Addict Behav [JOURNAL]
Sun
200 papers
Changing Norms, Changing Risks: Adolescent Cannabis Use Surpasses Tobacco in the United States.
Constantin J, Jayawardhana J
Addict Behav · 2026 Sep · PMID 42096868 · Publisher ↗
BACKGROUND: Rapid expansion of adult-use cannabis legalization in the U.S. altered adolescents' exposure to and perceptions of cannabis risk. Early initiation of cannabis use may increase dependence vulnerability and lon...
BACKGROUND: Rapid expansion of adult-use cannabis legalization in the U.S. altered adolescents' exposure to and perceptions of cannabis risk. Early initiation of cannabis use may increase dependence vulnerability and long-term health consequences, echoing early tobacco diffusion before its harms were fully recognized. This study examines national trends in tobacco and cannabis use and co-use among U.S. adolescents, identifying demographic groups experiencing most pronounced shifts. METHODS: Using nationally representative data from 2015 to 2023 National Survey on Drug Use and Health, we assessed past-30-day cannabis-only use, tobacco-only (cigarettes, cigars, pipes, and smokeless tobacco) use, and co-use among adolescents aged 12-17. Trends were examined across pre-pandemic (2015-2019), pandemic onset (2020), and post-pandemic (2021-2023) periods. Multivariable logistic regression models estimated sociodemographic predictors. RESULTS: Cannabis-only use predominated throughout the study period, increasing from 3.8% in 2015 to 5.1% in 2023. Conversely, tobacco-only use and co-use declined. Largest increase in cannabis-only use and sharpest decline in tobacco-only use occurred among older adolescents (16-17), consistently exhibiting higher probabilities of cannabis-only use than younger adolescents (AMEs between 10.9-16.0 percentage-points). Post-pandemic, Medicaid-insured adolescents were significantly more likely than privately insured peers to use cannabis-only (AME = 1.1 percentage-points; 95% CI: 0.1, 2.0). CONCLUSION: Cannabis use prevalence surpassed tobacco use prevalence as the dominant substance among U.S. adolescents. These patterns resemble tobacco uptake in early stages, underscoring the urgency of recalibrating youth prevention strategies. As cannabis policy continues to evolve, public health responses must prioritize adolescent-focused risk communication, integrate cannabis prevention into existing tobacco control infrastructures, and anticipate long-term population health consequences.
Latent classes of substance use patterns and cannabis use disorder Risk in U.S. Adults during recreational Legalization expansion (2015-2023).
Kim S, Saad B, Kelada A
Addict Behav · 2026 Sep · PMID 42096867 · Publisher ↗
BACKGROUND: Traditional surveillance may not capture heterogeneous patterns of cannabis use disorder (CUD) risk during policy transitions. We used latent class analysis (LCA) to identify substance use patterns associated...
BACKGROUND: Traditional surveillance may not capture heterogeneous patterns of cannabis use disorder (CUD) risk during policy transitions. We used latent class analysis (LCA) to identify substance use patterns associated with varying CUD risk during U.S. recreational cannabis legalization expansion (2015-2023). METHODS: We analyzed 326,193 U.S. adults aged 18 + from the National Survey on Drug Use and Health (2015-2023, excluding 2021). LCA identified classes based on eight indicators: past-year alcohol and cannabis use disorders, lifetime use of alcohol, cannabis, cocaine, and heroin, and arrest history and suicidal ideation. Model selection evaluated 2-15 class solutions using Bayesian Information Criterion (BIC) and entropy. RESULTS: Five classes emerged (BIC = 1,598,194, entropy = 0.680): Minimal Substance Use (47.3%), Low-Risk Cannabis Use (36.3%), Alcohol-Dominant Comorbidity (5.6%), Polysubstance/High Legal Involvement (7.3%), and High-Risk CUD (3.4%), with the highest cannabis use disorder (42.1%), alcohol use disorder (82.7%), arrest history (29.4%), and suicidal ideation (25.9%). This class increased from 2.6% (2015-2020) to 5.8% (2022-2023) (slope=+0.46 pp/year, p = 0.010). Daily/near-daily cannabis use showed a severity gradient: 32.2% in High-Risk CUD versus 0.0% in Minimal Substance Use (χ = 73,297, p < 0.001). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition period (2015-2019) sensitivity analyses confirmed stability (p = 0.614), indicating observed increases reflect population changes rather than diagnostic criteria evolution. CONCLUSIONS: LCA identified five classes with distinct CUD risk profiles. The High-Risk CUD class increased during legalization expansion, with frequency patterns validating clinical significance. Class-based surveillance may complement prevalence monitoring during policy transitions, though causal attribution requires longitudinal designs with state-level legalization timing.
The interactive role of perceived stress and nicotine dependence on failure to maintain abstinence after a smoking cessation treatment: a sex-stratified survival analysis.
Ramos-Carro M, Martínez-Vispo C, López-Durán A … +1 more , Becoña E
Addict Behav · 2026 Sep · PMID 42092225 · Publisher ↗
INTRODUCTION: Maintaining abstinence after smoking cessation is challenging, and factors associated with cessation success may differ by sex. Given the relevance of nicotine dependence and perceived stress in cessation o...
INTRODUCTION: Maintaining abstinence after smoking cessation is challenging, and factors associated with cessation success may differ by sex. Given the relevance of nicotine dependence and perceived stress in cessation outcomes, this study aimed to examine, separately for males and females, whether the interaction between perceived stress and nicotine dependence predicts failure to maintain abstinence over the year following a cognitive-behavioral smoking-cessation intervention. METHODS: The sample comprised 440 adults (64.3% female, M = 45.19) who quit smoking after receiving a smoking cessation intervention between 2015 and 2022. Study variables (perceived stress and nicotine dependence) were assessed at pretreatment. Failure to maintain abstinence was defined as smoking for at least seven consecutive days since the end of the smoking cessation intervention. Hierarchical Cox proportional-hazards regression models were conducted, separately in males and females, to analyze the association of nicotine dependence and perceived stress and their interaction with risk of failure to maintain abstinence. RESULTS: The interaction between perceived stress and nicotine dependence was significant in males (HR = 2.23, 95% CI [1.37, 3.62], p = 0.001), but not in females. Perceived stress significantly predicted risk of failure to maintain abstinence in males with low nicotine dependence (HR = 1.36, 95% CI [1.01, 1.83], p = 0.044), but not in males with high nicotine dependence. CONCLUSIONS: These findings identify perceived stress as a potential intervention target for preventing failure to maintain abstinence among males with low nicotine dependence. These results reinforce the relevance of incorporating sex- and nicotine-dependence-specific strategies in smoking cessation interventions.
Adult attachment and problematic social media use: a daily measure study.
Musetti A, Sforza M, Pupi V … +3 more , Mancinelli E, Gori A, Santoro G
Addict Behav · 2026 Sep · PMID 42068853 · Publisher ↗
Attachment theory provides a valuable framework for understanding individual vulnerability to problematic social media use (PSMU). Previous research has found consistent evidence that PSMU is associated with increased at...
Attachment theory provides a valuable framework for understanding individual vulnerability to problematic social media use (PSMU). Previous research has found consistent evidence that PSMU is associated with increased attachment anxiety, whereas the role of attachment avoidance remains unclear. Most studies have relied on cross-sectional designs and measures that may fail to distinguish intensive from maladaptive engagement with social media. In this study, we adopted a daily diary approach in a community sample of adults (N = 89; 77.5% female; mean age = 23.64 ± 5.92 years, range = 20-50) to test whether attachment styles, defined by positive or negative representations of the self and others, predicted PSMU over a 14-day period. Participants were administered self-report instruments evaluating attachment styles and central symptoms of PSMU (i.e., mood modification, relapse, withdrawal, and conflict). Linear mixed-effects modeling revealed that higher baseline preoccupied attachment significantly predicted greater daily PSMU. Given the modest sample size, these findings should be interpreted cautiously. Nonetheless, the results provide preliminary longitudinal evidence that a negative representation of the self and a positive representation of others, as well as high levels of attachment anxiety, may increase the vulnerability to engaging in social media use as a dysfunctional compensatory strategy.
Extending the prototype willingness model to daily life: examining risk-conducive contexts and drinking among adolescents and young adults.
Litt DM, Zhou Z, Fairlie AM … +5 more , Graupensperger S, Gilson MS, Greene A, Lee CM, Lewis MA
Addict Behav · 2026 Sep · PMID 42061052 · Publisher ↗
The Prototype Willingness Model (PWM) emphasizes the importance of risk-conducive contexts in shaping behavior, yet these contextual processes have not been examined at the daily level. This study, in line with the PWM,...
The Prototype Willingness Model (PWM) emphasizes the importance of risk-conducive contexts in shaping behavior, yet these contextual processes have not been examined at the daily level. This study, in line with the PWM, examined the extent to which risk-conducive contexts (e.g., personal cannabis use, others' cannabis use, others' drinking, others' drinking game engagement, being in new environments or with new people) increase alcohol use on days when individuals are more willing to engage in alcohol-related behaviors. Participants (N = 996, 57% female, 44.4% White, M = 20.00, SD = 3.22) were recruited in Texas (United States) for a longitudinal ecological momentary assessment (EMA) study examining cognitions and alcohol use. Results of a hurdle negative binomial model indicated on days participants reported elevated (i.e., higher than their own average level) willingness to engage in alcohol use, they had greater odds of drinking and consumed more drinks. Drinking odds increased on days they were around others who drank and decreased when around new people. Two significant interactions showed willingness was positively associated with the predicted probability of consuming any alcohol and the number of drinks consumed, and the strength of the association became stronger when the participant was around others who were drinking. Findings extend the PWM by demonstrating how theoretically-based contextual processes operate at the daily level, informing intervention targets to reduce risky alcohol use.
Validation of a Spanish translation of the nicotine dependence syndrome scale.
Moore JR, Castro Y, Guerra ZC … +2 more , Londoño T, Velasquez JE
Addict Behav · 2026 Sep · PMID 42048894 · Publisher ↗
BACKGROUND: Physical indicators of nicotine dependence are generally weaker predictors of smoking cessation among Hispanics compared to other racial and ethnic groups. While multidimensional measures of nicotine dependen...
BACKGROUND: Physical indicators of nicotine dependence are generally weaker predictors of smoking cessation among Hispanics compared to other racial and ethnic groups. While multidimensional measures of nicotine dependence may have utility, validated Spanish-language multidimensional measures of dependence are scarce. This study aims to test the five-factor structure of the revised translation of the Spanish Nicotine Dependence Syndrome Scale (NDSS) among a sample of Mexican-origin smokers in the U.S. METHODS: The revised NDSS scale was administered to 289 Mexican-origin smokers in the U.S. A confirmatory factor analysis was conducted among an evaluation sample (n = 144) and model modifications were employed using CFI, TLI, SRMR, and RMSEA until a good fit was achieved. The final model resulting from the analyses was replicated among 145 participants. Factor correlations and composite reliability for each subscale were estimated in each sample. RESULTS: The original 19-item, 5-factor model did not converge. Model modifications resulted in 16-item, five-factor scale with good fit (RMSEA = 0.023, CFI = 0.992, TLI = 0.99, SRMR = 0.051). Since the Tolerance scale only contained two items and was highly correlated with the Drive scale after modification, we fit an alternative model structure where these two scales were combined into one scale, also demonstrating good fit (RMSEA = 0.016, CFI = 0.996, TLI = 0.995, SRMR = 0.051). CONCLUSIONS: This study addresses the need for Spanish language nicotine dependence measures that are psychometrically sound. Future research in this area may facilitate better understanding of influential factors of smoking and cessation among Hispanic smokers.
Clinical effects of pharmacological and electronic cigarette interventions for smoking cessation in pregnancy: a systematic review and network meta-analysis.
Thimkorn P, Booncharoen C, Chaipitak P … +4 more , Wiengkeaw P, Thananithisak C, Boonpattharatthiti K, Dhippayom T
Addict Behav · 2026 Sep · PMID 42048893 · Publisher ↗
BACKGROUND: Smoking during pregnancy adversely affects both mothers and fetuses. This study aimed to evaluate the clinical effects of pharmacological and electronic cigarette (E-cigarette) interventions in supporting smo...
BACKGROUND: Smoking during pregnancy adversely affects both mothers and fetuses. This study aimed to evaluate the clinical effects of pharmacological and electronic cigarette (E-cigarette) interventions in supporting smoking cessation among pregnant women. METHODS: PubMed, EMBASE, CENTRAL, and EBSCO Open Dissertations were searched from inception to December 2024. Randomized controlled trials (RCTs) assessing pharmacotherapies or E-cigarette for smoking cessation during pregnancy were included. Quality of included RCTs was evaluated using the Cochrane risk of bias tool for randomized trials (RoB2). Pooled effects were measured using a random-effects model. The surface under the cumulative ranking curve (SUCRA) were used to rank intervention effects. RESULTS: Of 1,720 articles, 11 RCTs (n = 4,065) were included. One trial had a low risk of bias, three had some concerns, and six had a high risk. Both the combined use of nicotine patch and gum (relative risk [RR] 3.22; 95% confidence interval [CI]: 1.40, 7.39) and E-cigarette (RR 1.81; 95%CI: 1.11, 2.93) significantly improved point prevalence abstinence compared to usual care, with SUCRA values of 97.0% and 81.3%, respectively. Nicotine gum was significantly associated with higher birthweight (mean difference [MD] 337.00; 95% CI: 103.18, 570.82) and a lower risk of preterm birth compared to usual care (RR 0.39; 95% CI: 0.17, 0.91). CONCLUSIONS: The combination of a nicotine patch and gum and E-cigarette use are effective for smoking cessation in pregnant women. However, these findings were based on a limited number of studies, and further high-quality randomized controlled trials are needed to confirm their effectiveness.
Emotion regulation profiles moderate links between perceived interparental conflict, peer bullying victimization, and adolescent internet gaming disorder.
Liu L, Chen S, Tang X … +3 more , Bao J, Luo Y, Chen J
Addict Behav · 2026 Sep · PMID 42035710 · Publisher ↗
Perceived interparental conflict and peer bullying victimization are risk factors for adolescent internet gaming disorder (IGD). However, little is known about how these risks are associated with IGD across distinct emot...
Perceived interparental conflict and peer bullying victimization are risk factors for adolescent internet gaming disorder (IGD). However, little is known about how these risks are associated with IGD across distinct emotion regulation patterns from a person-centered perspective. This study examined whether associations of perceived interparental conflict and peer bullying victimization with adolescent IGD risk differ across emotion regulation profiles. Data were collected from 1,820 Chinese adolescents (M = 14.81, SD = 1.19). Latent profile analysis identified four emotion regulation profiles: "low cognitive reappraisal and expressive suppression", "moderate cognitive reappraisal and expressive suppression", "high cognitive reappraisal and expressive suppression", and "high cognitive reappraisal, low expressive suppression". Adolescents in the "high cognitive reappraisal, low expressive suppression" group reported the lowest IGD scores, perceived interparental conflict, and peer bullying victimization. Among moderate, high cognitive reappraisal-expressive suppression groups, both perceived interparental conflict and peer bullying victimization were positively associated with IGD risk, with stronger associations for perceived interparental conflict than those observed in high cognitive reappraisal and low expressive suppression group. These findings underscore the importance of considering complex emotion regulation patterns to better understand parental and peer influences on adolescent IGD risk.
Barriers to vape (e-cigarette) cessation encountered by adolescents who attempted to quit.
Poliakova N, Bouchard R, Haddad S … +3 more , Turcotte-Tremblay AM, Leatherdale ST, Bélanger RE
Addict Behav · 2026 Sep · PMID 42030767 · Publisher ↗
INTRODUCTION: Factors associated with vape (e-cigarette) cessation among adolescents remain poorly understood. This study aimed to describe barriers encountered by youth who attempted to quit vaping, identify correlates...
INTRODUCTION: Factors associated with vape (e-cigarette) cessation among adolescents remain poorly understood. This study aimed to describe barriers encountered by youth who attempted to quit vaping, identify correlates of these barriers, and examine their associations with abstinence. METHODS: Cross-sectional data were drawn from 6,808 students participating in the 2022/23 COMPASS host study who reported a past attempt to quit vaping. Seven items were used to assess perceived cessation barriers and were combined into a cumulative barrier score. Adjusted regressions were used to examine associations between this score as well as individual barrier items and sex, age, family-level material deprivation, use of other tobacco products, and past-30-day e-cigarette abstinence. RESULTS: Over half of adolescents (57%) reported at least one barrier, with "being addicted" (44%), "feeling less in control of moods" (37%), and "fear of failing to quit" (30%) being most frequently endorsed. Females had nearly twice the mean barrier score (mean ratio: 1.77 [1.63-1.90]) and were more likely to report all barriers, especially "weight gain concerns" (aRR: 2.36 [1.99-2.79]). Higher scores were also observed among older adolescents (ratio: 1.37 [1.22-1.52]), those experiencing greater material deprivation (1.12 [1.04-1.19]), and those who used other tobacco products (1.71 [1.58-1.85]). Among females and older adolescents, both individual barriers and the cumulative score were associated with a lower likelihood of abstinence. CONCLUSIONS: Adolescents face multiple and intersecting barriers when attempting to quit vaping. These barriers vary across groups and are linked to reduced abstinence, underscoring the need for tailored cessation interventions.
PTSD symptoms predict smoking outcomes following a computerized treatment for high trait anger.
Patel TA, Sala MC, Zvolenksy MJ … +1 more , Cougle JR
Addict Behav · 2026 Sep · PMID 42030766 · Publisher ↗
BACKGROUND: Research has linked trait anger to smoking and difficulties with cessation, leading to recent anger-focused interventions to facilitate smoking cessation. One factor relevant to both anger and difficulties wi...
BACKGROUND: Research has linked trait anger to smoking and difficulties with cessation, leading to recent anger-focused interventions to facilitate smoking cessation. One factor relevant to both anger and difficulties with cessation is elevated symptoms of posttraumatic stress disorder (PTSD). The present study sought to examine whether PTSD symptoms would predict smoking frequency and carbon monoxide levels in a computerized treatment for anger. METHODS: Trauma-exposed participants (N = 76; M = 37.9; 55.3% women) were examined to determine if PTSD symptoms at baseline predicted increased smoking at posttreatment and follow-up via structural equation modeling. RESULTS: PTSD symptoms predicted increased self-reported smoking and greater carbon monoxide levels at posttreatment, but not follow-up. Further, these relationships were independent of trait anger. CONCLUSIONS: Among trauma exposed individuals with high trait anger, greater PTSD symptoms at baseline predicted greater smoking at posttreatment, suggesting that anger alone may not be sufficient target to reduce smoking behaviors. The present study highlights the need to examine and address PTSD symptoms to impact smoking outcomes.
Drinking game behaviors, motivations to play, contextual factors, and perceived risks among university students in New Zealand.
Zamboanga BL, Newins AR, White B … +4 more , Berry KA, George AM, Hedger KV, Dresler E
Addict Behav · 2026 Aug · PMID 42025627 · Publisher ↗
University students from different countries report regular drinking game (DG) participation, a risky social activity known to encourage heavy consumption. Theory and research suggest that general drinking motives are pr...
University students from different countries report regular drinking game (DG) participation, a risky social activity known to encourage heavy consumption. Theory and research suggest that general drinking motives are proximal correlates of alcohol use. Motives specific to DGs are also associated with DG behaviors. Students can play DGs in different social contexts (e.g., house parties, with friends/roommates), and many recognize the associated health risks. However, the influence of motives to play DGs, perceived risk, and the social context on DG behaviors is unknown among New Zealand (NZ) university students. The present study addresses these research gaps among university students in NZ who reported past year DG participation (N = 217; M = 20.38, SD = 2.94, range = 18 to 35; female = 65%). Findings indicated that higher endorsement of the DG motive of sexual pursuit was associated with more frequent DG participation and more frequent DG intoxication. Additionally, 23.9% of participants who indicated there were risks associated with DG participation identified intoxication/rapid intoxication as a risk of DGs. Moreover, 73.3% of these participants reported becoming inebriated while playing at least once in the past 30 days, compared with 77.3% of those who did not identify this risk. Thus, students' perceived risk of getting drunk from playing DGs does not seem to deter some students from experiencing DG intoxication. Finally, most students played DGs with their friends (95.4%) and/or at residential settings (81.1%). When working with students who play frequently, practitioners could assess specific DG motives to help students understand their reasons for playing and identify less risky ways of achieving those motives.
Motives matter: predictive value of cannabis use motives in adolescents with dual disorders - A longitudinal study.
Matalí JL, Flores E, Estrada-Prat X … +1 more , Vidal-Ribas P
Addict Behav · 2026 Aug · PMID 42025626 · Publisher ↗
Cannabis is the most widely used illicit substance among adolescents, and early or frequent use is associated with adverse outcomes, particularly among those with dual disorders. This study examined whether specific cann...
Cannabis is the most widely used illicit substance among adolescents, and early or frequent use is associated with adverse outcomes, particularly among those with dual disorders. This study examined whether specific cannabis use motives are associated with baseline clinical severity and short- and mid-term outcomes in adolescents with cannabis use disorder (CUD) and psychiatric comorbidity A sample of 235 adolescents (aged 13-18 years; 40% female), who had met DSM-5 criteria for CUD at admission to outpatient program, was recruited from a specialized hospital-based outpatient unit within the public mental health system for adolescents with dual disorders and assessed at baseline shortly after being admitted into the program, and followed up at 3 and 6 months. Cannabis use motives were measured using the Marijuana Motives Measure. Outcomes included overall clinician-rated severity and improvement (CGI-S, CGI-I), global functioning (CGAS), and biological indicators of cannabis use based on urinary Δ9-tetrahydrocannabinol (THC) concentrations. Multivariate regression models examined the predictive value of motives while adjusting for relevant variables. Coping motives were associated with greater baseline cannabis use disorder severity and lower likelihood of externalizing comorbidity. Enhancement motives were linked to lower overall clinical severity and fewer comorbid disorders, and predicted abstinence based on THC concentrations at 6 months. Conformity motives predicted abstinence based on THC concentrations at 3 months; however, no associations were observed between social or expansion motives and clinical outcomes. Overall, associations were few and generally modest in magnitude, with substantial uncertainty across estimates. These findings indicate that some cannabis use motives show selective and time-dependent associations with clinical outcomes in adolescents with dual disorders. Larger clinical samples may help clarify whether motives may aid clinical characterization and risk stratification in adolescent substance use treatment.
Frustration-related cognitive, motivational, and self-regulatory dysregulation in gaming disorder: roles of frustration intolerance, frustrative non-reward, and procrastination.
Jian CR, Liao HY, Lee KL … +3 more , Yen JY, Hung CH, Ko CH
Addict Behav · 2026 Aug · PMID 42019189 · Publisher ↗
BACKGROUND: Frustration has been proposed as a key trigger of dysregulation in Gaming Disorder (GD), yet the specific frustration-related traits involved remain unclear. This study examined whether frustration-intoleranc...
BACKGROUND: Frustration has been proposed as a key trigger of dysregulation in Gaming Disorder (GD), yet the specific frustration-related traits involved remain unclear. This study examined whether frustration-intolerance beliefs (cognitive-appraisal), frustrative non-reward responsiveness (FNR; motivational reactivity), and procrastination (executive-behavioral dysregulation) are associated with GD diagnosis and severity. METHODS: This study presents secondary analyses of the same sample previously reported in Yen et al. (2022), with the present paper focusing on frustration-related variables. Adults aged 20-40 years completed clinical interviews for GD based on ICD‑11 criteria. Sixty individuals with GD were frequency‑matched to 120 community controls by gender and age. Measures included the Frustration Discomfort Scale, the FNR scale, and the General Procrastination Scale; CIAS‑G core symptoms and related problems indexed GD severity. Group comparisons, forward logistic regression, correlational analyses, and forward linear regression were conducted. RESULTS: Compared with controls, the GD group showed higher levels of procrastination, FNR, and frustration intolerance. In logistic models, discomfort intolerance, poor planning, and FNR independently predicted GD diagnosis. Across the whole sample, all three traits were intercorrelated and positively associated with GD severity. Within the GD group, core addictive symptoms were most strongly related to emotional intolerance and poor time management, whereas related problems were most strongly related to FNR and emotional intolerance. CONCLUSIONS: Findings support a frustration-related cognitive-motivational-self-regulatory framework for GD, in which frustration-intolerance beliefs, heightened non-reward sensitivity, and procrastination are jointly associated with the risk, core addictive symptoms, and related problems of GD.
Psychological, behavioral, cognitive and social factors associated with single vs dual alcohol and cannabis use in adolescents with chronic pain.
Koike C, Tacugue N, Nestor BA … +4 more , Weitzman ER, Shrier LA, Greco C, Kossowsky J
Addict Behav · 2026 Aug · PMID 41990709 · Full text
PURPOSE: Alcohol and cannabis are psychotropic substances most used by adolescents. Psychological, behavioral, social, and cognitive factors linked to substance use in adolescents with chronic pain (ACP) are unclear. We...
PURPOSE: Alcohol and cannabis are psychotropic substances most used by adolescents. Psychological, behavioral, social, and cognitive factors linked to substance use in adolescents with chronic pain (ACP) are unclear. We examined these factors among four groups: those reporting Only Alcohol Use (AU), Only Cannabis Use (CU), Co-use of Alcohol and Cannabis (CAM), and No Substance Use (No-SU). METHODS: From September 2021 to May 2024, we surveyed 243 patients from a pediatric pain clinic in the Northeastern U.S. Kruskal Wallis, Mann-Whitney U, and Monte Carlo Chi-Square tests assessed group differences. RESULTS: Among 243 (M = 16.9, SD = 1.42 years, 68% female), 12.3% reported AU, 5.3% CU, 19.8% CAM, and 62.6% No-SU in their lifetime. Groups differed by age, functional disability, depressive symptoms, and behavior avoidance in drive and fun-seeking domains (ps < 0.05). CAM group was older (p < 0.001), more depressed (p = 0.003), stressed (p = 0.03), and had more school-related anxious anticipation (p = 0.03) than No-SU, reporting more drinking and drunkenness (ps < 0.05) than AU. CU group reported greater pain interference (p = 0.04) and functional disability (p = 0.01) than AU, with 100% using for symptom relief and 85.6% for pain. Increased drunkenness past-year was positively associated with stricter curfew times and increased parental supervision in the CAM group (p < 0.006). DISCUSSION: CAM group reported more stress, depression, and alcohol consumption, complicating pain management. CU is frequently used for pain relief and is associated with greater functional disability. Interventions targeting substance use and mental, physical, and social wellbeing in ACP are limited, underscoring the need for multidisciplinary strategies addressing pain and substance use in parallel.
Unraveling the dynamics among Internet gaming disorder, depression and emotion dysregulation in Chinese adolescents: A cross-lagged panel network analysis.
Yu C, Liao X, Ni X … +4 more , Ou Z, Wang M, Chen J, Huang S
Addict Behav · 2026 Aug · PMID 41990708 · Publisher ↗
Internet gaming disorder (IGD) jeopardizes adolescents' physical and psychological health and often co-occurs with depression and emotion dysregulation. The current understanding of the symptom-level associations among I...
Internet gaming disorder (IGD) jeopardizes adolescents' physical and psychological health and often co-occurs with depression and emotion dysregulation. The current understanding of the symptom-level associations among IGD, depression, and emotion dysregulation remains limited. This study explored the unique longitudinal relationships among the symptoms of IGD, depression, and emotion dysregulation in adolescents. In total, 466 boys and 420 girls completed the IGD, Center for Epidemiological Studies Depression, and Difficulties in Emotion Regulation scales at three time points (Time 1, Time 2, and Time 3), with each wave spaced six months apart. Their ages ranged from 9 to 13 years, with a mean age of 10.17 years (SD = 0.73). A cross-lagged panel network (CLPN) was used for the data analysis. CLPN analysis indicated that "psychosocial problems", "depressed affect", and "somatic and retarded activity" were the most impactful symptoms from T1 to T2. From T2 to T3, "depressed affect", "lack of emotional clarity", and "psychosocial problems" were the most impactful symptoms. Additionally, "depressed affect" was the most important bridging symptom in the network. Notably, reciprocal relationships were observed among several factors: between "somatic and retarded activity" and "uncontrollability", between "limited access to emotion regulation strategies" and "uncontrollability", and between "somatic and retarded activity" and "difficulties engaging in goal-directed". This pattern points to a potential self-reinforcing cycle. This study identified the specific bidirectional predictive relationships among IGD, depression, and emotion dysregulation at the symptom level in adolescents. Additionally, it pinpointed central and bridging symptoms as targets for preventing co-occurring issues. The results underscore the imperative to design targeted strategies that bolster adolescents' psychological health.
Early onset of cannabis use and risk for opioid use disorder across two decades in the United States.
Agrawal A, Nelson EC
Addict Behav · 2026 Aug · PMID 41950659 · Full text
BACKGROUND: Opioid use disorder (OUD) and other risky forms of opioid engagement significantly impact the health of Americans. Those who use cannabis at an early age may be at greater likelihood of OUD and riskier forms...
BACKGROUND: Opioid use disorder (OUD) and other risky forms of opioid engagement significantly impact the health of Americans. Those who use cannabis at an early age may be at greater likelihood of OUD and riskier forms of opioid misuse. METHODS: We used data on individuals aged 18 years and older from the cross-sectional annual National Survey on Drug Use and Health data collected from 2002 to 2024, and two independent surveys comprising the National Epidemiological Survey on Alcohol and Related Conditions (2001-2002,2012-2013). Logistic regression with survey procedures were used to examine the association between cannabis use prior to age 15 and opioid use disorder, injection heroin and fentanyl use. RESULTS: Cannabis use onsets predominantly preceded first use of opioids. Use of cannabis prior to age 15 was robustly associated with past year (Odds Ratio OR ranging from 1.57 to 4.20) and lifetime (OR range 1.88-2.28) OUD, even after adjustment for sociodemographic and substance use measures. Additional control for behavioral factors only modestly attenuated effect sizes (OR range: 1.27-3.24). Early cannabis use was also associated with injection heroin use (OR range: 3.00-5.81) and misuse of illegally manufactured fentanyl (OR range: 2.19-3.01). CONCLUSION: Even after accounting for correlated variables, onset of cannabis use during early adolescence is associated with increased likelihood of OUD and riskier forms of opioid use that increase vulnerability to overdose and mortality. In this era of cannabis legalization, heightened vigilance is required to deter early onset of cannabis use.
Latent classes of substance use precursors predict positive alcohol and cannabis expectancies one year later in Black and Latino early adolescents in the ABCD study.
Chung T, Kennelly N, Latendresse SJ … +2 more , Powell MZ, Sartor CE
Addict Behav · 2026 Aug · PMID 41950658 · Full text
INTRODUCTION: Precursors of alcohol and cannabis use, such as friend (dis)approval, have rarely been examined in person-centered analyses that can inform tailored prevention, particularly among Black and Latino youth. Th...
INTRODUCTION: Precursors of alcohol and cannabis use, such as friend (dis)approval, have rarely been examined in person-centered analyses that can inform tailored prevention, particularly among Black and Latino youth. This study aimed to identify person-centered patterns (classes) of precursors of alcohol and cannabis use in Black and Latino youth, examine correlates across classes, and determine whether the classes predicted positive anticipated effects (expectancies) of alcohol and cannabis one year later. METHODS: Latent class analyses used data from Black and Latino pre-adolescents in the Adolescent Brain Cognitive Development Study Follow-up Year 2 (n = 3,003; 31.0% Black, 69.0% Latino; mean age: 12.0, SE = 0.0). The 3-step method examined correlates of the classes (e.g., parental monitoring, cultural values) and used class membership to predict positive expectancies at Follow-up Year 3. RESULTS: Three latent classes emerged: low risk (High friend disapproval/ moderate-high perceived risk of harm: 46.7%), high risk (Low friend disapproval/low perceived risk of harm: 10.5%), and a class characterized by protective (high friend disapproval) and risk-elevating (low perceived risk of harm) precursors (divergent class; 42.8%). The high (vs low) risk class reported greater externalizing behavior. The low risk (vs divergent) class was higher on an indicator of familism. Low risk (vs divergent) class membership predicted lower positive expectancies across substances, but low (vs high) risk class membership did not significantly predict expectancies. CONCLUSION: Findings underscore heterogeneity in the co-occurrence of precursors to alcohol and cannabis use among pre-adolescent Black and Latino youth and the relevance of distinct patterns of precursors in predicting positive expectancies.
The role of hopelessness and depression in cannabis-induced first-episode psychosis: a 24-month prospective study.
Ricci V, Martinotti G, Maina G
Addict Behav · 2026 Aug · PMID 41946034 · Publisher ↗
Cannabis use is a recognized risk factor for psychosis, yet the psychological mechanisms mediating this relationship remain incompletely understood. This 24-month prospective observational study investigated the role of...
Cannabis use is a recognized risk factor for psychosis, yet the psychological mechanisms mediating this relationship remain incompletely understood. This 24-month prospective observational study investigated the role of hopelessness and depression in the development, maintenance, and outcomes of cannabis-induced first-episode psychosis (CIP). Participants (N = 72) with CIP were assessed at baseline and followed up at 6, 12, and 24 months. Hopelessness (Beck Hopelessness Scale), depressive symptoms (Calgary Depression Scale for Schizophrenia), psychotic symptoms (PANSS), and cannabis use patterns were evaluated. Both hopelessness (β = 0.30, p < 0.001) and depression (β = 0.34, p < 0.001) independently predicted psychotic symptom severity after controlling for confounding variables. Mediation analyses revealed that hopelessness and depression partially mediated the relationship between cannabis use and persistent psychotic symptoms, accounting for 31% and 35% of the total effect, respectively. Continued cannabis use during follow-up was associated with increased hopelessness and depression, which predicted worse clinical outcomes. The combination of high hopelessness, clinically significant depression, and continued cannabis use conferred a particularly elevated risk for relapse (HR = 4.32, 95% CI [2.41, 7.75]). These findings highlight the importance of assessing and addressing hopelessness and depression in CIP patients and suggest that these psychological factors represent potentially modifiable treatment targets that may improve outcomes in this vulnerable population.
The influence mechanism of parenting styles on college Students' problematic smartphone use: a structural equation model study from the perspective of emotion regulation.
Zhang J, Xue H, Qiao L
Addict Behav · 2026 Aug · PMID 41936298 · Publisher ↗
This study examined the relationship between parental rearing styles and Problematic Smartphone Use (PSU) among college students, with a focus on analyzing the parallel mediating roles of cognitive reappraisal (CR) and e...
This study examined the relationship between parental rearing styles and Problematic Smartphone Use (PSU) among college students, with a focus on analyzing the parallel mediating roles of cognitive reappraisal (CR) and expressive suppression (ES) as emotion regulation strategies, in order to reveal the influencing mechanisms of PSU. A total of 4,396 college students (mean age = 19.84 years; SD = 1.37; 49.8% male) completed the Short Form of the Egna Minnen Beträffande Uppfostran (s-EMBU), the Emotion Regulation Questionnaire (ERQ), and the Mobile Phone Addiction Index (MPAI). Results showed that rejecting and overprotective parental rearing styles significantly and positively influenced PSU among college students, while emotional warmth significantly and negatively influenced PSU among college students. Both rejecting and overprotective rearing styles positively influenced PSU through CR and ES respectively. Emotional warmth negatively influenced PSU through CR and ES respectively. The mediating effect of CR between different parental rearing styles and PSU was approximately 1-3 times that of ES. The overall model explained 65% of the variance in PSU among college students. These findings may provide useful information for clinical practice to develop targeted interventions and prevention programs to address PSU among college students.
Experimental and observational evidence on substance use and metacognition among adults: a systematic review.
Seng S, Okoli CTC, Williams LB … +2 more , Babalonis S, Ashford KB
Addict Behav · 2026 Aug · PMID 41935518 · Publisher ↗
PURPOSE: Metacognition - the capacity to monitor, interpret, and regulate cognitive processes - is essential for adaptive behavioral regulation. Evidence on how substance use relates to metacognitive functioning remains...
PURPOSE: Metacognition - the capacity to monitor, interpret, and regulate cognitive processes - is essential for adaptive behavioral regulation. Evidence on how substance use relates to metacognitive functioning remains heterogeneous across substances and study designs. This systematic review synthesized evidence examining the relationship between substance use and metacognition among adults. METHODS: Following PRISMA 2020 guidelines, we searched PubMed, PsycINFO, CINAHL, and Web of Science from inception through March 2026. Eligible studies included experimental and observational designs enrolling adults (≥18 years) and reporting metacognitive outcomes. Studies not assessing metacognition, involving non-adult samples, or non-empirical publications were excluded. Risk of bias was assessed using Joanna Briggs Institute appraisal tools. Findings were synthesized narratively. RESULTS: Thirty-six studies (N = 2,852 participants) were included: randomized controlled trials (n = 16), quasi-experimental (n = 3), cross-sectional (n = 7), and case-control studies (n = 10). Experimental evidence showed substance-specific effects: alcohol findings were mixed across paradigms; cannabinoids generally impaired metacognitive accuracy and calibration; benzodiazepines impaired metacognitive awareness of performance and error detection; methamphetamine demonstrated dose-dependent effects on agency judgments; and nicotine replacement did not restore accuracy following abstinence. Craving states (nicotine, caffeine, methamphetamine) were associated with poorer monitoring and calibration. Observational studies indicated that cocaine, nicotine, opioid, cannabis, alcohol, and polysubstance use were generally associated with poorer metacognitive functioning, including greater maladaptive metacognitive beliefs and reduced monitoring accuracy, though some clinical comparisons showed domain-specific or relatively preserved functioning. CONCLUSION: Experimental studies suggest acute substance-related alterations in metacognitive functioning, while observational studies indicate that substance use is generally associated with poorer metacognitive functioning. Greater standardization and longitudinal research are needed to clarify mechanisms and inform interventions.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe