Dataset Information

Examining the Utility of a General Substance Use Spectrum Using Latent Trait Modeling.

ABSTRACT:

Background

Polysubstance use (PSU; lifetime use of multiple substances) is common among individuals with problematic alcohol/substance use and is associated with poor prognosis and poor physical/mental health. Furthermore, simultaneous co-use of substances, such that drug effects overlap, is also common and related to unique risks (e.g. overdose). Despite the importance of PSU, current diagnostic systems continue to conceptualize problems with alcohol/substances as class-specific constructs (e.g. Stimulant Use Disorder), which essentially ignore many unique PSU processes.

Methods

The current study modeled problems with alcohol, cannabis, stimulants, sedatives, opiates, and simultaneous co-use of these substances as a manifestation of a general substance use continuum versus as correlated class-specific constructs in a sample of young-adults(n = 2482) using confirmatory factor analysis. Utility of the models was evaluated by examining associations between the general substance use spectrum and class-specific latent factors with measures of anxiety, ADHD, adult antisocial problems, borderline symptoms, neuroticism, and intelligence in a subset of the sample(n=847).

Results

Findings supported the conceptualization of problems with all substances, including co-use of substances, as being manifestations of a general substance use spectrum, as class-specific constructs were not differentially associated with other measures of psychological dysfunction. Examination of this general substance use spectrum indicated that all substances, separately and co-use, were robustly informative of this spectrum, but tended to discriminate between different severity levels.

Discussion

The general substance use spectrum allows for integration of information from the use and co-use of all substances to provide better assessment of overall problems with substances compared to class-specific constructs.

SUBMITTER: Bailey AJ

PROVIDER: S-EPMC7293921 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ObjectiveThe authors qualitatively examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) young adults with probable substance use disorders conceptualized their substance use vis-à-vis their LGBTQ identities.MethodsIndividual, in-depth, semistructured interviews were conducted with 59 LGBTQ young adults (ages 21-34) who were participants in a larger longitudinal cohort study and who met criteria for a probable substance use disorder. Data were analyzed via iterative, thematic analytic processes.ResultsParticipants' narratives highlighted processes related to minority stress that shape substance use, including proximal LGBTQ stressors (e.g., self-stigma and expectations of rejection) and distal LGBTQ stressors (e.g., interpersonal and structural discrimination) and associated coping. Participants also described sociocultural influences, including the ubiquitous availability of substances within LGBTQ social settings, as salient contributors to their substance use and development of substance use disorders. Participants who considered themselves transgender or other gender minorities, all of whom identified as sexual minorities, described unique stressors and coping at the intersection of their minority identities (e.g., coping with two identity development and disclosure periods), which shaped their substance use over time.ConclusionsMultilevel minority stressors and associated coping via substance use in adolescence and young adulthood, coupled with LGBTQ-specific sociocultural influences, contribute to the development of substance use disorders among some LGBTQ young adults. Treatment providers should address clients' substance use vis-à-vis their LGBTQ identities and experiences with related stressors and sociocultural contexts and adopt culturally humble and LGBTQ-affirming treatment approaches. Efforts to support LGBTQ youths and young adults should focus on identifying ways of socializing outside of substance-saturated environments.

Project description:Progressive supranuclear palsy (PSP) is the second most common neurodegenerative Parkinsonian disorder after Parkinson's disease, and is characterized as a primary tauopathy. Leveraging the considerable clinical and neuropathologic heterogeneity associated with PSP, we measured tau neuropathology as quantitative traits to perform a genome-wide association study (GWAS) within PSP to identify genes and biological pathways that underlie the PSP disease process. In 882 PSP cases, semi-quantitative scores for phosphorylated tau-immunoreactive coiled bodies (CBs), neurofibrillary tangles (NFTs), tufted astrocytes (TAs), and tau threads were documented from 18 brain regions, and converted to latent trait (LT) variables using the R ltm package. LT analysis utilizes a multivariate regression model that links categorical responses to unobserved covariates allowing for a reduction of dimensionality, generating a single, continuous variable to account for the multiple lesions and brain regions assessed. We first tested for association with PSP LTs and the top PSP GWAS susceptibility loci. Significant SNP/LT associations were identified at rs242557 (MAPT H1c sub-haplotype) with hindbrain CBs and rs1768208 (MOBP) with forebrain tau threads. Digital microscopy was employed to quantify phosphorylated tau burden in midbrain tectum and red nucleus in 795 PSP cases and tau burdens were used as quantitative phenotypes in GWAS. Top associations were identified at rs1768208 with midbrain tectum and red nucleus tau burden. Additionally, we performed a PSP LT GWAS on an initial cohort, a follow-up SNP panel (37 SNPs, P < 10-5) in an extended cohort, and a combined analysis. Top SNP/LT associations were identified at SNPs in or near SPTBN5/EHD4, SEC13/ATP2B2, EPHB1/PPP2R3A, TBC1D8, IFNGR1/OLIG3, ST6GAL1, HK1, CALB1, and SGCZ. Finally, testing for SNP/transcript associations using whole transcriptome and whole genome data identified significant expression quantitative trait loci at rs3088159/SPTBN5/EHD4 and rs154239/GHRL. Modeling tau neuropathology heterogeneity using LTs as quantitative phenotypes in a GWAS may provide substantial insight into biological pathways involved in PSP by affecting regional tau burden.