Does the Direction of Effects in the Association Between Depressive Symptoms and Health-Risk Behaviors Differ by Behavior? A Longitudinal Study Across the High School Years
Adolescence is associated with the onset of depressive symptoms as well as significant increases in health-risk behaviors. Potential explanations for the direction of effects in the association between depressive symptoms and health-risk behaviors include the self-medication/acting out hypothesis and the failure hypothesis. In this longitudinal study, the authors assessed these competing hypotheses in a sample of 4,412 adolescents who were followed from grade nine to 12. Adolescents reported on their depressive symptoms and six health-risk behaviors: frequency of alcohol use, amount of alcohol consumed per drinking episode, cigarette smoking, marijuana use, hard drug use, and delinquency. Analyses were conducted with dual trajectory growth curve modeling. Adolescents who had higher levels of depressive symptoms in grade nine reported faster increases than their peers in smoking, marijuana, and hard drug use across the high school years, supporting the self-medication hypothesis. The failure hypothesis was not supported. The results suggest that targeting depressive symptoms during early adolescence may help prevent increases in the frequency of these risk behaviors later in adolescence. Modified Author Abstract.