DOI
https://doi.org/10.25772/H7RD-RB31
Author ORCID Identifier
https://orcid.org/0000-0001-9388-7269
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Psychology
First Advisor
Albert D. Farrell
Abstract
Early adolescents who engage in polysubstance use, defined as the use of three or more different substances, are at particularly high risk of future substance use disorders and adverse psychosocial outcomes. However, little is known about the development of substance use patterns during early adolescence, particularly among youth living in urban settings. Although theory and research suggest that youth with greater externalizing behaviors (e.g., aggression, delinquent behavior) may be more likely to escalate to polysubstance use at an early age, few studies have examined bidirectional relations between externalizing symptoms and polysubstance use. The goal of this study was to (a) identify subgroups of middle school students based on their history of initiation and recent substance use and examine transitions in those subgroups across two waves, and (b) evaluate longitudinal bidirectional associations between externalizing behaviors (i.e., aggression, delinquency) and substance use subgroups. Participants were 1,811 early adolescents (72% Black, 53% female) attending middle schools in neighborhoods with high rates of violence and of residents with incomes below the federal poverty line.
I used latent class analysis to identify subgroups of adolescents with different substance use patterns at two waves of data that were 3 months apart. A 4-class model was identified as optimal at both waves based on fit indices. The subgroups included (a) Non-use (76% of sample at wave 1, 73% at wave 2), (b) Initiation (11%, 13%), reflecting high probabilities of initiation of 2 or more substances, (c) Alcohol Use (7%, 7%), reflecting high probabilities of past 30-day alcohol use, and (d) Polysubstance Use (6%, 7%), reflecting high probabilities of alcohol, cannabis, and cigar use in the past 30-days. I then used latent transition analysis (LTA) to examine changes in subgroup membership over time and their prospective bidirectional associations with externalizing behaviors. LTA revealed longitudinal changes in substance use patterns among those early adolescents who had already initiated substance use. Whereas change in externalizing behaviors over time was not impacted by adolescents’ substance use patterns, adolescents who reported more frequent externalizing behaviors were more likely to initiate substance use, particularly polysubstance use, 3 months later. Delinquent behavior predicted initiation of polysubstance use even after accounting for distress symptoms, providing support for the pathway to early substance use onset via delinquent behaviors. These findings indicate that early adolescents engaging in substance use are not consistently using the same number of substances across 3-month periods. This study’s findings also suggest that selective prevention efforts for early adolescents with externalizing symptoms may be beneficial. Additional implications of these findings for theory and interventions are discussed.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-23-2024