Emerging Adult Development and Substance Use Disorders

Developmental processes influence emerging adults’ substance use. Such processes may occur both before and during the period of emerging adulthood, which lasts roughly from ages 18 to 29. This chapter begins by reviewing the prevalence of risky substance use and substance use disorders among emerging adults as well as the sequelae of such use. After a brief review of Arnett’s theory of emerging adulthood, the chapter provides an updated review of how the dimensions of emerging adulthood (i.e., identity exploration, feeling in between, self-focus, instability, optimism) are associated with substance use. Also reviewed are the additional risk factors for substance use that likely interact with these dimensions.

Download Full-text

Screening, Assessment, and Diagnosis of Substance Use Disorders among Emerging Adults

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0003 ◽

2017 ◽

pp. 38-70 ◽

Cited By ~ 1

Author(s):

Douglas C. Smith ◽

Kyle M. Bennett ◽

Michael L. Dennis ◽

Rodney Funk

Keyword(s):

Substance Use ◽

Emerging Adults ◽

Substance Use Disorders ◽

Emerging Adult ◽

Assessment Instruments ◽

Specific Research ◽

Dsm 5 ◽

Administration Time ◽

Symptom Patterns ◽

Using Data

Several challenges may hinder accurate screening for and assessment of substance use disorders among emerging adults ages 18–29. This chapter discusses emerging adult–specific research on diagnosing substance use disorders and several empirically supported screeners and assessments that may be useful to those working with emerging adults. First, emerging adult–specific research supporting changes to the most recent version of the Diagnostic and Statistical Manual for Mental Disorders, the DSM-5, is reviewed, and nuances in using the DSM-5 with emerging adults are discussed. The chapter highlights idiosyncrasies in emerging adult symptom patterns using data from large national surveys. Finally, a practice-friendly review of screening and assessment instruments commonly used with emerging adults is provided. For screening instruments, administration time, the instrument’s ability to discern which emerging adults exhibit substance use problems, and emerging adult–specific cutoff points in the literature are addressed. For assessment tools, comprehensiveness of the instrument, administration time, and contexts in which the instrument has been used with emerging adults are discussed.

Download Full-text

Why Should We Focus on Emerging Adults with Substance Use Disorders?

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0001 ◽

2017 ◽

pp. 1-15

Keyword(s):

Substance Use ◽

Emerging Adulthood ◽

Emerging Adults ◽

Substance Use Disorders ◽

First Language ◽

Developmentally Appropriate ◽

Age Groups ◽

Treatment Access ◽

Problematic Substance Use ◽

Problematic Substance

Emerging adulthood (roughly ages 18–29) is the lifespan period when the peak prevalence of substance use disorders (SUD) and substance use occurs. Opportunities for prevention and intervention abound during these years. This chapter provides a brief introduction to the concept of emerging adulthood, as well as a laundry list of terms used to describe problematic substance use. The chapter argues that we must be mindful of using person-first language and, based on available stigma research, advocates for use of the term substance use disorder. The chapter then presents a strong rationale for creating more developmentally appropriate treatments for emerging adults. This rationale is based on three pillars: (1) emerging adults’ current underrepresentation in large outcome studies, (2) existing disparities in treatment outcomes between emerging adults and individuals in other age groups, and (3) the possibility of expanded substance use treatment access under healthcare reform.

Download Full-text

Emerging Adults and Substance Use Disorder Treatment

10.1093/med-psych/9780190490782.001.0001 ◽

2017 ◽

Cited By ~ 2

Keyword(s):

Substance Use ◽

Emerging Adulthood ◽

Emerging Adults ◽

Substance Use Disorder ◽

Emerging Adult ◽

Developmental Theory ◽

Treatment Needs ◽

Substance Use Disorder Treatment ◽

Assessment And Treatment ◽

Disorder Treatment

Emerging adulthood, spanning roughly between ages 18 and 29, is increasingly recognized as a unique period of development within the human lifespan. Unfortunately, the peak prevalence for substance use and related disorders occurs during emerging adulthood. At the nexus of developmental theory and clinical practice, this volume explores the idiosyncrasies associated with the assessment and treatment of substance-related disorders among emerging adults. Comprehensive coverage is provided on the developmental aspects of emerging adulthood, emerging adult–specific substance use screening, assessment, and treatment. In addition, many related special topics are addressed, including U.S. healthcare reform and the Affordable Care Act’s impact on treatment for emerging adults, treatment for aging-out foster youth with substance use disorders, collegiate recovery programs, and treatment needs of emerging adults from privileged and marginalized backgrounds. Throughout the book, readers receive research-informed, yet practical, suggestions for emerging adult substance use disorder treatment.

Download Full-text

The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) and Substance Use Among College Students

Evaluation & the Health Professions ◽

10.1177/0163278716660742 ◽

2016 ◽

Vol 40 (4) ◽

pp. 401-408 ◽

Cited By ~ 1

Author(s):

Jon-Patrick Allem ◽

Steve Sussman ◽

Jennifer B. Unger

Keyword(s):

College Students ◽

Substance Use ◽

Emerging Adulthood ◽

Binge Drinking ◽

Emerging Adults ◽

Transition To Adulthood ◽

Marijuana Use ◽

Future Research ◽

Substance Use Prevention ◽

Identity Exploration

Transition-to-adulthood themes, or thoughts and feelings about emerging adulthood, have been measured by the Inventory of the Dimensions of Emerging Adulthood (IDEA) and found to be associated with substance use among emerging adults. It has been suggested, however, that the IDEA is lengthy and may not include the most unique and theoretically relevant constructs of emerging adulthood. The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) was developed as an alternative instrument, but research has yet to determine the relationship between the IDEA-R and substance use among emerging adults (ages 18–25 years). College students completed surveys indicating their identification with transition-to-adulthood themes and substance use. Logistic regression models examined the associations between transition-to-adulthood themes and marijuana use and binge drinking, respectively. Participants who felt emerging adulthood was a time of identity exploration were less likely to report marijuana use, while feelings of experimentation/possibility were positively associated with marijuana use and binge drinking. The IDEA-R may be useful for identifying correlates of substance use among emerging adults. Future research should evaluate the IDEA-R among representative samples of emerging adults to confirm the findings of this study. Health professionals working in substance use prevention may consider targeting the themes of identity exploration and experimentation/possibility in programs intended for emerging adults.

Download Full-text

Evidence accumulation and associated error-related brain activity as computationally informed prospective predictors of substance use in emerging adulthood

10.1101/2020.03.06.981035 ◽

2020 ◽

Author(s):

Alexander S. Weigard ◽

Sarah J. Brislin ◽

Lora M. Cope ◽

Jillian E. Hardee ◽

Meghan E. Martz ◽

...

Keyword(s):

Risk Factors ◽

Substance Use ◽

Risk Factor ◽

Emerging Adulthood ◽

Emerging Adults ◽

Neural Correlates ◽

Developmental Period ◽

Neurocognitive Performance ◽

Lower Efficiency ◽

Evidence Accumulation

AbstractSubstance use peaks during the developmental period known as emerging adulthood (roughly ages 18–25), but not every individual who uses substances during this period engages in frequent or problematic use. Previous studies have suggested that individual differences in neurocognition may prospectively predict problematic substance use, but mechanistic neurocognitive risk factors with clear links to both behavior and neural circuitry have not yet been identified. Here we take an approach rooted in computational psychiatry, an emerging field in which formal models of neurocognition are used to identify candidate biobehavioral dimensions that confer risk for psychopathology. Specifically, we test whether lower efficiency of evidence accumulation (EEA), a computationally tractable process that drives neurocognitive performance across many tasks, is a risk factor for substance use in emerging adults. In an fMRI substudy within a sociobehavioral longitudinal study (n=106), we find that lower EEA and reductions in a robust neural-level correlate of EEA (error-related activations in salience network and parietal structures) measured at ages 18–21 are both prospectively related to higher levels of substance use during ages 22–26, even after adjusting for other well-known risk factors. Results from Bayesian model comparisons corroborated inferences from conventional hypothesis testing and provided evidence that both EEA and its neural correlates contain unique predictive information about substance use involvement. Overall, these findings suggest that EEA is a mechanistic, computationally tractable neurocognitive risk factor for substance use at a critical developmental period, with clear links to both neural correlates and well-established formal theories of brain function.

Download Full-text

The Role of Different Aspects of Impulsivity as Independent Risk Factors for Substance Use Disorders in Patients with ADHD: A Review

Current Drug Abuse Reviews ◽

10.2174/1874473708666150916112913 ◽

2015 ◽

Vol 8 (2) ◽

pp. 119-133 ◽

Cited By ~ 24

Author(s):

Slobodin Ortal ◽

van de Glind Geurt ◽

Franck Johan ◽

Berger Itai ◽

Yachin Nir ◽

...

Keyword(s):

Risk Factors ◽

Substance Use ◽

Substance Use Disorders ◽

Independent Risk Factors

Download Full-text

Are Mental Health and Substance Use Disorders Risk Factors for Missed Acute Myocardial Infarction Diagnoses Among Chest Pain or Dyspnea Encounters in the Emergency Department?

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2021.08.016 ◽

2021 ◽

Author(s):

Adam L. Sharp ◽

Rani Pallegadda ◽

Aileen Baecker ◽

Stacy Park ◽

Najlla Nassery ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Emergency Department ◽

Substance Use ◽

Chest Pain ◽

Substance Use Disorders

Download Full-text

927-P: Risk of Substance Use Disorders among Adolescents and Emerging Adults with Type 1 Diabetes: A Population-Based Cohort Study

Diabetes ◽

10.2337/db21-927-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 927-P

Author(s):

ANA CREO ◽

SWETHA SRIRAM ◽

LISA VAUGHAN ◽

AMY WEAVER ◽

SEEMA KUMAR

Keyword(s):

Substance Use ◽

Type 1 Diabetes ◽

Cohort Study ◽

Emerging Adults ◽

Substance Use Disorders ◽

Population Based

Download Full-text

Substance Use Relapse Among Veterans at Termination of Treatment for Substance Use Disorders

Military Medicine ◽

10.1093/milmed/usab280 ◽

2021 ◽

Author(s):

Christian A Betancourt ◽

Panagiota Kitsantas ◽

Deborah G Goldberg ◽

Beth A Hawks

Keyword(s):

Risk Factors ◽

Substance Use ◽

Logistic Regression ◽

Substance Use Disorders ◽

Classification Tree ◽

Treatment Completion ◽

Classification Tree Analysis ◽

Data Set ◽

Tree Analysis ◽

Substance Addiction

ABSTRACT Introduction Military veterans continue to struggle with addiction even after receiving treatment for substance use disorders (SUDs). Identifying factors that may influence SUD relapse upon receiving treatment in veteran populations is crucial for intervention and prevention efforts. The purpose of this study was to examine risk factors that contribute to SUD relapse upon treatment completion in a sample of U.S. veterans using logistic regression and classification tree analysis. Materials and Methods Data from the 2017 Treatment Episode Data Set—Discharge (TEDS-D) included 40,909 veteran episode observations. Descriptive statistics and multivariable logistic regression analysis were conducted to determine factors associated with SUD relapse after treatment discharge. Classification trees were constructed to identify high-risk subgroups for substance use after discharge from treatment for SUDs. Results Approximately 94% of the veterans relapsed upon discharge from outpatient or residential SUD treatment. Veterans aged 18-34 years old were significantly less likely to relapse than the 35-64 age group (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.66, 0.82), while males were more likely than females to relapse (OR 1.55, 95% CI: 1.34, 1.79). Unemployed veterans (OR 1.92, 95% CI: 1.67, 2.22) or veterans not in the labor force (OR 1.29, 95% CI: 1.13, 1.47) were more likely to relapse than employed veterans. Homeless vs. independently housed veterans had 3.26 (95% CI: 2.55, 4.17) higher odds of relapse after treatment. Veterans with one arrest vs. none were more likely to relapse (OR 1.52, 95% CI: 1.19, 1.95). Treatment completion was critical to maintain sobriety, as every other type of discharge led to more than double the odds of relapse. Veterans who received care at 24-hour detox facilities were 1.49 (95% CI: 1.23, 1.80) times more likely to relapse than those at rehabilitative/residential treatment facilities. Classification tree analysis indicated that homelessness upon discharge was the most important predictor in SUD relapse among veterans. Conclusion Aside from numerous challenges that veterans face after leaving military service, SUD relapse is intensified by risk factors such as homelessness, unemployment, and insufficient SUD treatment. As treatment and preventive care for SUD relapse is an active field of study, further research on SUD relapse among homeless veterans is necessary to better understand the epidemiology of substance addiction among this vulnerable population. The findings of this study can inform healthcare policy and practices targeting veteran-tailored treatment programs to improve SUD treatment completion and lower substance use after treatment.

Download Full-text