A Prospective Study of Familial Conflict, Psychological Stress, and the Development of Substance Use Disorders in Adolescence

Background. Exposure to adverse family environments in childhood can influence the risk trajectory for developing substance use disorders in adolescence. Evidence for this is largely based on cross-sectional studies, which have implicitly been unable to examine the temporality of this association. We investigate this relationship in the context of a longitudinal study in which substance use disorders were assessed prospectively.

Methods. The sample consisted of 1,421 adolescents from the Project on Human Development in Chicago Neighborhoods, a three-wave longitudinal study conducted from 1994-2001 that followed children from ages 10 through 22. Logistic regression analyses with multiple imputation were conducted to examine the risk of adolescent alcohol and marijuana use disorders during adolescence. We conducted mediational analyses to determine if symptoms of psychological stress (internalizing and externalizing problems) explain the relation between familial conflict and substance use disorders, and we investigated whether external social support reduces the effect of familial conflict on adolescent substance use disorders.

Results. Familial conflict was significantly associated with the risk of substance use disorders during adolescence (Odds Ratio: 1.23; 95% CI: 1.02-1.47), and 30% of this effect was due to higher levels of externalizing problems (but not internalizing problems). External social support in childhood did not buffer the effects of familial conflict on substance use disorders during adolescence.

Conclusion. Exposure to familial conflict early in life increases the risk of substance use disorders during adolescence, due partly to higher levels of externalizing problems. Future research is needed to identify additional pathways by which this association occurs