***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This prospect i ve study tested the assertion that psychopathology would predict both adolescent alcohol use and problem use , whereas socialization factors would predict only use , and explored mechanisms by which predictors led to problem use in a community sample of families ( N = 216 ) .  Externalizing symptoms , parental alcoholism , peer influences , and parental support  were indirectly related to negative consequences through their effects on use level . Externalizing symptoms , internalizing symptoms , peer influences , and parental approval of use directly predicted consequences , controlling for the indirect effects through use level . Internalizing pathology potentiated the relation between consumption and consequences , whereas parental support and control mitigated this relation . Collectively , findings provided mixed support for the assertion that psychopathology would predict both use and problem use , whereas socialization factors would predict only use AIMS To examine the prospect i ve relationships between childhood externalizing and internalizing disorders and substance use in early adolescence . DESIGN Longitudinal , community-based study of twins ( aged 11 at intake ; aged 14 at follow-up ) . SETTING AND PARTICIPANTS The sample was composed of twins participating in the Minnesota Twin Family Study , an epidemiological sample of twins and their families representative of the state population of Minnesota . A total of 699 twin girls and 665 twin boys participated at both time-points . MEASUREMENTS Twins participated in in-person , life-time diagnostic assessment s of the following childhood DSM III-R externalizing and internalizing disorders at age 11 : conduct disorder , oppositional defiant disorder , attention deficit hyperactivity disorder , major depressive disorder and in addition , for girls only , overanxious disorder and separation anxiety disorder . At ages 11 and 14 , substance use and abuse were assessed . FINDINGS Externalizing psychopathology predicted having tried alcohol , nicotine and cannabis by age 14 as well as regular and advanced experience with these substances . Internalizing disorders showed weak effects , with only major depression at age 11 showing a significant relationship with substance use at age 14 . CONCLUSION The results suggest that externalizing psychopathology is a robust prospect i ve predictor of a variety of early onset substance use behaviors and is systematic ally related to degree of substance use involvement . The results also suggest that depression may predict initiation of licit substance use in early adolescence The present investigation examined the relationships between motives for cannabis use and negative consequences associated with cannabis use following a brief intervention . The sample consisted of 205 adolescent cannabis users ( 66.3 % male ) , who were recruited in high schools and r and omly assigned to a brief two-session motivational enhancement therapy ( MET ) or an educational feedback control ( EFC ) . Results supported the hypothesis that using cannabis to cope with negative affect would predict the number of problems and dependence symptoms related to cannabis use , after controlling for age , gender , years and frequency of cannabis use , and internalizing and externalizing behavior problems . Significant interactions between internalizing behavior problems and the coping motive showed that using to cope was associated with a higher number of cannabis dependence symptoms among adolescents reporting lower levels internalizing behavior problems . Findings support the potential utility of conducting further research to explore the coping motive as an important indicator of problematic cannabis use This study examined the link between childhood sexual abuse and adolescent substance use among girls , and evaluated depressive self-concept and  behavioral under-control  ( BUC ) as pathways to substance use for sexually abused girls . Participants ( n = 150 ) were drawn from a longitudinal study of the impact of domestic violence on the lives of women and children .  Structural equation modeling revealed that girls ’ childhood sexual abuse was associated prospect ively with their later substance use . This relationship persisted when age , co-occurring forms of child abuse ( physical , exposure to domestic violence ) , childhood depression and aggression , family income , maternal substance use , and parenting practice s were controlled . Behavioral under-control mediated the relationship between childhood sexual abuse and later substance use , but depressive self-concept did not . Implication s , limitations , and directions for future research are discussed Background Both early alcohol debut , behavioural and health problems are reported to enhance adolescence substance use . This prospect i ve study investigate the influence of behavioural and health problems on adolescents ' alcohol and drug use . Method Prospect i ve population based cohort study of 2 399 adolescents attending the Young-HUNT study , aged 13 - 15 at baseline in 1995/97 , and 17 - 19 at follow-up 4 years later . Exposure variables were self reported conduct problems , attention problems , anxiety and depressive symptoms , and muscular pain and tension . Outcome variables at follow-up were frequent alcohol use and initiation of drug use . Associations were estimated by logistic regression models , influence of gender and drinking status at baseline were controlled for by stratification . Results At follow-up 19 % of the students drank alcohol once a week or more frequently . Baseline conduct problems ( OR 2.2 , CI 1.7 - 3.0 ) and attention problems ( OR 1.5 , CI 1.2 - 2.0 ) increased the risk for frequent alcohol use at follow-up in the total population . Girls who had experienced alcohol-intoxications at baseline showed strong association between baseline problems and frequent alcohol use at follow-up . Conduct problems ( OR 2.5 , CI 1.3 - 4.8 ) , attention problems ( OR 2.1 , CI 1.2 - 3.4 ) , anxiety/depressive symptoms ( OR 1.9 , CI 1.1 - 3.1 ) and muscular pain and tension ( OR 1.7 , CI 1.0 - 2.9 ) all were associated with frequent alcohol use among early intoxicated girls.14 % of the students had tried cannabis or other drugs at follow-up . Conduct problems at baseline increased the odds for drug use ( OR 2.6 , CI 1.9 - 3.6 ) . Any alcohol intoxications at baseline , predicted both frequent alcohol use ( boys OR 3.6 , CI 2.4 - 5.2 ; girls OR 2.8 , CI 1.9 - 4.1 ) , and illegal drug use ( boys OR 4.7 ; CI 3.2 - 7.0 , girls OR 7.7 , CI 5.2 - 11.5 ) within follow-up . Conclusions Conduct problems in high-school more than doubles the risk for both frequent alcohol use and initiation of drug use later in adolescence . The combination of health problems and alcohol intoxication in early adolescence was closely associated with more frequent drinking later in adolescence among girls . Overall , early alcohol intoxication was closely associated with both frequent alcohol use and drug use at follow up in both OBJECTIVE To examine cross-sectionally and prospect ively relationships of  cigarette smoking  with  major depressive disorder ( MDD )  , controlling for comorbidity in a community sample of adolescents . METHOD A representative sample of 1,709 adolescents ( aged 14 through 18 years ) was assessed by using semistructured diagnostic interviews on two occasions , approximately 1 year apart . Logistic regression analyses were used to examine cross-sectionally and prospect ively the relationships between smoking and each psychiatric disorder , while statistically controlling for the other disorders . RESULTS Cross-sectional analyses revealed significant relationships of drug abuse/dependence and disruptive behavior disorders with adolescent smoking , even after the co-occurrence of all other disorders was controlled . Prospect ively , smoking was found to increase the risk of developing an episode of MDD and drug abuse/dependence , after adjusting for other disorders . Finally , only lifetime prevalence of MDD remained a significant predictor of smoking onset , after controlling for other disorders . Gender did not moderate any of the relationships between psychopathology and smoking . CONCLUSIONS The results suggest important relationships between cigarette smoking and psychiatric disorders among adolescents , particularly with regard to MDD , drug abuse/dependence , and disruptive behavior disorders . These findings have important clinical implication s , both for psychiatric care and for smoking prevention and cessation efforts with adolescents AIMS To examine whether child and adolescent psychopathology predicts subsequent tobacco use at 14 and 21 years of age . DESIGN Prospect i ve birth cohort study . SETTING Data are taken from the Mater Misericordiae Hospital and University of Queensl and Study of Pregnancy and its outcomes ( MUSP ) , a prospect i ve longitudinal study which recruited women at their first antenatal visit in Brisbane , Australia . PARTICIPANTS A 5- , 14- and 21-year follow-up of children whose mother 's were recruited into the MUSP birth cohort study at their first antenatal visit . MEASUREMENTS Psychopathology exposure was measured using the  Achenbach 's Child Behaviour Checklist ( CBCL ) at 5 years , the Youth Self Report  ( YSR ) at 14 years and the Young Adult Self Report ( YASR ) at 21 years . Outcome measures were the children 's tobacco smoking status at the 14 and 21 years ' follow-up and the Composite International Diagnostic Interview ( CIDI ) based DSM-IV nicotine dependence at 21 years ' follow-up . FINDINGS Externalizing symptoms had the strongest association with subsequent tobacco use . Children who met the criteria for CBCL aggression at 5 years were more likely to be tobacco smokers at the 14-year follow-up . YSR externalizing behaviours at the 14-year follow-up predicted tobacco smoking , but not DSM-IV nicotine dependence at the 21-year follow-up . Internalizing behaviour ( anxiety/depression ) was associated with a reduced rate of smoking at the 14- and 21-year follow-ups , but externalizing behaviour and attention problems at 14 and 21 years were associated separately and cumulatively with nicotine dependence at the 21-year follow-up . CONCLUSION Childhood and adolescent psychopathology predict tobacco smoking , but some forms of psychopathology predict increased ( aggression/delinquency ; attention problems ) and other forms decreased ( anxiety/depression ) smoking . There may be some benefits in targeting children with early onset aggressive/delinquent behaviour problems with tobacco smoking prevention initiatives The literature is equivocal regarding the role of internalizing problems in the etiology of adolescent substance use . In this study , we examined the association of internalizing and externalizing behavior problems and their co-occurrence with early adolescent substance use to help clarify whether internalizing problems operate as a risk or protective factor . A large community sample ( N = 387 ; mean age at the first assessment 12 years old ; 83 % White/non-Hispanic ) was assessed annually for 3 years .  Externalizing problem behavior in the absence of internalizing problems showed the strongest prospect i ve association with alcohol , cigarette , and marijuana use . A weaker , albeit statistically significant prospect i ve positive association was found between co-occurring internalizing and externalizing behavior problems and substance use .  Internalizing problems  in the absence of externalizing problems protected adolescents against cigarette and marijuana use . Clarifying the role of internalizing problems in the etiology of adolescent substance use can inform the development of early intervention and prevention efforts . Our results highlight the importance of further considering the co-occurrence of internalizing and externalizing behavior problems in developmental pathways to substance use OBJECTIVE To examine the progression of tobacco use and the patterns of comorbidity of tobacco use and psychiatric disorders . METHOD The authors conducted analyses of prospect i ve and retrospective reports , collected from 1988 to 1998 , of a sample of high- and low-risk youths identified on the basis of the presence or absence of a parental history of substance abuse or dependence .  RESULTS A parental history of substance use disorders was associated with regular tobacco use and nicotine dependence , but not with experimentation for all youths . Individual and composite psychiatric diagnoses were strongly associated with nicotine dependence , but not with regular use or experimentation . While the presence of an affective disorder and drug abuse/dependence generally increased the risk for co-occurring nicotine dependence , analyses based on the temporal onset of disorders showed that it was the initiation of alcohol or drug use that predicted the progression to nicotine dependence . For low-risk youths , oppositional defiant disorder was the single psychiatric risk factor that predicted the transition to nicotine dependence . CONCLUSIONS This study adds to the accumulating evidence that has implicated comorbid psychiatric disorders in the etiology and subsequent course of nicotine dependence . In addition , family history may represent an important indicator of an increased risk for nicotine dependence In this paper , we examine the effects of age at first substance use , and history of psychiatric disorders , on the development of  substance use disorder ( SUD ) by age 16 . We use a prospect i ve , longitudinal design to disaggregate the effects of age at first use and time since first use on the development of adolescent SUD . Second , we test the hypothesis that adolescent SUD is an unlikely progression from early substance use unless children also show other early conduct problems . A population sample of 1,420 children from the Great Smoky Mountains Study ( GSMS ) was assessed annually between ages 9 and 16 .  Logistic regression models were applied within the hierarchical Bayesian framework , where the covariate effects were described by time-varying parameters having a first-order auto-regressive prior distribution . Posterior analyses based on a Gibbs sampling approach revealed that , controlling for years of exposure , the risk of transition to SUD increased with age at onset for onsets before age 13 , but began to fall for onset at 14 . Among users , use alone , without early conduct problems , led to a 11 % prevalence of SUD by age 
    Output:
    
The most consistent associations were evident for depressive symptoms , particularly as predictors of substance use composite scores .
No clear association between anxiety and substance use or between internalizing symptoms and substance use was evident , and indeed these associations were as often negative as positive .
Mixed findings regarding the depression – substance use association , however , also call for greater attention to potential moderating factors that may help define who , when , and in what context depression serves as an important risk factor for later substance use above and beyond risk associated with externalizing symptoms