Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention

O'Neil, Kelly A.; Conner, Bradley T.; Kendall, Philip C.

doi:10.1016/j.cpr.2010.08.002

Cited by 166Substance Abuse Treatment and OutcomesChild and Adolescent Psychosocial and Emotional DevelopmentPersonality Disorders and Psychopathology

Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention

O'Neil, Kelly A., Conner, Bradley T., Kendall, Philip C.·2011·Clinical Psychology Review

DOI 10.1016/j.cpr.2010.08.002

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Abstract

This review examines the empirical literature on the relationship between internalizing disorders and substance use disorders (SUDs) in youth in terms of (a) comorbidity rates, (b) risk relationships, (c) temporal sequencing, and (d) implications for intervention. Findings from community and clinical samples suggest that comorbidity rates range from 9.0 to 47.9%. The majority of the evidence supports the temporal precedence of internalizing disorders before substance use disorders and a unidirectional risk model in which internalizing disorders increase risk for later substance use disorders. Implications of this relationship for interventions are considered, both in terms of treatment outcome for principal disorders and in terms of the potential "secondary benefit" of treating one disorder for preventing or reducing risk of the other. Finally, recommendations for future research on the relationship between internalizing disorders and SUDs in youth are discussed.

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In the shared etiology pathway of SUD and ID cooccurrence, SUD and ID are mutually influencing axes of dysregulation that compromise healthy development.
“(3) shared etiology: SUD and ID are mutually influencing axes of dysregulation that compromise healthy development.”
From Family Support Protocol for Adolescent Internalizing Disorders: Protocol for a Pre-Post Quantitative Treatment Development Study (2024) · cites this paper as [114]
In the SU exposure pathway of SUD and ID cooccurrence, SUD precedes the onset of ID and creates developmental lag in the emergence of self-regulatory functions that precipitate ID and, if severe, impair neurocognitive functioning.
“(2) SU exposure: SUD precedes the onset of ID and creates developmental lag in the emergence of self-regulatory functions that precipitate ID and, if severe, impair neurocognitive functioning;”
From Family Support Protocol for Adolescent Internalizing Disorders: Protocol for a Pre-Post Quantitative Treatment Development Study (2024) · cites this paper as [114]
In the self-medication pathway of SUD and ID cooccurrence, ID precedes the onset of SUD, and substances are valued for psychoactive properties that alleviate ID symptoms.
“(1) self-medication: ID precedes the onset of SUD, and substances are valued for psychoactive properties that alleviate ID symptoms;”
From Family Support Protocol for Adolescent Internalizing Disorders: Protocol for a Pre-Post Quantitative Treatment Development Study (2024) · cites this paper as [114]
Rates of comorbidity between affective and substance use disorders during adolescence range from 9.0-47.9%.
“Rates of comorbidity between affective and SUDs during adolescence range from 9.0–47.9%”
From Impact of Sleep and Circadian Rhythms on Addiction Vulnerability in Adolescents (2018) · cites this paper as [5]
Depression and anxiety typically precede substance problems in adolescence.
“depression and anxiety typically precede substance problems (5)”
From Impact of Sleep and Circadian Rhythms on Addiction Vulnerability in Adolescents (2018) · cites this paper as [5]

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Authors: O'Neil, K. A., Conner, B. T., & Kendall, P. C.
Affiliations: Temple University (US)
ORCID: Conner, Bradley T.
Kendall, Philip C.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2011-02
Volume: 31
Issue: 1
Pages: 104-112
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2010.08.002
OpenAlex: W1973380933
Cited by: 166
References: 63
Citations by year: 2026: 7 · 2025: 3 · 2024: 14 · 2023: 2 · 2022: 8 · 2021: 9 · 2020: 13 · 2019: 8 · 2018: 14 · 2017: 15 · 2016: 14 · 2015: 19 · 2014: 16 · 2013: 8 · 2012: 10
FWCI: 0.84
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: internalizing disorders, substance use disorders, youth, comorbidities, temporal precedence, risk model, prevention, treatment outcomes, adolescent mental health
MeSH terms: Adolescent, Anxiety Disorders, Child, Depressive Disorder, Humans, Risk, Comorbidity, Substance-Related Disorders, Young Adult

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Internalizing disorders and substance use disorders in youth: Comorbidity, risk, temporal order, and implications for intervention

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