Dissociable psychosocial profiles of adolescent substance users

ObjectiveAlcohol, tobacco and cannabis use in adolescence is associated with adverse outcomes. Characterizing adolescent substance misusers, however, is difficult due to the wide range of risk and protective factors linked to substance use. The aim of the present study was to examine the role of the Individual, Family, School, Peer, and Social Environment on alcohol (lifetime and risky), tobacco (risky only), and cannabis use (lifetime and riskiness).MethodData were analyzed from a national sample of 5,680 adolescents, capturing substance use behavior alongside risk and protective factors across Individual, Family, School, Peer and Social domains. We applied a sophisticated machine learning classifier to develop models of alcohol, tobacco and cannabis initiation and misuse.ResultsWe found highly accurate (area under curve of receiver-operator-characteristic for out-of-sample performance was > .88) and replicable (over multiple iterations and in comparison with permuted outcomes) dissociable psychosocial profiles of alcohol, tobacco and cannabis use. Alongside common predictors (peer relations and externalizing behavior), dissociable risk and resilience factors were observed. Adolescent profiles of alcohol use were distinguished by the contribution of multiple domains. In contrast, tobacco use was characterized by a small number of individual variables, including female gender and poor perceived academic position. Cannabis use was differentiated by the distinct contribution of Individual risk factors, in particular male gender and feelings of anger. Differential associations were also evident, with the strength and direction of association differing substantially across substances.ConclusionThis study indicates that the relationship between the environment and substance use is more complex than previously thought.

研究目的：青少年时期的酒精、烟草与大麻使用均与不良健康结局相关。然而，由于物质使用关联的风险与保护因素覆盖范围极广，精准刻画青少年物质滥用群体的特征存在较大挑战。本研究旨在探讨个体、家庭、学校、同伴及社会环境五大领域因素，对酒精（终身使用与高危使用）、烟草（仅高危使用）以及大麻使用（终身使用与高危使用）的影响作用。

研究方法：本研究分析了一项涵盖5680名青少年的全国性样本数据，该数据采集了青少年的物质使用行为，以及个体、家庭、学校、同伴与社会各领域的风险与保护因素。我们采用了高精度的机器学习分类器，构建了酒精、烟草与大麻的起始使用及滥用预测模型。

研究结果：本研究获得了高精度且可重复的、针对酒精、烟草与大麻使用的可分离社会心理特征谱：样本外表现的受试者工作特征曲线（Receiver-Operator Characteristic, ROC）下面积大于0.88，且经多次迭代验证，并与置换后的结局进行对比后，该结果具备可重复性。除共同预测因子（同伴关系与外化行为）外，我们还观察到具有物质特异性的风险与韧性因素。酒精使用的青少年特征谱由多个领域的因素共同贡献所区分。与之形成鲜明对比的是，烟草使用的特征仅由少量个体层面变量决定，包括女性性别与较差的自我感知学业地位。大麻使用的特征则由个体层面风险因素的独特贡献所区分，尤其是男性性别与愤怒情绪。此外，不同物质间还存在显著的差异关联，其关联强度与方向均存在实质性差异。

研究结论：本研究表明，环境与物质使用之间的关联比此前研究所认为的更为复杂。