This report presents an examination
of the association between psychological functioning and substance use among
adolescents aged 12 to 17 using data from the 1994-1996 National Household Survey
on Drug Abuse (NHSDA). The survey, conducted annually by Substance Abuse and
Mental Health Services Administration (SAMHSA), provides estimates of the prevalence
of use of a variety of illicit drugs, alcohol, and tobacco, based on a nationally
representative sample of the civilian noninstitutionalized population.In
addition, the 1994-1996 surveys include mental health data not previously available.
In 1994, the NHSDA added the Youth Self-Report (Achenbach, 1991), a comprehensive
mental health checklist that has been used extensively in studies of adolescents.
The instrument generates summary measures of emotional and behavioral problems,
as well as measures for specific syndromes, including depression, anxiety, withdrawal,
somatic complaints, social problems, thought problems, attention problems, delinquent
behavior, and aggressive behavior. Selected findings are given below.
Emotional and Behavioral Problems
In 1994-1996, an estimated thirteen
percent of adolescents aged 12 to 17 had emotional problems as indicated by
withdrawal, somatic problems, anxiety and depression.
In 1994-1996, an estimated seventeen
percent of adolescents aged 12 to 17 had behavioral problems indicated by
delinquent or aggressive behavior.
The likelihood of substance use
among adolescents is associated with the severity of emotional and behavioral
problems across age and gender groups.
Illicit Drug Use
In 1994-1996, nine percent
of adolescents aged 12 to 17 reported past month use of illicit drugs.
Seven percent reported past-month use of marijuana. Four percent of adolescents
aged 12 to 17 reported past-month use of illicit drugs other than marijuana.
Rates of illicit drug use were highest among older adolescents aged 16
to 17; 17 percent of males and 13 percent of females
reported past-month use.
Past-month marijuana use was nearly
twice as likely and use of other illicit drugs was four times more likely
for adolescents with serious emotional problems than for adolescents with
low levels of emotional problems.
Past-month marijuana use was four times
as likely and use of other illicit drugs was nearly seven times more likely
for adolescents with serious behavioral problems than for adolescents with
low levels of behavioral problems. Dependence on substances such as cocaine,
crack, inhalants, hallucinogens, heroin or abused prescription drugs was nearly
nine times as likely among adolescents with serious behavioral problems.
Alcohol Use
In 1994-1996, 20 percent of
adolescents aged 12 to 17 reported using alcohol in the past month. Rates
of past-month alcohol use were highest among older adolescents aged 16
to 17; 36 percent of males and 31 percent of females reported past month
use.
Past-month alcohol use was nearly twice
as likely for adolescents with serious emotional problems than for adolescents
with low levels of emotional problems.
Adolescents with serious behavioral
problems were nearly three times as likely to use alcohol in the past month
than adolescents with low levels of behavioral problems.
Cigarette Use
In 1994-1996, 19 percent of
adolescents 12 to 17 reported smoking cigarettes in the past month. Rates
were highest among older adolescents aged 16 to 17; 31 percent of males
and 27 percent of females reported past month cigarette smoking.
When compared to adolescents with low
levels of emotional problems, past-month cigarette smoking was twice as likely
for adolescents with serious emotional problems.
Past-month smoking was three times
more likely for adolescents with serious behavioral problems than for adolescents
with low levels of behavioral problems.
Alcohol or Illicit Drug Dependence
In 1994-1996, 6 percent of adolescents
aged 12 to 17 reported dependence on alcohol or illicit drugs. Rates were
highest among older adolescents; approximately 10 to 11 percent of adolescents
aged 16 to 17 reported alcohol or illicit drug dependence.
Adolescents with serious emotional
problems were nearly four times more likely to be dependent on alcohol or
illicit drugs than adolescents with low levels of emotional problems.
Alcohol or illicit drug dependence
was more than seven times more likely among adolescents with serious behavioral
problems than among adolescents with low levels of behavioral problems.
Using the Youth Self-Report (YSR) to Identify
Substance Users
Average scores on the YSR syndromes
for the NHSDA adolescents were generally consistent with the nonclinical norming
sample reported by Achenbach (1991). Overall, there were higher correlations
among scales in the NHSDA than in the norming sample.
When all of the syndromes are considered
together in the analysis, the syndrome most consistently associated with substance
use is Delinquent Behavior, even though the substance abuse items in the YSR
were removed from the syndrome scale. This is followed by scales measuring
Social Problems and Attention Problems. Here, more Attention Problems but
fewer Social Problems were associated with increased substance use (see pp.
42-43).
Assessment of individual items from
the syndromes most consistently associated with substance use indicate that
stealing , swearing, hanging around with troublemakers, and running away from
home (from the Delinquent Behaviors scale) were associated with higher levels
of substance use. The item, "feeling confused or in a fog" from
the Attention Problems scale, was also associated with more substance use.
In contrast, adolescents who used substances were less likely to acknowledge
getting teased, preferring younger friends, acting too young, or being overdependent
on adults (from the Social Problems scale).
SAMHSA, an agency in the Department of Health and Human Services, is the Federal
Government's lead agency for improving the quality and availability of
substance abuse prevention, addiction treatment, and mental health
services in the United States.
