Academic performance, popularity, and depression predict adolescent substance use.

Diego, Miguel A. ; Field, Tiffany M. ; Sanders, Christopher E. 等

Adolescent substance use remains high in the United States (Centers for Disease Control and Prevention, 1998). A recent National Institute on Drug Abuse report indicated that 65% of high school seniors had smoked cigarettes, 80% had consumed alcohol, 23% had tried marijuana, and 10% had used cocaine (Johnston, O'Malley, & Bachman, 2001). Although for some adolescents substance use may last for only a brief period of experimentation, tobacco, alcohol, marijuana, and cocaine use may lead to addiction (Botvin & Wills, 1985). Substance use in adolescence has been noted to have negative consequences, including health and emotional problems, lower social competence, and problems with school or work (Palmer & Liddle, 1996).

Substance use generally starts during adolescence, and a number of risk factors have been noted (Dryfoos, 1992; Jensen, 1997), including peer pressure, popularity, and depression (Jensen, 1997; Kandel, Johnson, Bird, & Camino, 1997; Newcomb & Felix-Ortiz, 1992). Protective factors, such as academic performance and extracurricular activities, have also been found to be strong predictors of adolescent substance use (Dryfoos, 1992; Jensen, 1997; Sutherland & Shepherd, 2001).

In the present study, high school seniors were administered a questionnaire that included these risk and protective factors, along with self-reported substance use. Based on previous studies, we expected that adolescent substance use would be positively related to depression and negatively related to academic performance and popularity (Dryfoos, 1992; Jensen, 1997; Newcomb & Felix-Ortiz, 1992; Sutherland & Shepherd, 2001). Because alcohol use and cigarette smoking often precede marijuana use, and because marijuana use in turn often precedes hard drug use (Kandel, 1980), the relations between cigarette, alcohol, marijuana, and cocaine use were also assessed.

METHOD

Participants

Eighty-nine seniors (52 females and 37 males) from a suburban Florida high school participated in this study. Their families were, on average, middle to upper middle socioeconomic status (M = 2.37 on the Hollingshead, 1975, Two-Factor Index). Seventy-six percent were Caucasian, 11% Hispanic, 5% Asian, 3% African American, and 5% other.

Measures

The students were given a 181-item Likert-type questionnaire that examined multiple behavioral and psychological aspects of adolescent life (Field & Yando, 1999). They completed the questionnaire anonymously, during a 45-minute class period, in a large assembly room.

Substance use. The students rated their level of substance use (one question for each substance) on a 4-point scale. They were asked how often they smoked cigarettes and consumed alcohol, marijuana, and cocaine in the past (1 = never to 4 = regularly).

Popularity. Popularity was determined by asking the students to rate their popularity at school on a 4-point Likert scale.

Academic performance. Academic performance was determined by asking the students to provide their school grade point average (GPA).

Center for Epidemiological Studies Depression Scale (CES-D). The CES-D (Radloff, 1977) is a 20-item scale, with scores ranging from 0 to 60. Respondents rate the frequency of 20 symptoms (experienced within the last week), including depressed mood, feelings of helplessness and hopelessness, feelings of guilt and worthlessness, loss of energy, and sleep and appetite problems. A score of 16 or greater is considered the clinical cutoff point for depression. Myers and Weissman (1980) reported a 6% false positive and 36% false negative rate. In addition, this scale has been shown to be reliable and valid for diverse demographic groups, including adolescents (Radloff, 1977).

RESULTS

Multiple Regression Analyses

To examine the relation between the predictor variables and substance use, four separate sets of regression analyses were conducted, with cigarette, alcohol, marijuana, and cocaine use as the dependent variables. Grade point average, popularity, and CES-D scores were entered as predictor variables. Furthermore, to examine the relations between cigarette, alcohol, marijuana, and cocaine use, four separate sets of regression analyses were conducted, with each substance as the dependent variable and the remaining substances entered as the predictor variables.

Cigarette use. A multiple regression analysis conducted with cigarette use as the dependent variable revealed that GPA, popularity at school, and CES-D scores accounted for a significant portion of the variance in adolescent cigarette smoking (Table 1). This suggests that adolescents with low GPA and high self-ratings of popularity and depression were more likely to smoke cigarettes. Furthermore, a regression analysis with cigarette use entered as the dependent variable revealed that only marijuana use accounted for a significant portion of the variance in cigarette smoking (Table 2).

Alcohol use. A multiple regression analysis conducted with alcohol consumption as the dependent variable revealed that GPA, popularity at school, and CES-D scores accounted for a significant portion of the variance in adolescent alcohol use, suggesting that adolescents with low GPA and high self-ratings of popularity and depression were more likely to drink alcohol (Table 1). Furthermore, a regression analysis with alcohol consumption entered as the dependent variable revealed that only marijuana use accounted for a significant portion of the variance in alcohol use (Table 2).

Marijuana use. A multiple regression analysis conducted with marijuana use as the dependent variable revealed that GPA, popularity at school, and CES-D scores accounted for a significant portion of the variance in adolescent marijuana smoking (Table 1). This suggests that adolescents with low GPA and high self-ratings of popularity and depression were more likely to smoke marijuana. Furthermore, a regression analysis with marijuana use entered as the dependent variable revealed that cigarette and alcohol use, and to a lesser extent cocaine use, accounted for a significant portion of the variance in marijuana smoking (Table 2).

Cocaine use. A multiple regression analysis conducted with cocaine consumption as the dependent variable revealed that GPA and popularity at school, but not CES-D scores, accounted for a significant portion of the variance in adolescent cocaine use, suggesting that adolescents with low GPA and low self-ratings of popularity were more likely to use cocaine (Table 1). Furthermore, a regression analysis with cocaine use entered as the dependent variable revealed that marijuana use accounted for a marginally significant portion of the variance in cocaine use (Table 2).

DISCUSSION

The present study supports previous findings indicating that academic performance, popularity, and depression are strong predictors of adolescent substance use. Adolescents with heavier substance use have been noted to have lower scores on measures of psychological adjustment and are more likely to have been maladjusted as children (Shedler & Block, 1990). Substance use in adolescence has also been associated with problems at school, psychological distress, depression (Kandel, Johnson, Bird, & Camino, 1997; Wu & Anthony, 1999), truancy, and delinquency (Newcomb & Bentler, 1989).

School performance, as measured by the students' grade point average, accounted for the greatest portion of the variance in alcohol, marijuana, and cocaine use and the second highest portion of the variance in cigarette use. This finding is consistent with previous studies that reported academic achievement as being the most significant protective factor (Jessor, Turbin, & Acosta, 1998; Newcomb & Felix-Ortiz, 1992).

Popularity also accounted for a significant portion of the variance in cigarette, alcohol, marijuana, and cocaine use. However, while adolescents who smoked cigarettes, drank alcohol, and smoked marijuana were more likely to report feeling popular, adolescents who used cocaine were more likely to feel unpopular. This is consistent with previous findings indicating that adolescents who experimented with more socially acceptable substances such as alcohol and marijuana, but not hard drugs such as cocaine, had greater social skills than their peers who did not use alcohol and marijuana (Baumrind, 1991; Scheier & Botvin, 1998).

Depression, as assessed by the CES-D, was also a significant predictor of cigarette, alcohol, and marijuana use, consistent with previous studies showing that depression was related to substance use (Kandel et al., 1997; Wu & Anthony, 1999). Research has suggested that the relationship between substance use and depression is bidirectional, with depression acting as an important risk factor for substance use on one hand and an outcome of substance use on the other (Kandel et al., 1997; Wu & Anthony, 1999). Unexpectedly, cocaine use was not significantly related to depression when the effects of GPA and popularity were partialled out.

Examination of the relations between the different substances suggested that cigarette and alcohol use predicted marijuana use, which in turn predicted cocaine use. This is consistent with previous findings indicating that alcohol use precedes the use of marijuana, and marijuana precedes the use of other illicit substances (Kandel, 1980). These findings suggest that alcohol and cigarettes are gateway substances that may lead adolescents to experiment with marijuana, which in turn may lead to experimentation with harder drugs such as cocaine.

Table 1

Relationships Between Substance Use and Predictor Variables

Cigarette Use

 b t p

GPA -.340 2.16 <.05
Popularity .338 2.24 <.05
CES-D .034 2.60 <.05
[R.sup.2] = .18 Adj. [R.sup.2] =
 .16, F(3, 85) = 6.38, p < .001

Alcohol Use
GPA -.321 3.83 <.001
Popularity .185 2.29 <.05
CES-D .015 2.19 <.05
[R.sup.2] = .27, Adj. [R.sup.2] =
 .24, F(3, 85) = 10.37, p < .001

Cigarette Use Partial Correlation

GPA -.221
Popularity .219
CES-D .255
[R.sup.2] = .18 Adj. [R.sup.2] =
 .16, F(3, 85) = 6.38, p < .001

Alcohol Use
GPA -.355
Popularity .212
CES-D .204
[R.sup.2] = .27, Adj. [R.sup.2] =
 .24, F(3, 85) = 10.37, p < .001

Marijuana Use

 b t p

GPA -.597 4.55 <.001
Popularity .340 2.69 <.01
CES-D .030 2.69 <.01
[R.sup.2] = .34, Adj. [R.sup.2] =
 .32, F(3, 85) = 14.83, p < .001

 Partial Correlation

GPA -.400
Popularity .237
CES-D .237
[R.sup.2] = .34, Adj. [R.sup.2] =
 .32, F(3, 85) = 14.83, p < .001

Cocaine Use

 b t p

GPA -.583 5.99 <.001
Popularity -.190 2.25 <.05
CES-D .002 0.27 N.S.
[R.sup.2] = .38, Adj. [R.sup.2] =
 .36, F(3, 85) = 12.21, p < .001

 Partial Correlation

GPA -.513
Popularity -.173
CES-D .023
[R.sup.2] = .38, Adj. [R.sup.2] =
 .36, F(3, 85) = 12.21, p < .001

Table 2

Relationships Between Cigarette, Alcohol, Marijuana, and Cocaine Use

 b t p

Cigarette Use

Alcohol .233 1.31 N.S.
Marijuana .571 5.18 <.001
Cocaine .059 0.46 N.S.
[R.sup.2] = .394, Adj. [R.sup.2] =
 .373, F(3, 85) = 18.44, p <.001

Alcohol Use

Cigarette .085 1.31 N.S.
Marijuana .236 3.26 <.01
Cocaine .088 1.14 N.S.
[R.sup.2] = .301, Adj. [R.sup.2] =
 .276, F(3, 85) = 12.20, p <.001

Marijuana Use

Cigarette .420 5.18 <.001
Marijuana .474 3.27 <.01
Cocaine .207 1.91 <.06
[R.sup.2] = .49, Adj. [R.sup.2] =
 .47, F(3, 85) = 26.77, p < .001

Cocaine Use

Cigarette .042 0.46 N.S.
Marijuana .171 1.14 N.S.
Cocaine .198 1.91 <.06
[R.sup.2] = .15, Adj. [R.sup.2] =
 .12, F(3, 85) = 5.08, p <.01

 Partial Correlation

Cigarette Use

Alcohol .111
Marijuana .437
Cocaine .039
[R.sup.2] = .394, Adj. [R.sup.2] =
 .373, F(3, 85) = 18.44, p <.001

Alcohol Use

Cigarette .119
Marijuana .296
Cocaine .104
[R.sup.2] = .301, Adj. [R.sup.2] =
 .276, F(3, 85) = 12.20, p <.001

Marijuana Use

Cigarette .148
Marijuana .403
Cocaine .254
[R.sup.2] = .49, Adj. [R.sup.2] =
 .47, F(3, 85) = 26.77, p < .001

Cocaine Use

Cigarette .046
Marijuana .114
Cocaine .190
[R.sup.2] = .15, Adj. [R.sup.2] =
 .12, F(3, 85) = 5.08, p <.01

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This research was supported by an NIMH Senior Research Scientist Award (MH00331) to Tiffany Field and funding from Johnson & Johnson. We would like to thank the adolescents who participated in this study.

Miguel A. Diego, Touch Research Institutes, University of Miami School of Medicine, and Department of Psychology, Florida Atlantic University.

Tiffany M. Field, Touch Research Institutes, University of Miami School of Medicine.

Christopher E. Sanders, Touch Research Institutes, University of Miami School of Medicine, and Department of Psychology, Nova Southeastern University.

Reprint requests to Tiffany Field, Touch Research Institutes, University of Miami School of Medicine, Department of Pediatrics (D-820), P.O. Box 016820, Miami, Florida 33101. E-mail: tfleld@med.miami.edu