title: When psychopathology matters most: identifying sensitive periods when within-person changes in conduct, affective and anxiety problems are associated with male adolescent substance use.
abstract: OBJECTIVE
  There is a documented link between common psychiatric disorders and substance use in adolescent males. This study addressed two key questions: (1) is there a within-person association between an increase in psychiatric problems and an increase in substance use among adolescent males and (2) are there sensitive periods during male adolescence when such associations are more evident?
  
  
  METHODS
  Analysis of longitudinal data collected annually on boys selected randomly from schools based on a comprehensive public school enrollment list from the Pittsburgh Board of Education.
  
  
  METHODS
  Recruitment occurred in public schools in Pittsburgh, Pennsylvania, USA.
  
  
  METHODS
  A total of 503 boys assessed at ages 13-19 years, average cooperation rate = 92.1%.
  
  
  METHODS
  Diagnostic and Statistical Manual (DSM)-oriented affective, anxiety and conduct disorder problems were measured with items from the caregiver, teacher and youth version of the Achenbach scales. Scales were converted to t-scores using age- and gender-based national norms and combined by taking the average across informants. Alcohol and marijuana use were assessed semi-annually by a 16-item Substance Use Scale adapted from the National Youth Survey.
  
  
  RESULTS
  When male adolescents experienced a 1-unit increase in their conduct problems t-score, their rate of marijuana use subsequently increased by 1.03 [95% confidence interval (CI) = 1.01, 1.05], and alcohol quantity increased by 1.01 (95% CI = 1.0002, 1.02). When adolescents experienced a 1-unit increase in their average quantity of alcohol use, their anxiety problems t-score subsequently increased by 0.12 (95% CI = 0.05, 0.19). These associations were strongest in early and late adolescence.
  
  
  CONCLUSIONS
  When adolescent boys experience an increase in conduct disorder problems, they are more likely to exhibit a subsequent escalation in substance use. As adolescent boys increase their intensity of alcohol use, they become more likely to develop subsequent anxiety problems. Developmental turning points such as early and late adolescence appear to be particularly sensitive periods for boys to develop comorbid patterns of psychiatric problems and substance use.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of California, Davis, CA, USA.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cerdá
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Prins
authors.affiliation: Boston University School of Public Health, Boston, MA, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
authors.forename: Chanelle J
authors.initials: CJ
authors.lastname: Howe
authors.affiliation: School of Criminology and Criminal Justice at Arizona State University, Phoenix, AZ, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Pardini
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001008:Anxiety Disorders / Q000150:complications* / Q000453:epidemiology; D019955:Conduct Disorder / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000150:complications* / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; comorbidity; conduct disorder; depression; substance use