Skip to main content Accessibility help

Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: a unitary trend?

  • R. A. Grucza (a1), R. F. Krueger (a2), Arpana Agrawal (a1), A. D. Plunk (a3), M. J. Krauss (a1), J. Bongu (a1), P. A. Cavazos-Rehg (a1) and L. J. Bierut (a1)...



Downward trends in a number of adolescent risk behaviors including violence, crime, and drug use have been observed in the USA in recent years. It is unknown whether these are separate trends or whether they might relate to a general reduction in propensity to engage in such behaviors. Our objectives were to quantify trends in substance use disorders (SUDs) and delinquent behaviors over the 2003–2014 period and to determine whether they might reflect a single trend in an Externalizing-like trait.


We analyzed data from 12 to 17 year old participants from the National Survey on Drug Use and Health, a representative survey of the household dwelling population of the USA, across the 2003–2014 period (N = 210 599). Outcomes included past-year prevalence of six categories of substance use disorder and six categories of delinquent behavior.


Trend analysis suggested a net decline of 49% in mean number of SUDs and a 34% decline in delinquent behaviors over the 12-year period. Item Response Theory models were consistent with the interpretation that declines in each set of outcomes could be attributed to changes in mean levels of a latent, Externalizing-like trait.


Our findings suggest that declines in SUDs and some delinquent behaviors reflect a single trend related to an Externalizing-like trait. Identifying the factors contributing to this trend may facilitate continued improvement across a spectrum of adolescent risk behaviors.


Corresponding author

Author for correspondence: R. A. Grucza, E-mail:


Hide All
Abma, JC, Martinez, GM and Copen, CE (2010) Teenagers in the United States: sexual activity, contraceptive use, and childbearing. Vital Health Statistics 23, 147.
Board on Children, Youth, and Families (2012) Social Trends and Child Maltreatment Trends in Child Maltreatment Research, Policy, and Practice for the Next Decade. National Academies Press: Washington, DC.
Burt, SA (2009) Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychological Bulletin 135, 608637. doi:10.1037/a0015702
Centers for Disease Control and Prevention (CDC) (2013) Blood lead levels in children aged 1-5 years - United States, 1999–2010. MMWR Morbidity and Mortality Weekly Report 62, 245248.
Cheung, GW and Rensvold, RB (2002) Evaluating Goodness-of-Fit indexes for testing measurement invariance. Structural Equation Modeling Multidisciplinary Journal 9, 233255. doi:10.1207/S15328007SEM0902_5
Child Trends Data Bank (2015) Teen Homicide, Suicide, and Firearm Deaths. [Online] ( Accessed 5 03 2016.
Dick, DM et al. (2005) Understanding the Co-variation among childhood externalizing symptoms: genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology 33, 219229. doi:10.1007/s10802-005-1829-8
Dietrich, KN et al. (2001) Early exposure to lead and juvenile delinquency. Neurotoxicology and Teratology 23, 511518. doi:10.1016/S0892-0362(01)00184-2
Diller, LH (1996) The run on ritalin: attention deficit disorder and stimulant treatment in the 1990s. Hastings Center Reports 26, 1218. doi:10.2307/3528571
Donovan, JE and Jessor, R (1985) Structure of problem behavior in adolescence and young adulthood. Journal of Consulting and Clinical Psychology 53, 890904. doi:10.1037/0022-006X.53.6.890
Eaton, NR et al. (2012) An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample. Journal Abnormal Psychology 121, 282288. doi: 10.1037/a0024780
Farrelly, MC et al. (2013) A comprehensive examination of the influence of state tobacco control programs and policies on youth smoking. American Journal of Public Health 103, 549555. doi:10.2105/AJPH.2012.300948
Finkelhor, D (2013) Trends in Bullying and Peer Victimization. University of New Hampshire: Crimes against Children Research Center: Durham.
Finkelhor, D and Johnson, M, (2015) Has psychiatric medication reduced crime and delinquency? Trauma Violence & Abuse 18, 19. doi:10.1177/1524838015620817.
Finkelhor, D et al. (2014) Trends in children's exposure to violence, 2003 to 2011. JAMA Pediatrics 168, 540546.
Grucza, RA, Agrawal, A and Krauss, MJ (2016) Declining prevalence of marijuana Use disorders among adolescents in the United States, 2002–2013. Journal of the American Academy of Child and Adolescent Psychiatry 55, 487494. doi:10.1016/j.jaac.2016.04.002
Grucza, RA et al. (2013) Long-term effects of laws governing youth access to tobacco. American Journal of Public Health 103, 14931499. doi:10.2105/AJPH.2012.301123
Gruenewald, PJ (2011) Regulating availability: how access to alcohol affects drinking and problems in youth and adults. Alcohol Research and Health 34, 248256. doi:SPS-AR&H-39
Hatzenbuehler, ML et al. (2015) Associations between antibullying policies and bullying in 25 states. JAMA Pediatrics 169, e152411. doi:10.1001/jamapediatrics. 2015.2411
Heatherton, TF et al. (1991) The Fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Addiction 86, 11191127.
Heim, C et al. (2010) Neurobiological and psychiatric consequences of child abuse and neglect. Developmental Psychobiology 52, 671690. doi:10.1002/dev.20494
Hicks, BM et al. (2004) Family transmission and heritability of externalizing disorders: a twin-family study. Archives of General Psychiatry 61, 922928. doi:10.1001/archpsyc.61.9.922
Hicks, BM et al. (2009) Environmental adversity and increasing genetic risk for externalizing disorders. Archives of General Psychiatry 61, 922928. doi:10.1001/archgenpsychiatry.2008.554
Hinshaw, SP (1991) Stimulant medication and the treatment of aggression in children with attentional deficits. Journal of Clinical Child Psychology 20, 301312. doi:10.1207/s15374424jccp2003_9
Hinshaw, SP, Buhrmester, D and Heller, T (1989) Anger control in response to verbal provocation: effects of stimulant medication for boys with ADHD. Journal of Abnormal Child Psychology 17, 393407. doi:10.1007/BF00915034
ICPSR (2016) National Survey on Drug Use and Health (NSDUH) Series. [Online] ( Published 2015. Accessed 1 August 2016.
Jessor, R (1991) Risk behavior in adolescence: a psychosocial framework for understanding and action. Journal of Adolescent Health 12, 587605.
Jessor, R and Jessor, S (1977) Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth. Academic Press: New York.
Johnston, L et al. (2013) Monitoring the Future: National Results on Adolescent Drug Use: 2013. Overview of Key Findings on Adolescent Drug Use. University of Michigan, Institute for Social Research: Michigan.
Kendler, KS et al. (2003) The structure of genetic and environmental risk factors for common psychiatric and substance Use disorders in Men and women. Archives of General Psychiatry 60, 929937. doi:10.1001/archpsyc.60.9.929
Krueger, RF (1999) The structure of common mental disorders. Archives of General Psychiatry 56, 921926. doi: 10.1001/archpsyc.56.10.921
Krueger, RF et al. (2002) Etiologic connections among substance dependence, antisocial behavior and personality: modeling the externalizing spectrum. Journal of Abnormal Psychology 111, 411424. doi:10.1037/0021-843X.111.3.411
Krueger, RF and South, SC (2009) Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine 39, 20612070. doi:10.1017/S0033291709990328
Lahey, BB (2008) Oppositional defiant disorder, conduct disorder, and juvenile delinquency. In: Child and Adolescent Psychopathology (ed. Beauchaine, T. and Hinshaw, S. P.), pp. 335369. Wiley: New York.
Lane, SD et al. (2008) Environmental injustice: childhood lead poisoning, teen pregnancy, and tobacco. Journal of Adolescent Health 42, 4349. doi:10.1016/j.jadohealth.2007.06.017
Lichtenstein, P et al. (2012) Medication for attention deficit–hyperactivity disorder and criminality. The New England Journal of Medicine 367, 20062014. doi:10.1056/NEJMoa1203241
McGue, M et al. (2001) Origins and consequences of age at first drink. II. Familial risk and heritability. Alcoholism: Clinical and Experimental Research 25, 11661173.
Morgan, R et al. (2015) Indicators of School Crime and Safety: 2014 (No. NCJ 248036). Bureau of Justice Statistics: Washington, DC.
Muthén, L and Muthén, B (1998) Mplus User's Guide. 7th edn. Muthén & Muthén: Los Angeles, CA.
Nevin, R (2000) How lead exposure relates to temporal changes in IQ, violent crime, and unwed pregnancy. Environmental Research 83, 122. doi:10.1016/j.envres.2007.02.008
Nevin, R (2007) Understanding international crime trends: the legacy of preschool lead exposure. Environmental Research 104, 315336. doi:10.1006/enrs.1999.4045
Office of Juvenile Justice and Delinquency Prevention OJJDP, (2015) OJJDP Statistical Briefing Book. Online. [Online] ( Accessed 11 March 2016.
Olfson, M, Druss, BG and Marcus, SC (2015) Trends in mental health care among children and adolescents. The New England Journal of Medicine 372, 20292038. doi:10.1056/NEJMsa1413512
Pattij, T and Vanderschuren, L (2008) The neuropharmacology of impulsive behaviour. Trends in Pharmacological Sciences, 29, 192199. doi:10.1016/
Perlus, J et al. (2014) Trends in bullying, physical fighting, and weapon carrying among 6th- through 10th-grade students from 1998 to 2010: findings from a national study. American Journal of Public Health 104, 11001106. doi:10.2105/AJPH.2013.301761
Reyes, JW (2007) Environmental policy as social policy? The impact of childhood lead exposure on crime. The B E Journal of Economic Analysis & Policy 7, 51. doi:10.2202/1935-1682.1796
Robers, S, Zhang, J and Truman, J (2010) Indicators of School Crime and Safety: 2010 (NCES 2011-002/ NCJ 230812). National Center for Education Statistics, U.S. Department of Education, and Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice: Washington, DC.
Schwarz, G (1978) Estimating the dimension of a model. Annals of Statistic 6, 461464.
Sinzig, J et al. (2007) Long-acting methylphenidate has an effect on aggressive behavior in children with attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology 17, 421432. doi:10.1089/cap.2007.0011
Stretesky, PB and Lynch, MJ (2001) The relationship between lead exposure and homicide. Archives of Pediatrics and Adolescent Medicine Journal 155, 579582. doi:10.1001/archpedi.155.5.579
Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use, Health: Summary of National Findings (No. NSDUH Series H-46, HHS Publication No. (SMA) 13–4795). Rock Hill MD. 2014.
Substance Abuse and Mental Health Services Administration (2014) National Survey on Drug Use and Health Methodological Summary and Definitions. Accessed October 4, 2017.
Substance Abuse and Mental Health Services Administration (2015) Methodological Resource Books. Population Data/NSDUH. Accessed August 24, 2016.
Teicher, MH et al. (2003) The neurobiological consequences of early stress and childhood maltreatment. Neuroscience & Biobehavioral Reviews 27, 3344. doi:10.1016/S0149-7634(03)00007-1
Verona, E and Sachs-Ericsson, N (2005) The intergenerational transmission of externalizing behaviors in adult participants: the mediating role of childhood abuse. Journal of Consulting and Clinical Psychology 27, 11351145. doi:10.1037/0022-006X.73.6.1135
Webster, DW, Meyers, JS and Buggs, MS (2014) Youth acquisition and carrying of firearms in the United States: Patterns, consequences, and strategies for prevention. Presented at the Proceedings of Means of Violence Workshop, Forum of Global Violence Prevention. Washington, DC, Institutes of Medicine of the National Academies.
White, N and Lauritsen, JL (2012) Violent crime against youth, 1994–2010. Off. Justice Programs Bur. Justice Stat. NJC 240106.
Young, SE et al. (2000) Genetic and environmental influences on behavioral disinhibition. American Journal of Medical Genetics 96, 684695. doi:10.1002/1096-8628(20001009)96:5<684::AID-AJMG16>3.0.CO.,2-G
Zuvekas, SH and Vitiello, B (2012) Stimulant medication use in children: a 12-year perspective. American Journal of Psychiatry 169, 160166. doi:10.1176/appi.ajp.2011.11030387
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Grucza et al supplementary material
Grucza et al supplementary material 1

 Word (241 KB)
241 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed