Academic journal article Social Behavior and Personality: an international journal

Intervening Processes between Adolescent Drug Use and Psychological Distress: An Examination of the Self-Medication Hypothesis

Academic journal article Social Behavior and Personality: an international journal

Intervening Processes between Adolescent Drug Use and Psychological Distress: An Examination of the Self-Medication Hypothesis

Article excerpt

The self-medication hypothesis suggests that individuals who experience high levels of psychological distress use drugs to relieve their pain. The extent to which this is the case (and to which people do feel better after using drugs) has had mixed support in the literature. The present analysis uses structural equation modeling of longitudinal data to explore how deviant disposition, deviant peers, and negative life events act as intervening variables in the hypothesized relationship between psychological distress and adolescent drug use. The results suggest that deviant disposition and association with deviant peers mediate the relationship between antecedent psychological distress and later drug use. Similarly, negative life events mediate the relationship between adolescent drug use and adult psychological distress.

Concern about adolescent drug use has led researchers to focus on two different perspectives: examination of (1) the causes and, more recently, (2) the consequences of adolescent drug use. Most studies concentrate on only one or the other of these two perspectives, examining causes of drug use (one the one hand) or some consequences of drug use, such as crime, (on the other hand) as independent ends. Tests of the relationship between psychological distress and drug use are a good example of this. The self-medication hypothesis suggests that drug use is initiated by people in an attempt to quench the psychological distress associated with the transition from adolescence to young adulthood (Khantzian, 1985). In most studies, however, the focus has been on the extent to which psychological distress resulted in later drug use (d'Houtaud & Field, 1987). The degree to which the pain is relieved has often been left untested.

This is unfortunate because it ignores the potential reciprocal, developmental, and interactive nature of drug use, its causes, and its consequences (Johnson & Kaplan, 1990). If drug use is caused by an expectation of decreased psychological distress, then what is the effect of drug use on psychological distress? This paper uses longitudinal data to go beyond this inconsistency by looking at (1) the mediated effect of antecedent psychological distress on adolescent drug use and (2) the mediated effect of adolescent drug use on later psychological distress as an adult in the same model. The hypotheses derived in this study are drawn from both sets of literatures (i.e. drugs as cause and consequence).


Many risk factors have been hypothesized to be related to drug use (e.g., sensation seeking [Zuckerman, 1979], poor family structure [Needle, Su, & Doherty, 1990], school problems [Mensch & Kandel, 1988], and poverty [Brunswick, 1988]). Exposure to, and experience of, psychological distress has often associated with these problems. The use of drugs by people experiencing high levels of emotional distress is a coping mechanism that has been referred to in the past as self-medication (Rado, 1933), relief from psychological pain (Cohen, 1971), and therapeutic need (Nail, Gunderson, & Kolb, 1974).

Several studies have shown that psychological distress results in drug use. Christie and her associates (Christie, Burke, Regier, Rae, Boyd, & Locke, 1988), for example, showed that major depressive episodes or anxiety disorders double the risk of later drug abuse among 18-30 year-olds (see also Crutchfield & Gove, 1984; Pihl, Murdoch, Lapp, & Marinier, 1986; Martin, Blum, & Roman, 1992; Newcomb & Bentler, 1988).

The evidence surrounding the self-medication hypothesis is not, however, consistent. Orive and Gerard (1980) and Sieber (1981) failed to find that drug use was dependent on psychological distress, while Mensch and Kandel (1988) concluded that the stresses associated with negative job conditions are not strong contributors to the etiology of drug use (see also Oetting & Beauvais 1987). …

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