The influence of substance use on depressive symptoms among young adult black men: The sensitizing effect of early adversity

Abstract

Background and objectives: Depressive symptoms have been identified as an important consequence of substance use. Both heavy drinking and marijuana use have acute and short-term effects on systems that regulate emotion, increasing the potential for substance use to induce problems with negative affect and irritability. We investigated the effects of alcohol and marijuana use on depressive symptoms among a sample of young Black men. We also tested the stress sensitization hypothesis that exposure to adverse childhood experiences would amplify the influence of substance use on men's depressive symptoms.

Methods: Hypotheses were tested with 505 rural Black men who, at ages 19-22 years, provided data on their substance use, adverse childhood experiences, and depressive symptoms; they provided data again 18 months later.

Results: Substance use forecasted increases in depressive symptoms; cross-lagged analyses yielded no evidence for the inverse path, depressive symptoms increasing substance use. The impact of substance use on depressive symptoms was amplified among young Black men who were exposed to adverse childhood experiences. Substance use did not significantly predict depressive symptoms when adversity was low.

Discussion and conclusions: Our findings suggest that, during young adulthood, substance use increases depressive symptoms among Black men who were exposed to childhood adversity. Because childhood adversity disproportionately affects Black men, these findings inform future cross-group research designed to investigate racial disparities in the consequences of substance use.

Scientific significance: Depressive symptoms may be understood as an effect as well as a cause of substance use, particularly among vulnerable young Black men. (Am J Addict 2017;26:400-406).

FIGURE 1

Second Order Confirmatory Factor Analysis of Depressive Symptoms Note. T1 model fit: χ² = 279.58, df= 113, P< .01, CFI= .95, RMSEA = .04; T2, model fit: χ² 287.08, df= 113, P< .01, CFI = .95, RMSEA = .04; **P <.01

FIGURE 2

Cross-lagged model of the links between substance use and depressive symptoms Note. χ² = 1431.69, df= 713, p < .01. RMSEA = .04. CFI = .95. Standardized coefficients are shown. Target age, educational level, employment status, economic stress, and incarceration at T1 were controlled. *P< .05. **P<.01