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Addiction. 2017 Feb;112(2):279-287. doi: 10.1111/add.13557. Epub 2016 Sep 22.

Trajectories of cannabis use disorder: risk factors, clinical characteristics and outcomes.

Author information

1
Oregon Research Institute, Eugene, OR, USA.
2
University of Oregon, College of Education, Eugene, OR, USA.

Abstract

AIMS:

To estimate cannabis use disorder (CUD) trajectory classes from ages 14 to 30 years and compare classes on clinical characteristics, risk factors and psychosocial outcomes.

DESIGN:

Four waves (T1-T4) of data from an epidemiological study of psychopathology among a regionally representative sample. Trajectory classes described risk for CUD as a function of age. The number of classes was determined by model fit.

SETTING:

Participants were selected randomly from nine high schools in western Oregon, USA.

PARTICIPANTS:

The sample included 816 participants [age at T1 mean = 16.6, standard deviation (SD) = 1.2; 44% male; 8% non-white].

MEASUREMENTS:

Participants completed diagnostic interviews, Child Trauma Questionnaire, Social Adjustment Scale and items adapted from the Wisconsin Manual for Assessing Psychotic-Like Experiences.

FINDINGS:

There were three CUD trajectory classes (Lo-Mendell-Rubin likelihood ratio test < 0.001): (1) persistent increasing risk; (2) maturing out, with increasing risk then decreasing risk; and (3) stable low risk. The persistent increasing class had later initial CUD onsets (η2  = 0.16, P < 0.001) and greater cumulative CUD durations (η2  = 0.26, P < 0.001). Male sex [odds ratio (OR) = 2.57, P = 0.018], externalizing disorders between ages 24 and 30 years (OR = 2.64, P < 0.001) and psychotic experiences during early adulthood (Cohen's d = 0.44, P = 0.016) discriminated between the persistent increasing and the maturing-out classes.

CONCLUSIONS:

Evidence suggests three distinguishable types of trajectory for development of cannabis use disorder starting in early teens: (1) persistent increasing risk; (2) maturing out, with increasing risk then decreasing risk; and (3) stable low risk.

KEYWORDS:

Adolescence; adulthood; cannabis use disorder; marijuana; outcomes; risk factors; trajectories

PMID:
27515021
PMCID:
PMC5233578
DOI:
10.1111/add.13557
[Indexed for MEDLINE]
Free PMC Article

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