Adolescent stressors, psychopathology, and young adult substance dependence: A prospective study

Objective: There is much theory, but sparse empirical evidence, supporting the notion that internalizing symptoms and negative affect are the mechanism by which exposure to stressful life events influence the development of substance-use disorders in adolescence and young adulthood. However, many empirical studies have shown that, in addition to elevations in internalizing symptoms, exposure to stressful life events also produces elevations in externalizing behaviors and conduct problems, which are important risk factors for substance-use disorders. The current study tested adolescent externalizing and internalizing symptoms as competitive mediators of the effects of stressors on young adult drug dependence. Method: Data from an ongoing study of children of alcoholics (n = 223) and matched controls (n = 204) were collected in two annual interviews in adolescence and two follow-ups in young adulthood. Results: Experiencing stressful life events during adolescence led to increases in both externalizing and internalizing symptoms, but only externalizing symptoms mediated the later effects of adolescent stressors on young adult drug dependence. Conclusions: These findings suggest that understanding how stressors produce elevations in behavioral problems may provide important insights into understanding how broad environmental risk factors lead to substance dependence and suggests that processes other than affect regulation may operate in the pathway from the experiences of stressors to substance use and disorder.