title: Polysubstance use patterns and trajectories in vocational students--a latent transition analysis.
abstract: BACKGROUND
  The transition from late adolescence to early adulthood (16-20 years) represents a time of exploration and self-discovery for many young people. As such, it is often associated with experimentation in substance use. Vocational students in particular report high substance use. Thus, the aim of this study is to examine patterns and trajectories of their substance use behavior.
  
  
  METHODS
  On two occasions (interval 18 months), we investigated 5214 students (M=19.39 years; 54% male) from 49 vocational schools in seven German federal states. We identified classes of substance use and trajectories via latent transition analysis, controlling for gender, age, and socio-economic status. Additionally, we investigated work-related (job demands/stress/satisfaction) and psychopathological (depressive symptoms) predictors of substance use via multinomial regressions.
  
  
  RESULTS
  We found three latent stages of substance use: low use (baseline: 43%/follow-up: 44%), mainly alcohol use (50%/45%), and polysubstance use (7%/11%). Over time, 10% of alcohol users at baseline transitioned to polysubstance use at follow-up, while there were smaller transition rates (2-9%) between the other stages. Compared to low use, polysubstance use at follow-up was predicted by high job stress (aOR=1.45, 1.07-1.96) at baseline.
  
  
  CONCLUSIONS
  High alcohol use is associated with bidirectional transitions in young adults. Hence, future research needs to identify mechanisms of change to identify protective factors. Regarding vocational practice, early stress management seems to be a viable path to prevent polysubstance use in vocational students.
authors.affiliation: Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany. Electronic address: tomczyk@ift-nord.de.
authors.forename: Samuel
authors.initials: S
authors.lastname: Tomczyk
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Kiel, Olshausenstraße 62, 24118 Kiel, Germany.
authors.forename: Anya
authors.initials: A
authors.lastname: Pedersen
authors.affiliation: Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
authors.forename: Reiner
authors.initials: R
authors.lastname: Hanewinkel
authors.affiliation: Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Isensee
authors.affiliation: Institute for Therapy and Health Research, Harmsstraße 2, 24114 Kiel, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
authors.forename: Matthis
authors.initials: M
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014829:Vocational Education; D055815:Young Adult
keywords: Latent class analysis; Longitudinal study; Polysubstance use; Vocational behavior; Young adult