Externalized anger as a mediator of harsh parenting and substance use among Appalachian adolescents

Adolescent substance use (SU) is a prevalent public health issue in the United States. Understanding how known risk factors such as harsh parenting and externalized anger may impact youth SU is crucial for structuring primary prevention efforts and interventions. This study examines the relationship between harsh parenting and both current SU and SU severity. We assess whether, and to what extent, externalized anger mediates the relationship between harsh parenting and the two SU outcomes. Two waves of a biannual prospective cohort study administered to adolescents between 10-16 years of age were used to test mediation models for SU outcomes. The sample was 44.5% female, 87.2% White, and 95.7% non-Hispanic. Significant direct effects (<i>p</i> < 0.05) were observed between harsh parenting and externalized anger (Stand. β = 0.27); harsh parenting and current SU (Stand. β = 0.11); and externalized anger and current SU (Stand. β = 0.33). Significant indirect effects were also observed between harsh parenting and current SU (Stand. β = 0.09) and between harsh parenting and SU severity (Stand. β <i>=</i> 0.06). Results indicate a total effect between harsh parenting and adolescent SU of Stand. β = 0.198; about 44% of which is attributed to mediation via externalized anger. While no significant direct effect between harsh parenting and SU severity was found, significant mediation effects (Stand. β = 0.06) were found for the role of externalized anger. While harsh parenting is known to affect adolescent SU directly, we found that this relationship is emphasized by the presence of externalized anger. Implications for prevention and interventions are discussed.