1 Dec 2022


Substance Use and Depressive Symptoms Among Adolescents

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Academic level: College

Paper type: Research Paper

Words: 1529

Pages: 6

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The quest to find practical solutions to existing problems drive research. One such issue is drug dependency and mental complications like depression which have been on the rise in recent years. Given the impact of drug use and depression on individuals, failure to curb the problem can cripple the entire community. In the article,  Substance Use and Depressive Symptoms Among Adolescents Treated in a Pediatric Emergency Department  by Hernandez, et al. the authors examine the link between substance use and depression in teenagers. Previous studies have indicated that adolescents who have suffered depression have a high risk of developing major depressive episodes in their adult life. As such, finding ways of dealing with the issue is essential. In this regard, the paper critiques Hernandez, et al. 's article to discuss its aim, sample, methodology, data analysis, results and, limitations.  

Analysis of Hernandez et al. 's aim 

This article aims to understand how the association between substance use (marijuana and alcohol) and the development of depression vary by gender as well as the type of substance that is used. Hernandez and her colleagues build their research on existing literature on the connection between substance abuse and depression. In essence, earlier studies had demonstrated that teens who abused drugs like alcohol and marijuana have a higher risk of suffering from depression compared to those who do not use such substances. Hernandez et al. filled the knowledge gap by extending their investigation beyond highlighting a link between substance use and depression. Instead, the group examined the difference in substance and depression association across gender as well as by substance used.   

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Research Questions 

Two research questions governed Hernandez et al. 's study. The first one was to analyze the relationship between substance use and depression which provided an overall direction to the study. The second question, determining the variation of substance usage and depressive mood across gender as well as the type of drug used allowed the investigators to narrow down the research by breaking down the question to examine four sub-elements. These sub-categories are no drug usage, alcohol, marijuana and, both alcohol and marijuana and development of depressive mood. In summary, the two research questions are specific and focused, which are vital traits in reaching an accurate conclusion. 

Importance of the Article to Healthcare Professionals 

This study equips healthcare professions with the knowledge that will influence clinical decision making. Note that a good proportion of teen emergency department cases are related to substance use. From Hernandez et al. 's finding, healthcare personnel can screen for depression to determine whether a patient needs a referral to get the necessary help. By using this approach, medics will be able to reduce cases of major depression among youths. 

Sample Analysis 

A sample of 713 adolescents between the ages of 13 and 17 years was recruited from a non-specified Pediatric Emergency Department. In the article, the scholars state that by 12th Grade, about 54 percent of teens report being drunk. From this figure, it can be argued that approximately half of the adolescents use either alcohol or marijuana or both which renders a sample size of 713 too small to produce accurate findings.  


Research instrument can be described as any tool used in the collection, measurement and, analysis of the respondents' data (Watson, 2016). In Hernandez's article, two research instruments were used, a checklist and questionnaire. The checklist fits a researcher-completed tool, and it was used to identify potential subjects while the questionnaire was used to collect data from subjects. Both instruments were designed by the investigators in accordance with the issue under investigation.  

Even though Hernandez and her colleagues offered detailed information on the application of the instrument, the instruments' reliability and validity were not discussed. According to Taherdoost (2016), validity determines the extent to which the collected data represents the specified area of investigations. In other words, validity measures whether the data is appropriate for the specified group and the intended group. Based on how data was collected, it can be argued that the two instruments employed in Hernandez et al. 's study is valid. Note that the study's setting was the pediatric department where laboratory physicians were tasked with the responsibility of noting adolescents with samples that indicated alcohol or marijuana usage. Furthermore, all the respondents were between the ages of 13 and 17. These points imply that the collected data was measuring what the investigators had intended to at the beginning of the study 

On the other hand, it is almost impossible to determine the instruments' reliability. Note that instrument reliability measures the degree at which the selected tools yields consistent results. In the study, the researchers do not mention using any tactic to determine the authenticity of the chosen instrument. Instrument validity and reliability are essential as they determine whether or not the findings can be generalized, thus allowing one drawing of inferences. Failure to mention the validity and reliability of the instrument can affect the readers' perception of the quality of the study's findings.  

Data Presentation 

Two tables were used to display the analyzed data, thus providing a visual representation which made it easy to note specific information. The first table (Table 1) depicted means as well as standard errors on the CES-D (Center for epidemiological studies-depression scale) overall scores and subscales by individual substances, i.e. alcohol and marijuana. Based on the figures in Table 1, it is clear teens who do not use alcohol and marijuana have a lower CES-D compared to those who used one or both drugs. Furthermore, adolescents with alcohol use scored a lower CES-D that those who used marijuana or both marijuana and alcohol. The second table (Table 2) illustrates how the association of substance use and depression vary by gender. From the figures, it is clear that women with both marijuana and alcohol use had a higher CES-D compared to male respondents with similar habits and women who reported no drug use. These two tables were set to answer the two research questions making it easy for the reader to understand the information. 

Methodological and Statistical Limitations 

The authors note several methodological and statistical limitations that might have adversely influenced the accuracy of the study's findings. First, the CES-D subscale that was applied yielded a Cronbach's alpha coefficient of -50, which could have interfered with the results generated from the used sample. Additionally, the CES-D measure did not consider other interpersonal symptoms (Sainohira et al., 2018). Lastly, the sample size that was used for those who reported having used marijuana was too small, making it difficult to ascertain whether any significant difference between single marijuana use and larger substance usage existed. Collectively, the listed limitations could have affected the findings, thus reducing overall reliability.  

In addition to the mentioned limitations, another issue that was not mentioned was the size of the sample used. Note that the researchers relied on a sample size of 713 yet in the background section it has been specified that by 12th Grade at least 54 percent of teens report being drunk and 24 admit to binge drinking. Fifty-four percent come down to almost half of American teens which means that a sample size of 713 is too small to represent the overall population.  

Findings Analysis 

The study's findings were organized in two tables to answer the study's research question. The first table was about finding a connection between the type of substance usage and depressive mood. By examining the link between CES-D and alcohol, marijuana and both (alcohol and marijuana), the authors established that the two drugs had a varying depressive effect. Adolescents, who used only a single substance that is either alcohol or marijuana recorded a lower CES-D compared to those who used both alcohol and marijuana. 

Additionally, teens who used alcohol had a lower CES-D than those who consumed marijuana only or both drugs. The second table addressed the second research question, which aimed to understand how the association between substance usage and depression varied across gender. The researchers established that women who used one or both substances had a higher tendency suffering from depression compared to their male counterparts.  

The study's findings are essential to any person who is obliged to support teens. Such groups include health professions, teachers, counsellors and, also parents. Clinicians can use the generalized findings to improve screening for drug dependency and depressed mood. Furthermore, healthcare professions can use the research findings to identify teens who are at a high risk of suffering from depression or getting into drugs. For teachers, counsellors and, parents, the information can be used to frame advice as a way of preventing high-risk behaviors that might lead to drug abuse and/or depression.  

  From a general point of view, it can be argued that the study offers essential concepts that can serve as a starting point for further research in the area. However, aspects like small sample size as well as the choice of instruments that failed to include other factors that can contribute to depression reduced the overall accuracy of the study. For this reason, increasing the sample size and adopting an appropriate research instrument could improve the study's outcomes and results. 

Lessons learnt from the applied Statistical Procedures, methodology and, Measurement 

Statistical procedures encompass the techniques for analyzing data. Such processes enable the investigator to summarize information allowing generalization. In the study, analytical methods have been used to merge collected data into variables that can be compared. Even though statistics enable researchers to cut through the clutter and examine the crucial aspects, it fails to consider other important factors that contribute to substance usage and depressive mood.  

Hernandez and her colleagues utilize quantitative methodology as well as instruments that record collected numbers in figures. Even though this approach has the advantage of removing possible bias, it fails to include other aspects that cannot be depicted in numbers. For this reason, the main lessons that can be learnt from statistical procedures, methodology and, the measurement used in this article is that considering other factors that cannot be reduced to figures is necessary to reach an accurate conclusion.   


Hernandez, L., Cancilliere, M. K., Graves, H., Chun, T. H., Lewander, W., & Spirito, A. (2016). Substance Use and Depressive Symptoms Among Adolescents Treated in a Pediatric Emergency Department. Journal of Child and Adolescent Substance Abuse , 124-133. 

Sainohira, M., Yamashita, T., Terasaki, H., Sonoda, S., Miyata, K., & Murakami, Y. (2018). Quantitative analyses of factors related to anxiety and depression in patients with retinitis pigmentosa. 

Taherdoost, H. (2016). Validity and Reliability of the Research Instrument; How to Test the Validation of a Questionnaire/Survey in a Research. International Journal of Academic Research in Management, 5 (3), 28-36. 

Watson, F. (2016). Lessons learned on approaches to data collection and analysis from a pilot study. 32-36. 

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StudyBounty. (2023, September 16). Substance Use and Depressive Symptoms Among Adolescents.


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