Longitudinal Relationship Between Psychological Distress and Multiple Substance Use: Results From a Three-Year Multisite Natural-History Study of Rural Stimulant Users

Abstract

ABSTRACT. Objective: Substance use is associated with poor mental health, but little is known regarding how use of multiple substances is associated with mental health, particularly longitudinally, in community studies. This article examines this issue in a large (N = 710), naturalhistory study of rural stimulant (cocaine and/or methamphetamine) users in three states. Method: Respondent-driven sampling recruited recent (past-30-day) stimulant users in three counties each in Arkansas, Kentucky, and Ohio. Participants were interviewed every 6 months for 3 years. Mental health was measured by the Brief Symptom Inventory, and prior 6 months' substance use was measured for 17 possible substances. Data analysis used generalized estimating equations for longitudinal data with the Global Severity Index of the Brief Symptom Inventory as the dependent variable at each interview and substance use as predictor variables measured by number of substances used in the past 6 months and, separately, the 17 individual substances, adjusting for use of substanceuse treatment, demographics, and recruitment site. Results: On average, both Global Severity Index score and use of many substances declined over the course of study. Global Severity Index score was signifi cantly associated with (a) greater number of substances used in the past 6 months (p < .0001) and (b) use of crack cocaine, methamphetamine, and nonprescription use of prescription painkillers and tranquilizers. Conclusions: Multiple and specifi c substances appear to incrementally increase psychological distress. Users of cocaine and methamphetamine are present in rural areas; these associations with poor psychological health raise concerns regarding availability of local treatment services for individuals with mental-health problems, as well as substance abuse. (J. Stud. Alcohol Drugs, 71, 258-267, 2010)

Temporal Associations Between Disordered Eating and Nonsuicidal Self-Injury: Examining Symptom Overlap Over 1 Year

“…That is, at any given time point an increase in NSSI frequency was associated with more severe DE behavior, and vice versa. Consistent with research underscoring the importance of psychological distress in accounting for fluctuations in selfdamaging behaviors (Booth et al, 2010), the strength of the relationship between NSSI and DE diminished when distress was taken into account; however, it remained significant, suggesting that there is a relationship between NSSI and DE that is independent of psychological distress.…”

“…Given that NSSI and DE are conceptualized as serving similar emotion regulatory functions (Haynos & Fruzzetti, 2011;Klonsky, 2007), we expected that these behaviors would positively covary within concurrent time periods. That is, during times of greater emotional distress we expected that both behaviors would increase, whereas during times of less emotional distress the behaviors would both decrease (see Booth et al, 2010). Thus, Hypothesis 1a was that DE at Time T would be positively, concurrently associated with NSSI at Time T and would account for unique and significant withinperson variance in this outcome.…”

Parents’ differential treatment and adolescents’ delinquent behaviors: Direct and indirect effects of difference-score and perception-based measures.

“…In this case, a one unit increase in the perception of being less favored was associated with being 1.87 times more likely to have used any substances (over not using any), using two substances (over using only one), or using three substances (over using two). This link has important clinical implications because multiple substance use has greater negative consequences for mental health and later substance abuse than does the use of a single substance (e.g., Booth et al, 2010; Martin, Clark, Lynch, Jupper, & Clienti, 1999). Clinicians working with adolescents may want to consider the possibility of youth’s perceptions of PDT leading to the initiation and intensification of substance use.…”

The topography of multiple drug use among adolescent Australians: Findings from the National Drug Strategy Household Survey

“…Adolescence is a high risk period for drug use, particularly alcohol, tobacco and marijuana (AIHW, 2008b;de Looze et al, 2011;Palmer et al, 2009), and the risks associated with the use of these substances is well established (Booth et al, 2010;Department of Health and Human Services, 2004;Ellickson, Tucker, & Klein, 2003;Hall & Solowij, 1998;Swahn, Simon, Hammig, & Guerrero, 2004). Despite evidence that the use of one drug increases the probability of use of other types of drugs (Fergusson, Boden, & Horwood, 2008;Korhonen et al, 2008;van Leeuwen et al, 2011), comparatively little research has examined the prevalence rates of adolescent multiple drug use (broadly defined as the use of two or more drugs either within a given time period).…”