IMPORTANCELittle is known about changes in marijuana use and cannabis use disorder (CUD) after recreational marijuana legalization (RML).OBJECTIVES To examine the associations between RML enactment and changes in marijuana use, frequent use, and CUD in the United States from 2008 to 2016. DESIGN, SETTING, AND PARTICIPANTSThis survey study used repeated cross-sectional survey data from the National Survey on Drug Use and Health (2008-2016) conducted in the United States among participants in the age groups of 12 to 17, 18 to 25, and 26 years or older.INTERVENTIONS Multilevel logistic regression models were fit to obtain estimates of before-vs-after changes in marijuana use among respondents in states enacting RML compared to changes in other states.MAIN OUTCOMES AND MEASURES Self-reported past-month marijuana use, past-month frequent marijuana use, past-month frequent use among past-month users, past-year CUD, and past-year CUD among past-year users. RESULTSThe study included 505 796 respondents consisting of 51.51% females and 77.24% participants 26 years or older. Among the total, 65.43% were white, 11.90% black, 15.36% Hispanic, and 7.31% of other race/ethnicity. Among respondents aged 12 to 17 years, past-year CUD increased from 2.18% to 2.72% after RML enactment, a 25% higher increase than that for the same age group in states that did not enact RML (odds ratio [OR], 1.25; 95% CI, 1.01-1.55). Among past-year marijuana users in this age group, CUD increased from 22.80% to 27.20% (OR, 1.27; 95% CI, 1.01-1.59). Unmeasured confounders would need to be more prevalent in RML states and increase the risk of cannabis use by 1.08 to 1.11 times to explain observed results, indicating results that are sensitive to omitted variables. No associations were found among the respondents aged 18 to 25 years. Among respondents 26 years or older, past-month marijuana use after RML enactment increased from 5.65% to 7.10% (OR, 1.28; 95% CI, 1.16-1.40), past-month frequent use from 2.13% to 2.62% (OR, 1.24; 95% CI, 1.08-1.41), and past-year CUD from 0.90% to 1.23% (OR, 1.36; 95% CI, 1.08-1.71); these results were more robust to unmeasured confounding. Among marijuana users in this age group, past-month frequent marijuana use and past-year CUD did not increase after RML enactment.CONCLUSIONS AND RELEVANCE This study's findings suggest that although marijuana legalization advanced social justice goals, the small post-RML increase in risk for CUD among respondents aged 12 to 17 years and increased frequent use and CUD among adults 26 years or older in this study are a potential public health concern. To undertake prevention efforts, further studies are warranted to assess how these increases occur and to identify subpopulations that may be especially vulnerable.
BACKGROUND: Average nightly sleep times precipitously decline from childhood through adolescence. There is increasing concern that historical shifts also occur in overall adolescent sleep time.METHODS: Data were drawn from Monitoring the Future, a yearly, nationally representative crosssectional survey of adolescents in the United States from 1991 to 2012 (N = 272 077) representing birth cohorts from 1973 to 2000. Adolescents were asked how often they get $7 hours of sleep and how often they get less sleep than they should. Age-period-cohort models were estimated.RESULTS: Adolescent sleep generally declined over 20 years; the largest change occurred between 1991-1995 and 1996-2000. Age-period-cohort analyses indicate adolescent sleep is best described across demographic subgroups by an age effect, with sleep decreasing across adolescence, and a period effect, indicating that sleep is consistently decreasing, especially in the late 1990s and early 2000s. There was also a cohort effect among some subgroups, including male subjects, white subjects, and those in urban areas, with the earliest cohorts obtaining more sleep. Girls were less likely to report getting $7 hours of sleep compared with boys, as were racial/ethnic minorities, students living in urban areas, and those of low socioeconomic status (SES). However, racial/ethnic minorities and adolescents of low SES were more likely to self-report adequate sleep, compared with white subjects and those of higher SES.CONCLUSIONS: Declines in self-reported adolescent sleep across the last 20 years are concerning. Mismatch between perceptions of adequate sleep and actual reported sleep times for racial/ ethnic minorities and adolescents of low SES are additionally concerning and suggest that health education and literacy approaches may be warranted. WHAT'S KNOWN ON THIS SUBJECT:Adequate sleep is critical for adolescent health. Available data suggest a historical downward trend in sleep behavior, but there has been no rigorous evaluation of recent US trends. WHAT THIS STUDY ADDS:The proportion of adolescents who regularly obtain $7 hours of sleep is decreasing. Decreases in sleep exhibit period effects that are constant across adolescents according to gender, race, socioeconomic factors, and urbanicity. The gender gap in adequate sleep is widening. Dr Keyes drafted the manuscript and led the statistical analysis; Dr Maslowsky supervised the statistical analysis and drafted critical sections of the manuscript; Ms Hamilton conducted the statistical analysis and drafted critical sections of the manuscript; and Dr Schulenberg assisted in the design and implementation of the parent study and provided critical feedback and revisions on the analysis plan and manuscript drafts; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi
Despite calls to incorporate population science into neuroimaging research, most studies recruit small, non-representative samples. Here, we examine whether sample composition influences age-related variation in global measurements of gray matter volume, thickness, and surface area. We apply sample weights to structural brain imaging data from a community-based sample of children aged 3–18 (N = 1162) to create a “weighted sample” that approximates the distribution of socioeconomic status, race/ethnicity, and sex in the U.S. Census. We compare associations between age and brain structure in this weighted sample to estimates from the original sample with no sample weights applied (i.e., unweighted). Compared to the unweighted sample, we observe earlier maturation of cortical and sub-cortical structures, and patterns of brain maturation that better reflect known developmental trajectories in the weighted sample. Our empirical demonstration of bias introduced by non-representative sampling in this neuroimaging cohort suggests that sample composition may influence understanding of fundamental neural processes.
Background Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6–11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Methods Data were collected on 7682 children for whom either parent- or teacher SDQ were completed. Results The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems. Conclusions As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress.
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