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Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle class youth.

ABSTRACT: There is a hypothesis that low socioeconomic status (SES) may explain the link between cannabis use and poorer academic performance and mental health. A key question, therefore, is whether adolescent cannabis use is associated with poorer academic performance and mental health in high SES communities where there is reduced potential for confounding.Youth (n=254) from an upper middle class community were followed prospectively through the four years of high school (from age 14/15 to age 17/18). Past-year frequency of cannabis use was assessed annually. Official school records of academic performance and self-reported mental health symptoms (externalizing and internalizing symptoms) were assessed in grades 9 and 12.Persistent cannabis use across the four years of high school was associated with lower grade-point average (?=-0.18, p=.006), lower Scholastic Aptitude Test (SAT) score (?=-0.13, p=.038), and greater externalizing symptoms (?=0.29, p<.001) in 12th grade, but not with greater internalizing symptoms (?=0.04, p=.53). Moreover, persistent cannabis use was associated with lower grade-point average (?=-0.13, p=.014) and greater externalizing symptoms (?=0.24, p=.002) in 12th grade, even after controlling for 9th grade levels of these outcomes. Similar associations were observed for persistent alcohol and tobacco use. Effects for persistent cannabis use became non-significant after controlling for persistent alcohol and tobacco use, reflecting the difficulties of disentangling effects of cannabis from effects of alcohol and tobacco.Low SES cannot fully explain associations between cannabis use and poorer academic performance and mental health.

SUBMITTER: Meier MH

PROVIDER: S-EPMC4633365 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle class youth.

Meier Madeline H MH Hill Melanie L ML Small Phillip J PJ Luthar Suniya S SS

Drug and alcohol dependence 20150921

<h4>Background</h4>There is a hypothesis that low socioeconomic status (SES) may explain the link between cannabis use and poorer academic performance and mental health. A key question, therefore, is whether adolescent cannabis use is associated with poorer academic performance and mental health in high SES communities where there is reduced potential for confounding.<h4>Methods</h4>Youth (n=254) from an upper middle class community were followed prospectively through the four years of high scho ...[more]

PMID: 26409752

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Project description:AIMS:This study tested whether adolescents who used cannabis or met criteria for cannabis dependence showed neuropsychological impairment prior to cannabis initiation and neuropsychological decline from before to after cannabis initiation. DESIGN:A longitudinal co-twin control study. SETTING AND PARTICIPANTS:Participants were 1989 twins from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of twins born in England and Wales from 1994 to 1995. MEASUREMENTS:Frequency of cannabis use and cannabis dependence were assessed at age 18. Intelligence quotient (IQ) was obtained at ages 5, 12 and 18. Executive functions were assessed at age 18. FINDINGS:Compared with adolescents who did not use cannabis, adolescents who used cannabis had lower IQ in childhood prior to cannabis initiation and lower IQ at age 18, but there was little evidence that cannabis use was associated with IQ decline from ages 12-18. For example, adolescents with cannabis dependence had age 12 and age 18 IQ scores that were 5.61 (t = -3.11, P = 0.002) and 7.34 IQ points (t = -5.27, P < 0.001) lower than adolescents without cannabis dependence, but adolescents with cannabis dependence did not show greater IQ decline from age 12-18 (t = -1.27, P = 0.20). Moreover, adolescents who used cannabis had poorer executive functions at age 18 than adolescents who did not use cannabis, but these associations were generally not apparent within twin pairs. For example, twins who used cannabis more frequently than their co-twin performed similarly to their co-twin on five of six executive function tests (Ps > 0.10). The one exception was that twins who used cannabis more frequently than their co-twin performed worse on one working memory test (Spatial Span reversed; ? = -0.07, P = 0.036). CONCLUSIONS:Short-term cannabis use in adolescence does not appear to cause IQ decline or impair executive functions, even when cannabis use reaches the level of dependence. Family background factors explain why adolescent cannabis users perform worse on IQ and executive function tests.

Project description:BackgroundExecutive functioning (EF) varies in children with autism spectrum disorder (ASD) and is associated with clinical symptoms, academic, and adaptive functioning. Here, we examined whether middle-childhood EF mediates associations between early-childhood autism symptoms and adolescent outcomes in children with ASD.MethodsThe Pathways in ASD Cohort comprising children recruited at the time of ASD diagnosis (at 2-4 years-of-age) and followed prospectively across eight subsequent timepoints over ~10 years was used. A subset of Pathways participants (n = 250) with Behavior Rating Inventory of Executive Function (BRIEF)-Parent Form data from at least one timepoint when participants were school-aged was analyzed. A mediation framework was used to examine whether BRIEF-measured EF across age 7-10 years (middle-childhood) mediated associations between early-childhood autism symptoms (measured using the parent-report Social Responsiveness Scale across age 2-6 years) and clinical, academic, and functional outcomes, indexed at age >10-11.8 years (early-adolescence) using the Child Behavior Checklist (CBCL)-Internalizing and Externalizing Scales, Academic Performance from the Teacher's Report Form, and Vineland Adaptive Behavior Scales. Models were rerun substituting clinician-rated and teacher-rated measures, where possible.ResultsMediation models indicated a significant indirect effect of middle-childhood EF on associations between early-childhood autism symptoms and externalizing behavior, academic performance, or adaptive functioning in early adolescence; kappa squared (κ2 ) effect sizes ranged from large to small. Model findings were stable across raters. Middle-childhood EF did not mediate associations between early-childhood autism symptoms and adolescent internalizing behavior.ConclusionsAmong children with an ASD diagnosis, middle-childhood EF may be one pathway through which early-childhood autism symptoms influence a variety of outcomes in early-adolescence. An experimental study targeting middle-childhood EF to improve adolescent academic, emotional/behavioral, and adaptive functioning is needed to evaluate the clinical meaningfulness of these findings.

Dataset Information

Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle class youth.

Publications

Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle class youth.

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