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Longitudinal associations between childhood and adulthood externalizing and internalizing psychopathology and adolescent substance use

Published online by Cambridge University Press:  13 September 2013

J. Miettunen ,
G. K. Murray ,
P. B. Jones ,
P. Mäki ,
H. Ebeling ,
A. Taanila ,
M. Joukamaa ,
J. Savolainen ,
S. Törmänen  and
M.-R. Järvelin
...Show all authors
J. Miettunen*
Affiliation:
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland Department of Psychiatry, Oulu University Hospital, Finland
G. K. Murray
Affiliation:
Department of Psychiatry, University of Cambridge and CPFT, UK Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
P. B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge and CPFT, UK
P. Mäki
Affiliation:
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland Department of Psychiatry, Oulu University Hospital, Finland
H. Ebeling
Affiliation:
Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
A. Taanila
Affiliation:
Institute of Health Sciences, University of Oulu, Finland Unit of Primary Care, Oulu University Hospital, Finland
M. Joukamaa
Affiliation:
Social Psychiatry Unit, School of Health Sciences, University of Tampere, Finland Department of Psychiatry, Tampere University Hospital, Finland
J. Savolainen
Affiliation:
School of Criminology and Criminal Justice, University of Nebraska at Omaha, NE, USA
S. Törmänen
Affiliation:
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
M.-R. Järvelin
Affiliation:
Institute of Health Sciences, University of Oulu, Finland Unit of Primary Care, Oulu University Hospital, Finland Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK Biocenter Oulu, University of Oulu, Finland Lifecourse and Services Department, National Institute of Health and Welfare, Oulu, Finland
J. Veijola
Affiliation:
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland Department of Psychiatry, Oulu University Hospital, Finland
I. Moilanen
Affiliation:
Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
*
* Address for correspondence: Adjunct Professor J. Miettunen, Department of Psychiatry, PO Box 5000, 90014University of Oulu, Finland. (Email: jouko.miettunen@oulu.fi)
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Abstract

Background

Emotional and behavioral problems are commonly associated with substance use in adolescence but it is unclear whether substance use precedes or follows mental health problems. The aim was to investigate longitudinal associations between externalizing and internalizing psychopathology and substance use in a prospective population study design.

Method

The sample was the Northern Finland Birth Cohort 1986 Study (NFBC 1986; n = 6349; 3103 males). Externalizing and internalizing mental health problems were assessed at age 8 years (Rutter scales), substance use and externalizing and internalizing problems [Youth Self-Report (YSR)] at age 15–16 years, and hospital diagnoses for internalizing disorders (age 25) and criminal offences (age 20) from nationwide registers in adulthood.

Results

Externalizing problems at age 8 were associated with later substance use. After adjustment for sociodemographic factors, parental alcohol use and psychiatric disorders, and earlier externalizing and internalizing problems, substance use predicted criminality, especially among males, with the highest odds ratio (OR) for cannabis use [adjusted OR 6.2, 95% confidence interval (CI) 3.1–12.7]. Early internalizing problems were not a risk for later substance use. Female adolescent cannabis (OR 3.2, 95% CI 1.4–7.3) and alcohol (OR 2.1, 95% CI 1.1–4.2) use predicted internalizing disorders in adulthood.

Conclusions

Externalizing problems precede adolescent substance use in both genders, whereas, among boys, substance use also precedes criminal offences. Internalizing problems may follow substance use in females. These associations were robust even when taking into account previous mental health problems.

Keywords

Affective symptomsalcohol drinkingbehavioral symptomscannabis usesmoking
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 8 , June 2014 , pp. 1727 - 1738
Copyright
Copyright © Cambridge University Press 2013 

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