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There is substantial evidence for the assumption that particularly heavy cannabis usett is associated with a variety of psychopathologic conditions. Little is known about the relationship between cannabis and anxiety. Prior studies have concluded that cannabis use alone is not sufficient for the development of long-term anxiety, and it has been suggested that cannabis is simply a risk factor that operates in conjunction with other risk factors. One such risk factor may be an individuals' genetic vulnerability. The present study examines the relationship between cannabis use and symptoms of anxiety by taking a developmental molecular-genetic perspective with a focus on a polymorphism involved in the regulation of serotonin. Specifically, we concentrated on changes in cannabis use and symptoms of anxiety over time and differences herein for individuals with and without the short allele of the 5-HTTLPR genotype. Data were from 1424 adolescents over a period of 5 years. We used different statistical analyses to test co-development of cannabis use and symptoms of anxiety throughout adolescence and the possible role of the 5-HTTLPR genotype in this process. Results from different analyses showed that cannabis use is associated with an increase in symptoms of anxiety, but only in carriers of the short allele of the 5-HTTLPR genotype, not in non-carriers. The findings of the present study show first evidence that the links between cannabis use and symptoms of anxiety are conditional on the individuals' genetic make-up. [ABSTRACT FROM AUTHOR]

Objectives.The present study examined whether the relation of parental solicitation, parental control, and child disclosure with adolescent alcohol and cannabis use is similar for native and non-Western immigrant Dutch adolescents. Design.Questionnaire data from two study-samples were used with a combined sample of 705 adolescents (mean age 16.2 years; 47.2% female; 25.2% non-Western immigrant background). Results.Native Dutch adolescents reported more weekly alcohol use than immigrant adolescents, while rates of cannabis use by native and immigrant adolescents were similar. Immigrant females reported lower levels of parental solicitation and child disclosure, but higher levels of parental control than native females. There were no differences in the sources of parental knowledge between native and immigrant males. Regression analyses showed no significant interaction effects of parental solicitation, parental control, or child disclosure with ethnic background for both alcohol and cannabis use (allpvalues > .05). Conclusion.Despite mean level differences in various factors, we did not find evidence of an interaction effect of the sources of parental knowledge with ethnic background on alcohol and cannabis use. This suggests that theories and prevention strategies focusing on these sources of parental knowledge in relation to substance use can be applicable to both native and immigrant Dutch adolescents. [ABSTRACT FROM AUTHOR]

Aims To determine (1) the prospective associations of conduct problems during early adolescence with tobacco, alcohol and cannabis use in young adulthood and (2) to what extent these associations are due to overlapping genetic versus environmental influences. Design A prospective twin study using biometric twin modelling. Setting Finland. Participants A total of 1847 Finnish twins (943 males and 904 females) were interviewed in early adolescence, 73% of whom ( n = 1353, 640 males and 713 females) were retained in young adulthood. Measurements Symptom counts of conduct disorder (CD) criteria were obtained from a semi-structured clinical interview in early adolescence [age 14-15 years, mean = 14.2, standard deviation (SD) = 0.15]. Frequency of alcohol, tobacco and cannabis use was obtained from a semi-structured clinical interview in young adulthood (age 19.9-26.6 years, mean = 22.4, SD = 0.7). Findings We found modest to moderate phenotypical correlations ( r = 0.16-0.35) between early adolescent CD symptoms and substance use in young adulthood. In males, the phenotypical correlations of CD symptoms with all three substance use variables are explained largely by overlapping genetic influences. In females, overlapping shared environmental influences predominantly explain the phenotypical correlation between CD symptoms and tobacco and cannabis use. Conclusions Conduct disorder symptoms in early adolescence appear to moderately predict substance use in early adulthood. In males, genetic influences seem to be most important in explaining the relationship between conduct disorder symptoms and substance use whereas in females, shared environmental influences seem to be most important. [ABSTRACT FROM AUTHOR]

Aims To examine whether early onset of tobacco or alcohol use, and continued use of tobacco or alcohol in early adolescence, are related to a higher likelihood of developing a cannabis use disorder during adolescence. Design and setting Data were used from four consecutive assessment waves of the TRacking Adolescents' Individual Lives Survey ( TRAILS), a general Dutch population study. TRAILS is an ongoing longitudinal study that will follow the same group of adolescents from the ages of 10 to 24 years. Participants The sample consisted of 1108 (58% female) adolescents (mean ages at the four assessment waves are 11.09, 13.56, 16.27 and 19.05 years, respectively) Measurements Cannabis use disorders were assessed using the Composite International Diagnostic Interview 3.0 ( CIDI). Adolescent tobacco and alcohol use were assessed using self-report questionnaires. Findings Early-onset tobacco use [odds ratio ( OR) = 1.82, confidence interval ( CI) = 1.05-3.14, P < 0.05], but not early-onset alcohol use ( OR = 1.33, CI = 0.84-2.12, P > 0.05), was associated with a higher likelihood of developing a cannabis use disorder. Similarly, adolescents who reported continued use of tobacco ( OR = 2.47, CI = 1.02-5.98, P < 0.05), but not continued use of alcohol ( OR = 1.71, CI = 0.87-3.38, P > 0.05), were more likely to develop a cannabis use disorder. Conclusions Early-onset and continued tobacco use appear to predict the development of a cannabis use disorder in adolescence, whereas early onset and continued alcohol use do not. [ABSTRACT FROM AUTHOR]

Abstract: Background: Several studies have shown that early cannabis use is correlated with poor educational performance including high school drop-out. The predominant explanation for this relationship is that cannabis use causes disengagement from education. Another explanation is that the association between early cannabis use and educational attainment is not causal, but the result of overlapping risk factors that increase the likelihood of both early cannabis use and disengagement from education. These confounding factors could be of genetic and/or environmental origin. Methods: Here we use data from a large community-based sample of adult twins (N =3337) who completed a comprehensive semi-structured telephone interview. We first apply the classical twin-design to determine whether genetic and/or environmental influences underlie the relationship between early-onset cannabis use (prior to age 18) and early school leaving. Next, with a co-twin control design we investigate whether the relationship between the two variables is more likely due to direct causality or overlapping risk factors. Results: We find a significant phenotypic correlation between early-onset cannabis use and early school leaving (r =0.26), which could be explained by familial influences (of genetic and/or shared environmental origin). The pattern of odds ratios found in the co-twin control design is not consistent with direct causation, but rather suggests that the association is due to shared environmental factors influencing both variables. Conclusion: Our findings suggest that the relationship between early-onset cannabis use and school leaving is due to shared environmental risk factors influencing both the risk of early-onset cannabis use and early school leaving. [Copyright &y& Elsevier]

Aims To examine the direction of the longitudinal association between vulnerability for psychosis and cannabis use throughout adolescence. Design Cross-lagged path analysis was used to identify the temporal order of vulnerability for psychosis and cannabis use, while controlling for gender, family psychopathology, alcohol use and tobacco use. Setting A large prospective population study of Dutch adolescents [the TRacking Adolescents' Individual Lives Survey ( TRAILS) study]. Participants A total of 2120 adolescents with assessments at (mean) age 13.6, age 16.3 and age 19.1. Measurements Vulnerability for psychosis at the three assessment points was represented by latent factors derived from scores on three scales of the Youth Self- Report and the Adult Self- Report, i.e. thought problems, social problems and attention problems. Participants self-reported on cannabis use during the past year at all three waves. Findings Significant associations ( r = 0.12-0.23) were observed between psychosis vulnerability and cannabis use at all assessments. Also, cannabis use at age 16 predicted psychosis vulnerability at age 19 ( Z = 2.6, P < 0.05). Furthermore, psychosis vulnerability at ages 13 ( Z = 2.0, P < 0.05) and 16 ( Z = 3.0, P < 0.05) predicted cannabis use at, respectively, ages 16 and 19. Conclusions Cannabis use predicts psychosis vulnerability in adolescents and vice versa, which suggests that there is a bidirectional causal association between the two. [ABSTRACT FROM AUTHOR]

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We examined whether externalizing problem behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) predict illicit drug use independently, or whether their associations with drug use are mediated through cigarette smoking. We used a prospective longitudinal design within the FinnTwin12-17 study among Finnish adolescents with baseline at age 12 and follow-up surveys at ages 14 and 17. Path models were conducted with Mplus and included 1992 boys and 2123 girls. The outcome was self-reported ever use of cannabis or other illicit drugs at age 17. The predictors were: externalizing behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) assessed by teachers and parents (age 12) and self-reported cigarette smoking (age 14). The findings differed across behavior studied. The association of hyperactivity-impulsivity with drug use was mostly mediated through earlier cigarette smoking. Concerning aggressiveness and inattention, the results were different among girls than boys. Among girls no significant mediation occurred, whereas among boys more consistent evidence on mediation was seen. Consistently in all models, the direct association of early cigarette smoking on drug use was strong and highly significant. We conclude that the associations of externalizing problem behaviors with illicit drug use are partially mediated through cigarette smoking. Although interventions targeting externalizing problem behaviors may protect adolescents from early onset smoking and subsequently experimenting with drugs, interventions to prevent cigarette smoking initiation are also important in reducing risk of later drug use. [ABSTRACT FROM AUTHOR]

Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods Objectives were studied using data from 1300 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a large, general population study of Dutch adolescents. We used parent-reports on the Early Adolescent Temperament Questionnaire to assess the dimensions of high-intensity pleasure, shyness, fearfulness, frustration and effortful control at age 10–12 years. By means of self-reports, life-time and regular cannabis use were determined at age 15–18 years, and proportion of substance-using peers was determined at ages 12–15 and 15–18 years. Models were adjusted for age, sex, intelligence and parental cannabis use. Results High-intensity pleasure [odds ratio (OR) = 1.09, 95% confidence interval (CI) = 1.05–1.13] and effortful control (OR = 0.92, 95% CI = 0.89–0.96) affected the risk for life-time cannabis use through their influence on affiliation with cannabis-using peers. Shyness affected this risk independently from peer cannabis use. Only the pathway from effortful control was associated additionally with the development of regular cannabis use (OR = 0.93, 95% CI = 0.89–0.98). Conclusions Peer cannabis use and, to a lesser extent, certain temperamental characteristics affect an adolescent's risk of cannabis use, and should be considered in prevention programmes. We recommend future research to focus upon factors that potentially modify the association between temperament, affiliation with cannabis-using peers and cannabis use. [ABSTRACT FROM AUTHOR]

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Aims To identify early onset cannabis users by measuring basal hypothalamic–pituitary–adrenal (HPA) axis activity, which may be a risk factor for early onset substance use when showing low activity. Design In a prospective cohort study, adolescents who initiated cannabis use at an early age (9–12 years), those who initiated at a later age (13–14 years) and those who did not use cannabis by the age of 14 were compared with respect to HPA axis activity. Setting and participants Data were used from the first and second assessment wave of the TRacking Adolescents’ Individual Lives Survey (TRAILS), that included 1768 Dutch young adolescents aged 10–12 years who were followed-up across a period of 2 years. Measurements Cortisol was measured in saliva samples at awakening, 30 minutes later and at 8 p.m. at age 10–12. Self-reported age at first cannabis use was used. Findings The early onset group had lower cortisol levels 30 minutes after awakening than the late onset group (OR = 0.93, 95% CI: 0.86–0.99). Furthermore, compared to non-users, the early and late onset cannabis users had higher levels of cortisol at 8 p.m. (OR = 1.25, 95% CI: 1.03–1.53 and OR = 1.21, 95% CI: 1.01–1.45, respectively). Conclusions Some evidence was found for HPA axis hypo-activity at awakening in adolescents with early onset of cannabis use compared to late onset users, which might indicate an increased risk for early onset users of seeking stimulation to restore arousal levels by using substances. [ABSTRACT FROM AUTHOR]

The author comments on a study by Degenhardt and colleagues, on specific effect of adolescent cannabis use on anxiety - tentative explanations. The study helps answer the question if continued cannabis use in adolescence into adulthood is associated with major depression and/or anxiety disorders in adulthood, and looks at the need to understand more pathways towards mental health problems after continued cannabis use, since they can guide us to formulate intervention strategies at early stages.

Abstract: Background: The present study examined the relation between two different acculturation measures (i.e., linguistic acculturation and the acculturation strategies integration, separation and marginalization) and past year cannabis use. Additionally, we studied the mediating role of affiliation with cannabis-using peers. Method: Data were utilized from i4culture, a Dutch study on immigrant adolescents and young adults aged 15–24 years. Participants belonged to the five largest immigrant populations in the Netherlands, living in or around the four major Dutch cities: Amsterdam, the Hague, Rotterdam, and Utrecht. In total, 771 adolescents and young adults (mean age 19.29, SD=2.61, 53.8% female) from Surinamese (n =210, 27.2%), Moroccan (n =209, 27.1%), Turkish (n =110, 14.3%), Antillean (n =109, 14.1%), and Asian (n =133, 17.3%) backgrounds participated. With questionnaires, past year cannabis use, acculturation strategy, linguistic acculturation, and affiliation with cannabis-using peers were assessed. Results: Using logistic regression analyses, we found no relation between acculturation strategy and past year cannabis use (OR=1.25, p =0.38 for separation vs integration and OR=0.86, p =0.50 for marginalization vs integration). Linguistic acculturation was positively related to cannabis use (OR=2.20, p <0.01). Affiliation with cannabis-using peers partly mediated this relation (OR=1.09, p <0.01). Conclusions: Non-Western immigrant youngsters who speak the host culture's language at home are more likely to use cannabis than youngsters who speak their native language at home. The former group is more likely to affiliate with cannabis-using peers, which partly explains their increased risk of cannabis use. [Copyright &y& Elsevier]

Background The present study examined (1) the association between changes in perceived parental control and support from age 13 to 15 and early onset of cannabis use (before age 16), and (2) whether personality modifies the association between a decline in perceived parental control and support and early onset of cannabis use. Method Objectives were studied using data (three waves covering two years) from 444 Dutch adolescents participating in the Research on Adolescent Development and Relationships (RADAR) study. Adolescents had a mean age of 13 years at baseline, and reported at each wave about perceived parental control and support. Big Five personality traits and past year cannabis use were also measured by self-report. Joint latent growth curve–discrete-time survival analyses were used to answer the research questions. Results Early onset of cannabis use was reported by 19.4% of the sample. Overall, a decline in perceived parental control or support from age 13 to age 15 was unrelated to the risk of early onset of cannabis use. In adolescents with low levels of emotional stability and extraversion, a stronger decline in perceived parental control was associated with an increased risk of early cannabis use. Conclusions Experiencing a decline in parental control from age 13 to 15 is associated with early onset of cannabis use in adolescents characterized by low emotional stability and low extraversion. [ABSTRACT FROM AUTHOR]

Abstract: Background: The development of the fetal endocannabinoid receptor system may be vulnerable to maternal cannabis use during pregnancy and may produce long-term consequences in children. In this study, we aimed to determine the relationship between gestational cannabis use and childhood attention problems and aggressive behavior. Methods: Using a large general population birth cohort, we examined the associations between parental prenatal cannabis and tobacco use and childhood behavior problems at 18 months measured using the Child Behavior Checklist in N =4077 children. Substance use was measured in early pregnancy. Results: Linear regression analyses demonstrated that gestational exposure to cannabis is associated with behavioral problems in early childhood but only in girls and only in the area of increased aggressive behavior (B =2.02; 95% CI: 0.30–3.73; p =0.02) and attention problems (B =1.04; 95% CI: 0.46–1.62; p <0.001). Furthermore, this study showed that long-term (but not short term) tobacco exposure was associated with behavioral problems in girls (B =1.16; 95% CI: 0.20–2.12; p =0.02). There was no association between cannabis use of the father and child behavior problems. Conclusions: Our results suggest that intrauterine exposure to cannabis is associated with an increased risk for aggressive behavior and attention problems as early as 18 months of age in girls, but not boys. Further research is needed to explore the association between prenatal cannabis exposure and child behavior at later ages. Our data support educating future mothers about the risk to their babies should they smoke cannabis during pregnancy. [Copyright &y& Elsevier]

Abstract: Background: Cannabis is commonly used among pregnant women. It is unclear whether cannabis exposure causes hemodynamic modifications in the fetus, like tobacco does. Aims: This study aims to ascertain fetal blood redistribution due to intrauterine cannabis exposure. Methods: This study was embedded in the Generation R Focus Study, a population-based cohort of parents and children followed from pregnancy onwards. In late pregnancy, fetal hemodynamics was assessed with ultrasound measurements in cannabis-exposed and non-exposed fetuses. Pregnant women reported about substance use during pregnancy. A distinction was made between continued cannabis use (n =9), cannabis use only in early pregnancy (n =14), continued tobacco use (n =85), tobacco use only in early pregnancy (n =92), and no tobacco or cannabis use during pregnancy (n =85). Results: Continued cannabis use was associated with an increased pulsatility and resistance index of the uterine artery, while discontinued cannabis use was associated with a decreased pulsatility, and resistance index, as compared to controls. Additionally, continued cannabis exposure resulted in a significantly higher uterine pulsatility index and uterine resistance index compared to tobacco exposure. Continued cannabis use was found to be associated with a smaller aortic diameter, as well. No association between intrauterine cannabis exposure and the fetal cerebral vascular system was found. Conclusions: Our findings suggest that intrauterine cannabis exposure was associated with changes in hemodynamic programming of the vascular system of the fetus in late pregnancy mainly due to tobacco exposure, but intrauterine cannabis exposure did demonstrate a specific effect on the uterine blood flow. [Copyright &y& Elsevier]

The article discusses a study to examine externalizing behavior problems and cigarette smoking as predictors of subsequent cannabis use. It involves an analysis which focused on externalizing behavior problems, self-reported smoking, and cannabis use among adolescents in the Netherlands. Furthermore, it shows that although externalizing behavior problem is a starting point for substance use trajectories, early smoking is more important in the prediction of later cannabis initiation.

The article presents a study which investigates the effect of intrauterine cannabis exposure of pregnant women on fetal growth. In this study, 7,452 mothers who provided information on substance use and fetal growth were examined while fetal growth in the early, mid and late pregnancy was determined through ultrasound measures. It concludes that several adverse fetal growth trajectories can be associated with cannabis use even if pregnant women used it for only a short period of time.

Abstract: Aims: To ascertain demographic, emotional and social determinants of cannabis use in early pregnancy. Design: This study was embedded in the Generation R study, a multiethnic population-based cohort of parents and their children, followed from pregnancy to childhood. Setting: Rotterdam, The Netherlands. Participants: Mothers enrolled in pregnancy who answered questions about their own and their partners substance use before and during pregnancy (n =7610). Measurements: Using self-report questionnaires, information was collected on maternal demographics, psychopathology, delinquency, childhood trauma, social stress, family functioning, and parental alcohol, tobacco and substance use. Multinomial logistic regression analysis was used, with non-using women as reference. Findings: 246 (3.2%) women used cannabis before pregnancy and 220 (2.9%) women used cannabis both before and during pregnancy. The strongest determinant for maternal cannabis use during pregnancy was cannabis use by the biological father of the child (OR=38.56; 95%CI=26.14–58.88). Maternal cannabis use during pregnancy was also independently associated with being single (OR=4.25; 95%CI=2.33–7.75) or having a partner without being married (OR=2.75; 95%CI=1.56–4.85), childhood trauma (OR=1.39; 95%CI=1.22–1.57) and delinquency (OR=3.37; 95%CI=1.90–5.98), but not with maternal age, ethnicity, psychopathology, family functioning and perceived stress. Being religious was protective (Islam: OR=0.25; 95%CI=0.09–0.65) for maternal cannabis use during pregnancy. Additionally, lower educational level determined continued cannabis use in ever-users (OR=3.22; 95%CI=1.54–6.74). Conclusions: Our results showed that multiple demographic, emotional and social characteristics were associated with maternal cannabis use. These characteristics should be considered when investigating offspring exposed to cannabis in utero, as they may play an important role in mother–child interaction and child development. [Copyright &y& Elsevier]