Structural Equation Modeling Framework Research Articles

Developing an integrated framework for risk management in policing: crisis management using big data analytics as a case study

Objective: The study seeks to develop an integrated framework for enhancing risk management and crisis management in policing through the utilization of big data analytics, using the Dubai police force as a case study. Theoretical Framework: This research is grounded in the intersection of big data analytics and risk management within the field of policing, focusing on how data-driven approaches can innovate and improve security crisis management. Method: Data for the study was collected via questionnaires distributed to 450 police officers across all departments in Dubai. The analysis was conducted using AMOS software within a Structural Equation Modeling framework to assess the impact of big data analytics on police risk and crisis management. Results and Discussion: The results indicate that big data analytics significantly enhances risk management and crisis management in policing. It was found that police risk management serves as a mediating factor between big data analytics and security crisis management. These findings suggest that the application of big data can substantially improve knowledge and operational performance in police organizations. Research Implications: The study emphasizes the crucial role of big data analytics in revolutionizing police risk and crisis management processes. It highlights the potential for these technologies to provide substantial improvements in the efficiency and effectiveness of police operations. Originality/Value: This research is valuable as it provides empirical evidence of the benefits of big data analytics in the context of policing. It offers practical guidelines to police departments, particularly within the UAE, on leveraging big data to enhance their operational performance in managing risks and crises. The study contributes to the broader understanding of integrating advanced data analytics into public safety and emergency response strategies.

Internet Use and Loneliness among Urban and Non-Urban Chinese Older Adults: The Roles of Family Support, Friend Support, and Social Participation.

This study investigated the association between Internet use and loneliness among older Chinese adults, and the mediating effects of family support, friend support, and social participation. These associations were evaluated in the context of urban and non-urban geographic settings. This study used data from the 2018 wave of the China Longitudinal Ageing Social Survey (N=10,126), examining samples of urban (n=3,917) and non-urban (n=6,209) older adults separately. Linear regression and path analysis within a structural equation modeling framework were employed. Internet use was negatively associated with loneliness for both urban and non-urban residing older adults. Family support and social participation mediated the association between Internet use and loneliness for both urban and non-urban residing older Chinese adults, but friend support mediated this association only for urban older residents. This study shed light on our understanding about the relationship between Internet use and loneliness among older adults in the Chinese context. Also, these findings suggested that digital interventions for loneliness should pay special attention to the different characteristics of urban and non-urban dwelling older Chinese adults.

US Immigration Policy Stressors and Latinx Youth Mental Health

The youth mental health crisis is exacerbated for Latinx adolescents, a group whose families are targets of anti-immigrant rhetoric and policy. To investigate how immigration-related stressors are associated with disruptions in parent-child relationships and, in turn, the mental health symptoms of Latinx adolescents. Data for this prospective cohort study of adolescent-mother dyads were derived from surveys completed at 3 time points spanning 4 years (time 1 [T1] in 2018, time 2 [T2] in 2020, and time 3 [T3] in 2022). Mediation analyses estimated paths from immigration-related stressors to parent-child relationship qualities to mental health symptoms from early to late adolescence. Multivariable and multivariate linear models within a structural equation modeling framework regressed mediators and outcome variables on their own T1 values, offering a scientifically rigorous test of mediation. The setting was a school district in suburban Atlanta, Georgia, and included Latinx adolescents (ages 11-16 years) randomly selected from grade and gender strata. Data were analyzed from June 2023 to March 2024. The primary independent variables were T1 mother reports of anti-immigrant worry and behavioral modification and adolescent reports of family member detention or deportation. Mediating variables were the reports of parental support and parent-child conflict of T2 adolescents. T3 adolescent reports of past 6-month internalizing and externalizing symptoms. A total of 547 Latinx adolescents (mean [SD] age, 13.3 [1.0] years; 303 female [55.4%]; 244 male [44.6%]) were included in this study. Response rates were 65.2% (547 of 839) among contacted parents and 95.3% (547 of 574) among contacted adolescents with parental permission. Four-year retention rates were 67% (366 of 547 adolescents) and 65% (177 of 271 mothers). Structural model results showed that T1 anti-immigrant worry and behavioral modification was associated with T3 increases in externalizing symptoms indirectly through T1 to T2 increases in parent-child conflict (β = 0.03; SE = 0.02; 95% CI, 0-0.08). For girls, T1 family member deportation or detention was associated with T1 to T3 increases in internalizing and externalizing symptoms indirectly through T1 to T2 declines in parental support (internalizing: β = 0.04; SE = 0.02; 95% CI, 0-0.08; externalizing: β = 0.03; SE = 0.02; 95% CI, 0-0.07). Sensitivity analyses supported structural model findings. Results of this cohort study suggest that legislative bodies, the health care system, and educational institutions should implement safeguards to mitigate potential harm conferred by anti-immigrant environments for parent-child relationships and, in turn, Latinx adolescents' mental health.

Reciprocal relationship between self-efficacy and achievement in mathematics among high school students

Self-efficacy or perceived ability refers to the confidence an individual has in their ability to successfully perform a specific task. Previous researchers have demonstrated the importance of self-efficacy beliefs and its impact on predicting students’ mathematics performances. Specifically, gender has been regarded as an important moderator variable in the prediction of achievement from measures of affect. To this end, using data from High School Longitudinal Study of 2009, this study utilized the multi-group analysis under the framework of structural equation modeling to examine gender differences in the reciprocal relationship between mathematics self-efficacy and mathematics achievement. The results showed that there were statistically significant differences between male students and female students in the reciprocal relationship between mathematics self-efficacy and mathematics achievement; the impact of prior mathematics achievement on later mathematics achievement was stronger than the impact of prior mathematics self-efficacy on later mathematics self-efficacy. Significance of these findings were discussed in this paper.

Decoding green food safety information dependency in the digital era: An intelligent validation using SEM-ANN framework

Dependence on mobile phone information in the Internet era is a crucial issue, and psychological perception and personalized and accurate pushing significantly impact this field. This introduction of rational and planned behaviour combined with the theoretical framework of Structural Equation Modelling (SEM) and Artificial Neural Networks (ANN) are intricacy analytical tools to explore the key factors affecting the information dependence on green food safety. The key factors affecting the reliance on green food safety information were investigated. The survey covered 630 participants aged 17 to 70 in Guangdong Province, China. The study showed that perceived risk, regulation, price volatility, innovativeness, and anticipatory confirmation significantly influence the perceived usefulness of green food information, affecting satisfaction with green food. The study also highlights the significant impact of the degree of anticipatory confirmation by users on satisfaction and perceived usefulness of green food. Model path analysis revealed that anticipatory confirmation and perceived usefulness explained 61% and 74% of the variance in financial sustainability, respectively. The application of deep ANN multilayer perceptron improved the prediction accuracy of perceived usefulness with 87.54% training accuracy and 90.34% testing accuracy, further deepening the understanding of the mechanism of relying on green food safety information. This study provides strong support for a deeper understanding of the relationship between consumer behaviour and green food safety information dependence, which helps promote enterprises and market camps to more effectively formulate product or service promotion strategies and provides a solid theoretical and empirical foundation for future green food safety and personalized and accurate push thus enhancing information dependence.

Исследование взаимосвязи данных о результате и процессе выполнения заданий при оценке цифровой грамотности

<p style="text-align: justify;">Measuring complex latent constructs is challenging because of their multi-dimensionality. In this context, computer-based assessments have gained popularity due to its ability to handle large diverse data. The aim of the study is to investigate the interrelationship between performance, time, and actions in computer-based digital literacy assessment. The study involved more than 400 8<sup>th</sup>-grade schoolchildren (approximately 14—15 years old) from secondary schools in Russia. A subset was obtained from indicators capturing the demonstration of analysis of data, information, and digital content, which is a component of the information literacy in the digital literacy framework. The data was used to create latent models in the structural equation modeling framework. Confirmatory one-factor model for the Performance factor showed a good fit to the data (CFI=1; TLI=1; RMSEA=0). The model with dependencies among indicators demonstrated improved model fit (χ<sup>2</sup><sub>(18)</sub>=510,65; p=0,05) compared to the model without such dependencies. The results suggest that performance, time, and actions are interdependent. The findings underscore the need for a comprehensive approach to assessing digital literacy that accounts for these interdependencies, as well as investigating behavioral patterns of interaction with a large amount of information in the digital environment.</p>

Perception of place, active transportation, and community participation: A mediation analysis

IntroductionActive transportation is associated with many benefits, including community participation, a salient form of social capital. Positive neighborhood perceptions are likewise associated with higher social capital, including community involvement. However, little is known about how active transportation may mediate the relationship between perception of place and community participation. MethodsUsing representative data from the Survey of the Health of Wisconsin (n = 1758), path analysis within a structural equation modeling framework assessed mediation. Covariates include age, education, race/ethnicity, gender, and community size. ResultsResults suggest perception of place (well-maintained, interesting places with walkable destinations) has a relationship to community participation (p = 0.001); however, when assessed for mediation through active transportation, only an indirect effect remained significant (p = 0.003), indicating the relationship between perception of place and community participation occurs through active transportation. ConclusionsInvesting in bike and pedestrian infrastructure that connects places, creates interesting spaces, and protects funding for routine maintenance is critical to support higher participation in active transportation as well as higher social capital in the form of greater involvement in community participation. Inequities in maintenance and infrastructure may impact not only active transportation, but community participation as well.

Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach.

This study hypothesizes that depression mediates the association between exposure to stigma and medication non-adherence in people living with HIV (PLHIV). We recruited 372 PLHIV from the Stigma, health-related Quality of life, antiretroviral Adherence, and Depression among people living with HIV (SQuAD-HIV) project, a multicenter cross-sectional study conducted between October 2021 and February 2022 among PLHIV attending six ART clinics in two geopolitical regions of northern Nigeria. A structural equation modeling (SEM) framework, utilizing the full information maximum likelihood estimator, was used to elucidate the pathways linking stigma, depression, and ART medication adherence, adjusting for sociodemographic characteristics. The total number of eligible participants analyzed (353) included 32.7% male PLHIV with a mean age (SD) of 39.42 (10.14). Being female was positively associated with adherence (β, 95% CI 0.335, 0.163-0.523, p-value < 0.001) but negatively associated with stigma (β, 95% CI - 0.334, - 0.561 to - 0.142, p-value = 0.001), while urban residence was negatively associated with stigma (β, 95% CI - 0.564, - 0.804 to - 0.340, p-value < 0.001). Our analysis also indicated that a higher level of experienced stigma was associated with decreased medication adherence. This association was partially mediated by depression (indirect effect = (0.256) (- 0.541) = - 0.139; p-value < 0.01). The proportion of the association between stigma and medication adherence explained through mediation by depression was 35.6%. These findings underscore the need for targeted interventions aimed at lowering exposure to stigma among PLHIV to improve medication adherence.

Academic performance, emotional intelligence, and academic burnout: A cross-sectional study of a mediational effect in nursing students

BackgroundCourse failure arises as the ultimate result of students' declining academic performance in the face of high course demands. It can eventually lead to dropout and academic dissatisfaction. Emotional intelligence may play an essential role in decreasing the emotional effects of stress, such as academic burnout in nursing students. However, emotional intelligence is conceptualized multidimensionally, and each of its attributes may have a different impact on burnout reduction. ObjectiveTo explore the dimensions of emotional intelligence that may mediate the association between academic performance (course failure) and academic burnout in nursing students. DesignThe design was cross-sectional, with survey-based data collection. SettingsEducational setting, undergraduate nursing students at a private university in Metropolitan Lima, Peru. Participants154 students (77.3 % female) with a mean age of 25.9 years. MethodsA multiple mediation strategy was used, using the Wong-Law Emotional Intelligence Scale. Four emotional intelligence attributes (self-emotional appraisal, others' emotional appraisal, use of emotion, and regulation of emotion) were evaluated in the relationship of failed courses (dichotomous variable: yes/no) and academic burnout (single item based on physical and emotional exhaustion). The structural equation modeling framework was used. ResultsCourse failure (academic performance) positively affects academic burnout. Regulation of emotion is the only dimension of emotional intelligence mediating between course failure and academic burnout. The proportion of the mediating effect was 0.315, while the rest was around zero. Statistically significant gender differences were detected concerning burnout, with men scoring moderately higher than women. ConclusionsThe results indicate that the regulation of emotion may have a relevant role in reducing burnout compared to other emotional intelligence attributes. These regulatory skills are important for developing health care and positive patient relationships. Interventions focused on the regulatory characteristics of emotions and distinguishing different attributes of emotional intelligence while exploring its mediating effect should be strengthened. These implications are linked to the growing call to include EI in university education.

Sexual Passion in Adolescence: Examining Its Transmission Through Mothers

ABSTRACT Sexual passion is an important element of adult romantic relationships, but little is known about how it is developed or expressed during adolescence. From a Self Determination Theory perspective, this study explored the connections between parents’ sexual passion and children’s sexual passion, and whether these links were mediated by parents’ communication about sexuality with their children. Using a diverse sample of 484 mother-adolescent dyads (Mage = 14.48, SD = 1.68, 50% female, 56% White), we specified a path model in a Structural Equation Modeling framework to test hypothesized associations. Results indicated that all three types of parent sexual passion – harmonious, obsessive, and inhibited – were positively associated with children’s sexual passion in the same domains. Additionally, the frequency of parent-child sexual communication partially mediated the transmission of harmonious passion, whereas controlling parent-child sexual communication partially mediated the transmission of obsessive passion. These findings highlight the importance of parents’ sexual relationships in the sexual socialization and development of adolescents. Additionally, helping parents to have more frequent conversations about sex with their children could help facilitate the transmission of harmonious sexual passion.

Predictors of Global Scientific Literacy of Pre-Service Teachers: A Structural Equation Modeling Study

The purpose of this study was to examine the relationship among pre-service science teachers' global scientific literacy and various variables within the scope of the structural equation model. Since the relations among the variables were investigated in the structural model established for this study, correlational research methodology was applied. The application was carried out with 294 pre-service teachers studying in the departments of chemistry, physics, biology and elementary science education of a state university. The data of the study were obtained with the scales of global scientific literacy, the perception of science process skills, the inquiry skills, the self-directed learning readiness in laboratory, the attitude scale towards the laboratory and the personal information questionnaire. Within the framework of structural equation modeling, the causal and relational analyses of the data were examined. The results showed that the proposed model of the relationship among global scientific literacy and the variables predicting global scientific literacy was also found to be compatible with the data, and the entire model was confirmed except for the attitude towards the laboratory. In this context, it can be claimed that these variables play an essential role in pre-service teachers’ being global scientifically literate.

Investment by maternal grandmother buffers children against the impacts of adverse early life experiences

Exogenous shocks during sensitive periods of development can have long-lasting effects on adult phenotypes including behavior, survival and reproduction. Cooperative breeding, such as grandparental care in humans and some other mammal species, is believed to have evolved partly in order to cope with challenging environments. Nevertheless, studies addressing whether grandparental investment can buffer the development of grandchildren from multiple adversities early in life are few and have provided mixed results, perhaps owing to difficulties drawing causal inferences from non-experimental data. Using population-based data of English and Welsh adolescents (sample size ranging from 817 to 1197), we examined whether grandparental investment reduces emotional and behavioral problems in children resulting from facing multiple adverse early life experiences (AELEs), by employing instrumental variable regression in a Bayesian structural equation modeling framework to better justify causal interpretations of the results. When children had faced multiple AELEs, the investment of maternal grandmothers reduced, but could not fully erase, their emotional and behavioral problems. No such result was observed in the case of the investment of other grandparent types. These findings indicate that in adverse environmental conditions the investment of maternal grandmothers can improve child wellbeing.

Irritability across adolescence: Examining longitudinal trajectory, stability, and associations with psychopathology and functioning at age 18

BackgroundIrritability, marked by diminished frustration tolerance, holds significant implications for youth mental health treatment. Despite prior research on irritability trajectories, understanding of individual differences during adolescence remains limited. This study examines the stability and trajectory of irritability across ages 12–18, investigating associations with psychopathology and functioning at age 18. MethodsA community sample of families with 3-year-old children (N = 518) was recruited via commercial mailing lists. Irritability was assessed at ages 12, 15, and 18 using the Affective Reactivity Index. Psychopathology at age 18 was evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia, and functioning was assessed through the UCLA Life Stress Interview. Measurement invariance analyses and latent growth curve modeling were conducted within a structural equation modeling (SEM) framework. ResultsConfigural, metric, and scalar invariance models were supported. Elevated irritability at age 12 predicted adverse outcomes at age 18, including increased psychotropic medication use, mental health treatment, suicidal ideation, self-injury, and psychiatric disorders. Importantly, these associations persisted even after accounting for corresponding variables at age 12. The trajectory of irritability during early adolescence significantly predicted heightened risks for various outcomes at age 18, including suicidal ideation, depression, anxiety, disruptive behavior disorders, and impaired interpersonal functioning. DiscussionLimitations include using only youth-reported data at age 18, limited generalizability from a mostly White, middle-class sample, and insufficient exploration of the broader developmental trajectory of irritability. Nevertheless, the findings emphasize the crucial role of irritability's trajectory in influencing various psychopathological and functional outcomes in late adolescence.

Antecedents of Corruption Perception in Guyana

Regardless of its utility as a measure of actual corruption, perceived corruption is related to many political attitudes and other variables which makes it an important phenomenon to understand. This paper explores demographic variables, ideological orientations, socioeconomic status, interpersonal trust, political attitudes and feelings of resentment as explanations for corruption perception with response styles controlled within a structural equation modelling framework using survey data collected in Guyana where corruption is salient and thought to be pervasive. It finds that the categories of variables jointly explain 31.5% of the variance in corruption perception and that there is explanatory utility for each category of variables evaluated except socioeconomic status with demographics and ideological orientations accounting for the largest changes in explained variance. It also finds that political cynicism attenuates an initial effect of interpersonal trust and concludes that ethnicity appears to function as partisan orientation in its relationship with corruption perception.

Choice Behavior and Diffusion Impact Analysis of Connected and Autonomous Vehicle Travelers with Managed Lanes

Choice Behavior and Diffusion Impact Analysis of Connected and Autonomous Vehicle Travelers with Managed Lanes

Fostering Women’s Entrepreneurial Success: The Significance of Informal Institutional support in Venture Creation

The significance of women entrepreneurs in creating jobs and driving social and economic progress cannot be overstated. In less developed economies like Pakistan, the participation and impact of women entrepreneurs are notably lower as compared to more advanced nations. This research aims to investigate the effect of informal institutions on venture creation in Pakistan within the framework of institutional theory. Employing a quantitative approach, the study concentrates on women entrepreneurs operating in Hazara and Peshawar divisions. Data collection involved the utilization of five point Likert scale questionnaire through simple random sampling. Empirical analysis of the collected data was executed employing the path analysis methodology within the framework of structural equation modeling (SEM) facilitated by Smart PLS 3. Findings from the research revealed a significant positive impact between informal institutional support in women entrepreneurship and venture creation. The study underscores the significance of government and relevant bodies focusing on critical determinants such as family support, fear of failure, and social networking to enhance the landscape of venture creation. This research contributes to the theoretical literature and sheds light to bring clarity to the particular role of informal institutional factors generally, social networking, family support and fear of failure constraints in enhancing venture creation. It's crucial to evolve women entrepreneurship support programs by government. These programs necessarily address the unique challenges being faced by women when handling the informal institutions. Raising awareness and stimulating societal norms and stereotypes that curtail women’s economic participation is decisive. Launching campaigns to mold societal perceptions can aid break down gender-based obstructions and promote a more comprehensive entrepreneurial setting.

Employer Branding – Employer Attractiveness as a New Mindset in the Healthcare Sector

Abstract The shortage of skilled labour, demographic change and ever-increasing cost pressures are presenting healthcare organisations with key challenges in the areas of strategy, leadership and portfolio management. In the Federal Republic of Germany, there is an acute shortage of skilled workers in 352 of 801 occupational groups (44% of all occupational groups). Effective employer branding is the only way to sustainably increase employer attractiveness and generate competitive advantages on the labour market. Employer branding is the identity-based development and positioning of a company as an attractive employer. The aim of the article is to identify relevant characteristics of employer attractiveness, which can be located in particular in the perception of IT specialists. The identification of these characteristics should help organizations to optimize their personnel policy in the long term. The authors chose the mixed-methods research approach. The hypothesis system is conceptualized and operationalized within the framework of structural equation modelling (SEM). The practical relevance of the findings from the quantitative research is examined in expert interviews. The data analysis is based on qualitative content analysis according to Kuckartz. Due to the research background, data collection is limited to the EU member state Germany. The shift in the balance of power in the labour market towards employees is not a development that can be limited to Europe. In a globalized world, companies have access to a wider talent pool, but are also exposed to increased competition for the best talent. A strong employer brand enables companies to stand out and attract top talent. The empirical results show that a positively perceived employer attractiveness can achieve the employer branding goals of recruiting employees and retaining them in the long term. The clever combination of tangible and intangible benefits, embedded in a modern corporate and error culture (mindset), is decisive in determining whether qualitative growth of the organization is possible.

Salutogenic health measures: Psychometric properties of the Danish versions of the Flourish Index and the Secure Flourish Index.

Measurement of human flourishing represents a salutogenic approach to epidemiological and behavioral research emphasizing factors contributing to "good lives" rather than pathology. The objective of this study was to translate and psychometrically test the 10-item Flourish Index (FI) and 12-item Secure Flourish Index (SFI) in a convenience sample of Danish adults. A total of 325 participants completed a cross-sectional survey, with 148 of those participants completing the survey a second time (retest). Confirmatory factor analysis in a structural equation modelling framework was used to establish structural validity by comparing four different pre-specified models of the indexes. Additionally, internal consistency, convergent and incremental validity, and retest reliability were examined. The FI models exhibited superior structural validity compared with similar models of the SFI, although all models had good fits. Internal consistencies with McDonald's omega were 0.89 and 0.87 for the FI and SFI, respectively. The five (FI) or six (SFI) domains were happiness & life satisfaction, mental & physical health, meaning & purpose, character & virtue, close social relationships, and financial & material stability (λ4 = 0.51-0.91). Convergent and incremental validity tests supported predefined hypotheses. Retest analyses with the FI and SFI showed a high degree of retest reliability. Based on the psychometric evidence reported in this study, the Danish Flourish Index and Secure Flourish Index seem suitable for use with healthy adult Danes. The authors hope that this psychometric evaluation of the FI and SFI will stimulate research on patterns, health and economic outcomes, and predictors of human flourishing in Denmark.

Towards Clarification of the Second Language Learner Engagement Construct: Taking Stock of its Conceptual Overlap and Hierarchical Structure

Abstract L2 learner engagement is an emerging but critical construct in the field of psychology of language learning and teaching. However, research on L2 learner engagement has suffered from the inconsistent operationalization of the multidimensional structure of the construct and the conceptual overlap among its different components, making research synthesis and comparison across studies and contexts challenging. This study tested the utility of the bi-factor exploratory structural equation modelling framework (B-ESEM)—an overarching psychometric framework that can address the two critical concerns associated with the operationalization and measurement of L2 learner engagement. Data were collected from 413 Vietnamese EFL students. Through two stages of rigorous and strategic data analysis, the results suggested that participants’ responses to the L2 learner engagement scale could be best represented by a B-ESEM model that simultaneously assessed the global L2 engagement factor along with the specific components of behavioural, cognitive, affective, and social engagement while, at the same time, controlling for the cross-loadings of items onto non-target factors. Results of the study were discussed from both psychometric and substantive perspectives and implications were provided to capitalize on the utility of the B-ESEM approach in the assessment of L2 learner engagement.

Substance use and its association with mental health among Swiss medical students: A cross-sectional study.

Studies on mental health and substance use among medical students indicated worrying prevalence but have been mainly descriptive. To evaluate the prevalence of substance use in a sample of medical students and investigate whether mental health variables have an influence on substance use. The data were collected as part of the first wave of the ETMED-L, an ongoing longitudinal open cohort study surveying medical students at the University of Lausanne (Switzerland). N = 886 students were included and completed an online survey including measures of mental health (depression, suicidal ideation, anxiety, stress, and burnout) and use of and risk related with several substances (tobacco, alcohol, cannabis, cocaine, stimulants, sedatives, hallucinogens, opioids, nonmedical prescription drugs, and neuroenhancement drugs). We evaluated the prevalence of use of each substance and then tested the association between mental health and substance use in an Exploratory Structural Equation Modeling framework. Statistical indices indicated a four-factor solution for mental health and a three-factor solution for substance use. A factor comprising risk level for alcohol, tobacco, and cannabis use - which were the most prevalent substances - was significantly associated with a burnout factor and a factor related to financial situation and side job stress. There was a significant association between a factor comprising depression, anxiety, and suicidal ideation and a factor related to the use of sedatives, nonmedical prescription drugs and neuroenhancement drugs. Although their use was less prevalent, a factor comprising the risk level of stimulants and cocaine use was significantly but more mildly related to the burnout factor. A factor comprising stress related to studies and work/life balance as well as emotional exhaustion was not related to substance use factors. In this sample of medical students, the prevalence of substance use was substantial and poorer mental health status was related with higher substance use risk levels.