Depressive symptoms, alcohol use, and alcohol-related consequences: the moderating role of gender among American Indian adolescents.

Objectives: Depression, alcohol use, and alcohol-related consequences are experienced disproportionately by American Indian (AI) adolescents. The co-occurrence of depression and alcohol use is clinically relevant, as it is associated with increased risk for suicide, among other negative consequences. Understanding how the association between depressive symptoms and alcohol use and related consequences is influenced by gender is important to understand for whom intervention efforts might be particularly relevant. Thus, the present study seeks to evaluate gender differences in these associations among AI adolescents.
Methods: Participants were a representative sample of AI adolescents ( N  = 3,498, M _age =14.76, 47.8% female) residing on or near reservations who completed self-report questionnaires in school classrooms. Study activities were approved by IRB, school boards, and tribal authorities.
Results: The interaction of depressive symptoms and gender was significant in predicting past-year alcohol use frequency ( b =.02, p =.02) and, among youth reporting lifetime alcohol use, alcohol-related consequences ( b =.03, p =.001). Analysis of simple slopes revealed that, for females, depressive symptoms were significantly associated with past-year alcohol use frequency ( b =.02, p <.001) and alcohol-related consequences ( b =.05, p <.001). For males, depressive symptoms were only significantly associated with alcohol-related consequences ( b =.02, p =.04), and this effect was weaker than for females.
Conclusions: Results of the present study may inform the development of gender-sensitive recommendations for the assessment and treatment of alcohol use and alcohol-related consequences among AI adolescents. For instance, results suggest that treatments focusing on depressive symptoms may subsequently reduce alcohol use and related consequences for female AI adolescents.