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Cited by 24Substance Abuse Treatment and OutcomesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Internalizing symptoms and conduct problems: Redundant, incremental, or interactive risk factors for adolescent substance use during the first year of high school?

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Khoddam, Rubin, Jackson, Nicholas J., Leventhal, Adam M.·2016·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2016.10.007PMC PMC5140846
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Abstract

Aim The complex interplay of externalizing and internalizing problems in substance use risk is not well understood. This study tested whether the relationship of conduct problems and several internalizing disorders with future substance use is redundant, incremental, or interactive in adolescents. Methods Two semiannual waves of data from the Happiness and Health Study were used, which included 3383 adolescents (M age=14.1years old; 53% females) in Los Angeles who were beginning high school at baseline. Logistic regression models tested the likelihood of past six-month alcohol, tobacco, marijuana, and any substance use at follow-up conditional on baseline conduct problems, symptoms of one of several internalizing disorders (i.e., Social Phobia and Major Depressive, Generalized Anxiety, Panic, and Obsessive-Compulsive Disorder), and their interaction adjusting for baseline use and other covariates. Findings Conduct problems were a robust and consistent risk factor of each substance use outcome at follow-up. When adjusting for the internalizing-conduct comorbidity, depressive symptoms were the only internalizing problem whose risk for alcohol, tobacco, and any substance use was incremental to conduct problems. With the exception of social phobia, antagonistic interactive relationships between each internalizing disorder and conduct problems were found when predicting any substance use; internalizing symptoms was a more robust risk factor for substance use in teens with low (vs. high) conduct problems. Conclusions Although internalizing and externalizing problems both generally increase risk of substance use, a closer look reveals important nuances in these risk pathways, particularly among teens with comorbid externalizing and internalizing problems.

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Cited by

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Authors
Khoddam, R., Jackson, N. J., & Leventhal, A. M.
Affiliations
University of Southern California (US)
Corresponding author
Leventhal, Adam M.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2016-12
Volume
169
Pages
48-55
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2016.10.007
PMC
PMC5140846
OpenAlex
W2535004600
Cited by
24
References
3
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 4
FWCI
2.19
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (R01DA033296, F31DA039708)
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 › Social Psychology › Mental Health Treatment and Access
Keywords
adolescent substance use, conduct problems, internalizing disorders, depressive symptoms, social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, alcohol consumption, tobacco use, cannabis use, comorbidities, risk factors, high school students
MeSH terms
Problem Behavior, Adolescent, Mental Disorders, Depression, Female, Humans, Male, Risk Factors, Schools, Los Angeles, Substance-Related Disorders

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