Developmental pathways of adolescent cannabis use: Risk factors, outcomes and sex-specific differences

Abstract

Background: Characterizing patterns of adolescent cannabis use (CU), as well as risk factors and outcomes uniquely associated with these pathways is essential for informing treatment and prevention efforts. Yet, few studies have examined these issues among youth at-risk of engaging in problematic cannabis use. Further, research accounting for use of other substances or sex differences in patterns of CU remains exceedingly sparse. Methods: Trajectory-based modeling was used to identify underlying CU pathways among a predominantly Hispanic (90%) sample of at-risk youth (n=401; 46% female) across adolescence (ages~14–18), controlling for baseline substance use and participant demographics. Adolescent psychopathology (i.e., conduct disorder, ADHD, anxiety, depression) was examined as a predictor and outcome of CU. Results: Three trajectories of adolescent CU were identified, with most youth (74%) engaging in relatively ‘low’ levels of use, followed by approximately 12% exhibiting an early-initiating ‘chronic’ course, and 14% ‘escalating’ in use. Although boys and girls both experienced increased levels of CU across adolescence, boys were more likely to exhibit escalating and chronic patterns of use. Findings revealed unique associations between adolescent CU pathways and facets of psychopathlogy; most notably, the relatively robust and bidirectional association between CU trajectories and conduct problem symptoms. Conclusions: Specific facets of psychopathology may confer unique associations with CU across development, including the initiation and exacerbation of CU during adolescence.

Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

“…Three different U.S. based studies independently found that cannabis use trajectory group status was not predictive of increased anxiety levels or lifetime anxiety diagnosis in adulthood. 28,37,44 For instance, in a cohort of 401 adolescents with chronic, escalating, and low cannabis use, anxiety outcome did not differ across groups at 2-year follow-up (χ 2 = 0.12, df = 2, P = .94). 44 One small study from 1985 focused on the adult population and found 11 out of 97 regular cannabis users were newly diagnosed with anxiety disorders at follow-up 6 to 7 years later, but this increase in prevalence was not considered to be statistically significant.…”

“…28,37,44 For instance, in a cohort of 401 adolescents with chronic, escalating, and low cannabis use, anxiety outcome did not differ across groups at 2-year follow-up (χ 2 = 0.12, df = 2, P = .94). 44 One small study from 1985 focused on the adult population and found 11 out of 97 regular cannabis users were newly diagnosed with anxiety disorders at follow-up 6 to 7 years later, but this increase in prevalence was not considered to be statistically significant. 24 In another study of 2,429 U.S. youth, latent growth modeling suggested GAD symptoms at 10-year follow-up were predicted by higher probability of cannabis and tobacco couse, but not cannabis use alone (intercept estimate = −0.01, slope estimate = 0.00, P > 0.05).…”

Decision-Making as a Latent Construct and its Measurement Invariance in a Large Sample of Adolescent Cannabis Users

“…The majority of the sample (90%) reported some use, even if minimal, of either alcohol, cigarettes, or other drugs at time of screening. Additional information on participant selection can be found in prior publications with this cohort (Duperrouzel et al, in press; Hawes, Trucco, Duperrouzel, Coxe, & Gonzalez, 2018; Lopez-Quintero et al, 2018; Ross, Graziano, Pacheco-Colón, Coxe, & Gonzalez, 2016). Participants were also between the ages of 14 and 17 at baseline, and able to read and write English.…”

Youth’s Proximity to Marijuana Retailers and Advertisements: Factors Associated with Washington State Adolescents’ Intentions to Use Marijuana

“…Age, gender, and socioeconomic factors were found to be associated with marijuana use in previous studies (Hawes, Trucco, Duperrouzel, Coxe, & Gonzalez, 2019;Widome, Wall, Laska, Eisenberg, & Neumark-Sztainer, 2013), and so we controlled for these demographic characteristics. Age was measured by years (ratio scale), gender was coded as a binary variable (male = 1, other = 0), and socioeconomic status was measured by a self-reported status of receiving free or reduced lunch at school (yes = 1, no = 0).…”