Risk and Protective Factors for Adolescent Substance Use and Mental Health Symptoms

The purpose of this study was to gain a better understanding of the association between youth substance use patterns and mental health symptoms, and the risk and protective factors unique and common to each of these areas. A survey was administered to a random sample of 663 youth ages 12 to 18 in Victoria, British Columbia. As expected, age was a strong predictor of greater frequency and amounts of alcohol consumption. Males were at higher risk for alcohol consumption and externalizing problems while females were more susceptible to internalizing problems. Youth who scored lower on substance use and reported fewer mental health symptoms rated their parents and peers as being more protective. Youth who scored higher on substance use scored higher on the risky peer affiliations scale. Mental health surveys have shown that there is a very high prevalence of psychiatric morbidity in youth aged 15–24 years (e.g., Kessler et al., 1994). Many health authorities in Canada, for example in Ontario and British Columbia, have moved to amalgamate addiction and mental health services. The successful implementation of these integrated services for youth requires an understanding of the nature of the association between substance use and mental health in youth, and the risk and protective factors that are shared or unique to each. Research on risk and protective factors related to maladjustment in adolescence has recognized a cluster of problem behaviours, including delinquency and CANADIAN JOURNAL OF COMMUNITY MENTAL HEALTH 2 substance abuse, as a syndrome (Allen, Leadbeater, & Aber, 1994). However, previous studies have rarely looked at the overlap of these behavioural problems with mental health concerns such as anxiety and depression, which are related to internalizing problems. The co-occurrence of behavioural and mental health problems suggests a need to understand to what extent different problems have common or unique predictors. In this investigation an expanded version of the Jessor et al. model (e.g., Costa, Jessor, & Turbin, 2007; Jessor et al., 2003; Turbin, Jessor, & Costa, 2006) was developed and tested to inform approaches to integrating mental health and substance use services. In the framework proposed by Jessor and colleagues, risk and protective factors are identified across different social contexts (i.e., family, peer, neighbourhood, and school). Protective factors are associated with a reduced risk while risk factors are associated with an increased risk for engaging in problem behaviours (Costa et al., 2007). Risk and protective factors are classified as either psychosocial or behavioural. Psychosocial protective factors include peer role models, personal and social controls against norm-violating behaviour, and environmental support (e.g., family closeness). Behavioural protective factors include participation in positive or prosocial activities such as religious attendance. Psychosocial risk factors include models for high-risk behaviour, opportunities for engaging in risk behaviour, and personal and social vulnerability (e.g., peer pressure). Behavioural risk factors include problem behaviour involvement. Our adaptation of the Jessor model, presented in Figure 1, shows interrelated risk and protective factors that are salient for the prediction of either substance use problems or mental health problems (including broad categories of externalizing and internalizing symptoms). The purpose of this study is to investigate the common and unique predictors of substance use and mental health symptoms. By examining the effects of similar risk and protective factors on heterogeneous outcomes, we can gain a better understanding of their common and unique influences.