Adolescent Relationship Stress and Psychopathology: The Role of Substance Use and Non-Suicidal Self-Injury

• In Event: Self-Injurious Thoughts and Behaviors in Understudied Samples Across the Lifespan: Implications for Transdiagnostic Interventions

Abstract

Introduction: Students attending high-achieving schools (HAS) have traditionally been understudied, in part because they were considered to be at low risk for maladjustment. However, replicated evidence suggests that HAS youth are at elevated risk for psychopathology, including prospectively into adulthood (e.g., Luthar et al., 2013) and independent of SES and private vs. public school status (Luthar & Barkin, 2012; Lyman & Luthar, 2014). Recent work has implicated parental criticism, peer victimization, and envy as correlates of psychopathology in this population (Ciciolla et al., 2017; Luthar & Becker, 2003; Lyman & Luthar, 2014). Notably, non-suicidal self-injury (NSSI) and substance use are elevated among HAS populations (Yates et al., 2008; Luthar & Goldstein, 2008), which may reflect maladaptive compensatory responses to stressors. Additionally, self-harm and substance use predict adolescent psychopathology (Moran et al., 2011; Halfors et al., 2009). Therefore, we propose that the association of relationship stress, estimated from parental criticism, peer victimization, and envy, with depression, anxiety, and suicide ideation (SI) may be partially explained by NSSI and substance use.

Method: Students (N= 6100) from 10 HAS schools around the United States provided self-report data for the present study. The sample included students ages 15-20 (M = 15.50), had approximately equal numbers of boys (50.2%) and girls (49.7%), and was highly diverse (57.3% White). Parental criticism was evaluated via the Multidimensional Perfectionism Scale (MPS; Frost et al., 1990). Peer victimization was measured using the Revised Peer Experience Questionnaire-V (RPEQ-V; Prinstein et al., 2001), which assesses frequency of peer victimization in the past week. Envy of peers was reported on four domains: academic, popularity, wealth, and appearance (Luthar et al., 2013). NSSI in the past year was measured with The Functional Assessment of Self-Mutilation (FASM; Lloyd et al., 1997). Substance use was estimated from the Well-Being Index (WBI; Luthar et al., 2020), which measures cigarette, marijuana, vape, and alcohol use in the past 6 months. Psychopathology was similarly examined with WBI subscales comprising depression and anxiety, and frequency of SI.

Results: Analyses examined NSSI and substance use as underlying mechanisms of associations between parental criticism, peer victimization, and envy with depression, anxiety, and SI. Parental criticism: Substance use and NSSI each significantly mediated associations of parental criticism with depression, anxiety, and SI. Peer victimization: Substance use and NSSI each significantly mediated the associations of peer victimization with depression, anxiety, and SI. Envy: Substance use significantly mediated the association of envy with anxiety, but not with depression or SI. NSSI significantly mediated associations of envy with depression, anxiety, and SI.

Discussion: Data from this sample of HAS youth suggest that relationship distress was concurrently associated with dimensions of psychopathology. Some associations were partially explained by substance use or NSSI. Results implicate affect regulation as a critical link between parental and peer relationships and psychopathology. Implications for interventions targeting affect regulation among adolescents will be discussed.

Authors

• Julia S. Yarrington, University of California, Los Angeles
  Presenting Author

• Sarit Forman, University of California - Los Angeles
  Non-Presenting Author

• Kelsey Stiles, University of California - Los Angeles
  Non-Presenting Author

• Steve Lee, University of California, Los Angeles
  Non-Presenting Author

• Suniya Luthar, Authentic Connections
  Non-Presenting Author