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A network approach to substance use, internalizing, and externalizing comorbidity in U.S. adults
Courtney T Blondino1, Elizabeth C Prom-Wormley1
1Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA.
Addictive Behaviors
|July 25, 2022
Summary
This study reveals significant links between substance use and mental health symptoms. Prescription drug misuse showed the strongest association with internalizing symptoms, while marijuana, alcohol, and prescription drug misuse linked to externalizing symptoms.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Substance use, including conventional cigarettes (CIG), alcohol, and marijuana, frequently co-occurs with internalizing and externalizing disorders.
- The relationships between electronic cigarettes (ECIGs), prescription drugs not prescribed (PDNP), and mental health symptoms remain unclear, particularly concerning gender differences.
Purpose of the Study:
- To investigate the network of associations between various substance use categories and internalizing/externalizing symptoms.
- To examine gender-specific differences in these substance use and mental health symptom networks.
Main Methods:
- Utilized adult data (N=30,211) from Wave 1 of the Population Assessment of Tobacco and Health Study (2013-2014).
- Estimated networks of current or past-month use for six substances and past-month internalizing and externalizing symptoms.
- Employed network analysis techniques, including visual comparisons and invariance testing, to detail substance use and symptom networks.
Main Results:
- Networks were generally consistent between men and women.
- Strongest associations included marijuana with lying (EW=0.60) and engaging in fights (EW=0.54).
- Prescription drugs not prescribed (PDNP) showed a strong link with trouble sleeping (EW=0.53), and alcohol with impulsivity (EW=0.48).
Conclusions:
- While many connections in the substance use and mental health symptom network were weak, several significant associations were identified.
- Prescription drugs not prescribed (PDNP) demonstrated the strongest association with internalizing symptoms.
- Marijuana, alcohol, and PDNP use were most strongly linked to externalizing symptoms.
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