Adolescent Abuse Research Articles

Childhood Maltreatment and Adolescent Risky Behavior: Mediating the Effect of Parent-Adolescent Conflict and Violent Tendencies.

Childhood maltreatment experiences are an important public health issue associated with a variety of short- and long-term social and psychological outcomes. Despite the negative impact of these experiences, little research has examined the mechanisms underlying the relationship between childhood maltreatment and adolescent risky behavior, which is a critical step in developing intervention services to prevent such behavior during adolescence. The present study aimed to examine the mediating role of parent-adolescent conflict and violent tendency in the relationships between childhood maltreatment and adolescent risky behavior in adolescence. Participants were 303 high school students, 60.1% female (n = 182) and 39.9% (n = 121) male, from four different high schools in Türkiye. It was found that childhood maltreatment was significantly and positively associated with adolescent risky behavior. In addition, that parent-adolescent conflict and violent tendencies mediated the relationship between childhood maltreatment and adolescent risky behavior. And also parent-adolescent conflict mediated the relationship between childhood maltreatment and violent tendencies and adolescent risky behavior. The results of this study suggest that parent-adolescent conflict and violent tendencies are important in increasing the impact of childhood maltreatment on adolescent risky behavior. In order to reduce the impact of maltreated childhood experiences on risky behavior, interventions can be designed to increase positive adolescent-parent relationships and reduce violent tendencies.

Exploring the Dimensions and Correlates of Teen Economic Abuse Through a Cross-Sectional Survey

PurposeTeen economic abuse (TEA) is an understudied form of adolescent relationship abuse with limited measures available to assess prevalence. The purpose of this article is to assess the underlying dimensions of survey items (developed with youth) to refine measurement of and validate the structures comprising TEA and examine differences in prevalence of TEA perpetration (Prp) and victimization (Vct) by demographic characteristics. MethodsThis cross-sectional, online survey was conducted between July and September 2021. Youth ages 13–19 who read English and reside in the United States were eligible to complete this study. Recruitment occurred through a national violence prevention listserv with an emphasis on reaching organizations serving youth who are unhoused, juvenile justice and child welfare-system involved, identifying as sexual or gender minorities, or from communities of color. Based on exploratory and confirmatory factor analysis, negative binomial regression models were run to assess associations of demographic characteristics, with levels of TEA Vct and Prp. ResultsAdolescents who identify as White reported significantly more types of TEA exposures than their American Indian or Alaskan Native (adjusted incident rate ratios = 1.3; 95% CI = [1.1, 1.4]), Hispanic Latino (1.2 [1.1, 1.4]), and Multiracial peers (2.4 [1.8, 3.1]). Gender diverse adolescents (1.14 [1, 1.3]) and cisgender females (1.08 [1, 1.2]) had significantly more types of TEA exposures than cisgender males. Those with past-year physical or sexual violence in dating relationships reported more types of TEA exposures (4.1 [3.8, 4.4]) than those who had not experienced such violence. Adolescents with exposure to foster care or homelessness had more types of TEA (1.3 [1.2, 1.4]) than those without such experiences. DiscussionHealthcare providers serving youth should be aware of how economic abuse manifests in adolescent relationships when providing support and resources for youth, especially those who are system-involved or experiencing housing instability. Findings also highlight the need for education about TEA and economic justice in violence prevention programs.

Peran Guru Bimbingan Konseling dalam Merealisasikan Sistem Pendidikan Anti Narkoba di Kalangan Remaja: Studi Kasus Prodi Bimbingan Konseling Unimed

Drugs are substances or drugs that are natural, synthetic, or semi-synthetic in nature that cause hallucinations and stimulation. Meanwhile, according to the Narcotics Law article 1 paragraph 1 states that narcotics are artificial substances or those derived from plants that have the effect of hallucinations, decreased awareness, and cause addiction. The method used in this research is a qualitative approach. The data collection techniques used are observation, interviews, and documentation with the number of respondents studied in this study were 10 respondents. This study aims to determine how much the role of counseling teachers in preventing and handling cases of drug abuse in adolescents and the impact of drug abuse on the lives of adolescents as a whole.

Konseling Individual untuk Mengatasi Problematika Penyalahgunaan Narkoba pada Remaja

Adolescence is a transition stage from childhood to adulthood. In this phase, teenagers are very vulnerable to the influence of their peers' social environments. Lack of guidance and support from the immediate environment can encourage teenagers to dare to commit deviant acts to attract the attention of others. One form of juvenile delinquency that may occur is drug abuse. To face the challenges of drug abuse in adolescents, one approach that can be applied is individual counseling. This research uses a qualitative approach. The analytical method used in this research is the library research method. The analysis is carried out carefully, critically, and sharply so as to produce a synthesis that is logical and rational and can be tested. Through individual counseling sessions, teenagers can receive special guidance and support tailored to their unique needs and conditions in an effort to overcome drug dependence.

To study impact of drug abuse in adolescence

Adolescent drug usage can lead to a variety of outcomes that are different from those associated with adult drug use. Alcohol is a common illicit substance in youth, and the molecular mechanisms behind alcohol-induced neuro inflammation, brain injury, and behavioural dysfunction caused by ethanol are not fully understood. In the adult brain, alcoholism is associated with a higher chance of neuropsychiatric diseases. Adolescent alcohol use can cause long-lasting modifications to the control of cytokines and the sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis, which can impact neuropathology and behaviour long into adulthood... Synthetic androgens used for muscle and strength gain, especially in adolescence, are called alcoholic androgenic steroids (AAS). Adult neuropathology and alcoholism can be prevented and treated using AAS, an anabolic steroid.

Bipolar disorder and early childhood trauma

Case Background There is a reported 48.8 million case of bipolar disorder (BD) world- wide. It can also be one of the most challenging disorders to manage clinically as patients often have poor medical compliance and numerous relapses throughout their lifetime. The etiology of this illness is still poorly understood, but it is recognized to compromise both genetic and environmental factors. Regarding the latter, abuse and instability in childhood and adolescence was reported as an important area of consideration in regard to the development and prognosis of bipolar disorder. We report here the case of a female who exemplifies the significance of early childhood experience in this disorder. Case Presentation Isabelle is a 21 year old, female, with a background history of bipolar disorder. She presented to the Cork University Hospital accident and emergency 2 weeks after discharge after a 4 week admission for a depressive episode. Isabelle was referred from the home-based team with an acute episode of mania and was detained involuntarily under the Mental Health Act. Her history is significant for childhood neglect, physical, emotional and sexual abuse, along with multiple foster care placements. She was managed as an inpatient with antipsychotics and a mood stabilizer before being discharged after a lengthy, arduous, admission. Conclusion Childhood trauma is an important consideration in BD. Therefore, practitioner awareness of the role of such trauma with regard to its etiology and prognosis is of great importance. It is also essential to the practice of preventive medicine. Patient Consent Obtained: Yes

"It's a Slippery Slope": Antecedents of Female-Perpetrated Sexual Abuse of Adolescents in Australian Educational Settings.

Sexual victimization of students endures-especially in secondary schools-and women's perpetration in this setting is increasingly recognized. Nonetheless, our understanding of this population and contemporary cases remains limited, and research in the Australian context is lacking. This study contributes to the evidence base and represents the first Australian study of its kind. We draw on (1) legal documents (N = 19) describing 18 established cases of female-perpetrated sexual abuse against 20 adolescent students (aged 13-17 inclusive) and (2) semi-structured expert interviews with professionals possessing specialized experience of female-perpetrated cases involving adolescent students (N = 8). These data are integrated in a reflexive thematic analysis to identify the personal, contextual, and situational antecedents of female-perpetrated cases thereby exploring the 'why' and 'how' of their perpetration. Taken together, the results indicate a key interaction between individual emotional and relational needs, environmental opportunities, and contextual tolerance. Practical implications for targeting and disrupting these dynamics are discussed.

Adaptation of Childhood Emotional Abuse Measurement Instrumen in Indonesia

Childhood emotional abuse has long-term impacts on individuals. A specific measuring instrument to measure the history of childhood emotional abuse in Indonesian adolescents is needed. The current study adapted the Emotional Abuse Questionnaire developed by Momtaz et al. (2022) into an Indonesian version (ID-EAQ). Participants in this study were 100 adolescents aged 17-21 years, selected using a purposive sampling technique. The adaptation was carried out with the guidance of the International Test Commission (2016). The results showed that the ID-EAQ has a high level of validity and reliability with a value of 0.921. It can be concluded that the ID-EAQ is a valid and reliable measuring instrument to measure the history of childhood emotional abuse in adolescent samples

Associations Between Acculturation, Discrimination, and Adolescent Relationship Abuse: A Matched Parent-Adolescent Study of Latine Families.

Adolescent relationship abuse (ARA) is prevalent among adolescents, including those who identify as Latine. However, there is limited research that has considered the cultural and structural mechanisms that may impact ARA experiences among Latine youth. Further, although parents play a crucial role in ARA prevention, few studies have investigated how adolescent-parent differences in acculturation and discrimination are associated with ARA. The objective of this exploratory study of Latine families was to examine how acculturation, discrimination, and adolescent-parent acculturation/discrimination differences relate to ARA victimization and perpetration. Parent-adolescent dyads recruited from clinic and community-based settings in Pittsburgh and Kansas City completed matched surveys. Parent-adolescent acculturation and discrimination differences were calculated using multilevel linear models. Multivariable logistic regression was used to examine associations among ARA victimization and perpetration and adolescent-reported acculturation, adolescent-reported discrimination, and adolescent-parent acculturation and discrimination differences. One hundred eighty-two adolescents and their parent/caregiver (n = 364) completed a matched survey in English or Spanish from March 2020 to March 2021. Forty-three percent of adolescents reported that they had started dating; of these 35% and 24% reported ARA victimization and perpetration, respectively. Higher levels of adolescent-reported acculturation conflict were associated with lower ARA victimization (adjusted odds ratio [aOR]: 0.24; 95% confidence interval, CI [0.08, 0.75]); conversely, higher adolescent-reported discrimination was associated with ARA victimization (aOR: 2.50 [1.30, 4.60]) and perpetration (aOR: 2.10 [1.10, 3.90]). Wider adolescent-parent acculturation differences in Spanish language (aOR: 3.40 [1.04, 11.30]) and interpersonal discrimination (aOR: 2.40 [1.10, 5.20]) were associated with increased ARA victimization. Results underscore the importance of discrimination in understanding ARA experiences among Latine youth. Future work should consider developing culturally and linguistically affirming ARA prevention programs for Latine adolescents and parents.

The Factors Affecting Substance Use and the Most Effective Mental Health Interventions in Adolescents and Young Adults

Adolescents and young adults are particularly susceptible to substance abuse. They have yet to solidify their sense of self to the degree necessary to effectively resist temptations from negative peer pressure. It is vital for mental health counselors to understand the factors affecting substance abuse in adolescents/young adults and to comprehend the effectiveness of common intervention strategies fully. This paper produces a narrative literature review of 27 international journal publications from 2004 through June 2024 related to causal factors and interventions effective for treating substance abuse in adolescents and young adults. The results indicate that adolescents who idolize antisocial peers and lack a strong sense of self, family attachment, parental monitoring, and role models are more likely to suffer from substance abuse. Successful interventions include those that help strengthen the adolescent’s sense of self, a mental-health-friendly school environment staffed with professional mental health counselors, and interactive programs that engage students in positive behaviors. Positive family and peer role models can also assist in helping adolescents/young adults build a strong self-image and resist substance use. Positive peer influence is another critical factor, but more work must be undertaken to fully assess its effectiveness as an intervention.

Injury, substance abuse, verbal abuse, and emotional and behavioral issues among adolescents in Uttarakhand, India: A categorical principal component analysis of global school-based health survey

Background: Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component. Methods: A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser–Meyer–Olkin and Bartlett’s test. Variance Accounted For index was used to evaluate the importance of each component. Results: A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P < 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P <0.0001) and tobacco chewing (3.4% vs 0.3%, P = 0.001) was more likely in 12–15-year-old boys. One-third of the students reported male guardians to use either alcohol or some form of tobacco. CATPCA yielded an 11-factor model accounting for 58.26% of variances with the most important principal component named “Tobacco (Smoking and Chewing): Initiation, Frequency and Attempt to Stop” (eigenvalue: 4.109). Conclusion: Significant differences in various items of injury, verbal abuse, substance use, and emotional behavior were recorded between boys and girls. CATPCA revealed patterns among injury, verbal abuse, emotional behavior, and substance abuse domains of GSHS by categorizing them into 11 components. On the basis of these patterns, prioritizing and development of appropriate school-based interventions may be implemented by various stakeholders of Uttarakhand.

Sexual Abuse Among Adolescents (13 to 19 Years) of Boys and Girls in Three Private Schools in Dhaka City, Bangladesh

Background: Sexual abuse in adolescents is a global public health issue with severe physical, psychological, and long-term effects. In Bangladesh, societal stigma, underreporting, and weak legal enforcement further exacerbate the issue. Objectives: The primary objective is to evaluate the prevalence and patterns of sexual abuse among adolescents in three Dhaka schools, with secondary objectives to assess their clinical, demographic, and mental health status. Method and Materials: This cross-sectional study aims to evaluate the prevalence of sexual abuse among 130 adolescents (aged 13-19) from three private schools in Dhaka, selected through purposive sampling. Data will be collected using a pre-tested questionnaire administered by trained research assistants. The data will be analyzed using SPSS and STATA for both descriptive and inferential statistics. Result: The study included 130 adolescents, with boys making up 53.8% and girls 46.2%. The most prevalent form of sexual abuse was verbal abuse, reported by 46.2% of participants, followed by physical touch (30.8%) and online abuse (15.4%). Peers or schoolmates were the primary perpetrators in 38.5% of cases, while 19.2% reported abuse by strangers. Notably, 46.2% of the adolescents did not report the abuse to anyone. Of those who did, 30.8% informed school authorities, and 23.1% confided in their family. Conclusion: Children, particularly girls, are highly vulnerable to sexual abuse due to lack of parental awareness, weak reporting systems, and difficulty in disclosing abuse. Strengthening community vigilance and reporting mechanisms is essential to protect them.

Unlocking Early Detection and Intervention Potential: Analyzing Visual Evoked Potentials (VEPs) in Adolescents/Teenagers with Narcotics Abuse Tendencies from the TelUnisba Neuropsychology EEG Dataset (TUNDA)

Narcotics abuse has extensive negative impacts on individuals, families, and society, including physical harm to organs and mental health disorders. Addressing teenage narcotics problems requires collaborative efforts involving educational institutions, families, and psychologists. Currently, narcotics has increasingly targeted teenagers, becoming a serious issue that demands special attention in prevention and treatment. Handling narcotic problems at the adolescent level necessitates close collaboration among educational institutions, families, and the community, including psychologists. Emphasizing the importance of early detection and prevention, this study proposes a method to detect the possibility of narcotic abuse in adolescents using the Go/No-Go Association Task (GNAT) test designed by psychologists. The study introduced the TelUnisba Neuropsychology EEG Dataset (TUNDA), an open EEG dataset with data on the emotional and habitual aspects of drug abuse in Indonesia, classified into "normal" and "risk" by psychologists. The processed EEG signal is the visual evoked potential (VEP) within 1000 milliseconds following the visual stimulus onset. The data is classified as “slow” and “fast” based on respondent's responses using MobileNetV2 architecture. Results showed MobileNetV2 achieved the highest accuracy for both normal and risk categories, with accuracies of 0.86 and 0.85 respectively. This study obtained ethical clearance and received funding support from Telkom University and Universitas Islam Bandung, with technical assistance from the Smart Data Sensing Laboratory. The authors declare no conflicts of interest related to this study.

Alcohol abuse among adolescents and suicide risk - is there a correlation?

Introduction: Adolescent alcohol abuse is a critical public health issue with far-reaching consequences for individual development and societal well-being. Adolescent alcohol consumption poses significant health risks, particularly due to its effects on brain development and its association with increased suicide risk. Purpose of the work: This study aims to investigate the relationship between alcohol abuse and suicide risk in adolescents. Materials and methods: A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the search terms including the following keywords: alcohol abuse/ alcohol abuse in adolescence/ alcohol consumption in adolescence/ alcohol abuse and suicide risk in adolescence/ suicide risk factors in adolescence/ suicidal tendencies among teenagers. Conclusions:Adolescent alcohol abuse has profound implications for brain development and mental health, significantly increasing the risk of suicide. Effective public health strategies, including early intervention, education, and strong support systems, are essential to mitigate these risks and promote healthier environments for young individuals. Addressing the underlying causes of alcohol abuse and providing targeted support can reduce its long-term consequences and improve adolescent well-being.

Structural covariance network activity in the medial prefrontal cortex is modulated by childhood abuse in adolescents with depression

Aberrant structural covariance (SC) in the medial prefrontal cortex (mPFC) is believed to play a crucial role in adolescent-onset major depressive disorder (AO-MDD). However, the effect of childhood abuse (CA) on SC in AO-MDD patients is still unknown. Here, we measured anomalous SC in the mPFC of AO-MDD patients and assessed the potential modulation of this feature by CA. We acquired T1-weighted structural images of AO-MDD patients (n = 93) and healthy controls (HCs, n = 81). Using voxel-based morphometry analysis, we calculated gray matter volumes for each subject. Subsequently, we classified abnormal SC in the mPFC into three subtypes according to overall CA. Compared with HCs, AO-MDD patients showed alterations in the structural covariance network of the mPFC, which is a central region in the default mode network (DMN). We also found an anterior-posterior dissociation in the structural covariance connectivity of the DMN. A history of CA modulated bilateral mPFC SC. These changes were primarily focused on the SC between the mPFC and the limbic system, indicating a gap in the rate of neural maturation between these regions. In summary, the DMN and frontal-limbic system, which are involved in emotional processing, appear to play a significant role in the development of AO-MDD. These findings highlight the crucial effects of CA on neurophysiological alterations in individuals with AO-MDD.

Adolescent Relationship Abuse Among Hospitalized Adolescents

ObjectiveWe assessed adolescent relationship abuse (ARA) prevalence and ARA intervention acceptability and perceived benefit among hospitalized adolescents and young adults (AYA). MethodsThis was a planned secondary analysis of a cross-sectional survey exploring sexual and reproductive health among a convenience sample of AYA (14–25 years) hospitalized in medical/surgical units at two Midwest children’s hospitals. Survey items assessed history of dating, lifetime prevalence of four types of ARA (physical abuse, sexual abuse, reproductive coercion, sexual exploitation), and demographics. ResultsAmong 324 participants, 72.5% reported dating and, among those with history of dating, 17% reported one or more types of ARA. ARA was more common among those who reported foregone health care in the preceding 12 months. There was no difference in likelihood of dating and ARA between those with and without a chronic health condition. Approximately half felt it is helpful for clinicians to discuss dating relationships with adolescents (58.6%) and acceptable to do this during a hospitalization (50.6%). Conversations with clinicians about dating relationships were more likely to be reported helpful by those who had dated (63.9% reporting dating vs 50.6% not reporting dating, P 0.04) and those who reported prior ARA (79.5% reporting ARA vs 60.4% not reporting ARA, P 0.02). ConclusionsHospitalization may represent a unique opportunity to support healthy AYA dating relationships. Further work is needed to further explore acceptability and feasibility of such interventions.

Patterns and Emerging Trends in Acute Poisoning with Substances of Abuse Used for Recreational Purposes in Adolescents: A Six-Year Multicentre Study.

This six-year multicentre study investigated acute intentional poisoning with substances of abuse in adolescents to identify changes and patterns in substance use. Data from 562 adolescents were collected from three paediatric poison centres in Romania between January 2017 and December 2022. This study analysed the epidemiological and sociodemographic characteristics of the adolescents, including age, gender, place of residence, history of substance abuse, psychiatric history, and history of institutionalised care. The findings revealed that cannabis and new psychoactive substances (NPSs) are the most commonly implicated substances, each with distinct profiles among adolescents. Cannabis was involved in 46.1% of cases, with a significant association with urban residency. NPSs were identified as the second most prevalent substance, accounting for 39.3% of cases. These were more prevalent in rural areas and among patients with psychiatric disorders. Cannabis and NPSs were also the most commonly implicated substances in acute intentional poisoning cases with substances of abuse. These substances have distinct profiles among adolescents, including age, gender, residency area, history of substance abuse, psychiatric history, and institutional care. These findings underscore the necessity of targeted public health interventions and integrated care approaches to address substance use and related mental health issues in adolescents.

Online Child Sexual Exploitation and Abuse (OCSEA) of children and adolescents: A Systematic Literature Review

Online Child Sexual Exploitation and Abuse (OCSEA) of children and adolescents: A Systematic Literature Review

A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: statistical analysis plan for a pragmatic cluster randomised controlled trial

BackgroundGlobally, violence against children poses substantial health and economic challenges, with estimated costs nearing USD 7 trillion. This prompts the urgent call for effective evidence-based interventions in preventing and mitigating violence against children. ParentApp is a mobile, open-source application designed to offer a remote version of the Parenting for Lifelong Health (PLH) programme. ParentApp is the first digital parenting intervention for caregivers of adolescents aged 10–17 years to be tested in low- and middle-income settings.MethodsThis study is a pragmatic, two-arm, cluster-randomised trial in Mwanza, Tanzania’s urban and peri-urban areas. Assessments are set for baseline, 1 month post-intervention, and 12 months post-intervention. We randomised 80 clusters, each with about 30 caregiver-adolescent dyads, with a 1:1 ratio stratified by urban or peri-urban location. Both arms receive an entry-level smartphone preloaded with Kiswahili apps—ParentApp for intervention and WashApp control.The primary method of analysis will be generalised linear mixed-effects models with adjustment for person-level characteristics and multiple imputation. In three-level models, measurement waves are nested within a person, nested within a sub-ward. Regressions will constrain groups to be equal at baseline and include covariates for stratification, percentage of male caregivers, and individual-level characteristics.DiscussionsPreparations for the trial began in December 2022, including community mobilisation and sensitisation. Rolling recruitment, baseline data collection, and implementation onboarding took place between April and September 2023. One-month post-test data collection began in August 2023 and thus far achieved 97% and 94% retention rates for caregivers and adolescents respectively. Final post-test data collection will begin in September 2024, anticipated to run until April 2025. This SAP was submitted to the journal before the interim analysis to preserve scientific integrity under a superiority hypothesis testing framework.Trial registrationThe trial was registered on the Open Science Framework on 14 March 2023: https://doi.org/10.17605/OSF.IO/T9FXZ.The trial protocol was published in Trials 25, 119 (2024): Baerecke, L., Ornellas, A., Wamoyi, J. et al. A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial. Trials 25, 119 (2024). https://doi.org/10.1186/s13063-023-07893-x.

Validity and Reliability of the Indonesian Version of the Internalized Stigma Mental Illness Instrument: Substance Abuse in Adolescents

The prevalence rate of drug abusers in adolescents in Indonesia is relatively high. There is no valid and reliable instrument in the Indonesian language to measure stigma in drug users in adolescents. Therefore, this study aims to measure the validity and reliability of the self-stigma questionnaire in adolescent drug users. This cross-sectional study involved 59 teenage drug users who, at the time of the study, were in good health and could read and write to answer the questionnaire. Data were collected between March and September 2020 using Internalized Stigma Mental Illness (ISMI): Substance Abuse questionnaire. Pearson’s correlation coefficient, r, was used to measure the cross-validity value of the correlation between item scores and total statement scores. Meanwhile, researchers used Cronbach’s Alpha to assess the internal consistency of the questionnaire. Pearson’s r values for 29 statements showed that 1 statement was invalid. After eliminating the invalid statements, 28 statements with valid results at rcount ≥ 0.256 and Corrected item-total correlation >0.3 with a confidence level of 95% (rcount 0.323-0.642) and reliable Cronbach Alpha > 0.700 (Cronbach Alpha If Items Deleted: 0.888-0.895) with a 95% confidence level were used in the instrument. The ISMI is a valid and reliable version of drug abuse that can be used as an assessment and evaluation tool for adolescent drug abusers in clinical, rehabilitation, research, and community settings.