Anxiety, depression and social support can predict early alcohol and illicit drug use in youth

Youth with parental separation anxiety also at decreased risk

Anxiety, depression, stress and social support can predict early alcohol and illicit drug use in youth, according to a study from Carolyn McCarty, PhD, of Seattle Children's Research Institute, and researchers from the University of Washington and Seattle University. Middle school students from the sixth to the eighth grade who felt more emotional support from teachers reported a delay in alcohol and other illicit substance initiation. Those who reported higher levels of separation anxiety from their parents were also at decreased risk for early alcohol use. The study, "Emotional Health Predictors of Substance Use Initiation During Middle School," was published in advance online in Psychology of Addictive Behaviors.

Relatively few studies have examined support for youth from nonfamily members of the adolescent's social support network, including teachers. "Our results were surprising," said Dr. McCarty, who is also a University of Washington research associate professor. "We have known that middle school teachers are important in the lives of young people, but this is the first data-driven study which shows that teacher support is associated with lower levels of early alcohol use." Middle school students defined teacher support as feeling close to a teacher or being able to talk with a teacher about problems they are experiencing.

Youth that are close to or even cling to parents can have separation anxiety and may be less susceptible to negative influences from peers, including experimentation with risky behaviors like alcohol use. "Teens in general seek new sensations or experiences and they take more risks when they are with peers," said Dr. McCarty. "Youth with separation anxiety symptoms may be protected by virtue of their intense connection to their parents, making them less likely to be in settings where substance use initiation is possible," she said.

The study also found that youth who initiated alcohol and other illicit drug use prior to sixth grade had significantly higher levels of depressive symptoms. This suggests that depression may be a consequence of very early use or a risk factor for initiation of use prior to the middle school years. Depression was defined by asking youth about their mood and feelings, and asking them if statements such as "I felt awful or unhappy" and "I felt grumpy or upset with my parents" were true, false or sometimes true during a two-week timeframe.

"Based on the study and our findings, substance use prevention needs to be addressed on a multidimensional level," said Dr. McCarty. "We need to be aware of and monitor early adolescent stress levels, and parents, teachers and adults need to tune into kids' mental health. We know that youth who initiate substance abuse before age 14 are at a high risk of long-term substance abuse problems and myriad health complications."

• Know where your child is, and check in with your child on a regular basis
• Get to know your child's friends, and who your child spends time with
• Teach stress management skills
• Help your child feel connected with adults at school

Dr. McCarty and the research team analyzed data from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Researchers analyzed the effects of depression, anxiety, stress and support on initiation of substance use, which was measured at five different time points between sixth and eighth grade.

Seattle Children's Research Institute, in collaboration with the University of Washington and Seattle University, will continue to study this topic, next looking at the timing between youth substance use and depression, as well as how intervention programs for depression impact substance use.