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Biomedical subjects

James C Anthony

Publications and source records attributed to James C Anthony.

At least 19 recordsLinked to original sources
PubMed2007

Childhood antecedents of exposure to traumatic events and posttraumatic stress disorder.

OBJECTIVE: The authors prospectively examined childhood antecedents of exposure to traumatic events to estimate the risk of posttraumatic stress disorder (PTSD) among those exposed to trauma. METHOD: Two consecutive cohorts of children entering first grade of a public school system in a large mid-Atlantic city in the mid-1980s were followed into young adulthood (mean age=21). Exposure to traumatic events and PTSD were assessed in 75% of the original cohort (N=1,698). Childhood assessments, conducted upon entry into the first grade, included standardized measures of reading readiness, teacher ratings of behavioral problems, and child self-reports about depression and anxiety. Family characteristics were assessed by parental report. RESULTS: Young adults who had been rated by their first grade teacher as having aggressive/disruptive behavior problems were more likely to experience traumatic assaultive violence events (e.g., being mugged/threatened with a weapon, badly beaten-up) (relative risk=2.6) but not PTSD following trauma exposure. Youths with high levels of self-rated depressive and anxious feelings in first grade were more likely to experience PTSD once exposed to trauma (relative risk=1.5). Youths who scored in the highest quartile on a reading test in the first grade were at lower risk for exposure to assaultive violence traumas. CONCLUSIONS: Childhood behavioral and depressive/anxious problems may influence the risk for PTSD directly by increasing the vulnerability to the PTSD effects of trauma exposure, and indirectly by increasing the likelihood of exposure to assaultive violence.

Adolescent↗
PubMed2006

Male-female differences in the risk of progression from first use to dependence upon cannabis, cocaine, and alcohol.

INTRODUCTION: We extend prior reports about the risk of dependence on specific drugs by providing developmental-specific risk estimates for progression from first use to meeting criteria for DSM-III-R dependence upon cannabis, cocaine, or alcohol, as well as male-female differences. METHODS: The data are from the National Comorbidity Survey, with a national probability sample of persons 15-44 years old in the United States, which included many respondents who used cannabis, cocaine and alcohol on at least one occasion (n=3558, 1337, and 6149, for cannabis, cocaine, and alcohol, respectively). Survival analysis procedures provided cumulative risk estimates of progression from first use to dependence upon each drug. RESULTS: The estimated risk of cannabis dependence among male cannabis users was 1% in the first year after first use, and reached a peak at 4% per year 2 years later, before declining. In contrast, the estimated risk of cannabis dependence among female cannabis users remained at 1% per year for 3 years, without the peak. For both male and female cocaine users, the estimated risk for developing cocaine dependence was 5 to 6% within the first year after first use. Thereafter, the estimated risk declined from the peak value, with a somewhat faster decline for females in the next 3 years after first use. For alcohol, the estimated risk period extended for many years after the first drink, with female drinkers becoming alcohol dependent at a rate of about 1% per year; with somewhat higher risk for male drinkers. For both male and female drinkers, the period of risk for developing alcohol dependence extended for a span of more than 20 years since first use; for cannabis and cocaine, the estimated period of risk was much shorter. COMMENT: There are male-female differences in the risk of becoming cannabis dependent during the first several years after initiation of cannabis use, less pronounced male-female differences for alcohol, and relatively smaller male-female differences for cocaine. These results should interest scientists whose focus is upon the origins of male-female differences in the occurrence of drug dependence.

Adolescent↗
PubMed2006

Who is becoming hallucinogen dependent soon after hallucinogen use starts?

This study, based upon epidemiological survey data from the United States (U.S.) National Household Surveys on Drug Abuse (NHSDA) from 2000 to 2001, presents new estimates for the risk of developing a hallucinogen dependence syndrome within 24 months after first use of any hallucinogen (median elapsed time approximately 12 months). Subgroup variations in risk of becoming hallucinogen dependent also are explored. Estimates are derived from the NHSDA representative samples of non-institutionalized U.S. residents ages 12 and older (n=114,241). A total of 2035 respondents had used hallucinogens for the first time within 24 months prior to assessment. An estimated 2-3% of these recent-onset hallucinogen users had become dependent on hallucinogens, according to the NHSDA DSM-IV computerized diagnostic algorithm. Controlling for sociodemographic and other drug use covariates, very early first use of hallucinogens (age 10-11 years) is associated with increased risk of hallucinogen dependence (p<0.01). Excess risk of developing hallucinogen dependence was found in association with recent-onset use of mescaline; excess risk also was found for recent-onset users of ecstasy and of PCP. This study's evidence is consistent with prior evidence on a tangible but quite infrequent dependence syndrome soon after the start of hallucinogen use; it offers leads that can be confirmed or disconfirmed in future investigations.

Adolescent↗
PubMed2006

Is there epidemiological evidence to support the idea that a cocaine dependence syndrome emerges soon after onset of cocaine use?

The present study uses latent class methods and multiple regression to shed light on hypothesized cocaine dependence syndromes experienced by community residents, who initiated cocaine use within 24 months of survey assessment, and explores possible variation in risk. Identified within public use data files from the United States National Household Surveys on Drug Abuse (NHSDA), and with assessments completed between 1995 and 1998, the study sample consists of 927 recent-onset cocaine users, defined as having initiated cocaine use no more than 24 months prior to assessment (approximate median elapsed time since onset of use approximately 12-13 months). The NHSDA included items to assess seven clinical features often associated with cocaine dependence, which were used in latent class modeling. Empirically derived latent classes, in conjunction with prior theory, tend to support a three-class solution, according to which 4% of recent-onset users are members of a class that resembles the DSM-IV cocaine dependence syndrome (mean: 5.4 clinical features (CF)); 16% might be in a cocaine dependence prodrome (mean: 2.4 CF); 80% of recent-onset cocaine users had few or no clinical features (mean<1 CF). Results from latent class regressions indicate that susceptibility to rapid transition from first cocaine use to onset of the LCA-assigned cocaine dependence syndrome might depend upon whether the user starts smoking crack-cocaine and, independently, age at first cocaine use.

Adolescent↗
PubMed2006

Drug dependence enviromics: job strain in the work environment and risk of becoming drug-dependent.

In a prospective epidemiologic study of a sample of young adults, the authors estimated the risks of being drug-dependent and becoming drug-dependent in relation to the psychosocial work environment encountered during young adulthood. Data were obtained from two young adult assessments of 2,311 children who entered the first grade of primary school in 1985-1986. A total of 1,692 participants completed the first young adult assessment (YAT0) in 2000-2002, and a follow-up young adult assessment (YAT1) was completed approximately 1 year later. Work environments characterized by high job strain (low job control combined with high job demands assessed at YAT0) signaled a 2- to 3-fold excess risk of being drug-dependent (adjusted prevalence ratio = 2.3, 95% confidence interval: 1.4, 4.0). In reestimation for 861 young adults (61% female) with no drug dependence at YAT0, low job control alone was associated with a 2- to 3-fold excess risk of developing drug dependence (adjusted relative risk = 2.6, 95% confidence interval: 1.1, 6.5) between YAT0 and YAT1. The relative risk estimates did not change appreciably with statistical adjustment for demographic covariates, individual drugs used, childhood predispositional traits, job characteristics, and measurements of socioeconomic status at three time points (first grade, adolescence, and young adulthood).

Adult↗
PubMed2006

Learning disabilities and intellectual functioning in school-aged children with prenatal cocaine exposure.

Risk for developing a learning disability (LD) or impaired intellectual functioning by age 7 was assessed in full-term children with prenatal cocaine exposure drawn from a cohort of 476 children born full term and enrolled prospectively at birth. Intellectual functioning was assessed using the Wechsler Intelligence Scale for Children-Third Edition (Wechsler, 1991) short form, and academic functioning was assessed using the Wechsler Individual Achievement Test (WIAT; Wechsler, 1993) Screener by examiners blind to exposure status. LDs were categorized based on ability-achievement discrepancy scores, using the regression-based predicted achievement method described in the WIAT manual. The sample in this report included 409 children (212 cocaine-exposed, 197 non-cocaine-exposed) from the birth cohort with available data. Cumulative incidence proportions and relative risk values were estimated using STATA software (Statacorp, 2003). No differences were found in the estimate of relative risk for impaired intellectual functioning (IQ below 70) between children with and without prenatal cocaine exposure (estimated relative risk = .95; 95% confidence interval [CI] = 0.65, 1.39; p = .79). The cocaine-exposed children had 2.8 times greater risk of developing a LD by age 7 than non-cocaine-exposed children (95% CI = 1.05, 7.67; p = .038; IQ >/= 70 cutoff). Results remained stable with adjustment for multiple child and caregiver covariates, suggesting that children with prenatal cocaine exposure are at increased risk for developing a learning disability by age 7 when compared to their non-cocaine-exposed peers.

Alcohol Drinking↗
PubMed2005

The Fagerström test for nicotine dependence: a comparison of standard scoring and latent class analysis approaches.

The classification of being tobacco dependent obtained via the established scoring method of the Fagerström test for nicotine dependence (FTND) is compared to a method that bases classification on the pattern of item responses. Young adults participating in a longitudinal study, who indicated they had ever smoked, were asked six standardized items (n = 962; mean age 21 years). By standard scoring, the mean FTND score was 1.9 (S.E.= 2.3): 66% of the smokers qualified for a very low level of dependence, 17% low, 9% moderate, and 9% a high level of dependence. Response patterns detected by latent class analysis (LCA) indicated class differences based on severity gradations and of qualitative content. Three profiles of tobacco dependence were found: a non-dependent class (50%), a class manifesting a moderate number of dependence features (31%), and more severely affected class (19%). The vast majority of smokers (three-fourth) were classified congruently by these two methods. Discrepancies involved LCA classifying smokers into a higher level of dependence when compared to the conventional scoring classification. Patterns of dependence features obtained from population samples that include a wide range of smokers may provide insight into possible phenotypic differences among tobacco smokers, particularly when LCA methods are used to complement standard scoring methods.

Adult↗
PubMed2005

Who becomes cannabis dependent soon after onset of use? Epidemiological evidence from the United States: 2000-2001.

In this paper we estimate the risk of becoming cannabis dependent within 24 months after first use of cannabis and examine subgroup variation in this risk. The study estimates are based on the National Household Survey on Drug Abuse conducted during 2000-2001, with a representative sample of U.S. residents ages 12 and older (n=114,241). A total of 3352 respondents were found to have used cannabis for the first time within a span of up to 24 months prior to assessment. An estimated 3.9% of these recent-onset users developed a cannabis dependence syndrome during the interval since first use (median interval duration approximately 12 months). Excess risk of cannabis dependence was found for those with cannabis onset before late-adolescence, those with family income less than US dollars 20,000, and those who had used three or more drugs before the first use of cannabis (i.e., tobacco, alcohol, and other drugs). While these findings generally support previous study results, this study's focus on recent-onset users more closely approximates prospective and longitudinal research on the incidence (risk) of becoming cannabis dependent soon after onset of cannabis use, removing the influence of users with long-sustained or persistent cannabis dependence developed years ago.

Adolescent↗
PubMed2005

Early onset inhalant use and risk for opiate initiation by young adulthood.

In this study, we estimate a hypothesized link from early onset inhalant use to later use of opiates by young adulthood, with data from an epidemiological sample of 2311 first graders who entered an urban mid-Atlantic public school system in 1985 or 1986 (49.8% male; 67.1% ethnic minority), and who were studied longitudinally to young adulthood. An estimated 9% had initiated inhalant use before the age of 14 and at follow-up in young adulthood an estimated 3% (n=66) of the sample had tried opiates at least once. Youth who used inhalants prior to age 14 were twice as likely to initiate opiate use, as compared to those who had never tried (relative risk 2.2; 95% CI=1.4, 3.3). Statistical adjustment for other covariates attenuated but did not dissolve this relationship. These findings help confirm previously reported evidence that the use of inhalants might be an early marker of vulnerability for future involvement with illegal drugs such as heroin, but an exploratory analysis suggests that there may be no direct inhalants--opiate link once a general early onset susceptibility trait is taken into account.

Administration, Inhalation↗
PubMed2005

The structure of posttraumatic stress disorder: latent class analysis in 2 community samples.

CONTEXT: Latent structure analysis of DSM-IV posttraumatic stress disorder (PTSD) can help clarify how persons who experience traumatic events might be sorted into clusters with respect to their symptom profiles. Classification of persons exposed to traumatic events into clinically homogeneous groups would facilitate further etiologic and treatment research, as well as research on the relationship of trauma and PTSD with other disorders. OBJECTIVES: To examine empirically the structure underlying PTSD criterion symptoms and identify discrete classes with similar symptom profiles. DESIGN: Data on PTSD symptoms from trauma-exposed subsets of 2 community samples were subjected to latent class analysis. The resultant classes were studied in associations with trauma type and indicators of impairment. SETTING: The first sample is from the Detroit Area Survey of Trauma (1899 trauma-exposed respondents with complete data) and the second is from a mid-Atlantic study of young adults conducted by The Johns Hopkins University Prevention Research Center, Baltimore, Md (1377 trauma-exposed respondents with complete data). PARTICIPANTS: Respondents in the 2 community samples who experienced 1 or more qualifying PTSD-level traumatic events. MAIN OUTCOME MEASURES: Number, size, and symptom profiles of latent classes. RESULTS: In both samples, analysis yielded 3 classes: no disturbance, intermediate disturbance, and pervasive disturbance. The classes also varied qualitatively, with emotional numbing distinguishing the class of pervasive disturbance, a class that approximates the subset with DSM-IV PTSD. Members of the pervasive disturbance class were far more likely to report use of medical care and disruptions in life or activities. CONCLUSIONS: The 3-class structure separates trauma-exposed persons with pervasive disturbance (a class that approximates DSM-IV PTSD) from no disturbance and intermediate disturbance, a distinction that also helps identify population subgroups with low risk for any posttrauma disturbance. The results suggest that the structure of PTSD is ordinal and configurational and that emotional numbing differentiates the class with pervasive disturbance. These results should motivate prospective research of persons who have experienced trauma to trace the emergence of posttrauma symptoms and the timing of emotional numbing relative to other symptoms.

Adult↗
PubMed2005

Risk of becoming cocaine dependent: epidemiological estimates for the United States, 2000-2001.

In this paper, we present new estimates for the risk of becoming cocaine dependent within 24 months after first use of the drug, and study subgroup variation in this risk. The study estimates are based on the National Household Survey on Drug Abuse conducted during 2000-2001, with a representative sample of US residents aged 12 years and older (n=114 241). A total of 1081 respondents were found to have used cocaine for the first time within 24 months prior to assessment. Between 5 and 6% of these recent-onset users had become cocaine dependent since onset of use. Less [corrected] risk of recent cocaine dependence soon after onset of cocaine use was found for female subjects, young adults aged 21-25 years, and non-Hispanic Black/African-Americans. Use of crack-cocaine and taking cocaine by injection were associated with having become cocaine dependent soon after onset of use. These epidemiologic findings help to quantify the continuing public health burden associated with new onsets of cocaine use in the 21st century.

Adolescent↗
PubMed2005

Are educational aspirations associated with the risk of alcohol use and alcohol use-related problems among adolescents?

OBJECTIVE: Using prospective data, we hypothesized that public middle school students with high educational aspirations would report less alcohol use, and alcohol use-related problems in the subsequent year. METHODS: The participants for these analyses included students, ages 11 to 14 years old, participating in a longitudinal study in an urban sample of public schools (n = 1229). As part of the prospective annual assessments of the students, in 1992 (to) and 1993 (t1), data on educational aspirations and on alcohol use, and alcohol use-related problems were gathered. Latent variable modeling was used to assess the relationship between educational aspirations at baseline (to) and subsequent year drinking behavior (t1) in two separate models, one to examine the relationship of educational aspirations with self-reported alcohol use (model 1), and another to examine the association with alcohol use-related problems (model 2). Potential confounding by age, sex, race-ethnicity, alcohol use by peers, self-reported school performance, and neighborhood environment was held constant in each model. In addition, each model took into account the prior year report of alcohol use and alcohol use-related problems, respectively. RESULTS: The evidence indicated that students with high aspirations were no more nor less likely to report subsequent alcohol use [beta = 0.15, 95% confidence interval (CI) = -0.19, 0.49; p = 0.38] nor alcohol use-related problems (beta = -0.009, CI = -0.07, 0.06; p = 0.80). Other characteristics were associated with alcohol use at follow-up and included race-ethnicity (being non-Black), neighborhood environment, and having friends who drink alcohol. Characteristics associated with alcohol use-related problems at the time of the follow-up interview also included race-ethnicity, peer drinking, neighborhood environment, as well as older age. CONCLUSIONS: Findings from the current study do not support the hypothesis that educational aspirations have significant influences on alcohol consumption or drinking problems in this study population of urban, predominantly Black students. As such, this work helps to advance our understanding of suspected relationships between educational aspirations, as well as factors associated with resilience to alcohol use and the occurrence of alcohol use-related problems.

Achievement↗
PubMed2005

Cocaine use and the occurrence of panic attacks in the community: a case-crossover approach.

The epidemiologic case-crossover method is a powerful tool for research on suspected hazards of illegal drug use, the advantage being a subject-as-own-control approach that constrains stable individual-level susceptibility traits. Here, we use the case-crossover method to estimate the magnitude of excess occurrence of panic attacks during months of cocaine use vs. months of no cocaine use, motivated by a prior estimate that cocaine users have three-fold excess risk of panic attack. The self-report data on cocaine and panic are from assessments of a nationally representative sample of 1071 recent panic cases age 18 years or older identified as part of the National Household Surveys on Drug Abuse conducted in the United States during 1994-1997. Based on case-crossover estimates, cocaine use is associated with a three- to- four-fold excess occurrence of panic attack (estimated relative risk (RR) = 3.3, p = 0.049; 95% confidence interval: 1.0, 13.7). Year-by-year, the RR estimates from four independent yearly replicates (1994-1997) are 5.0, 2.0, 3.0, and 3.0. While there are several important limitations, this study adds new evidence about a previously reported suspected causal association linking cocaine use to occurrence of panic attacks, and illustrates advantages of the epidemiologic case-crossover approach and new directions in research on hazards of illegal drug use.

Adolescent↗
PubMed2005

Incidence rates for alcohol dependence among adults: prospective data from the Baltimore Epidemiologic Catchment Area Follow-Up Survey, 1981-1996.

OBJECTIVE: Using prospectively gathered data, we assessed cumulative incidence of alcohol dependence using the Diagnostic Interview Schedule (DIS) based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). METHOD: Probability samples of area residents were selected by census tracts and households in five communities of the Epidemiologic Catchment Area Survey program. The baseline interview for the Baltimore site was completed in 1981, and between 1993 and 1996 the original Baltimore site cohort was traced. After excluding individuals with current or prior history of alcohol dependence at the time of the baseline interview, we identified a cohort of 1,642 individuals who were at risk for alcohol dependence. Person-years of risk were calculated, cumulative incidence obtained, and survival analyses completed. RESULTS: Several principal findings that confirm some from studies of shorter follow-up intervals are as follows: (1) incidence of alcohol dependence is consistently greater for men and generally decreases with age; (2) problem drinkers have the highest incidence of dependence, and the male-to-female ratio is attenuated in this group; (3) no differences were found for risk of dependence by racial group; and (4) predictors of alcohol dependence include male gender, young age, not being married and having a history of tobacco smoking. CONCLUSIONS: The current study supplies data on the rate of development of DIS/DSM-III-R alcohol dependence in a population-based sample with an extended interval of follow-up. Methodological considerations in the analysis and interpretation of this type of prospectively gathered data are discussed.

Adolescent↗
PubMed2005

Influences of parenting practices on the risk of having a chance to try cannabis.

BACKGROUND: Parenting practices have been linked with an array of adolescent health-compromising behaviors, but little is known about their possible long-lasting effects. In this study, we estimate the extent to which parental monitoring, parental involvement and reinforcement, and coercive parental discipline during primary school might exert a durable influence on the risk of transitioning into an early stage of youthful cannabis involvement, ie, the first chance to try cannabis. METHODS: Data were from a prospective study of first-graders who entered an urban public school system in the middle 1980s. Parenting was assessed in fourth grade, and cannabis experiences were evaluated during periodic assessments from middle childhood through young adulthood. RESULTS: The estimated risk of the first chance to try cannabis peaked around 16 to 18 years of age. Lower parental involvement and reinforcement and higher coercive parental discipline were associated modestly with a greater risk of cannabis exposure opportunity through the years of adolescence and into early adulthood (parental involvement and reinforcement: adjusted relative risk: 1.4; 95% confidence interval: 1.1-1.7; parental discipline: adjusted relative risk: 1.3; 95% confidence interval: 1.1-1.5); the estimated impact of parental monitoring was less durable. CONCLUSIONS: Early-onset cannabis involvement can be hazardous. Certain parenting practices in the mid-primary school years may have a durable impact, perhaps helping to shield youths from having a chance to try cannabis throughout adolescence and into young adulthood.

Adolescent↗
PubMed2005

Ethnicity as manifest in drug-specific vocabulary and subsequent risk of starting cannabis use in early adolescence.

Working knowledge or vocabulary of drug slang, as a manifestation of learned behavior, might help predict or explain risk of starting to use cannabis in early adolescence. To study this issue, an epidemiologic sample of 1,255 11- to 12-year-olds was assessed for knowledge of cannabis slang terms in 1992, with follow-up in 1993 and 1994. The basic design is that of a prospective and longitudinal study, with recruitment of an epidemiologic sample of children as they entered primary school in a single metropolitan area, also with baseline assessments and randomization to intervention conditions, and subsequent multiple waves of follow-up assessment. Youths assessed in 1992 and who were familiar with terms such as blunts, Mary Jane, roach, and herb were more likely to start using cannabis within the subsequent two years of the follow-up interval, as compared to other youths (estimated relative risk, RR=11.0; 95% CI 3.6-33.7; P<.001). A youth's working vocabulary may signal important variations in health- and disease-related behavior, such as illegal drug use.

Adolescent↗
PubMed2004

The development of suicide ideation and attempts: an epidemiologic study of first graders followed into young adulthood.

Studying community residing youths originally recruited for an intervention trial upon entry into first grade, this project sought to estimate risk of suicide ideation and attempts to young adulthood, with focus on those who used drugs before age 16, as compared to youths who used later in development or not at all. Standardized interview assessments in 1989-1994 were completed with 2311 youths age 8-15. Roughly 15 years after recruitment, our study team reassessed 1695, nearly 75% of the survivors (mean age = 21), finding 155 to have made suicide attempts (SA) and 218 with onset of depression-related suicide ideation (SI). We estimate relative risk (RR), from survival analysis and logistic regression models, to study early use of tobacco, alcohol, cannabis, and inhalants, with covariate adjustments for age, sex, race-ethnicity, and other pertinent covariates. Early-onset of cannabis use and inhalant use for females, but not for males, signaled modestly excess risk of suicide attempt (cannabis-associated RR = 1.9; p = 0.04; inhalant-associated RR = 2.2; p = 0.05). Early-onset of cannabis use by females (but not for males) signaled excess risk for suicide ideation (RR = 2.9; p = 0.006). Early-onset alcohol and tobacco use were not associated with later risk of SA or SI. In light of the relatively modest strength of association, the evidence may well reflect an underlying common diathesis or unmeasured prior confounding influences that link early-onset illegal drug use with later risk of these suicide-related events, rather than an influence of early-onset drug use per se.

Adolescent↗