Developmental pathways to adolescent cannabis abuse and dependence: Child maltreatment, emerging personality, and internalizing versus externalizing psychopathology.

Abstract

Child maltreatment is strongly associated with adolescent psychopathology and substance abuse and dependence (Clark, Thatcher, & Martin, 2010; Ellis & Wolfe, 2009). However, developmental processes unfolding from childhood into adolescence that delineate this trajectory are not well understood. The current study uses path analysis in a structural equation modeling framework to examine multiple mediator models, including ego control, ego resiliency, and internalizing and externalizing symptoms to investigate this developmental process. Participants were 415 children, assessed across three waves of data, (i.e., at ages 7 to 9, 10 to 12, and 13 to 15). The sample included maltreated (n = 259) and nonmaltreated (n = 156) children; groups were comparable in sociodemographic characteristics. Findings support an ecological-transactional model by revealing a developmental sequence in which severity of early childhood maltreatment potentiates less adaptive childhood personality functioning, followed by externalizing problems in preadolescence, and ultimately adolescent cannabis abuse and dependence symptoms. A developmental pathway from child maltreatment to adolescent cannabis abuse and dependence symptoms via personality and preadolescent internalizing problems was not supported. Understanding developmental pathways by which maltreatment experiences increase risk for substance abuse and dependence symptoms in youth has far-reaching implications for the treatment and prevention of substance use disorders.

The National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA): A Multisite Study of Adolescent Development and Substance Use

“…The broad range of risk and resilience factors assessed by the full clinical battery will allow for the effects of multiple domains to be examined in concert when evaluating the influence of alcohol on brain development during the adolescent years. For example, the relationship between externalizing/conduct disorder symptoms and risk for alcohol use has been described for many years (Anderson et al, 2010;Slutske et al, 1998), but the emergence of symptoms over the course of adolescence and the interaction of externalizing symptoms with emerging symptoms from other domains have not been fully examined in such a large sample and with the breadth of assessments in the current study (Hussong et al, 2011;Oshri et al, 2011). Based on previous reports associating these risk domains with drinking during adolescence, the NCANDA sample is well positioned to capture transitions to heavy alcohol consumption during the 4 years of data collection and examine brain changes in relation to use characteristics.…”

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

“…Additionally, Swift et al (2008) found that persistent anxiety and depression were also associated with an increased risk of later cannabis problems and dependence. Another longitudinal study of children and adolescents demonstrated support for a particular developmental pathway to adolescent cannabis use disorders; whereby severity of early childhood maltreatment potentiated less adaptive childhood personality functioning, followed by externalizing problems in preadolescence, and ultimately, adolescent cannabis abuse and dependence symptoms (Oshri, Rogosch, Burnette, & Cicchetti, 2011). Interestingly, a developmental pathway from child maltreatment to adolescent cannabis use disorder symptoms via personality and preadolescent internalizing problems was not supported (Oshri et al, 2011 (Agrawal et al, 2011;Verweij et al, 2012).…”

Mental health differences between frequent cannabis users with and without dependence and the general population

“…These considerable differences between frequent cannabis users and the general population were responsible for the attenuation of most of the mental health differences between the user groups and the general population sample, most prominently regarding the high prevalence of internalizing disorders in dependent frequent users. Based on the assumed chronology, one may suggest that childhood adversity is partly responsible for the co-occurrence of cannabis dependence and mental disorders later in life [29]. However, compared to the general population, nondependent users also had more childhood adversity without a higher risk of internalizing disorders.…”

“…This is also true for childhood adversities [27,28]. In particular, it has been suggested that the development of cannabis abuse and dependence symptoms are influenced by childhood maltreatment both directly and through the development of externalizing (but not internalizing) disorders [29]. Although these factors do not negate mental health differences, they should be considered as alternative explanatory factors for mental health differences between these groups.…”