Adolescence is a time of physical, psychological, and social change and generally is considered a stressful period during normal development. Additional psychosocial stressors such as pregnancy may predispose some adolescents to poorer functioning (Ensminger, 1990). In fact, adolescent pregnancy has been associated with increased depression and lower self-esteem (Bolton, 1980), more disadvantaged socioeconomic backgrounds (Barnett, Papini, & Gbur, 1991), and poorer family communication (Lewis, 1978; Shah, Zelnik, & Kantner, 1975). The constellation of psychosocial problems facing the adolescent mother also places her at risk for illicit drug use. For example, disadvantaged socio-economic backgrounds frequently are associated with increased drug use, and adolescent girls have been noted to self-medicare for depression. Peer and family systems also play an important role in the onset of drug use. For example, the strongest single predictor of current and future drug use is whether an adolescent's friends use drugs. Similarly, familial use and their attitudes toward drugs and alcohol are highly correlated with adolescent drug use. Adolescents living in dysfunctional family systems including poor family cohesion, negative communication patterns, unrealistic parental expectations, and parental disengagement are at increased risk for drug use (Andrews et al., 1991; Friedman & Utada, 1992; Swadi, 1992; Wills, Vacarro, & McNamara, 1992). Poor academic achievement, poor sense of competence, low self-concept, and nonconforming behaviors such as sexual activity and rebelliousness also have been associated with early drug use (Andrews et al., 1991).
Prevention and intervention programs for drug abuse could benefit from evaluations of potential psychosocial stressors in many aspects of the adolescent's life. Since poor mental health, dysfunctional family and peer relationships, poor social skills, low educational and vocational achievement, and inappropriate use of leisure time have been related to early drug use (Andrews et al., 1991; Swadi, 1992; Willis et al., 1992), it is important that these potentially problematic areas be evaluated.
The present study attempted to identify the psychosocial stressors associated with adolescent pregnancy and drug abuse. The sample consisted of economically disadvantaged adolescent mothers classified as drug abusing and nondrug abusing during pregnancy. The primary question was whether drug-abusing mothers experienced more psychosocial stressors than did the nondrug-abusing mothers from the same low socioeconomic background. A secondary question was whether there was a cluster of psychosocial stressors that differentiated the two groups of young mothers.
The sample consisted of 104 adolescent mothers between 13 and 21 years of age (M = 18) who received their obstetrical care at a large inner-city university hospital. The young women were primarily single, African-American, and Hispanic, with a tenth grade education (see Table 1).
BDI PBF and Sociodemographic Variables for Drug Abusing and
Non-Drug Abusing Adolescent Mothers
Variables Drug-using Non-drug-using
(N = 55) (N = 49)
Mean (sd) Mean (sd) p
BDI 14.0 (9.2) 6.0 (2.4) .001
PBF 6.8 (3.0) 5.8 (3.2) .15
Age 18.6 (1.9) 18.2 (2.1) .31
Education 10.3 (1.6) 10.6 (1.5) .29
Socioeconomic Status 4.4 (0.8) 4.4 (0.6) .64
In order to identify adolescents who abused drugs during pregnancy the following measures were conducted:
Urine toxicology. A urine toxicology screen was conducted on all adolescent mothers upon admission to labor and delivery. Specific immunoassays (EMIT, Syva) were performed for cocaine metabolite (benzoylecgonine), opiates, and marijuana. …