A network approach to substance use, internalizing, and externalizing comorbidity in U.S. adults. (November 2022)

• Record Type: Journal Article
• Authors: Blondino, Courtney T.; Prom-Wormley, Elizabeth C.
• Is Part Of: Addictive behaviors. Volume 134(2022)
• Publication Date: 2022-11
• Subjects: Substance use -- Internalizing symptoms -- Externalizing symptoms -- Comorbidity -- Gender; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2022.107421
• Languages: English
• ISSNs: 0306-4603

Abstract

Highlights: Comorbidity network structure did not significantly differ between men and women. Nodes within their respective constructs grouped together within the network. Prescription drugs not prescribed connected with internalizing symptoms. Marijuana, alcohol and prescription drugs not prescribed connected with externalizing symptoms. Abstract: Introduction: Use of conventional cigarettes (CIG), alcohol, marijuana, and sedatives [i.e., benzodiazepines and barbiturates]) commonly co-occur with internalizing and externalizing disorders. It is unclear how these relationships extend to electronic cigarettes (ECIGs) and prescription drugs not prescribed (i.e., sedatives, tranquilizers, and painkillers [PDNP]), and whether they differ by gender. Methods: Adult data (N = 30, 211) from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health Study were used to estimate a network of current or past-month use for six substances, experiencing four internalizing symptoms in the past month, and experiencing seven externalizing symptoms in the past month. Visual comparisons, global strength invariance, network structure invariance, and edge strength invariance were tested to detail substance use and internalizing/externalizing symptom networks. Results: Overall, networks were consistent between men and women. The strongest substance use/mental health symptom connections estimated as edge-weights (EW) were between marijuana with lying (EW = 0.60, 95% CI = 0.49; 0.70), marijuana with engaging in fights (EW = 0.54, 95% CI = 0.27; 0.81), PDNP with having trouble sleeping (EW = 0.53, 95% CI = 0.40; 0.66), and alcohol and impulsivity (EW = 0.48, 95% CI = 0.42; 0.53). Discussion: There were many weak connections throughout the substance use and internalizing/externalizing network. A few important connections were identified and encourage future study. In particular, PDNP was most strongly associated with internalizing symptoms. Marijuana, alcohol and PDNP use were most strongly associated with externalizing symptoms.