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On the other hand, substance use has been generally declining, and little is known about the role of emotional concerns in these trends. Several studies have explored the changes in co-occurring substance use and emotional concerns among adolescents over time, with mixed results and inconsistent messaging about the implications of the findings. In response, we developed a theoretical framework for exploring the intersection between trends in substance use and emotional concerns (InterSECT Framework). This framework includes a discussion and related examples for 3 core hypotheses: (1) strengthening of co-occurrence, or the \u201chardening\u201d hypothesis; (2) co-occurrence staying the same, or the \u201cconsistency\u201d hypothesis; and (3) weakening of co-occurrence, or the \u201cdecoupling\u201d hypothesis. This framework seeks to guide the conceptualization, evaluation, and understanding of changes in the co-occurrence of substance use and emotional concerns over time, including outlining a research agenda informed by pre-existing research and youth perspectives.<\/jats:p>","DOI":"10.1093\/aje\/kwae013","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T08:33:22Z","timestamp":1708763602000},"page":"1066-1074","source":"Crossref","is-referenced-by-count":10,"title":["The InterSECT Framework: a proposed model for explaining population-level trends in substance use and emotional concerns"],"prefix":"10.1093","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4393-2572","authenticated-orcid":false,"given":"Jillian","family":"Halladay","sequence":"first","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney , Sydney 2006, Camperdown 2006, New South Wales , Australia"},{"name":"School of Nursing, McMaster University , Hamilton, Ontario L8S 4K1 , Canada"},{"name":"Peter Boris Centre for Addictions Research, McMaster University \/ St. Joseph's Healthcare Hamilton , Hamilton, Ontario L8P 3P2 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8452-364X","authenticated-orcid":false,"given":"Matthew","family":"Sunderland","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney , Sydney 2006, Camperdown 2006, New South Wales , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-6862","authenticated-orcid":false,"given":"Cath","family":"Chapman","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney , Sydney 2006, Camperdown 2006, New South Wales , 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