Peer Victimization, Internalizing Problems, and Substance Use in Urban African American Adolescents in Chicago: The Relevance of the Self-Medication Hypothesis

Background: Reducing the rate of bullying and substance use are important behavioral health priorities. For adolescents in impoverished urban areas, violence is a serious concern. Research has documented urban adolescents’ exposure to serious forms of violence (e.g., homicide). Fewer studies have explored “less serious” violence in urban areas, such as peer victimization. Experiences in peer victimization can contribute to serious health problems, including depression, anxiety, and suicidal thoughts and behavior. In addition, a large body of the research has documented that peer victimized youth turn to substances as a coping mechanism, consistent with the idea that one will utilize substances to alleviate negative emotions or pain, rather using a healthier alternative. The aim of the present study is to explore the mediating role of internalizing problems in the association between peer victimization and substance use from a sample of urban African American adolescents in Chicago.       

Method: The Resilience Project was a cross-sectional research comprising of a purposive sample of mostly low-income African American youth, conducted between August of 2013 and January of 2014 in Chicago’s Southside. The total sample size was 638 African American youth, ages 13 to 24. Measures include peer victimization, substance use, internalizing problems, sex, age, and family substance use. A series of analyses were performed to examine the mediating effects of internalizing problems on the relationship between peer victimization and adolescent substance use, including the hierarchical linear regression. The mediational hypothesis tested was that urban African American adolescents who experienced peer victimization were more likely to have internalizing problem, and those who have internalizing problems are at a higher risk of substance use. Finally, it was hypothesized that once the relationship between internalizing problem and substance use was accounted for, there would be a weaker relationship between peer victimization and substance use.

Results: First, peer victimization was associated with substance use, after controlling for covariates. Second, the result also indicated a significant relationship between peer victimization and internalizing problems. Third, the strength of the relationship between peer victimization and substance use was significantly reduced when internalizing problem was added to the model. Therefore, internalizing problems partially mediated the effect of peer victimization on substance use. The Sobel test also supported the finding of the mediating effect.

Conclusion and Implications: The present study findings suggest that substance use rarely exists in a vacuum, as there are often factors that need to be considered. Consistent with the self-medication hypothesis, although the association between peer victimization and substance use have been found in the empirical literature, rarely do youths who experience victimization immediately turn to drugs. Rather, bullied youths are likely follow complex pathways, experiencing psychosocial problems before turning to drugs as a coping mechanism. If mental health practitioners in the school setting are to effectively address the needs of their clients, they must look beyond addressing the presenting problem exclusively. They also need to consider the relationships between the presenting problems and contributing factors, which would ultimately contribute to a more effective treatment plans in schools.