Premium
Towards a comprehensive developmental model of cannabis use disorders
Author(s) -
Blanco Carlos,
Rafful Claudia,
Wall Melanie M.,
Ridenour Ty A.,
Wang Shuai,
Kendler Kenneth S.
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12382
Subject(s) - cannabis , odds ratio , confidence interval , impulsivity , depression (economics) , risk factor , logistic regression , medicine , psychiatry , suicide attempt , young adult , demography , poison control , suicide prevention , psychology , gerontology , environmental health , sociology , economics , macroeconomics
Aims To develop a comprehensive risk‐factor model of cannabis use disorders ( CUD ) based on K endler's development model for major depression. Design Risk factors were divided into five developmental tiers based on K endler's model of depression (childhood, early adolescence, late adolescence, adulthood, past year). Hierarchical logistic regression models were used to examine the independent contribution of each risk factor. Separate models were built to predict the lifetime risk of cannabis use and the risk of CUD among those with a history of lifetime risk of cannabis use. Setting Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC ) in the U nited S tates. Participants Participants consisted of wave 2 of the NESARC ( n = 34 653). Measurements Odds ratios ( OR ), Adjusted OR ( AOR ) and confidence intervals (95% CI ) were used to determine the risk factors in each tier and with multiple models. Findings After mutually adjusting for the effect of other risk factors, lifetime history of drug use disorder ( AOR = 4.78, 95% CI = 1.53–14.91), past year alcohol use disorders ( AOR = 6.55, 95% CI = 2.54–16.89) and independent ( AOR = 1.57, 95% CI = 1.15–2.14) and dependent ( AOR = 1.25, 95% CI = 1.01–1.55) stressful life events predicted lifetime cannabis use. Impulsivity ( AOR = 2.18, 95% CI = 1.34–3.53), past year alcohol use disorders ( AOR = 4.09, 95% CI = 2.29–7.31), greater number of Axis I disorders ( AOR = 1.56, 95% CI = 1.01–2.40) and social deviance ( AOR = 1.19, 95% CI = 1.08–1.32) independently increased the risk of the development of CUD , whereas religious service attendance ( AOR = 0.50, 95% CI = 0.30–0.85) decreased this risk. In both models, the effect of earlier development tiers was mediated by more proximal ones. There were few gender differences in both models. Conclusions A modification of K endler's risk factor model for major depression which stratifies risk factors into five groups (childhood, early adolescence, late adolescence, adulthood, past year) provides a useful foundation for a comprehensive developmental model of cannabis use and cannabis use disorders.