A latent class analysis of changes in adolescent substance use between 1988 and 2011 in Sweden: associations with sex and psychosomatic problems

Abstract

Aims To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. Design Secondary analysis of repeated cross‐sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988–91, 1995–98, 2002–05 and 2008–11). Setting and participants The sample included all 15–16‐year‐olds in Värmland County, Sweden (n = 20 057). Measurements Binary‐coded substance use measures included life‐time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight‐item scale was used to assess psychosomatic problems. Findings A three‐class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps < 0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps < 0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps < 0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period. Conclusions Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non‐use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period.

Examining the heterogeneity of polysubstance use patterns in young adulthood by age and college attendance.

“…However, high-risk substance use patterns [e.g., polysubstance use (PSU)] yield serious negative consequences, including unintentional injury, poorer psychological functioning, more persistent patterns of substance misuse and problems, and fatal and nonfatal overdose (Connor et al, 2014; Peppin et al, 2020; Saunders et al, 2016). Research characterizing the heterogeneity of use patterns has identified between three and five types of young adult substance users: Polysubstance users (PSU), nonusers or infrequent users, and users of specific combinations or levels of use (Bailey et al, 2019; Evans et al, 2020; Evans-Polce et al, 2016; Shi et al, 2020). In the existing PSU literature, the following three latent classes typically emerge: limited-range polysubstance users (LR PSU; using alcohol/tobacco/cannabis); moderate-range PSU (in which amphetamines are added), and extended-range polysubstance users (ER PSU; in which other nonmedical prescription drug use and illicit drug use are added; Connor et al, 2014; Saunders et al, 2016).…”

The Gaming Problem: A Latent Class Analysis of DSM-5 Criteria For Internet Gaming Disorder In A Non-Clinical Sample

“…Despite this, we can examine the classes found across several studies and see that research on problem gambling typically reports a three- [12][13][14] or four-class pattern [15,16] , with increasing severity between classes. Similarly, substance use has been found to t a three-class [17][18][19][20] , or four-class model [21,22] , categorised by severity. Interestingly, Deleuze, Rochat [23] investigated both behavioural and substance addiction and found three theoretical subgroups.…”

Commentary on Evans et al. (2020): The complex interplay between adolescent substance use, internalizing and externalizing symptoms

“…Evans and colleagues [1] found that adolescents who presented more psychosomatic symptoms had higher odds of alcohol and polysubstance use. The authors highlight that throughout the study period this association remained stable, and intervention strategies that address both adolescent substance use and psychosomatic problems may be appropriate.…”