Different Kinds of Lonely: Dimensions of Isolation and Substance Use in Adolescence
Social isolation is broadly associated with poor mental health and risky behaviors in adolescence, a time when peers are critical for healthy development. However, expectations for isolates’ substance use remain unclear. Isolation in adolescence may signal deviant attitudes or spur self-medication, resulting in higher substance use. Conversely, isolates may lack access to substances, leading to lower use. Although treated as a homogeneous social condition for teens in much research, isolation represents a multifaceted experience with structurally distinct network components that present different risks for substance use. This study decomposes isolation into conceptually distinct dimensions that are then interacted to create a systematic typology of isolation subtypes representing different positions in the social space of the school. Each isolated position’s association with cigarette, alcohol, and marijuana use is tested among 9th grade students (n = 10,310, 59% female, 83% white) using cross-sectional data from the PROSPER study. Different dimensions of isolation relate to substance use in distinct ways: unliked isolation is associated with lower alcohol use, whereas disengagement and outside orientation are linked to higher use of all three substances. Specifically, disengagement presents risks for cigarette and marijuana use among boys, and outside orientation is associated with cigarette use for girls. Overall, the adolescents disengaged from their school network who also identify close friends outside their grade are at greatest risk for substance use. This study indicates the importance of considering the distinct social positions of isolation to understand risks for both substance use and social isolation in adolescence.
KeywordsSocial Isolation Adolescence Social Networks Substance Use
The authors thank the members of working groups at PSU and Duke University for their helpful comments. We gratefully acknowledge the contributions of study participants and families and the PROSPER staff to the success of this project.
M.C. wrote the manuscript and contributed to the study design; J.F. conducted analyses and participated in data interpretation and drafting; JM generated the networks; J.M. and M.E.F. conceived of the study and participated in design and revision. All authors read and approved the final manuscript.
Grants from the W.T. Grant Foundation (8316), National Institute on Drug Abuse (R01-DA018225), National Science Foundation (1535370), the National Institutes of Health (UL1-TR002240), and National Institute of Child Health and Development (R24-HD041025) supported this research. The analyses used data from PROSPER, a project directed by R. L. Spoth, funded by the National Institute on Drug Abuse (RO1-DA013709) and the National Institute on Alcohol Abuse and Alcoholism (AA14702).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
The procurement of the data required for this study was approved by the Iowa State University and Pennsylvania State University institutional review boards
All youth and families were informed about and consented to participate in this project.
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