Substance use among adolescents: fulfilling a need state

Adolescence, Winter, 1996 by Arch G. Mainous, III, Catherine A. Martin, Michael J. Oler, Eric T. Richardson, Amy S. Haney

Recent data indicate that the use of drugs and alcohol by adolescents is substantial, and that heavy use adversely affects healthy development (Newcomb & Bentler, 1988). Substance-abusing teens smoke at higher rates than do those of the general adolescent population, and these adolescents are at increased risk for negative health consequences (Myers & Brown, 1994). Further, suicidal ideation and behavior have been associated with drug and alcohol use among adolescents (Felts, Chenier, & Barnes, 1992; King, Hill, Naylor, Evans, & Shain, 1983). Consequently, researchers and health professionals continue to search for correlates and determinants of adolescent substance use (Donnermeyer, 1992; Hays et al., 1986; Huba, Wingard, & Bentler, 1983).

Underlying feeling states may be particularly important to understanding substance use, especially during adolescence. For instance, a linkage seems to exist between depression and alcohol and drug use (Henry et al., 1993; Van Hasselt, Null, Kempton, & Bukstein, 1993; Swanson et al., 1992). The onset of major depression is associated with, and almost always precedes, alcohol or substance use (Deykin, Leroy, & Wills, 1987). Further, research has indicated that depressive mood is associated with the onset of marijuana use among nonusers, and predicts the use of other illicit drugs by marijuana users (Paton, Kessler, & Kandel, 1977).

A feeling state that has not been investigated in relation to substance use in adolescents, but may have particular relevance, is the feeling of fulfillment of basic needs. In a study of feeling states of adult narcotic addicts, alcoholics, and controls, Martin, Hewett, Baker, and Haertzen, 1977), developed a scale to measure basic needs and drives in an effort to characterize the feelings associated with substance abuse. The Need scale correlated with testosterone and was higher in alcoholics and narcotic addicts than in controls. Moreover, the Need scale correlated with the severity of addiction. Although the scale was developed on an adult population, the concept of heightened needs and drives seems particularly germane to an investigation of adolescent substance use. In an attempt to further understand the adolescent who uses alcohol and drugs, the relation between the adolescent feeling state of an awareness of bodily needs and substance use in a sample of noninstitutionalized youth was examined.

METHOD

All students at a public high school in a metropolitan statistical area in the Southeastern United States were requested to participate in a survey. The protocol was reviewed and approved by an institutional review board. The surveys were completed with the assistance of the school's administration during school hours. The questionnaires were distributed during class and completed within the 50 minutes allotted for the class period, and collected by the presiding teacher. All questionnaires were completed on the same day.

Variable

An awareness of need states are measured by a modified version of the Addiction Research Center Maturation Scale's (ARCMS) Need subscale (Martin et al., 1977). The ARCMS contains 11 items and was designed for use with adults. The Need scale focuses on basic needs including sexual desire, hunger, body health, pain, and general wanting. Although the purpose of this study was not to create a new scale to measure bodily need states, several modifications were made to the ARCMS to make the scale more understandable and acceptable for children and adolescents. The ARCMS Need subscale was modified by deleting two items and changing the wording of several of the remaining items (Figure 1.). The deleted items focused on homosexual sexual activity and voyeuristic sexual activity which has been found in clinical use to be offensive to adolescents. Each item in the scale answered as a positive response to a need state is scored as a 1; negative responses are scored as a 0. The higher the score on the scale, the greater the lack of fulfillment of the needs state.

Depression was measured by the Children's Depression Inventory (CDI) (Kovacs, 1980). This scale is considered to be a valid and reliable measure of depression in children and adolescents. The CDI is designed to measure the level of depressive symptomatology in children rated for the past two weeks. The CDI contains 27 items rated 0 to 2; the higher the score, the greater the level of depressive symptomatology.

Cigarette use was measured by items from the 1991 National Health Interview Survey (Adams & Benson, 1992). Current use of smokeless tobacco, both snuff and chewing tobacco, was also assessed. Substance use indicators were drawn from the National Institute on Drug Abuse's 1991 Monitoring the Future Survey of adolescents (Johnston, O'Malley, & Bachman, 1992). Items measuring current use (past 30 days) of alcohol, marijuana, and cocaine were included.

Analysis

Descriptive statistics (frequencies, means, standard deviations) were computed for the variables. Pearson correlations were computed between the modified ARCMS Need scale and the Children's Depression Inventory. The modified ARCMS Need Scale was analyzed in relation to substance use. Specifically, t-tests were conducted between current substance use and the modified ARCMS Need Scale. The t-tests were computed with the individuals who had complete scores on the modified ARCMS Need Scale (n = 796). Because the initial research on the Need scale with adults indicated that the scale was positively correlated with testosterone, the bivariate relations were also investigated separately for males and females.