Social and generalized anxiety symptoms and alcohol and cigarette use in early adolescence: The moderating role of perceived peer norms

This study prospectively examines the association between social and generalized anxiety symptoms and alcohol and cigarette use in early adolescence and how injunctive (perceived peer approval of use) and descriptive (perceived peer use) norms may moderate the association. Sex differences were also examined. Data were taken from a longitudinal study investigating problem behavior and adolescent substance use. The community sample (N = 387) was assessed annually, and data from the first two waves of assessment were used for this study. Early adolescents were between the ages of 11 and 13 at the first assessment (mean age = 11.05, SD = 0.55, 55% female). Peer norms moderated the association between both social and generalized anxiety symptoms and the likelihood of alcohol and cigarette use for girls, but not for boys. Specifically, girls with elevated levels of generalized anxiety symptoms were at risk for use when perceived peer use was low, and protected from use when perceived peer use was high. Girls with elevated levels of social anxiety symptoms were at risk for use when perceived peer approval of use was high, and protected from use when perceived peer approval of use was low. Past studies have found inconsistent support for an association between anxiety and adolescent substance use, and our findings provide some clarity regarding for whom and when anxiety operates as a risk/protective factor. Social context and sex are critical for understanding the role of different forms of anxiety in the etiology of adolescent alcohol and cigarette use.

► We examine pathways from social and generalized anxiety to substance use.
► Peer norms and sex were tested as moderators in a sample of early adolescents.
► Social anxiety is a risk factor for girls when perceived peer approval is high.
► Generalized anxiety is a risk factor for girls when perceived peer use is low.
► Distinguishing different forms of anxiety and norms clarifies sex-specific risk.