Dataset Information

Early tobacco smoking in adolescents with externalizing disorders: inferences for reward function.

ABSTRACT:

Introduction

Tobacco smoking is the leading preventable cause of mortality in the United States, and 90% of regular smokers initiate smoking before age 18 years. Factors that confer risk for chronic smoking include psychiatric factors, such as externalizing disorders, and potentially related neurobiological substrates, such as reward function. The present study examined the relationship between the externalizing disorders and the temporal progression of smoking among adolescent smokers.

Methods

Data were from 64 adolescents who requested smoking cessation treatment and included information on developmental smoking trajectory, number of cigarettes per day, and Fagerström Test for Nicotine Dependence score. This sample was assessed carefully for psychiatric disorders. Analyses examined the relationships between externalizing psychiatric disorders and smoking trajectory.

Results

Adolescents with an externalizing disorder consumed more tobacco in the first 2 years of smoking than those without a disorder. There were no differences in speed of progression between groups, which may index a distinct functional pattern of reward systems that confers vulnerability for tobacco dependence.

Discussion

These data are discussed in terms of potential predictors of early smoking behavior that can inform interventions for adolescents with externalizing behaviors and tobacco dependence. They also provide some hypotheses for how the development of chronic smoking can be influenced by specific patterns of reward responses.

SUBMITTER: Aklin WM

PROVIDER: S-EPMC2688605 | biostudies-literature | 2009 Jun

REPOSITORIES: biostudies-literature

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Publications

Early tobacco smoking in adolescents with externalizing disorders: inferences for reward function.

Aklin Will M WM Moolchan Eric T ET Luckenbaugh David A DA Ernst Monique M

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 20090519 6

<h4>Introduction</h4>Tobacco smoking is the leading preventable cause of mortality in the United States, and 90% of regular smokers initiate smoking before age 18 years. Factors that confer risk for chronic smoking include psychiatric factors, such as externalizing disorders, and potentially related neurobiological substrates, such as reward function. The present study examined the relationship between the externalizing disorders and the temporal progression of smoking among adolescent smokers.< ...[more]

PMID: 19454552

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Project description:Background Mental disorders are the leading cause of disability for youth worldwide. However, there is a dearth of validated, brief instruments to assess mental health in low- and middle-income countries (LMIC). We aimed to facilitate identification of mental disorders in LMIC contexts by adapting and validating measures of internalizing and externalizing disorders for adolescents in Mozambique, an LMIC in southeastern Africa. Methods We selected instruments with good support for validity in high-income and other LMIC settings: the Patient Health Questionnaire Adolescent (PHQ-A), Generalized Anxiety Disorders 7 (GAD-7), and Strengths and Difficulties Questionnaire (SDQ). Instruments were adapted by local and international mental health specialists followed by cognitive interviews (n = 48) with Mozambican adolescents. We administered the instruments along with the Miniature International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)to 485 adolescents aged 12–19 years attending two secondary schools in Maputo City, Mozambique. One week later, we re-administered instruments to a randomly selected sample of 49 adolescents. Results Participants were 66.2% (n = 321) female and the average age was 15.9 (S.D = 1.7).Internal consistency (alpha = 0.80, PHQ-A; 0.84, GAD-7; 0.80, SDQ) and test–retest reliabilty (ICC = 0.74, PHQ-A; 0.70, GAD-7; 0.77, SDQ) were acceptabe for the PHQ-A, GAD-7, and the full SDQ. The SDQ internalizing subscale showed poor test–retest reliability (ICC = 0.63) and the SDQ externalizing subscale showed poor internal consistency (alpha = 0.65). All instruments demonstrated good sensitivity and specificity (> 0.70). Youden’s index identified optimal cutoff scores of 8 for the PHQ-A, 5 for the GAD-7, 10 for the SDQ internalizing and 9 for the SDQ externalizing subscales, though a range of scores provided acceptable sensitivity and specificity. Conclusions Our data supports reliability and validity of the PHQ-A, GAD-7, and SDQ instruments for rapidly assessing mental health problems in Mozambican adolescents. Use of these tools in other contexts with limited specialists may asist with expanding mental health assessment. Specific instrument and cutoff selection should be based on screening goals, treatment resources, and program objectives. Supplementary Information The online version contains supplementary material available at 10.1186/s12888-022-04189-3.

Project description:Background and aimsSeveral studies have indicated an association between maternal prenatal substance use and offspring externalizing disorders; however, it is uncertain whether this relationship is causal. We conducted a systematic review to determine: (1) if the literature supports a causal role of maternal prenatal substance use on offspring externalizing disorders diagnosis and (2) whether these associations differ across externalizing disorders.MethodsWe searched Web of Science, Embase, PsycINFO and Medline databases. Risk of bias assessment was conducted using the Newcastle-Ottawa Scale (NOS), and where possible meta-analysis was conducted for studies classed as low risk of bias. We included studies of any design that examined prenatal smoking, alcohol or caffeine use. Studies in non-English language, fetal alcohol syndrome and comorbid autism spectrum disorders were excluded. Participants in the included studies were mothers and their offspring. Measurements included prenatal smoking, alcohol or caffeine use as an exposure, and diagnosis of attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional defiant disorder (ODD) in offspring as an outcome.ResultsWe included 63 studies, 46 of which investigated smoking and ADHD. All studies were narratively synthesized, and seven studies on smoking and ADHD were meta-analysed. The largest meta-analysis based on genetically sensitive design included 1 011 546 participants and did not find evidence for an association [odds ratio (OR)1-9 cigarettes = 0.90, 95% confidence interval (CI) = 0.83-1.11; OR > 10 cigarettes = 1.04, 95% CI = 0.79-1.36). Studies on alcohol exposure in all the outcomes reported inconsistent findings and no strong conclusions on causality can be made. Studies on caffeine exposure were mainly limited to ADHD and these studies do not support a causal effect.ConclusionsThere appears to be no clear evidence to support a causal relationship between maternal prenatal smoking and offspring attention-deficit hyperactivity disorder. Findings with alcohol and caffeine exposures and conduct disorder and oppositional-defiant disorder need more research, using more genetically sensitive designs.

Dataset Information

Early tobacco smoking in adolescents with externalizing disorders: inferences for reward function.

Introduction

Methods

Results

Discussion

Publications

Early tobacco smoking in adolescents with externalizing disorders: inferences for reward function.

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