Gender-specific substance use patterns and associations with individual, family, peer, and school factors in 15-year-old Portuguese adolescents: a latent class regression analysis

Abstract

Background Adolescence is a critical period of vulnerability to substance use. Recent research has shown that gender differences in adolescence substance use are complex and in constant flux. The present study aims to investigate gender differences in substance use and initiation patterns in male and female adolescents, and to assess individual, family, peer, and school associated factors of these patterns. Methods We applied latent class regression analysis to a Portuguese representative population sample of 1551 15-year-old adolescents, drawn from the 2010 ‘Health Behavior in School-Aged Children’ survey, to characterise different profiles of substance use and initiation for boys and girls, and to identify factors associated with latent class membership, stratifying the associations analysis by gender. Results Three common classes were found for both genders, specifically, Non - Users (boys [B] 34.42%, girls [G] 26.79%), Alcohol Experimenters (B 38.79%, G 43.98%) and Alcohol and Tobacco Frequent Users (B 21.31%, G 10.36%), with two additional unique classes: Alcohol Experimenters and Tobacco Users in girls (18.87%), and Early Initiation and Poly - Substance Users in boys (5.48%). Poor school satisfaction, bullying, fighting and higher family affluence scale score formed a common core of associated factors of substance use, although we found gender differences in these associations. In girls, but not in boys, family factors were associated with more problematic substance use. Not living with both parents was associated with girl’s Alcohol and Tobacco Frequent Users (gATFU) class (OR 3.78 CI 1.18–12.11) and Alcohol Experimenters and Tobacco Users (AETU) class (OR 3.22 CI 1.4–7.44). Poor communication with mother was also associated with gATFU class membership (OR 3.82 CI 1.26–11.53) and AETU class (OR 3.66 CI 1.99–6.75). Additionally, a higher psychological symptoms score was associated with gATFU class membership (OR 1.16 CI 1.02–1.31). Conclusion Although we found common patterns and associated factors between boys and girls, we report two unique patterns of substance use in boys and girls and specific associations between family, school and peers, and individual factors with these patterns. These findings underscore the need for substance use prevention and health promotion programmes that address potential differences in substance use patterns and associated factors. Electronic supplementary material The online version of this article (10.1186/s13034-019-0281-4) contains supplementary material, which is available to authorized users.

Psychiatric morbidity, somatic comorbidity and substance use in an adolescent psychiatric population at 3-year follow-up

“…Opposite to our finding, Turner et al demonstrated in a review that self-medication with alcohol or drugs for mood and anxiety disorders was associated with male gender [53]. A recent population-based study showed gender-specific substance use patterns among Portuguese adolescents [54]. We found increasing rates of illicit drug use among patients with ADHD for both genders, which corresponds with recent findings from the MTA longitudinal study [55].…”

Connections between Family Assets and Positive Youth Development: The Association between Parental Monitoring and Affection with Leisure-Time Activities and Substance Use

“…Our results also confirm, in line with previous studies, that substance use is lower among women [58,59] and in young people who live with both biological parents [59][60][61].…”

Belief patterns and drug use in a sample of Brazilian youth: an exploratory latent class analysis

“…Although to our knowledge, ours is the first study to explore latent classes of drug-related beliefs in adolescents, numerous others have classified adolescents based on substance use behaviors and have subsequently explored demographic differences across classes. 21,23,24 Our findings are consistent with those of similar studies in high-income countries, particularly regarding gender and Table 4 Fit indices for latent class models age. [21][22][23] One study of high-schoolers in New Zealand found that among current drinkers, those who engaged in the highest risk behavior also held the most positive drug-related beliefs.…”

“…LCA is a modeling method that categorizes individuals based on an unobservable ''latent'' trait, using responses to more readily measure indicator variables; this type of analysis has thus far only been used in a limited way with adolescent substance use and has served primarily as a means of categorizing behavior rather than to examine how beliefs relate to real-world use. [21][22][23][24] In this study, we begin to explore beliefs as an indicator of substance use to better understand the feasibility of their use to predict future drug use in prevention programming. Conceptualizing drug-related beliefs as an underlying categorical construct may provide useful insights to help develop more effective prevention programs.…”