Gaete Jorge, Rojas Graciela, Fritsch Rosemarie, Araya Ricardo
Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile.
Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Front Psychiatry. 2018 Feb 8;9:25. doi: 10.3389/fpsyt.2018.00025. eCollection 2018.
Substance use among adolescents is a major problem worldwide, producing many health and economic consequences. Even though there are well-known personal, familial, and social factors associated with drug use, less is known about the effect of school-related factors. School membership is a recognized variable affecting academic performance among students; however, its effect on substance use is less understood.
The primary aim of this study was to explore the association between school membership and cigarette, alcohol, and cannabis use among a representative sample of secondary students from municipal state-funded schools in Santiago of Chile, and secondly, to test the hypothesis that depressive or anxiety symptoms mediate this association.
A total of 2,508 students from 22 state-funded schools in Santiago, Chile, answered a questionnaire. This instrument included an abbreviated version of the psychological sense of school membership (PSSM), questions regarding the use of alcohol, tobacco, and cannabis and scales of psychological functioning (depression, anxiety, self-concept, and problem-solving). The association analyses were performed using adjusted regression models for each outcome using all independent variables while controlling for gender and age. For the mediation effect, a combination of ordinary least square and logistic regression analyses was conducted.
There was an association between a strong PSSM and low risk for smoking (OR 0.57; 95% CI 0.46-0.72), drinking (0.65; 95% CI: 0.51-0.83), and cannabis use (0.52; 95% CI 0.37-0.74). We also found that depressive and anxiety symptoms do not fully mediate the association between school membership and any substance use, and 73% of this effect in the case of smoking, 80% in the case of drinking, and 78.5% in the case of cannabis use, was direct.
This is the first study in Latin America exploring the association between school membership and substance use among secondary students. School membership seems to be an important and independent factor to be included in preventive interventions. Therefore, these results support future research aiming to test interventions at increasing the sense of school membership to prevent substance use among adolescents.
ISRCTN19466209. Retrospectively registered.
青少年物质使用是一个全球性的重大问题，会产生诸多健康和经济后果。尽管已知有许多个人、家庭和社会因素与药物使用有关，但对于与学校相关因素的影响却知之甚少。学校归属感是影响学生学业成绩的一个公认变量；然而，其对物质使用的影响却鲜为人知。
本研究的主要目的是探讨智利圣地亚哥市立公立学校的代表性中学生样本中，学校归属感与吸烟、饮酒和使用大麻之间的关联，其次，检验抑郁或焦虑症状介导这种关联的假设。
智利圣地亚哥22所公立学校的2508名学生回答了一份问卷。该问卷包括学校归属感心理量表（PSSM）的简化版、关于酒精、烟草和大麻使用的问题以及心理功能量表（抑郁、焦虑、自我概念和解决问题能力）。使用调整后的回归模型对每个结果进行关联分析，将所有自变量纳入模型，并对性别和年龄进行控制。对于中介效应，进行了普通最小二乘法和逻辑回归分析的组合。
强烈的学校归属感与吸烟低风险（比值比0.57；95%置信区间0.46 - 0.72）、饮酒（0.65；95%置信区间：0.51 - 0.83）和使用大麻（0.52；95%置信区间0.37 - 0.74）之间存在关联。我们还发现，抑郁和焦虑症状并未完全介导学校归属感与任何物质使用之间的关联，在吸烟方面，这种关联的73%是直接的，饮酒方面为80%，使用大麻方面为78.5%。
这是拉丁美洲第一项探索中学生学校归属感与物质使用之间关联的研究。学校归属感似乎是预防性干预措施中一个重要且独立的因素。因此，这些结果支持未来旨在测试通过增强学校归属感来预防青少年物质使用的干预措施的研究。
ISRCTN19466209。回顾性注册。
