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A developmental etiological model for drug abuse in men

Kendler, Kenneth S. LU ; Ohlsson, Henrik LU ; Edwards, Alexis C. LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2017) In Drug and Alcohol Dependence 179. p.220-228
Abstract

Background We attempt to develop a relatively comprehensive structural model of risk factors for drug abuse (DA) in Swedish men that illustrates developmental and mediational processes. Methods We examined 20 risk factors for DA in 48,369 men undergoing conscription examinations in 1969–70 followed until 2011 when 2.34% (n = 1134) of them had DA ascertained in medical, criminal and pharmacy registries. Risk factors were organized into four developmental tiers reflecting i) birth, ii) childhood/early adolescence, iii) late adolescence, and iv) young adulthood. Structural equational model fitting was performed using Mplus. Results The best fitting model explained 47.8% of the variance in DA. The most prominent predictors, in order, were:... (More)

Background We attempt to develop a relatively comprehensive structural model of risk factors for drug abuse (DA) in Swedish men that illustrates developmental and mediational processes. Methods We examined 20 risk factors for DA in 48,369 men undergoing conscription examinations in 1969–70 followed until 2011 when 2.34% (n = 1134) of them had DA ascertained in medical, criminal and pharmacy registries. Risk factors were organized into four developmental tiers reflecting i) birth, ii) childhood/early adolescence, iii) late adolescence, and iv) young adulthood. Structural equational model fitting was performed using Mplus. Results The best fitting model explained 47.8% of the variance in DA. The most prominent predictors, in order, were: early adolescent externalizing behavior, early adult criminal behavior, early adolescent internalizing behavior, early adult unemployment, early adult alcohol use disorder, and late adolescent drug use. Two major inter-connecting pathways emerged reflecting i) genetic/familial risk and ii) family dysfunction and psychosocial adversity. Generated on a first and tested on a second random half of the sample, a model from these variables predicted DA with an ROC area under the curve of 83.6%. Fifty-nine percent of DA cases arose from subjects in the top decile of risk. Conclusions DA in men is a highly multifactorial syndrome with risk arising from familial-genetic, psychosocial, behavioral and psychological factors acting and interacting over development. Among the multiple predisposing factors for DA, a range of psychosocial adversities, externalizing psychopathology and lack of social constraints in early adulthood are predominant.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Development, Drug abuse, Environment, Externalizing pathway, Personality, Structural equation model
in
Drug and Alcohol Dependence
volume
179
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85027356942
  • pmid:28806639
  • pmid:28806639
  • wos:000412250100032
ISSN
0376-8716
DOI
10.1016/j.drugalcdep.2017.06.036
language
English
LU publication?
yes
id
ab04b0bb-99a1-4cab-b20c-ec9e2aac6f6f
date added to LUP
2017-09-01 13:24:48
date last changed
2024-03-31 15:49:42
@article{ab04b0bb-99a1-4cab-b20c-ec9e2aac6f6f,
  abstract     = {{<p>Background We attempt to develop a relatively comprehensive structural model of risk factors for drug abuse (DA) in Swedish men that illustrates developmental and mediational processes. Methods We examined 20 risk factors for DA in 48,369 men undergoing conscription examinations in 1969–70 followed until 2011 when 2.34% (n = 1134) of them had DA ascertained in medical, criminal and pharmacy registries. Risk factors were organized into four developmental tiers reflecting i) birth, ii) childhood/early adolescence, iii) late adolescence, and iv) young adulthood. Structural equational model fitting was performed using Mplus. Results The best fitting model explained 47.8% of the variance in DA. The most prominent predictors, in order, were: early adolescent externalizing behavior, early adult criminal behavior, early adolescent internalizing behavior, early adult unemployment, early adult alcohol use disorder, and late adolescent drug use. Two major inter-connecting pathways emerged reflecting i) genetic/familial risk and ii) family dysfunction and psychosocial adversity. Generated on a first and tested on a second random half of the sample, a model from these variables predicted DA with an ROC area under the curve of 83.6%. Fifty-nine percent of DA cases arose from subjects in the top decile of risk. Conclusions DA in men is a highly multifactorial syndrome with risk arising from familial-genetic, psychosocial, behavioral and psychological factors acting and interacting over development. Among the multiple predisposing factors for DA, a range of psychosocial adversities, externalizing psychopathology and lack of social constraints in early adulthood are predominant.</p>}},
  author       = {{Kendler, Kenneth S. and Ohlsson, Henrik and Edwards, Alexis C. and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0376-8716}},
  keywords     = {{Development; Drug abuse; Environment; Externalizing pathway; Personality; Structural equation model}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{220--228}},
  publisher    = {{Elsevier}},
  series       = {{Drug and Alcohol Dependence}},
  title        = {{A developmental etiological model for drug abuse in men}},
  url          = {{http://dx.doi.org/10.1016/j.drugalcdep.2017.06.036}},
  doi          = {{10.1016/j.drugalcdep.2017.06.036}},
  volume       = {{179}},
  year         = {{2017}},
}