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Models of substance use in adolescents with and without psychosis.

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IWK Health Centre, Halifax, Nova Scotia.



The use of substances is a major concern with adolescents with psychotic disorders, as it can have detrimental effects on psychotic symptoms and other aspects of functioning. The purpose of this study is to increase our understanding of the association between substance use and psychosis in adolescents by testing three models of substance use: the normative development model, the deviance-prone model, and the affect regulation model.


Participants were 35 adolescents with a psychotic disorder, and 35 typically developing adolescents. Measures used: Personal Experience Screening Questionnaire, Youth Self-Report, Beck Depression Inventory, and the Beck Anxiety Inventory.


The normative development model, hypothesizing that mild substance use leads to better socio-emotional adjustment, was not supported for either group. The deviance-prone model was supported for both groups, indicating that rule-breaking behaviour and aggression significantly predicted substance use. The affect-regulation model was supported for adolescents with psychosis only, indicating that negative affect significantly predicted substance use.


The treatment of substance misuse in adolescents with psychosis may be complicated by a number of factors including deviant behaviour and negative affective symptoms. Thus, the current results point to the importance of integrated treatments to help reduce substance misuse and associated problems.


adolescence; psychosis; substance use


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