Affluent adolescents, depression, and drug use: the role of adults in their lives

Adolescence, Summer, 2005 by Kimber L. Bogard

Although recent studies have indicated that affluent youth are potentially at risk for emotional distress and substance use (Csikszentmihalyi & Schneider, 2000; Blum et al., 2000; Luthar & D'Avanzo, 1999; Way, Strauber, Nakkula, & London, 1994), little effort has gone into investigating the adjustment and well-being of this population (Luthar & Becker, 2002). Contrary to popular belief, money does not necessarily make one less at risk for mental illness (Czechzentmehayli, 1999). Specifically, affluent suburban adolescents have been shown to be at greater risk for depression and drug use than are both middle-class and lower-class samples of youth (Luthar & D'Avanzo, 1999).

Regardless of socioeconomic status (SES), adolescents experience increased rates of depression and substance use as they enter their teen years (Hankin et al., 1998; Blum et al., 2000). Among both high school and middle school students, upper SES adolescents are more likely to become depressed and use illegal substances than are their lower income counterparts (Luthar & D'Avanzo, 1999). While female adolescents in general experience higher rates of depression than do adolescent males (Petersen, Sarigiani, & Kennedy, 1991; Nolen-Hoeksema, 1990; Hankin et al., 1998), upper SES females are more likely to report depressive symptoms than are their lower SES females (Way et al., 1994; Luthar & D'Avanzo, 1999). Whereas male adolescents report more increased substance use than females (Blum et al., 2000; Luthar & D'Avanzo, 1999), affluent suburban males have been found to be more likely to use drugs than do their lower-income counterparts (Luthar & D'Avanzo, 1999). Taken together, the previously stated findings indicate a need for further research on affluent adolescents who are potentially at risk for maladjustment.

Way, Strauber, Nakkula, and London (1994) reported that depression and drug use were significantly related among high-income, suburban adolescents, but not low-income urban adolescents. In their qualitative analysis, Way et al. (1994) reported different reasons for substance use between their high- and low-income samples. The more affluent adolescents reported using drugs as a means to "escape from problems" or "relax." In general, affluent teens were more likely to use drugs as a way to cope with distress. Urban adolescents typically reported using drugs because of peer pressure or to have fun. These findings are consistent with those of Luthar and D'Avanzo (1999) who suggest that affluent youth use drugs to alleviate personal distress.

Adolescent Depression and Substance Use

Adolescence is a period of rapid maturational and social change, and youth who do not adjust well to the challenges during this identity-forming stage of development may commence a pattern of pathology that influences future development (Clarizio, 1989; Ebata et al., 1990). Both clinical levels of depressive symptomatology and substance use among adolescents have been found to have a negative impact on future development. While depression and substance use are strongly associated among affluent adolescent females, substance use levels are highest among upper-class males, leaving both males and females within this population at risk for negative developmental outcomes.

Recent longitudinal studies designed to examine adult outcomes of adolescent depression give support to the notion that one does not outgrow depression experienced during adolescence. Depressed adolescents are more likely than their nondepressed counterparts to experience depression as adults. These findings are common across both clinical (Rao, Hammen, & Daley, 1999; Harrington, Fudge, Rutter, Pickles, & Hill, 1990; Weissman et al., 1999) and community (Bardone, Moffitt, Caspi, Dickson & Silva, 1996; Hankin et al. 1998; Lewinsohn, Rohde, Klein, & Seeley, 1999; Pine, Cohen, Gurley, Brook, & Ma, 1998) samples.

In addition to an increased risk of developing major depression disorder in the future, some common adult psychosocial outcomes of adolescent depression include: poor functioning in the nature and quality of romantic relationships and academics (Rao et al., 1999); lower educational achievement (Rao et al., 1995); general social impairment in areas of work and family (Weissman et al., 1999; lack of school completion, increased drug use, and an increased likelihood of being pregnant before age 21 (Bardone et al., 1996); impairment in relationships with friends, lower overall satisfaction with life, and lower global functioning (Rao et al., 1995); and elevated risks of psychiatric hospitalization (Harrington et al., 1990).

Similar to the long-term impacts of adolescent depression on adult outcomes, studies examining long-term effects of adolescent substance use found continuity in substance use over different developmental periods leading into adulthood. Evidence of substance use in early adolescence has been shown to predict late adolescent substance use and adult maladjustment (Stacy & Newcomb, 1999; Brook, Balka, Gursen, Brook, & Shapiro, 1997; Newcomb & Bentler, 1988; Kandel, Simcha-Fagan, & Davies, 1986). In a 13-year longitudinal study of a community sample of female adolescents, substance use in adolescence significantly predicted multiple drug-use problems as adults (Stacy & Newcomb, 1999). In addition to predicting adult drug problems, adolescent substance use in females has been found to predict delinquent behavior and theft in adulthood (Kandel et al., 1986).