Patterns of Substance Use and Teen Dating Violence Among High School Students: A Latent Class Analysis

Adolescence is a developmental period in which several risk behaviors, including substance use, may begin to emerge; these risky behaviors have important health and mental health consequences in adulthood. While the extant literature has shown that adolescents generally use more than one substance at a time, few studies have considered patterns of substance use and how those patterns are associated with teen dating violence (TDV) victimization. The current study aimed to (a) identify subtypes of substance use among high school students in Maryland and (b) examine the association between past year physical and psychological TDV and substance use classes.

Data come from 16,979 high school students participating in the Maryland Safe and Supportive Schools Initiative who self-identified as having been in a romantic relationship in the past 12 months. Latent class analysis (LCA) was used to group students into classes based on their past month use of alcohol, cigarettes, cigarillos, marijuana, and prescription medications (non-medical use), as well as binge drinking (consuming 5 or more drink in a row). Two questions examined students’ experiences of physical and psychological TDV victimization in the past year. LCA regression was used to test the association between substance use class and TDV. Models were adjusted for clustering of students within schools.

Five classes of substance use were identified: no use (Class 1: 62.2%, n = 11,698), high poly-substance use (Class 2: 5.8%, n = 1,088), alcohol use (Class 3: 13.9%, n = 2,597), alcohol and marijuana use (Class 4: 8.1%, n = 1,520), and moderate poly-substance use (Class 5: 9.5%, n = 1,777). Students who experienced physical TDV victimization, compared to those who did not, were more likely to be in the high poly-substance use (AOR = 4.8, p<0.001); alcohol and marijuana use (AOR = 1.75, p<0.001); and moderate poly-substance use (AOR = 2.11, p<0.001) classes. Students who experienced psychological TDV victimization, compared to those who did not, were more likely to be in the high poly-substance use (AOR = 4.38, p<0.001); alcohol and marijuana use (AOR= 1.64, p<0.001); and moderate poly-substance use (AOR = 1.68, p<0.001) classes.

There is heterogeneity in the self-reported recent substance use histories of high school students, although a large proportion of students using substances reported recent alcohol and marijuana. This study highlights the need for prevention programs that target high-risk groups, like poly-substance using students, or varied patterns of substance use.