Externalizing and internalizing trajectories to adolescent substance use

Année :
Référence

*Fletcher, É, Boutin S, Lemieux A, Déry M, Derevensky J, Temcheff CE. (2025). Externalizing and internalizing trajectories to adolescent substance use. International Journal of Mental Health and Addiction.

Résumé

Adolescent substance use remains a significant public health concern and is associated with future negative outcomes. Risk factors for the development of adolescent substance use behaviours include the presence of externalizing and/or internalizing problems; however, previous studies have not always considered their co-occurring influences. This study aims to better understand the role of externalizing and internalizing problems in the development of adolescent substance use using a person-centred approach. Participants were drawn from an ongoing longitudinal study of children with and without early conduct problems (N = 744). Externalizing and internalizing problems were measured annually using teacher and parent reports from study inception to 7 years later. Substance use outcomes were measured using self-report when participants were approximately 17 years old. Latent class growth analyses identified four trajectory classes: (i) a decreasing externalizing co-occurring trajectory characterised by clinical and at-risk levels of both externalizing and internalizing problems, (ii) a high stable co-occurring trajectory characterised by clinical levels of externalizing problems and at-risk/clinical levels of internalizing problems, (iii) an at-risk externalizing trajectory characterised by at-risk levels of externalizing problems and non-clinical levels of internalizing problems, and (iv) a non-clinical trajectory. Youth in the high stable externalizing co-occurring trajectory were significantly more likely to report substance use behaviours and consequences when compared to other developmental trajectories, including the decreasing externalizing co-occurring trajectory. Our results suggest that the highest risk for substance use remains with those who follow a trajectory with high and stable externalizing problems. Early prevention and intervention efforts targeting externalizing problems could help decrease one’s future risk of engaging in substance use.

DOI