Introduction

Use of conventional cigarettes (CIG), alcohol, marijuana, and sedatives [i.e., benzodiazepines and barbiturates]) commonly co-occur with internalizing and externalizing disorders. It is unclear how these relationships extend to electronic cigarettes (ECIGs) and prescription drugs not prescribed (i.e., sedatives, tranquilizers, and painkillers [PDNP]), and whether they differ by gender.

Methods

Adult data (N = 30,211) from Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health Study were used to estimate a network of current or past-month use for six substances, experiencing four internalizing symptoms in the past month, and experiencing seven externalizing symptoms in the past month. Visual comparisons, global strength invariance, network structure invariance, and edge strength invariance were tested to detail substance use and internalizing/externalizing symptom networks.

Results

Overall, networks were consistent between men and women. The strongest substance use/mental health symptom connections estimated as edge-weights (EW) were between marijuana with lying (EW = 0.60, 95% CI = 0.49; 0.70), marijuana with engaging in fights (EW = 0.54, 95% CI = 0.27; 0.81), PDNP with having trouble sleeping (EW = 0.53, 95% CI = 0.40; 0.66), and alcohol and impulsivity (EW = 0.48, 95% CI = 0.42; 0.53).

Discussion

There were many weak connections throughout the substance use and internalizing/externalizing network. A few important connections were identified and encourage future study. In particular, PDNP was most strongly associated with internalizing symptoms. Marijuana, alcohol and PDNP use were most strongly associated with externalizing symptoms.

中文翻译：

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美国成年人物质使用、内化和外化合并症的网络方法

 介绍

使用传统香烟（CIG）、酒精、大麻和镇静剂（即苯二氮卓类药物和巴比妥类药物）通常与内化和外化疾病同时发生。目前尚不清楚这些关系如何延伸到电子烟 (ECIG) 和非处方药（即镇静剂、安定剂和止痛药 [PDNP]），以及它们是否因性别而异。

 方法

烟草与健康研究人口评估第一波（2013-2014）的成人数据（N = 30,211）被用来估计当前或过去一个月使用六种物质的网络，在过去一个月经历四种内化症状，并在过去一个月经历七种外在症状。测试视觉比较、整体强度不变性、网络结构不变性和边缘强度不变性，以详细说明物质使用和内化/外化症状网络。

 结果

总体而言，男性和女性之间的网络是一致的。以边缘权重 (EW) 估计，最强的物质使用/心理健康症状关联是大麻与说谎（EW = 0.60，95% CI = 0.49；0.70）、大麻与打架（EW = 0.54，95% CI = 0.27；0.81），PDNP 伴有睡眠问题（EW = 0.53，95% CI = 0.40；0.66），以及酒精和冲动（EW = 0.48，95% CI = 0.42；0.53）。

 讨论

整个物质使用和内化/外化网络存在许多薄弱的联系。确定了一些重要的联系并鼓励未来的研究。尤其是，PDNP 与内化症状的相关性最强。大麻、酒精和 PDNP 的使用与外化症状最密切相关。