Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls

Jessica L. Schleider, Feifei Ye, Frances Wang, Alison E. Hipwell, Tammy Chung, Carolyn E. Sartor*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background: Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence—particularly in girls. However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem–alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls. Methods: Data were drawn from a population-based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self-reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth-report) as covariates. Anxiety and depression severity were included within a single cross-lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior. Results: Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated. Conclusions: Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.

Original languageEnglish (US)
Pages (from-to)98-107
Number of pages10
JournalAlcoholism: Clinical and Experimental Research
Issue number1
StatePublished - Jan 2019


  • Adolescence
  • Alcohol Use
  • Anxiety
  • Depression
  • Longitudinal

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health


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