The Relationship Between Mental Health and Substance
Abuse Among Adolescents
3.6 Psychological
Functioning Among Adolescents
Table 3.2 presents information concerning
psychological functioning among adolescents. The percentages of adolescents
reporting significant emotional and behavioral problems are presented for different
age groups by gender. The measures of emotional problems and behavioral problems
which are the principal focus of Chapter 3 are based on the Achenbach YSR. The
Achenbach scales representing specific syndromes are presented in Figure 3-1
(and discussed further in Chapter 4). Syndromes in the YSR can be conceptualized
as reflecting either an internal or external expression of psychological functioning.
This distinction is consistent with influential theories characterizing adolescents
as Overcontrolled vs. Undercontrolled (Achenbach & Edelbrock, 1978); as
characterized by Inhibition vs. Aggression (Miller, 1967); and contrasting Personality
vs. Conduct Problems (Peterson, 1961). The measure of emotional problems ("Internalizing")
is constructed by combining scores for the Withdrawn, Somatic Problems, and
Anxious/Depressed scales. The measure of behavioral problems is
Figure 3-1 Syndrome
and Problem Scales of the Youth Self-Report
Withdrawn1
Somatic Complaints1
Anxious/
Depressed1
Social
Problems
Thought
Problems
Attention
Problems
Delinquent Behavior2
Aggressive Behavior2
Rather be alone
Dizzy
Lonely
Acts young
Can't get
mind off certain thoughts
Acts young
No guilt
Argues
Won't talk
Tired
Cries
Clings
Hears things
others don't
Concentrate
Hangs around
kids who get in trouble
Brags
Secretive
Aches
Harms self
Not get along
Repeats acts
Trouble sitting
still
Lies/cheats
Mean
Shy
Headaches
Fears might
think/do something bad
Teased
Sees things
others don't
Confused
Prefers to
be with older kids
Demands attention
Underactive
Nausea
Perfect
Not liked
Stores up
things
Daydreams
Runs away
Destroys property
Sad
Eye problems
Unloved
Clumsy
Strange behavior
Impulsive
Sets fires
Destroys others'
property
Withdrawn
Skin problems
Others out
to get them
Prefers younger
kids as friends
Strange ideas
Nervous
Steals from
home
Disobeys school
Stomach problems
Worthless
Withdrawn
Poor school
work
Steals from
outside
Jealous
Vomiting
Nervous
Clumsy
Swears
Fights
Fearful
Truant
Attacks
Guilty
Uses alcohol/drugs
Screams
Self-conscious
Show-off
Suspicious
Stubborn
Talks suicide
Mood change
Sad
Talks too
much
Worried
Teases
Temper
Threatens
others
Loud
1Emotional Problems [E]
sums up the scores on three syndrome scales: Withdrawn, Somatic Complaints,
and Anxious/Depressed.
2Behavioral Problems [B]
sums up the scores on two syndrome scales: Delinquent Behavior and Aggressive
Behavior.
constructed by combining scores for the
Delinquent and Aggressive Behavior scales ("Externalizing").6
The Achenbach scales and summary measures are described more extensively in
an earlier mental health report (SAMHSA, 1996).
The YSR syndromes and summary measures can
be evaluated for severity according to the following classification: normal,
borderline, or clinical. The borderline and clinical classifications indicate
the presence of significant problems. Table 3.2 presents the percentages of
adolescents who were in the borderline or clinical range for emotional and behavioral
problems. Among adolescents surveyed in the 1994-B-1995-1996 NHSDA, approximately
13 percent reported significant emotional problems as evidenced by measures
of withdrawal, somatic problems, anxiety, and depression (Emotional Problems).
Approximately 17 percent of the adolescents surveyed reported the behavioral
problems indicated by aggressive or delinquent behavior. Emotional and behavioral
problems were commonly reported even by very young adolescents. Among early
adolescents aged 12 to 13, emotional problems were reported by approximately
13 percent of males and 10 percent of females; behavioral problems were reported
by approximately 13 percent of males and 16 percent of females.
The percentage of males who reported
emotional problems was approximately 12 to 13 percent for all three age groups.
The percentage of females with significant emotional problems is 10 percent
among very young adolescents aged 12 to 13 and is approximately 16 percent
among older adolescents aged 14 to 17. The percentage of males with significant
behavioral problems is approximately 13 to 15 percent for all age groups.
The percentage of females with significant behavioral problems is 16 percent
among very young adolescents aged 12 to 13 and 22 percent among older adolescents
aged 14 to 17.
6 For this investigation
the delinquent behavior scale and the corresponding behavioral problem summary
measure were slightly modified. These measures were computed using all designated
YSR items except the drug use item in order to avoid spurious inflation
of associations due to content redundancy with the substance use measures. We
found the average scores on both the delinquent scale and the behavioral problem
summary scale to be lower when the drug use item was omitted, but the median scores
of both measures are nearly identical with and without the drug use item. Similarly,
for each of the two scales, the percentage of NHSDA adolescents scoring above
the Achenbach cutpoint is approximately the same regardless of whether the drug
use item is used. Thus, we did not change Achenbach's cutpoint for "borderline"
on either the delinquent scale or the behavioral summary scale, even though both
scales were modified by omitting the drug use item when we summed up the item
scores to produce the delinquent behavior scale and the behavioral problem summary
scale.
This page was last updated on August 05, 2008.
SAMHSA, an agency in the Department of Health and Human Services, is the Federal
Government's lead agency for improving the quality and availability of
substance abuse prevention, addiction treatment, and mental health
services in the United States.
