A systematic review of the unique prospective association of negative affect symptoms and adolescent substance use controlling for externalizing symptoms.

Abstract

This systematic review examines whether negative affect symptoms (i.e., anxiety, depression, and internalizing symptoms more broadly) predict subsequent adolescent substance use after controlling for co-occurring externalizing symptoms. Following PRISMA procedures, we identified 61 studies that tested the association of interest. Findings varied depending on the type of negative affect symptom and to some extent on the substance use outcome. The most consistent associations were evident for depressive symptoms, particularly as predictors of substance use composite scores. No clear association between anxiety and substance use or between internalizing symptoms and substance use was evident, and indeed these associations were as often negative as positive. Mixed findings regarding the depression-substance use association, however, also call for greater attention to potential moderating factors that may help define who, when, and in what context depression serves as an important risk factor for later substance use above and beyond risk associated with externalizing symptoms.

Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta‐analysis of prospective cohort studies

“…Overall, a clear association between anxiety and alcohol use was not evident, consistent with previous reviews [24,25]. When distinguishing between alcohol outcomes, anxiety was generally positively associated with AUD, supporting a previous meta-analysis which found that social anxiety was associated with alcohol-related problems [9].…”

“…Thirdly, studies in the narrative synthesis may have been too heterogeneous to provide clear combined evidence, a concern raised by other researchers [25]. However, absence of evidence is not evidence of absence.…”

“…There are limitations. Given that depression can be a more consistent predictor of alcohol use than anxiety [25], the use of internalizing measures as a proxy for anxiety may contribute to misclassification or measurement bias. Studies with significant positive results are more likely to be published in English language journals [77], therefore we may have missed relevant studies, particularly those with null findings.…”

“…This reinforces the importance of examining the relationship separately for different alcohol outcomes, although direction of effect could not be inferred, as this was a review of cross-sectional studies. In a review of longitudinal studies which adjusted for co-occurring externalizing symptoms, Hussong and colleagues [25] also found no clear association between anxiety and internalizing symptoms with subsequent adolescent alcohol use. However, the authors acknowledged that findings from individual studies were highly heterogeneous, and only five studies on anxiety and alcohol use were included.…”

Depressive symptoms are associated with salivary shedding of Epstein-Barr virus in female adolescents: The role of sex differences

“…(Mojtabai et al, 2016) The increasing rate of depression is of significant concern as suicide rates among adolescents have also increased over time, particularly among female adolescents aged 10 to 14 years in which rates have increased 200% since 1999. (Curtin et al, 2016) In addition to suicide, adolescent depression is associated prospectively with obesity,(Mannan et al, 2016; Zhu et al, 2016) substance use,(Hussong et al, 2017) accelerated atherosclerosis, and early cardiovascular disease. (Goldstein et al, 2015)…”