title: Triple comorbid trajectories of tobacco, alcohol, and marijuana use as predictors of antisocial personality disorder and generalized anxiety disorder among urban adults.
abstract: OBJECTIVE
  We modeled triple trajectories of tobacco, alcohol, and marijuana use from adolescence to adulthood as predictors of antisocial personality disorder (ASPD) and generalized anxiety disorder (GAD).
  
  
  METHODS
  We assessed urban African American and Puerto Rican participants (n = 816) in the Harlem Longitudinal Development Study, a psychosocial investigation, at 4 time waves (mean ages = 19, 24, 29, and 32 years). We used Mplus to obtain the 3 variable trajectories of tobacco, alcohol, and marijuana use from time 2 to time 5 and then conducted logistic regression analyses.
  
  
  RESULTS
  A 5-trajectory group model, ranging from the use of all 3 substances (23%) to a nonuse group (9%), best fit the data. Membership in the trajectory group that used all 3 substances was associated with an increased likelihood of both ASPD (adjusted odds ratio [AOR] = 6.83; 95% CI = 1.14, 40.74; P < .05) and GAD (AOR = 4.35; 95% CI = 1.63, 11.63; P < .001) in adulthood, as compared with the nonuse group, with control for earlier proxies of these conditions.
  
  
  CONCLUSIONS
  Adults with comorbid tobacco, alcohol, and marijuana use should be evaluated for use of other substances and for ASPD, GAD, and other psychiatric disorders. Treatment programs should address the use of all 3 substances to decrease the likelihood of comorbid psychopathology.
authors.affiliation: Judith S. Brook, Jung Yeon Lee, Elizabeth Rubenstone, and David W. Brook are with the Department of Psychiatry, New York University School of Medicine, New York, NY. Stephen J. Finch is with the Department of Applied Mathematics & Statistics, Stony Brook University, Stony Brook, NY.
authors.forename: Judith S
authors.initials: JS
authors.lastname: Brook
authors.forename: Jung Yeon
authors.initials: JY
authors.lastname: Lee
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rubenstone
authors.forename: David W
authors.initials: DW
authors.lastname: Brook
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Finch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D000987:Antisocial Personality Disorder / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D009519:New York City / Q000453:epidemiology; D064424:Tobacco Use / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult