Leah J Welty1, Jennifer A Hershfield2, Karen M Abram1, Hongyun Han1, Gayle R Byck1, Linda A Teplin3. 1. Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago. 2. Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago; Children's Hospital Los Angeles, University of Southern California Center for Excellence in Developmental Disabilities, Los Angeles. 3. Health Disparities and Public Policy, Northwestern University Feinberg School of Medicine, Chicago. Electronic address: healthdisparities@northwestern.edu.
Abstract
OBJECTIVE: To identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention and how gender, race/ethnicity, and age at baseline predict trajectories. METHOD: As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois from 1995 through 1998, participants were reinterviewed in the community or correctional facilities up to 9 times over 12 years. Independent interviewers assessed SUDs using the Diagnostic Interview Schedule for Children 2.3 (baseline) and the Diagnostic Interview Schedule IV (follow-ups). Primary outcome was a mutually exclusive 5-category typology of disorder: no SUD, alcohol alone, marijuana alone, comorbid alcohol and marijuana, or "other" illicit ("hard") drug. Trajectories were estimated using growth mixture models with a 3-category ordinal variable derived from the typology. RESULTS: During the 12-year follow-up, 19.6% of youth did not have an SUD. The remaining 81.4% were in 3 trajectory classes. Class 1 (24.5%), a bell-shaped trajectory, peaked 5 years after baseline when 42.7% had an SUD and 12.5% had comorbid or "other" illicit drug disorders. Class 2 (41.3%) had a higher prevalence of SUD at baseline, 73.8%. Although prevalence decreased over time, 23.5% had an SUD 12 years later. Class 3 (14.6%), the most serious and persistent trajectory, had the highest prevalence of comorbid or "other" illicit drug disorders-52.1% at baseline and 17.4% 12 years later. Males, Hispanics, non-Hispanic whites, and youth who were older at baseline (detention) had the worst outcomes. CONCLUSION: Gender, race/ethnicity, and age at detention predict trajectories of SUDs in delinquent youth. Findings provide an empirical basis for child psychiatry to address health disparities and improve prevention.
OBJECTIVE: To identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention and how gender, race/ethnicity, and age at baseline predict trajectories. METHOD: As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois from 1995 through 1998, participants were reinterviewed in the community or correctional facilities up to 9 times over 12 years. Independent interviewers assessed SUDs using the Diagnostic Interview Schedule for Children 2.3 (baseline) and the Diagnostic Interview Schedule IV (follow-ups). Primary outcome was a mutually exclusive 5-category typology of disorder: no SUD, alcohol alone, marijuana alone, comorbid alcohol and marijuana, or "other" illicit ("hard") drug. Trajectories were estimated using growth mixture models with a 3-category ordinal variable derived from the typology. RESULTS: During the 12-year follow-up, 19.6% of youth did not have an SUD. The remaining 81.4% were in 3 trajectory classes. Class 1 (24.5%), a bell-shaped trajectory, peaked 5 years after baseline when 42.7% had an SUD and 12.5% had comorbid or "other" illicit drug disorders. Class 2 (41.3%) had a higher prevalence of SUD at baseline, 73.8%. Although prevalence decreased over time, 23.5% had an SUD 12 years later. Class 3 (14.6%), the most serious and persistent trajectory, had the highest prevalence of comorbid or "other" illicit drug disorders-52.1% at baseline and 17.4% 12 years later. Males, Hispanics, non-Hispanic whites, and youth who were older at baseline (detention) had the worst outcomes. CONCLUSION: Gender, race/ethnicity, and age at detention predict trajectories of SUDs in delinquent youth. Findings provide an empirical basis for child psychiatry to address health disparities and improve prevention.
Authors: Amy Jo Harzke; Jacques Baillargeon; Gwen Baillargeon; Judith Henry; Rene L Olvera; Ohiana Torrealday; Joseph V Penn; Rajendra Parikh Journal: J Correct Health Care Date: 2012-03-14
Authors: Leah J Welty; Anna J Harrison; Karen M Abram; Nichole D Olson; David A Aaby; Kathleen P McCoy; Jason J Washburn; Linda A Teplin Journal: Am J Public Health Date: 2016-03-17 Impact factor: 9.308
Authors: D Shaffer; P Fisher; M K Dulcan; M Davies; J Piacentini; M E Schwab-Stone; B B Lahey; K Bourdon; P S Jensen; H R Bird; G Canino; D A Regier Journal: J Am Acad Child Adolesc Psychiatry Date: 1996-07 Impact factor: 8.829