Family Influences Related to Adult Substance Use and Mental Health Problems: A Developmental Analysis of Child and Adolescent Predictors

Abstract

This study investigated measures of family conflict, family management, and family involvement at ages 10-12, 13-14, and 15-18 years as predictors of adult depression, anxiety, and substance use disorder symptoms classes at age 27. The objective was to assess the relative influence on adult outcomes of each family predictor measured similarly at different points in adolescent development. Data were obtained from the Seattle Social Development Project, a theory-driven longitudinal study that began in 1985, with 808 fifth-grade students from 18 Seattle public elementary schools. A latent class analysis of adult outcomes was followed by bivariate and multivariate models for each family predictor. Of the original 808 participants, 747 (92% of the original sample) had available data at age 27 on the mental health and substance use latent class indicators. Missing data were handled using full-information maximum likelihood estimation. Four latent classes were derived: a "low disorder symptoms" class, a "licit substance use disorder symptoms" class, a "mental health disorder symptoms" class, and a "comorbid" class. Multivariate results show that family conflict is the strongest and most consistent predictor of the adult mental health and substance use classes. Family management, but not family involvement, was also predictive of the adult outcome classes. It is important to lessen family conflict and improve family management to prevent later mental health and substance use problems in adulthood.