The Moderating Role of Spirituality in the Association between Stress and Substance Use among Adolescents: Differences by Gender
Adolescents are exposed to various stressors that may increase the risk for substance use. Due to the detrimental, and potentially long-lasting, effects related to substance use, it is necessary to explore more optimal coping strategies. This study explored the association between substance use and stress among male and female high school students in relation to spirituality as a moderator. To examine these relationships, the study used cross-sectional data collected from 27,874 high school students (Male = 50.7%, Female = 49.3%) across 58 high schools in Maryland that included an ethnically diverse sample (49% Caucasian, 30% African American) with an average age of 16 years old. Bivariate results showed differences in substance use, stress, and spirituality between male and female students. Higher rates of substance use were generally found among male students compared to female students; rates tended to be higher among female students for stress and spirituality compared to their male counterparts. Multilevel analyses indicated a positive association between stress and substance use among male and female students after adjusting for demographic and school-level factors. Both male and female students who reported turning to spiritual beliefs when experiencing problems were less likely to use substances. However, the interaction between stress and spirituality was significant for males only. These findings suggest that stress may increase the propensity for substance use and that spirituality might be a viable coping mechanism useful for helping high school students adapt to stressful circumstances and situations.
KeywordsAdolescents Substance use Stress Spirituality Gender
Support for this study came from the Centers for Disease Control and Prevention (1U49CE000728 & 5U01CE001954-05), the U.S. Department of Education’s Safe and Supportive Schools Initiative, the William T. Grant Foundation, and the National Institute of Justice. We thank the Maryland State Department of Education and Sheppard Pratt Health System for their continued support of this research through the Maryland Safe and Supportive Schools Project.
K.D. developed the study, contributed to the study design and analysis, and assisted in drafting the manuscript; A.M. assisted in the study design and analyses, and helped draft the manuscript; M.M. performed literature reviews and helped draft the manuscript; K.L. helped with the study analyses and assisted in drafting the manuscript; C.B. is the principal investigator on the larger study and reviewed drafts of the manuscript and analyses. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interests.
All procedures performed in the current study were in accordance with the ethical standards of the Institutional Review Boards at the Johns Hopkins Bloomberg School of Public Health and University of Virginia, and are consistent with the 1964 Helsinki declaration in order to ensure proper treatment, safety, and confidentiality of all participants.
Passive consent was obtained from parents of students who participated in the study.
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