ArticlePLOS mental health2026
Impact of problematic substance use and social anxiety on school functioning: Insights from the Texas Youth Depression and Suicide Research Network.
Article in PLOS mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Early onset substance use and social anxiety are associated with adverse psychosocial outcomes, including impaired academic performance. This study aimed to investigate if problematic substance use is associated with poorer school functioning and if social anxiety is associated with this relationship. Participants (n = 711), aged 8-20, were enrolled in the Texas Youth Depression and Suicide Research Network registry study aiming to characterize youth with depression and/or suicidality. Baseline data from CRAFFT 2.1 + N, MINI-KID, SAS-SR, and PHQ-A were used for multivariate analyses using linear regression to examine the relationship between problematic substance use and school functioning, as well as the interaction between problematic substance use and social anxiety and their association with school functioning. Over 20% of participants met criteria for problematic substance use, with alcohol and marijuana being the two most common reported substances used. Youth with problematic substance use were on average two years older and had significantly greater impairment in school functioning compared to youth without problematic substance use. However, youth with problematic substance use and social anxiety had comparable impairments in school functioning compared to those with problematic substance use that did not have social anxiety. In youth without problematic substance use, having social anxiety was associated with similar levels of impairment in school functioning compared to youth with problematic substance use alone. The significant co-occurrence of problematic substance use, social anxiety, and depression suggests the need for early identification and intervention to prevent and/or mitigate impairment in school functioning. Significant levels of comorbid depression and/or suicidality experienced by our participants may have impacted our findings. Future research comparing youth with and without depression will help elucidate this.
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