Drinking, cannabis use and mental health as predictors of within-person changes in aggression over eight weeks among youth involved with binge drinking.

In 30 seconds

This analysis of a sequential, multiple-assignment randomized trial examined weekly within-person correlates of aggression among 400 emergency-department patients aged 14–20 who reported binge drinking and aggression. Participants received a brief behavioral health intervention, were randomized to booster conditions, and completed weekly surveys over eight weeks. In adjusted conditional logistic regression, earlier survey week, any cannabis use, greater alcohol consumption, and more mental health symptoms were associated with a higher likelihood of aggression in the same week. The findings identify temporally proximate associations, not evidence that these factors caused aggression.

Key findings

• In adjusted analyses, any cannabis use and greater alcohol consumption were associated with increased likelihood of aggression in the same week.
• More mental health symptoms were associated with increased likelihood of same-week aggression in adjusted analyses.
• Earlier survey week was associated with increased likelihood of same-week aggression in adjusted analyses.
• Hopefulness and social support were associated with lower aggression likelihood in unadjusted analyses, but not among the reported adjusted findings.

Why it matters

The results highlight substance use and mental health symptoms as factors that co-occur with aggression over short time intervals in adolescents and emerging adults with binge drinking and aggression. This temporal detail may help inform adaptive prevention approaches, while the observational within-person associations do not establish that changing these factors will reduce aggression.

What to keep in mind

The analysis reports within-person associations and cannot establish causation. Participants were a selected group of emergency-department patients aged 14–20 who reported both binge drinking and aggression.