The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents' motivations for alcohol, cigarette, and marijuana use

Abstract

The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age=15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted “risky” substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety–coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.

Introduction

Use of alcohol, cigarettes, and marijuana is highly prevalent among adolescents Kaminer, 1999, Wagner et al., 1999. For example, the Monitoring the Future Study (Johnston, O'Malley, & Backman, 1998) investigated substance use among high school students in the United States. Johnston et al. (1998) found 31% of students reported one or more episodes of binge drinking during the past 2 weeks; 37% reported smoking cigarettes in the past month; and 42% reported illicit drug use in the past year, with 6% reporting daily marijuana use. In addition to its prevalence, substance use carries significant risk of adverse consequences Cooper, 1994, Kandel et al., 1986. For example, adolescent alcohol and marijuana use is associated with injuries, motor vehicle accidents, and assaults Brookoff et al., 1994, Maio et al., 1994. A substantial number of young people who smoke cigarettes will die prematurely from a preventable, smoking-related disease (Jansen, Glynn, & Howard, 1996). Successful efforts to prevent these and other adverse consequences should optimally be based on empirically derived understanding of the risk factors that contribute to heavy and problem substance use among teens.

Motivational theorists argue that substance use “motives” or reasons for use are the final common pathway to substance use and abuse through which more distal risk variables, such as personality factors, exert their influences (Cooper, 1994). Motivational models all contend that different motives are associated with unique patterns of use and use-related outcomes (e.g., Cox & Klinger, 1988, Cox & Klinger, 1990).

Cooper (1994) proposed a 2×2 (Source×Valence) model of drinking motivations to describe the various reasons why teens consume alcohol. With respect to source, a teen might drink to achieve an internal reward (e.g., mood change) or an external reward (e.g., social approval). With respect to valence, an adolescent might drink to obtain a positive outcome or to avoid a negative outcome. Crossing these two dimensions yields four specific drinking motives: coping (internal, negative reinforcement); conformity (external, negative reinforcement); enhancement (internal, positive reinforcement); and social (external, positive reinforcement). Coping (drinking to reduce/avoid negative emotions) and conformity (drinking to reduce/avoid social censure) motives are associated with greater drinking problems even after controlling for usual alcohol consumption levels Bradizza et al., 1999, Carey & Correia, 1997, Cooper et al., 1992. Enhancement (drinking to increase positive mood states) and coping motives have been shown to relate to increased levels of alcohol use (Cooper, 1994).

Tate, Pomerleau, and Pomerleau (1994) have identified several distinct reasons for cigarette smoking which include sedative, psychosocial, and stimulation motives. These motive categories appear roughly equivalent to Cooper's (1994) coping, conformity, and enhancement drinking motives, respectively, suggesting that Cooper's motivational model may also apply to the reasons underlying cigarette smoking. Coping and enhancement motives are associated with more chronic smoking behavior; and enhancement and conformity motives are associated with a faster smoking rate (Tate et al., 1994).

Simons, Correia, Carey, and Borsari (1998) have argued that Cooper's (1994) categorical model may also be a useful means of conceptualizing adolescents' reasons for marijuana use. Using a marijuana motives measure designed to tap Cooper's four motives, they showed that coping and enhancement motives related to increased levels of marijuana use, and that conformity motives were associated with more problems related to marijuana use (Simons et al., 1998).

Across alcohol, cigarettes, and marijuana, coping, enhancement, and conformity motives appear relatively “risky” in that they have been closely related to heavy and/or problem use (Cooper, 1994). Patterns suggest that those who use substances to change internal states (i.e., for coping and enhancement reasons) may use more heavily and/or chronically than others (e.g., Cooper, 1994, Tate et al., 1994). Additionally, it appears that using substances for negative reinforcement reasons (i.e., coping and conformity) may represent a relatively maladaptive style of use that results in problems (e.g., Cooper, 1994, Simons et al., 1998). In contrast, social motives appear to be associated with a relatively lighter, less problematic style of substance use and thus are considered less risky reasons for use (e.g., Cooper, 1994).

It stands to reason that different types of individuals would use substances for different reasons Conrod et al., 2000, Cooper et al., 1995. Research suggests that different personality variables known to be risk factors for substance-related disorders are indeed associated with unique reasons for alcohol use (e.g., Stewart & Devine, 2000, Stewart et al., 2001) and cigarette smoking (e.g., Stewart et al., 1997, Tate et al., 1994), at least among adults. Trait anxiety, anxiety sensitivity, and sensation seeking are three such personality risk factors.

Trait anxiety involves the general tendency to experience anxiety symptoms across a wide variety of stressful situations (McNally, 1996). Trait anxiety levels have been correlated, albeit weakly, with increased drinking levels in adults (Welte, 1985). Stewart and Zeitlin (1995) found that high trait anxiety scores are related to coping motives for alcohol use. Similarly, in an adult sample, Tate et al. (1994) found a positive correlation between trait anxiety levels and coping cigarette smoking motives. They also found that trait anxiety was related to conformity motivated smoking (Tate et al., 1994).

Although anxiety sensitivity is correlated with trait anxiety, the two constructs are conceptually and empirically distinct (McNally, 1996). Anxiety sensitivity involves a specific fear of anxiety-related bodily sensations due to beliefs that such sensations will lead to catastrophic outcomes such as physical illness, social embarrassment, or loss of mental control (Reiss, Peterson, Gursky, & McNally, 1986). Among adults, anxiety sensitivity predicts increased drinking levels Stewart et al., 1995, Stewart et al., 2001 and a higher incidence of problem drinking symptoms (Conrod, Pihl, & Vassileva, 1998). Several studies have shown relations between anxiety sensitivity and coping motives both for alcohol use (see review by Stewart, Samoluk, & MacDonald, 1999) and cigarette smoking (Stewart, Karp, et al., 1997). Recently, Stewart, Zvolensky, & Eifert (in press) found that anxiety sensitivity was also related to conformity motivated drinking. The degree to which anxiety sensitivity (or the correlated variable of trait anxiety) relates to risky conformity motives for marijuana use (Simons et al., 1998) remains to be investigated.

Sensation seeking is a personality factor that refers to the desire for intense and novel experiences (Zuckerman, 1994). It has been associated with heavier drinking and with increased risk for adverse drinking consequences Conrod et al., 1997, Schall et al., 1992. It is also associated with increased risk taking among youth such as dangerous driving, shoplifting, sex without use of contraceptives, and experimenting with drugs (Arnett, 1994). Similar to findings with adult drinkers (e.g., Stewart & Devine, 2000), Cooper et al. (1995) found sensation seeking was associated with enhancement motives for alcohol use among adolescent drinkers. The degree to which sensation seeking may be related to adolescents' use of cigarettes and marijuana for risky enhancement motives is unknown. Moreover, Arnett (1994) has argued that two components of sensation seeking—namely, novelty seeking and intensity seeking—should be assessed separately as they may relate differently to risky alcohol/drug use in youth. The degree to which each component is responsible for previous observations of associations between sensation seeking and enhancement drinking remains to be established.

The primary aim of the present study was to determine whether previous findings of relations among trait anxiety, anxiety sensitivity, and sensation seeking with substance use motives, extend from adults to adolescents. We were also interested in the possible similarities in personality to substance use motives relations across three different drugs: alcohol, cigarettes, and marijuana. We hypothesized that, among our sample of adolescents, the personality measures would predict the three “risky” substance use motives (conformity, coping, and enhancement), over and above demographics, across drugs. With respect to negative reinforcement motives, we expected that anxiety sensitivity would predict conformity motives for alcohol use (cf. Stewart et al., in press) and that anxiety sensitivity and/or trait anxiety might also predict conformity motives for cigarette and/or marijuana use (cf. Tate et al., 1994). We further expected both anxiety sensitivity and trait anxiety to independently predict coping motives for alcohol and cigarettes (cf. Stewart et al., 1997, Stewart & Zeitlin, 1995, Tate et al., 1994). With respect to positive reinforcement motives, we expected sensation seeking to be related to enhancement drinking motives (cf. Cooper et al., 1995, Stewart & Devine, 2000). We also explored whether this expected relation of sensation seeking to enhancement motives for alcohol use extends to cigarettes and/or marijuana, and examined whether relations of sensation seeking to enhancement motives are due to the intensity—and/or novelty—seeking component (Arnett, 1994).