Examining protective factors for substance use problems and self-harm behavior during adolescence: A longitudinal co-twin control study

Abstract

Sports participation, physical activity, and friendship quality are theorized to have protective effects on the developmental emergence of substance use and self-harm behavior in adolescence, but existing research has been mixed. This ambiguity could reflect, in part, the potential for confounding of observed associations by genetic and environmental factors, which previous research has been unable to rigorously rule out. We used data from the prospective, population-based Child and Adolescent Twin Study in Sweden (n = 18,234 born 1994–2001) and applied a co-twin control design to account for potential genetic and environmental confounding of sports participation, physical activity, and friendship quality (assessed at age 15) as presumed protective factors for adolescent substance use and self-harm behavior (assessed at age 18). While confidence intervals widened to include the null in numerous co-twin control analyses adjusting for childhood psychopathology, parent-reported sports participation and twin-reported positive friendship quality were associated with increased odds of alcohol problems and nicotine use. However, parent-reported sports participation, twin-reported physical activity, and twin-reported friendship quality were associated with decreased odds of self-harm behavior. The findings provide a more nuanced understanding of the risks and benefits of putative protective factors for risky behaviors that emerge during adolescence.

A Multi-Level Analysis of Biological, Social, and Psychological Determinants of Substance Use Disorder and Co-Occurring Mental Health Outcomes

“…For adolescents, any level of SU is risky and can result in negative developmental outcomes, including disruption of brain development, educational underachievement, behavioral consequences (e.g., driving, sexual behavior), and injury, as well as the potential for inducing or exacerbating mental comorbidities and progression to SUD [6,51]. Furthermore, early-onset substance use is associated with increased psychosocial problems and problematic substance use later in life [52].…”

“…Peer interactions are often enmeshed within physical activities in adolescence, and physical activity is broadly (positively) related to mental health via psychosocial, behavioral, and physiological mechanisms [52]. Two studies that examined pairs of discordant twins on physical activity found that physical inactivity in adolescence was associated with increased consumption of alcohol, drugs, and smoking in young adulthood [52].…”

“…Peer interactions are often linked to physical activities during adolescence. Across adolescence, peer relationships become more important as friends increasingly become a source of social support and influence on developing adaptive and maladaptive behaviors [52]. In the context of substance use disorders, observational studies on adolescents have yielded conflicting results depending on the type of physical activity and substances under examination [52].…”

“…Across adolescence, peer relationships become more important as friends increasingly become a source of social support and influence on developing adaptive and maladaptive behaviors [52]. In the context of substance use disorders, observational studies on adolescents have yielded conflicting results depending on the type of physical activity and substances under examination [52]. Factors such as rejection and loneliness may increase the risk of substance-related issues in adolescence and early adulthood.…”

Risk and protective factors for self-harm in secure mental health hospitals: a systematic review

“…For example, a systematic review focusing on self-harm and cyberbullying noted that only one third of articles investigated protective factors (Dorol-Beauroy-Eustache and Mishara, 2021). Those reviewed found that life satisfaction, family and school satisfaction protected against self-harm (Dorol-Beauroy-Eustache and Mishara, 2021; Janiri et al , 2021), as did positive peer relationships (Neufeld et al , 2015; O’Reilly et al , 2022). Evidently, further investigation of protective factors in this area is warranted.…”