Features of anxiety and loneliness as predictors of narcotics use by adolescents (based on a survey of addicts aged 12-18)

Komissarova Ol'ga Andreevna ORCID: 0009-0003-2642-2340 Postgraduate student of the Department of Psychology and Pedagogy, Peoples' Friendship University of Russia 6 Miklukho-Maklaya str., Moscow, 117198, Russia olg.komissarova2016@yandex.ru Other publications by this author

Milovanova Ol'ga Andreevna Doctor of Medicine Professor; Department of Pediatric Neurology; Federal State Budgetary Educational Institution of Higher Professional Education of the Ministry of Health of the Russian Federation 2/1 Barrikadnaya str., Moscow, 125993, Russia olg.komissarova2016@yandex.ru

Introduction

The formation of chemical dependence in adolescents is a multifactorial problem covering a wide range of psychological, sociological and biological aspects. In recent decades, the number of cases of addictive behavior among young people has been growing rapidly, which underscores the need for a deep scientific analysis of the causes and mechanisms contributing to this phenomenon.

Psychological research has established a significant link between emotional disorders and the formation of addictions. For example, Abdrakhmanova E.V. and Starodubets O.D. in their study emphasize that adolescents with a high degree of severe depression and anxiety have an increased risk of substance abuse. The authors note that low self-esteem, feelings of loneliness, and lack of emotional support from parents can lead to attempts to escape from negative emotions through drug or alcohol use ^{[1, pp. 23-24]}.

Data from foreign studies also confirm this concept. For example, a number of researchers from Starboro University of Toronto and the University of Colorado conducted a systematic review in which they found that emotional disorders are a powerful predictor for teenagers who engage in drug use. Researchers note that adolescents experiencing chronic stress or social isolation are more prone to addictive behavior, which confirms the hypothesis of the interaction of individual and social factors in the development of addictions ^[2,10].

Sociological research examines the influence of the environment on the development of addictions. The works of A.A. Rean and I.A. Konovalov consider aspects of family relations as key factors influencing predisposition to addictions. This study highlights that conflictual relationships in the family, as well as a lack of emotional support, can significantly increase the risk of addictive behavior in adolescents ^[3]. The corresponding influence of social circles is also important: studies show that adolescents in groups with a tendency to use drugs have a higher chance of developing addiction ^[4,11].

In foreign works, such as the meta-analysis of adolescent addictive behavior, attention is also focused on the importance of peers in the formation of addiction. The authors concluded that peers play a dual role: teenagers can receive both support and protection from them, as well as a propensity to use drugs ^[5,9]. This confirms the need for a comprehensive understanding of the dynamics of deviant behavior in the context of the adolescent social environment ^[6,7,8].

Thus, it can be said that the formation of addiction in adolescents is a multidimensional and complex phenomenon, having both a psychosocial and a medical nature. In turn, predictors of addictive behavior can be both elements of a genetic predisposition, as well as social (family, environment, level of wealth, place of residence), and psychological – personal – factors (experiencing loneliness, anxiety, a tendency to aggression, etc.).

Subject of the study: the peculiarities of experiencing anxiety and loneliness in Russian adolescents who use surfactants.

The object of research: the peculiarities of experiencing anxiety and loneliness.

The main purpose of the study is to identify the characteristics of loneliness and anxiety among Russian adolescents who use surfactants.

The scientific novelty and practical significance of the conducted research lies in the direct study of adolescents suffering from chemical dependence and who are in the process of rehabilitation.

The theoretical and methodological basis for the study of substance use in adolescents is based on provisions reflecting medical, psychological and psychosocial concepts of addiction and its impact on adolescent development (Wymbs, B. T., McCarty, C. A., Mason, W. A., King, K. M., Baer, J. S., Vander Stoep, A., & McCauley, E. 2014; Khudyakov A.V. 2003); research in the field of psychological disorders and their relationship to substance use (Slobodskaya, Kharchenko 2004; Stellern, J., Xiao, K. B., Grennell, E., Sanches, M., Gowin, J. L., & Sloan, M. E. 2023); provisions reflecting the influence of family and social factors on the formation of dependent behavior (Rean A.A., Konovalov I.A. 2020; Basalaeva N.V., Zakharova I.V. 2022; Trucco, E. M., & Hartmann, S. A. 2021; Slabodskaya, Kharchenko 2004); research in the field of genetic predispositions to addictions and their interaction with psychological and social aspects (Ducci, F., & Goldman, D. 2012; Henneberger, A.K., Mushonga, D.R. & Preston, A.M. 2021); as well as studying the role of social networks and peers in the formation of dependent behavior (Abdrakhmanova E.V., Starodubets O.D. 2019; Watts, Lara & Hamza, Eid & Bedewy, Dalia & Moustafa, Ahmed 2023).

Research materials

The type of research is a questionnaire, descriptive. The study involved 50 adolescents addicted to surfactants (mephedrone– a synthetic drug of the amphetamine class) undergoing a drug rehabilitation program.

Criteria for the inclusion of respondents in the study: 1) is undergoing rehabilitation in a 24-hour or day-type narcological hospital; 2) age from 12 to 17 years; 3) signing informed consent to participate in the study from official representatives of the minor; 4) rehabilitation support by a full-time psychologist; 5) regular attendance at psychological sessions and trainings, regular questionnaires and testing of the psycho-emotional state; 6) no use of surfactants during the hospital stay. Exclusion criteria: 1) age younger than 12 and older than 17 years; 2) active use of surfactants (outside the hospital, refusal to undergo testing); 3) presence of severe mental disorders; 4) refusal to participate in rehabilitation psychological therapy; 5) lack of informed consent of the official representatives of the minor. The psychologist's support during the rehabilitation process included regular outpatient appointments (4-6 times a week, depending on the type of hospital), as well as separate rehabilitation group and/or individual consultations with a psychologist to regulate and stabilize the psycho-emotional state, as well as holistic rehabilitation therapy.

Research methods:

To study and evaluate the characteristics of anxiety and loneliness among adolescents who use surfactants, we used the methods of questionnaires, semantic and factor analysis, and statistical methods. The questionnaire method or the clinical and psychological method included an information questionnaire for analyzing the socio-demographic characteristics of respondents, a number of psychological techniques for assessing the level and specifics of experiencing anxiety and loneliness: assessment of the subjective experience of loneliness by D. Russell, M. Ferguson (UCLA); the A. Beck anxiety scale (BAI); the scale of overt anxiety for adolescents by A.M. Parishioners.

Statistical methods of empirical data processing were used to evaluate the parameters of the data sample with an abnormal distribution due to the small number of respondents divided into subgroups by age (older and younger adolescents) and gender (girls and boys). For the analysis, we used Spearman's rank correlation coefficient and the Mann-Whitney U-test to assess significant differences between groups of respondents. The psychodiagnostic study was conducted at the beginning of rehabilitation therapy after the admission of adolescents to the rehabilitation center and the passage of detoxification measures, after the respondents achieved relative psycho-emotional stability.

Results and discussion

Sample description

The study involved 50 adolescents aged 12 to 17 years. The respondents were divided into subgroups according to gender and age (younger and older age groups). Thus, 10 boys and 10 girls of younger adolescence (12-14 years old) and 15 boys and girls participated in the study.

25 boys and 25 girls, 20 of them younger teenagers – 10 boys and 10 girls – and 30 older teenagers – 15 boys and 15 girls made up the sample of respondents to this study.

Sociodemographic characteristics of the respondents: all respondents grew up and were raised in full families with a family income of the middle and above average, received secondary education in public schools and lived in Moscow and the Moscow region, and were native speakers of Russian linguistic culture.

Clinical and medical characteristics of the sample: all respondents were addicted to mephedrone as a synthetic drug of the amphetamine class (slang name "salt"), were hospitalized in a drug treatment hospital, after which they were sent to a drug rehabilitation center to undergo comprehensive medical, psycho-social rehabilitation with the official consent of official representatives (parents) and were in round-the-clock or a day hospital, depending on the stage of rehabilitation and the psychoemotional and physical condition.

The results of psychodiagnostics:

According to the results of psychological tests, we found that teenage girls have a more pronounced feeling of loneliness as a negative experience and disruption of social contacts, while teenage boys have a feeling of loneliness as a misunderstanding from others. It should be noted that, in general, adolescent boys subjectively feel a sense of loneliness more strongly than teenage girls. At the same time, both observed trends persist and develop from younger adolescence to older age, which is reflected in the graph in Fig.1:

Figure 1. Average values of the assessment of subjective loneliness among adolescents using surfactants

In turn, the assessment of anxiety levels according to the A.Beck Anxiety Level Questionnaire (BAI) shows a tendency to decrease anxiety in adolescents from younger adolescence to older adolescence (anxiety levels are higher in younger adolescents) both girls and boys. At the same time, girls have significantly higher anxiety levels than boys in both age groups, as can be seen in the graph in Fig. 2.:

Figure 2. Average values of anxiety level assessment on the BAI scale in adolescents using surfactants

Similar results can be observed according to the survey data on the scale of apparent anxiety for teenagers of A.M. Parishioners. At the same time, it can be noted that the scale of social desirability (the "scale of lies") for all adolescents is within the range of obtaining a reliable result, however, the results on this scale are significantly higher for girls than for boys, Fig.3:

Figure 3. Average values of overt manifestations of anxiety in adolescents using surfactants

The level of social desirability among representatives of all groups of respondents is no higher than 8, which, according to A.M. Parishioners, allows us to regard the result as reliable.

Thus, it can be noted that based on the initial observations, a preliminary conclusion can be drawn that adolescents of different age and gender groups have different profiles of anxiety and loneliness. At the same time, adolescent anxiety decreases with age, while the subjective experience of loneliness increases, reflecting a general trend towards the development of the psychoemotional state of adolescents who are addicted to surfactants.

To confirm the initial observations based on the survey data, we conducted an analysis by applying the Mann-Whitney U-test to identify differences between small groups in independent samples.:

Table 1. Comparative results of groups of respondents by age according to the Mann-Whitney criterion (N=50)

Interpreting the data obtained as a result of the comparative analysis (Table 1), it can be noted that the primary observations based on the interpretation of the study data were confirmed: there are significant differences between the groups of older and younger adolescents in terms of general loneliness, loneliness as a negative experience, general anxiety, and the level of expression of social desirability.

Further analysis was carried out based on a comparison of groups by gender: adolescent girls and boys without dividing into age groups.:

Table 1. Comparative results of groups of respondents by gender according to the Mann-Whitney criterion (N=50)

The data obtained as a result of the criterion analysis also confirmed the data based on the primary interpretation of the questionnaires. There are significant differences in the manifestation of general loneliness, the subjective experience of loneliness as a violation of social contacts and misunderstanding on the part of others, the level of anxiety, the obvious manifestation of anxiety and the manifestation of social desirability.

Further analysis lay in the plane of searching for significant connections between the studied components.

Examining the mechanisms of interaction of the studied components (for representatives of each of the 4 subgroups: younger teenage girls, younger teenage boys, older teenage girls and older teenage boys), the following conclusions can be drawn:

1) for representatives of all groups, there is a direct two-way relationship between an increase in the overall level of subjective loneliness and its manifestation in the form of negative experiences (younger adolescents, girls R=0.322, p=0.01; younger adolescents, boys R=0.409, p=0.01; older adolescents, girls R=0.177, p=0.01; and older adolescents boys R=0.133, p=0.01) and social contact disorders (younger teenage girls R=0.126, p=0.01; younger teenage boys R=0.536, p=0.01; older teenage girls R=0.289, p=0.01; and older teenage boys R=0.447, p=0.01), and also between the level of anxiety and the manifestation of overt anxiety (younger teenage girls R=0.349, p=0.01; younger teenage boys R=0.253, p=0.01; older teenage girls R=0.113, p=0.01; and older teenage boys R=0.246, p=0.01);

2) in adolescents of the younger age group (boys and girls), there is a direct two-way relationship between the level of anxiety and disruption of social contacts as an aspect of the subjective experience of loneliness (younger adolescents, girls R=0.326, p=0.01; younger adolescents, boys R=0.442, p=0.01);

3) in adolescent girls of both age groups (older and younger adolescents), there is a two-way direct relationship between the severity of social desirability and the level of subjective loneliness (younger adolescent girls R=0.347, p=0.01; older adolescent girls R=0.335, p=0.01), and an inverse two-way relationship between the level of anxiety and manifestation of social desirability (younger teenage girls R=-0.417, p=0.01; older teenage girls R=-0.392, p=0.01);

4) in adolescent boys of both age groups (older and younger adolescents), there is a direct two-way relationship between the general level of subjective loneliness and the severity of the aspect of misunderstanding on the part of others (younger adolescent boys R=0.325, p=0.01; older adolescent boys R=0.304, p=0.01);

5) in older adolescents of both gender groups (boys and girls), there is a one-way inverse relationship between the overall level of subjective loneliness and anxiety (older adolescents, girls R=-0.217, p=0.01; older adolescents, boys R=-0.246, p=0.01), as well as the level of overt anxiety (older adolescents, girls R=-0.223, p=0.01; older teenage boys R=-0.255, p=0.01).

Discussion

The study participants included 50 adolescents suffering from surfactant addiction (dependence on mephedrone) aged 12 to 17 years, inclusive, undergoing comprehensive rehabilitation measures at a drug treatment center. In the course of the study, we studied the features of anxiety and the subjective experience of loneliness in adolescents of the older and younger age groups, divided by gender.

The aim of the study was to identify the features of the subjective experience of loneliness and anxiety as predictors of the use of surfactants. The study revealed that, despite the differences in the profiles of adolescent drug users (different levels of manifestation of elements of subjective loneliness, anxiety levels) Nevertheless, it is possible to say that all adolescents of the age groups under consideration have an increased level of anxiety (Beck scale, Parishioner scale), decreasing as they grow older, and a high level of subjective loneliness and, above all, a sense of loneliness as a violation of social contacts and misunderstanding from others.

Similar data on the predictive effects of anxiety ^[6,7,11] and loneliness ^[2,10] were obtained by a number of foreign researchers who studied the medical and clinical psychological characteristics of adolescents in the United States, Canada, and the Middle East who use various types of surfactants, including alcohol, tobacco, and non-synthetic narcotic substances.

Conclusions

It can be stated that there are significant links between the studied components of the subjective experience of loneliness and the level of anxiety in adolescents: as they grow older, the feeling of subjective loneliness worsens, as well as a violation in the field of social contacts and an increase in the level of social desirability, while the level of anxiety decreases with age in adolescents, which may be associated with an aggravation of the psychoemotional state of adolescents. At the same time, it can be noted that girls are more likely to display social desirability (marking socially acceptable responses, rather than those that will represent a real psycho-emotional state), and teenage boys are more likely to interpret loneliness as a misunderstanding on the part of others.

Conclusion

When conducting psychological activities aimed at working with dependent adolescents, the accompanying psychologist must work in conjunction with a psychiatrist-narcologist and/ or a specialist qualified to work with clinical cases due to a number of features of the psychoemotional and physical condition of dependent adolescents.

An integrated approach to the rehabilitation of adolescents suffering from chemical dependence should include not only a study of the current psycho-emotional state, but also influence the factors that increase the risk of relapse of addictions, among which a number of researchers note a strong subjective experience of loneliness and a high level of anxiety.

In the course of the analysis of data from older and younger adolescents, divided into subgroups by gender, we identified a number of features of the subjective experience of loneliness and the level of anxiety. Based on the analysis of the data obtained during the statistical analysis, it can be argued that all respondents, regardless of gender and age, have an increase in the level of subjective loneliness in the form of negative experiences and impaired social contacts, while the level of anxiety and overt anxiety decreases with age (younger adolescents have higher anxiety levels than older ones teenagers). However, there are also a number of differences in gender and age groups.:

1) adolescents of the younger age group demonstrate an increase in the level of anxiety with an increase in the level of subjective experience of loneliness in the form of disruption of social contacts;

2) adolescents of the older age group, on the contrary, demonstrate a decrease in anxiety levels with an increase in the level of subjective loneliness in all the aspects under consideration.;

3) teenage girls show an increased level of the scale of social desirability, which is inversely proportional to the manifestation of the level of obvious anxiety, which may demonstrate a desire to hide their own anxiety and experience negative feelings associated with loneliness.;

4) teenage boys perceive loneliness more as a misunderstanding on the part of others, whereas the scale of social desirability has virtually no degree of severity.

Thus, it can be concluded that the subjective experience of loneliness and the anxiety level of addicted adolescents can have a direct impact on the use of surfactants, and therefore the psychologist of rehabilitation and client support needs to pay attention to the study of these aspects, reducing the anxiety level of respondents, as well as working out models for building social contacts and stable social relationships. When working with teenage girls, attention should also be paid to hidden feelings and experiences that addicts may hide under socially desirable behavior. When working with teenage boys, more attention should be paid to establishing communication with significant personalities and transforming the social circle. When working with younger teenagers, the first step is to reduce anxiety levels.

As further research prospects, we see the continuation of the stated work, the identification of other hidden predictors of adolescent addictive behavior, as well as the observation and comparison of indicators at the beginning and at the end of the rehabilitation process.