Prevention Science

, Volume 5, Issue 4, pp 267–277 | Cite as

Tobacco and Alcohol Use as an Explanation for the Association Between Externalizing Behavior and Illicit Drug Use Among Delinquent Adolescents

  • Amy Helstrom
  • Angela Bryan
  • Kent E. Hutchison
  • Paula D. Riggs
  • Elaine A. Blechman


The prevalence and persistence of adolescent substance use and abuse is a national health issue, and substance use among adolescents is frequently comorbid with other psychiatric disorders. Most studies in this area utilize samples of middle or high school students or from inpatient settings. Less is known about substance use and psychiatric comorbidity among delinquent adolescents. The present study examined data from two cohorts of juvenile offenders collected over a 2-year period (n = 245, n = 299). Participants reported frequency of cigarette, alcohol, marijuana, and other substance use. Participants' parents completed a measure of behavior problems. Path analyses suggested that parental reports of externalizing problems were significantly related to self-reported substance use while parental reports of internalizing problems were not. Results also suggested that smoking and alcohol use act as mediators between externalizing problems and marijuana and other drug use. Although there were some mean differences by gender, the pattern of relationships amongst the variables did not differ by gender. Implications of the findings and future directions are discussed.

juvenile offenders externalizing behavior internalizing problems adolescent substance use 


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  1. Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Ver-mont, Department of Psychiatry.Google Scholar
  2. Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238-246.Google Scholar
  3. Boyle, M. H., Offord, D. R., Racine, Y. A., Szatmari, P., Fleming, J. E., & Links, P. S. (1992). Predicting substance use in late adoles-cence: Results from the Ontario Child Health Study follow-up. American Journal of Psychiatry, 149, 761-767.Google Scholar
  4. Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. Bollen & K. Long (Eds.), Testing structural equation models (pp. 136-162). Newbury Park, CA: Sage.Google Scholar
  5. Bryan, A., & Stallings, M. C. (2002). Acase control study of adoles-cent risky sexual behavior and its relationship to personality dimensions, conduct disorder, and substance use. Journal of Youth and Adolescence, 31, 387-396.Google Scholar
  6. Chassin, L., Presson, C. C., Sherman, S. J., & Edwards, D. A. (1992). The natural history of cigarette smoking and young adult social roles. Journal of Health and Social Behavior, 33, 328-347.Google Scholar
  7. Chassin, L., Presson, C. C., Pitts, S. C., & Sherman, S. J. (2000). The natural history of cigarette smoking from adolescence to adulthood in a midwestern community sample: Multiple tra-jectories and their psychosocial correlates. Health Psychology, 19, 223-231.Google Scholar
  8. Chassin, L., Presson, C. C., Sherman, S. J., & Edwards, D. A. (1996). The natural history of cigarette smoking from adolescence to adulthood: Demographic predictors of continuity and change. Health Psychology, 15, 478-484.Google Scholar
  9. Crowley, T. J., & Riggs, P. D. (1995). Adolescent substance use dis-order with conduct disorder and comorbid conditions. NIDA Research Monograph, 156, 49-111.Google Scholar
  10. Dawes, M. A., Antelman, S. M., Vanykov, M. M., Giancola, P., Tarter, R. E., Susman, E. J., Mezzich, A., & Clark, D. B. (2000). Developmental sources of variation in liability to adolescent substance use disorders. Drug and Alcohol Dependence, 61, 3-14.Google Scholar
  11. Dembo, R., Williams, L., Getreu, A., Genung, L., Schmeidler, J., Berry, E., Wish, E. D., & LaVoie, L. (1991). A longitudinal study of the relationship among marijuana/hashish use, co-caine use, and delinquency in a cohort of high-risk youths. Journal of Drug Issues, 21, 271-312.Google Scholar
  12. Disney, E. R., Elkins, I. J., McGue, M., & Iacono, W. G. (1999). Effects of ADHD, conduct disorder, and gender on substance use and abuse in adolescence. American Journal of Psychiatry, 156, 1515-1521.Google Scholar
  13. Donovan, J. E., & Jessor, R. (1985). Structure of problem behavior in adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 53, 890-904.Google Scholar
  14. Duclos, C. W., Beals, J., Novins, D. K., Martin, C., Jewett, C., & Manson, S. M. (1998). Prevalence of common psychiatric dis-orders among American Indian adolescent detainees. Journal of the American Academy of Child and Adolescent Psychiatry, 37,866-873.Google Scholar
  15. Ellickson, P. L., Hays, R. D., & Bell, R. M. (1992). Stepping through the drug-use sequence: Longitudinal scalogram analysis of ini-tiation and regular use. Journal of Abnormal Psychology, 101, 441-451.Google Scholar
  16. Ellickson, P. L., Tucker, J. S., & Klein, D. J. (2001). High-risk be-haviors associated with early smoking: Results from a 5-year follow-up. Journal of Adolescent Health, 28, 465-473.Google Scholar
  17. Farrell, A. D., Kung, E. M., White, K. S., & Valois, F. R. (2000). The structure of self-reported aggression, drug use, and delinquent behaviors during early adolescence. Journal of Clinical Child Psychology, 29, 282-292.Google Scholar
  18. Flay, B. R. (1993). Youth tobacco use: Risks, patterns and control. In C. T. Orleans & J. D. Slade (Eds.), Nicotine addiction: Principles and Management. New York: Oxford University Press.Google Scholar
  19. Forgatch, M., & Patterson, G. (1998). Behavioral family therapy. In F. M. Dattilio (Ed.), Case studies in couple and family therapy: Systemic and cognitive perspectives (pp. 85-107). New York: Guilford Press.Google Scholar
  20. Jessor, R., & Jessor, S. L. (1977). Problem behavior and psychoso-cial development: A longitudinal study of youth. New York: Academic Press.Google Scholar
  21. Johnston, L. D. (1996). The rise in drug use among American teens continues in 1996. Press release from the Monitoring the Fu-ture Study, December 19. Ann Arbor: University of Michigan.Google Scholar
  22. Johnston, L. D., O'Malley, P. M., & Bachman, J. G. (1992). Smok-ing, drinking, and illicit drug use among American secondary school college students and young adults, 1975-1991: Vol-ume I. Secondary school students. Washington, DC: U.S.Google Scholar
  23. Johnston, L. D., O'Malley, P. M., & Bachman, J. G. (1998). National survey results on drug use from the Monitoring the Future Study, 1975-1997 (National Institute on Drug Abuse NIH Publica-tion No. 98-4345). Washington, DC: US Government Printing Office.Google Scholar
  24. Kandel, D. (1975). Stages in adolescent involvement in drug use. Science, 190, 912-914.Google Scholar
  25. Kandel, D. B., & Davies, M. (1992). Progression to regular mari-juana involvement: Phenomenology and risk factors for near-daily use. In M. Glantz & R. Pickens (Eds.), Vulnerability to drug abuse (pp. 211-253). Washington, DC: American Psycho-logical Association.Google Scholar
  26. Kandel, D. B., Davies, M., Karus, D., & Yamaguchi, K. (1986). The consequences in young adulthood of adolescent drug involve-ment: An overview. Archives of General Psychiatry, 43, 746-754.Google Scholar
  27. Kandel, D. B., Johnson, J. G., & Bird, H. R. (1999). Psychiatric co-morbidity among adolescents with substance use disorders: Findings from the MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 693-699.Google Scholar
  28. Kandel, D. B., Johnson, J. G., Bird, H. R., Canino, G., Good-man, S. H., Lahey, B. B., Regier, D. A., & Schwab-Stone, M. (1997). Psychiatric disorders associated with substance use among children and adolescents: Findings from the methods for the epidemiology of child and adolescent mental disorders (MECA) study. Journal of Abnormal Child Psychology, 25, 121-132.Google Scholar
  29. Kandel, D. B., & Yamaguchi, K. (2002). Stages of drug involvement in the U.S. population. In D. B. Kandel & K. Yamaguchi (Eds.), Stages and pathways of drug involvement: Examining the gate-way hypothesis (pp. 65-89). New York: Cambridge University Press.Google Scholar
  30. Kandel, D. B., Yamaguchi, K., & Chen, K. (1992). Stages of pro-gression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory. Journal of Studies on Alcohol, 53, 447-457.Google Scholar
  31. Kazdin, A. E., & Weisz, J. R. (1998). Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19-36.Google Scholar
  32. McConaughy, S. H., & Skiba, R. J. (1993). Comorbidity of external-izing and internalizing problems. School Psychology Review, 22, 421-436.Google Scholar
  33. McConaughy, S. J., Stanger, C., & Achenbach, T. M. (1992). Three-year course of behavioral/emotional problems in a national sample of 4-to 16-year-olds: I. Agreement among informants. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 932-939.Google Scholar
  34. Merrill, J. C., Kleber, H. D., Shwartz, M., Liu, H., & Lewis, S. R. (1999). Cigarettes, alcohol, marijuana, other risk behaviors, and American youth. Drug and Alcohol Dependence, 56, 205-212.Google Scholar
  35. Milberger, S., Biederman, J., Faraone, S. V., Chen, L., & Jones, J. (1997). Further evidence of an association between attention-deficit/ hyperactivity disorder and cigarette smoking: Findings from a high-risk sample of siblings. American Journal on Ad-dictions, 6, 205-217.Google Scholar
  36. Muthén, L. K., & Muthén, B. O. (2001). Mplus User's Guide (2nd ed.). Los Angeles: Muthén & Muthén.Google Scholar
  37. Newcomb, M. D. (1995). Identifying high-risk youth: Prevalence and patterns of adolescent drug abuse. In E. Rahdert & D. Czechowicz (Eds.), Adolescent drug abuse: Clinical assessment and therapeutic interventions (NIDA Research Monograph 156, pp.7-38), Rockville, MD: U.S. Department of Health and Human Services.Google Scholar
  38. Oetting, E. R., & Beauvais, F. (1990). Adolescent drug use: Find-ings of national and local surveys. Journal of Consulting and Clinical Psychology, 58, 385-394.Google Scholar
  39. Office of Applied Studies. (1999). National Household Survey on Drug Abuse: Main Findings 1997 (DHHS Pub. No. (SMA) 99-3295). Substance Abuse and Mental Health Services Ad-ministration, U.S. Department of Health and Human Services.Google Scholar
  40. Patton, G. C., Hibbert, M., Rosier, M. J., Carlin, J. B., & Bowes, G. (1996). Is smoking associated with depression and anxi-ety in teenagers? American Journal of Public Health, 86, 225-230.Google Scholar
  41. Rigdon, E. E. (1996). CFI versus RMSEA: Acomparison of two fit indexes for structural equation modeling. Structural Equation Modeling, 3, 369-379.Google Scholar
  42. Riggs, P. D., Baker, S., Mikulich, S. K., Young, S. E., & Crowley, T. J. (1995). Depression in substance-dependent delinquents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 764-771.Google Scholar
  43. Robins, L. M., & McEvoy, L. (1990). Sturdy childhood predictors of adult antisocial behaviour: Replications from longitudinal studies. Psychological Medicine, 6, 611-622.Google Scholar
  44. Robins, L. N., & Przybeck, T. R. (1985). Age of onset of drug use as a factor in drug and other disorders. National Institute on Drug Abuse: Research Monograph Series, 56, 178-192.Google Scholar
  45. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhardt (Ed.), Sociological Methodology 1982 (pp. 290-312). San Francisco: Jossey-Bass.Google Scholar
  46. Swadi, H. (1999). Individual risk factors for adolescent substance use. Drug and Alcohol Dependence, 55, 209-224.Google Scholar
  47. Tarter, R. E., Vanyukov, M., Giancola, P., Dawes, M., Blackson, T., & Mezzich, A. (1999). Etiology of early age onset substance use disorder: A maturational perspective. Development and Psychopathology, 11, 657-683.Google Scholar
  48. Turbin, M. S., Jessor, R., & Costa, F. M. (2000). Adolescent cigarette smoking: Health-related behavior or normative transgression? Prevention Science, 1, 115-124.Google Scholar
  49. U.S. Department of Health and Human Services. (1994). Prevent-ing tobacco use among young people: A report of the Sur-geon General. Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
  50. Van Kammen, W. B., & Loeber, R. (1994). Are fluctuations in delin-quent activities related to the onset and offset in juvenile illegal drug use and drug dealing? Journal of Drug Issues, 24,9-24.Google Scholar
  51. Weinberg, N. Z., Rahdert, E., Colliver, J. D., & Glantz, M. D. (1998). Adolescent substance abuse: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 252-261.Google Scholar
  52. Whitmore, E. A., Mikulich, S. K., Thompson, L. L., Riggs, P. D., Aarons, G. A., & Crowley, T. J. (1997). Influences on ado-lescent substance dependence: Conduct disorder, depression, attention deficit hyperactivity disorder, and gender. Drug and Alcohol Dependence, 47,87-97.Google Scholar
  53. Young, S. E., Mikulich, S. K., Goodwin, M. B., Hardy, J., Martin, C. L., Zoccolillo, M. S., & Crowley, T. J. (1995). Treated delin-quent boys' substance use: Onset, pattern, relationship to con-duct and mood disorders. Drug and Alcohol Dependence, 37, 149-162.Google Scholar
  54. Yu, C.-Y., & Muthén, B. (2001). Evaluation of model fit indices for latent variable models with categorical and continuous out-comes. Technical report in preparation.Google Scholar

Copyright information

© Society for Prevention Research 2004

Authors and Affiliations

  • Amy Helstrom
    • 1
  • Angela Bryan
    • 1
  • Kent E. Hutchison
    • 1
  • Paula D. Riggs
    • 2
  • Elaine A. Blechman
    • 1
  1. 1.Department of PsychologyUniversity of ColoradoBoulderColorado
  2. 2.University of Colorado Health Sciences CenterColorado

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