Many studies have reported significant associations between YSR scores and substance use in middle and high income countries. To test these associations in a low income country that is culturally quite different from countries where most mental health research is done, Karki et al. (2019) arranged for 408 12-18-year-old students at Nepalese urban and rural schools to complete the YSR and the Adolescent Substance Use Measurement (ADSUME) adapted for Nepal. After partialing out age, gender, residential area, and ethnic group, Karki et al. found that high scores for tobacco and intoxicant use, as well as classification as a high risk user, were significantly associated with high YSR Attention Problems syndrome scores. High scores for tobacco use were also significantly associated with high YSR Delinquent (Rule-Breaking) Behavior syndrome scores, while high scores for intoxicant use were significantly associated with high YSR Aggressive Behavior syndrome scores. Interestingly, high scores on both the Anxious/Depressed syndrome and the broad-spectrum Internalizing scale were associated with low scores for substance use. These findings suggest that internalizing problems may protect against substance use by Nepalese adolescents, and also that high scores for substance use are not artifacts of yea-saying tendencies to report problems. The authors concluded that their study “provides evidence that emotional and behavioral problems were associated with substance use among Nepalese adolescents” (p. 306).

Reference: Karki, S., Laukkanen, E., Lansimies, H., Tuomainen, T-P, & Pietila, A-M. (2019). Substance use and associated emotional and behavioral problems in Nepalese adolescents. Journal of Substance Use, 24, 300-308.