Associations Between First Use of Substances and Change in Internalizing Symptoms Among Girls: Differences by Symptom Trajectory and Substance Use Type

Abstract

This study examined how girls' initial use of alcohol, cigarettes, and marijuana related to changes in depressive, generalized anxiety, and social anxiety symptoms, and whether these changes varied based on which internalizing symptom trajectories the girls were on. Data came from the Pittsburgh Girls Study, a community-based study of girls assessed at ages 5 to 8 and followed for 6 years. Growth mixture modeling was used to identify trajectory groups. The results indicated that for girls on a “high depressive symptom” trajectory, initial use of marijuana was related to further increases in depressive symptoms. Initial uses of alcohol and cigarettes were associated with overall increases in depressive symptoms, and the initial use of cigarettes was associated with an overall increase in generalized anxiety symptoms. Initial use of all substances was related to change in social anxiety, but the direction of change varied by trajectory group and substance. Links between initial use and internalizing symptoms depended on the type of substance, type of internalizing symptom, and trajectory group.

This study was supported by grants from the National Institute on Drug Abuse (022456, 012237), the National Institute on Alcohol Abuse and Alcoholism (014357, 017128 and 016798), and the National Institute of Mental Health (055630 and 071790). We thank the Pittsburgh Girls Study personnel and participants for their contributions to this project.

Notes

Note: traj = trajectory group; positive parameter estimates indicate that the initial use is associated with a symptom increase, whereas negative parameter estimates indicate that the initial use is associated with a symptom decrease.

^a traj1 = stable low; traj2 = decreasing; traj3 = increasing; traj4 = stable high.

^b traj1 = stable low; traj2 = low increasing; traj3 = moderate; traj4 = high decreasing; traj5 = stable high.

^c traj1 = moderate decreasing; traj2 = high decreasing; traj3 = increasing; traj4 = stable moderate; traj5 = stable high.

^d Too little variability to calculate parameter estimate.

^§ p ≤ .10. *p ≤ .05. **p ≤ .01. ***p ≤ .001.