Race, Coping Style, and Substance Use Disorder Among Non-Hispanic African American and White Young Adults in South Florida

Abstract

Background: Despite their higher rates of stress, African American young adults tend toward similar or lower rates of substance misuse than their White counterparts. Arguably, such patterns derive from: (1) racial variations in the availability of coping strategies that mitigate stress; and/or (2) racial differences in the efficacy of available coping styles for reducing substance misuse. Objectives: We assessed whether two coping style types—problem-focused and avoidance-oriented—varied by race (non-Hispanic African American vs. non-Hispanic White) and whether the effects of coping styles on substance misuse were moderated by race. Methods: Using data from a community sample of South Florida young adults, we employed logistic regression analyses to examine racial differences in coping style and to test if race by coping style interactions (race × problem-focused coping and race × avoidance-oriented coping) influenced the odds of qualifying for a DSM-IV substance use disorder, net of lifetime stressful events and sociodemographic controls. Results: We found that African American young adults displayed lower problem-focused coping, and higher avoidance-oriented coping, than did White young adults. Among both African American and White respondents, problem-focused coping was associated with reduced odds of illicit drug use disorder (excluding marijuana), and among Whites, avoidance-oriented coping was associated with increased odds of an aggregate measure of alcohol, marijuana, and other illicit drug use disorders. Among African Americans, however, avoidance-oriented coping was associated with lower odds of marijuana use disorder. Conclusion: Substance misuse policies and practices that consider the sociocultural contexts of stress and coping are recommended.

Keywords :

• race
• stressful life events
• problem-focused coping
• avoidance-oriented coping
• substance use disorder

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

THE AUTHORS

Karen T. Van Gundy is an associate professor of sociology, core faculty in justice studies, and a faculty fellow at the Carsey School of Public Policy at the University of New Hampshire. Her work applies ‘stress process’ and ‘life course’ approaches to understanding place-linked variations in physical, emotional, and behavioral health over time. Her current work, funded by two National Science Foundation grants and by the New Hampshire Charitable Foundation, examines the health­-related impact of social contexts among rural and urban youth and emerging adults. Her recent publications appear in the Journal of Health and Social Behavior, Social Psychology Quarterly, and Rural Sociology.

Amanda Howerton-Orcutt is an associate professor of criminal justice at Salem State University. Her work applies the ‘stress process’ model to understanding variations in emotional and behavioral health and criminality. She teaches a range of classes related to her research interests, including: Drugs and Crime, Mental Illness and Crime, and Offender Rehabilitation.  Her recent publications appear in Sociology of Health and Illness, Journal of Offender Rehabilitation, and International Journal of Stress Management.

Meghan L. Mills is an assistant professor of sociology at Birmingham Southern College. As a medical sociologist, her research interests center on applying the stress process framework in better understanding the unequal social distribution of health outcomes. Partnering with local non-profit agencies, her current work focuses on the role of service learning in teaching sociology and the relationship between service animals and stigma among those with invisible disabilities. Her recent publications appear in Psychiatric Services and Rural Sociology.

GLOSSARY

• Avoidance-oriented coping: Stress management strategies that include approaches such as withdrawal, denial, or evasion.

• COPE index: Measure developed to assess coping style types.

• Coping style: Strategy or strategies used to manage stress.

• Problem-focused coping: Stress management strategies that include direct, active, or approach-oriented methods.

• Substance use disorder: Clinical categories of alcohol or other drug ‘abuse’ or ‘dependence’ that meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, which is published by the American Psychiatric Association.

Notes

¹ In addition, studies on race and coping have shown that, more so than Whites, African Americans rely on religious or spiritual coping (Boyd–Franklin, 2003; Bautista, 2013; Chapman & Mullis, 2000; Constantine et al., 2005; Cotton et al., 2006; Decoster & Cummings, 2005; Koenig et al. 1992). While some scholars have considered such coping as avoidance-oriented (see Anshel, 2005; Anshel et al., 2009; Belgrave & Allison, 2010; Boyd-Franklin, 2003), the present study does not include this type of coping as part of our conceptualization or assessment of avoidant coping.

² Because this is a secondary analysis of data, we were unable to oversee the original data collection efforts. As such, the initial decision to focus on male students and under-sample female students is unclear.

³ Although most indicators suggested little difference between interviewed and refused or lost cases, there were a few exceptions. Compared with current respondents, those who refused interview or were not located were less likely to live in two-parent households or to report lifetime DSM-IV abuse of drugs other than alcohol or marijuana. Interviews with parents suggested that refused or lost cases had significantly lower household income, and that the fathers of such cases were significantly less likely to have ever used alcohol.

⁴ An alternative to the ‘dispositional’ conceptualization of coping style is the ‘contextual’ model. This approach considers coping responses to be contingent upon specific stressful situations rather than dispositions (see Folkman & Lazarus, 1985). We acknowledge the utility of that approach; yet, as Frydenberg and Lewis have observed, ‘[I]t is also clear that an individual's choice of coping strategies is to a large extent consistent regardless of the nature of the concern’ (1994, p. 424).

⁵ In addition, statistical adjustments for other psychosocial attributes (i.e., the assertion of autonomy, emotional reliance, sense of mattering, and perceived social support) did not appreciably alter the substantive findings presented herein (analyses available upon request).