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.

Background: Among college students, research has found distinct classes of polysubstance use patterns differentially associated with negative consequences. However, there is less clarity regarding how vulnerability factors discriminate across polysubstance use types and cross-cultural variability in these patterns.

Objectives: In addressing these gaps, we identified typologies of substance use based on reported lifetime use of a set of substances in college students from seven countries. We also examined mean differences across classes on 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 located in the U.S., Canada, South Africa, Spain, Argentina, England, and Uruguay completed an online survey following 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. was more similar to South Africa regarding polysubstance use than the other classes.

Conclusions: Most participants exhibited polysubstance use and constructs with the potential of being targeted in interventions discriminating against these classes. Findings highlight the pervasiveness of these patterns, indicating a need for global prevention efforts to reduce the likelihood of engaging in polysubstance use.