A Latent Class Analysis of Polysubstance Use Patterns and Their Association with Ruminative Thinking Styles, Impulsivity-Like Traits, and Adverse Childhood Experiences Among College Students from Seven Countries

Abstract

Background: Among college students, research has identified distinct classes of polysubstance use patterns that are differentially associated with negative consequences. However, there is less clarity regarding how vulnerability factors discriminate across polysubstance use types and the extent of cross-cultural variability in these patterns. Objectives: To address these gaps, we identified typologies of substance use based on reported lifetime use of several substances among college students from seven countries. We also examined mean differences across classes in ruminative thinking styles, impulsivity-like traits, and adverse childhood experiences, and compared the proportion of students in each subgroup between pairs of countries. Methods: College students from the U.S., Canada, South Africa, Spain, Argentina, England, and Uruguay completed an online survey using a convenience sampling procedure (n = 9,065; 71% women). Results: Using latent class analysis, we identified Class 1 (“Polysubstance Users”), Class 2 (“Alcohol, Marijuana, and Tobacco Co-Users”), and Class 3 (“Drinkers”). Class 1 exhibited greater adverse childhood experiences, higher ruminative thinking, and greater impulsivity than Classes 2 and 3. Our results suggest that the U.S. was more similar to Spain, Argentina, and Uruguay in alcohol, marijuana, and tobacco co-use than in the other two classes. Additionally, the U.S. resembled South Africa more closely regarding polysubstance use than the other classes. Conclusions: Most participants reported polysubstance use and endorsed characteristics that could be targeted in preventive interventions aimed at differentiating between these classes. These findings highlight the pervasiveness of such patterns and underscore the need for global prevention efforts to reduce the likelihood of engaging in polysubstance use.