The Role of Stress and Spirituality in Adolescent Substance Use

ABSTRACT

Background: Substance use can occur as a result of coping with stress. Within the school context, youth are exposed to stressors related to school achievement and peer-relationships. Protective factors, such as spirituality, may moderate adolescents' engagement in substance use. Objective: The current study investigated the role of spirituality in the association between stress and substance use, in an effort to test the hypothesis that spirituality moderates the association between stress and substance use. Methods: This study used data from youth in grades 6–8 attending 40 parochial private schools. A total of 5,217 students participated in the web-based survey administered in Spring 2013. Multilevel structural equation models were used to examine the association between stress, spirituality, and substance use, while accounting for the nested nature of the data (i.e., students within schools). Results: Higher stress was significantly associated with increased alcohol, tobacco, and other drug use among youth (b =.306, p <.001). In addition, lower spiritual beliefs were associated with greater substance use (b =.349, p <.001). Spiritual beliefs did not moderate the relationship between stress and substance use. Conclusions/Importance: Implications for increasing students' adaptive coping when confronted with school-related stressors and the role of school climate are discussed.

KEYWORDS:

• Alcohol
• drugs
• adolescents
• spirituality

Acknowledgments

We would like to thank the Maryland State Department of Education and Sheppard Pratt Health System for their support of this research through the Maryland Safe and Supportive Schools Project.

Declaration of Interest

This study was approved by the Internal Review Board at the authors' affiliated university. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This work was funded in part by grants from the U.S. Department of Education (grant number 145089) and William T. Grant Foundation (grant number 180509) awarded to Catherine Bradshaw.

Additional information

Notes on contributors

Katrina Debnam

Katrina Debnam, PhD, MPH, is an Assistant Scientist in the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health. She has expertise in mixed-methods research, including hierarchical linear modeling and the conduct and analysis of data from focus groups and interviews. Her research interests include health disparities, adolescent dating violence prevention, school culture, and faith-based programs for positive youth development.

Adam J. Milam

Adam J. Milam, PhD, MHS, is a Faculty Associate in the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health and a medical student at Wayne State University. His research interests include the impact of neighborhood environment on children and adolescent exposure to alcohol, tobacco, and other drugs. Dr. Milam's research also focuses on policy interventions to prevent child and adolescent exposure to alcohol and tobacco. Dr. Milam has been recognized by the U.S. Public Health Service and the Association of American Medical Colleges for his work in health disparities and health inequities.

C. Debra Furr-Holden

C. Debra Furr-Holden, PhD, is an Associate Professor in the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health, Director at the Drug Investigations Violence and Environmental (DIVE) Studies Laboratory, and public health expert in the field of alcohol and drug dependence epidemiology, psychiatric epidemiology, and prevention science. She has been very influential in shifting the lens through which the public health field views health disparities, and has been recognized by the President for her work, receiving the Presidential Early Career Award for Scientists and Engineers (PECASE) in 2006.

Catherine Bradshaw

Catherine Bradshaw, PhD, M.Ed., is a Professor and the Associate Dean for Research and Faculty Development at the Curry School of Education at the University of Virginia; she is also the Deputy Director of the CDC-funded Johns Hopkins Center for the Prevention of Youth Violence and Co-Director of the NIMH-funded Johns Hopkins Center for Prevention and Early Intervention. She collaborates on federally funded research projects examining bullying and school climate; the development of aggressive and problem behaviors; and the design, evaluation, and implementation of evidence-based prevention programs in schools. She is a former associate editor for the Journal of Research on Adolescence and is the editor of Prevention Science, and co-editor of the Handbook of School Mental Health.