Every parent worries that his or her child may turn to drugs, or worse, become dependent on them, and a new Florida State University study indicates that parents of boys who have very low self-esteem and have friends who approve of drug and alcohol use may have good cause to worry.
FSU sociology professors John Taylor and Donald Lloyd, along with University of Miami professor emeritus George Warheit, found that low self-esteem and peer approval of drug use at age 11 predicted drug dependency at age 20. The researchers came to that conclusion after analyzing data from a multiethnic sample of 872 boys collected over a period of nine years. The study was published in the Journal of Child and Adolescent Substance Abuse.
"Low self-esteem is kind of the spark plug for self-destructive behaviors, and drug use is one of these," Taylor said. "It's a fundamental need to have a good sense of self. Without it, people may become pathologically unhappy with themselves, and that can lead to some very serious problems."
Children with very low self-esteem, or what the researchers called self-derogation, were 1.6 times more likely to meet the criteria for drug dependence nine years later than other children. The researchers also found that early drug use is an important risk factor in drug dependence. The odds of drug dependence among early drug users were 17.6 times greater than among those who had not tried drugs by age 13. Put another way, 37 percent of those who reported using drugs at age 13 later met criteria for drug dependence, compared to only 3 percent of those who had not tried drugs by 13.
The findings underscore the importance of identifying children with low self-esteem for prevention and early intervention efforts before they reach ages that are associated with initial experimentation with drugs, Taylor said.
"The fact that you can identify a group of people who are at risk for problematic behaviors is very important," Taylor said. "If you can intervene on a group of people before they begin drug use or embark on a cycle of addiction, that could have huge health benefits."
A simple questionnaire such as the one the researchers used could help parents and teachers identify at-risk kids, Taylor said.
"If you're a parent of a young child and you notice that the child has very low self-esteem, that should be a warning signal that this child needs some attention or perhaps professional counseling," he said, adding that intervention needs to go beyond the feel-good efforts of the self-esteem movement of a decade ago.
To test self-derogation, the boys were asked to rate the truthfulness of statements such as, "In general I feel I am a failure" and "I don't like myself as much as I used to." They also were asked to rate the level of approval their close friends had for people who smoked marijuana or cigarettes, used cocaine or drank alcohol.
By the time the study participants were 20 years old, nearly 64 percent had used drugs, and 10 percent of those drug users had developed a drug dependency as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The manual defines dependence as someone who exhibits three or more symptoms, such as failing attempts to quit using drugs, giving up important activities like work, sports or seeing family or friends in order to get or use drugs, and using increasingly larger amounts of a chosen drug or for a greater period of time than intended when the drug use began.
The study sample was randomly drawn from a census of students in the Miami-Dade County school system. Data were first gathered when the participants were in either sixth or seventh grade; the subjects were then interviewed three more times over a nine-year period, with the final follow-up when most were between 19 and 21 years old.
The researchers did not include female students in this study, and Taylor cautioned against generalizing the findings to girls. Studies show low self-esteem in girls typically manifests itself in depression and eating disorders rather than substance abuse.