Mental Health, School Problems, and Substance Use Among Urban Adolescents: The Mediating Effect of Social Network Quality

This study tested a meditational model of the relationship of mental health and school problems, social network quality, and substance use in a primary care sample of 301 urban adolescents. We theorized that social network quality would mediate the effects of mental health (internalizing problems and PTSD symptoms) and school problems (attitude to school, attitude to teachers, sensation seeking) on substance use. An interaction variable was created to test the moderating effects of gender by internalizing problems on substance use. Neither the interaction of gender with internalizing problems nor PTSD symptoms was significant with the mediator variable, social network quality. The final model indicated the effect of school problems was completely mediated, showing a sharp decline in influence on substance use from the non-mediated model (â = 0.6, Æ = 7.07, p = 0.01) to the mediated impact (â = 0.01, Æ = 0.28, p = 0.78). Although still statistically significant (â = -0.09, Æ = 2.31, p = 0.02), the effect of internalizing problems on substance use was diminished; the non-mediated effect being approximately 300% larger (â = 0.30, Æ = 2.51, p = 0.01). These findings make a plausible argument that social network quality mediates the effects of school problems and partially mediates the effect of internalizing problems on substance use. The results highlight the role of social network quality in addressing urban adolescent substance use and the associated mental health and school problems.