Skip to main content

Advertisement

Log in

Externalizing behavior problems are related to substance use in adolescents across six samples from Nordic countries

European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The aim of this study is to investigate associations between use of cigarettes, cannabis, and alcohol (CCA) and psychosocial problems among adolescents with different cultural backgrounds living in Nordic countries. Data from six questionnaire-based surveys conducted in Denmark, Norway, and Greenland, with participants from different cultural and religious backgrounds, were compared. A total of 2212 adolescents between 15 and 18 years of age participated in the study. The surveys were carried out nationally and in school settings. All adolescents answered a 12-item questionnaire (YouthMap12) with six questions identifying externalizing behavior problems and six questions identifying internalizing behavior problems, as well as four questions regarding childhood neglect and physical or sexual abuse, and questions about last month use of CCA. Externalizing behavior problems were strongly associated with all types of CCA use, while childhood history of abuse and neglect was associated with cigarette and cannabis use. The associations did not differ by sample. Despite differences between samples in use of CCA, national, cultural, and socioeconomic background, very similar associations were found between psychosocial problems and use of CCA. Our findings highlight the need to pay special attention to adolescents with externalizing behavior problems and experiences of neglect and assault in CCA prevention programs, across different ethnic and socioeconomic backgrounds.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Jensen L (2015) Postcolonial Denmark: beyond the rot of colonialism? Postcolon Stud 18(4):440–452

    Article  Google Scholar 

  2. Connell J (2016) Greenland and the Pacific Islands: an improbable conjunction of development trajectories. Isl Stud J 11(2):465–484

    Google Scholar 

  3. Kraus L, Guttormsson U, Leifman H, Arpa S, Molinaro S (2016) ESPAD Report 2015: results from the European School Survey Project on alcohol and other drugs. Publications Office of the European Union, Luxembourg

    Google Scholar 

  4. Niclasen BV (2015) Trivsel og sundhed blandt folkesskoleelever i Grønland. SIF’s Grønlandsskrifter, vol 27. Statens Institut for Folkesundhed, København

    Google Scholar 

  5. Pedersen CP, Bjerregaard P, Nielsen NO, Dahl-Petersen IK, Larsen CVL, Olesen I, Budtz CK (2012) Det svære ungdomsliv: Unges trivsel i Grønland 2011—En undersøgelse om de ældste folkeskoleelever [The Difficult Youth Years: Well-being of Youth in Greenland 2011—a survey on lower secondary pupils]. The Danish National Institute of Public Health (NIPH) in Greenland

  6. Skogen JC, Bøe T, Sivertsen B, Hysing M (2018) Use of alcohol, tobacco and illicit drugs among ethnic Norwegian and ethnic minority adolescents in Hordaland county, Norway: the youth@ hordaland-survey. Ethn Health 23(1):43–56

    Article  Google Scholar 

  7. Van Ours JC, Williams J (2009) Why parents worry: initiation into cannabis use by youth and their educational attainment. J Health Econ 28(1):132–142

    Article  Google Scholar 

  8. Leach LS, Butterworth P (2012) The effect of early onset common mental disorders on educational attainment in Australia. Psychiatry Res 199(1):51–57

    Article  Google Scholar 

  9. Wiefferink CH, Peters L, Hoekstra F, Ten Dam G, Buijs GJ, Paulussen TGWM (2006) Clustering of health-related behaviors and their determinants: possible consequences for school health interventions. Prev Sci 7(2):127–149. https://doi.org/10.1007/s11121-005-0021-2

    Article  PubMed  Google Scholar 

  10. Farmer RF, Gau JM, Seeley JR, Kosty DB, Sher KJ, Lewinsohn PM (2016) Internalizing and externalizing disorders as predictors of alcohol use disorder onset during three developmental periods. Drug Alcohol Depend 164:38–46. https://doi.org/10.1016/j.drugalcdep.2016.04.021

    Article  PubMed  PubMed Central  Google Scholar 

  11. Farmer RF, Seeley JR, Kosty DB, Gau JM, Duncan SC, Lynskey MT, Lewinsohn PM (2015) Internalizing and externalizing psychopathology as predictors of cannabis use disorder onset during adolescence and early adulthood. Psychol Addict Behav 29(3):541–551. https://doi.org/10.1037/adb0000059

    Article  PubMed  PubMed Central  Google Scholar 

  12. Laukkanen E, Shemeikka S, Notkola I-L, Koivumaa-Honkanen H, Nissinen A (2002) Externalizing and internalizing problems at school as signs of health-damaging behaviour and incipient marginalization. Health Promot Int 17(2):139–146. https://doi.org/10.1093/heapro/17.2.139

    Article  PubMed  Google Scholar 

  13. Griffith-Lendering MFH, Huijbregts SCJ, Mooijaart A, Vollebergh WAM, Swaab H (2011) Cannabis use and development of externalizing and internalizing behaviour problems in early adolescence: a TRAILS study. Drug Alcohol Depend 116(1–3):11–17. https://doi.org/10.1016/j.drugalcdep.2010.11.024

    Article  CAS  PubMed  Google Scholar 

  14. Brook JSE, Zhang CP, Brook DWMD (2011) Developmental trajectories of marijuana use from adolescence to adulthood: personal predictors. Arch Pediatr Adolesc Med 165(1):55

    Article  Google Scholar 

  15. Hayatbakhsh MR, Mcgee TR, Bor W, Najman JM, Jamrozik K, Mamun AA (2008) Child and adolescent externalizing behavior and cannabis use disorders in early adulthood: an Australian prospective birth cohort study. Addict Behav 33(3):422–438. https://doi.org/10.1016/j.addbeh.2007.10.004

    Article  PubMed  Google Scholar 

  16. Fergusson DM, Horwood LJ, Ridder EM (2005) Show me the child at seven II: childhood intelligence and later outcomes in adolescence and young adulthood. J Child Psychol Psychiatry 46(8):850–858. https://doi.org/10.1111/j.1469-7610.2005.01472.x

    Article  PubMed  Google Scholar 

  17. Patrick ME, Schulenberg JE (2013) Prevalence and predictors of adolescent alcohol use and binge drinking in the United States. Alcohol Res 35(2):193–200

    PubMed  Google Scholar 

  18. Pedersen W, von Soest T (2015) Adolescent alcohol use and binge drinking: an 18-year trend study of prevalence and correlates. Alcohol Alcohol 50(2):219–225. https://doi.org/10.1093/alcalc/agu091

    Article  CAS  PubMed  Google Scholar 

  19. Hinshaw SP (1992) Externalizing behavior problems and academic underachievement in childhood and adolescence: causal relationships and underlying mechanisms. Psychol Bull 111(1):127–155. https://doi.org/10.1037/0033-2909.111.1.127

    Article  CAS  PubMed  Google Scholar 

  20. Savolainen J, Mason WA, Bolen JD, Chmelka MB, Hurtig T, Ebeling H, Nordstrom T, Taanila A (2015) The path from childhood behavioural disorders to felony offending: investigating the role of adolescent drinking, peer marginalisation and school failure. Crim Behav Ment Heal 25(5):375–388. https://doi.org/10.1002/cbm.1931

    Article  Google Scholar 

  21. Hayatbakhsh R, Mamun AA, Williams GM, O’Callaghan MJ, Najman JM (2013) Early childhood predictors of early onset of smoking: a birth prospective study. Addict Behav 38(10):2513–2519. https://doi.org/10.1016/j.addbeh.2013.05.009

    Article  PubMed  Google Scholar 

  22. Ellickson PL, Tucker JS, Klein DJ (2001) High-risk behaviors associated with early smoking: results from a 5-year follow-up. J Adolesc Health Off Publ Soc Adolesc Med 28(6):465–473

    Article  CAS  Google Scholar 

  23. Fischer JA, Najman JM, Williams GM, Clavarino AM (2012) Childhood and adolescent psychopathology and subsequent tobacco smoking in young adults: findings from an Australian birth cohort. Addiction 107(9):1669–1676. https://doi.org/10.1111/j.1360-0443.2012.03846.x

    Article  PubMed  Google Scholar 

  24. Griffin KW, Botvin GJ, Scheier LM, Doyle MM, Williams C (2003) Common predictors of cigarette smoking, alcohol use, aggression, and delinquency among inner-city minority youth. Addict Behav 28(6):1141–1148

    Article  Google Scholar 

  25. Heron J, Barker ED, Joinson C, Lewis G, Hickman M, Munafo M, Macleod J (2013) Childhood conduct disorder trajectories, prior risk factors and cannabis use at age 16: birth cohort study. Addiction 108(12):2129–2138. https://doi.org/10.1111/add.12268

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lee SS, Humphreys KL, Flory K, Liu R, Glass K (2011) Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clin Psychol Rev 31(3):328–341. https://doi.org/10.1016/j.cpr.2011.01.006

    Article  PubMed  PubMed Central  Google Scholar 

  27. Fergusson DM, Boden JM (2008) Cannabis use and later life outcomes. Addiction 103(6):969–976. https://doi.org/10.1111/j.1360-0443.2008.02221.x (discussion 977–968)

    Article  PubMed  Google Scholar 

  28. Volkow ND, Baler RD, Compton WM, Weiss SR (2014) Adverse health effects of marijuana use. New Engl J Med 370(23):2219–2227. https://doi.org/10.1056/NEJMra1402309

    Article  CAS  PubMed  Google Scholar 

  29. Monshouwer K, Van Dorsselaer S, Verdurmen J, Ter Bogt T, De Graaf RON, Vollebergh W (2006) Cannabis use and mental health in secondary school children: findings from a Dutch survey. Br J Psychiatr 188(2):148–153

    Article  Google Scholar 

  30. Miettunen J, Murray GK, Jones PB, Maki P, Ebeling H, Taanila A, Joukamaa M, Savolainen J, Tormanen S, Jarvelin MR, Veijola J, Moilanen I (2014) Longitudinal associations between childhood and adulthood externalizing and internalizing psychopathology and adolescent substance use. Psychol Med 44(8):1727–1738. https://doi.org/10.1017/S0033291713002328

    Article  CAS  PubMed  Google Scholar 

  31. Oshri A, Rogosch FA, Burnette ML, Cicchetti D (2011) Developmental pathways to adolescent cannabis abuse and dependence: child maltreatment, emerging personality, and internalizing versus externalizing psychopathology. Psychol Addict Behav J Soc Psychol Addict Behav 25(4):634–644. https://doi.org/10.1037/a0023151

    Article  Google Scholar 

  32. Pedersen MU, Rømer Thomsen K, Pedersen MM, Hesse M (2016) Mapping risk factors for substance use: introducing the YouthMap12. Addict Behav 23(65):40–50. https://doi.org/10.1016/j.addbeh.2016.09.005

    Article  Google Scholar 

  33. King SM, Iacono WG, McGue M (2004) Childhood externalizing and internalizing psychopathology in the prediction of early substance use. Addiction 99(12):1548–1559. https://doi.org/10.1111/j.1360-0443.2004.00893.x

    Article  PubMed  Google Scholar 

  34. Colder CR, Scalco M, Trucco EM, Read JP, Lengua LJ, Wieczorek WF, Hawk LW Jr (2013) Prospective associations of internalizing and externalizing problems and their co-occurrence with early adolescent substance use. J Abnorm Child Psychol 41(4):667–677. https://doi.org/10.1007/s10802-012-9701-0

    Article  PubMed  PubMed Central  Google Scholar 

  35. Edwards AC, Latendresse SJ, Heron J, Cho SB, Hickman M, Lewis G, Dick DM, Kendler KS (2014) Childhood internalizing symptoms are negatively associated with early adolescent alcohol use. Alcohol Clin Exp Res 38(6):1680–1688. https://doi.org/10.1111/acer.12402

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lynam DR, Caspi A, Moffitt TE, Wikström P-OH, Loeber R, Novak S (2000) The interaction between impulsivity and neighborhood context on offending: the effects of impulsivity are stronger in poorer neighborhoods. J Abnorm Psychol (1965) 109(4):563–574

    Article  CAS  Google Scholar 

  37. Shin SH, Miller DP, Teicher MH (2013) Exposure to childhood neglect and physical abuse and developmental trajectories of heavy episodic drinking from early adolescence into young adulthood. Drug Alcohol Depend 127(1–3):31–38. https://doi.org/10.1016/j.drugalcdep.2012.06.005

    Article  PubMed  Google Scholar 

  38. Oshri A, Carlson MW, Kwon JA, Zeichner A, Wickrama KK (2016) Developmental growth trajectories of self-esteem in adolescence: associations with child neglect and drug use and abuse in young adulthood. J Youth Adolesc. https://doi.org/10.1007/s10964-016-0483-5

    Article  PubMed  PubMed Central  Google Scholar 

  39. Rodham K, Hawton K, Evans E, Weatherall R (2005) Ethnic and gender differences in drinking, smoking and drug taking among adolescents in England: a self-report school-based survey of 15 and 16 year olds. J Adolesc 28(1):63–73. https://doi.org/10.1016/j.adolescence.2004.07.005

    Article  PubMed  Google Scholar 

  40. Smith SM, Stinson FS, Dawson DA, Goldstein R, Huang B, Grant BF (2006) Race/ethnic differences in the prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Med 36(7):987–998

    Article  Google Scholar 

  41. Amey CH, Albrecht SL (1998) Race and ethnic differences in adolescent drug use: the impact of family structure and the quantity and quality of parental interaction. J Drug Issues 28(2):283–298

    Article  Google Scholar 

  42. James WH, Kim GK, Armijo E (2000) The influence of ethnic identity on drug use among ethnic minority adolescents. J Drug Educ 30(3):265–280

    Article  CAS  Google Scholar 

  43. Chen P, Jacobson KC (2012) Developmental trajectories of substance use from early adolescence to young adulthood: gender and racial/ethnic differences. J Adolesc Health 50(2):154–163. https://doi.org/10.1016/j.jadohealth.2011.05.013

    Article  PubMed  Google Scholar 

  44. Pedersen MU, Villumsen S (2016) The complete YouthMap questionnaire. Centre for Alcohol and Drug Research, Aarhus University, Aarhus

    Google Scholar 

  45. Friedman AS, Terras A, Ôberg D (2001) Euro Adolescent Drug Abuse Diagnosis (Euro-ADAD). European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon

    Google Scholar 

  46. Blacken P, Hendriks V, Pozzi G, Tempesta E, Hartgers C, Koeter M, Fahrner EM, Gsellhofer B, Küfner H, Kokkevi A, Uchtenhagen A (1994) European Addiction Severity Index (EuropASI). European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon

    Google Scholar 

  47. Gray MJ, Litz BT, Hsu JL, Lombardo TW (2004) Psychometric properties of the life events checklist. Assessment 11(4):330–341. https://doi.org/10.1177/1073191104269954

    Article  PubMed  Google Scholar 

  48. EMCDDA (2012) Prevalence of daily cannabis use in the European Union and Norway. Publications Office of the European Union, Luxembourg. https://doi.org/10.2810/73754

    Book  Google Scholar 

  49. Agrawal A, Grant JD, Waldron M, Duncan AE, Scherrer JF, Lynskey MT, Madden PAF, Bucholz KK, Heath AC (2006) Risk for initiation of substance use as a function of age of onset of cigarette, alcohol and cannabis use: findings in a Midwestern female twin cohort. Prev Med Int J Devot Pract Theory 43(2):125–128. https://doi.org/10.1016/j.ypmed.2006.03.022

    Article  Google Scholar 

  50. Hammond D, Fong GT, Zanna MP, Thrasher JF, Borland R (2006) Tobacco denormalization and industry beliefs among smokers from four countries. Am J Prev Med 31(3):225–232. https://doi.org/10.1016/j.amepre.2006.04.004

    Article  PubMed  Google Scholar 

  51. Doran N, McChargue D, Spring B, VanderVeen J, Cook JW, Richmond M (2006) Effect of nicotine on negative affect among more impulsive smokers. Exp Clin Psychopharmacol 14(3):287–295. https://doi.org/10.1037/1064-1297.14.3.287

    Article  CAS  PubMed  Google Scholar 

  52. Gardner TW, Dishion TJ, Posner MI (2006) Attention and adolescent tobacco use: a potential self-regulatory dynamic underlying nicotine addiction. Addict Behav 31(3):531–536

    Article  Google Scholar 

  53. Griesler PC, Hu M, Schaffran C, Kandel DB (2011) Comorbid psychiatric disorders and nicotine dependence in adolescence. Addiction 106(5):1010–1020. https://doi.org/10.1111/j.1360-0443.2011.03403.x

    Article  PubMed  PubMed Central  Google Scholar 

  54. Levin ED, Conners CK, Silva D, Canu W, March J (2001) Effects of chronic nicotine and methylphenidate in adults with attention deficit/hyperactivity disorder. Exp Clin Psychopharmacol 9(1):83–90

    Article  CAS  Google Scholar 

  55. Potter AS, Newhouse PA (2004) Effects of acute nicotine administration on behavioral inhibition in adolescents with attention-deficit/hyperactivity disorder. Psychopharmacology 176(2):182–194

    Article  CAS  Google Scholar 

  56. van Lier PA, Huizink A, Vuijk P (2011) The role of friends’ disruptive behavior in the development of children’s tobacco experimentation: results from a preventive intervention study. J Abnorm Child Psychol 39(1):45–57. https://doi.org/10.1007/s10802-010-9446-6

    Article  PubMed  Google Scholar 

  57. Skogen JC, Sivertsen B, Lundervold AJ, Stormark KM, Jakobsen R, Hysing M (2014) Alcohol and drug use among adolescents: and the co-occurrence of mental health problems. Ung@hordaland, a population-based study. BMJ Open 4(9):e005357. https://doi.org/10.1136/bmjopen-2014-005357

    Article  PubMed  PubMed Central  Google Scholar 

  58. Scalco MD, Colder CR, Hawk LW, Read JP, Wieczorek WF, Lengua LJ (2014) Internalizing and externalizing problem behavior and early adolescent substance use: a test of a latent variable interaction and conditional indirect effects. Psychol Addict Behav 28(3):828–840. https://doi.org/10.1037/a0035805

    Article  PubMed  PubMed Central  Google Scholar 

  59. Dahl-Petersen IK, Larsen CVL, Nielsen NO, Jørgensen ME, Bjerregaard P (2016) Befolkningsundersøgelsen i Grønland 2014, Kalaallit Nunaanni Innuttaasut Peqqissusaannik Misissuisitsineq 2014 [The population survey in Greenland, 2014]. National Institute of Public Health’s Greenland works, vol 28. National Institute of Public Health, University of Southern Denmark, Copenhagen

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mads Uffe Pedersen.

Ethics declarations

Ethical standards

The manuscript does not contain clinical studies or patient data. All participants gave their consent and the surveys were approved by the Danish Data Protection Agency just as all confidentiality and privacy requirements were met.

Conflict of interest

The authors declare that they have no conflict of interest. This work was funded by a block Grant from the Danish Ministry for Social Affairs and the Interior (MUP, KRT, and SJ), and the Health Ministry of Western Norway (OH). JCS did not receive any specific funding for this project. The funding sources had no role in the writing of the manuscript or the decision to submit it for publication.

Appendix 1

Appendix 1

YouthMap12

With filter questions (survey version)

  1. 7.1, 8.1, 9.1, 10.1, 11.1, and 12.1 are filter questions. 1, 2, 3, 4, 5, 6, 7.2, 8.2, 9.2, 10.2, 11.2, and 12.2 = YouthMap12. Dichotomization: all white cells = 0 point, all black cells = 1 point. 1 = not at all, 2 = to a lesser degree, 3 = to some degree, 4 = to a high degree, and 5 = to a very high degree
  2. N never, AN almost never, S sometimes, O often, NA nearly always, Not not at all, Lit a little, Som somewhat, Lot a lot, and VM very much

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pedersen, M.U., Thomsen, K.R., Heradstveit, O. et al. Externalizing behavior problems are related to substance use in adolescents across six samples from Nordic countries. Eur Child Adolesc Psychiatry 27, 1551–1561 (2018). https://doi.org/10.1007/s00787-018-1148-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-018-1148-6

Keywords

Navigation