Citation

Richmond-Rakerd LS, Fleming KA, Slutske WS. Clinical Psychological Science 2016; 4(2): 167-182.

Affiliation

Department of Psychological Sciences, University of Missouri - Columbia; Alcoholism Research Center at Washington University School of Medicine.

Copyright

(Copyright © 2016, Association for Psychological Science, Publisher SAGE Publishing)

DOI

10.1177/2167702615587457

PMID

27127730

PMCID

PMC4844227

Abstract

The order and timing of substance initiation has significant implications for later problematic patterns of use. Despite the need to study initiation from a multivariate framework, survival analytic methods typically cannot accommodate more than two substances in one model. The Discrete-Time Multiple Event Process Survival Mixture (MEPSUM; Dean, Bauer, & Shanahan, 2014) model represents an advance by incorporating more than two outcomes and enabling establishment of latent classes within a multivariate hazard distribution. Employing a MEPSUM approach, we evaluated patterns of tobacco, alcohol, and cannabis initiation in the National Longitudinal Study of Adolescent to Adult Health (N=18,923). We found four classes that differed in their ages and ordering of peak initiation risk. Demographics, externalizing psychopathology, and personality significantly predicted class membership. Sex differences in the association between delinquency and initiation patterns also emerged.

FINDINGS support the utility of the MEPSUM approach in elucidating developmental pathways underlying clinically relevant phenomena.

Language: en