Understanding higher substance use among early adolescent females: A decomposition analysis of adverse childhood experiences, bullying victimization, and depressive symptoms.

Meghan Powers, Stephanie M Koning, Wei Yang, Minggen Lu, Jennifer McClendon, Kristen Clements-Nolle

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Article in Addictive behaviors reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Meghan PowersDepartment of Biostatistics, Epidemiology, and Environmental Health, School of Public Health, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Stephanie M KoningDepartment of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Wei YangDepartment of Biostatistics, Epidemiology, and Environmental Health, School of Public Health, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Minggen LuDepartment of Biostatistics, Epidemiology, and Environmental Health, School of Public Health, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Jennifer McClendonDepartment of Human Development, Family Science, and Counseling, College of Education & Human Development, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Kristen Clements-NolleDepartment of Biostatistics, Epidemiology, and Environmental Health, School of Public Health, University of Nevada, Reno, 1664 N. Virginia Street, Reno, NV 89557, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Historically, U.S. adolescent boys have reported higher substance use than girls, but this has changed in recent years with girls reporting more use. The reasons for this demographic shift are unclear, but girls may be more likely to turn to substance use as a way to cope with stress and internalizing problems. Methods: We used cross-sectional data from the 2023 Nevada Middle School Youth Risk Behavior Survey (YRBS) (grades 6-8; Results: Substance use was higher for girls versus boys: EVP (aPR:2.05, 95%CI:1.62,2.61), alcohol (aPR:1.76, 95%CI:1.39,2.21), marijuana (aPR:1.93, 95%CI:1.43,2.59), and NMPPM (aPR:1.91, 95%CI:1.44,2.54). Girls also reported higher prevalence of intervention-relevant factors. The factors that made the largest contributions to statistically accounting for the substance use sex disparities were depressive symptoms (range:44.9-64.0%), household substance abuse (range:31.0-44.7%), emotional abuse (range:28.4-43.6%), and household mental illness (range:26.9-41.5%). Conclusions: Recent substance use was approximately twice as high among girls compared to boys. These sex disparities may be statistically accounted for by the higher prevalence of ACEs, electronic bullying, and depressive symptoms among girls. There is a need for sex-specific substance use prevention that is trauma-informed and includes healthy coping strategies.

Indexed as

AdolescentAdverse childhood experiencesBullyingDepressive symptomsSex disparitySubstance use

Identifiers

PMID42699626

DOI10.1016/j.abrep.2026.100744

PMCPMC13543975

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