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Drug Alcohol Depend. 2011 Jul 1;116(1-3):11-7. doi: 10.1016/j.drugalcdep.2010.11.024. Epub 2011 Jan 3.

Cannabis use and development of externalizing and internalizing behaviour problems in early adolescence: A TRAILS study.

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Department of Clinical Child and Adolescent Studies- Neurodevelopmental Disorders, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands.



To examine the prospective relationship between externalizing and internalizing problems and cannabis use in early adolescence.


Data were used from the TRAILS study, a longitudinal cohort study of (pre)adolescents (n=1,449), with measurements at age 11.1 (T1), age 13.6 (T2) and age 16.3 (T3). Internalizing (withdrawn behaviour, somatic complaints and depression) and externalizing (delinquent and aggressive behaviour) problems were assessed at all data waves, using the Youth Self Report. Participants reported on cannabis use at the second and third wave. Path analysis was used to identify the temporal order of internalizing and externalizing problems and cannabis use.


Path analysis showed no associations between cannabis use (T2-T3) and internalizing problems (T1-2-3). However, cannabis use and externalizing problems were associated (r ranged from .19-.58); path analysis showed that externalizing problems at T1 and T2 preceded cannabis use at T2 and T3, respectively. In contrast, cannabis use (T2) did not precede externalizing problems (T3).


These results suggest that in early adolescence, there is no association between internalizing behaviour and cannabis use. There is an association between externalizing behaviour and cannabis use, and it appears that externalizing behaviour precedes cannabis use rather than the other way around during this age period.

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