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The Relationship Between Mental Health and Substance
Abuse Among Adolescents
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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is constructed by combining scores for the Withdrawn, Somatic Problems, and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| Withdrawn |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Withdrawn |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 |
|
|
|
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Mood change |
| |
|
Sad |
|
|
|
|
Talks too
much |
| |
|
Worried |
|
|
|
|
Teases |
| |
|
|
|
|
|
|
Temper |
| |
|
|
|
|
|
|
Threatens
others |
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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.
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