Biomedical subjects

James C Anthony

Publications and source records attributed to James C Anthony.

At least 55 records · Page 3Linked to original sources

PubMed2004

The adolescent behavioral repertoire: its latent structure in the PACARDO region of Latin America.

In this study, the authors probed the latent structure of the adolescent behavioral repertoire (ABR) and estimated its sociodemographic correlates. The authors drew a nationally representative sample of 12,797 school-attending youth from the 7 countries in the PACARDO region of Latin America: Panama, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and the Dominican Republic. On the basis of the Behavioral Repertoire Self Report scale (Johanson, Duffy, and Anthony, 1996), the authors identified 5 primary dimensions, including religious behaviors, socializing, sports, home-based activities, and gender socialization activities. The authors found that the levels of involvement in these dimensions of the ABR varied across sociodemographic characteristics. The observed multidimensional structure of the ABR sets the stage for future research on adolescent health in relation to these behaviors and activities.

Adolescent↗

PubMed2003

Epidemiological estimates of risk in the process of becoming dependent upon cocaine: cocaine hydrochloride powder versus crack cocaine.

RATIONALE: To estimate the risk of experiencing clinical features of cocaine dependence within 1-2 years of starting cocaine use, and to examine whether crack smoking might increase this risk. METHODS: A national sample of recent-onset cocaine users was identified within public data files of the National Household Surveys on Drug Abuse (NHSDA) for the years 1995 through 1998. The sample included 572 recent-onset users of cocaine HCl powder but not crack, and 190 recent-onset users of crack, some of whom had also started use of cocaine powder no more than 23 months prior to assessment. A separate group of 93 recent-onset crack users was identified; this comparison group had started using cocaine HCl powder 2+ years before assessment. Cocaine dependence was assessed via seven standardized questions about clinical features experienced within 12 months of assessment, such as feeling unable to cut down. Multivariate response regressions were used to evaluate crack-associated excess risk and clinical profiles of cocaine dependence. RESULTS: Among persons who had recently started to use cocaine HCl powder but not crack cocaine, about 5-12% experienced clinical features of cocaine dependence. Most clinical features occurred 2-3 times more often among crack smoking users as compared to those using powder only, even with statistical adjustment for frequency of cocaine use ( P<0.01). This crack-associated excess risk is more prominent for several clinical features of cocaine dependence, including tolerance associated with cocaine use and narrowed behavioral repertoire attributed to cocaine use. CONCLUSIONS: This new epidemiological evidence suggests that crack-smoking may increase risk of cocaine dependence once cocaine use starts, but we cannot rule out the possibility that crack users start out with a greater susceptibility to become cocaine dependent.

Cocaine↗

PubMed2003

Psychological distress and progression to AIDS in a cohort of injection drug users.

OBJECTIVE: We investigated whether distress was independently associated with more rapid progression to AIDS among HIV-infected injection drug users (IDUs). DESIGN: A cohort study of IDUs in Baltimore followed from 1988 through 1999. A total of 451 IDUs met the eligibility criteria of being HIV-seropositive but AIDS-free at baseline. METHODS: We used Cox proportional hazards models to investigate progression to AIDS within 2 years of baseline, controlling for CD4 lymphocyte count, HIV-1 viral load, and oral thrush. RESULTS: Of the 451 participants, 76.3% were male and 95.8% were African-American; the median age at enrollment was 34 years. The cumulative incidence of AIDS within 2 years of baseline was 7.1%. In multiple regression analysis, distress was associated with more rapid time to AIDS (adjusted relative hazard [RH] = 2.39; 95% CI: 1.16-4.90). The strongest association was observed among IDUs with the lowest (<200 x 10 /L) CD4 counts (adjusted RH = 4.94; 95% CI: 1.30-18.77). CONCLUSIONS: Psychological distress was independently associated with shorter time to AIDS among HIV-infected IDUs, especially among those with the lowest CD4 cell counts, but was not predictive of mortality in this cohort. Further study of the effects of psychological distress on AIDS progression within this population is warranted.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Epidemiologic differences in drug dependence--a US-UK cross-national comparison.

BACKGROUND: Published epidemiologic survey statistics do not allow direct cross-national comparison of drug dependence in the US and the UK, primarily because of a lack of uniformity across case definitions and methods of case ascertainment. AIMS: The current study sought to re-estimate these prevalence values after calibration of case definitions (i. e., imposing methodological constraints to unify case definitions), to identify suspected determinants, and also to investigate symptom profiles among active cases. METHOD: Analyses of data from the US National Household Survey on Drug Abuse and the UK Survey of Psychiatric Morbidity were conducted. Prevalence of active drug dependence symptoms was estimated. Logistic regression analysis was used to estimate the magnitude of the association between suspected socio-demographic variables and drug dependence. RESULTS: The prevalence of drug dependence was an estimated 1.4 % in the US and 0.5 % in the UK. This difference was somewhat attenuated when the effect of living in an urban setting was controlled. Symptom profiles among active cases were very similar. In both countries, being male, non-married, of a low socio-economic status (SES), and living in an urban setting were associated with an increased occurrence of drug dependence. CONCLUSION: There are US-UK differences in prevalence of active drug dependence beyond what available statistics imply and some of this difference can be explained by variations associated with living in urban and rural conditions.

Adolescent↗

PubMed2003

Examining the range of normal intraindividual variability in neuropsychological test performance.

Neuropsychologists often diagnose cerebral dysfunction based, in part, on marked variation in an individual's cognitive test performance. However, little is known about what constitutes the normal range of intraindividual variation. In this study, after excluding 54 individuals with significant health problems, we derived 32 z-transformed scores from 15 tests administered to 197 adult participants in a study of normal aging. The difference between each person's highest and lowest scores was computed to assess his or her maximum discrepancy (MD). The resulting MD values ranged from 1.6 to 6.1 meaning that the smallest MD shown by any person was 1.6 standard deviations (SDs) and the largest MD shown by any person was 6.1 SDs. Sixty-six percent of participants produced MD values that exceeded 3 SDs. Eliminating each person's highest and lowest test scores decreased their MDs, but 27% of the participants still produced MD values exceeding 3. Although MD values appeared to increase with age, adjusting test scores for age, which is standard in clinical practice, did not correct for this. These data reveal that marked intraindividual variability is very common in normal adults, and underscore the need to base diagnostic inferences on clinically recognizable patterns rather than psychometric variability alone.

Aged↗

PubMed2003

Possible age-associated bias in reporting of clinical features of drug dependence: epidemiological evidence on adolescent-onset marijuana use.

AIMS: To probe recent evidence on apparent excess occurrence of marijuana dependence when marijuana smoking starts in adolescence. DESIGN AND PARTICIPANTS: A national sample of recent-onset marijuana users was identified within public data files of the National Household Survey on Drug Abuse (NHSDA), 1995-98 (1,866 adolescents and 762 adults). MEASUREMENTS: Marijuana dependence was assessed via seven standardized questions about its clinical features, such as being unable to cut down. Multivariate response models (GLM/GEE and MIMIC) were used to evaluate adolescent excess risk and possible item biases. FINDINGS: Among people who had just started to use marijuana, clinical features of marijuana dependence occurred twice as often among adolescents compared to adults, even with statistical adjustment for other covariates (P < 0.01 from GLM/GEE). MIMIC analyses suggest that adolescent-onset users have somewhat higher levels of marijuana dependence, and they also provide evidence of age-associated response bias for some but not all clinical features of marijuana dependence. That is, even with level of marijuana dependence held constant, adolescent recent-onset users were more likely than adults to report being unable to cut down (P = 0.01) and tolerance (P = 0.029). CONCLUSION: Nosologic, methodological and substantive reasons for observed age-related excess in occurrence of marijuana dependence problems among early onset users deserve more attention in future research.

Adolescent↗

PubMed2003

Family attention and tobacco smoking among adolescents in Central America, Panama, and the Dominican Republic.

This study examined the association between family attention and tobacco use among 5549 adolescent students in five Central American countries, Panama, and the Dominican Republic who participated in a survey of drug use in 1994. Drug use and other variables were assessed using an adapted version of the Drug Use Screening Inventory (DUSI) in Spanish. Students with the highest level of family attention had a lower occurrence of tobacco smoking than students with the lowest level of family attention. Country-specific analyses show similar associations. These findings underscore the need to understand tobacco use in Central America and neighboring countries and to test whether interventions aimed at enhancing parental-child attention, communication, and monitoring reduce the incidence of tobacco use among youths.

Adolescent↗

PubMed2003

Hanging out with the wrong crowd: how much difference can parents make in an urban environment?

This longitudinal study of youths growing up in an urban area tests whether and by how much increased levels of supervision and monitoring by parents might influence levels of affiliation with delinquent and deviant peers--possibly our most sturdily replicated proximal determinant of early-onset illegal drug use and associated conduct problems in adolescence, aside from aggression and rule-breaking in childhood. Standardized interviews were used to assess parenting, affiliation with deviant peers, and other characteristics of the urban-dwelling youths in this epidemiologically defined sample (>70% African American heritage). Longitudinal analyses and generalized estimating equation (GEE) methods were used to estimate prospective relationships across the transition from late childhood into early adolescence. Results from the longitudinal analyses showed that higher levels of monitoring signaled later lower levels of affiliation with deviant peers, even with statistical adjustment for multiple covariates (beta=-0.04; 95% confidence interval [CI]=-0.07 to -0.02; P=.001). Closer parental supervision at ages 8-9 years was linked to subsequently lower levels of deviant peer affiliation (beta=-0.05; 95% CI=-0.08 to -0.01), and subsequent age-associated increases in levels of parental supervision from year to year were followed by decreases in levels of affiliation with deviant peers (beta=-0.12; 95% CI=-0.15 to -0.09). The main evidence from this study indicates that maintenance of parental supervision and monitoring through the transition from childhood to adolescence may yield important reductions in levels of affiliation with deviant peers, even in the context of our urban and sometimes socially disadvantaged community environments.

Adolescent↗

PubMed2003

Influence of prenatal cocaine exposure on early language development: longitudinal findings from four months to three years of age.

The influence of prenatal cocaine exposure on children's language functioning was evaluated longitudinally at six time points from 4 months to 3 years of age. The Miami Prenatal Cocaine Study prospectively enrolled 476 full-term African-American infants at birth, categorized as cocaine-exposed (n = 253) or non-cocaine-exposed (n = 223) by maternal self-report and bioassays (maternal/infant urine, meconium). The Bayley Scales of Infant Development, scored using the Kent Scoring Adaptation for language, was administered at 4, 8, 12, 18, and 24 months. The Clinical Evaluation of Language Fundamentals-Preschool was administered at 3 years. In longitudinal analyses using Generalized Estimating Equations, cocaine-exposed children had lower overall language skills than non-cocaine-exposed children (D = -0.151; 95% CI = -0.269, -0.033; p =.012). Longitudinal findings remained stable after evaluation of potential confounding influences including other prenatal substance exposures and sociodemographic factors. Preliminary evidence also indicated possible mediation through an intermediary effect involving cocaine-associated deficits in fetal growth.

Case-Control Studies↗

PubMed2003

Behavioral problems and tobacco use among adolescents in Chile.

OBJECTIVE: To examine the association between behavioral problems and tobacco smoking among adolescent students in Chile. METHODS: Data were drawn from a study that included questionnaire surveys of 46 907 school-attending adolescents in all 13 of the administrative regions of Chile. Assessments were based on an adapted, Spanish-language version of the Drug Use Screening Inventory. The conditional form of the logistic regression model was used for analysis, with matching of students on individual schools, and with further statistical adjustments for sex, age, and selected risk factors. RESULTS: The prevalence of tobacco smoking among the adolescents was very high across all of Chile, with a level between 56% and 65% in each of the 13 regions. The estimated odds of tobacco use in youths at the highest level of behavioral problems was about twice that for youths at the lowest levels, both before and after controlling for sex, age, lack of participation in recreational activities, level of irritability, and levels of problems with school, family attention, and mental health. CONCLUSIONS: These findings help to complement and complete the evidence of prior studies on tobacco smoking among adolescents with behavior problems, including recent research on Central American youths. Although the magnitude of observed associations in Chile was not as great as that for the associations found in Central America, both the strength of these associations and their statistical significance were observed throughout Chile. This is the first study in Chile on potentially causal relationships such as these.

Adolescent↗

PubMed2003

Firesetting in adolescence and being aggressive, shy, and rejected by peers: new epidemiologic evidence from a national sample survey.

This population-based case control study examined the hypothesis that the occurrence of firesetting might be greater in youths who exhibit a combination of shyness and aggressiveness and may be complicated by peer rejection. The study's self-report data were from a nationally representative sample survey conducted in 1995. There were 284 cases involving 12- to 17-year-old youths who self-reported recent firesetting, regardless of their intentions. Control subjects were 4,207 youths with no such history. After subjects were matched according to age and neighborhood, conditional logistic regressions were used for estimation. Moderate to strong associations were observed between firesetting and both shyness and aggressiveness (odds ratio [OR] = 6.6; 95% confidence interval [CI] = 2.2-20.4) and feeling highly rejected by peers (OR = 14.5, 95% CI = 3.5-59.6). Independently, boys were 3.8 times more likely to be firesetters (p = .001). Although this cross-sectional study revealed associations of firesetting with shyness and aggressiveness, with evidence of a possibly separate influence of peer rejection, correlation should not be construed as causation. More longitudinal research is needed to clarify temporal sequencing of these characteristics. Prevention trials may indicate whether firesetting can be reduced by amelioration of socially maladaptive behavior and peer rejection as manifested in the child and teenage years.

Adolescent↗

PubMed2002

Reduced incidence of AD with NSAID but not H2 receptor antagonists: the Cache County Study.

BACKGROUND: Previous analyses from the Cache County (UT) Study showed inverse associations between the prevalence of AD and the use of nonsteroidal anti-inflammatory drugs (NSAID), aspirin compounds, or histamine H(2) receptor antagonists (H(2)RA). The authors re-examined these associations using data on incident AD. METHODS: In 1995 to 1996, elderly (aged 65+) county residents were assessed for dementia, with current and former use of NSAID, aspirin, and H(2)RA as well as three other "control" medication classes also noted. Three years later, interval medication histories were obtained and 104 participants with incident AD were identified among 3,227 living participants. Discrete time survival analyses estimated the risk of incident AD in relation to medication use. RESULTS: AD incidence was marginally reduced in those reporting NSAID use at any time. Increased duration of use was associated with greater risk reduction, and the estimated hazard ratio was 0.45 with >/=2 years of exposure. Users of NSAID at baseline showed little reduction in AD incidence, regardless of use thereafter. By contrast, former NSAID users showed substantially reduced incidence (estimated hazard ratio = 0.42), with a trend toward greatest risk reduction among those with extended exposure. Similar patterns appeared with aspirin but not with any other medicines examined. CONCLUSIONS: Long-term NSAID use may reduce the risk of AD, provided such use occurs well before the onset of dementia. More recent exposure seems to offer little protection. Recently initiated randomized trials of NSAID for primary prevention of AD are therefore unlikely to show effects with treatment until participants have been followed for several years.

Aged↗

PubMed2002

Marijuana use and cessation of tobacco smoking in adults from a community sample.

Tobacco smokers are more likely to use marijuana than those who do not smoke tobacco. Little is known about how marijuana use affects the probability of tobacco smoking cessation. This analysis was based on 431 adults less than 45 years of age who reported recent tobacco smoking in the 1981 baseline interview in the household-based Baltimore Epidemiologic Catchment Area study and were re-interviewed 13 years later. At baseline, 41% of the tobacco smokers reported ever use of marijuana, 27% reported use of marijuana in the previous 30 days, and 9% reported daily use of marijuana for 2 weeks or more in the last 30 days. Marijuana users in the past 30 days at baseline were more likely than nonusers to still be using tobacco at follow-up after adjusting for race, educational level and marital status (OR = 1.94, 95% CI = 1.03, 3.63). Daily use of marijuana at baseline was even more strongly related to continued tobacco smoking 13 years later. Difficulty in tobacco cessation might be considered one of the most important adverse effects of marijuana use. Clinicians working with patients who are trying to stop tobacco smoking may be aided by routinely assessing marijuana use history, particularly with the recent increase in co-smoking of marijuana and tobacco.

Adolescent↗

PubMed2002

Into the world of illegal drug use: exposure opportunity and other mechanisms linking the use of alcohol, tobacco, marijuana, and cocaine.

Drawing upon an "exposure opportunity" concept described by Wade Hampton Frost, the authors studied two mechanisms to help account for prior observations about the "stepping-stone" or "gateway" sequences that link the use of alcohol, tobacco, marijuana, and cocaine. Data were obtained from four nationally representative and independent cross-sectional samples of US household residents (n = 44,624 persons aged 12-25 years). Data were gathered using standardized self-report methods and were analyzed via survival methods. Results indicated that users of tobacco and alcohol were more likely than nonusers to have an opportunity to try marijuana and were more likely to actually use marijuana once a marijuana opportunity had occurred. Opportunity to use cocaine was associated with prior marijuana smoking. Among young people with a cocaine opportunity, those who had used marijuana were more likely to use cocaine than were those with no history of marijuana use. The observed associations did not seem to arise solely as a result of young drug users' seeking out opportunities to use drugs. Applying Frost's epidemiologic concept of exposure opportunity, the authors offer new epidemiologic evidence on the sequences that link earlier use of alcohol and tobacco to later illegal drug involvement.

Adolescent↗

PubMed2002

Exposure opportunity as a mechanism linking youth marijuana use to hallucinogen use.

The aim of this study is to shed light upon an observed association between the use of marijuana and hallucinogens (e.g. LSD), with a specific focus on the idea that two separate mechanisms might link marijuana use to hallucinogen use: (1) greater hallucinogen exposure opportunity for marijuana users versus nonusers; (2) increased probability of hallucinogen use for marijuana users versus nonusers, once the opportunity to use hallucinogens has occurred. This work is based on a novel analysis of retrospective, self-report data from more than 40000 young participants in the 1991-1994 National Household Surveys on Drug Abuse (NHSDA), with discrete time survival analysis models. Youths who had used marijuana were substantially more likely than nonusers to have the opportunity to use hallucinogens (estimated unadjusted relative risk, uRR=16.3; 95%. Confidence interval (CI)=14.3-18.6). Once an opportunity to use hallucinogens occurred, marijuana users were more likely than nonusers to initiate hallucinogen use (uRR=12.6; 95% CI=9.0-17.6). This evidence provides a more complete view of interconnections between marijuana use and hallucinogen use, and helps to clarify the pivotal role for drug exposure opportunities. Important next steps will be to understand what accounts for variation in the exposure opportunities experienced by marijuana users, and to understand why some marijuana users do not progress even when they have a chance to do so.

Adolescent↗

PubMed2002

A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

Child↗

PubMed2002

Marijuana use and the risk of Major Depressive Episode. Epidemiological evidence from the United States National Comorbidity Survey.

BACKGROUND: This is an epidemiological study of a possible causal role of marijuana use in the development of Major Depressive Episode (MDE). Male-female differences in the suspected causal association have also been studied. METHOD: Data are from 6,792 National Comorbidity Survey participants aged 15-45 years, assessed via the University of Michigan modified version of the Composite International Diagnostic Interview (UM-CIDI). Survival analysis methods were used to estimate cumulative risk of MDE by levels of marijuana use and to estimate suspected causal associations after adjustment for other influences. RESULTS: The risk of first MDE was moderately associated with the number of occasions of marijuana use and with more advanced stages of marijuana use. Relative to never users, non-dependent marijuana users had 1.6 times greater risk of MDE (95 % Confidence Interval: 1.1, 2.2), even with statistical adjustment for sex, birth cohorts, alcohol dependence, and history of daily tobacco smoking. CONCLUSIONS: There was male-female variation in the degree of association between stage of marijuana involvement and MDE, but the strength of the association is modest at best.

Adolescent↗

PubMed2002

From first drug use to drug dependence; developmental periods of risk for dependence upon marijuana, cocaine, and alcohol.

The focal point of this paper is the transition from drug use to drug dependence. We present new evidence on risk for starting to use marijuana, cocaine, and alcohol, as well as risks for progression from first drug use to the onset of drug dependence, separately for each of these drugs. Data from the National Comorbidity Survey (NCS) were analyzed. The NCS had a representative sample of the United States population ages 15-54 years (n = 8,098). Survival analysis techniques were used to provide age- and time-specific risk estimates of initiating use of marijuana, cocaine, and alcohol, as well as of becoming dependent on each drug. With respect to risk of initiating use, estimated peak values for alcohol and marijuana were found at age 18, about two years earlier than the later peak in risk of initiating cocaine use. With respect to risk of meeting criteria for the clinical dependence syndrome, estimated peak values for alcohol and marijuana were found at age 17-18. Peak values for cocaine dependence were found at age 23-25. Once use began, cocaine dependence emerged early and more explosively, with an estimated 5-6% of cocaine users becoming cocaine dependent in the first year of use. Most of the observed cases of cocaine dependence met criteria for dependence within three years after initial cocaine use. Whereas some 15-16% of cocaine users had developed cocaine dependence within 10 years of first cocaine use, the corresponding values were about 8% for marijuana users, and 12-13% for alcohol users. The most novel findings of this study document a noteworthy risk for quickly developing cocaine dependence after initial cocaine use, with about one in 16 to 20 cocaine users becoming dependent within the first year of cocaine use. For marijuana and alcohol, there is a more insidious onset of the drug dependence syndrome.

Adolescent↗