Adolescent emotional disorder symptoms and transdiagnostic vulnerabilities as predictors of young adult substance use during the COVID-19 pandemic: mediation by substance-related coping behaviors

ABSTRACT

The COVID-19 pandemic presents unique stressors (e.g. social isolation) that may increase substance use risk among young adults with a history of emotional disturbance. This study examined whether emotional disorder symptoms and transdiagnostic vulnerabilities during adolescence predicted young adult substance use during COVID-19, and whether using substances to cope with the pandemic’s social conditions mediated these associations. Adolescents (N = 2,120) completed baseline surveys assessing transdiagnostic emotional vulnerabilities (anhedonia, distress intolerance, anxiety sensitivity, negative urgency) and symptoms (major depression[MD], generalized anxiety[GAD], panic disorder[PD], social phobia[SP], obsessive-compulsive disorder[OCD]) in adolescence (September–December 2016; M[SD] age = 17.45[0.38]). At follow-up (May–August 2020; M[SD] age = 21.16[0.39]), past 30-day substance use and using substances to cope with social isolation during the pandemic were reported. Adjusted models showed that baseline distress intolerance, anxiety sensitivity, negative urgency, and MD symptoms each significantly predicted higher number of past-month single-substance using days and number of substances used at follow-up (βs = 0.04–0.06). In each case, associations were mediated by tendency to use substances to cope with the pandemic (β_indirect range: 0.028–0.061). To mitigate disproportionate escalation of substance use in young adults with a history of certain types of emotional disturbance, interventions promoting healthy coping strategies to deal with the pandemic’s social conditions warrant consideration.

KEYWORDS:

• COVID-19 pandemic
• transdiagnostic emotional vulnerabilities
• emotional disorder symptoms
• substance-related coping behaviors
• substance use

Disclosure statement

No potential conflict of interest was reported by the authors. JC had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Supplementary material

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Additional information

Funding

This research was supported by funds from the National Cancer Institute (NCI) of the National Institutes of Health (NIH) under Award Number R01CA229617; the National Institute on Drug Abuse (NIDA) Award Number K24DA048160; and National Science Foundation (NSF) Graduate Research Fellowship Grant DGE-1418060. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH and NSF. Funding sources had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.