Substance use and common child mental health problems: examining longitudinal associations in a British sample
Article first published online: 7 JUN 2010
© 2010 The Author. Journal compilation © 2010 Society for the Study of Addiction
Volume 105, Issue 8, pages 1484–1496, August 2010
How to Cite
Goodman, A. (2010), Substance use and common child mental health problems: examining longitudinal associations in a British sample. Addiction, 105: 1484–1496. doi: 10.1111/j.1360-0443.2010.02981.x
- Issue published online: 9 JUL 2010
- Article first published online: 7 JUN 2010
- Submitted 13 September 2009; initial review completed 15 December 2009; final version accepted 1 February 2010
- externalizing problems;
- internalizing problems;
- substance use
Aims To examine the longitudinal associations in both directions between mental health and substance use in adolescence.
Design Three-year longitudinal cohort.
Setting Britain (nationally representative sample).
Participants 3607 youths aged 11–16 years at baseline.
Measurements Externalizing and internalizing mental health problems were measured using brief questionnaires (parent-reported Strengths and Difficulties Questionnaire) and diagnostic interviews, including clinician-rated diagnoses of mental disorder. Substance use was measured by youth self-report, and included regular smoking, frequent alcohol consumption, regular cannabis use and ever taking other illicit drugs.
Findings Externalizing (specifically behavioural) problems at baseline independently predicted all forms of substance use, with a particularly strong effect on smoking. In all cases this association showed a dose–response relationship. In contrast, although internalizing problems had a strong univariable association with smoking, this disappeared after adjusting for comorbid externalizing problems. There was little or no evidence that baseline substance use predicted mental health at follow-up.
Conclusions Externalizing problems predict adolescent substance use, and adjusting for comorbid externalizing problems is vital when investigating the effects of internalizing problems. A dose–response effect of externalizing problems is seen across the full range. Programmes seeking to prevent adolescent substance use by reducing externalizing problems may therefore wish to consider population-wide interventions rather than targeting individuals only at the negative extreme.