title: Trajectories of Substance Use Disorder in Youth After Detention: A 12-Year Longitudinal Study.
abstract: OBJECTIVE
  To identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention and how gender, race/ethnicity, and age at baseline predict trajectories.
  
  
  METHODS
  As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois from 1995 through 1998, participants were reinterviewed in the community or correctional facilities up to 9 times over 12 years. Independent interviewers assessed SUDs using the Diagnostic Interview Schedule for Children 2.3 (baseline) and the Diagnostic Interview Schedule IV (follow-ups). Primary outcome was a mutually exclusive 5-category typology of disorder: no SUD, alcohol alone, marijuana alone, comorbid alcohol and marijuana, or "other" illicit ("hard") drug. Trajectories were estimated using growth mixture models with a 3-category ordinal variable derived from the typology.
  
  
  RESULTS
  During the 12-year follow-up, 19.6% of youth did not have an SUD. The remaining 81.4% were in 3 trajectory classes. Class 1 (24.5%), a bell-shaped trajectory, peaked 5 years after baseline when 42.7% had an SUD and 12.5% had comorbid or "other" illicit drug disorders. Class 2 (41.3%) had a higher prevalence of SUD at baseline, 73.8%. Although prevalence decreased over time, 23.5% had an SUD 12 years later. Class 3 (14.6%), the most serious and persistent trajectory, had the highest prevalence of comorbid or "other" illicit drug disorders-52.1% at baseline and 17.4% 12 years later. Males, Hispanics, non-Hispanic whites, and youth who were older at baseline (detention) had the worst outcomes.
  
  
  CONCLUSIONS
  Gender, race/ethnicity, and age at detention predict trajectories of SUDs in delinquent youth. Findings provide an empirical basis for child psychiatry to address health disparities and improve prevention.
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago.
authors.forename: Leah J
authors.initials: LJ
authors.lastname: Welty
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago; Children's Hospital Los Angeles, University of Southern California Center for Excellence in Developmental Disabilities, Los Angeles.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Hershfield
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Abram
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago.
authors.forename: Hongyun
authors.initials: H
authors.lastname: Han
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago.
authors.forename: Gayle R
authors.initials: GR
authors.lastname: Byck
authors.affiliation: Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago. Electronic address: healthdisparities@northwestern.edu.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Teplin
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D000328:Adult; D000367:Age Factors; D002641:Chicago / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000208:ethnology / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult
keywords: delinquents; high-risk youth; longitudinal; substance use disorders; trajectories