Ethnic differences in comorbidity among substance-abusing adolescents referred to outpatient therapy

Objective: To examine differences in psychiatric comorbidity between African-American and Hispanic substance-abusing adolescents referred for outpatient therapy. Method: Participants were 167 substance-abusing adolescents and their family members who completed an intake assessment. As part of the intake assessment, adolescents and parents were administered the Diagnostic Interview Schedule for Children-Predictive Scales to screen for the presence of nine psychiatric diagnoses representing both externalizing and internalizing disorders. Results: Both African-American and Hispanic youths presented with high-above-threshold symptom rates of co-occurring disorders. However, both adolescents and parents reported that Hispanic youths (78.3% and 83.9%, respectively) demonstrated greater rates of externalizing symptoms than African-American youths (65.2% and 70.1%, respectively). African-American youths (40%) reported significantly more symptoms of agoraphobia than Hispanic youths (19.5%). Conclusions: The presence of high rates of co-occurring internalizing and externalizing problems provides evidence of the need for developing and implementing multifaceted interventions that address the complex emotional and behavioral needs of adolescent substance abusers, Among Hispanic youths in particular, treatments must address constellations of problem behaviors that appear to co-occur and likely represent the child's entrenchment in a deviant subculture.