Studies have sought to disentangle predictors of adolescent substance use versus problem use, yet research has not examined this question in a clinical sample and usually does not control for the effects of consumption level. The authors tested whether psychosocial variables showed direct relations to substance use, and direct, indrect, and interactive relations to use-related negative consequences within a clinical sample of youth. Psychopathology, temperamental disturbances, use motives, expectancies, and socialization influences showed indirect relations to problem use because they were associated with heavy consumption. Psychopathology, expectancies, and socialization influences also related directly to problem use, controlling for consumption level. Psychopathology, temperamental disturbances, use motives, and socialization influences moderated the relation between consumption and problems. Results support the assertion that psychosocial variables are related to problem use above and beyond the simple indirect effect via consumption level.
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