Studies of teen substance use
Today, I address two studies of substance use in teens and young adults. First, Carbonneau, Vitaro, Brendgen, Boivin, Côté & Tremblay (2024) published “Preadolescent Individual, Familial, and Social Risk Factors Associated with Longitudinal Patterns of Adolescent Alcohol, Cannabis, and Other Illicit Drug Use in a Population-Representative Cohort” in Developmental Psychology. Here are the edited abstract and impact statements:
The aim of this exploratory study was to identify developmental patterns of adolescent concurrent alcohol, cannabis, and other illicit drug use and their preadolescent individual, familial, and social risk factors in a population-representative cohort from the province of Quebec, Canada (N = 1,593; 48.4% male). Age 12–17 years self-reports of alcohol, cannabis, and other illicit drug use were collected. Latent growth modeling was used to analyze developmental patterns of single- or polysubstance use (SU/PSU), and multinomial regression examined their association with risk factors assessed at age 10–12 years. Five developmental patterns were revealed, including nonusers (12.8% sample) and four classes reflecting different levels of SU/PSU (5.8%–37.5%), varying in severity based on onset, frequency, and type of substances used. Boys and girls were similarly represented throughout SU/PSU patterns. In comparisons with nonusers, several preadolescent risk factors were associated with increasing severity of SU/PSU. Possibly indexing fearlessness/disinhibition, low internalizing symptoms were common to all adolescent users. An earlier onset of substance use and increasing use of substances throughout adolescence were linked with having deviant peers for all user classes but later-onset users. Preadolescents manifesting externalizing problems and exposed to family adversity in addition to the above risk factors showed the earliest onset and most frequent adolescent SU/PSU, especially those also exposed to less appropriate parenting. Consistent with the developmental model of substance use, the nature, number, and severity of preadolescent risk factors distinguished between the type and severity of SU/PSU patterns in adolescence and call for a consistent strategy of universal, selective, and indicated preventive interventions.
Results from a large population-representative sample revealed a crescendo in the nature, number, and severity of risk factors at the individual, familial, and social levels associated with increasingly complex longitudinal patterns of single- or polysubstance use (SU/PSU: alcohol, cannabis, other illicit drugs) in adolescents. In the recent context of a narrowing gap between sexes on SU, the similar representation of boys and girls in SU/PSU patterns suggests that adolescent girls’ SU/PSU may warrant monitoring.
I thought this article was important in identifying externalizing problems and family adversity as important predictors of both early onset and frequent substance use in early adolescence. It’s also important to note the narrowing gender gap. The next study looks at attachment in older teens. Clinchard, Deater-Deckard, Casas & Kim-Spoon (2024) published “Longitudinal Links from Attachment with Mothers and Fathers to Adolescent Substance Use: Internalizing and externalizing pathways” in Developmental Science. Here are highly edited excerpts:
The present study examined whether internalizing and externalizing symptoms may mediate the association between adolescent–mother and adolescent–father attachment and substance use. The sample included 167 adolescents (47% girls) who were assessed at five time points with approximately 1 year between each assessment, beginning in middle adolescence (Mage = 14.07) and ending in the transition to young adulthood (Mage = 18.39). The adolescents reported their perceived attachment with both their mother and father during middle adolescence (Times 1 and 2), their internalizing and externalizing symptoms during late adolescence (Times 3 and 4), and their alcohol use during the transition to young adulthood (Time 5). The results showed that less secure adolescent–father attachment, but not adolescent–mother attachment, was predictive of heightened externalizing and internalizing symptoms. In turn, heightened externalizing symptoms were predictive of heightened alcohol use. Despite the nonsignificant direct association between adolescent–father attachment and alcohol use, less secure adolescent–father attachment was indirectly predictive of greater alcohol use, mediated through heightened externalizing symptoms. The findings highlight the importance of close and trusting father–adolescent relationships in the development of psychopathology and substance use behaviors. The developmental cascade from a less secure adolescent–father attachment to greater externalizing symptoms and heightened substance use, as well as implications for prevention and intervention of young adult substance use, are discussed.
Reviewing prior research reveals two plausible developmental pathways through which adolescents’ attachment with parents is linked to substance use. For one, insecurely attached adolescents may not have the necessary self-regulation skills available (Mikulincer & Shaver, 2019), and the resulting disinhibited, externalizing behaviors may facilitate problematic substance use. Additionally, insecure attachment may lead to low self-esteem and high negative affect associated with the lack of positive social interactions, and the resulting internalizing behaviors may facilitate substance use as a maladaptive coping strategy (Kassel et al., 2007; Schindler et al., 2007).
Our findings demonstrate that earlier relationship quality with fathers during middle adolescence is important in predicting alcohol use during the transition to young adulthood when substance use behaviors are facilitated by increased exposure to substances, diminished parental monitoring, and decreased structure (Stone et al., 2012). Further, our data suggested that the link between adolescent–father attachment and substance use was mediated through externalizing symptoms. Finally, our exploratory analysis indicated nonsignificant youth gender differences in the associations among attachment, psychopathology, and alcohol use. This result was consistent with prior meta-analyses reporting nonsignificant gender moderation effects on the attachment-psychopathology link across childhood and through late adolescence for both adolescent–mother and adolescent–father attachment (Deneault et al., 2021; Madigan et al., 2016).
Our data suggest that less secure adolescent–father attachment experienced during middle adolescence was associated with externalizing and internalizing symptoms during late adolescence. Adolescents with less secure attachment to fathers may act out and take negative risks that are harmful to themselves or others (e.g., greater externalizing behaviors) in part due to the lack of secure internal working models that facilitate regulating their risk-seeking and negative emotions (Tops et al., 2014). Additionally, given that the internal working model is a representation formed by experiences with a caregiver over time, repeatedly experiencing unresponsiveness and alienation from the father growing up can give rise to negative affect and feelings of unworthiness, resulting in internalizing symptoms (Dozois & Beck, 2008).
Specifically, even though both adolescent–father attachment and adolescent–mother attachment exhibited significant bivariate correlations with internalizing and externalizing symptoms, when they were simultaneously included in the model to evaluate relative contributions, only the effects of adolescent–father attachment were significant. This finding is consistent with prior research demonstrating that only adolescent–father attachment, not adolescent–mother attachment, was predictive of adolescents’ aggressiveness (Gallarin & Alonso-Arbiol, 2012). Further, these findings support prior literature suggesting that the influence of father love is greater than the influence of mother love for certain developmental outcomes including delinquency and substance use (Rohner & Veneziano, 2001).
Acceptance by fathers (i.e., warmth, affection, care, comfort, nurturance, support, and love) has been found to be a stronger predictor of child adjustment when compared with acceptance by mothers (see Khaleque & Rohner, 2012 for a meta-analysis). Coupled with fathers’ increasing involvement in their children's lives (Lamb et al., 2014), it is crucial to understand how attachment with mothers and fathers may differently impact child and adolescent development. Within the psychopathology literature, it has been suggested that fathering behaviors are more potent predictors than mothering behaviors particularly for externalizing symptoms, as fathers are more likely to engage in more rough-and-tumble play, compete with them, and encourage them to take risks (Paquette, 2004; Volling et al., 2019). Through such experiences, adolescents with a secure adolescent–father attachment may solidify internal working models that guide risk taking in socially acceptable ways (e.g., standing up for themselves) while regulating emotions of excitement, frustration, and fear. In the absence of a secure attachment with a father, the adolescent may not have the opportunity to gain and practice these necessary skills and may regulate their emotions in socially maladaptive ways such as acting out or acting in an antagonistic manner (e.g., externalizing symptoms).
[L]ess secure adolescent–father attachment in middle adolescence predicted greater externalizing symptoms in late adolescence, which, in turn, predicted greater alcohol use during the transition to young adulthood. The findings have important implications especially for young adults who are beginning college. It has been found that college students drink more than their same-age noncollege peers (Schulenberg & Maggs, 2002), and alcohol use during this transition to young adulthood has been found to be associated with an increased risk of dropping out of school as well as developing substance use disorders later in adulthood.
Our finding indicates that the individual differences in adolescent–father attachment were greater than those of the adolescent–mother attachment. That is, the effects of adolescent–father attachment may be more prominent on their adolescents’ outcomes in part because the level of secure attachment varied more drastically with fathers than mothers. It follows that adolescent–mother attachment security was not a significant predictor due to not having as wide of a range in individual differences concerning the amounts of secure quality. We note that the effects of adolescent–father attachment and adolescent–mother attachment are dynamically determined, such that secure father–adolescent attachment may become more influential in attenuating less secure mother–adolescent attachment. We also note that our findings do not contradict prior research indicating overall importance of insecure attachment with mothers in child and adolescent psychopathology. Rather, when simultaneously examining the relative effects of adolescent–mother and adolescent–father attachment, adolescent–father attachment quality seems to be a more influential factor for the development of externalizing and internalizing symptoms during adolescence.
Notably, internalizing symptoms were not prospectively associated with later alcohol use. This finding contradicts the self-medication hypothesis, which posits that those with internalizing symptoms are more likely to use substances to decrease their symptoms (Bolton et al., 2009) and further adds to the mixed literature regarding the link between internalizing symptoms and substance use (e.g., Colder et al., 2013; Hussong et al., 2011; Isaksson et al., 2020). One primary reason for this nonsignificant link between internalizing symptoms in late adolescence and alcohol use during the transition to young adulthood may be due to the social contexts in which young adults consume alcohol. During this developmental period, drinking is often socially motivated and amplified by affiliation with substance-using peers (Otten et al., 2017; Van Ryzin et al., 2012). It follows that young adults with greater levels of internalizing symptoms are less likely to be exposed to contexts in which they can partake in substance use (Siebenbruner et al., 2006). That is, young adults experiencing depression or anxiety may prefer to stay home and not go to a party, therefore not having that opportunity to drink alcohol.
The transition to young adulthood is an important time to examine the development of substance use behaviors. Our findings highlight the significance of the adolescent–father relationship in a developmental cascading pathway, wherein adolescent–father attachment during middle adolescence plays a critical role in the development of externalizing symptoms in late adolescence, and, in turn, predicts subsequent alcohol use during the transition to young adulthood. The findings from the current study support the theoretical perspective that emphasizes the importance of social relationship factors in substance use disorders (Volkow et al., 2011), by illustrating that insecure adolescent–father attachment sets the stage for the developmental cascade into more externalizing symptoms and more alcohol use. The findings have implications for the prevention of problematic substance use, providing evidence that addressing insecure attachment with fathers during adolescence may reduce unhealthy substance use later (Fletcher et al., 2015). Further, the association between late adolescent externalizing symptoms and later alcohol use suggests that behavioral disinhibition during adolescence, likely prevalent among those with poor attachment qualities with their father, may be a target for the prevention of alcohol use during the transition to young adulthood.
This article is available in full text. I thought it was helpful in addressing the role of the father in the developmental cascade from attachment via behavioral disinhibition to both externalizing symptoms and alcohol use.