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Internalizing and Externalizing Problem Behavior: a Test of a Latent Variable Interaction Predicting a Two-Part Growth Model of Adolescent Substance Use

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Abstract

Externalizing symptoms robustly predict adolescent substance use (SU); however, findings regarding internalizing symptoms have been mixed, suggesting that there may be important moderators of the relationship between internalizing problems and SU. The present study used a longitudinal community sample (N = 387, 55% female, 83% White) to test whether externalizing symptoms moderated the relationship between internalizing symptoms and trajectories of alcohol and marijuana use from early (age 11–12 years old) to late (age 18–19 years old) adolescence. Two-part latent growth models were used to distinguish trajectories of probability of use from trajectories of amount of use among users. Results suggested that externalizing symptoms moderated the association between internalizing symptoms and probability of alcohol, but not marijuana use. The highest probability of alcohol use was observed at high levels of externalizing symptoms and low levels of internalizing symptoms. A negative protective effect of internalizing symptoms on probability of alcohol use was strongest in early adolescence for youth high on externalizing symptoms. Although moderation was not supported for amount of use among users, both domains of symptomology were associated with amount of alcohol and marijuana use as first-order effects. High levels of externalizing symptoms and low levels of internalizing symptoms were associated with high levels of amount of use among users. These findings suggest that developmental models of substance use that incorporate internalizing symptomology should consider the context of externalizing problems and distinguish probability and amount of use.

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Notes

  1. We also considered the possibility that our proposed moderational model might be different for anxiety and depression symptoms. There is some evidence that subdomains of internalizing symptoms may operate differently in the etiology of adolescent SU (Colder et al. 2010). Accordingly, we used the ASEBA Diagnostic Statistical Manual (DSM) – oriented scales for anxiety and affective symptoms (depression symptoms), and tested interactions between these clusters of symptoms and externalizing symptoms. Interaction effects for anxiety by externalizing and depression by externalizing replicated across both alcohol and marijuana models. That is, only the slope for probability of alcohol use was predicted by the interaction terms. Moreover, the strength of the anxiety by externalizing and depression by externalizing interactions on the slope were similar, β = 5.51, p < 0.01 and β = 5.80, p < 0.01, respectively. This suggests that depression and anxiety do not operate differently in our moderational model predicting trajectories of alcohol and marijuana use.

  2. Multiple group models were used to test for potential gender differences in relations between the symptom variables and growth factors. To do this, we computed observed symptom variables and their cross-products. Nested model tests revealed no significant gender differences in the association of externalizing and internalizing symptoms and the interaction term with marijuana use, Δχ2(12) = 16.02, p > 0.05, or alcohol use, Δχ2(12) = 12.79, p > 0.05, growth factors.

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Acknowledgements

This research was funded by a grant from the National Institute on Drug Abuse (R01 DA019631) awarded to Dr. Craig R. Colder.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Colder, C.R., Frndak, S., Lengua, L.J. et al. Internalizing and Externalizing Problem Behavior: a Test of a Latent Variable Interaction Predicting a Two-Part Growth Model of Adolescent Substance Use. J Abnorm Child Psychol 46, 319–330 (2018). https://doi.org/10.1007/s10802-017-0277-6

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