{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:08:46Z","timestamp":1789798126057,"version":"4.0.1"},"reference-count":71,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Clinic Psychol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol and cannabis use disorders are among the most prevalent substance use disorders worldwide. They frequently co\u2010occur and show high comorbidity with psychological distress and suicidal ideation. Although these relationships are well established, their underlying structure remains unclear, as mental health is embedded within a complex network of individual, social and environmental factors. The aim of this study was to explore the interplay between alcohol and cannabis use disorders, psychological distress and suicidal ideation within the context of sociodemographic factors and social determinants of mental health using network analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional secondary analysis of nationally representative survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were drawn from the 2021 National Survey on Drug Use and Health (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200944,360). A mixed graphical model was estimated and partitioned into three communities (psychological, sociodemographic, social determinants of mental health). Bridge centrality and odds ratio analyses were conducted to identify key nodes and quantify associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sociodemographic variables (e.g., age, sexual orientation) showed more direct connections to mental health outcomes, whereas social determinants (e.g., housing instability, employment) occupied more distal positions. Cannabis use disorder and psychological distress emerged as key bridging nodes linking sociodemographic and structural domains to broader mental health outcomes, including suicidal ideation and alcohol use disorder, suggesting pathways through which contextual risk translates into psychological vulnerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mental health outcomes are shaped by both individual and structural factors. Targeting key bridging nodes (e.g., cannabis use disorder and psychological distress) may improve prevention and intervention, alongside policies addressing adverse social conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjc.70098","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T05:30:51Z","timestamp":1789795851000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cannabis use disorder, alcohol use disorder, and suicidal ideation within a social determinants of mental health framework: Insights from a network analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5236-9841","authenticated-orcid":false,"given":"Angela","family":"Giugovaz","sequence":"first","affiliation":[{"name":"Department of Life Sciences University of Trieste  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4709-7941","authenticated-orcid":false,"given":"Igor","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00207411.2020.1859347"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2021.1912572"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291716002300"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.01.001"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.02.007"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2017.02.025"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010clinpsy\u2010050212\u2010185608"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.11.002"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010016\u20101225\u20104"},{"key":"e_1_2_13_12_1","volume-title":"2021 National Survey on drug use and health public use file codebook","author":"Center for Behavioral Health Statistics and Quality","year":"2022"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/urbansci6040075"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.111088"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/19485506177098"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2019.103419"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000694"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363461518823933"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13428\u2010017\u20100862\u20101"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i04"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1363461518823933"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11930\u2010017\u20100096\u20103"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1081\/JA\u2010120030892"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e31825322cf"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1037\/cdp0000170"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115821"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10597\u2010019\u201000385\u2010w"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178221817711415"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.0584"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2021.100393"},{"key":"e_1_2_13_31_1","volume-title":"StatPearls","author":"Harmer B.","year":"2024"},{"key":"e_1_2_13_32_1","unstructured":"Haslbeck J.(2020).Computing Odds Ratios from Mixed Graphical Models.https:\/\/jonashaslbeck.com\/ORs\u2010in\u2010MGMs\/"},{"key":"e_1_2_13_33_1","unstructured":"Haslbeck J. &Waldorp L. J.(2015).Structure estimation for mixed graphical models in high\u2010dimensional data.arXiv. Preprint. arXiv:1510.05677."},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v093.i08"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2019.1663329"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160\u2010010\u20109210\u20108"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021\u2010843X.116.3.433"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.03.022"},{"key":"e_1_2_13_39_1","unstructured":"Jones P.(2024).networktools: Tools for identifying important nodes in networks. R package version 1.5.2.https:\/\/CRAN.R\u2010project.org\/package=networktools"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2019.1614898"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agm011"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291702006074"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21160"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707001572"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(18)30060\u20109"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2021.1936700"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2022.37"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.3352"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796020000633"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20102909.129.5.674"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.2307\/3090194"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14651"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11081182"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.04.007"},{"key":"e_1_2_13_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.12.043"},{"key":"e_1_2_13_56_1","doi-asserted-by":"publisher","DOI":"10.34172\/jrhs.2022.72"},{"key":"e_1_2_13_57_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2024"},{"key":"e_1_2_13_58_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2021.2020191"},{"key":"e_1_2_13_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.02.005"},{"key":"e_1_2_13_60_1","doi-asserted-by":"publisher","DOI":"10.3109\/00952990.2016.1164711"},{"key":"e_1_2_13_61_1","volume-title":"Handbook of research methods in personality psychology","author":"Robins R. W.","year":"2007"},{"key":"e_1_2_13_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.10.045"},{"key":"e_1_2_13_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508\u2010018\u20101150\u20106"},{"key":"e_1_2_13_64_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380\u2010021\u201001161\u20107"},{"key":"e_1_2_13_65_1","volume-title":"Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on drug use and health (HHS publication No. PEP22\u201007\u201001\u2010005, NSDUH series H\u201057)","author":"Substance Abuse and Mental Health Services Administration","year":"2022"},{"key":"e_1_2_13_66_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121\u2010018\u20100904\u20107"},{"key":"e_1_2_13_67_1","unstructured":"U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. (2022).National Survey on Drug Use and Health 2021. (NSDUH\u20102021\u2010DS0001).https:\/\/datafiles.samhsa.gov\/"},{"key":"e_1_2_13_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.06.009"},{"key":"e_1_2_13_69_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0026027"},{"key":"e_1_2_13_70_1","volume-title":"Social determinants of health","author":"World Health Organization","year":"2021"},{"key":"e_1_2_13_71_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40429\u2010017\u20100149\u20108"},{"key":"e_1_2_13_72_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579419000713"}],"container-title":["British Journal of Clinical Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjc.70098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bjc.70098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjc.70098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T05:30:57Z","timestamp":1789795857000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/10.1111\/bjc.70098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":71,"alternative-id":["10.1111\/bjc.70098"],"URL":"https:\/\/doi.org\/10.1111\/bjc.70098","archive":["Portico"],"relation":{},"ISSN":["0144-6657","2044-8260"],"issn-type":[{"value":"0144-6657","type":"print"},{"value":"2044-8260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"assertion":[{"value":"2026-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"bjc.70098"}}