title: Tobacco, Alcohol, and Drug Use of People With Mood and Anxiety Disorders: Differential Impact of Family and Friends.
abstract: OBJECTIVE
  Substance use among people with mood and anxiety disorders is highly prevalent. The literature suggests that substance use among people with mood and anxiety disorders is linked to social relational factors, yet it has rarely been the case that studies explicitly examine the differential impact of family and friends. This study investigated the association among family relationships, friendships, and substance use among people with mood and anxiety disorders.
  
  
  METHODS
  Using the National Survey of American Life, structural equation modeling tested the unique effects of family relationships and friendships on tobacco, alcohol, and drug use (n = 1,076). The quality of family relationships was assessed using 12 items on the frequency of contact with family, received help from family, closeness in feeling toward family, and emotional support from family. The quality of friendships was assessed using four items on the frequency of contact with friends, received and given help, and closeness in feeling toward friends. Substance use was measured using self-reported use of tobacco, alcohol, and drugs.
  
  
  RESULTS
  Findings indicated that family relationships (β = -.101, p = .031) and friendships (β = .142, p = .004) were associated with drug use among people with mood and anxiety disorders, controlling for gender, age, race, education level, employment status, income, and family substance use history. Yet, family relationships and friendships were not significantly associated with tobacco and alcohol use.
  
  
  CONCLUSIONS
  People with mood and anxiety disorders who had better family relationships were less likely to use drugs, while those who had better friendships were more likely to use drugs. Practitioners should be attentive to the differential impact of family and friends when working with people with mood and anxiety disorders to reduce the risk of drug use. Family interventions promoting and maintaining quality relationships with family will be helpful. However, friendships may facilitate drug use of people with mood and anxiety disorders. Practitioners should be cognizant of the potential risks of friendship networks for people with mood and anxiety disorders.
authors.affiliation: a School of Social Welfare , University of Kansas , Lawrence , Kansas , USA.
authors.forename: Eunji
authors.initials: E
authors.lastname: Nam
authors.affiliation: a School of Social Welfare , University of Kansas , Lawrence , Kansas , USA.
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Fukui
mesh_terms: D000328:Adult; D017677:Age Distribution; D000437:Alcoholism / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D005195:Family Relations; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology*; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology
keywords: Family; alcohol; drugs; friends; mood and anxiety disorders; tobacco