Momentary affective states predicting substance use events in depressed youth

Abstract

The relationship between mood and substance use in depressed adolescents has been well established, but the precise mechanisms need elucidation. We sought to characterize 24-h momentary affective antecedents of alcohol and marijuana use in depressed youth. Thirty-eight participants (84% females, 15–22 years old), all clinically depressed and substance users, completed four to six daily momentary reports for two weeks using a hand-held device. The reports included participants' momentary positive and negative affect (PA and NA) and their recent consumption of alcohol and/or marijuana. Statistical models compared affect characteristics during 24-h periods preceding substance use with affect at other times. Because most participants were females, we also examined data for girls alone. Participants reported 394 total substance use events. Prior to use, participants displayed narrower ranges of PA and NA compared with times distant from use, especially for marijuana use. Girls had lower maximum PA prior to marijuana use. For everyone, minimum NA was higher before substance use. Those who reported less baseline substance use had lower mean and maximum PA prior to alcohol use, but higher minimum PA prior to marijuana use, than participants with greater baseline use. Substance use followed periods of constricted momentary PA and NA. Less frequent users displayed this pattern more strongly than heavier users. An understanding of momentary affective factors underlying substance use in depressed youth will help better tailor preventive strategies and counseling in this population.

Keywords:

• alcohol use
• drug use
• substance use
• mental health
• mood disorder
• outcome predictors

Notes

The NA subscale consisted of irritable, distracted, upset, hostile, guilty, and scared. The PA subscale included strong, proud, interested, alert, inspired, and determined.