic variables, long-term cancer survivors were more likely to have an anxiety disorder (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.04-2.13), including specific phobia (OR: 1.59, 95% CI: 1.06-2.44) and medical phobia (OR: 3.45, 95% CI: 1.15-10.0), during the past 12 months compared with those without cancer histories. Rates for social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder, and agoraphobia were not significantly different between groups. CONCLUSION: Long-term survivors of adult cancers were more likely to have an anxiety disorder diagnosis, namely specific phobia, in the past 12 months compared with the general public. Further longitudinal study is needed to clarify the timing and course of anxiety relative to the cancer diagnosis.