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The Protective Impact of Social Support on the Cascade Rates Between Internalizing Problems and Alcohol Misuse in
Laila Volpe1, Daniel J O Roche2, Katherine T Foster3
1University of Washington, Department of Psychology, Seattle, Washington.
Purpose:
Alcohol misuse (i.e., frequent, heavy drinking) and internalizing problems (i.e., anxiety, depression) typically manifest in adolescence. Both follow cascading trajectories where presence of one confers risk for the other. Delaying or preventing the cascade allows more time and opportunity to address symptoms before consequences accumulate and disrupt development. One candidate moderator for their cascading trajectories is social support, which is independently negatively associated with both alcohol misuse and internalizing problems. We tested whether social support affects bidirectional cascade rates between alcohol misuse and internalizing problems from adolescence through adulthood.
Methods:
Time-to-event analysis was applied to 7 years of longitudinal National Consortium on Alcohol and NeuroDevelopment in Adolescence data (n = 730, 51.23% female, Mage = 16.44) to test whether between-person variation in social support delayed cascade rates between alcohol misuse markers (i.e., early, regular, heavy drinking) and internalizing problems.
Results:
Social support delayed the cascade rate (i.e., months to event) from each alcohol misuse marker to first internalizing episode (Mmonths = 40.13-56.19; Hazard ratios [HRs] = 0.12-0.42) and from first internalizing episode to first drink (Mmonths = 31.2; HR = 0.80). Social support protected boys from each alcohol misuse marker to first internalizing episode (Mmonths = 38.33-56.05; HRs = 0.11-0.32) but only protected girls from first binge drink to first internalizing episode (Mmonths = 49.66; HR = 0.34).
Discussion:
Social support delays cascade rates triggered by alcohol misuse markers and first internalizing episode and may have long-term protective benefits, especially for boys. Targeted social support prevention efforts at ages of onset may prevent later alcohol misuse and internalizing problems. Critically, future research must identify what factors delay cascading trajectories in girls.
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