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Further, few studies in this area have been prospective, and therefore it is unclear how religion may impact less alcohol\/substance use among adolescents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We prospectively evaluated effects of religious affiliation on initiation of alcohol\/substance use in a sample of 81 psychiatrically healthy 13\u201314\u2010year\u2010olds from New England, over a 3\u2010year period (from November 2015 to January 2019). Known risk factors were also evaluated including anxiety, depression, and impulsivity; family history of mental illness and alcohol\/substance misuse; and volume of brain regions implicated in adolescent alcohol\/substance misuse (assessed by Magnetic Resonance Imaging).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Religiously affiliated adolescents were significantly less likely to initiate use of alcohol\/substances (hazard ratio [HR]\u2009=\u20090.38). The addition of family history of alcohol\/substance misuse to the model increased the predictive value of religious affiliation (HR\u2009=\u20090.34). Other risk factors did not diminish nor increase observed effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings support and extend the current research by suggesting that religious affiliation protects against initiation of alcohol\/substance use during early adolescence, particularly in individuals with elevated risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jad.12119","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T04:40:02Z","timestamp":1667882402000},"page":"372-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Religious affiliation protects against alcohol\/substance use initiation: A prospective study among healthy adolescents"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0146-7716","authenticated-orcid":false,"given":"David H.","family":"Rosmarin","sequence":"first","affiliation":[{"name":"Department of Psychiatry Harvard Medical School Boston Massachusetts USA"},{"name":"Spirituality and Mental Health Program McLean Hospital Belmont Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Pirutinsky","sequence":"additional","affiliation":[{"name":"Department of Social Work Touro College New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline C.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School Boston Massachusetts USA"},{"name":"Spirituality and Mental Health Program McLean Hospital Belmont Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sion K.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Harvard Medical School Boston Massachusetts USA"},{"name":"Center for Adolescent Behavioral Health Research Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer T.","family":"Sneider","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School Boston Massachusetts USA"},{"name":"Neurodevelopmental Laboratory on Addictions and Mental Health McLean Hospital Belmont Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9668-8548","authenticated-orcid":false,"given":"Marisa M.","family":"Silveri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School Boston Massachusetts USA"},{"name":"Neurodevelopmental Laboratory on Addictions and Mental Health McLean Hospital Belmont Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.1503"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2010.08.017"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452159"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2011.10.029"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4603(01)00238-6"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-816766-3.00007-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1972.tb00899-x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2000.61.637"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/01639625.2012.726170"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0704"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/Oxfordjournals.Aje.A115529"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2012.01.021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0896-6273(02)00569-X"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/81.3.515"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2013.74.684"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/swr\/35.3.137"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617719001395"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","unstructured":"Kassambara A. 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