THE LATENT CLASS STRUCTURE OF SUBSTANCE USE IN U.S. ADULTS 50 YEARS AND OLDER

Author(s):  
Ty S. Schepis ◽  
Sean Esteban McCabe
2021 ◽  
pp. 016502542110055
Author(s):  
Benjamin L. Bayly ◽  
Sara A. Vasilenko

To provide a comprehensive view of the unique contexts shaping adolescent development in the U.S., we utilized latent class analysis (LCA) with indicators of risk and protection across multiple domains (family, peers, school, neighborhood) and examined how latent class membership predicted heavy episodic drinking, illicit substance use, and depression in adolescence and 6 years later when participants were young adults. Data came from Wave 1 (W1) and Wave 3 (W3) of the nationally representative U.S.-based Add Health study ( N = 6,649; Mage W1 = 14.06; Mage W3 = 20.38; 53.8% female; 56.1% White/European American, 22.8% Black/African American, 9.5% Hispanic, 6.7% Biracial, Asian or Pacific Islander 4.2%, American Indian/Native American 0.7%). A six-class solution was selected with classes named: Two Parent: Low Risk, Two Parent: Relationship Risks, Two Parent: Neighborhood Risks, Single Parent: Low Risk, Single Parent: Relationship Risks, and Single Parent: Multidimensional Risk. Subsequent analyses suggested that adolescent social relationships are particularly important for prevention interventions as the classes marked by substance using peers and a lack of closeness to parents and teachers in adolescence (Two Parent: Relationship Risks and Single Parent: Relationship Risks) had consistently poorer outcomes in adolescence and young adulthood.


Author(s):  
Gillian C. Williams ◽  
Karen A. Patte ◽  
Mark A. Ferro ◽  
Scott T. Leatherdale

The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.


Author(s):  
Bruce G Taylor ◽  
Weiwei Liu ◽  
Elizabeth A. Mumford

The purpose of this study is to understand the availability of employee wellness programs within law enforcement agencies (LEAs) across the United States, including physical fitness, resilience/wellness, coping skills, nutrition, mental health treatment, and substance use treatment. The research team investigated whether patterns of LEA wellness programming are identifiable and, if so, what characteristics describe these patterns. We assess using latent class analysis whether there are distinct profiles of agencies with similar patterns offering different types of wellness programs and explore what characteristics distinguish agencies with certain profiles of wellness programming. Data were from a nationally representative sample of 1135 LEAs: 80.1% municipal, 18.6% county and 1.3% other agencies (state-level and Bureau of Indian Affairs LEAs). We found that many agencies (62%) offer no wellness programming. We also found that 23% have comprehensive wellness programming, and that another group of agencies specialize in specific wellness programming. About 14% of the agencies have a high probability of providing resilience coping skill education, mental health and/or substance use treatment services programming. About 1% of the agencies in the United States limit their programming to fitness and nutrition, indicating that fitness and nutrition programs are more likely to be offered in concert with other types of wellness programs. The analyses revealed that agencies offering broad program support are more likely to be large, municipal LEAs located in either the West, Midwest or Northeast (compared with the southern United States), and not experiencing a recent budget cut that impacted wellness programming.


2021 ◽  
Vol 23 (1) ◽  
pp. 39-52
Author(s):  
Michele Schmitter ◽  
Jeroen Vermunt ◽  
Eric Blaauw ◽  
Stefan Bogaerts

Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.


2021 ◽  
Author(s):  
Lara Carter ◽  
Lydia Gabriela Speyer ◽  
Arthur Caye ◽  
Luis Augusto Rohde ◽  
Aja Louise Murray

Background: There exists substantial heterogeneity in the developmental trajectories of ADHD symptoms, with distinctions often made between persistent versus remittent, and early- versus late-onset. However, how these trajectories relate to late adolescent functioning and whether, in particular, later onset trajectories mark a milder subtype remains unclear. Methods: We applied latent class growth analysis to data from the UK Millennium Cohort Study (N = 16,703) to evaluate whether developmental trajectories of ADHD symptoms (ages 3-17) were associated with differing levels of impairment in peer problems, mental health, substance use, and delinquency at age 17. Results: Our optimal model included five trajectory groups, labelled unaffected (37.6%), mildly affected (34.8%), subclinical remitting (14.4%), adolescent onset (7.6%), and stable high (5.6%). Adolescent onset and stable high trajectories were similarly impaired across all outcomes, other than substance use. Subclinical remitting individuals were impaired on self-esteem and well-being compared to unaffected individuals. Conclusions: By adolescence, those with a later onset have similar impairments to those following an early onset/persistent trajectory. Residual impairment remains for those on a remitting trajectory.


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