Moderators and Mediators of the Effect of Early Substance Use on Later Substance Use Disorder: Can Developmental and Neuropsychological Theories of Substance Use and Substance Use Disorder be Integrated?
Scalco, Matthew David
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Substance use (SU) during adolescence is of great concern because evidence suggests that drug use impacts brain development during this period, potentially impacting long-term patterns of SU and the emergence of substance use disorder (SUD). The current project integrates neuropsychological and developmental models of SU and SUD to assess moderators and mediators of the effect of early SU on later SU and SUD. Several theories were used to develop competing hypotheses regarding several conditional indirect effect models that were estimated using propensity score weighted marginal structural equation models that adjusted for between 16 and 27 confounds. Hypotheses were that individual differences in temperament (inhibitory control [IC], sensitivity to reward [SR], and negative affect [NA]) would interact with early SU experiences and peer SU to increase levels of SU specifically and to effect developmental trajectories of IC, SR, and NA consistent with neuropsychological theories of SUDs. Utilizing a prospective design (age 10-21) and multiple reporters/methods of measurement, results supported developmental epigenetic theory in that pre-existing differences in temperament, especially SR and IC, in conjunction with early SU experiences and the peer context discriminated youth who would develop long term patterns of SU and SUD. Furthermore, increases in NA and increases in SR that occurred from SU mediated later increases in SU and the emergence of SUD consistent with neuroscience theories. However, many changes in temperament were also conditioned on peer SU and on pre-existing individual differences suggesting that neuroscience models may benefit from incorporating such constructs in theoretical models. While results did not often replicate across reporters or methods of measurement, they underscore the importance of considering multiple temperament dimensions and social context together in empirical investigations.
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