Abstract
A primary goal of the current study was to examine impulsivity and stressful life events as predictors of at-risk youth substance use and its consequences. These factors were assessed in a sample of 205 adolescents (82% male, 60% white) in a military-style residential facility. Participants completed self-report measures of lifetime substance use behaviors (YRBSS), personality factors associated with impulsive tendencies (UPPS-P), and experiences of stressful life events (SLES). Results indicated that select impulsivity dimensions predicted substance use and the inclusion of stress as a model predictor outperformed models of impulsivity alone. Additionally, impulsivity dimensions were primarily associated with substance use consequence outcomes. These findings are consistent with previous research suggesting that individual differences and environmental factors are both important when understanding adolescent substance use. Results highlight the significance of reducing stress exposure and increasing stress coping strategies in combating at-risk youth substance use behaviors. Such results may be considered when developing and/or enhancing substance use intervention efforts. Future research may further explore result generalizability, as well as project limitations such as response bias. Keywords: Impulsivity, Adolescent substance use, Stressful life events, General liability theory, UPPS-P model of impulsivity, At-risk youth.
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Afifi, T. O., Enns, M. W., Cox, B. J., Asmundson, G. J., Stein, M. B., & Sareen, J. (2008). Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. American Journal of Public Health, 98(5), 956–952. https://doi.org/10.2105/AJPH.2007.120253
Anda, R. F., Whitfield, C. L., Felitti, V. J., Chapman, D., Edwards, V. J., Dube, S. R., & Williamson, D. F. (2002). Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 53(8), 1001–1009. https://doi.org/10.1176/appi.ps.53.8.1001
Anestis, J. C., Charles, N. E., Lee-Rowland, L. M., Barry, C. T., & Gratz, K. L. (2020). Implementing dialectical behavior therapy skills training with at-risk male youth in a military-style residential program. Cognitive and Behavioral Practice, 27(2), 169–183. https://doi.org/10.1016/j.cbpra.2019.07.001
Ansell, E. B., Gu, P., Tuit, K., & Sinha, R. (2012). Effects of cumulative stress and impulsivity on smoking status. Human Psychopharmacology: Clinical and Experimental, 27(2), 200–208. https://doi.org/10.1002/hup.1269
Bates, M. E., & Labouvie, E. W. (1995). Personality environment constellations and alcohol use: A process-oriented study of intraindividual change during adolescence. Psychology of Addictive Behaviors, 9(1), 23–35. https://doi.org/10.1037/0893-164X.9.1.23
Berg, J. M., Latzman, R. D., Bliwise, N. G., & Lilienfeld, S. O. (2015). Parsing the heterogeneity of impulsivity: A meta-analytic review of the behavioral implications of the UPPS for psychopathology. Psychological Assessment, 27(4), 1129–1146. https://doi.org/10.1037/pas0000111
Cardoso, J. B., Goldbach, J. T., Cervantes, R. C., & Swank, P. (2016). Stress and multiple substance use behaviors among Hispanic adolescents. Prevention Science, 17(2), 208–217. https://doi.org/10.1007/s11121-015-0603-6
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. Journal of Personality and Social Psychology, 67(2), 319–333. https://doi.org/10.1037/0022-3514.67.2.319
Centers for Disease Control and Prevention. (2017). High School YRBS. Retrieved December 19, 2018 from https://nccd.cdc.gov/youthonline/app/Results.aspx?LID=XX
Charles, N. E., Mathias, C. W., Acheson, A., & Dougherty, D. M. (2017). Preadolescent sensation seeking and early adolescent stress relate to at-risk adolescents’ substance use by age 15. Addictive Behaviors, 69(1), 1–7. https://doi.org/10.1016/j.addbeh.2017.01.005
Charles, N. E., Ryan, S. R., Acheson, A., Mathias, C. W., Liang, Y., & Dougherty, D. M. (2015). Childhood stress exposure among preadolescents with and without family histories of substance use disorders. Psychology of Addictive Behaviors, 29(1), 192–200. https://doi.org/10.1037/adb0000020
Chassin, L. (2008). Juvenile justice and substance use. The Future of Children, 165-183.https://doi.org/10.1353/foc.0.0017
Clark, D. B., Cornelius, J. R., Kirisci, L., & Tarter, R. E. (2005). Childhood risk categories for adolescent substance involvement: A general liability typology. Drug and Alcohol Dependence, 77(1), 13–21. https://doi.org/10.1016/j.drugalcdep.2004.06.008
Clark, D. B., Lesnick, L., & Hegedus, A. M. (1997). Traumas and other adverse life events in adolescents with alcohol abuse and dependence. Journal of the American Academy of Child & Adolescent Psychiatry, 36(12), 1744–1751. https://doi.org/10.1097/00004583-199712000-00023
Coskunpinar, A., Dir, A. L., & Cyders, M. A. (2013). Multidimensionality in impulsivity and alcohol use: A meta-analysis using the UPPS model of impulsivity. Alcoholism: Clinical and Experimental Research, 37(9), 1441–1450. https://doi.org/10.1111/acer.12131
Cox, R. G., Zhang, L., Johnson, W. D., & Bender, D. R. (2007). Academic performance and substance use: Findings from a state survey of public high school students. Journal of School Health, 77(3), 109–115. https://doi.org/10.1111/j.1746-1561.2007.00179.x
Cyders, M. A., & Smith, G. T. (2007). Mood-based rash action and its components: Positive and negative urgency. Personality and Individual Differences, 43(4), 839–850. https://doi.org/10.1016/j.paid.2007.02.008
Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19(1), 107–118. https://doi.org/10.1037/1040-3590.19.1.107
Daruna, J. H., & Barnes, P. A. (1993). A neurodevelopmental view of impulsivity. In The impulsive client: Theory, research, and treatment (pp. 23–37). American Psychological Association. https://doi.org/10.1037/10500-002
Dawe, S., & Loxton, N. J. (2004). The role of impulsivity in the development of substance use and eating disorders. Neuroscience & Biobehavioral Reviews, 28(3), 343–351. https://doi.org/10.1016/J.NEUBIOREV.2004.03.007
Derefinko, K., DeWall, C. N., Metze, A. V., Walsh, E. C., & Lynam, D. R. (2011). Do different facets of impulsivity predict different types of aggression? Aggressive Behavior, 37(3), 223–233. https://doi.org/10.1002/ab.20387
Enoch, M. A. (2011). The role of early life stress as a predictor for alcohol and drug dependence. Psychopharmacology (berl), 214(1), 17–31. https://doi.org/10.1007/s00213-010-1916-6
Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology (berl), 146(4), 348–361. https://doi.org/10.1007/PL00005481
Finer, L. B., & Zolna, M. R. (2014). Shifts in intended and unintended pregnancies in the United States, 2001–2008. Journal of Public Health, 104(S1), S43–S58. https://doi.org/10.2105/AJPH.2013.301416
Ford, J. D., Elhai, J. D., Connor, D. F., & Frueh, B. C. (2010). Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. Journal of Adolescent Health, 46(6), 545–552. https://doi.org/10.1016/j.jadohealth.2009.11.212
Fox, H. C., Bergquist, K. L., Gu, P., & Sinha, R. (2010). Interactive effects of cumulative stress and impulsivity on alcohol consumption. Alcoholism: Clinical and Experimental Research, 34(8), 1376–1385. https://doi.org/10.1111/j.1530-0277.2010.01221.x
Garnefiski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311–1327. https://doi.org/10.1016/S0191-8869(00)00113-6
Gray, J. A., & McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system (2nd ed.). Oxford University Press.
Gullo, M. J., & Dawe, S. (2008). Impulsivity and adolescent substance use: Rashly dismissed as “all-bad”? Neuroscience Biobehavioral Reviews, 32(8), 1507–1518. https://doi.org/10.1016/j.neubiorev.2008.06.003
Hershberger, A. R., Um, M., & Cyders, M. A. (2017). The relationship between UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis. Drug and Alcohol Dependence, 178, 408–416. https://doi.org/10.1016/j.drugalcdep.2017.05.032
Horn, N. R., Dolan, M., Elliott, R., Deakin, J. F., & Woodruff, P. W. R. (2003). Response inhibition and impulsivity: An fMRI study. Neuropsychologia, 41(14), 1959–1966. https://doi.org/10.1016/S0028-3932(03)00077-0
Jakubczyk, A., Trucco, E. M., Kopera, M., Kobylinski, P., Suszek, H., Fudalej, S., Brower, K. J., & Wojnar, M. (2018). The association between impulsivity, emotion regulation, and symptoms of alcohol use disorder. Journal of Substance Abuse Treatment, 91, 49–56. https://doi.org/10.1016/j.jsat.2018.05.004
Kandel, D. B., Yamaguchi, K., & Chen, K. (1992). Stages of progression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory. Journal of Studies on Alcohol, 53(5), 447–457. https://doi.org/10.15288/jsa.1992.53.447
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550
Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71(4), 692–700. https://doi.org/10.1037/0022-006X.71.4.692
Kong, G., Smith, A. E., McMahon, T. J., Cavallo, D. A., Schepis, T. S., Desai, R. A., Potenza, M. N., & Krishnan-Sarin, S. (2013). Pubertal status, sensation-seeking, impulsivity, and substance use in high-school-aged boys and girls. Journal of Addiction Medicine, 7(2), 116–121. https://doi.org/10.1097/ADM.0b013e31828230ca
Lawrence, D. B., & Russ, S. W. (1985). Mediating variables between life stress and symptomatology among young adolescents. In 93rd annual meeting of the American Psychological Association, Los Angeles.
Leeman, R. F., Hoff, R. A., Krishnan-Sarin, S., Patock-Peckham, J. A., & Potenza, M. N. (2014). Journal of Adolescent Health, 54(4), 460–466. https://doi.org/10.1016/j.jadohealth.2013.09.014
Low, N. C. P., Dugas, E., O’Loughlin, E., Rodriguez, D., Contreras, G., Chaiton, M., & O’Loughlin, J. (2012). Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents. BMC Psychiatry, 12(116), 1–10. https://doi.org/10.1186/1471-244X-12-116
Lynam, D. R., Smith, G. T., Whiteside, S. P., & Cyders, M. A. (2006). The UPPS-P: Assessing five personality pathways to impulsive behavior. Purdue University.
McLaughlin, K. A., Hatzenbuehler, M. L., & Phil, M. (2009). Mechanisms linking stressful life events and mental health problems in a prospective, community-based sample of adolescents. Journal of Adolescent Health, 44(2), 153–160. https://doi.org/10.1016/j.jadohealth.2008.06.019
Moody, L., Franck, C., Hatz, L., & Bickel, W. K. (2016). Impulsivity and polysubstance use: A systematic comparison of delay discounting in mono-, dual-, and trisubstance use. Experimental and Clinical Psychopharmacology, 24(1), 30–37. https://doi.org/10.1037/pha0000059
O’Doherty, F., & Davies, J. B. (1987). Life events and addiction: A critical review. British Journal of Addiction, 82(2), 127–137. https://doi.org/10.1111/j.1360-0443.1987.tb01451.x
Ohsri, A., Kogan, S. M., Kwon, J. A., Wickrama, K. A. S., Vanderbroek, L., Plamer, A. A., & MacKillop, J. (2018). Impulsivity as a mechanism linking child abuse and neglect with substance use in adolescence and adulthood. Developmental Psychopathology, 30(2), 417–435. https://doi.org/10.1017/S0954579417000943
Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 184–214. https://doi.org/10.1080/15374410701818681
Pilowsky, D. J., Keyes, K. M., & Hasin, D. S. (2009). Adverse childhood events and lifetime alcohol dependence. American Journal of Public Health, 99(2), 258–263. https://doi.org/10.2105/AJPH.2008.139006
Robinson, T. E., & Berridge, K. C. (2001). Incentive-sensitization and addiction. Addiction, 96(1), 103–114. https://doi.org/10.1046/j.1360-0443.2001.9611038.x
Rotham, E. F., Edwards, E. M., & Hingson, R. W. (2008). Adverse childhood experiences predict earlier age of drinking onset: Results from a representative US sample of current or former drinkers. Pediatrics, 122(2), e298–e304. https://doi.org/10.1542/peds.2007-3412
Schmidt, B., Mussel, P., Osinsky, R., Rash, B., Debener, S., & Johannes, H. (2017). Work first then play: Prior task difficulty increases motivation-related brain responses in a risk game. Biological Psychology, 126, 82–88. https://doi.org/10.1016/j.biopsycho.2017.04.010
Shin, S. H., Hong, H. G., & Jeon, S.-M. (2012). Personality and alcohol use: The role of impulsivity. Addictive Behaviors, 37(1), 102–107. https://doi.org/10.1016/j.addbeh.2011.09.006
Shin, S. H., Edwards, E., Heeren, T., & Amodeo, M. (2009). Relationship between multiple forms of maltreatment by a parent or guardian and adolescent alcohol use. American Journal on Addictions, 18(3), 266–234. https://doi.org/10.1080/10550490902786959
Simons, J. S., & Carey, K. B. (2003). Personal strivings and marijuana use initiation, frequency, and problems. Addictive Behaviors, 28(7), 1311–1322. https://doi.org/10.1016/S0306-4603(02)00247-2
Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141(1), 105–130. https://doi.org/10.1196/annals.1441.030
Sjödin, L., Larm, P., Karlsson, P., Livingston, M., & Raninen, J. (2021). Drinking motives and their associations with alcohol use among adolescents in Sweden. Nordic Studies on Alcohol and Drugs, 38(3), 256–269. https://doi.org/10.1177/1455072520985974
Sutin, A. R., Terracciano, A., Milaneschi, Y., An, Y., Ferrucci, L., & Zonderman, A. B. (2013). The trajectory of depressive symptoms across the adult life span. JAMA Psychiatry, 70(8), 803–811. https://doi.org/10.1001/jamapsychiatry.2013.193
Swendsen, J., Burstein, M., Case, B., Conway, K. P., Dierker, L., He, J., & Merikangas, K. R. (2012). Use and abuse of alcohol and illicit drugs in US adolescents: Results of the National Comorbidity Survey-Adolescent Supplement. Archives of General Psychiatry, 69(4), 390–398. https://doi.org/10.1001/archgenpsychiatry.2011.1503
Tarter, R. E., Kirisci, L., Habeych, M., Reynolds, M., & Vanyukov, M. (2004). Neurobehavior disinhibition in childhood predisposes boys to substance use disorder by young adulthood: Direct and mediated etiologic pathways. Drug and Alcohol Dependence, 73(2), 121–132. https://doi.org/10.1016/j.drugalcdep.2003.07.004
Tice, P., Lipairi, R. N., & Van Horn, S. L. (2017) Substance use among 12th grade aged youths, by dropout status. The CBHSQ Report: August 15, 2017. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
Tomko, R. L., Prisciandaro, J. J., Falls, S. K., & Magid, V. (2016). The structure of the UPPS-R-Child impulsivity scale and its relations with substance use outcomes among treatment-seeking adolescents. Drug and Alcohol Dependence, 161(1), 276–283. https://doi.org/10.1016/j.drugalcdep.2016.02.010
Trudeau, L., Spoth, R., Lillehoj, C., Redmond, C., & Wickrama, K. A. (2003). Effects of a preventive intervention on adolescent substance use initiation, expectancies, and refusal intentions. Prevention Science, 4(2), 109–122. https://doi.org/10.1023/A:1022926332514
Turner, R. J., & Lloyd, D. A. (1995). Lifetime traumas and mental health: The significance of cumulative adversity. Journal of Health and Social Behavior, 36(4), 360–376. https://doi.org/10.2307/2137325
van den Bree, M. B. M., & Pickworth, W. B. (2005). Risk factors predicting changes in marijuana involvement in teenagers. Archives of General Psychiatry, 62(3), 311–319. https://doi.org/10.1001/archpsyc.62.3.311
VanderVeen, J. D., Hershberger, A. R., & Cyders, M. A. (2016). UPPS-P model impulsivity and marijuana use behaviors in adolescents: A meta-analysis. Drug and Alcohol Dependence, 168(1), 181–190. https://doi.org/10.1016/j.drugalcdep.2016.09.016
Wagner, F. A., & Anthony, J. C. (2002). From first drug use to drug dependence: Developmental periods of risk for dependence upon marijuana, cocaine, and alcohol. Neuropsychopharmacology, 26(4), 479–488. https://doi.org/10.1016/S0893-133X(01)00367-0
Weafer, J., Baggott, M. J., & de Wit, H. (2013). Test–retest reliability of behavioral measures of impulsive choice, impulsive action, and inattention. Experimental and Clinical Psychopharmacology, 21(6), 475–481. https://doi.org/10.1037/a0033659
Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30(4), 669–689. https://doi.org/10.1016/S0191-8869(00)00064-7
Whiteside, S. P., & Lyname, D. R. (2003). Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: Application of the UPPS Impulsive Behavior Scale. Experimental and Clinical Psychopharmacology, 11(3), 210–217. https://doi.org/10.1037/1064-1297.11.3.210
Wills, T. A. (1986). Stress and coping in early adolescence: Relationships to substance use in urban school samples. Health Psychology, 5(6), 503–529. https://doi.org/10.1037/0278-6133.5.6.503.
Williamson, D. E., Birmaher, B., Ryan, N. D., Shiffrin, T. P., Lusky, J. A., Protopapa, J., … & Brent, D. A. (2003). The stressful life events schedule for children and adolescents: Development and validation. Psychiatry Research, 119(3), 225–241. https://doi.org/10.1016/S0165-1781(03)00134-3
Yoo, W., Mayberry, R., Bae, S., Singh, K., & Lillard, J. W. (2014). A study of effects of multicollinearity in the multivariable analysis. Int J Appl Sci Technol, 4. Retrieved January 5, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318006/pdf/nihms653352.pdf
Young, S. E., Rhee, S. H., Stallings, M. C., Corley, R. P., & Hewitt, J. K. (2006). Genetic and environmental vulnerabilities underlying adolescent substance use and problem use: General or specific? Behavior Genetics, 36(4), 603–615. https://doi.org/10.1007/s10519-006-9066-7
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Bullerjahn, M.R., Charles, N.E., Burns, L.C. et al. Impulsivity and Stressful Life Events Independently Relate to Problematic Substance Use in At-Risk Adolescents. Int J Ment Health Addiction 21, 2334–2353 (2023). https://doi.org/10.1007/s11469-021-00725-6
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DOI: https://doi.org/10.1007/s11469-021-00725-6