Addictive Behaviors, Vol. 24, No. 6, pp. 769–779, 1999Copyright © 1999 Elsevier Science LtdPrinted in the USA. All rights reserved

0306-4603/99/$–see front matter

PII S0306-4603(99)00058-1

769

Pergamon

STRESS-COPING AND TEMPTATION-COPING AS PREDICTORS OF ADOLESCENT

SUBSTANCE USE

ERIC F. WAGNER,* MARK G. MYERS,† and

JESSICA L. M

C

ININCH‡

*College of Urban and Public Affairs, Florida International University;†Department of Psychiatry, University of California, San Diego; and

‡Center for Psychological Studies, Nova Southeastern University

Abstract —

The stress-coping model of addiction posits that stress-coping and temptation-coping skills each make an independent contribution to the likelihood of substance use. De-spite the popularity of this model, this proposition has never been examined empirically. Thecurrent study tested this proposition using a sample of public high school students (

n

5

332).Results supported the model, as stress-coping and temptation-coping each accounted forstatistically unique and significant variance in teenagers’ substance use. In addition, sub-stance-abusing adolescents reported engaging in significantly more avoidance stress-copingand significantly less temptation-coping than demographically-matched nonsubstance-abus-ing adolescents. Our results replicate and expand previous findings from the stress-coping lit-erature and have implications for future research and intervention efforts in the adolescentsubstance abuse field. © 1999 Elsevier Science Ltd

Key Words.

Adolescence, Stress-coping, Substance abuse.

I N T R O D U C T I O N

One of the most popular cognitive-behavioral theories of the addictive process is thestress-coping model (Wills & Hirky, 1996; Wills & Shiffman, 1985). From this perspec-tive, substance use is viewed as a coping response to life stress that can function to re-duce negative affect or increase positive affect.

Stress

refers to the problems or strainsthat people encounter throughout life, and

coping

refers to the behavioral or cognitiveresponses that people use to manage stress (Lazarus & Folkman, 1984; Wills & Shiff-man, 1985). In comparison to other potential coping strategies, coping via substanceuse generally is regarded to be limited in effectiveness, as repeated use of substances isdetrimental to physical and psychosocial well-being (Wills & Hirky, 1996; Wills &Shiffman, 1985). The stress-coping model of addiction also assumes

stress-buffering ef-fects

, consistent with the general stress coping literature (Cohen & Wills, 1985). Spe-cifically, coping mechanisms relevant to well-being should be most strongly related tooutcomes (including substance use) at high levels of stress and less related to out-comes at lower levels of stress. Finally, the model assumes a distinction between

stress-coping skills

, which are responses intended to deal with general life stress, and

tempta-tion-coping skills

, which are coping responses specific to situations in which there aretemptations for substance use. According to Wills and Shiffman (1985, p. 17), “as aworking assumption it is reasonable to predict that each type of coping [i.e., stress-

Requests for reprints should be sent to Eric F. Wagner, Ph.D., College of Urban and Public Affairs,Florida International University, North Campus, AC-1, Suite 200, North Miami, FL 33181-3600; E-mail:wagnere@fiu.edu

770 E. F. WAGNER et al.

coping and temptation-coping] will make an independent contribution to the probabil-ity of substance use.” This final assumption is the focus of the current research.

A reasonably large literature has accumulated examining the relation betweenstress-coping and substance use. As noted above, stress-coping skills are relevant forcoping with general life stress, and the goal of stress-coping is to maintain physical andpsychosocial well-being. The majority of research in the area has utilized Lazarus andcolleagues’ (Lazarus & Folkman, 1984; Monat & Lazarus, 1991) typology of stress-coping that distinguishes between

problem-focused coping strategies

, which are di-rected at altering or removing a stressor, and

emotion-focused coping strategies

, whichare directed at managing affective states associated with or resulting from the prob-lem. In principle, some coping responses are assumed to be more effective in certainsituations than others (Monat & Lazarus, 1991). For example, problem-focused cop-ing responses may be of greatest benefit in situations where a stressor is controllableand an individual has sufficient resources to devote toward the resolution of the prob-lem, whereas emotion-focused coping strategies might be more effective when stres-sors are outside one’s personal control and must be endured.

Despite the situational specificity of the effectiveness of problem-focused and emo-tion-focused coping, a general finding in the substance use literature has been that in-dividuals who routinely use problem-focused stress-coping strategies are less likely todevelop and more likely to overcome substance use problems than the individualswho routinely use emotion-focused stress-coping strategies (Wills & Hirky, 1996). Forexample, both Wills (1986; Wills, McNamara, Vaccaro, & Hirky, 1996) and Labouvie(1986, 1987) have found that adolescents who characteristically employ emotion-fo-cused relief-oriented coping strategies are at greatest risk for developing substance useproblems. Among adults, Finney and Moos (1995) found that individuals who relymore on approach coping, a form a problem-focused stress-coping, and less on avoid-ance coping, a form of emotion-focused coping, are less likely to develop substanceuse problems and experience greater success in recovery attempts if they do developsuch problems. Similar results have been found in studies of alcohol abuse and depen-dence status among adult drinkers (Cooper, Russell, & George, 1988), problem drink-ing among incarcerated, drug using women (El-Bassel, Ivanoff, Schilling, Gilbert, &Chen, 1995), alcoholics and drug abusers undergoing detoxification (Madden, Hinton,Holman, Mountjouris, & King, 1995), success in attempts at smoking cessation (Wew-ers, 1988), alcohol consumption among community-dwelling middle-aged women(Breslin, O’Keeffe, Burrell, Ratliff-Crain, & Baum, 1995), marijuana use among innercity, minority youth (Epstein, Botvin, Diaz, Toth, & Schinke, 1995), and smoking be-havior among seventh graders (Sussman, Brannon, Dent, & Hansen, 1993).

A well-developed literature also exists concerning the relation between temptation-coping and substance use. The immediate goal of temptation-coping is to avoid the useof substances, with consequent long-term goals of promoting physical health and feel-ings of self-efficacy derived from success in controlling substance use. A general find-ing has been that individuals who employ temptation-coping skills do better in at-tempts to manage substance use problems than those without these skills. Forexample, Shiffman (1984) found that engaging in temptation-coping, especially when acombination of cognitive and behavioral responses is used, increases the effectivenessof former smokers’ attempts to manage relapse crises.

The role of temptation-coping in managing alcohol use problems has been an espe-cially influential area of research. In a study of males completing inpatient alcoholismtreatment, Ito and Donovan (1990) found that greater reliance on cognitive forms of

Stress-coping and temptation-coping 771

temptation-coping predicted higher rates of abstinence 6 months after discharge.Training in a specific form of temptation-coping, drinking urge reduction coping, hasbeen shown to enhance the effectiveness of cue exposure treatment for adult alcohol-ics (Monti et al., 1993). In addition, temptation-coping also was the primary focus ofthe Cognitive-Behavioral Coping Skills Therapy condition (see

Cognitive-BehavioralCoping Skills Therapy Manual

[Kadden et al., 1992]) of Project MATCH, the multisitetreatment outcome study initiated by the Treatment Research Branch of the NationalInstitute on Alcohol Abuse and Alcoholism; see

Journal of Studies on Alcohol

, Janu-ary, 1997).

It is important to note that temptation-coping skills differ from drug resistance orrefusal skills. Temptation-coping applies in situations in which there is both the oppor-tunity and the desire (at least to some degree) to use a substance. In contrast, resis-tance skills apply in situations in which there is an opportunity but not necessarily anydesire to use. Overall, evaluations of resistance skills training programs suggest thatthey have limited effectiveness for delaying or decreasing substance use among ado-lescents (e.g., Elder, Sallis, Woodruff, & Wildey, 1993; Sussman, Dent, Stacy, & Sun,1993), and at least one study indicates that resistance skills predict substance use onlywhen adolescents believe substance use to be undesirable (Donaldson, Graham, Picci-nin, & Hansen, 1995). Stated differently, it appears that resistance skills apply only insituations in which there is no temptation to use a substance. In contrast, temptation-coping should, by definition, influence substance use in situations where there is somedegree of interest in using alcohol or other drugs.

To summarize, Wills and Shiffman (1985) have argued that stress-coping and temp-tation-coping independently contribute to the likelihood of substance use. Researchon stress-coping has demonstrated that a reliance on problem-focused coping de-creases risk for substance use problems, whereas a reliance on emotion-focused cop-ing increases risk for substance use problems. Research on temptation-coping hasshown that these skills enhance success in attempts to manage substance use prob-lems. Despite their shared relevance to the stress-coping model of addiction, these twobodies of literature have remained entirely separate from one another. Not a singlepublished report has examined stress-coping and temptation-coping together as inde-pendent contributors to substance use.

The current research examines directly the assumption that stress-coping and temp-tation-coping indeed contribute independently to the prediction of substance use. Weexplore the degree to which stress-coping and temptation-coping simultaneously andindividually explain substance use involvement among a sample of high school stu-dents. We hypothesize that (a) stress-coping and temptation-coping independentlywill account for significant variance in substance use problems among teenagers, and(b) substance-abusing adolescents will demonstrate more emotion-focused stress-cop-ing, less problem-focused stress-coping, and less temptation-coping than adolescentswithout substance use problems.

M E T H O D

Participants

Participants were 332 ninth through twelfth graders from a suburban public schooldistrict in Rhode Island. Participants were selected from an initial pool of 606 studentswho completed two testing sessions over the course of two consecutive days. Two hun-dred and thirty-one subjects were excluded because of missing data or unscorable re-

772 E. F. WAGNER et al.

sponses from one or both of the testing sessions. Of these 231 students, 63% were ex-cluded because of missing data, and 37% were excluded because they providedunscorable responses (e.g., geometric patterns, all responses were the same for allquestions) on the bubble-coded, computer-scanned NCS answer sheets. Another 43students were excluded because of scores above cutoff criteria on underreporting (i.e.,defensiveness) and/or overreporting response distortion scales from the Personal Ex-perience Screening Questionnaire (PESQ; Winters, 1991) The 332 participants did notdiffer from the excluded students on demographic variables including age, grade, andethnicity (White vs. African-American, Asian, etc.). However, excluded students aremore likely to be boys than were those individuals included in the study (60% vs.35%).

Participants were on average 15 years, 10 months old, with a range of 13 years, 10months, to 18 years, 8 months. More girls (65% vs. 49%) and fewer minorities (16% vs.20%) were included in the sample than is representative of the U.S. population of 15-to 19-year-olds (U.S. Census Bureau, 1997). The median household income of thesample ($30,000–$45,000) is consistent with the median household income for the na-tion ($32,949) and the state ($35,341) during the same year as data collection (North-east Midwest Institute, 1997).

MeasuresStress-coping.

The Revised Ways of Coping Checklist (RWCCL; Vitaliano, Russo,Carr, Mauiro, & Becker, 1985), designed to assess strategies utilized by an individualin response to stressful situations, was used to evaluate stress-coping. The ProblemFocused and Seeks Social Support scales were used to represent problem-focused cop-ing, while the Wishful Thinking, Avoidance, and Blamed Self scales were used to rep-resent emotion-focused relief-oriented coping. Previous studies have demonstratedthat the RWCCL displays good construct and concurrent validity, both with adult (Vi-taliano et al., 1985) and adolescent (Wagner, 1993) samples. Previous estimates of in-ternal consistency (

coefficient alpha

) range from .71 to .88 across the five RWCCLcoping scales (Vitaliano et al., 1985; Wagner, 1993). In the current study, internal con-sistencies of the five RWCCL coping scales were adequate, ranging from .69 to .96.

Temptation-coping.

The Temptation-Coping Questionnaire (TCQ; Myers, Stice, &Wagner, 1999; Myers & Wagner, 1995), designed to assess high school students’ cop-ing with situations presenting temptations for substance use, was used to evaluatetemptation-coping. The TCQ consists of three parts: (a) situation description, (b) ap-praisal questions, and (c) temptation-coping items. The situation description was de-veloped from adolescents’ reports of the most common and tempting substance usesituation they are likely to encounter: a social gathering in the evening at a friend’shouse with a few others present and alcohol and drugs available and offered. Thethree appraisal items assess self-efficacy about managing the situation, perceived diffi-culty of managing the situation, and the importance of not using in the situation. Theremaining eleven items assess the likelihood that a teenager would engage in differentcognitive and behavioral strategies for coping with the temptation to use, and theseitems are summed to provide an overall temptation-coping score.

In terms of construct validity, temptation-coping scores are strongly and positivelycorrelated with all three appraisal items (Myers & Wagner, 1995). Furthermore, My-ers and Wagner (1995) found temptation-coping scores were highly correlated withsubstance use indicators including past year alcohol and marijuana use, with higher

Stress-coping and temptation-coping 773

temptation-coping scores corresponding to less frequent use. Internal consistency hasalso been shown to be high (

coefficient alpha

5

.90 [Myers & Wagner, 1995]). In thecurrent study, internal consistency of the TCQ was .88.

Substance use involvement.

The PESQ (Winters, 1991), a standardized self-reportquestionnaire for measuring adolescent alcohol and other drug involvement, was usedto measure substance use. The PESQ includes a Problem Severity scale, two responsedistortion scales, and a Supplemental Information section that provides data about therespondent’s psychosocial status and drug use history. In the current study, the Prob-lem Severity scale score, which is a continuous measure of the extent to which an indi-vidual is psychologically and behaviorally involved with alcohol and other drugs, wasused as the primary lifetime substance use involvement measure. Secondary measuresincluded the annual frequency of alcoholic beverage consumption, marijuana/hashishuse, and hard drug use.

Internal consistency estimates of the Problem Severity scale (PESQPS) with varioussamples of juvenile offenders, public school students, and adolescent drug clinic clientshave ranged from .89 to .95 (Wagner, 1993; Winters, 1991). The scale has been shownto discriminate among groups at different levels of risk for drug problems, distinguishadolescents with substance abuse diagnoses from adolescents with substance depen-dence diagnoses, and predict counselor referral for drug abuse evaluation (Wagner,1993; Winters, 1991). Moreover, scores from the PESQ correlate positively and signif-icantly (range .55 to 94) with scores from longer, well-validated measures of adoles-cent substance use problems (Winters, 1992). Finally, estimates of 1-week test-retestreliability have ranged from .85 to .89, and estimates of 1-month test-retest reliabilityhave ranged from .79 to .86 (K.C. Winters, personal communication, August 2, 1999).In the current study, internal consistency of the PESQPS was similar in magnitude toprevious validation studies (

coefficient alpha

5

.88).

Response distortion.

The PESQ (Winters, 1991) includes two response distortionscales. Items on the Infrequency scale are intended to detect purposefully exaggeratedresponding, inattentive responding, or random responding. The Defensiveness scaleincludes eight items, five of which were derived from the Marlowe-Crowne Desirabil-ity Scale. Consistent with Winters’ recommendations, subjects in the current studywith either or both response distortion scores above critical cut-offs were excludedfrom the data set.

Procedure

This research was approved by the superintendent of the school district involved inthe study, and was included as part of the school district’s alcohol and drug-abuse cur-riculum evaluation. Parents were informed that students would be participating in aschool-based substance-abuse prevention curriculum and that the effectiveness of thiscurriculum would be evaluated on a regular basis. Thus, active parental permission(i.e., signed consent forms for each student) was not required, and all students attend-ing on the days of questionnaire administration participated. Prior to questionnaireadministration, a printed description of the study, including study rationale and assur-ance of confidentiality was distributed.

The project staff administered questionnaire booklets, precoded with identificationnumbers, during English classes. Two class periods were needed to complete all theassessments, and thus the questionnaires were divided into two packets administered

774 E. F. WAGNER et al.

on consecutive school days. The measures of temptation-coping and alcohol and druguse were included as part of the packet administered during the initial day of assess-ment. The measures of stress-coping were included as part of the packet administeredduring the second day of assessment. Thus, only participants who provided usabledata on both days of testing were included in the analyses.

R E S U L T S

Analyses

Initially, hierarchical multiple regression analysis was used to examine the degree towhich stress-coping and temptation-coping independently predict substance use in-volvement among adolescents. A second series of analyses compared substance abus-ing participants with demographically-matched (i.e., on age, gender, and household in-come) nonsubstance abusing participants. The age- and gender-specific ProblemSeverity cut-off scores suggested by Winters (1991) were used to identify substance-abusing participants.

Self-reported substance use frequency and prevalence

Past-year substance use frequency and prevalence data are presented by grade andgender in Table 1. The frequency and prevalence of substance use in the current sam-ple are similar to that reported for the same year (1993) by the Monitoring the Futurestudy (National Institute on Drug Abuse, 1994). A notable exception is that the se-niors in the sample reported less involvement with substances than would be expectedgiven their grade. This finding may be the result of an over-sampling of more conven-tional, less drug-involved seniors, as data were collected near the end of the schoolyear when less conventional, more drug-involved seniors may have been less likely toattend school or cooperate with a school survey. Consistent with previous studies, al-cohol was the most frequently used substance, and marijuana was the most frequentlyused illicit substance.

Hierarchical multiple regression analysis

Hierarchical multiple regression analysis was used to examine the hypothesis thatstress-coping and temptation-coping independently will account for significant vari-ance in substance use involvement among adolescents. Demographic controls (i.e.,grade and gender) were entered in the first block of the hierarchy, each of the fivescores from the subscales of RWCCL were entered in the second block, and the scorefrom the TCQ was entered in the third block of the regression analysis (see Table 2).After controlling for grade and gender, both stress-coping and temptation-coping ac-counted for unique and significant variance in substance involvement as indicated by

R

2

change values (stress-coping

R

2

D

5

.107,

p

,

.001; temptation-coping (

R

2

D

5

.186,

p

,

.001).Inspection of the block-wise beta weights associated with each of the subscales of

the RWCCL revealed that the stress-coping scales representing Avoidance (e.g.,“Went on as if nothing had happened”) and Focusing on the Problem (e.g., “Made aplan of action and followed it”) were significantly related to PESQ Problem Severity.Adolescents who reported a greater reliance on Avoidance stress-coping (an emotion-focused coping strategy) were more likely to demonstrate substance use problems,and adolescents who reported a greater reliance on Problem-Focused stress-copingwere less likely to show substance use problems. Blamed Self, Wishful Thinking, and

Stress-coping and temptation-coping 775

Seek Social Support stress-coping strategies were unrelated to substance use involve-ment.

In regard to temptation-coping, adolescents who reported engaging in more tempta-tion-coping were less likely to demonstrate problems with substance use.

Comparison of substance-abusing and nonsubstance-abusing participants

A second set of analyses compared the degree to which stress-coping and tempta-tion-coping variables discriminated between substance-abusing adolescents and non-substance-abusing adolescents. Substance abusers were identified using the ProblemSeverity scale of the PESQ (Winters, 1991). Eight percent of the sample met substanceabuse criteria, and rates of self-reported substance use supported the substance-abusecategorization. Substance abusing participants reported significantly higher rates ofpast year alcohol, marijuana, and hard drug use than the remainder of the sample (all

p

s

,

.01). Modal drinking frequency for the substance abusing participants was 10–19times during the past year, past year marijuana use was reported by 71% of the sub-stance abusers, past year hard drug use was reported by 18% of the substance abusers.

Table 1. Past-year substance use frequency and prevalence by grade and gender (entries are percentages)

Alcoholic beverages

Grade Gender

9 (

n

5

106)10

(

n

5

80)11

(

n

5

70)12

(

n

5

76)Female

(

n

5

217)Male

(

n

5

115)

Never 34.9 27.5 16.2 31.6 31.0 23.71–2 34.0 30.0 23.5 22.4 29.6 25.43–5 12.3 18.8 23.5 22.4 19.0 17.56–9 4.7 11.3 14.7 9.2 8.3 11.410–19 8.5 7.5 10.3 6.6 7.4 9.620–39 4.7 1.3 4.4 5.3 2.3 7.040

1

0.9 3.8 7.4 2.6 2.3 5.3

Marijuana or hashish

Grade Gender

9(

n

5

106)10

(

n

5

80)11

(

n

5

70)12

(

n

5

76)Female

(

n

5

217)Male

(

n

5

115)Never 94.3 90.0 76.5 81.6 89.4 81.61–2 2.8 5.0 4.4 1.3 3.7 2.63–5 0.0 0.0 4.4 6.6 1.9 3.56–9 0.9 1.3 4.4 2.6 1.4 3.510–19 0.0 1.3 5.9 1.3 1.4 2.620–39 0.9 1.3 2.9 2.6 1.9 1.840

1

0.3 0.3 0.6 0.6 0.5 4.4

Hard drugs

Grade Gender

9(

n

5

106)10

(

n

5

80)11

(

n

5

70)12

(

n

5

76)Female

(

n

5

217)Male

(

n

5

115)Never 99.1 98.8 94.1 97.4 98.1 96.51–2 0.9 0.0 4.4 1.3 0.9 2.63–5 0.0 0.0 1.5 0.0 0.0 0.96–9 0.0 1.3 0.0 1.3 0.9 0.0

776 E. F. WAGNER et al.

It should be noted that our point prevalence rates of adolescent substance abuse weresomewhat higher than those typically found in epidemiological studies of high schoolstudents (e.g., Lewinsohn, Hops, Roberts, Seeley, & Andrews [1993] found a pointprevalence of DSM-III-R-defined substance abuse of 2.34%). The primary reason forour higher prevalence rates is that the adolescent-specific identification criteria of thePESQ are broader and more inclusive than the adult-derived diagnostic criteria thathave been used in other studies.

Substance-abusing and nonsubstance-abusing participants were compared onAvoidance stress-coping, Problem-Focused stress-coping, and temptation-coping (seeTable 3), the three coping scales found to significantly predict substance use involve-ment in the earlier analyses. As predicted, avoidance coping was significantly higheramong the substance abusing participants (

t

5

2.35,

df

5

54,

p

5

.023), and tempta-tion-coping was significantly higher among the nonsubstance abusing sample (

t

5

5.98,

df

5

54,

p

,

.001). However, problem-focused coping did not discriminate substanceabusers from nonsubstance abusers (

t

5

.74,

df

5

54,

p

5 .462).

D I S C U S S I O N

The current research examined an important assumption of the stress-coping modelof addiction which never before has been subjected to empirical scrutiny. Wills andShiffman (1985) maintain that stress-coping and temptation-coping contribute inde-pendently to the prediction of substance use, and we tested this proposition using asample of public high school students. In addition, we compared substance-abusingand nonsubstance-abusing adolescents on both stress-coping and temptation-coping,hypothesizing that substance-abusing adolescents would demonstrate more emotion-focused stress-coping, less problem-focused stress-coping, and less temptation-copingthan adolescents without substance use problems.

Table 2. PESQ problem severity regressed on stress-coping and temptation-coping

Independent variables Block-wise b R2total R2change

Demographic controls .04** .04**Stress-coping .15** .11**

Avoidance .37**Blamed self 2.05Wishful thinking .01Problem focused 2.19*Seek social support .01

Temptation-coping 2.463** .33** .19**

*p , .01; **p , .001.

Table 3. Substance abusers vs. demographically matched non substance abusers (matched on gender, ethncity, grade, age and household income)

Dependent variables Abusers (n 5 28) Non abusers (n 5 28) t

Avoidance 16.29 (5.54) 13.07 (6.00) 2.35*Problem-focused 20.79 (8.6) 22.61 (9.04) .74Temptation-coping 33.57 (11.91) 53.64 (12.91) 5.98**

Significance (1-tailed): *p , .05; ** p , .001.

Stress-coping and temptation-coping 777

We found support for the independence of stress-coping and temptation-coping inpredicting adolescent substance use involvement. After controlling for demographicvariables (i.e., grade and gender), hierarchical multiple regression analyses revealedthat both stress-coping and temptation-coping accounted for statistically unique andsignificant variance in teenagers’ substance use. These analyses also demonstratedthat avoidance and problem-focused coping were the stress-coping strategies moststrongly related to adolescent substance use. Adolescents who reported a greater reli-ance on avoidance stress-coping (an emotion-focused strategy) exhibited greater sub-stance involvement, whereas adolescents who reported a greater reliance on problem-focused stress-coping exhibited less substance involvement.

These results are consistent with previous findings published in both the adolescent(e.g., Labouvie, 1987; Wills, McNamara, Vaccaro, & Hirky, 1996) and adult (Finney &Moos, 1995) literatures about the relations between substance use and stress-coping.The present study suggests that a reliance on emotion-focused relief-oriented copingstrategies increases the risk for developing substance use problems. Conversely, a reli-ance on problem-focused coping strategies may protect against the development ofsubstance use problems. Furthermore, our finding that temptation-coping is inverselyrelated to substance use involvement has much precedence in the substance abuse lit-erature. Temptation-coping skills consistently have been found to be critical determi-nants of individuals’ attempts to manage alcohol and other drug use (e.g., Monti et al.,1993; Shiffman, 1984), and our results confirm that temptation-coping is an importantpredictor of teenagers’ levels of substance use involvement.

Our comparison of substance-abusing and nonsubstance abusing adolescents clari-fied further the roles of stress-coping and temptation-coping in the development ofsubstance use problems. We hypothesized that substance-abusing teenagers woulddemonstrate more emotion-focused stress-coping, less problem-focused stress-coping,and less temptation-coping than non-substance-abusing teenagers. Two of these threehypotheses were supported. Adolescents with substance use problems reported (a) agreater reliance on avoidance to cope with daily stressors and (b) a smaller repertoireof temptation-coping skills. However, they were no less likely to report engaging inproblem-focused coping than adolescents who were not substance abusers.

The fact that substance abusers and nonsubstance abusers could be distinguished onboth emotion-focused stress-coping and temptation-coping underscores the impor-tance of both types of coping in the development substance use problems. Even at theextremes of substance use involvement, it appears that stress-coping and temptation-coping independently influence substance use behavior. Our results also suggest thatrelying on avoidance to manage stress may place teenagers at particular risk for sub-stance abuse. In the stress-coping literature, avoidance coping is viewed as effectivefor managing short-term, uncontrollable stressors, but ineffective (and potentiallymaladaptive) for managing more enduring, controllable stressors (Folkman & Laz-arus, 1991). It may be that at-risk adolescents indiscriminately use avoidance stress-coping strategies without regard to the nature of stressors (this could be the result ofproblems in stressor appraisal and/or limitations in coping repertoires). Such individu-als may find substance use inviting because it represents another avoidance strategy orbecause it temporarily alleviates stress resulting from the unsuccessful resolution ofmore enduring, controllable stressors. An important focus of future research will be tobetter understand the mechanisms by which avoidance coping increases the risk of ad-olescent substance abuse.

Although the results of present study are intriguing, they should be interpreted cau-

778 E. F. WAGNER et al.

tiously due to several limitations. First, conclusions about causality cannot be madedue to the study’s cross-sectional design. Even though the data are consistent with theassumptions of the stress coping model, the direction of causality may be specified in-correctly. For example, increases in substance use involvement may lead to increasesin avoidance coping, perhaps because of increased stress resulting from escalating al-cohol and other drug use. Similarly, increases in substance use may lead to decreasesin temptation-coping rather than vice versa. Second, the study relied exclusively onself-report data. While several investigators have found such data to be reliable indica-tors of substance use among adolescents (e.g., Polich, 1982; Rouse, Kozel, & Richards,1985; Single, Kandel, & Johnson, 1975), particularly when attempts are made to con-trol response distortion, it is unclear to what extent subjects’ reports were valid. A fi-nal limitation concerns sample restrictions. The present study was restricted to mostlywhite, middle-class high school students from a single school district in New England.The stress-coping model of addiction may apply less well to substance use in early ad-olescence, in late adolescence, among adolescent substance abusers in treatment, oramong adolescents from significantly different environments or of different races/eth-nicities. Additionally, adolescents who had dropped out of school, who had a high rateof absenteeism, or responded inappropriately to the questionnaire were necessarilyoverlooked. Because these individuals often demonstrate high rates of substance use,it is likely that the upper end of the range of adolescent substance use involvementwas under-represented in the current sample.

Despite these limitations, the current investigation represents an important step invalidating the stress coping model for adolescents, and particularly its assumption thatstress-coping and temptation-coping are significantly and independently related tosubstance use involvement. While conclusive causal statements cannot be made, thepresent study also identifies relations which merit further investigation, such as the as-sociation between avoidance stress-coping and adolescent substance abuse. Addition-ally, the study highlights two factors that should be taken into account in substanceabuse prevention and intervention efforts. Our findings suggest that prevention andintervention programs, in order to be optimally effective, should aim to (a) decreasereliance on emotion-focused coping for managing controllable and/or longer-termstressors and (b) bolster temptation-coping skills for managing tempting situations.

R E F E R E N C E S

Breslin, F. C., O’Keeffe, M. K., Burrell, L., Ratliff-Crain, J., & Baum, A. (1995). The effects of stress andcoping on daily alcohol use in women. Addictive Behaviors, 20, 141–147.

Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin,98, 310–357.

Cooper, M. L., Russell, M., & George, W. H. (1988). Coping, expectancies, and alcohol abuse: A test ofsocial learning formulations. Journal of Abnormal Psychology, 97, 218–230.

Donaldson, S. I., Graham, J. W., Piccinin, A. M., & Hansen, W. B. (1995). Resistance-skills training andonset of alcohol use: Evidence for beneficial and potentially harmful effects in public schools and in pri-vate catholic school. Health Psychology, 14, 291–300.

El-Bassel, N., Ivanoff, A., Schilling, R. F., Gilbert, L., & Chen, D. R. (1995). Correlates of problem drinkingamong drug-using incarcerated women. Addictive Behaviors, 20, 359–369.

Elder, J. P., Sallis, J. F., Woodruff, S. I., & Wildey, M. B. (1993). Tobacco-refusal skills and tobacco useamong high-risk adolescents. Journal of Behavioral Medicine, 16, 629–642.

Epstein, J. A., Botvin, G. J., Diaz, T., Toth, V., & Schinke, S. P. (1995). Social and personal factors in mari-juana use and intentions to use drugs among inner city minority youth. Developmental and BehavioralPediatrics, 16, 14–20.

Finney, J. W., & Moos, R. H. (1995). Entering treatment for alcohol abuse: A stress and coping model.Addiction, 90, 1223–1240.

Stress-coping and temptation-coping 779

Folkman, S., & Lazarus, R. S. (1991). Coping and emotion. In A. Monat & R. S. Lazarus (Eds.), Stress andcoping: An anthology (pp. 207–227). New York: Columbia University Press.

Ito, J. R., & Donovan, D. M. (1990). Brief report. Predicting drinking outcome: Demography, chronicity,coping, and aftercare. Addictive Behaviors, 15, 553–559.

Kadden, R., Carrol, K., Donovan, D., Cooney, N., Monti, P., Abrams, D., Litt, M., & Hester, R. (1992).Cognitive-behavioral coping skills therapy manual. Rockville, MD: National Institute on AlcoholAbuse and Alcoholism (DHHS Publication No. (ADM)9201895).

Labouvie, E. W. (1986). Alcohol and marijuana use in relation to adolescent stress. The International Jour-nal of the Addictions, 21, 333–345.

Labouvie, E. W. (1987). Relation of personality to adolescent alcohol and drug use: A coping perspective.Pediatrician, 14, 19–24.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing Company.Lewinsohn, P. M., Hops, H., Roberts, R., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathol-

ogy: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students.Journal of Abnormal Psychology, 102, 133–144.

Madden, C., Hinton, E., Holman, C. P., Mountjouris, S., & King, N. (1995). Factors associated with copingin persons undergoing alcohol and drug detoxification. Drug and alcohol dependence, 38, 229–235.

Monat, A., & Lazarus, R. S. (1991). Introduction: Stress and coping—some current issues and controversies.In A. Monat & R. S. Lazarus (Eds.), Stress and coping: An anthology (pp. 1–16). New York: ColumbiaUniversity Press.

Monti, P. M., Rohsenow, D. J., Rubonis, A. V., Niaura, R. S., Sirota, A. D., Colby, S. M., Goddard, P., &Abrams, D. B. (1993). Cue exposure with coping skills treatment for male alcoholics: A preliminaryinvestigation. Journal of Consulting and Clinical Psychology, 61, 1011–1019.

Myers, M. G., Stice, E., & Wagner, E. F. (1999). Cross-validation of the Temptation Coping Questionnaire:Adolescent coping with temptations to alcohol and illicit drugs. Journal of Studies on Alcohol, 60, 712–718.

Myers, M. G., & Wagner, E. F. (1995). The temptation-coping questionnaire: Development and validation.Journal of Substance Abuse, 4, 463–480.

National Institute on Drug Abuse. (1994). National survey results on drug use from The Monitoring theFuture Study, 1975–1993. NIH Publication No. 94-3809. Rockville, MD: NIDA.

Northeast Midwest Institute. (1997). Median Money Income of Households by State: 1989 to 1995 [On-line].Available: http://www.nemw.org.

Polich, J. M. (1982). The validity of self-reports in alcoholism research. Addictive Behaviors, 7, 123–132.Rouse, B. A., Kozel, N. J., & Richards, L. G. (1985). Self-report methods for estimating drug use: meeting

current challenges to validity. Rockville, MD: Department of Health and Human Services.Shiffman, S. (1984). Coping with temptations to smoke. Journal of Consulting and Clinical Psychology, 52,

261–267.Single, E., Kandel, D. B., & Johnson, B. (1975). The reliability and validity of drug use responses in a large

scale longitudinal survey. Journal of Drug Issues, 5, 426–443.Sussman, S., Brannon, B. R., Dent, C. W., & Hansen, W. B. (1993). Relations of coping effort, coping strat-

egies, perceived stress, and cigarette smoking among adolescents. International Journal of the Addic-tions, 28, 599–612.

Sussman, S., Dent, C. W., Stacy, A. W., & Sun, P. (1993). Project Towards No Tobacco Use: 1-year behavioroutcomes. American Journal of Public Health, 83, 1245–1250.

U.S. Census Bureau. (1997). Resident population of the United States [On-line]. Available: http://www.census.gov.

Vitaliano, P., Russo, J., Carr, J., Mauiro, R., & Becker, S. (1985). The ways of coping checklist: Revision andpsychometric properties. Multivariate Behavioral Research, 20, 3–26.

Wagner, E. F. (1993). Delay of gratification, coping with stress, and substance use in adolescence. Experi-mental and Clinical Psychopharmacology, 1, 27–43.

Wewers, M. E. (1988). Brief report: The role of postcessation factors in tobacco abstinence: Stressful eventsand coping responses. Addictive Behaviors, 13, 297–302.

Wills, T. A. (1986). Stress and coping in early adolescence: Relationships to substance use in urban schoolsamples. Health Psychology, 5, 503–529.

Wills, T. A., & Hirky, A. E. (1996). Coping and substance abuse: A theoretical model and review of the evi-dence. In M. Zeichnec & N. S. Eudler (Eds.), Handbook of coping: Theory research, and applications(pp. 279–302). New York: Wiley.

Wills, T. A., McNamara, G., Vaccaro, D., & Hirky, A. E. (1996). Escalated substance use: A longitudinalgrouping analysis from early to middle adolescence. Journal of Abnormal Psychology, 105, 166–180.

Wills, T. A., & Shiffman, S. (1985). Coping and substance use: A conceptual framework. In S. Shiffman & T.A. Wills (Eds.), Coping and substance use (pp. 3–24). San Diego, CA: Academic Press.

Winters, K. C. (1991). The personal experience screening questionnaire. Los Angeles: Western PsychologicalServices.

Winters, K. C. (1992). Development of an adolescent alcohol and other drug abuse screening scale: Personalexperience screening questionnaire. Addictive Behaviors, 17, 479–490.