Psychosocial correlates of alcohol and substance use in college youth with type 1 diabetes.

Objective: Adolescents and young adults with chronic diseases face unique challenges during the college years and may consume alcohol and other substances to cope with stressors. This study aimed to assess the patterns of substance use and to determine psychosocial correlates of these behaviors among college youth with type 1 diabetes (T1D).

Methods: College youth with T1D were recruited via social media and direct outreach into a web-based study. Participants answered validated questions about substance use, and they completed validated screeners of depressive and anxiety symptoms (PHQ-2 and GAD-2), illness acceptance (ICQ), interpersonal support (ISEL), and grit (Grit scale). Descriptive statistics, bivariate analyses, and multivariable regression evaluated substance use behaviors as a function of psychosocial factors while adjusting for age and sex.

Results: Alcohol (84.06%) and marijuana (41.30%) were the most common substances reported. In bivariate analyses, depressive symptoms were positively associated (p = .01) and illness acceptance was inversely associated (p = .02) with marijuana use. Higher grit scores were inversely associated with marijuana use (p < .001) and prescription drug misuse (p = .04). The significant associations between marijuana use and depressive symptoms (adjusted odds ratio [AOR] 1.31, 95% confidence interval [CI] 1.04-1.66), illness acceptance (AOR 0.96, 95% CI 0.91-0.99), and grit (AOR 0.32, 95% CI 0.17-0.60) persisted after adjustment for age and sex.

Conclusions: Substance use is prevalent among college youth with T1D. While psychosocial factors such as depressive symptoms may confer an increased risk, illness acceptance and grit may be protective-especially against marijuana use. Providers should address both positive and negative psychosocial factors to mitigate substance use in this population.