There is a consensus among addictions researchers and clinicians that mental health concerns and substance use problems are often interrelated. It is less clear to what extent the general public, and university students in particular, understand connections between substance use and mental health. The current study aimed to understand university students’ perceived links between substance use and mental health by conducting three semistructured focus groups (N = 24 participants, 67% female). Thematic analysis of the data yielded five themes: (1) Students use substances to cope with mental health issues, (2) substance use can lead to mental health problems, (3) links between mental health and substance use are cyclical, (4) substance use is an aspect/indicator of mental health, and (5) substance use and mental health are not always linked. Findings provide insight into the understudied area of perceived links between substance use and mental health and have implications for campus programming.
AlbertsA.ElkindD.GinsbergS. (2007). The personal fable and risk-taking in early adolescence. Journal of Youth and Adolescence, 36, 71–76. doi:10.1007/s10964-006-9144-4
2.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). New York, NY: Author.
3.
BowersM. B.SwigarM. E. (1983). Vulnerability to psychosis associated with hallucinogen use. Psychiatry Research, 9, 91–97. doi:10.1016/0165-1781(83)90030-6
4.
BraunV.ClarkeV. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. doi:10.1191/1478088706qp063oa
5.
BurnsL.TeessonM. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders: Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence, 68, 299–307. doi:10.1016/S0376-8716(02)00220-X
6.
CarpenterK. M.HasinD. S. (1999). Drinking to cope with negative affect and DSM-IV alcohol use disorders: A test of three alternative explanations. Journal of Studies on Alcohol, 60, 694–704. doi:10.15288/jsa.1999.60.694
7.
ChenP.JacobsonK. C. (2012). Developmental trajectories of substance use from early adolescence to young adulthood: Gender and racial/ethnic differences. Journal of Adolescent Health, 50, 154–163. doi:10.1016/j.jadohealth.2011.05.013
8.
CuffelB. J. (1996). Comorbid substance use disorder: Prevalence, patterns of use, and course. New Directions for Mental Health Services, 1996, 93–105. doi:10.1002/yd.23319960209
9.
CurranC.ByrappaN.McBrideA. (2004). Stimulant psychosis: Systematic review. The British Journal of Psychiatry, 185, 196–204. doi:10.1192/bjp.185.3.196
10.
DaviesJ.McCraeB. P.FrankJ.DochnahlA.PickeringT.HarrisonB.…WilsonK. (2000). Identifying male college students’ perceived health needs, barriers to seeking help, and recommendations to help men adopt healthier lifestyles. Journal of American College Health, 48, 259–267. doi:10.1080/07448480009596267
11.
DawsonD. A.GrantB. F.StinsonF. S.ChouP. S. (2005). Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug and Alcohol Dependence, 77, 139–150. doi:10.1016/j.drugalcdep.2004.07.012
12.
de BeursE.den Hollander-GijsmanM. E.van RoodY. R.Van der WeeN. J.GiltayE. J.van NoordenM. S.…ZitmanF. G. (2011). Routine outcome monitoring in the Netherlands: Practical experiences with a web-based strategy for the assessment of treatment outcome in clinical practice. Clinical Psychology & Psychotherapy, 18, 1–12. doi:10.1002/cpp.696
13.
DegenhardtL.HallW.LynskeyM. (2003). Exploring the association between cannabis use and depression. Addiction, 98, 1493–1504. doi:10.1046/j.1360-0443.2003.00437.x
14.
DeJongW. (2002). The role of mass media campaigns in reducing high-risk drinking among college students. Journal of Studies on Alcohol, 14, 182–192. doi:10.15288/jsas.2002.s14.182
15.
EisenbergD.GolbersteinE.GollustS. E. (2007). Help-seeking and access to mental health care in a university student population. Medical Care, 45, 594–601. doi:10.1097/MLR.0b013e31803bb4c1
16.
GeyerM. A.VollenweiderF. X. (2008). Serotonin research: Contributions to understanding psychoses. Trends in Pharmacological Sciences, 29, 445–453. doi:10.1016/j.tips.2008.06.006
17.
GlassmanT. J.BraunR. E. (2010). Confusion surrounding social marketing strategies and social norm theory: To prevent high-risk drinking among college students. Social Marketing Quarterly, 16, 94–103. doi:10.1080/15245001003746741
18.
González-MaesoJ.AngR. L.YuenT.ChanP.WeisstaubN. V.López-GiménezJ. F.…GingrichJ. A. (2008). Identification of a serotonin/glutamate receptor complex implicated in psychosis. Nature, 452, 93–97. doi:10.1038/nature06612
19.
GrantV. V.StewartS. H.O’ConnorR. M.BlackwellE.ConrodP. J. (2007). Psychometric evaluation of the five-factor modified drinking motives questionnaire—Revised in undergraduates. Addictive Behaviors, 32, 2611–2632. doi:10.1016/j.addbeh.2007.07.004
20.
GrantB. F.StinsonF. S.DawsonD. A.ChouS. P.DufourM. C.ComptonW.…KaplanK. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61, 807–816. doi:10.1001/archpsyc.61.8.807
21.
HallW. D. (1998). Cannabis use and psychosis. Drug and Alcohol Review, 17, 433–444. doi:10.1080/09595239800187271
22.
HasinD. S.GoodwinR. D.StinsonF. S.GrantB. F. (2005). Epidemiology of major depressive disorder: Results from the national epidemiologic survey on alcoholism and related conditions. Archives of General Psychiatry, 62, 1097–1106. doi:10.1001/archpsyc.62.10.1097
23.
HasinD. S.GrantB. F. (2002). Major depression in 6050 former drinkers: Association with past alcohol dependence. Archives of General Psychiatry, 59, 794–800. doi:10.1001/archpsyc.59.9.794
24.
HowardD. E.GriffinM.BoekelooB.LakeK.BellowsD. (2007). Staying safe while consuming alcohol: A qualitative study of the protective strategies and informational needs of college freshmen. Journal of American College Health, 56, 247–254. doi:10.3200/JACH.56.3.247-254
25.
HuntJ.EisenbergD. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 46, 3–10. doi:10.1016/j.jadohealth.2009.08.008
26.
KesslerR. C.BerglundP.DemlerO.JinR.MerikangasK. R.WaltersE. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. doi:10.1001/archpsyc.62.6.593
27.
KhantzianE. J. (1985). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. American Journal of Psychiatry, 142, 1259–1264. doi:10.1176/ajp.142.11.1259
28.
KhantzianE. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4, 231–244. doi:10.3109/10673229709030550
29.
KruegerR. A.CaseyM. A. (2009). Focus groups: A practical guide for applied research. London, England: Sage.
30.
KuppinS.CarpianoR. M. (2008). Public conceptions of serious mental illness and substance abuse, their causes and treatments: Findings from the 1996 General Social Survey. American Journal of Public Health, 98, S120–S125. doi:10.2105/AJPH.2004.060855
31.
KushnerM. G.SherK. J.BeitmanB. D. (1990). The relation between alcohol problems and the anxiety disorders. The American Journal of Psychiatry, 147, 685–695. doi:10.1176/ajp.147.6.685
32.
KwanM. Y.FaulknerG. E.Arbour-NicitopoulosK. P.CairneyJ. (2013). Prevalence of health-risk behaviours among Canadian post-secondary students: Descriptive results from the national college health assessment. BMC Public Health, 13, 1–6. doi:10.1186/1471-2458-13-548
33.
LarimerM. E.CronceJ. M. (2002). Identification, prevention and treatment: A review of individual-focused strategies to reduce problematic alcohol consumption by college students. Journal of Studies on Alcohol, 14, 148–163. doi:10.15288/jsas.2002.s14.148
34.
LasserK.BoydJ. W.WoolhandlerS.HimmelsteinD. U.McCormickD.BorD. H. (2000). Smoking and mental illness: A population-based prevalence study. Journal of the American Medical Association, 284, 2606–2610. doi:10.1001/jama.284.20.2606
35.
LevyK. B.O’GradyK. E.WishE. D.ArriaA. M. (2005). An in-depth qualitative examination of the ecstasy experience: Results of a focus group with ecstasy-using college students. Substance Use & Misuse, 40, 1427–1441. doi:10.1081/JA-200066810
36.
LinkB. G.PhelanJ. C.BresnahanM.StueveA.PescosolidoB. A. (1999). Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health, 89, 1328–1333. doi:10.2105/AJPH.89.9.1328
37.
LinszenD. H.DingemansP. M.LeniorM. E. (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry, 51, 273–279. doi:10.1016/1353-1131(95)90097-7
38.
MartinJ. K.PescosolidoB. A.TuchS. A. (2000). Of fear and loathing: The role of disturbing behavior, labels, and causal attributions in shaping public attitudes toward people with mental illness. Journal of Health and Social Behavior, 41, 208–223. doi:10.2307/2676306
39.
MannM. M.HosmanC. M.SchaalmaH. P.de VriesN. K. (2004). Self-esteem in a broad-spectrum approach for mental health promotion. Health Education Research, 19, 357–372. doi:10.1093/her/cyg041
40.
MenezesP. R.JohnsonS.ThornicroftG.MarshallJ.ProsserD.BebbingtonP.KuipersE. (1996). Drug and alcohol problems among individuals with severe mental illness in south London. British Journal of Psychiatry, 168, 612–619. doi:10.1192/bjp.168.5.612
41.
MoreiraM. T.SmithL. A.FoxcroftD. (2009). Social norms interventions to reduce alcohol misuse in university or college students. Cochrane Database of Systematic Reviews, 3, CD006748–CD006748. doi:10.1002/14651858.CD006748.pub2
42.
MorganD. L. (1988). Focus groups as qualitative research (2nd ed.), Qualitative Research Methods Series 16. Thousand Oaks, CA: Sage.
43.
NutbeamD. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15, 259–267. doi:10.1093/heapro/15.3.259
44.
O’MalleyP. M.JohnstonL. D. (2002). Epidemiology of alcohol and other drug use among American college students. Journal of Studies on Alcohol, 14, 23–39. doi:10.15288/jsas.2002.s14.23
45.
PatelV.FlisherA. J.HetrickS.McGorryP. (2007). Mental health of young people: A global public-health challenge. The Lancet, 369, 1302–1313. doi:10.1016/S0140-6736(07)60368-7
46.
PattonG. C.CoffeyC.CarlinJ. B.DegenhardtL.LynskeyM.HallW. (2002). Cannabis use and mental health in young people: Cohort study. British Medical Journal, 325, 1195–1198. doi:10.1136/bmj.325.7374.1195
47.
PhelanJ. C.LinkB. G.StueveA.PescosolidoB. A. (2000). Public conceptions of mental illness in 1950 and 1996: What is mental illness and is it to be feared?Journal of Health and Social Behavior, 41, 188–207. doi:10.2307/2676305
48.
PrattL. A.BrodyD. J. (2008). Depression in the United States household population. NCHS Data Brief, 7, 1–8.
49.
RhodesT. (2000). The multiple roles of qualitative research in understanding and responding to illicit drug use. In GreenwoodG.RobertsonK. (Eds.), Understanding and responding to drug use: The role of qualitative research (pp. 21–36). Monograph Series 4. Luxembourg: European Monitoring Centre for Drugs and Drug Addiction.
50.
RossH. E. (1995). DSM-III-R alcohol abuse and dependence and psychiatric comorbidity in Ontario: Results from the Mental Health Supplement to the Ontario Health Survey. Drug and Alcohol Dependence, 39, 111–128. doi:10.1016/0376-8716(95)01150-W
51.
SchulenbergJ. E.MaggsJ. L. (2002). A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood. Journal of Studies on Alcohol, 14, 54–70. doi:10.15288/jsas.2002.s14.54
52.
SimonsJ.CorreiaC. J.CareyK. B.BorsariB. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology, 45, 265–273. doi:10.1037/0022-0167.45.3.265
53.
StewartS. H.ConrodP. J. (Eds.). (2007). Anxiety and substance use disorders: The vicious cycle of comorbidity. New York, NY: Springer Science & Business Media.
54.
StewartS. H.GrantV. V.MackieC. J.ConrodP. J. (2016). Comorbidity of anxiety and depression with substance use disorders. In SherK. J. (Ed.), The Oxford handbook of substance use disorders (Vol. 2). New York, NY: Oxford University Press. doi:10.1093/oxfordhb/9780199381708.001.0001
55.
StewartS. H.MorrisE.MellingsT.KomarJ. (2006). Relations of social anxiety variables to drinking motives, drinking quantity and frequency, and alcohol-related problems in undergraduates. Journal of Mental Health, 15, 671–682. doi:10.1080/09638230600998904
56.
StewartS. H.ZvolenskyM. J.EifertG. H. (2001). Negative-reinforcement drinking motives mediate the relation between anxiety sensitivity and increased drinking behavior. Personality and Individual Differences, 31, 157–171. doi:10.1016/S0191-8869(00)00213-0
57.
von SydowK.LiebR.PfisterH.HöflerM.WittchenH. U. (2002). What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults. Drug and Alcohol Dependence, 68, 49–64. doi:10.1016/S0376-8716(02)00102-3
58.
WhitefordH. A.DegenhardtL.RehmJ.BaxterA. J.FerrariA. J.ErskineH. E.…BursteinR. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382, 1575–1586. doi:10.1016/S0140-6736(13)61611-6
59.
WoicikP. A.StewartS. H.PihlR. O.ConrodP. J. (2009). The substance use risk profile scale: A scale measuring traits linked to reinforcement-specific substance use profiles. Addictive Behaviors, 34, 1042–1055. doi:10.1016/j.addbeh.2009.07.001
