Associations between negative life events and adolescent alcohol/drug-related problems, and the potential moderating role of individual and social resilience factors. The youth@hordaland-survey

Introduction: Alcohol/drug use is common in adolescence and it is important to gain a better understanding of risk and protective factors for potential alcohol/drug-related problems (ADPs) in this population.

Methods: A large population-based survey comprised the dataset of this study, including 10,183 Norwegian adolescents aged 16 to 19 years. The main explanatory variable were negative life events (NLEs) including deaths of close persons and having experienced or witnessing violence. The main outcome variable were self-reported ADPs, using the validated CRAFFT scale. Self-reported individual and family resilience factors were measured with the five subscales from the Resilience Scale For Adolescents (READ) questionnaire, and were in addition to gender used as moderators for the associations between NLEs and ADPs.

Results: Ordinal levels of NLEs were strongly associated with potential ADPs even after adjustment from age and socioeconomic status (adjusted odds ratios ranging from 1.69 to 6.12). We found a three-way interaction between NLEs x family cohesion x gender on the association with ADP (mean difference -0.06, p<0.05), suggesting that family cohesion protects boys with NLEs more strongly than girls with NLEs compared with the adolescent counterparts without NLEs. We also found two-way interactions between structured style x NLEs (mean difference -0.05, p<0.01), social resources x NLEs (mean difference -0.05, p<0.01), and personal competence x NLEs (mean difference -0.04, p<0.01) on the association with ADP, suggesting that these resilience factors protected both boys and girls with NLEs more strongly than adolescents without NLEs. Social competence were the only resilience factor that did not moderate the association between NLEs and ADP.

Conclusions: NLEs are strong and robust correlates of ADPs among adolescents. A structured style, social resources and personal competence moderated the association between NLEs and ADP for both genders, while family cohesion also moderated this association for boys. These findings highlight the need for prevention efforts to strengthen selected resilience factors in individuals at risk for developing ADPs during adolescence.