title: Internalizing disorders and substance use disorders in youth: comorbidity, risk, temporal order, and implications for intervention.
abstract: This review examines the empirical literature on the relationship between internalizing disorders and substance use disorders (SUDs) in youth in terms of (a) comorbidity rates, (b) risk relationships, (c) temporal sequencing, and (d) implications for intervention. Findings from community and clinical samples suggest that comorbidity rates range from 9.0 to 47.9%. The majority of the evidence supports the temporal precedence of internalizing disorders before substance use disorders and a unidirectional risk model in which internalizing disorders increase risk for later substance use disorders. Implications of this relationship for interventions are considered, both in terms of treatment outcome for principal disorders and in terms of the potential "secondary benefit" of treating one disorder for preventing or reducing risk of the other. Finally, recommendations for future research on the relationship between internalizing disorders and SUDs in youth are discussed.
authors.affiliation: Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA 19122, United States. kelly.oneil@temple.edu
authors.forename: Kelly A
authors.initials: KA
authors.lastname: O'Neil
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Conner
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D012306:Risk; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult