Attitudes Towards Substance Use: A Potential Mechanism in the Relationship Between Conduct Disorder and Substance Use in Detained Youth

Abstract

Background: There is a well-established relationship between conduct disorder and substance use, particularly in detained youth. Attitudes toward substance use predict alcohol and marijuana use; however, little research has investigated attitudes as a mechanism between conduct disorder and substance use specifically in detained youth. Methods: Ninety-three detained youth (Mean age=15; SD=1.346; Female=15.1%) completed a court ordered psychological assessment, which included the Substance Abuse Subtle Screening Inventory for Adolescents (SASSI-A) and the Youth Self Report (YSR) to assess alcohol and drug use, attitudes towards substance use, and conduct disorder symptomology. Results: Two mediation models were run using Andrew Hayes’ PROCESS to test the effect of conduct disorder on alcohol use and drug use (run in separate models) through attitudes towards substance use, controlling for age and gender. Conduct disorder directly related to positive attitudes toward substance use in the alcohol model (b=0.47, t(91)=4.45, p<.001) and drug use model (b=0.30, t(91)=3.33, p=.001). Conduct disorder directly related to alcohol use (b=0.32, t(89)=2.60, p=.02) and drug use (b=0.44, t(89)=3.04, p=0.003). Attitudes toward substance use were associated with higher alcohol use scores, (b=0.42, t(89)=3.99, p<.001) and drug use scores (b=0.27, t(89)=1.92, p=.06). The relationship between conduct disorder and alcohol use was significantly mediated by positive attitudes toward substance use (b=0.20, CI 0.04 to 0.42); however, the relationship between conduct disorder and drug use as mediated by positive attitudes towards substance use was non-significant (b=0.07, CI -0.003 to 0.24). Discussion: The results support that one way in which conduct disorder increases risk for substance use in detained youth is through increasing the likelihood of holding positive attitudes towards substance use. Modifying positive alcohol attitudes might be a prime point of intervention to avoid risks associated with substance use among conduct disordered detained youth.