Aims

To explore the process of applying counterfactual thinking in examining causal determinants of substance use trajectories in observational cohort data. Specifically, we examine the extent to which quality of the parent-adolescent relationship and affiliations with deviant peers are causally related to trajectories of alcohol, tobacco, and cannabis use across adolescence and into young adulthood.

Methods

Data were drawn from the Australian Temperament Project, a population-based cohort study that has followed a sample of young Australians from infancy to adulthood since 1983. Parent-adolescent relationship quality and deviant peer affiliations were assessed at age 13–14 years. Latent curve models were fitted for past month alcohol, tobacco, and cannabis use (n = 1590) from age 15–16 to 27–28 years (5 waves). Confounding factors were selected in line with the counterfactual framework.

Results

Following confounder adjustment, higher quality parent-adolescent relationships were associated with lower baseline cannabis use, but not alcohol or tobacco use trajectories. In contrast, affiliations with deviant peers were associated with higher baseline binge drinking, tobacco, and cannabis use, and an earlier peak in the cannabis use trajectory.

Conclusions

Despite careful application of the counterfactual framework, interpretation of associations as causal is not without limitations. Nevertheless, findings suggested causal effects of both parent-adolescent relationships and deviant peer affiliations on the trajectory of substance use. Causal effects were more pervasive (i.e., more substance types) and protracted for deviant peer affiliations. The exploration of causal relationships in observational cohort data is encouraged, when relevant limitations are transparently acknowledged.

中文翻译：

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在观察性队列数据中探究因果模型：父母和同伴在塑造物质使用轨迹方面的作用。

目的

探索运用反事实思维来检查观察性队列数据中物质使用轨迹的因果决定因素的过程。具体来说，我们研究了青少年之间父母与青少年之间的关系和亲属关系的质量与酒精，烟草和大麻使用轨迹之间的因果关系，该趋势在整个青春期和成年后均会发生。

方法

数据来自澳大利亚气质项目，这是一项基于人群的队列研究，自1983年以来，该研究一直对澳大利亚年轻婴儿从婴儿期到成年的情况进行了评估。评估了13-14岁之间父母与青少年的关系质量和异常的同伴关系。潜伏曲线模型适用于过去15至16岁至27至28岁（5次波动）的酒，烟和大麻使用（n = 1590）。根据反事实框架选择混杂因素。

结果

经过混杂因素的调整，较高质量的父母与青少年的关系与较低的基准大麻使用量相关，但与酒精或烟草使用轨迹无关。相反，与异常同伴的隶属关系与基线暴饮暴食，烟草和大麻使用量较高，以及大麻使用轨迹出现较早高峰有关。

结论

尽管对反事实框架进行了仔细的应用，但将关联作为因果关系的解释并非没有限制。然而，研究结果表明，父母与青少年之间的关系和异常的同伴关系对物质使用的轨迹具有因果关系。因果效应更加普遍（即，更多的物质类型），并且对于异常的同伴关系而言，其持久性很长。当透明地确认了相关限制时，鼓励探索观察性队列数据中的因果关系。