Mental Health, Academic Engagement, and Youths' Nonmedical Use of Stimulants: A Latent Profile Analysis.

Background:  Nonmedical prescription stimulant (NPS) use is a growing problem in Europe. Poor mental health and lack of academic engagement are potent sources of risk for substance use. Studies suggest that considerable heterogeneity may characterize the risk profiles of NPS users. To understand better the potential profiles of risk that characterize NPS users, we conducted a latent profile analysis (LPA) to document subgroups of users based on their mental health and academic engagement. Methods:  A nationally representative, cross sectional survey of Icelandic youth was analyzed. The sample included 584 (5% of the sample) older adolescent students participating in a national study in Iceland who reported lifetime NPS use. Results:  Three subgroups of NPS users emerged from our analyses. The largest subgroup (43.1%) we labeled mentally healthy achievers; youth who appear to be academically motivated and have few if any mental health concerns. The second largest group (40.4%), low achievers, resembled a typical profile for drug users in that they reported low or modest academic engagement and moderate levels of mental health concerns. The third group, anxious achievers (16.5%) appears to represent youth who felt academics were very important, had moderate study motivation, and also reported elevated mental health concerns, especially anxiety. Conclusions:  LPA revealed considerable heterogeneity among these users. Group membership suggests distinct approaches to prevention to address heterogeneity in motivations for NPS use.