Iranian Adolescents Research Articles

The Mediating Role of Alexithymia in the Relationship Between Defense Mechanisms and Tendency to High-risk Behaviors Among Adolescents

Background: Although high-risk behaviors lead to adverse physical, psychological, and sociological consequences, less attention has been paid to identifying their related factors. The aim of this study was to investigate the mediating role of alexithymia in the relationship between defense mechanisms and high-risk behaviors among adolescents in Zahedan. Methods: In this descriptive-correlative study, junior and senior high school students of Zahedan, Iran were studied in the academic year 2015-2016. A sample of 250 (125 males and 125 females) students were chosen by multi-stage cluster sampling and asked to complete the Defense Style Questionnaire (DSQ), Toronto Alexithymia Scale (TAS), and the Risk-Taking Scale (IARS) for Iranian Adolescents. Data analysis was conducted by measuring coefficients of correlation and performing a path analysis. Results: Path analysis showed a significant correlation between defense mechanisms and alexithymia (P<0.01) and a significant correlation was found between immature defense mechanisms and high-risk behaviors (P<0.01). Conclusion: In the relationship between dysfunctional defense mechanisms and high-risk activities, alexithymia played a mediating role. It can be inferred that dysfunctional defense mechanisms play a key role in high-risk activities by influencing alexithymia.

Effect of an Educational Intervention on Healthy Lifestyle in Iranian Children and Adolescents: The Iran-ending Childhood Obesity (IRAN-ECHO) Program

Background: This study aimed at examining the effect of an educational program on children’s and adolescents’ knowledge of, attitude toward, and practice of healthy lifestyle habits. Methods: This was a quasi-experimental nationwide intervention carried out as part of the Iran-Ending Childhood Obesity (IRAN-ECHO) program. Participants were selected from six cities of Iran. The sample size was calculated to be 1264 for each city. Knowledge of, attitude toward, and practice of healthy nutritional habits were measured at baseline and following the intervention. A physician and a dietitian provided recommendations on healthy diet, screen time, physical activity, and sleep time. Behavioral therapy was given when necessary. Results: The prevalence of overweight or obesity was 7.6%. The frequency of students with desirable knowledge was significantly greater after the intervention compared with baseline (32.5% vs 24.8%, p = 0.02). The mean score for attitude toward obesity complications significantly increased from 73.09 to 74.78 (p = 0.03). There was also a significant increase in the mean score for the practice of low consumption of unhealthy snacks after the intervention (difference = 1.63, p = 0.03). The mean score for participation in mild physical activity increased from 50.67 to 65 after the intervention (p < 0.001). However, there were no significant changes in the number of students with desirable attitude and practice following the intervention (p> 0.05). Conclusion: The study shows that an educational intervention based on WHO-ECHO recommendations can be useful for improving the knowledge of a healthy lifestyle in children and adolescents. Over time, it might lead to a positive attitude and behavior toward a healthier lifestyle. Continued professional education and implementation of guidelines for the prevention and management of early childhood overweight and obesity are suggested.

Effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults: an application of socio-ecological model

BackgroundThe present study aimed to investigate the effects of a multi-level intervention on hookah smoking frequency and duration among Iranian adolescents and adults.MethodsIn this study, two comparable cities in Iran were selected to participate in an intervention program based on a social-ecological model (SEM). In each city, 133 hookah smokers in coffee houses were selected. Environmental changes in coffee houses such as serving light foods and games were conducted. A virtual group named “no hookah” was established on the Telegram application to train participants in the intervention group. Messages, pictures, and short videos were sent to the participants through that virtual network. The frequency and duration of hookah consumption were assessed in both groups at baseline and after the intervention.ResultsThe frequency of hookah consumption decreased in 72.6% of participants in the intervention group (vs. 6.3% in the control group), and the duration of hookah consumption per session decreased in 39.5% of participants in the intervention group (vs. 5.5% in the control group).ConclusionsUsing multi-level interventions through a social-ecological model can reduce hookah consumption in adults.

The main physical components of body image from the perspectives of Iranian adolescents: a qualitative study

BackgroundAlthough different aspects of body image have been extensively studied in Western societies, there is little evidence regarding the main physical components that contribute to perceptions of body image from the perspective of adolescents, especially in Eastern-Mediterranean regions. This study aims to investigate main physical components of body image from the perspectives of Iranian boys and girls.MethodsThis qualitative study has been conducted using a grounded theory approach. The focus of the current study was on identifying the main physical characteristics of body image as perceived by participants. A total of 13 semi-structured focus group discussions were conducted with 84 adolescents (42 girls and 42 boys), aged 15–18 years. All focus group discussions were audio recorded and transcribed verbatim. Data collection continued until saturation was reached.ResultsThe mean age and BMI of participants were 16.2±0.9 years and 24.3±8.0 kg/m2 respectively. Regarding main physical components of body image, three main themes emerged from the data: 1) perceived face/hair, which included three subthemes-facial features, facial shape/form and hair, 2) perceived body, which included three subthemes-body size, body shape and bone structure and 3) perceived physical functioning which included three subthemes-physical ability, physical health and voice tone. Among mentioned themes, perceived body was the concept which was most frequently addressed by both adolescent boys and girls. Additionally, in terms of the other remaining two themes, when adolescents were talking about their bodies, girls more frequently mentioned their faces and its features, while boys tended to talk more about their physical functioning.ConclusionThis qualitative study provide further insight into the physical components of body image as perceived by Iranian boys and girls. Current findings indicated that besides those features that focused on body appearance and its aesthetic aspects, physical functioning was another main component of perceived body image by participants. These findings can contribute to the design and implementation of effective interventions aiming at improving body image and its related disorders in Iranian adolescents.

Association of Vitamin D Concentrations with subjective health complaints in children and adolescents: the CASPIAN-V study

BackgroundVitamin D deficiency (VDD) is recognized as a global pandemic. Identification, any association between VDD and subjective health complaints (SHC), can be helpful to realize critical mechanisms and improve psychological and somatic symptoms. Given few studies published on this issue and the importance of its clarification, the main objective of this study was to examine the association between VDD and the SHC in children and adolescents.MethodsIn this national cross-sectional study, 2596 Iranian children and adolescents aged 8–18 years were included. Data on SHC, anthropometric indices, physical activity, and serum levels of vitamin D were collected. Logistic regression models (crude, adjusted) were applied to examine the association between the VDD and the SHC. Statistical analysis was performed using STATA version 11. P-values< 0.05 were considered as statistically significant.ResultsSerum levels of vitamin D in approximately 70% of Iranian children and adolescents were lower than 30 ng/mL. Among the SHC, irritability (40.9%) and feeling anxiety (33.7%) were the most prevalent ones. Multiple complaints in students with the VDD was 2.5 times greater than those with sufficient vitamin D concentrations (p < 0.001). Compared to the reference group, the strongest association was found between vitamin D status and difficulties in getting to sleep (OR: 2.5, 95%CI: 1.18, 3.53, p < 0.001).ConclusionVDD was observed in the considerable percentage of the study population. There were no significant differences between the two gender groups. In addition, there were significant associations between vitamin D status and most of the somatic and psychological symptoms, particularly for getting to sleep. It seems national interventional programs for vitamin D supplementation or food fortifications can be helpful.

Intervention-based Puberty Program: A Study on the Tendency of &amp;lt;i&amp;gt;Afghan female youths &amp;lt;/i&amp;gt;to Engage in High-risk Behaviours in Iran

Risky behaviours are one of the major problems for adolescents. These behaviours are rooted in physical, sexual, mental, and social changes. This study aims at designing a puberty training program for Afghan female youths in Iran and assesses its effectiveness in reducing their tendency to high-risk behaviour. The aim of this study is in line with the fifth goal of Sustainable Development Goals which is "Gender equality". This study provides Afghan girls with easy access to information on puberty and its issues. Forty-three Afghan adolescent girls were selected through a random sampling method and organized into three intervention groups. The participants were given trainings on the physical symptoms of puberty, early/late puberty, genital anatomy, menstruation and hygiene, psychological changes symptoms, sexual relationships, sexually transmitted diseases, peer pressure, and addiction. The intervention consisted of seven sessions. Thirty-eight participants in the control group received no intervention. The Iranian adolescents' risk-taking scale was used to measure the dependent variable at baseline and completion of the program. The results showed that there were significant decreases in the tendency to smoke, substance abuse, alcohol consumption, and unprotected sexual relationships in the intervention groups (<I>P</I> < 0.01). However, the tendency to violence had no significant differences among the control nor in the intervention groups. This study provides evidence on the effectiveness of puberty training among Afghan adolescent girls with a tendency to engage in high-risk behaviours. Further research on the the immigrant adolescent’s tendency towards violence are recommended. Longitudinal follow-ups are suggested to support the generalization of these kinds of interventions.

Psychometric properties of insomnia severity index in Iranian adolescents.

ObjectivesSleep deprivation and insomnia have negative impacts on mental and physical health in adolescents. In order to examine the problems caused by insomnia, we need tools with acceptable validity and reliability for the target population. The aim of this study was to evaluate the psychometric properties of Insomnia Severity Index (ISI) in Iranian adolescent population.Material and MethodsThe study was carried out as a descriptive-analytic normalization. Study group consisted of 701 adolescents aged 12 to 19, who were selected through cluster sampling. The participants completed ISI, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Inventory (PSQI), Adolescent sleep hygiene scale (ASHS) and global sleep assessment questionnaire (GSAQ). In addition, SPSS ver.22 and AMOSS ver.10 were used to analyze the data.ResultsThe reliability of the test was obtained equal to 0.77 based on Cronbach’s alpha and a good reliability (0.84) was obtained through test/retest method. Exploratory and confirmatory factor analyses with seven items were computed. The models fitness indexes were suitable for the structural model (CFI=0.99%, NFI=0.98%, GFI=0.99%, TLI=0.98%, RMSEA=0.049%). Moreover, there was a direct and significant correlation between the ISI index and the total score of other indexes. As to gender-based reliability, Cronbach’s alpha was 0.78 in female adolescents and 0.85 in male adolescents.ConclusionThe results indicated that the Persian version of the insomnia severity index can be used as a reliable and valid tool for assessing the severity of insomnia in Persian-speaking adolescents.

Prevalence of water pipe smoking and associated risk factors among female adolescents.

BACKGROUND:The prevalence of water pipe smoking is increasing among young people, but there are limited data on its use among adolescents in Iran. The aim of this study is to investigate the prevalence of WP smoking and associated risk factors among female adolescents in Western Iran.MATERIALS AND METHODS:This cross-sectional study was conducted in schools. It included 1302 middle school (48.1%) and high school (51.9%) female students (grades 7–12) recruited through stage random sampling and conducted in 2019 in the western city of Kermanshah, Iran. The data collection tool was a researcher-made questionnaire. Logistic regression analyses and descriptive statistics were executed using SPSS version 22.RESULTS:The mean (standard deviation) ages of the students and the ages when the participants started WP smoking were 15.22 ± 1.85 and 13.64 (1.64), respectively. Nearly 32.2% had a single experience of WP smoking during their lifetime and 20.4% were current consumers of WP. Most of the subjects smoked WPs at their friends’ home (45.8%) and with their friends (47.4%). The significantly important factors that affect WP smoking in these age groups are the father's and mother's occupation, family size, living with others, father's education, having a friend who smokes WPs, friends’ encouragement to smoke WP, and being in a family that smoke WPs.CONCLUSIONS:Considering the increasing popularity of WP among adolescent females and its increasing prevalence, the results showed that Water pipe smoking with friends played a key role in WP smoking among female adolescents. There is a need to design interventional studies to increase people's skills and to design and implement programs to prevent water pipe.

Validity and Reliability of Youth Anxiety Measure for DSM-5 in Iranian Non-Clinical Children and Adolescents.

The present study aimed to explore the validity and reliability of the Persian version of the Youth Anxiety Measure for DSM-5 (YAM-5). Two groups of non-clinical children and adolescents were recruited. The first group (n = 520) was recruited via 4 schools of Tehran, Iran, and only completed the YAM-5. The second group (n = 557) was recruited via 4 schools of Tabriz, Iran. In addition to the YAM-5, they completed another anxiety scale and a depression scale. The exploratory factor analysis of data of the first group revealed a five factor model similar to the original model of the scale. The confimatory factor analysis showed that the five factor model fit with the data of second group. Also, the convergent validity was supported. The current findings, thus, provide support for validity and reliability of Persian version of the YAM-5 in a nonclinical sample of children and adolescents in Iran.

Dental Trauma among Iranian Children and Adolescents: A Comprehensive Study

Background Various accidents threaten children and adolescents. One of these accidents is Traumatic dental injury (TDI). This study aimed to review systematically TDI in children and adolescents in Iran. Materials and Methods: This study is a systematic review of the literature that has searched TDI articles from April 2000 to April 2020. Search was conducted using keywords including Epidemiology, Prevalence, Traumatic Injuries, Dental Trauma, Traumatic dental injury, Etiology, Pediatric, Children, Adolescent, Iran, in English or their Persian equivalent, using the AND and OR search strategy. Search was conducted on online national databases of (SID), Magiran, Iran Doc, as well as on international sites such as Scopus, Medline, EMBASE, Web of Science, CINAHL, and Science Direct. The articles were analyzed after entering the End Note X8 software and reviewing them according to the instructions of the systematic review articles. Results: In this review, firstly, 189 studies were identified. Then 120 duplicates were omitted and after the assessment of titles and abstracts, 84 other articles were excluded. Finally, eight articles entered this systematic review. The sample size in 8 extracted articles was equal to 4567 children and adolescents. According to the findings, the prevalence ranged from 8.9% to 36.9%. The prevalence of dental trauma was also higher in boys and adolescents of the male sex. One of the most common causes of fall trauma as well as trauma occurred in environments such as home, school, playground and passages. Conclusion Given that most dental trauma occurs in boys; it is necessary to give this group the necessary training to reduce trauma.

Epidemiology of Psychotic Disorders Based on Demographic Variables in Iranian Children and Adolescents.

Objective: Psychosis is still among the most debilitating and severe mental disorders. The main objective of the present study was to investigate the estimated prevalence of psychotic disorders and finding the main predictors of psychotic disorders among Iranian children and adolescents. Method : Our total sample consisted of 30 553 individuals (49% males and 51%females) from 30 provinces of Iran, aged between 6 and 18 years, who were selected via cluster sampling method from rural and urban areas of all provinces. The data were analyzed using descriptive statistical analysis and multiple logistic regression method. Results: The results of multiple regression analysis showed that prevalence estimate of psychotic disorders was 0.25%. It was 0.3% and 0.2% in males and females, respectively. The age of 10-14 (OR = 2.24; 95% CI, 1.11-4.55) and the age of 15-18 (OR = 3.42; 95% CI, 1.74-6.75) were significant positive predictors, whereas none of the demographic variables were predictors for psychotic symptoms. Conclusion: This research highlights the main predictors of psychosis in children and adolescents. The study design also allowed a better understanding of predictors of psychotic disorders. The assessment of the prevalence of psychiatric disorders, particularly their comorbidities, may help to prevent mental illnesses in children and adolescents.

The Prevalence of Asthma among Iranian Children and Adolescent: A Systematic Review and Meta-Analysis.

Background Asthma is an important reason for hospitalization in children aged under five years. Information about the current status of asthma in Iranian children can help the Iranian health sector plan carefully and prevent asthma incidence by educating the families. The present systematic review and meta-analysis is aimed at estimating asthma prevalence in Iranian children and adolescents. Method Data were found using keywords such as prevalence, epidemiology, asthma, adolescent, children, pediatrics, Iran in Web of Science, Scopus, PubMed, Cochrane, and Embase databases. Three national databases, including Magiran, Barakat Pharmed Co (Iran medex), and Scientific Information Databank (SID) were searched until 1 October 2020. Cross-sectional and original studies were included in the study, and then, quality assessment was done using the National Institutes of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A pooled estimated prevalence of asthma was calculated using Der Simonian-Laird random model. Egger's test was used to evaluate publication bias. The data were analyzed using the STATA software version 16. Results 30 studies were selected and investigated. The prevalence of asthma in children and adolescents was 6% and 8%, and the prevalence in boys and girls was 9% and 8%, respectively. Among the asthma symptoms, wheezing had the most prevalence (17% in children and 19% in adolescents) and sleep disturbance had the lowest prevalence (6% in children and 6% in adolescents). Conclusion The prevalence of asthma in Iranian children and adolescents is lower than in the world. Existing strategies should be pursued followed. Also, guidelines for asthma control and prevention should be considered in the future.

Associations between Physical Activity and Mental Health in Iranian Adolescents during the COVID-19 Pandemic: An Accelerometer-Based Study

Associations between Physical Activity and Mental Health in Iranian Adolescents during the COVID-19 Pandemic: An Accelerometer-Based Study

Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran

ABSTRACT Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13–30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants’ preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco

Predictors of Childhood High Blood Pressure among Overweight and Obese Children and Adolescents according to the Lifestyle-Scoring Algorithm Using Data from Iranian Health Care Reform Plan.

In this study, the association between dietary pattern and lifestyle in predicting hypertension (HTN) among 425 overweight and obese children and adolescents aged 6 to 18 years was evaluated. In the current cross-sectional study, the lifestyle-scoring algorithm was developed considering the Iranian Health Reform Plan (HRP) criterion. HTN was defined according to standard protocols. Hierarchical linear regression models were used for the analysis. The prevalence of overweight/obesity was 5.82%. The results showed that systolic and diastolic blood pressure (SBP, DBP) had significant positive correlation with age (p < 0.001 and p < 0.001) and body mass index (BMI) (p < 0.005 and p < 0.007), respectively. Moreover, DBP had a significant correlation with fruit consumption of less than 2 servings per day versus no consumption (p = 0.014, B = 0.444), fruit consumption of more than 2 servings per day versus no consumption (p = 0.014, B = 0.480), and vegetable consumption less than 3 servings per day versus no consumption (p = 0.045, B = −0.374). Moreover, DBP had a significant correlation with fast foods/junk foods consumption of 1–2 items per week versus almost daily consumption (p = 0.047, B = −0.177). The final model could predict 32.1% of HTN by SBP and DBP (R2 = 0.32). According to our findings, lower intake of vegetables and fruits, higher amounts of fast foods, higher age and BMI could be potent predictors of high blood pressure among Iranian children and adolescents.

Factor structure and psychometric properties of the Persian versions of the Pediatric Daytime Sleepiness Scale and Morningness-Eveningness Scale for Children.

BACKGROUND:The Pediatric Daytime Sleepiness Scale (PDSS) and the Morningness–Eveningness Scale for Children (MESC) are widely used to measure two important facets of sleep patterns, but neither have been adapted and validated for use in Iran. The purpose of this study was to examine the psychometric properties and factor structure of the Persian versions of the PDSS and the MESC in a sample of Iranian adolescents.MATERIALS AND METHODS:The Persian versions of PDSS and MESC were translated and administered to a representative sample (n = 407) of Iranian early adolescents, aged 9–15 years, who attended school in morning shifts. The factor structure of both scales, found in prior studies, was tested using Confirmatory Factor Analyses to assess their validity and reliability.RESULTS:The results revealed that the model fit indices of the one factor solution of the PDSS and the two factor solution of the MESC were acceptable to good. A high Pearson correlation was found between raw and latent factor scores for the PDSS and the two factors derived from the MESC (i.e., Morningness and Planning). Furthermore, the higher the PDSS score (more daytime sleepiness), the lower the MESC scores (more eveningness), indicating criterion validity of the scales showing the expected increase in daytime sleepiness in evening oriented adolescents who wake up early for attending school.CONCLUSION:The Persian versions of the PDSS and the MESC can be considered reliable and valid tools for evaluating, respectively, daytime sleepiness and morningness-eveningness in the adolescent population of Iran.

Development of the Social Interest Scale for Iranian Adolescents

Development of the Social Interest Scale for Iranian Adolescents

Iranian Adolescent Girls' Self-Concepts of Eating Behaviors: A Qualitative Study

Background: Self-concept plays an important role in understanding behavioral patterns. The purpose of the present study was to explain Iranian adolescent girls' self-concepts of eating behaviors. Materials and Methods: In this qualitative study, conventional content analysis was used and participants were selected through purposeful sampling. This study was conducted in the government girls’ schools of Shiraz City, Iran from October 2018 to March 2019. Data were collected through in-depth, semi-structured individual interviews with 42 girl students. Interviews were recorded with the audio recorder and continued until data saturation was achieved so that no new conceptual information was obtained after 35 interviews, while individual interviews were conducted with seven other individuals to ensure data saturation, and no additional conceptual information emerged from the seven interviews. The data were analyzed according to the conventional content analysis approach. Results: From the analysis of the data, six categories for adolescent girls' self-concepts were drawn including: (1) physical self-concept, (2) social self-concept, (3) academic self-concept, (4) self-satisfaction, (5) self-confidence, and (6) self-esteem. These self-concepts included subcategories of effective eating behaviors on appearance, physical energy status, morals, academic performance, satisfaction and happiness, self-confidence and popularity and respect. Conclusion: Adolescent girls' self-concepts of eating behaviors encompass a wide range of dimensions such as physical, social, academic, self-satisfaction, self-confidence and self-esteem, and their identification is one of the determinants of the development of intention to adopt healthy eating behaviors.

Psychometric Properties of the Abdominal Pain Index (API) in the Iranian Adolescent Population.

Considering the high prevalence of abdominal pain in children and adolescents in Iran, it is essential to use appropriate screening tools. One of the most comprehensive, yet concise, tools for this purpose is the Abdominal Pain Index (API). This study aimed to investigate the psychometric properties of the Persian version of the self-report API in adolescents. In this descriptive study, A total of 162 Iranian adolescents in the age range of 12 to 18 years were considered as the sample group, which included two groups of school students (n = 125) and adolescent patients with abdominal pain (n = 37). Clinical sample was selected by the available sampling method, and nonclinical sample was selected by the cluster sampling method. Adolescents in the sample group were selected from both clinical and nonclinical groups in order to evaluate differential validity. Instruments, including API, somatic symptoms subscale of the General Health Questionnaire (GHQ), and McGill Pain Questionnaire (MPQ), were also completed for the participants. Also, to evaluate the construct validity of API, exploratory and confirmatory factor analysis methods were applied. The exploratory factor analysis identified one general factor, and the confirmatory factor analysis results show the model's satisfactory fitting. Also, the researchers' hypothesis, i.e., API is a single-factor model (with five items), was approved. The reliability coefficient of the questionnaire was satisfactory for the total scale (α < 0.7). This study showed that API could be used with considerable confidence for Iranian children and adolescents with chronic pain.

Prevalence and determinants of substance use among a sample of Iranian adolescents with ease of access to drugs: an application of Social Development Model

ABSTRACT The aim of this study was to investigate the prevalence rate and determinants of SU in adolescents based on the social development model (SDM). In 2018, applying a cross-sectional design, cluster multistage random sampling was employed to recruit 600 adolescents in Bam County, Iran, to participate in the study. A valid and reliable SDM-based instrument was used to collect data. The prevalence rate of using at least one substance was 42% (in girls 33.6% and in boys 50.3%). Adjusted for covariates, having close friends with SU was found as the factor with the highest risk. Higher scores in involvement in prosocial activities and interactions (OR: 0.47; 95% Confidence interval (CI): 0.33–0.66, p < 0.001), attachment and commitment to prosocial others (family and school) (OR: 0.73; 95% CI: 0.58–0.93, p < 0.05), and skills for interaction/involvement (OR: 0.51; 95%CI: 0.39–0.67, p < 0.001) reduced the odds of ever use of SU among adolescents. Also, higher levels of perceived rewards for antisocial interaction/involvement (OR: 2.22; 95% Confidence interval (CI): 1.53–3.22, p < 0.001) and belief in antisocial values (OR: 2.24; 95% CI: 1.67–2.94, p < 0.001) increased the odds of ever use SU among the respondents. In community-based interventions to prevent SU among adolescents, a great focus should be firstly on identifying the probability of SU in close friends. Moreover, the involvement of adolescents in prosocial activities and interactions, attachment and commitment to prosocial others (family and school), and skills for interaction/involvement should be core categories while designing community-based interventional studies.