Racial/ethnic disparities in sources of stress and social support among adolescent entering substance abuse treatment

Background: Stress and lack of social support are linked to substance abuse (SA). We examined differences in sources of stress and social support among diverse group of adolescents entering SA treatment programs.

Methods: We used data collected from 4,916 adolescents (12-17 yr olds; 73% male; 53.3% White, 19.4% Black; 15.3% Hispanic; 12.1% mixed race) who were admitted into federally funded SA treatment programs. Logistic regression analyses were used to examine racial/ethnic differences in past year sources of stress and social support, after controlling for socio-demographic characteristics, SA, and mental health symptoms.

Results: Death (33.3%) or health problems of a family member or close friend (31.3%), fighting with others (26.1%), changes in relationships (22.9%), and school/work issues (21.0%) were the most common sources of stress among all groups. Whites were more likely than Blacks or Hispanics to report problems associated with relationships, health, school/work, transportation, and threat or loss of something important. In contrast, Blacks were more likely than Whites to have experienced stress due to addition of a family member, death, and witnessing a negative event. In addition, minorities were less likely than Whites to report social support from professionals, friends, or family members. Stress was positively associated with mental health symptoms among all groups, whereas social support was negatively associated with frequency of substance use only among Whites and Blacks.

Conclusions: Sources of stress and social support, and their relationships to SA and mental health vary by race/ethnicity. Implications of these disparities for SA treatment programs will be discussed.