Predicting Substance Use in Diabetic Adolescents: The Role of Depression and Stress with the Mediation of Family Relationships

Diabetes is one of the most common chronic diseases among children and adolescents. This study aimed to investigate the role of depression and stress, mediated by family relationships, in substance use among diabetic adolescents.

This study utilized a correlational design employing structural equation modeling. The research population consisted of diabetic adolescents who were members of the Urmia Diabetes Association and were referred to diabetes specialists at Imam Khomeini Hospital (RA) in Urmia city in 2019. A total of 206 individuals were selected using available sampling methods. The research tools included the Substance Use Screening Scale-Adolescent Version and questionnaires on depression, stress, and family relationships. Data were analyzed using Pearson correlation coefficients and structural equation modeling.

The findings indicated that the current research model fit well based on model fit indices such as CFI (0.97) and GFI (0.94). Moreover, the direct effects of depression (β=-0.33, P<0.001) and stress (β=-0.51, P<0.001) on family relationships, and family relationships (β=-0.25, P<0.008) on substance use, were significant. However, the direct effects of depression (β=0.02, P=0.73) and stress (β=0.04, P=0.64) on substance use were not significant. Additionally, the indirect effects of depression (β=0.17, P=0.007) and stress (β=0.26, P=0.006), mediated by family relationships, on substance use were significant.

depression and stress, through their impact on decreasing family relationships, may contribute to increased substance abuse among diabetic adolescents.