Short communicationAnger expression, coping, and substance use in adolescent offenders
Introduction
Substance use represents a significant health risk for adolescents in the juvenile justice system. It is estimated that over 90% of delinquent youth experiment with some form of alcohol or other illicit drug use, and between 68% and 81% meet criteria for either abuse or dependence Neighbors et al., 1992, Wierson et al., 1992, Young et al., 1995. Given the pervasiveness of substance-use problems in this population, identification of psychosocial factors contributing their development remains an important priority.
Recent evidence suggests that negative mood states may constitute a significant risk factor for substance-use disorders among incarcerated adolescents, with approximately 20% to 40% of incarcerated adolescents qualifying for a formal diagnosis of major depression or dysthymia, and similar numbers experiencing some form of anxiety disorder (e.g., Neighbors et al., 1992). In many instances, these negative mood states have been linked with higher levels of substance use Barnea et al., 1993, Neighbors et al., 1992, Riggs et al., 1995.
Despite recognition that depression and anxiety may contribute to substance use among adolescent offenders, the influence of other negative mood states remains largely unexplored. Anger, in particular, has received less attention, possibly because it has proved difficult to quantify or discretely categorize. As a result, formal empirical evaluations of the prevalence of anger have often been absent from the research literature. One method of overcoming obstacles to assessing anger is to examine individuals' perceptions of its manifestations. Spielberger's Anger Expression Scale (AES) represents a well-validated means of assessing anger by providing a self-report checklist of anger-related behaviors that are either inwardly or outwardly expressed (Spielberger et al., 1985).
The stress-coping model of addictive process suggests that substance use represents one of many cognitive and behavioral coping strategies adolescents may employ to manage life stresses Wagner et al., 1999, Wills and Hirky, 1996. Negative mood states, such as anger, may serve as both the cause and the product of such stresses, and substance use may serve as a means of regulating them. From this perspective, adolescents with high levels of anger, and other generalized coping resources that are maladaptive or nonexistent, will be more likely to turn to substance use to alleviate their distress. Avoidant coping, often viewed as a consistent pattern of effort to remove, ignore, or distract oneself from distress, may represent one particularly maladaptive means of emotional management (e.g., Fuendeling, 1998). Over time, such a strategy does not provide practice in developing active solutions to distress, but encourages an individual to seek the path of least resistance to restore affective balance and, consequently, increases the attractiveness of substance use (Wills & Hirky, 1996).
The following study represents an attempt to examine whether anger and avoidant coping represent independent and interrelated risk factors for substance use among incarcerated youth. It is hypothesized that adolescents who report higher levels of inwardly and outwardly expressed anger, and higher levels of avoidance as a global coping strategy, will report more frequent use of alcohol and marijuana, and higher levels of consequences associated with this use. The interaction of high levels of expressed anger and high levels of avoidant coping is expected to produce significant additional risk for both alcohol and marijuana use, and use-related consequences.
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Participants and procedure
Three hundred and four of 376 eligible adolescents (81%) were recruited from the total census of two facilities housing serious adolescent offenders. Adolescents were recruited from their residential living units and completed paper-and-pencil assessments in groups of 5–15. Participation was limited to youth who had been detained on site for at least 30 days to minimize the possibility that adolescents might be suffering from acute substance withdrawal or stress associated with the transition
Sample characteristics and associations between study variables
Older adolescents reported more alcohol-related consequences (r=.12, P<.05), but age and race were not significantly related to any other study variables. Mean values and zero-order correlations are presented in Table 1. All study variables were significantly correlated except anger-in was not associated with alcohol use or with marijuana use, and its association with marijuana consequences only trended towards significance (P=.06).
Anger and avoidant coping-relationship to alcohol use
Adolescent offenders' reports of anger-out and avoidant coping
Discussion
Anger expression and avoidant coping concurrently predicted alcohol and marijuana use and use-related consequences in a sample of incarcerated adolescents. The risk of substance-use behavior varied by style of anger expression. Higher levels of outwardly expressed anger and avoidant coping were independently related to alcohol and marijuana use and consequences. Higher levels of inwardly expressed anger were not related to any substance use or consequence variable with one exception: inwardly
Acknowledgements
This research was supported by a grant from the Washington State Alcohol and Drug Abuse Institute (Grant # 661036, Mary Larimer, PI). Additional support provided by the VA Center of Excellence in Substance Abuse Treatment and Education. Special thanks to Eric Trupin and the Division of Public Health and Justice Policy.
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