Hostname: page-component-848d4c4894-pjpqr Total loading time: 0 Render date: 2024-06-25T13:31:10.942Z Has data issue: false hasContentIssue false

Interaction matters: Quantifying Conduct Problem × Depressive Symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample

Published online by Cambridge University Press:  08 November 2013

Julie Maslowsky*
University of Wisconsin, Madison
John E. Schulenberg
University of Michigan, Ann Arbor
Address correspondence and reprint requests to: Julie Maslowsky, University of Wisconsin, Madison, 707 WARF Building, 610 Walnut Street, Madison, WI 53726-2397; E-mail:


Substance use is a major contributor to morbidity and mortality among American adolescents. Conduct problems and depressive symptoms have each been found to be associated with adolescent substance use. Although they are highly comorbid, the role of the interaction of conduct problems and depressive symptoms in substance use is not clear. In national samples of 8th-, 10th-, and 12th-grade students from the Monitoring the Future study, latent moderated structural equation modeling was used to estimate the association of conduct problems, depressive symptoms, and their interaction to the use of alcohol (including binge drinking), cigarettes, and marijuana. Moderation by age and sex was tested. The interaction of conduct problems with depressive symptoms was a strong predictor of substance use, particularly among younger adolescents. With few exceptions, adolescents with high levels of both conduct problems and depressive symptoms used substances most frequently. Conduct problems were a strong positive predictor of substance use, and depressive symptoms were a weak positive predictor. Whereas conduct problems are often thought to be a primary predictor of substance use, this study revealed that depressive symptoms potentiate the relation of conduct problems to substance use. Therefore, substance use prevention efforts should target both depressive symptoms and conduct problems.

Regular Articles
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 5787.Google Scholar
Armstrong, T. D., & Costello, E. J. (2002). Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity. Journal of Consulting and Clinical Psychology, 70, 12241239. doi:10.1037/0022-006X.70.6.1224Google Scholar
Aseltine, R. H. Jr., Gore, S., & Colten, M. E. (1998). The co-occurrence of depression and substance abuse in late adolescence. Development and Psychopathology, 10, 549570. doi:10.1017/S0954579498001746Google Scholar
Bachman, J. G., Johnston, L. D., O'Malley, P. M., & Schulenberg, J. E. (2011). The Monitoring the Future project after thirty-seven years: Design and procedures (Monitoring the Future Occasional Paper No. 76). Ann Arbor, MI: University of Michigan Press.Google Scholar
Bonin, M. F., McCreary, D. R., & Sadava, S. W. (2000). Problem drinking behavior in two community-based samples of adults: Influence of gender, coping, loneliness, and depression. Psychology of Addictive Behaviors, 14, 151161.Google Scholar
Brook, J. S., Zhang, C., & Brook, D. W. (2011). Developmental trajectories of marijuana use from adolescence to adulthood: Personal predictors. Archives of Pediatrics & Adolescent Medicine, 165, 5560.Google Scholar
Capaldi, D. M. (1991). Co-occurrence of conduct problems and depressive symptoms in early adolescent males: I. Familial factors and general adjustment at Grade 6. Development and Psychopathology, 3, 277300. doi:10.1017/S0954579400005319Google Scholar
Capaldi, D. M. (1992). Co-occurrence of conduct problems and depressive symptoms in early adolescent males: II. A 2-year follow-up at Grade 8. Development and Psychopathology, 4, 125144. doi:10.1017/S0954579400005605Google Scholar
Capaldi, D. M., & Stoolmiller, M. (1999). Co-occurrence of conduct problems and depressive symptoms in early adolescent males: III. Prediction to young-adult adjustment. Development and Psychopathology, 11, 5984. doi:10.1017/S0954579499001959CrossRefGoogle ScholarPubMed
Chen, R., & Simons-Morton, B. (2009). Concurrent changes in conduct problems and depressive symptoms in early adolescents: A developmental person-centered approach. Development and Psychopathology, 21, 285307. doi:10.1017/S0954579409000169Google Scholar
Cicchetti, D., & Rogosch, F. A. (1999). Psychopathology as risk for adolescent substance use disorders: A developmental psychopathology perspective. Journal of Clinical Child Psychology, 23, 355365. doi:10.1207/S15374424jccp280308Google Scholar
Cohen, P., Cohen, J., Kasen, S., & Velez, C. N. (1993). An epidemiological study of disorders in late childhood and adolescence: I. Age- and gender-specific prevalence. Journal of Child Psychology and Psychiatry, 34, 851867. doi:10.1111/j.1469-7610.1993.tb01094.xGoogle Scholar
Costello, E. J., Erkanli, A., Federman, E., & Angold, A. (1999). Development of psychiatric comorbidity with substance abuse in adolescents: Effects of timing and sex. Journal of Clinical Child Psychology, 28(3), 298311. doi:10.1207/S15374424jccp280302Google Scholar
Crosnoe, R. (2011). Fitting in, standing out: Navigating the social challenges of high school to get an education. New York: Cambridge University Press.CrossRefGoogle Scholar
DeWit, D. J., Adlaf, E. M., Offord, D. R., & Ogborne, A. C. (2000). Age at first alcohol use: A risk factor for the development of alcohol disorders. American Journal of Psychiatry, 157, 745750. doi:10.1176/appi.ajp.157.5.745Google Scholar
Dodge, K. A., Malone, P. S., Lansford, J. E., Miller, S., Pettit, G. S., & Bates, J. E. (2009). A dynamic cascade model of the development of substance-use onset. Monographs of the Society for Research in Child Development, 74, vii–119.Google ScholarPubMed
Ellickson, S. L., Tucker, J. S., Klein, D. J., & McGuigan, K. A. (2001). Prospective risk factors for alcohol misuse in late adolescence. Journal of Studies on Alcohol, 62, 773782.Google Scholar
Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1996). Origins of comorbidity between conduct and affective disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 451460. doi:10.1097/00004583-199604000-00011Google Scholar
Fite, P. J., Colder, C. R., & O'Connor, R. M. (2006). Childhood behavior problems and peer selection and socialization: Risk for adolescent alcohol use. Addictive Behaviors, 31, 14541459. doi:10.1016/j.addbeh.2005.09.015Google Scholar
Fleisher, W. P., & Katz, L. Y. (2001). Early onset major depressive disorder. Paediatrics & Child Health, 6, 444448.Google Scholar
Glantz, M. D., Anthony, J. C., Berglund, P. A., Degenhardt, L., Dierker, L., Kalaydjian, A., et al. (2009). Mental disorders as risk factors for later substance dependence: Estimates of optimal prevention and treatment benefits. Psychological Medicine, 39, 13651377. doi:10.1017/S0033291708004510Google Scholar
Goodman, E., & Capitman, J. (2000). Depressive symptoms and cigarette smoking among teens. Pediatrics, 106, 748755.Google Scholar
Graham, K., Massak, A., Demers, A., & Rehm, J. (2007). Does the association between alcohol consumption and depression depend on how they are measured? Alcoholism, Clinical and Experimental Research, 31, 7888. doi:10.1111/j.1530-0277.2006.00274.xGoogle Scholar
Grant, B. F., & Dawson, D. A. (1997). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, 9, 103110. doi:10.1016/S0899-3289(97)90009-2Google Scholar
Hinshaw, S. P. (1987). On the distinction between attentional deficits/hyperactivity and conduct problems/aggression in child psychopathology. Psychological Bulletin, 101, 443463. doi:10.1037/0033-2909.101.3.443Google Scholar
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155. doi:10.1080/10705519909540118Google Scholar
Ingoldsby, E. M., Kohl, G. O., McMahon, R. J, & Lengua, L. (2006). Conduct problems, depressive symptomatology and their co-occurring presentation in childhood as predictors of adjustment in early adolescence. Journal of Abnormal Child Psychology, 34, 603621.Google Scholar
Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Monitoring the Future national results on drug use, 1975–2012: Vol. 1. Secondary school students. Ann Arbor, MI: University of Michigan, Institute for Social Research.Google Scholar
Keenan, K., Wroblewski, K., Hipwell, A., Loeber, R., & Stouthamer-Loeber, M. (2010). Age of onset, symptom threshold, and expansion of the nosology of conduct disorder for females. Journal of Abnormal Psychology, 119, 689698. doi:10.1037/a0019346Google Scholar
Kenny, D. A., & Judd, C. M. (1984). Estimating the nonlinear and interactive effects of latent variables. Psychological Bulletin, 96, 201210. doi:10.1037/0033-2909.96.1.201Google Scholar
Klein, A., & Moosbrugger, H. (2000). Maximum likelihood estimation of latent interaction effects with the LMS method. Psychometrika, 65, 457474. doi:10.1007/BF02296338Google Scholar
Kline, R. B. (2004). Principles and practice of structural equation modeling (2nd ed.). New York: Guilford Press.Google Scholar
Kovacs, M., Paulauskas, S., Gatsonis, C., & Richards, C. (1988). Depressive disorders in childhood: III. A longitudinal study of comorbidity with and risk for conduct disorders. Journal of Affective Disorders, 15, 205217. doi:10.1016/0165-0327(88)90018-3Google Scholar
Lansford, J. E., Erath, S., Yu, T., Pettit, G. S., Dodge, K. A., & Bates, J. E. (2008). The developmental course of illicit substance use from age 12 to 22: Links with depressive, anxiety, and behavior disorders at age 18. Journal of Child Psychology and Psychiatry, 49, 877885. doi:10.1111/j.1469-7610.2008.01915.xGoogle Scholar
Larsen, H., Overbeek, G., Vermulst, A. A., Granic, I., & Engels, R. C. M. E. (2010). Initiation and continuation of best friends and adolescents' alcohol consumption: Do self-esteem and self-control function as moderators? International Journal of Behavioral Development, 34, 406416. doi:10.1177/0165025409350363Google Scholar
Mackie, C. J., Castellanos-Ryan, N., & Conrod, P. J. (2011). Personality moderates the longitudinal relationship between psychological symptoms and alcohol use in adolescents. Alcoholism: Clinical and Experimental Research, 35, 703716. doi:10.1111/j.1530-0277.2010.01388.xGoogle Scholar
Maggs, J. L., & Schulenberg, J. E. (2005). Initiation and course of alcohol consumption among adolescents and young adults. In Galanter, M. (Ed.), Recent developments in alcoholism: Vol. 17. Alcohol problems in adolescents and young adults (pp. 2947). New York: Kluwer Academic/Plenum Press.Google Scholar
Marmorstein, N. R. (2010). Longitudinal associations between depressive symptoms and alcohol problems: The influence of comorbid delinquent behavior. Addictive Behaviors, 35, 564571. doi:10.1016/j.addbeh.2010.01.004Google Scholar
Marmorstein, N. R., & Iacono, W. G. (2001). An investigation of female adolescent twins with both major depression and conduct disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 299306. doi:10.1097/00004583-200103000-00009Google Scholar
Marmorstein, N. R., & Iacono, W. G. (2003). Major depression and conduct disorder in a twin sample: Sex, functioning, and risk for future psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 225233. doi:10.1097/00004583-200302000-00017Google Scholar
Marsh, H. W., Wen, Z., Hau, K.-T., Little, T. D., Bovaird, J. A., & Widaman, K. F. (2007). Unconstrained structural equation models of latent interactions: Contrasting residual- and mean-centered approaches. Structural Equation Modeling, 14, 570580.Google Scholar
Maslowsky, J., Schulenberg, J., O'Malley, P., & Kloska, D. (2013). Depressive symptoms, conduct problems, and risk for polysubstance use among adolescents: Results from US national surveys, mental health and substance use. Manuscript submitted for publication.Google Scholar
Mason, C. A. (2003). Developmental epidemiology: Issues, application, and relevance for clinical child psychologists. Journal of Clinical Child and Adolescent Psychology, 32, 178180. doi:10.1207/S15374424JCCP3202_1Google Scholar
Mason, W. A., Hitchings, J. E., & Spoth, R. L. (2008). The interaction of conduct problems and depressed mood in relation to adolescent substance involvement and peer substance use. Drug and Alcohol Dependence, 96, 233248. doi:10.1016/j.drugalcdep.2008.03.012Google Scholar
McCaffery, J. M., Papandonatos, G. D., Stanton, C., Lloyd-Richardson, E. E., & Niaura, R. (2008). Depressive symptoms and cigarette smoking in twins from the National Longitudinal Study of Adolescent Health. Health Psychology, 27(Suppl. 3), S207S215. doi:10.1037/0278-6133.27.3(Suppl.).S207Google Scholar
McMahon, R. J. (1999). Child and adolescent psychopathology as risk factors for subsequent tobacco use. Nicotine & Tobacco Research, 1, S45S50.Google Scholar
Merline, A., Jager, J., & Schulenberg, J. E. (2008). Adolescent risk factors for adult alcohol use and abuse: Stability and change of predictive value across early and middle adulthood. Addiction, 103(Suppl. 1), 8499. doi:10.1111/j.1360-0443.2008.02178.xGoogle Scholar
Miller-Johnson, S., Lochman, J. E., Coie, J. D., Terry, R., & Hyman, C. (1998). Comorbidity of conduct and depressive problems at sixth grade: Substance use outcomes across adolescence. Journal of Abnormal Child Psychology, 26, 221232. doi:10.1023/A:1022676302865Google Scholar
Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674701. doi:10.1037/0033-295X.100.4.674Google Scholar
Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291, 12381245. doi:10.1001/jama.291.10.1238Google Scholar
Mooijaart, A., & Bentler, P. (2010). An alternative approach for nonlinear latent variable models. Structural Equation Modeling, 17, 357373. doi:10.1080/10705511.2010.488997Google Scholar
Mooijaart, A., & Satorra, A. (2009). On insensitivity of the chi-square model test to nonlinear misspecification in structural equation models. Psychometrika, 74, 443455.Google Scholar
Muthén, L., & Muthén, B. (1998–2010). Mplus user's guide (6th ed.). Los Angeles, CA: Author.Google Scholar
Pardini, D., White, H. R., & Stouthamer-Loeber, M. (2007). Early adolescent psychopathology as a predictor of alcohol use disorders by young adulthood. Drug and Alcohol Dependence, 88, S38S49. doi:10.1016/j.drugalcdep.2006.12.014Google Scholar
Patrick, M. E., & Schulenberg, J. E. (2011). How trajectories of reasons for alcohol use relate to trajectories of binge drinking: National panel data spanning late adolescence to early adulthood. Developmental Psychology, 47, 311317. doi:10.1037/a0021939Google Scholar
Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.Google Scholar
Reboussin, B. A., Hubbard, S., & Ialongo, N. S. (2007). Marijuana use patterns among African-American middle-school students: A longitudinal latent class regression analysis. Drug and Alcohol Dependence, 90, 1224. doi:10.1016/j.drugalcdep.2007.02.006Google Scholar
Rushton, J. L., Forcier, M., & Schectman, R. M. (2002). Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 199205. doi:10.1097/00004583-200202000-00014Google Scholar
Satorra, A., & Bentler, P. M. (2010). Ensuring positiveness of the scaled difference chi-square test statistic. Psychometrika, 75, 243248. doi:10.1007/s11336-009-9135-yGoogle Scholar
Schulenberg, J., Bachman, J. G., O'Malley, P. M., & Johnston, L. D. (1994). High school educational success and subsequent substance use: A panel analysis following adolescents into young adulthood. Journal of Health and Social Behavior, 35, 4562. doi:10.2307/2137334Google Scholar
Schulenberg, J. E., & Zarrett, N. (2006). Mental health during emerging adulthood: Continuity and discontinuity in courses, causes, and functions. In Arnett, J. J. & Tanner, J. L. (Eds.), Emerging adults in America: Coming of age in the 21st century (pp. 135172). Washington, DC: American Psychological Association.Google Scholar
Spoth, R., Trudeau, L., Guyll, M., Shin, C., & Redmond, C. (2009). Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation. Journal of Consulting and Clinical Psychology, 77, 620632. doi:10.1037/a0016029Google Scholar
Sroufe, L. A. (1997). Psychopathology as an outcome of development. Development and Psychopathology, 9, 251268. doi:10.1017/S0954579497002046Google Scholar
Sung, M., Erkanli, A., Angold, A., & Costello, E. J. (2004). Effects of age at first substance use and psychiatric comorbidity on the development of substance use disorders. Drug and Alcohol Dependence, 75, 287299. doi:10.1016/j.drugalcdep.2004.03.013Google Scholar
Wagner, F. A., & Anthony, J. C. (2002). From first drug use to drug dependence: Developmental periods of risk for dependence upon marijuana, cocaine, and alcohol. Neuropsychopharmacology, 26, 479488. doi:10.1016/S0893-133X(01)00367-0Google Scholar
Weissman, M. M., Wolk, S., Wickramaratne, P., Goldstein, R. B., Adams, P., Greenwald, S., et al. (1999). Children with prepubertal-onset major depressive disorder and anxiety grown up. Archives of General Psychiatry, 56, 794801. doi:10.1001/archpsyc.56.9.794Google Scholar
Wolff, J. C., & Ollendick, T. H. (2006). The comorbidity of conduct problems and depression in childhood and adolescence. Clinical Child and Family Psychology Review, 9, 201220. doi:10.1007/s10567-006-0011-3Google Scholar
World Health Organization. (2008). WHO report on the global tobacco epidemic, 2008—The MPOWER package. Geneva: Author. Retrieved from Scholar
World Health Organization. (2011a). Global status report on alcohol and health 2011. Geneva: Author. Retrieved from Scholar
World Health Organization. (2011b). Alcohol fact sheet number 349. Geneva: Author. Retrieved from Scholar
Zoccolillo, M. (1992). Co-occurrence of conduct disorder and its adult outcomes with depressive and anxiety disorders: A review. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 547556. doi:10.1097/00004583-199205000-00024Google Scholar