Abstract
Introduction
Identifying adolescents at risk for marijuana use who can be targeted for intervention efforts is critical. Certain personality traits are strongly associated with substance use, including marijuana use. We investigated the associations of impulsivity (and its subscales sensation seeking and lack of planning), aggression, and neuroticism with marijuana use (lifetime and frequency of past 12-month use) in a national sample of adolescents.
Methods
We used data from the National Comorbidity Survey: Adolescent Supplement, a nationally representative, cross-sectional study of 8495 U.S. adolescents aged 14 to 18 years. We calculated adjusted prevalence ratios and odds ratios to assess associations of the five personality scales with lifetime use and frequency of past 12-month use and examined gender as a potential moderator of these associations.
Results
Each of the personality traits was positively associated with lifetime use (all p < 0.001). Impulsivity (the total scale and both subscales) and aggression (all p < 0.05) were positively associated with frequency of past 12-month use. The neuroticism–lifetime use association was stronger among girls (p < 0.001) than boys (p < 0.05), and the associations of impulsivity and lack of planning with frequency of use were significant only among girls, with moderate female users reporting higher levels of the personality scales than infrequent users (both p < 0.01).
Conclusions
Our study highlights the potential importance of identifying personality traits, specifically disinhibition-related traits such as impulsivity and aggression, to reduce and prevent adolescent marijuana use.
Keywords: Marijuana, Personality, Adolescents, Zuckerman-Kuhlman Personality Questionnaire (ZKPQ), The National Comorbidity Survey: Adolescent Supplement (NCS-A)
Highlights
-
•
Impulsivity and aggression were each associated with higher lifetime and frequency of marijuana use.
-
•
Neuroticism was associated with higher lifetime marijuana use.
-
•
Personality–marijuana use associations differed by adolescent gender.
-
•
Early identification of disinhibition-related traits may be important for prevention efforts.
1. Introduction
Marijuana remains the most widely used illicit drug among adolescents (Johnston, O'Malley, Miech, Bachman, & Schulenberg, 2016). Most people initiate marijuana use in adolescence (Schulden, Thomas, & Compton, 2009), highlighting the importance of prevention and early intervention. Personality, an individual's behavioral, cognitive, and emotional response tendencies (Shiner & Caspi, 2003), has been proposed as a key risk factor for youth substance use (Conrod, 2016; Sher, Bartholow, & Wood, 2000; Woicik, Stewart, Pihl, & Conrod, 2009).
A recent meta-analysis identified conscientiousness, agreeableness, and neuroticism as key correlates of adult substance use (Kotov, Gamez, Schmidt, & Watson, 2010). Findings from cross-sectional and prospective studies with non-nationally representative samples of adolescents suggest that disinhibition-related personality traits such as conscientiousness and agreeableness are strongly associated with marijuana use (Flory, Lynam, Milich, Leukefeld, & Clayton, 2002; Kong et al., 2013; Malmberg et al., 2012; Muro & Rodríguez, 2015; VanderVeen, Hershberger, & Cyders, 2016). Assessing personality traits and their relationships with marijuana use in a nationally representative adolescent sample is a key next step in solidifying the evidence regarding these associations, which in turn guide intervention efforts. Evidence suggests altering the trajectory of maladaptive personality traits is possible with cost-effective, early psychological interventions (Barlow, Sauer-Zavala, Carl, Bullis, & Ellard, 2014; Kennedy, Rapee, & Edwards, 2009; Rapee, Kennedy, Ingram, Edwards, & Sweeney, 2010).
We used cross-sectional, nationally representative data from the National Comorbidity Survey: Adolescent Supplement (NCS-A) (Kessler, Avenevoli, Costello, et al., 2009; Kessler, Avenevoli, Green, et al., 2009; Merikangas, Avenevoli, Costello, Koretz, & Kessler, 2009). We examined impulsivity, aggression, and neuroticism as assessed by the Zuckerman Kuhlman Personality Questionnaire (ZKPQ) (Zuckerman, Michael, Joireman, Teta, & Kraft, 1993), which was adapted for use in the NCS-A. These ZKPQ personality traits correspond with NEO-PI-R (Costa & McCrae, 1992)'s conscientiousness, agreeableness, and neuroticism, respectively (Zuckerman, 2002; Zuckerman et al., 1993). We explored gender as a potential moderator of personality–marijuana use associations.
2. Material and methods
2.1. Study design and participants
The NCS-A (2001–2004) (Kessler, Avenevoli, Costello, et al., 2009; Kessler, Avenevoli, Green, et al., 2009; Merikangas et al., 2009) is a nationally representative, cross-sectional dataset containing information on prevalence and correlates of major mental disorders for 10,148 U.S. adolescents aged 13 to 18. We excluded 13 year olds because they had very low levels of marijuana use, yielding a sample of 8495 adolescents. We received authorization to access restricted NCS-A data from the Interuniversity Consortium for Political and Social Research and also obtained university IRB approval.
2.2. Measures
2.2.1. Marijuana use
Interviewers asked, “Have you ever used marijuana or hashish, even once?”, to determine lifetime marijuana use (yes: n = 2214, never: n = 6262). For frequency of past 12-month marijuana use, interviewers asked “How often did you use marijuana or hashish in the past 12 months- nearly every day, 3 to 4 days a week, 1 to 2 days a week, 1 to 3 days a month, or less than once a month?” to adolescents who responded affirmatively to marijuana use in the past 12 months (n = 1379). We categorized the data into three groups: frequent use (nearly every day or 3–4 days a week: n = 380), moderate use (1–2 days a week or 1–3 days a month: n = 410), and infrequent use (less than once a month: n = 580).
2.2.2. Personality scales
The adapted version of the ZKPQ was used in the NCS-A to assess adolescents' personality. The ZKPQ has good test/retest reliability as well as good convergent and discriminant validity (Zuckerman, 2002; Zuckerman et al., 1993). We utilized five ZKPQ personality scales: 1) impulsivity-sensation seeking (11 items; 2) sensation seeking (a 7-item subscale of impulsivity); 3) lack of planning (a 4-item subset of impulsivity); 4) aggression-hostility (7 items); and 5) neuroticism-anxiety (8 items) (labeled ‘impulsivity’, ‘sensation seeking’, ‘lack of planning’, ‘aggression’, and ‘neuroticism’ hereafter). Internal consistencies of each scale were acceptable (Cronbach's alpha for impulsivity = 0.77; sensation seeking = 0.71; lack of planning = 0.66; aggression = 0.80; neuroticism = 0.77).
We separately assessed sensation seeking and lack of planning—subscales of ZKPQ impulsivity—to better understand the “active ingredients” of impulsivity, as evidence for the association of impulsivity and marijuana use among adolescents is mixed, possibly due to differential associations of separate features of impulsivity with marijuana use (VanderVeen et al., 2016).
2.2.3. Sociodemographic variables
Adolescents' self-reported age (range: 14–18 years), race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, “other”), gender (girl, boy), and educational attainment of either parent (less than high school, high school graduate, some college, college graduate) were covariates.
2.3. Statistical analyses
Lifetime prevalence of marijuana use and frequency of past 12-month marijuana use were dependent variables. Impulsivity, sensation seeking, lack of planning, aggression, and neuroticism were independent variables; each was examined in a separate regression model.
We calculated descriptive statistics for age, race/ethnicity, gender, and parent education and identified their associations with the personality scales and marijuana use variables using weighted Chi-square and adjusted Wald tests. We used generalized linear modeling to calculate adjusted prevalence ratios in assessing associations between the five personality scales and lifetime use. We used multinomial logistic regression to calculate relative risk ratios in examining associations between the five personality scales and frequency of use. We adjusted for age, race/ethnicity, gender, and parent education, as these variables were associated with substance use in previous studies (Dierker et al., 2012; Keyes et al., 2015; Muro & Rodríguez, 2015). To examine gender as a potential moderator, we created terms to represent the interaction between each personality scale and gender and entered these interaction terms into our regression models. We planned gender-stratified analyses in the event that the coefficient for an interaction term was significant. As <1% of responses were missing, we used listwise deletion by default to handle missing data. Complex survey weights were applied prior to analyses to account for the NCS-A sampling method. Statistical significance was set at p-values < 0.05. Analyses were conducted using Stata13 (StataCorp, 2013).
3. Results
3.1. Sample characteristics
Adolescents aged 15 and older (χ2 = 71.63, p < 0.001) and those whose parents had not graduated college (χ2 = 10.55, p < 0.001) were more likely to report lifetime marijuana use. More boys than girls (χ2 = 4.98, p = 0.01) and more adolescents in the “other” race/ethnicity group than their non-Hispanic White counterparts (χ2 = 3.03, p = 0.03) reported high frequency of past 12-month marijuana use.
As displayed in Table 1, impulsivity-lack of planning differed by age (p < 0.05), impulsivity (total and both subscales) and neuroticism differed by gender (p < 0.001), impulsivity (total and both subscales) differed by race/ethnicity (p < 0.05), and impulsivity-lack of planning, aggression, and neuroticism differed by parent education level (p < 0.05).
Table 1.
Associations of participant characteristics with the five personality scales in the National Comorbidity Survey: Adolescent Supplement (2001–2004).
| Characteristics | Personality traits |
||||
|---|---|---|---|---|---|
| Impulsivity | Impulsivity-sensation seeking | Impulsivity-lack of planning | Aggression | Neuroticism | |
| Mean score (SE) | 16.4 (0.1) | 11.6 (0.1) | 4.8 (0.1) | 11.6 (0.1) | 8.6 (0.1) |
| Age | |||||
| 14 (ref) | 16.5 (0.2) | 11.5 (0.2) | 5.0 (0.1) | 11.6 (0.2) | 8.3 (0.2) |
| 15 | 16.5 (0.2) | 11.6 (0.1) | 4.8 (0.1) | 11.6 (0.2) | 8.8 (0.2) |
| 16 | 16.4 (0.2) | 11.7 (0.2) | 4.7 (0.1)⁎ | 11.7 (0.2) | 8.5 (0.2) |
| 17–18 | 16.3 (0.2) | 11.8 (0.1) | 4.5 (0.1)⁎⁎⁎ | 11.5 (0.2) | 8.7 (0.2) |
| Gender | |||||
| Female (ref) | 15.7 (0.2) | 11.2 (0.1) | 4.5 (0.1) | 11.5 (0.1) | 9.7 (0.1) |
| Male | 17.1 (0.1)⁎⁎⁎ | 12.1 (0.1)⁎⁎⁎ | 5.1 (0.1)⁎⁎⁎ | 11.7 (0.1) | 7.5 (0.1)⁎⁎⁎ |
| Race/ethnicity | |||||
| Non-Hispanic White (ref) | 16.7 (0.1) | 11.9 (0.1) | 4.9 (0.1) | 11.5 (0.1) | 8.6 (0.1) |
| Non-Hispanic Black | 15.2 (0.2)⁎⁎⁎ | 10.8 (0.1)⁎⁎⁎ | 4.3 (0.1)⁎⁎⁎ | 12.0 (0.2) | 8.2 (0.2) |
| Hispanic | 16.7 (0.2) | 11.8 (0.2) | 4.9 (0.1) | 11.5 (0.3) | 8.5 (0.1) |
| Other | 15.4 (0.4)⁎⁎ | 11.1 (0.3)⁎ | 4.3 (0.2)⁎ | 11.3 (0.3) | 9.2 (0.4) |
| Parent education | |||||
| Did not complete than high school | 16.6 (0.3) | 11.6 (0.3) | 5.0 (0.1)⁎⁎ | 11.9 (0.2)⁎⁎ | 8.9 (0.2)⁎⁎ |
| Completed high school | 16.5 (0.2) | 11.7 (0.1) | 4.8 (0.1)⁎ | 12.1 (0.2)⁎⁎⁎ | 8.7 (0.2) |
| Attended college | 16.5 (0.2) | 11.6 (0.1) | 4.9 (0.1)⁎⁎ | 11.8 (0.1)⁎⁎⁎ | 8.6 (0.2) |
| College graduate (ref) | 16.2 (0.1) | 11.6 (0.1) | 4.6 (0.1) | 10.9 (0.1) | 8.3 (0.1) |
Note. Adjusted Wald tests were conducted to compare sociodemographic characteristics of participants by personality traits.
SE = standard error. Ranges for each style are impulsivity: 0–33; impulsivity-sensation seeking: 0–21; impulsivity-lack of planning: 0–12; aggression: 0–21; neuroticism: 0–24.
Significant (p < 0.05) differences are in bold font.
p < 0.05.
p < 0.01.
p < 0.001.
3.2. Personality scales and marijuana use
All five personality scales were positively associated with lifetime prevalence of marijuana use (all p < 0.001). Impulsivity (including both sensation seeking and lack of planning), and aggression were positively associated with higher frequency of past 12-month marijuana use (all p < 0.01) (see Table 2).
Table 2.
Associations between personality and marijuana use in the National Comorbidity Survey: Adolescent Supplement (2001–2004).
| Adolescent marijuana use |
||||
|---|---|---|---|---|
| Lifetime use aPR (95% CI) |
Frequency of use in the past 12 months aORa (95% CI) |
|||
| Ever (26.5%) vs. never (73.5%) |
Infrequent (43.0%) |
Moderate (30.0%) |
Frequent (27.0%) |
|
| Personality traits | ||||
| Impulsivity | 1.08⁎⁎⁎ (1.06, 1.09) | 1.00 (ref) | 1.06⁎⁎ (1.02, 1.10) | 1.08⁎⁎⁎ (1.04, 1.13) |
| Sensation seeking | 1.10⁎⁎⁎ (1.08, 1.12) | 1.00 (ref) | 1.18⁎⁎ (1.03, 1.13) | 1.09⁎⁎ (1.02, 1.16) |
| Lack of planning | 1.12⁎⁎⁎ (1.10, 1.14) | 1.00 (ref) | 1.08⁎ (1.01, 1.16) | 1.17⁎⁎⁎ (1.10, 1.24) |
| Aggression | 1.10⁎⁎⁎ (1.09, 1.11) | 1.00 (ref) | 1.07⁎⁎ (0.90, 1.08) | 1.08⁎⁎ (1.03, 1.12) |
| Neuroticism | 1.04⁎⁎⁎ (1.02, 1.05) | 1.00 (ref) | 1.00 (0.96, 1.05) | 1.05 (1.00, 1.11) |
Note. CI = confidence interval, aPR = adjusted prevalence ratio, aOR = adjusted odds ratio, regression models were adjusted for age, race/ethnicity, gender, and education attainment of either parent.
Past 12-month frequency of use: frequent use = nearly every day or 3 to 4 days a week; moderate use = 1 to 2 days a week or 1 to 3 days a month; infrequent use = less than once a month.
Relative risk ratios from multinomial logistic regression interpreted as odds ratios.
p < 0.05.
p < 0.01.
p < 0.001.
3.3. Moderation by gender
Gender was a significant moderator of the neuroticism–lifetime use association (β = 1.05, 95% confidence interval [CI] = 1.01, 1.08, p = 0.013), the impulsivity–frequency of use association (moderate vs. infrequent: β = 1.08, CI = 1.02, 1.14, p = 0.013), and the lack of planning–frequency of use association (moderate vs. infrequent: β = 1.23, CI = 1.07, 1.42, p = 0.006). The neuroticism–lifetime use association was stronger in girls (aPR = 1.05, CI = 1.03, 1.06, p < 0.001) than boys (aPR = 1.02, CI = 1.01, 1.04, p = 0.021). Among girls, moderate users showed higher impulsivity (aOR = 1.09, CI = 1.05, 1.14, p < 0.001) and higher lack of planning (aOR = 1.18, CI = 1.06, 1.31, p = 0.003) than infrequent users. Among boys, moderate users did not differ from infrequent users in impulsivity (aOR = 1.02, CI = 0.98, 1.07, p = 0.240) and lack of planning (aOR = 0.97, CI = 0.88, 1.08, p = 0.577).
4. Discussion
We examined associations of personality scales with lifetime marijuana use and frequency of past 12-month marijuana use in a nationally representative sample of U.S. adolescents. Each personality scale showed small but significantly positive associations with lifetime use, indicating higher levels of impulsivity, aggression, and neuroticism may distinguish adolescents who have ever used marijuana from those who have not. Impulsivity and aggression but not neuroticism were positively associated with frequency of use, suggesting adolescents with higher levels of impulsivity and aggression were more frequent users of marijuana than their peers without such tendencies. Our moderation analyses showed that the association of neuroticism and lifetime use was stronger among girls than boys, and the association of impulsivity (the total impulsivity score and the lack of planning subscale) with frequency of use was significant for girls but not boys, with significant associations for girls who reported moderate but not infrequent use.
Impulsivity and aggression were significantly associated with marijuana use. Our findings are similar to those of previous studies in non-representative samples that assessed lifetime use (Malmberg et al., 2012), past 12-month use (Muro & Rodríguez, 2015), and past 30-day use (Kong et al., 2013). We also found neuroticism was not associated with frequency of marijuana use and that the association of neuroticism with lifetime use was not as robust as those of impulsivity and aggression with lifetime use. These results are similar to a recent meta-analysis that showed strong associations of both low conscientiousness (i.e., high impulsivity) and low agreeableness (i.e., high aggression) but relatively weak associations of neuroticism with adult substance use disorders. Our findings contribute to the current efforts in developing a comprehensive developmental model of marijuana use, as our findings are consistent with a recent theoretical model that argues for a crucial role of disinhibition-related traits, such as impulsivity and aggression, in substance use and other externalizing behaviors as compared with a key role of neuroticism in internalizing behaviors (Clark & Watson, 2008; Krueger, Markon, Patrick, Benning, & Kramer, 2007).
Associations between neuroticism and lifetime use, as well as between impulsivity (the total impulsivity score and the lack of planning subscale) and frequency of use significantly differed by gender in our study. Girls reported higher neuroticism and stronger positive associations between neuroticism and lifetime use as compared with boys. Boys reported higher impulsivity and more frequent use of marijuana than girls. Impulsivity and lack of planning were only associated with frequency of use among girls, with moderate female users reporting higher levels of these personality characteristics than infrequent users. Our findings suggest the lack of planning component of impulsivity may be more relevant for marijuana use frequency than the sensation-seeking component. Girls with lack of planning capacities may benefit from a program that teaches them organization skills.
One possible implication of our findings is that personality screening among adolescents may contribute to effective prevention and early intervention strategies for marijuana use. Longitudinal studies have shown that changes in personality traits can prevent future substance use in children (Hampson, Tildesley, Andrews, Luyckx, & Mroczek, 2010) and adults (Turiano, Whiteman, Hampson, Roberts, & Mroczek, 2012). Evidence suggests altering the trajectory of maladaptive personality traits is possible with cost-effective, early psychological interventions (Barlow et al., 2014; Kennedy et al., 2009; Mihalopoulos et al., 2015; Rapee et al., 2010). There is emerging evidence for personality-targeted approaches to substance use prevention, specifically in the Netherlands, England, and Australia (Conrod, 2016; Conrod, Castellanos-Ryan, & Strang, 2010; Mahu, Doucet, O'Leary-Barrett, & Conrod, 2015). The Preventure Programme screens high-risk individuals based on their personality scales and target personality-specific pathways to substance misuse (for a detailed description of the Preventure Programme, see Conrod, 2016).
This study is limited by the fact that data on personality scales and marijuana use were obtained via self-report. In addition, we cannot make causal inferences about the personality–marijuana use relationship as the NCS-A is cross-sectional in design. However, findings from several prospective studies indicate that maladaptive personality traits are likely to develop before substance use initiation and may predict maintenance and treatment outcome (Bogg & Roberts, 2013; Hengartner, Kawohl, Haker, Rössler, & Ajdacic-Gross, 2016; Lahey, 2009).
5. Conclusions
Our study highlights the potential importance of identifying personality traits, specifically disinhibition-related traits such as impulsivity and aggression, to reduce and prevent adolescent marijuana use. Given emerging evidence for benefits of personality-informed interventions in delaying the onset of or reducing marijuana use among non-U.S. adolescents, we recommend exploring implementation of such interventions in the U.S. Mindfulness-based interventions that promote self-regulation may also be promising in this context. Research has identified an inverse relationship between impulsivity and trait mindfulness (Murphy & MacKillop, 2012; Peters, Erisman, Upton, Baer, & Roemer, 2011) and supported the effectiveness of a mindfulness program in lowering impulsivity and aggression among high school students with behavioral issues (Franco, Amutio, López-González, Oriol, & Martínez-Taboada, 2016). Future research should explore whether such strategies could also be useful in preventing adolescent marijuana use.
Contributor Information
Angela E. Lee-Winn, Email: aleewin1@jhu.edu.
Tamar Mendelson, Email: tmendel1@jhu.edu.
Renee M. Johnson, Email: rjohnson@jhu.edu.
References
- Barlow D.H., Sauer-Zavala S., Carl J.R., Bullis J.R., Ellard K.K. The nature, diagnosis, and treatment of neuroticism back to the future. Clinical Psychological Science: A Journal of the Association for Psychological Science. 2014;2(3):344–365. doi: 10.1177/1745691614544528. [DOI] [PubMed] [Google Scholar]
- Bogg T., Roberts B.W. The case for conscientiousness: Evidence and implications for a personality trait marker of health and longevity. Annals of Behavioral Medicine. 2013;45(3):278–288. doi: 10.1007/s12160-012-9454-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Clark L.A., Watson D. Temperament: An organizing paradigm for trait psychology. In: John O.P., Robins R.W., Pervin L.A., editors. Handbook of personality: Theory and research. 3rd ed. Guilford Press; New York, NY: 2008. pp. 265–286. [Google Scholar]
- Conrod P.J. Personality-targeted interventions for substance use and misuse. Current Addiction Reports. 2016;3(4):426–436. doi: 10.1007/s40429-016-0127-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Conrod P.J., Castellanos-Ryan N., Strang J. Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence. Archives of General Psychiatry. 2010;67(1):85–93. doi: 10.1001/archgenpsychiatry.2009.173. [DOI] [PubMed] [Google Scholar]
- Costa P.T., McCrae R.R. Psychological Assessment Resources; Odessa, FL: 1992. Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI) [Google Scholar]
- Dierker L., Swendsen J., Rose J., He J., Merikangas K., Tobacco Etiology Research Network (TERN) Transitions to regular smoking and nicotine dependence in the Adolescent National Comorbidity Survey (NCS-A) Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine. 2012;43(3):394–401. doi: 10.1007/s12160-011-9330-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Flory K., Lynam D., Milich R., Leukefeld C., Clayton R. The relations among personality, symptoms of alcohol and marijuana abuse, and symptoms of comorbid psychopathology: Results from a community sample. Experimental and Clinical Psychopharmacology. 2002;10(4):425–434. doi: 10.1037//1064-1297.10.4.425. [DOI] [PubMed] [Google Scholar]
- Franco C., Amutio A., López-González L., Oriol X., Martínez-Taboada C. Effect of a mindfulness training program on the impulsivity and aggression levels of adolescents with behavioral problems in the classroom. Frontiers in Psychology. 2016;7(1385) doi: 10.3389/fpsyg.2016.01385. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hampson S.E., Tildesley E., Andrews J.A., Luyckx K., Mroczek D.K. The relation of change in hostility and sociability during childhood to substance use in mid adolescence. Journal of Research in Personality. 2010;44(1):103–114. doi: 10.1016/j.jrp.2009.12.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hengartner M.P., Kawohl W., Haker H., Rössler W., Ajdacic-Gross V. Big five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community. Journal of Psychosomatic Research. 2016;84:44–51. doi: 10.1016/j.jpsychores.2016.03.012. [DOI] [PubMed] [Google Scholar]
- Johnston L.D., O'Malley P.M., Miech R.A., Bachman J.G., Schulenberg J.E. Institute for Social Research, The University of Michigan; Ann Arbor: 2016. Monitoring the future national survey results on drug use, 1975–2015: Overview, key findings on adolescent drug use. [Google Scholar]
- Kennedy S.J., Rapee R.M., Edwards S.L. A selective intervention program for inhibited preschool-aged children of parents with an anxiety disorder: Effects on current anxiety disorders and temperament. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48(6):602–609. doi: 10.1097/CHI.0b013e31819f6fa9. [DOI] [PubMed] [Google Scholar]
- Kessler R.C., Avenevoli S., Costello E.J., Green J.G., Gruber M.J., Heeringa S.…Zaslavsky, M A. National comorbidity survey replication adolescent supplement (NCS-A): II. Overview and design. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48(4):380–385. doi: 10.1097/CHI.0b013e3181999705. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kessler R.C., Avenevoli S., Green J., Gruber M.J., Guyer M., He Y.…Zaslavsky, M A. National comorbidity survey replication adolescent supplement (NCS-A): III. Concordance of DSM-IV/CIDI diagnoses with clinical reassessments. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48(4):386–399. doi: 10.1097/CHI.0b013e31819a1cbc. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Keyes K.M., Vo T., Wall M., Caetano R., Suglia S.F., Martins S.S.…Hasin D. Racial/ethnic differences in use of alcohol, tobacco, and marijuana: Is there a cross-over from adolescence to adulthood? Social Science & Medicine (1982) 2015;124:132–141. doi: 10.1016/j.socscimed.2014.11.035. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kong G., Smith A.E., McMahon T.J., Cavallo D.A., Schepis T.S., Desai R.A.…Krishnan-Sarin S. Pubertal status, sensation-seeking, impulsivity, and substance use in high school-aged boys and girls. Journal of Addiction Medicine. 2013;7(2):116–121. doi: 10.1097/ADM.0b013e31828230ca. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kotov R., Gamez W., Schmidt F., Watson D. Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin. 2010;136(5):768–821. doi: 10.1037/a0020327. [DOI] [PubMed] [Google Scholar]
- Krueger R.F., Markon K.E., Patrick C.J., Benning S.D., Kramer M.D. Linking antisocial behavior, substance use, and personality: An integrative quantitative model of the adult externalizing spectrum. Journal of Abnormal Psychology. 2007;116(4):645–666. doi: 10.1037/0021-843X.116.4.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lahey B.B. Public health significance of neuroticism. The American Psychologist. 2009;64(4):241–256. doi: 10.1037/a0015309. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahu I.T., Doucet C., O'Leary-Barrett M., Conrod P.J. Can cannabis use be prevented by targeting personality risk in schools? Twenty-four-month outcome of the adventure trial on cannabis use: A cluster-randomized controlled trial. Addiction (Abingdon, England) 2015;110(10):1625–1633. doi: 10.1111/add.12991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Malmberg M., Kleinjan M., Vermulst A.A., Overbeek G., Monshouwer K., Lammers J., Engels R.C.M.E. Do substance use risk personality dimensions predict the onset of substance use in early adolescence? A variable- and person-centered approach. Journal of Youth and Adolescence. 2012;41(11):1512–1525. doi: 10.1007/s10964-012-9775-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Merikangas K., Avenevoli S., Costello J., Koretz D., Kessler R.C. National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures. Journal of the American Academy of Child and Adolescent Psychiatry. 2009;48(4):367–369. doi: 10.1097/CHI.0b013e31819996f1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mihalopoulos C., Vos T., Rapee R.M., Pirkis J., Chatterton M.L., Lee Y.-C., Carter R. The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2015;56(9):1026–1033. doi: 10.1111/jcpp.12438. [DOI] [PubMed] [Google Scholar]
- Muro I., Rodríguez A. Age, sex and personality in early cannabis use. European Psychiatry: The Journal of the Association of European Psychiatrists. 2015;30(4):469–473. doi: 10.1016/j.eurpsy.2015.02.008. [DOI] [PubMed] [Google Scholar]
- Murphy C., MacKillop J. Living in the here and now: Interrelationships between impulsivity, mindfulness, and alcohol misuse. Psychopharmacology. 2012;219(2):527–536. doi: 10.1007/s00213-011-2573-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peters J.R., Erisman S.M., Upton B.T., Baer R.A., Roemer L. A preliminary investigation of the relationships between dispositional mindfulness and impulsivity. Mindfulness. 2011;2(4):228–235. [Google Scholar]
- Rapee R.M., Kennedy S.J., Ingram M., Edwards S.L., Sweeney L. Altering the trajectory of anxiety in at-risk young children. The American Journal of Psychiatry. 2010;167(12):1518–1525. doi: 10.1176/appi.ajp.2010.09111619. [DOI] [PubMed] [Google Scholar]
- Schulden J.D., Thomas Y.F., Compton W.M. Substance abuse in the United States: findings from recent epidemiologic studies. Current Psychiatry Reports. 2009;11(5):353. doi: 10.1007/s11920-009-0053-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sher K.J., Bartholow B.D., Wood M.D. Personality and substance use disorders: A prospective study. Journal of Consulting and Clinical Psychology. 2000;68(5):818–829. [PubMed] [Google Scholar]
- Shiner R.L., Caspi A. Personality differences in childhood and adolescence: Measurement, development, and consequences. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2003;44(1):2–32. doi: 10.1111/1469-7610.00101. [DOI] [PubMed] [Google Scholar]
- StataCorp . StataCorp LP; College Station, TX: 2013. Stata statistical software: Release 13. [Google Scholar]
- Turiano N.A., Whiteman S.D., Hampson S.E., Roberts B.W., Mroczek D.K. Personality and substance use in midlife: conscientiousness as a moderator and the effects of trait change. Journal of Research in Personality. 2012;46(3):295–305. doi: 10.1016/j.jrp.2012.02.009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- VanderVeen J.D., Hershberger A.R., Cyders M.A. UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis. Drug and Alcohol Dependence. 2016;168:181–190. doi: 10.1016/j.drugalcdep.2016.09.016. [DOI] [PubMed] [Google Scholar]
- Woicik P.A., Stewart S.H., Pihl R.O., Conrod P.J. The Substance Use Risk Profile Scale: A scale measuring traits linked to reinforcement-specific substance use profiles. Addictive Behaviors. 2009;34(12):1042–1055. doi: 10.1016/j.addbeh.2009.07.001. [DOI] [PubMed] [Google Scholar]
- Zuckerman M. Zuckerman-Kuhlman personality questionnaire (ZKPQ): An alternative five-factorial model. In: de Raad B., Perugini M., editors. Big five assessment. Hogrefe & Huber Publishers; Ashland, OH, US: 2002. pp. 376–392. [Google Scholar]
- Zuckerman M., Michael D., Joireman J., Teta P., Kraft M. A comparison of three structural models for personality: The Big Three, the Big Five, and the Alternative Five. Journal of Personality and Social Psychology. 1993;65(4):757–768. [Google Scholar]
