Adolescent Withdrawn/Depressed Symptoms: A Pathway From Early Adversity to Later Marijuana Use

Vollständiger Abstract

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ABSTRACT Introduction Adverse childhood experiences (ACEs) are robust predictors of marijuana use, yet the developmental mechanisms remain unclear. Building on prior cross‐sectional studies using broad internalizing composites, this study prospectively distinguishes withdrawn/depressed from anxious/depressed symptoms as candidate mediators across nearly two decades. Methods This prospective, longitudinal study used data from the Future of Families and Child Wellbeing Study (FFCWS), a US cohort of children born between 1998 and 2000. The final analytic sample included 2 865 participants (52.1% female; 46.6% Black, 27.3% Hispanic, 18.5% White). A parallel mediation model was tested using parent‐reported cumulative and specific ACEs (age 3) as predictors, parent‐reported withdrawn/depressed and anxious/depressed symptoms (CBCL; age 15) as mediators, and youth self‐reported monthly marijuana use (age 22) as the outcome. Results Cumulative ACEs at age 3 significantly predicted more frequent marijuana use at age 22. This association was partially mediated by adolescent withdrawn/depressed symptoms, which accounted for approximately 16% of the total effect, whereas anxious/depressed symptoms were not a significant mediator. The strength of this mediating pathway varied across specific ACE types, consistent with a dimensional model of adversity. Conclusions These findings provide prospective longitudinal evidence for a specific internalizing pathway linking early adversity to young adult marijuana use. Although a minority of the overall association, this indirect pathway is notable given the nearly two‐decade span and points to adolescent depressive symptoms as a meaningful, modifiable intervention target. The differential mediation patterns suggest that interventions should be tailored to specific ACE profiles, with depression‐focused approaches being particularly relevant for deprivation‐based adversities.