Prevention Science, Vol. 7, No. 2, June 2006 (
Mediators of the Stress–Substance–Use Relationship
in Urban Male Adolescents
Diana H. Fishbein,
Mallie J. Paschall,
and Nicholas Ialongo
Published online: 3 May 2006
Exposure to chronic or severe acute stressors throughout the lifespan has been linked with
numerous negative behavioral, emotional, cognitive, and physical consequences. Adoles-
cence is considered to be a particularly vulnerable period given that the brain is experiencing
dramatic developmental change during this time. The present study examined a sample of
adolescents (N = 125) considered to be at high risk for stress exposures and drug use by virtue
of their environment and low income levels to identify possible neurocognitive (i.e., impulsiv-
ity, delay of gratiﬁcation, emotional perception, and risky decision-making) and social compe-
tency mechanisms that may mediate this relationship. Using Mplus, a mediational model was
tested using full information maximum likelihood estimates. Risky decision-making and poor
social competency skills were related to previous stressful experiences; however, only social
competencies mediated the effect of stressors on reports of past year marijuana, alcohol, and
polydrug use. As such, stress appears to exert its negative impact through alterations in abil-
ities to generate and execute prosocial decisions and behaviors. Interventions that directly
address the effects of stress on social competencies may be especially important for children
who have experienced adversity including those exposed to parental divorce, parental psy-
chopathology, neglect or abuse, parental death, and poverty.
KEY WORDS: stress; substance use; executive cognitive function; social competency; adolescence.
Exposure to signiﬁcant stressors during child-
hood and adolescence has been linked to a number of
negative behavioral outcomes (Compas et al., 2001).
Stressors refer to environmental circumstances or
Behavioral Health Research Division, RTI International,
Behavioral Health Research Division, RTI International, Re-
search Triangle Park, North Carolina.
Prevention Research Center, Paciﬁc Institute for Research and
Evaluation, Berkeley, California.
BioAssessments, LLC, Elkton, Maryland.
Technology Assisted Learning Division, RTI International,
Research Triangle Park, North Carolina.
Bloomberg School of Public Health, Johns Hopkins University,
Correspondence should be directed to Diana H. Fishbein
, RTI International, 6801 Eastern Avenue, Suite 203 Baltimore,
Maryland 21224; e-mail: dﬁshbein@rti.org.
conditions that threaten, harm, challenge, or exceed
the psychological or biological capacities of an indi-
vidual to cope, thereby inducing stress (Cohen et al.,
1996). Severe or chronic stressors appear to increase
propensity for psychopathology, including the initi-
ation and progression of substance abuse (Fishbein,
2000a; Newcomb & Bentler, 1988; Wills et al., 1996).
Negative life events have been associated with the
quantity and frequency of alcohol use, alcohol-
related problems, and heavy drinking, while cumu-
lative family stress has been associated with high
alcohol abuse scores (Barrera et al., 1993; Johnson
& Pandina, 1993; Windle, 1992). Moreover, negative
life events predict escalation of tobacco and mari-
juana use (Hoffman et al., 2000; Wills et al., 2002).
Stress may exert its impact directly on
substance-use behaviors or indirectly through
altering the cognitive, affective, and social com-
petency processes that underlie behavior (Sinha,
2006 Society for Prevention Research