Skip to main content

Advertisement

Log in

Gender differences in associations between depressive symptoms and patterns of substance use and risky sexual behavior among a nationally representative sample of U.S. adolescents

  • Original contribution
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Summary

Objective: This study uses a cluster analysis of adolescents, based on their substance use and sexual risk behaviors, to 1) examine associations between risk behavior patterns and depressive symptoms, stratified by gender, and 2) examine gender differences in risk for depression.

Methods: Data are from a nationally representative survey of over 20,000 U.S. adolescents. Logistic regression was used to examine the associations between 16 risk behavior patterns and current depressive symptoms by gender.

Results: Compared to abstention, involvement in common adolescent risk behaviors (drinking, smoking, and sexual intercourse) was associated with increased odds of depressive symptoms in both sexes. However, sex differences in depressive symptoms vary by risk behavior pattern. There were no differences in odds for depressive symptoms between abstaining male and female adolescents (OR = 1.07, 95% CI 0.70–1.62). There were also few sex differences in odds of depressive symptoms within the highest-risk behavior profiles. Among adolescents showing light and moderate risk behavior patterns, females experienced significantly more depressive symptoms than males.

Conclusions: Adolescents who engage in risk behaviors are at increased risk for depressive symptoms. Girls engaging in low and moderate substance use and sexual activity experience more depressive symptoms than boys with similar behavior. Screening for depression is indicated for female adolescents engaging in even experimental risk behaviors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • S Allison L Roeger G Martin J Keeves (2001) ArticleTitleGender differences in the relationship between depression and suicidal ideation in young adolescents Aust N Z J Psychiatry 35 IssueID4 498–503 Occurrence Handle10.1046/j.1440-1614.2001.00927.x Occurrence Handle1:STN:280:DC%2BD3MvovFGgsA%3D%3D Occurrence Handle11531732

    Article  CAS  PubMed  Google Scholar 

  • A Angold C Worthman EJ Costello (2003) Puberty and depression C Hayward (Eds) Gender differences in puberty Cambridge University Press Cambridge 137–164

    Google Scholar 

  • K Basen-Engquist EW Edmundson GS Parcel (1996) ArticleTitleStructure of health risk behavior among high school students J Consult Clin Psychol 64 IssueID4 764–775 Occurrence Handle10.1037/0022-006X.64.4.764 Occurrence Handle1:STN:280:DyaK28zps1antA%3D%3D Occurrence Handle8803367

    Article  CAS  PubMed  Google Scholar 

  • Bearman P, Jones J, Udry J (2003, last update on July 25, 2003). The National Study of Adolescent Health: Research Design, from www.cpc.unc.edu/projects/addhealth/design.html

  • LR Bergman (1998) A pattern-oriented approach to studying individual development – snapshots and processes RB Cairns LR Bergman J Kagan (Eds) Methods and models for studying the individual – essays in honor of Marian Radke-Yarrow Sage Thousand Oaks, CA 83–122

    Google Scholar 

  • SM Berman T Ozkaragoz EP Noble T Antolin C Sheen P Siddarth et al. (2003) ArticleTitleDifferential associations of sex and D2 dopamine receptor (DRD2) genotype with negative affect and other substance abuse risk markers in children of alcoholics Alcohol 30 IssueID3 201–210 Occurrence Handle10.1016/j.alcohol.2003.06.002 Occurrence Handle1:CAS:528:DC%2BD3sXnt1aqs7k%3D Occurrence Handle13679114

    Article  CAS  PubMed  Google Scholar 

  • L Born A Shea M Steiner (2002) ArticleTitleThe roots of depression in adolescent girls: Is menarche the key? Curr Psychiatry Rep 4 IssueID6 449–460 Occurrence Handle12441025

    PubMed  Google Scholar 

  • ND Brener JL Collins (1998) ArticleTitleCo-occurrence of health-risk behaviors among adolescents in the United States J Adolesc Health 22 IssueID3 209–213 Occurrence Handle10.1016/S1054-139X(97)00161-4 Occurrence Handle1:STN:280:DyaK1c7mt1Oguw%3D%3D Occurrence Handle9502008

    Article  CAS  PubMed  Google Scholar 

  • JS Brook P Cohen DW Brook (1998) ArticleTitleLongitudinal Study of Co-occurring Psychiatric Disorders and Substance Use J Am Acad Child Adolesc Psychiatry 37 IssueID3 322–330 Occurrence Handle10.1097/00004583-199803000-00018 Occurrence Handle1:STN:280:DyaK1c7otVWltQ%3D%3D Occurrence Handle9519638

    Article  CAS  PubMed  Google Scholar 

  • TL Brooks SK Harris JS Thrall ER Woods (2002) ArticleTitleAssociation of adolescent risk behaviors with mental health symptoms in high school students J Adolesc Health 31 IssueID3 240–246 Occurrence Handle10.1016/S1054-139X(02)00385-3 Occurrence Handle12225736

    Article  PubMed  Google Scholar 

  • V Burge M Felts T Chenier AV Parrillo (1995) ArticleTitleDrug use, sexual activity, and suicidal behavior in U.S. high school students J School Health 65 222–227 Occurrence Handle1:STN:280:DyaK28%2FktVynug%3D%3D Occurrence Handle7564284 Occurrence Handle10.1111/j.1746-1561.1995.tb03366.x

    Article  CAS  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (2002) Surveillance Summaries. MMWR Morb Mortal Wkly Rep 2202:51(No. SS-4).

  • InstitutionalAuthorNameCenters for Disease Control and Prevention (2004) ArticleTitleMethods of suicide among persons aged 10–19 years – United States, 1992–2001 MMWR Morb Mortal Wkly Rep 53 IssueID22 471–474

    Google Scholar 

  • RA Chambers JR Taylor MN Potenza (2003) ArticleTitleDevelopmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability Am J Psychiatry 160 IssueID6 1041–1052 Occurrence Handle10.1176/appi.ajp.160.6.1041 Occurrence Handle12777258

    Article  PubMed  Google Scholar 

  • AB Elster (1998) ArticleTitleComparison of recommendations for adolescent clinical preventive services developed by national organizations Arch Pediatr Adolesc Med 152 IssueID2 193–198 Occurrence Handle1:STN:280:DyaK1c7ltFOnug%3D%3D Occurrence Handle9491048

    CAS  PubMed  Google Scholar 

  • C Esposito-Smythers A Spirito (2004) ArticleTitleAdolescent substance use and suicidal behavior: a review with implications for treatment research Alcohol Clin Experiment Res 28 IssueID5 77S–88S Occurrence Handle10.1097/01.ALC.0000127417.99752.87

    Article  Google Scholar 

  • AD Farrell SJ Danish CW Howard (1992) ArticleTitleRelationship between drug use and other problem behaviors in urban adolescents J Consult Clin Psychol 60 IssueID5 705–712 Occurrence Handle10.1037/0022-006X.60.5.705 Occurrence Handle1:STN:280:DyaK3s%2FhslalsQ%3D%3D Occurrence Handle1401386

    Article  CAS  PubMed  Google Scholar 

  • M Feldman A Wilson (1997) ArticleTitleAdolescent suicidality in urban minorities and its relationship to conduct disorders, depression, and separation anxiety J Am Acad Child Adolesc Psychiatry 36 IssueID1 75–84 Occurrence Handle10.1097/00004583-199701000-00021 Occurrence Handle1:STN:280:DyaK2s7ltlymsQ%3D%3D Occurrence Handle9000784

    Article  CAS  PubMed  Google Scholar 

  • DM Fergusson MT Lynskey (1995) ArticleTitleChildhood circumstances, adolescent adjustment, and suicide attempts in a New Zealand birth cohort J Am Acad Child Adolesc Psychiatry 34 IssueID5 612–622 Occurrence Handle10.1097/00004583-199505000-00013 Occurrence Handle1:STN:280:DyaK2M3ptlyruw%3D%3D Occurrence Handle7775356

    Article  CAS  PubMed  Google Scholar 

  • X Ge RD Conger GH Elder SuffixJr (2001) ArticleTitlePubertal transition stressful life events, and the emergence of gender differences in adolescent depressive symptoms Dev Psychol 37 IssueID3 404–417 Occurrence Handle10.1037/0012-1649.37.3.404 Occurrence Handle1:STN:280:DC%2BD38%2FhtVKnug%3D%3D Occurrence Handle11370915

    Article  CAS  PubMed  Google Scholar 

  • E Goodman J Capitman (2000) ArticleTitleDepressive symptoms and cigarette smoking among teens Pediatrics 106 IssueID4 748–755 Occurrence Handle10.1542/peds.106.4.748 Occurrence Handle1:STN:280:DC%2BD3cvmslansg%3D%3D Occurrence Handle11015518

    Article  CAS  PubMed  Google Scholar 

  • DD Hallfors MW Waller CA Ford CT Halpern PH Brodish B Iritani (2004) ArticleTitleAdolescent depression and suicide risk: association with sex and drug behavior Am J Prev Med 27 IssueID3 224–231 Occurrence Handle15450635

    PubMed  Google Scholar 

  • DD Hallfors MW Waller D Bauer CA Ford CT Halpern (2005) ArticleTitleWhich comes first in adolescence – Sex and drugs or depression? Am J Prev Med 29 IssueID3 163–170 Occurrence Handle10.1016/j.amepre.2005.06.002 Occurrence Handle16168864

    Article  PubMed  Google Scholar 

  • CT Halpern DD Hallfors D Bauer B Iritani MW Waller H Cho (2004) ArticleTitleImplications of racial and gender differences in patterns of adolescent risk behavior for sexually transmitted diseases and HIV Perspect Sexual Reprod Health 36 IssueID6 239–247 Occurrence Handle10.1363/3623904

    Article  Google Scholar 

  • KM Harris (1999) The health status and risk behavior of adolescents in immigrant families D Hernandez (Eds) Children of immigrants: Health, Adjustments, and public assistance National Academy Press Washington, DC 286–347

    Google Scholar 

  • R Jessor (1991) ArticleTitleRisk behavior in adolescence: a psychosocial framework for understanding and action J Adolesc Health 12 597–605 Occurrence Handle10.1016/1054-139X(91)90007-K Occurrence Handle1:STN:280:DyaK387ptVWqug%3D%3D Occurrence Handle1799569

    Article  CAS  PubMed  Google Scholar 

  • Johnston LD, O’Malley PM, Bachman JG (2003) Monitoring the future national results on adolescent drug use: Overview of key findings, 2002. NIH Publication No. 03-5374. National Institute on Drug Abuse, Bethesda, MD.

  • R Kaltiala-Heino E Kosunen M Rimpela (2003) ArticleTitlePubertal timing, sexual behaviour and self-reported depression in middle adolescence J Adolesc 26 IssueID5 531–545 Occurrence Handle10.1016/S0140-1971(03)00053-8 Occurrence Handle12972267

    Article  PubMed  Google Scholar 

  • PM Lewinsohn P Rohde JR Seeley (1993) ArticleTitlePsychosocial characteristics of adolescents with a history of suicide attempt J Am Acad Child Adolesc Psychiatry 32 IssueID1 60–68 Occurrence Handle1:STN:280:DyaK3s7lsV2qtQ%3D%3D Occurrence Handle8428885

    CAS  PubMed  Google Scholar 

  • PM Lewinsohn JR Seeley J Hibbard P Rohde WH Sack (1996) ArticleTitleCross-sectional and prospective relationships between physical morbidity and depression in older adolescents J Am Acad Child Adolesc Psychiatry 35 IssueID9 1120–1129 Occurrence Handle10.1097/00004583-199609000-00009 Occurrence Handle1:STN:280:DyaK28vitFertA%3D%3D Occurrence Handle8824055

    Article  CAS  PubMed  Google Scholar 

  • PM Lewinsohn P Rohde JR Seeley (1998) ArticleTitleMajor depressive disorder in older adolescents: prevalence, risk factors, and clinical implications Clin Psychol Rev 18 IssueID7 765–794 Occurrence Handle10.1016/S0272-7358(98)00010-5 Occurrence Handle1:STN:280:DyaK1M%2FksVGksg%3D%3D Occurrence Handle9827321

    Article  CAS  PubMed  Google Scholar 

  • LD Lindberg S Boggess S Williams (2000) Multiple threats: The co-occurrence of teen health risk-behaviors U.S. Department of Health and Human Services Washington, DC

    Google Scholar 

  • A MacKay L Fingerhut C Duran (2000) Adolescent health chartbook Health, United States, 2000. National Center for Health Statistics Hyattsville, MD

    Google Scholar 

  • D Magnusson (1998) The logic and implications of a person-oriented approach RB Cairns LR Bergman J Kagan (Eds) Methods and models for studying the individual. Essays in honor of Marian Radke-Yarrow Sage Thousand Oaks, CA 33–64

    Google Scholar 

  • D Neumark-Sztainer M Story S French N Cassuto DR Jacobs SuffixJr MD Resnick (1996) ArticleTitlePatterns of health-compromising behaviors among Minnesota adolescents: sociodemographic variations Am J Publ Health 86 IssueID11 1599–1606 Occurrence Handle1:STN:280:DyaK2s%2Fntl2kug%3D%3D Occurrence Handle10.2105/AJPH.86.11.1599

    Article  CAS  Google Scholar 

  • L Radloff (1977) ArticleTitleThe CES-D Scale: A self-report depression scale for research in the general population Appl Psychol Measurement 1 385–401

    Google Scholar 

  • U Rao ND Ryan RE Dahl B Birmaher R Rao DE Williamson et al. (1999) ArticleTitleFactors associated with the development of substance use disorder in depressed adolescents J Am Acad Child 38 IssueID9 1109–1117 Occurrence Handle10.1097/00004583-199909000-00014 Occurrence Handle1:STN:280:DyaK1MvjsVChug%3D%3D

    Article  CAS  Google Scholar 

  • RE Roberts PM Lewinsohn JR Seeley (1991) ArticleTitleScreening for adolescent depression: a comparison of depression scales J Am Acad Child Adolesc Psychiatry 30 IssueID1 58–66 Occurrence Handle1:STN:280:DyaK3M7ntVWgsQ%3D%3D Occurrence Handle2005065

    CAS  PubMed  Google Scholar 

  • LA Shrier SJ Emans ER Woods RH DuRant (1997) ArticleTitleThe association of sexual risk behaviors and problem drug behaviors in high school students J Adolesc Health 20 IssueID5 377–383 Occurrence Handle10.1016/S1054-139X(96)00180-2 Occurrence Handle1:STN:280:DyaK2szhtFKksg%3D%3D Occurrence Handle9168385

    Article  CAS  PubMed  Google Scholar 

  • NG Stevens S Lyle (1994) ArticleTitleGuidelines for adolescent preventive services: a critical review J Am Board Fam Pract 7 IssueID5 421–430 Occurrence Handle1:STN:280:DyaK2M7gvFelsg%3D%3D Occurrence Handle7810358

    CAS  PubMed  Google Scholar 

  • RE Tarter (2002) ArticleTitleEtiology of adolescent substance abuse: a developmental perspective Am J Addict 11 IssueID3 171–191 Occurrence Handle10.1080/10550490290087965 Occurrence Handle12202010

    Article  PubMed  Google Scholar 

  • JM Townshend T Duka (2005) ArticleTitleBinge drinking, cognitive performance and mood in a population of young social drinkers Alcohol Clin Exp Res 29 IssueID3 317–325 Occurrence Handle10.1097/01.ALC.0000156453.05028.F5 Occurrence Handle15770105

    Article  PubMed  Google Scholar 

  • U.S. Department of Health and Human Services (1996) Mental health estimates from the 1994 National Household Survey on Drug Abuse (No. 15). U.S. Department of Health and Human Services, Washington, DC.

  • U.S. Preventive Services Task Force (2002) Screening for depression, Update, 2002 Release Agency for Health Care Research and Quality, Department of Health and Human Services, Washington, DC.

  • Udry JR, Hendrickson-Smith J (1999) (unpublished documentation). Carolina Population Center, The University of North Carolina at Chapel Hill.

  • TJ Wade J Cairney DJ Pevalin (2002) ArticleTitleEmergence of gender differences in depression during adolescence: national panel results from three countries J Am Acad Child Adolesc Psychiatry 41 IssueID2 190–198 Occurrence Handle10.1097/00004583-200202000-00013 Occurrence Handle11837409

    Article  PubMed  Google Scholar 

  • DW Zeigler CC Wang RA Yoast BD Dickinson MA McCaffree CB Robinowitz et al. (2005) ArticleTitleThe neurocognitive effects of alcohol on adolescents and college students Prev Med 40 IssueID1 23–32 Occurrence Handle10.1016/j.ypmed.2004.04.044 Occurrence Handle1:CAS:528:DC%2BD2cXpsVKiur8%3D Occurrence Handle15530577

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waller, M., Hallfors, D., Halpern, C. et al. Gender differences in associations between depressive symptoms and patterns of substance use and risky sexual behavior among a nationally representative sample of U.S. adolescents. Arch Womens Ment Health 9, 139–150 (2006). https://doi.org/10.1007/s00737-006-0121-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-006-0121-4

Navigation