Death of the 'stepping-stone' hypothesis and the 'gateway' model? Comments on Morral et al.
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Adolescent↗
Biomedical subjects
James C Anthony
Publications and source records attributed to James C Anthony.
The association of tobacco smoking and depression in adolescence: evidence from the United States.
INTRODUCTION: We examine a suspected causal association between tobacco smoking and depression. Using data from the National Household Survey on Drug Abuse (NHSDA), we explore variation in depression severity among current and former smokers compared to nonsmokers. We focus on the association between time since last smoke in former smokers and depression severity, to examine whether the level of tobacco-depression relationship might vary in a time-dependent fashion. METHODS: Our cross-sectional data come from three public use files of the U.S. National Household Survey on Drug Abuse (NHSDA), collected with different respondents each year from 1994 to 1996, for participants 12-17 years old (N = 13,827). Ordinal logistic regression is used to assess the association between severity of depression and cigarette smoking among former and current smokers. RESULTS: Current smokers had the highest odds for depression, followed by former smokers, then nonsmokers. Females had higher odds of depression compared to males. The odds of depression varied in subgroups of former smokers. Odds of depression were lower with more elapsed time since last smoke. DISCUSSION: We add new evidence on depression in association with tobacco smoking. Teens who quit smoking may reduce their odds of depressed mood, but more research is needed before a definite causal path can be established.
Adolescent↗
Regional variation in drug purchase opportunity among youths in the United States, 1996-1997.
This study was designed to examine geographic variation in illegal drug purchase opportunity among young people living in the United States; there was a subfocus on age, sex, and urban/rural residence. Data from the 1996-1997 National Household Surveys on Drug Abuse were analyzed; the nationally representative sample of community residents included 21,531 participants aged 12-24 years old. Respondents were asked if someone had approached them to sell them an illegal drug during the past 30 days. To protect respondents' confidentiality, there is no finegrained geographical coding of data in the National Household Surveys on Drug Abuse public use data files, but nine geographical divisional indicators are provided (i.e., West North Central, New England, etc.). Results indicated males were an estimated 1.8 times more likely than females to have had a recent illicit drug purchase opportunity, and urban residents were 1.5 times more likely than rural residents to have had a recent drug purchase opportunity. As for geographic divisions, the Pacific division surpassed all other divisions: Its residents were 1.5 times more likely to have recent drug purchase opportunities than the West North Central division (used here as a reference category). After controlling statistically for age, sex, and urban/rural residence, residence in four divisions was found to be associated with greater likelihood of an illicit drug purchase opportunity. The observed patterns of drug purchase opportunity add new features to our understanding of illicit drug involvement across the United States.
Adolescent↗
Maternal cocaine use: estimated effects on mother-child play interactions in the preschool period.
The study objective was to evaluate the quality of parent-child interactions in preschool-aged children exposed prenatally to cocaine. African-American mothers and their full-term newborns (n = 343) were enrolled prospectively at birth and classified as either prenatally cocaine-exposed (n = 157) or non-cocaine-exposed (n = 186) on the basis of maternal self-report and bioassays. Follow-up evaluations at 3 years of age (mean age, 40 mo) included a videotaped dyadic play session and maternal interviews to assess ongoing drug use and maternal psychological distress. Play interactions were coded using a modified version of Egeland et al's Teaching Task coding scheme. Regression analyses indicated cocaine-associated deficits in mother-child interaction, even with statistical adjustment for multiple suspected influences on interaction dynamics. Mother-child interactions were most impaired in cocaine-exposed dyads when the mother continued to report cocaine use at the 3-year follow-up. Multivariate profile analysis of the Egeland interaction subscales indicated greater maternal intrusiveness and hostility, poorer quality of instruction, lower maternal confidence, and diminished child persistence in the cocaine-exposed dyads.
Adult↗
Is pharmacological prevention of Alzheimer's a realistic goal?
A growing body of evidence suggests that several classes of drugs marketed for other indications may be effective in the prevention of Alzheimer's disease. Among the most promising of these are nonsteroidal anti-inflammatory agents, oestrogens (oestrogen replacement therapy) and antioxidant vitamins. Other less well-established candidates include histamine H(2) receptor antagonists (H(2) blockers) and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). For each of these, we discuss possible mechanisms for their postulated neuroprotective effects and review the studies suggesting their benefits in Alzheimer's disease. We conclude that nonsteroidal anti-inflammatory drugs and oestrogen replacement therapies may be effective in preventing Alzheimer's disease only if taken during the latent phase of the disease several years prior to the appearance of disturbances. Antioxidants may also prevent Alzheimer's disease, but unlike nonsteroidal anti-inflammatory drugs and oestrogen replacement therapies, they may continue to have beneficial effects even after the clinical onset of the disease. The only way to demonstrate the efficacy of these agents will be through randomised, controlled prevention trials. Such trials are currently underway but conclusive results may not be available for several years. Although intriguing, more studies on the neuroprotective effects of statins and H(2) blockers are needed before trials of these agents are initiated. Finally, there are other classes of pharmacological compounds emerging on the horizon, including folic acid, anti-beta-sheet conformational agents, secretase inhibitors and vaccines, that may soon prove to be effective for the prevention of Alzheimer's disease.
Alzheimer Disease↗
Behavioral problems and tobacco use among adolescents in Central America and the Dominican Republic.
OBJECTIVES: The purpose of this study was to examine the association between behavioral problems and tobacco use among adolescent students in six countries of Central America and in the Dominican Republic. METHODS: Data were drawn from a multinational collaborative study that included questionnaire surveys of between 451 and 1,170 school-attending adolescents in each of the seven countries studied. Assessments were based on an adapted, Spanish-language version of the Drug Use Screening Inventory (DUSI). The conditional form of logistic regression was employed for analysis, matching students on type of school and area, with further statistical adjustments for sex, age, and selected risk factors. RESULTS: Occurrence of tobacco use was observed to vary dramatically from country to country. Nonetheless, for the combined group of countries, the estimated odds of tobacco use in youths at the highest levels of behavioral problems was more than five times that for youths at the lowest levels, after controlling for sex, age, lack of participation in recreational activities, level of irritability, and levels of problems with school, family, and mental health. Country-specific analyses show that youths at the highest levels of behavioral problems have a consistently greater occurrence of tobacco use as compared to youths at the lowest levels of behavioral problems. CONCLUSIONS: These findings are concordant with prior studies on tobacco use among adolescents with behavioral problems. Although the magnitude of observed associations varied according to the country of residence, the strength of these associations and their significance by conventional standards were observed in nearly all the countries sampled. This is the first study in these seven countries on potentially causal relationships such as these. More research is needed to augment our knowledge regarding the observed cross-country differences and ultimately to develop, implement, and evaluate effective tobacco preventive intervention programs.
Adolescent↗
Longitudinal influence of prenatal cocaine exposure on child language functioning.
The present study estimates the longitudinal effects of in utero cocaine exposure on language functioning at 3, 5 and 7 years of age in an urban sample of 443 full-term children (236 cocaine-exposed and 207 noncocaine-exposed) participating in the Miami Prenatal Cocaine Study. The sample was enrolled prospectively at birth, with documentation of prenatal drug exposure status through maternal interview and urine and meconium toxicology assays. Language functioning was measured at ages 3 and 5 years using the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P) and at age 7 years using the Core Language Domain of the NEPSY: A Developmental Neuropsychological Assessment. Longitudinal Generalized Linear Model and Generalized Estimating Equations (GLM/GEE) analyses revealed an association between prenatal cocaine exposure and deficits in total language functioning after statistically controlling for child sex, visit age, prenatal exposure to alcohol, marijuana and tobacco and over 20 additional medical and sociodemographic covariates drawn from potentially confounding influences assessed at birth and follow-up visits (D=-0.17; 95% CI=-0.32, -0.03; P=.019). The link from prenatal cocaine exposure to later language deficits does not appear to be mediated by cocaine-associated deficits in birth weight, length or head circumference. Overall, the evidence tends to support an inference of a stable cocaine-specific effect on indicators of language functioning during early childhood through age 7 years.
Adult↗
Behavioral outcome of preschoolers exposed prenatally to cocaine: role of maternal behavioral health.
OBJECTIVE: To examine the impact of prenatal cocaine exposure and maternal behavioral health (recent drug use and psychological functioning) on child behavior at age 5 years. METHOD: In this longitudinal investigation, maternal report of child behavior was assessed using the Achenbach Child Behavior Checklist (CBCL) in 140 cocaine-exposed and 181 noncocaine-exposed (61 alcohol, tobacco, and/or marijuana-exposed, and 120 nondrug-exposed) low-income, African American children. Structural equation modeling was used to estimate suspected causal relationships between indicators of maternal behavioral health at 5-year follow-up, according to self-report on a modified Addiction Severity Index (ASI) and CBCL scores. RESULTS: Prenatal cocaine exposure was not related to child behavior at age 5. Recent maternal drug use and psychological functioning had relationships with CBCL Internalizing and Externalizing scores. However, when considered within a combined model, only maternal psychological functioning remained significant. CONCLUSIONS: Findings highlight the importance of maternal functioning in the behavioral outcome of children exposed prenatally to cocaine.
Black or African American↗
Prenatal cocaine exposure: an examination of childhood externalizing and internalizing behavior problems at age 7 years.
AIM: This study examines the relationship between prenatal cocaine exposure and parent-reported child behavior problems at age 7 years. METHODS: Data are from 407 African-American children (210 cocaine-exposed, 197 non-cocaine-exposed) enrolled prospectively at birth in a longitudinal study on the neurodevelopmental consequences of in utero exposure to cocaine. Prenatal cocaine exposure was assessed at delivery through maternal self-report and bioassays (maternal and infant urine and infant meconium). The Achenbach Child Behavior Checklist (CBCL), a measure of childhood externalizing and internalizing behavior problems, was completed by the child's current primary caregiver during an assessment visit scheduled when the child was seven years old. RESULTS: Structural equation and GLM/GEE models disclosed no association linking prenatal cocaine exposure status or level of cocaine exposure to child behavior (CBCL Externalizing and Internalizing scores or the eight CBCL subscale scores). CONCLUSIONS: This evidence, based on standardized ratings by the current primary caregiver, fails to support hypothesized cocaine-associated behavioral problems in school-aged children with in utero cocaine exposure. A next step in this line of research is to secure standardized ratings from other informants (e.g., teachers, youth self-report).
Adult↗