Consistent predictors of adolescent substance use: cross-sectional comparison across five countries

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• Adolescent substance use patterns and their underlying factors can vary significantly across different cultural contexts.
• Despite cultural differences, shared psychological and environmental factors may drive substance use among adolescents globally.
• Understanding these common drivers is crucial for developing effective, universally applicable prevention strategies.

Purpose of the Study:

• To investigate the associations between country of residence, psychological distress, adverse childhood experiences (ACEs), and Big Five personality traits with alcohol and drug use among adolescents.
• To determine if these associations differ across various countries.

Main Methods:

• A cross-sectional online survey was administered to 5,108 upper-secondary students (aged 15-19) in the United States, Sweden, Serbia, Morocco, and Vietnam.
• Data collected included scores on the Alcohol Use Disorders Identification Test (AUDIT) and Drug Use Disorders Identification Test (DUDIT), alongside measures of psychological distress, four types of ACEs, and Big Five personality traits.
• Statistical analyses examined the relationships between predictors and substance use outcomes, considering country as a variable.

Main Results:

• Alcohol use was highest in Sweden and Serbia, while drug use was most prevalent in the United States.
• Psychological distress emerged as the strongest predictor of both alcohol and drug use.
• Personality traits showed consistent effects: extraversion was associated with higher use, whereas conscientiousness and agreeableness were protective factors.

Conclusions:

• While the prevalence of adolescent alcohol and drug use varies internationally, the core predictors—psychological distress, early adversity, and personality traits—remain consistent.
• Prevention programs should integrate trauma-informed mental health care with personality-focused interventions.
• Findings suggest that addressing psychological distress and adverse experiences, alongside leveraging personality strengths, can mitigate adolescent substance use risks across diverse cultural settings.