◦ 1,000 10th and 11th grade high school students (53% girls)

◦ 58% Caucasian; 23% African-American; 12% Hispanic

◦ Mean age = 16.09 (SD=.68); age range 15-17

◦ All participants attended a public high school in Delaware, Pennsylvania, or Maryland

◦ Most of the adolescents (56%) lived with both biological parents; 89% lived with their biological mother and 61% lived with their biological father

Sample

Anxiety and Substance Use During Adolescence:

The Need to Consider Gender and Race

Christine McCauley Ohannessian, University of Delaware

Conclusions

African American BoysResults for African American adolescents are presented in Table 2. As shown, higher levels of social anxiety predicted lower levels of alcohol consumption (β = -.35, p<.05) and binge drinking (β = -.38, p<.05). Similarly, higher levels of separation anxiety predicted lower levels of drug use (β = -.31, p<.05). In contrast, higher levels of panic disorder predicted higher levels of alcohol consumption (β = .49, p<.01), binge drinking (β = .44, p<.01), and drug use (β = .48, p<.01). Higher levels of generalized anxiety also predicted more drug use for African American boys (β = .38, p<.01) .

African American GirlsAs shown in Table 2, none of the anxiety disorders predicted substance use for African American girls.

Hispanic BoysResults for Hispanic adolescents are presented in Table 3. As shown, higher levels of panic disorder predicted binge drinking for Hispanic boys (β = .64, p<.05). None of the other anxiety disorders predicted substance use for Hispanic boys.

Hispanic GirlsNone of the anxiety disorders predicted substance use for Hispanic girls.

Results

Measures

Measures

During the spring of 2007, adolescents who provided assent, and who had parental consent, were administered a self-report survey in school by trained research staff. The survey took approximately 40 minutes to complete. After completing the survey, participants were compensated with a movie pass.

Procedures

The primary goal of this study was to examine the relationship between anxiety and substance use during adolescence. This relationship was examined by both gender and race. Surveys were administered to 1,000 adolescents in the spring of 2007. Results indicated that for African American and Hispanic boys, higher levels of panic disorder symptomatology predicted greater substance use involvement. Higher levels of generalized anxiety also predicted greater substance use involvement for African American boys. In contrast, higher levels of social anxiety and separation anxiety symptomatology predicted less substance use involvement for African American boys. None of the anxiety disorders predicted substance use for Caucasian boys. However, for Caucasian girls, higher levels of panic disorder and school avoidance predicted greater substance use involvement and higher levels of generalized anxiety predicted less substance use involvement. None of the anxiety disorders predicted substance use for African American or Hispanic girls.

Adolescent Anxiety. The Screen for Child Anxiety Related Disorders (SCARED; Birmaher, Khetarpal, Cully, Brent, & McKenzie, 1995) was used to assess adolescent anxiety. The SCARED includes 41-items completed in relation to the last three months. A sample item is “I am nervous.” The response scale for the SCARED ranges from 0 = not true or hardly ever true to 2 = very true or often true. The SCARED includes the following anxiety disorder scales: Generalized anxiety disorder, panic disorder, social anxiety disorder, separation anxiety, and significant school avoidance disorder. Previous studies have shown that the SCARED has good psychometric properties (Birmaher, Khetarpal, Cully, Brent, & McKenzie, 2003; Muris, Merckelbach, Ollendick, King, & Bogie, 2002). The Cronbach alpha coefficients for the SCARED scales in the present sample ranged from .60-.87.

A series of regression models predicting substance use from the anxiety disorders was conducted. These models were run separately by race and gender. Caucasian BoysResults for Caucasian adolescents are shown in Table 1. As shown, for boys, higher levels of social anxiety predicted lower levels of alcohol consumption (β = -.21, p<.05) and binge drinking (β = -.25, p<.05). Similarly, higher levels of separation anxiety predicted lower levels of drug use for Caucasian boys (β = -.28, p<.01) .

Caucasian GirlsConsistent with the results for Caucasian boys, higher levels of separation anxiety predicted lower levels of alcohol consumption for Caucasian girls (β = -.17, p<.05). In addition, higher levels of generalized anxiety predicted less frequent binge drinking for Caucasian girls (β = -.19, p<.05). In contrast, higher levels of panic disorder and school avoidance predicted more frequent binge drinking (β = .19, p<.05 and β = .22, p<.01, respectively). Higher levels of panic disorder and school avoidance also predicted more drug use for Caucasian girls (β = .19, p<.05 and β = .18, p<.05, respectively).

In the present study, anxiety was found to be systematically related to substance use. However, the pattern of relations differed depending on the specific anxiety disorder. More specifically, the anxiety disorders that may make it difficult for youth to be with peers (e.g., social anxiety disorder, separation anxiety disorder) appeared to protect youth from substance use. In contrast, anxiety disorders that typically do not block peer interaction (e.g., panic disorder) were associated with more substance use. It may be that some youth with these disorders cope with their high anxiety levels by using alcohol (a depressant) and/or other drugs that depress the CNS. Interestingly, the relations were somewhat stronger for boys, especially for African American boys. Of note, none of the anxiety disorders were related to substance use for African American or Hispanic girls. These results underscore the importance of considering both race and gender when examining adolescent psychological adjustment.

Abstract

Results

Drug Use. The adolescents also were asked how frequently they had used marijuana, sedatives, stimulants, inhalants, hallucinogens, cocaine or crack, and opiates (non-medical use only) in the last 6 months. The response scale ranged from 0 = no use to 7 = every day. A total drug use score was calculated by summing the scores of the seven different types of drugs. Because this score was positively skewed, the logarithmic transformation was used.

Binge Drinking. Youth were asked how many times they drank 6 or more drinks (cans/bottles of beer, glasses of wine, or drinks of liquor) in the last 6 months. This variable was skewed. Therefore it was linearly transformed.

Alcohol Use. The adolescents were asked to report how much, on the average day, they usually drank (beer, wine, or liquor) in the last six months (separate questions were used for beer, wine, and liquor). The response scale ranged from 0 = none to 9 = more than 8 drinks. In addition, they were asked to report how often they usually had a drink (beer, wine, or liquor) in the last six months. The response scale ranged from 0 = never to 7 = every day. Based on this information, a total alcohol quantity x frequency score was calculated. Because this score was positively skewed, the logarithmic transformation was used.

*Supported by NIAAA K01AA015059

*To obtain a copy of this poster, please visit www.aap.udel.edu.