Psychiatry. 2024 Summer;87(2):111-133. doi: 10.1080/00332747.2024.2303897. Epub 2024 Feb 20.
We assessed the associations of substance (alcohol, tobacco, cannabis, and other illicit drugs) use of adolescents with that of their family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers, and the mediating role of school and mental difficulties (SMDs) which remained insufficiently addressed.
This cross-sectional population-based study included 1,559 middle-school adolescents in France (mean age = 13.5 ± 1.3, 778 boys, 781 girls). They completed a questionnaire including socioeconomic features (nationality, family structure and parents' education, occupation, and income), substance use, cumulative number of substance use of family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers (noted familySUcn and peerSUcn), SMDs (grade repetition, suffered physical/verbal violence, sexual abuse, lack of family/peer support, depressive symptoms, suicide attempt, and age at onset). Data were analyzed using logistic regression models and Kaplan-Meier estimates.
Most adolescents had familySUcn 1-2, 3-5, and ≥ 6 (39.1%, 23.0%, and 4.5%, respectively) and peerSUcn 1-2 and ≥ 3 (36.1% and 13.0%, respectively). Strong dose-effect associations were found between all substance use and familySUcn and peerSUcn (odds ratio adjusted for sex, age, and socioeconomic features reaching 13.44 and 9.90, respectively, most with < .001). SMDs explained more the associations of all substance use with familySUcn than with peerSUcn (contributions reaching 69% and 34%, respectively). The proportion of subjects without each substance use decreased with age more quickly among the adolescents with higher familySUcn or peerSUcn.
Early prevention reducing familySUcn, peerSUcn and SMDs among adolescents and their families may reduce efficiently initiation and regular use of substances during adolescents' life course.
我们评估了青少年物质（酒精、烟草、大麻和其他非法药物）使用与其家庭成员（父亲、母亲、继父/母、兄弟姐妹和祖父母）和同龄人之间的关联，以及学校和心理困难（SMD）的中介作用，而这些因素的作用仍未得到充分关注。
本横断面基于人群的研究纳入了法国的 1559 名中学生（平均年龄 13.5±1.3 岁，男生 778 名，女生 781 名）。他们完成了一份问卷，其中包括社会经济特征（国籍、家庭结构和父母教育程度、职业和收入）、物质使用情况、家庭成员（父亲、母亲、继父/母、兄弟姐妹和祖父母）和同龄人（记录的家庭使用量和同伴使用量）的累积物质使用量、SMD（年级留级、遭受身体/言语暴力、性虐待、缺乏家庭/同伴支持、抑郁症状、自杀企图和发病年龄）。使用逻辑回归模型和 Kaplan-Meier 估计分析数据。
大多数青少年的家庭使用量为 1-2、3-5 和≥6（分别为 39.1%、23.0%和 4.5%），同伴使用量为 1-2 和≥3（分别为 36.1%和 13.0%）。所有物质使用与家庭使用量和同伴使用量之间都存在强烈的剂量效应关联（性别、年龄和社会经济特征调整后的比值比分别达到 13.44 和 9.90，大多数 P<0.001）。SMD 解释了所有物质使用与家庭使用量之间的关联程度大于与同伴使用量之间的关联程度（分别为 69%和 34%）。在具有更高家庭使用量或同伴使用量的青少年中，没有任何一种物质使用的个体比例随着年龄的增长而更快地下降。
减少青少年及其家庭中家庭使用量、同伴使用量和 SMD 的早期预防措施，可能会有效减少青少年一生中物质的初始使用和常规使用。
