Adolescence is a critical developmental period characterized by increased experimentation with psychoactive substances and heightened sensitivity to social influences. From a health psychology perspective, substance use behaviors are shaped by the cumulative interaction of individual, social and contextual factors. While adolescent alcohol use is widely recognized as a major public health concern, stimulant consumption (coffee and energy drinks) is often viewed as normative, despite its frequent co-occurrence with other risk behaviors. This study examines whether cumulative psychosocial vulnerability differentially predicts alcohol and stimulant use among adolescents.
A cross-sectional study was conducted on 521 adolescents using self-administered questionnaires. Outcomes included self-reported consumption of alcohol, energy drinks and coffee. Binary logistic regression analyses were performed for each type of consumption, including demographic (sex, age), contextual (residence; living with/without family), socio-economic (perceived family income), behavioral (smoking) and psychosocial (perceived peer influence) predictors. To assess cumulative effects, a composite behavioral score was constructed (mean of standardized indicators) reflecting personal, social and contextual stability, with higher values indicating lower psychosocial vulnerability. Correlational analyses and logistic regressions were used to test associations between the composite score and consumption behaviors.
The composite behavioral score was negatively and significantly associated with alcohol consumption (OR = 0.51, p = .002), indicating substantially lower odds of alcohol use among adolescents with more stable psychosocial profiles, yet was not significantly associated with coffee or energy drink consumption. Smoking and perceived peer influence emerged as strong predictors of both alcohol and energy drink use, whereas coffee consumption was associated primarily with living conditions. Large effect sizes were observed for differences in psychosocial vulnerability by gender (with boys exhibiting higher vulnerability) and residential environment (adolescents from rural areas), highlighting structural disparities relevant to adolescent health. Overall, findings suggest that cumulative psychosocial vulnerability is particularly relevant for alcohol use, whereas stimulant consumption appears more normative and context-dependent.