Subtypes for classifying adolescents with marijuana use disorders: construct validity and clinical implications.
OBJECTIVE
To evaluate the construct and predictive validity of six different subtyping classifications selected on the basis of their empirical support in the literature on adolescent substance abuse.


METHODS
Typological data were collected from a heterogeneous sample of 600 adolescents presenting for marijuana treatment. The classification schemes were gender, onset age, family history, externalizing disorders, internalizing disorders and temperament. Subgroups were compared in terms of substance use frequency, substance abuse problems, social support for substance use, family conflict, school problems and negative peer associations.


RESULTS
Each of the categorical classification schemes differentiated subtypes significantly on some or all of the construct validation measures after controlling for demographic factors, thereby indicating that each has valuable explanatory power from a theoretical perspective. Externalizing disorders, onset age, difficult temperament and internalizing disorders continued to add unique variance to discrimination after the effects of the other subtypes had been removed. At 12-month follow-up there were no differences between subtypes on substance use frequency, but adolescents with higher levels of externalizing disorders and internalizing disorders continued to experience more substance use problems.


CONCLUSIONS
Categorical subtypes may have particular relevance to the development of treatment interventions as well as prevention measures.
Babor
Thomas F
TF
Department of Community Medicine and Health Care and Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-6325, USA. babor@nso.uchc.edu
Webb
Charles
C
Burleson
Joseph A
JA
Kaminer
Yifrah
Y
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D017668:Age of Onset; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005192:Family Health; D005196:Family Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D002189:Marijuana Abuse / Q000145:classification / Q000523:psychology* / Q000628:therapy; D015999:Multivariate Analysis; D017678:Sex Distribution; D012944:Social Support