Nurturant-Involved Parenting and Adolescent Substance Use: Examining an Internalizing Pathway through Adolescent Social Anxiety Symptoms and Substance Refusal Efficacy

Introduction: Considerable research has linked parenting behaviors to adolescent substance use, finding both direct and indirect effects. Most studies of indirect effects have examined the effects of parenting on adolescent deviant behaviors. A developmental psychopathology framework emphasizes that individuals may follow different pathways to reach similar outcomes. Consistent with this perspective, more recent research also has examined internalizing pathways to substance use, suggesting that internalizing problems predict substance use through effects on coping motives, expectations, and/or interpersonal skill deficits. Guided by these perspectives, this study examines whether adolescent social anxiety symptoms (SAS) and substance refusal efficacy mediate associations between nurturant-involved parenting and adolescent substance use over time.

Methods: Data were utilized from a large longitudinal study aimed at reducing adolescent substance use. This study utilized a subsample of two-parent families (n = 687). Data were collected via parent and adolescent report and were analyzed using latent growth modeling. Intercepts reflected substance use during 8^th grade, and the slope reflected the linear rate of change (8^th to 12^th grades). Adolescent drunkenness and alcohol, cigarette, and marijuana use were examined in separate models.

Results: Across models, lower nurturant-involved parenting (Fall 6^th grade) was associated with increased adolescent SAS (Fall to Spring 6^th grade). In turn, increased SAS were associated with decreased adolescent refusal efficacy (6^th to 7^th grades). Decreased refusal efficacy was associated with greater drunkenness and alcohol, cigarette, and marijuana use during 8^th grade. Refusal efficacy was not significantly associated with in growth substance use over time.

Conclusions: The results expand beyond deviance models of substance use and demonstrate the role of adolescent SAS and refusal efficacy in adolescent substance use. The results suggest that internalizing pathways might be particularly relevant for early substance use but not growth over time. Prevention efforts that target substance use should expand beyond deviant models. Prevention efforts might help socially anxious adolescents reduce their social fears and develop the necessary interpersonal skills and confidence to refuse substances when offered by friends.