Access Type

Open Access Thesis

Date of Award

January 2013

Degree Type


Degree Name




First Advisor

Paul A. Toro


The present study examined temporal relationships between psychological distress and two types of risk behavior; risky sexual behavior and substance abuse/dependence, in a sample of 253 at-risk youth. Using structural equation modeling, the self-medication and risk-first hypotheses were tested using longitudinal data spanning 7 years. Each model lent support to both hypotheses, further supporting the relationship between risk-taking behaviors and psychological distress among youth. Early psychological distress predicted later involvement in risky sexual behaviors, while later distress predicted substance abuse/dependence. Earlier risky sexual behaviors and substance abuse/dependence predicted psychological distress at later time points. These findings suggest the need to examine for possible subgroups who experience either risk-involvement or psychological distress earlier, as such findings would inform the targets of intervention and prevention work among youth and potentially aid in reducing the impact of both in the lives of youth. Results also indicate the importance of assessing and treating psychological and behavioral concerns, including substance use and risky sexual behaviors, concomitantly when working with youth.