Journal of Youth and Adolescence

, Volume 44, Issue 4, pp 793–805 | Cite as

At-Risk Depressive Symptoms and Alcohol Use Trajectories in Adolescence: A Person-Centred Analysis of Co-Occurrence

  • Teena WilloughbyEmail author
  • Adrian Fortner
Empirical Research


Long-term longitudinal studies that examine whether there are distinct trajectories of at-risk depressive symptoms and alcohol use across the high school years (e.g., high co-occurrence) are rare in normative samples of adolescent boys and girls; yet, this assessment is of critical importance for developing effective prevention and intervention strategies. Moreover, the role of self-regulation and novelty-seeking behavior in differentiating among distinct subgroups of adolescents is not clear. To address these gaps, the present study sought to identify subgroups of adolescent boys and girls that indicated at-risk trajectories across the high school years for both depressive symptoms and alcohol use, and examined the role of delay of gratification and novelty seeking at baseline in differentiating among the subgroups. Canadian adolescents (N = 4,412; 49 % female) were surveyed at four time points (grades 9, 10, 11, and 12). Parallel process latent class growth analyses revealed four distinct subgroups for both boys and girls, encompassing high co-occurrence, depressive symptoms only, alcohol use only, and low co-occurrence. Across gender, delay of gratification at baseline differentiated among the four subgroups, with the High Co-Occurrence Group group scoring the lowest and the Low Co-Occurrence Group the highest. Lower novelty-seeking scores at baseline were associated more with being in the Depressive Symptoms Only Group relative to the other groups, particularly the Alcohol Use Only Group for boys. Thus, delay of gratification and novelty seeking may be useful in identifying youth at risk for co-occurring depressive symptoms and alcohol use trajectories, as well as at-risk trajectories for only one of these behaviors.


Co-occurrence Depressive symptoms Alcohol use Delay of gratification Novelty seeking Adolescence 



Funding for this longitudinal project was provided by the Social Sciences and Humanities Research Council of Canada to Teena Willoughby.

Author contributions

T.W conceived of the study, participated in the design and coordination of the study, performed the statistical analyses, collected the data, and participated in the drafting of the manuscript; A.F participated in the design, performed the statistical analyses, and participated in the drafting of the manuscript. Both authors read and approved the final manuscript.


  1. Adlaf, E. M., Ivis, F. J., & Smart, R. G. (1997). Ontario student drug use survey, 1977–1997. Toronto, Ontario: Addiction Research Foundation.Google Scholar
  2. Block, J., & Block, J. H. (1980). The role of ego-control and ego-resiliency in the organization of behavior. In W. A. Collins (Ed.), Development of cognition, affect, and social relations: The Minnesota symposia on child psychology. NJ: Erlbaum.Google Scholar
  3. Block, J. H., & Kremen, A. M. (1996). IQ and ego-resiliency: Conceptual and empirical connections and separateness. Journal of Personality and Social Psychology, 70, 349–361. doi: 10.1037/0022-3514.70.2.349.CrossRefPubMedGoogle Scholar
  4. Chen, K., Sheth, A., Elliott, D., & Yeager, A. (2004). Prevalence and correlates of past-year substance use, abuse, and dependence in a suburban community sample of high-school students. Addictive Behaviors, 29, 413–423. doi: 10.1016/j.addbeh.2003.08.013.CrossRefPubMedGoogle Scholar
  5. Chen, R., & Simons-Morton, B. (2009). Concurrent changes in conduct problems and depressive symptoms in early adolescents: A developmental person-centered approach. Development and Psychopathology, 21, 285–307. doi: 10.1017/S0954579409000169.CrossRefPubMedCentralPubMedGoogle Scholar
  6. Cranford, J. A., Nolen-Hoeksema, S., & Zucker, R. A. (2011). Alcohol involvement as a function of co-occurring alcohol use disorders and major depressive episode: Evidence from the National Epidemiological Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 117, 145–151. doi: 10.1016/j.drugalcdep.2011.01.011.CrossRefPubMedCentralPubMedGoogle Scholar
  7. Crews, F. T., Braun, C. J., Hoplight, B., Switzer, R. C., & Knapp, D. J. (2000). Binge ethanol consumption causes differential brain damage in young adolescent rats compared with adult rats. Alcoholism, Clinical and Experimental Research, 24, 1712–1723. doi: 10.1111/j.1530-0277.2000.tb01973.x.CrossRefPubMedGoogle Scholar
  8. Duncan, T. E., Duncan, S. C., Strycker, L. A., Li, F., & Alpert, A. (2006). An introduction to latent variable growth curve modeling: Concepts, issues, and applications (2nd ed.). NJ: Erlbaum.Google Scholar
  9. Eaton, W. W., Muntaner, C., Ybarra, M., Smith, C. B., & Tien, A. Y. (2004). Revision of the Center for Epidemiologic Studies Depression (CESD) scale. In M. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment. NJ: Erlbaum.Google Scholar
  10. Eisenberg, N., Cumberland, A., Spinrad, T. L., Fabes, R. A., Shephard, S. A., Reiser, M., et al. (2001). The relations of regulation and emotionality to children’s externalizing and internalizing problem behavior. Child Development, 72, 1112–1134. doi: 10.1111/1467-8624.00337.CrossRefPubMedGoogle Scholar
  11. Eisenberg, N., Edwards, A., Spinrad, T. L., Sallquist, J., Eggum, N. D., & Reiser, M. (2013). Are effortful and reactive control unique constructs in youth children? Developmental Psychology, 49, 2082–2094. doi: 10.1037/a0031745.CrossRefPubMedGoogle Scholar
  12. Ernst, M., Luckenbaugh, D. A., Moolchan, E. T., Leff, M. K., Allen, R., Eshel, N., et al. (2006). Behavioral predictors of substance-use initiation in adolescence with and without attention deficity/hyperactivity disorder. Pediatrics, 117, 2030–2039. doi: 10.1542/peds.2005-0704.CrossRefPubMedGoogle Scholar
  13. Fergusson, D. B., Boden, J. M., & Horwood, L. J. (2009). Tests of causal links between alcohol use or dependence and major depression. Archives of General Psychiatry, 66, 260–266. doi: 10.1001/archgenpsychiatry.2008.543.CrossRefPubMedGoogle Scholar
  14. Fleming, C. B., Mason, W. A., Mazza, J. J., Abbott, R. D., & Catalano, R. F. (2008). Latent growth modeling of the relationship between depressive symptoms and substance use during adolescence. Psychology of Addictive Behaviors, 22, 186–197. doi: 10.1037/0893-164X.22.2.186.CrossRefPubMedGoogle Scholar
  15. Forbes, E. E., Hariri, A. R., Martin, S. L., Silk, J. S., Moyles, D. L., Fisher, P. M., et al. (2009). Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder. American Journal of Psychiatry, 166, 64–73. doi: 10.1176/appi.ajp.2008.07081336.CrossRefPubMedCentralPubMedGoogle Scholar
  16. Harden, K. P., & Tucker-Drob, E. M. (2011). Individual differences in the development of sensation seeking and impulsivity during adolescence: Further evidence for a dual systems model. Developmental Psychology, 47, 739–746. doi: 10.1037/a0023279.CrossRefPubMedGoogle Scholar
  17. Hooshmand, S., Willoughby, T., & Good, M. (2012). Does the direction of effects in the association between depressive symptoms and health-risk behaviors differ by behavior? A longitudinal study across the high school years. Journal of Adolescent Health, 50, 140–147. doi: 10.1016/j.jadohealth.2011.05.016.CrossRefPubMedGoogle Scholar
  18. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. doi: 10.1080/10705519909540118.CrossRefGoogle Scholar
  19. Huckle, T., You, R. Q., & Casswell, S. (2010). Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction, 105, 1192–1202. doi: 10.1111/j.1360-0443.2010.02931.x.CrossRefPubMedGoogle Scholar
  20. Hyde, J. S., & Petersen, J. L. (2009). A longitudinal investigation of peer sexual harassment victimization in adolescence. Journal of Adolescence, 32, 1173–1188. doi: 10.1016/j.adolescence.2009.01.011.CrossRefPubMedGoogle Scholar
  21. Jung, T., & Wickrama, K. (2008). An introduction to latent class growth analysis and growth mixture modeling. Social and Personality Psychology Compass, 2, 302–317. doi: 10.1111/j.1751-9004.2007.00054.x.CrossRefGoogle Scholar
  22. Kandel, D. B., & Davies, M. (1982). Epidemiology of depressive mood in adolescents: An empirical study. Archives of General Psychiatry, 39, 1205–1212.CrossRefPubMedGoogle Scholar
  23. Kim, S. Y., & Ge, X. (2000). Parenting and adolescent depressive symptoms in Chinese American families. Journal of Family Psychology, 14, 420–435. doi: 10.1037/0893-3200.14.3.420.CrossRefPubMedGoogle Scholar
  24. Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence of incidence of depression and other DSM -III -R disorders in high school students. Journal of Abnormal Psychology, 102, 133–144.CrossRefPubMedGoogle Scholar
  25. Lewinsohn, P. M., Pettit, G. S., Joiner, J., Thomas, E., & Seeley, J. R. (2003). The symptomatic expression of major depressive disorder in adolescents and young adults. Journal of Abnormal Psychology, 112, 244–252. doi: 10.1037/0021-843X.112.2.244.CrossRefPubMedGoogle Scholar
  26. Locke, T. F., & Newcomb, M. D. (2001). Alcohol involvement and dysphoria: A longitudinal examination of gender differences from late adolescence to adulthood. Psychological and Addictive Behaviors, 15, 227–236. doi: 10.1037/0893-164X.15.3.227.CrossRefGoogle Scholar
  27. López-Caneda, E., Holquin, S. R., Cadaveia, F., Corral, M., & Doallo, S. (2013). Impact of alcohol use on inhibitory control (and vice versa) during adolescence and young adulthood: A review. Alcohol and Alcoholism,. doi: 10.1093/alcalc/agt168.Google Scholar
  28. Lorant, V., Deliége, D., Eaton, W., Robert, A., Philippt, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157, 98–112. doi: 10.1093/aje/kwf182.CrossRefPubMedGoogle Scholar
  29. Marmorstein, N. R. (2010). Longitudinal associations between depressive symptoms and alcohol problems: The influence of comorbid delinquent behavior. Addictive Behaviors, 35, 564–571. doi: 10.1016/j.addbeh.2010.01.004.CrossRefPubMedCentralPubMedGoogle Scholar
  30. Measelle, J. R., Stice, E., & Hogansen, J. M. (2006). Developmental trajectories of co- occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. Journal of Abnormal Psychology, 115, 524–538. doi: 10.1037/0021-843X.115.3.524.CrossRefPubMedCentralPubMedGoogle Scholar
  31. Miller, J. W., Naimi, T. S., Brewer, R. D., & Jones, S. E. (2007). Binge drinking and health risk behaviors among high school students. Pediatrics, 119, 76–85. doi: 10.1542/peds.2006-1517.CrossRefPubMedGoogle Scholar
  32. Mischel, W., Shoda, Y., & Rodriguez, M. L. (1989). Delay of gratification in children. Science, 244, 933–938.CrossRefPubMedGoogle Scholar
  33. Moriya, J., & Tanno, Y. (2008). Relationships between negative emotionality and attentional control in effortful control. Personality and Individual Differences, 44, 1348–1355. doi: 10.1016/j.paid.2007.12.003.CrossRefGoogle Scholar
  34. Murray, K. T., & Kochanska, G. (2002). Effortful control: Factor structure and relation to externalizing and internalizing behaviors. Journal of Abnormal Child Psychology, 30, 503–514.CrossRefPubMedGoogle Scholar
  35. Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
  36. Nagin, D. S. (2005). Group-based modelling of development. Cambridge: Harvard Press.Google Scholar
  37. Needham, B. L. (2007). Gender differences in trajectories of depressive symptomatology and substance use during the transition from adolescence to young adulthood. Social Science and Medicine, 65, 1166–1179.CrossRefPubMedGoogle Scholar
  38. Nylund, K. L., Asparouohov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A monte carlo simulation study. Structural Equation Modeling, 14, 535–569.CrossRefGoogle Scholar
  39. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  40. Radloff, L. S. (1991). The use of the Center for Epidemiological Studies Depression Scale in adolescents and young adults. Journal of Youth and Adolescence, 20, 149–166.CrossRefPubMedGoogle Scholar
  41. Rohde, P., Beevers, C. G., Stice, E., & O’Neil, K. (2009). Major and minor depression in female adolescents: Onset, course, symptom presentation, and demographic associations. Journal of Clinical Psychology, 65, 1339–1349. doi: 10.1002/jclp.20629.CrossRefPubMedCentralPubMedGoogle Scholar
  42. Rohde, P., Lewinsohn, P. M., Klein, D. N., Seeley, J. R., & Gau, J. M. (2013). Key characteristics of major depressive disorder occurring in childhood, adolescence, emerging adulthood, and adulthood. Clinical Psychological Science, 1(41), 53. doi: 10.1177/2167702612457599.Google Scholar
  43. Rohde, P., Lewinsohn, P. M., & Seeley, J. R. (1996). Psychiatric comorbidity with problematic alcohol use in high school students. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 101–109. doi: 10.1097/00004583-199601000-00018.CrossRefPubMedGoogle Scholar
  44. Rothbart, M. K., & Bates, J. E. (2006). Temperament. In N. Eisenberg & W. Damon (Eds.), Handbook of child psychology: vol 3. Social, emotional, and personality development (6th ed., pp. 99–166). NY: Wiley.Google Scholar
  45. Ruchkin, V., Sukhodolsky, D. G., Vermeiren, R., Koposov, R. A., & Schwab-Stone, M. (2006). Depressive symptoms and associated psychopathology in urban adolescents: A cross-cultural study of 3 countries. The Journal of Nervous and Mental Disease, 194, 106–113. doi: 10.1097/01.nmd.0000198142.26754.18.CrossRefPubMedGoogle Scholar
  46. Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147–177. doi: 10.1037/1082-989X.7.2.147.CrossRefPubMedGoogle Scholar
  47. Simons, J. S., & Carey, K. B. (2002). Risk and vulnerability for marijuana use problems: The role of affect dysregulation. Psychology of Addictive Behaviors, 16, 72–75. doi: 10.1037/0893-164X.16.1.72.CrossRefPubMedGoogle Scholar
  48. Smoski, M. J., Felder, J., Bizzell, J., Green, S. R., Ernst, M., Lynch, T. R., et al. (2009). fMRI of alterations in reward selection, anticipation, and feedback in major depressive disorder. Journal of Affective Disorders, 118, 69–78. doi: 10.1016/j.jad.2009.01.034.CrossRefPubMedCentralPubMedGoogle Scholar
  49. Spear, J. P. (2000). The adolescent brain and age-related behavioral manifestations. Neuroscience and Biobehavioral Reviews, 24, 417–463. doi: 10.1016/S0149-7634(00)00014-2.CrossRefPubMedGoogle Scholar
  50. Statistics Canada. (2006). Population by ethnic origin [Online]. Available at
  51. Steinberg, L. (2010). A dual systems model of adolescent risk-taking. Developmental Psychobiology, 52, 216–224. doi: 10.1002/dev.20445.PubMedGoogle Scholar
  52. Steinberg, L., Albert, L., Cauffman, E., Banich, M., Graham, S., & Woolard, J. (2008). Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: Evidence for a dual systems model. Developmental Psychology, 44(6), 1764–1778. doi: 10.1037/a0012955.CrossRefPubMedGoogle Scholar
  53. Swendsen, J. D., & Merikangas, K. R. (2000). The comorbidity of depression and substance use disorders. Clinical Psychology Review, 20, 173–189. doi: 10.1016/S0272-7358(99)00026-4.CrossRefPubMedGoogle Scholar
  54. Tice, D. M., Bratslavsky, E., & Baumeister, R. F. (2001). Emotional distress regulation takes precedence over impulse control: If you feel bad, do it! Journal of Personality and Social Psychology, 80, 53–67. doi: 10.1037/0022-3514.80.1.53.CrossRefPubMedGoogle Scholar
  55. Van Dam, N. T., & Earleywine, M. (2011). Validation of the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186, 128–132. doi: 10.1016/j.psychres.2010.08.018.CrossRefPubMedGoogle Scholar
  56. Verstraeten, K., Vasey, M., Raes, F., & Bijttebier, P. (2009). Temperament and risk for depressive symptoms in adolescence: Mediation by rumination and moderation by effortful control. Journal of Abnormal Child Psychology, 37, 349–361. doi: 10.1007/s10802-008-9293-x.CrossRefPubMedGoogle Scholar
  57. Wang, M. T., Brinkworth, M., & Eccles, J. (2012). Moderating effects of teacher–student relationship in adolescent trajectories of emotional and behavioral adjustment. Developmental Psychology,. doi: 10.1037/a0027916.PubMedCentralGoogle Scholar
  58. Willoughby, T., Chalmers, H., & Busseri, M. (2004). Where is the syndrome? Examining co-occurrence among multiple problem behaviors in adolescence. Journal of Consulting and Clinical Psychology, 72, 1022–1037.CrossRefPubMedGoogle Scholar
  59. Wills, T. A., Cleary, S., Filer, M., Shinar, O., Mariani, J., & Spera, K. (2001). Temperament related to early-onset substance use: Test of a developmental model. Prevention Science, 2, 145–163. doi: 10.1023/A:1011558807062.CrossRefPubMedGoogle Scholar
  60. Wills, T. A., & Stoolmiller, M. (2002). The role of self-control in early escalation of substance use: A time-varying analysis. Journal of Consulting and Clinical Psychology, 70, 986–997. doi: 10.1037/0022-006X.70.4.986.CrossRefPubMedGoogle Scholar
  61. Wills, T. A., Windle, M., & Cleary, S. D. (1998). Temperament and novelty seeking in adolescent substance use: Convergence of dimensions of temperament with constructs from Cloninger’s theory. Journal of Personality and Social Psychology, 74, 387–406.CrossRefPubMedGoogle Scholar
  62. Wilson, A. C., Lengua, L. J., Tininenko, J., Taylor, A., & Trancik, A. (2009). Physiological profiles during delay of gratification: Associations with emotionality, self-regulation, and adjustment problems. Journal of Applied Developmental Psychology, 30, 780–790. doi: 10.1016/j.appdev.2009.05.002.CrossRefPubMedCentralPubMedGoogle Scholar
  63. Windle, M., & Davies, P. T. (1999). Depression and heavy alcohol use among adolescents: Concurrent and prospective relations. Development and Psychopathology, 11, 823–844.CrossRefPubMedGoogle Scholar
  64. Windle, M., & Lerner, R. M. (1986). Reassessing the dimensions of temperamental individuality across the life span: The Revised Dimensions of Temperament Survey (DOTS-R). Journal of Adolescent Research, 1(2), 213–230.CrossRefGoogle Scholar
  65. Windle, M., Spear, L. P., Fuligni, A. J., Angold, A., Brown, J. D., Pine, D., et al. (2008). Transitions into underage and problem drinking: Summary of developmental processes and mechanisms: Ages 10–15. Pediatrics, 121, S273–S289. doi: 10.1542/peds.2007-2243C.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of PsychologyBrock UniversitySt. CatharinesCanada

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