Psychosocial Predictors of High CRAFFT Scores among Adolescents

Open Access

Abstract

Background: Adolescence is a vulnerable developmental period characterized by emotional, behavioral, and social transitions that may increase susceptibility to substance use. The CRAFFT screening tool is widely used to identify adolescents at risk for alcohol- and substance-related problems. However, evidence regarding psychosocial predictors of high CRAFFT scores among adolescents in Bangladesh remains limited. Aim of the study: To determine the psychosocial predictors associated with high CRAFFT scores among adolescents. Methods & Materials: This cross-sectional analytical study was conducted from October 2020 to September 2022 among 140 adolescents aged 12-19 years in selected educational institutions and community settings in Bangladesh. Participants were enrolled using purposive sampling. Data were collected using a structured questionnaire assessing socio-demographic and psychosocial characteristics, including peer influence, parental supervision, parent-child relationship, stress level, and exposure to substance-using peers. Substance use risk was evaluated using the CRAFFT screening tool. Chi-square tests and multivariable logistic regression analyses were performed using SPSS version 26. Statistical significance was set at p<0.05. Result: The mean age of participants was 17.42±1.247 years, and most were male (93.6%). High CRAFFT scores (≥3) were observed in 18.6% of adolescents, while 37.1% screened positive for CRAFFT (≥2). Significant associations were found between high CRAFFT scores and socio-demographic variables including age, gender, education, residence, and family type (p<0.05). Psychosocial factors significantly associated with high CRAFFT scores included negative peer influence (p<0.001), inadequate parental supervision (p=0.004), poor parent-child relationship (p=0.006), high stress level (p=0.011), and substance-using peers (p<0.001). Multivariable logistic regression identified older age (AOR=1.82, 95% CI: 1.11-2.98), male gender (AOR=2.45, 95% CI: 1.12-5.36), negative peer influence (AOR=2.96, 95% CI: 1.54-5.69), inadequate parental supervision (AOR=2.31, 95% CI: 1.18-4.52), poor parent-child relationship (AOR=2.58, 95% CI: 1.32-5.05), high stress level (AOR=2.12, 95% CI: 1.07-4.21), and substance-using peers (AOR=3.41, 95% CI: 1.71-6.80) as independent predictors of high CRAFFT scores. Conclusion: High CRAFFT scores among adolescents were significantly influenced by multiple psychosocial factors, particularly peer-related influences, inadequate family supervision, poor parent-child relationships, and stress. Early psychosocial screening and targeted preventive interventions are essential to reduce substance use risk among adolescents.