Under pressure: Social support and performance pressure in the relationship between substance use and mental health

Abstract

Existing research widely acknowledges the frequently co-occurrence and mutual reinforcement of substance use and problems in mental health. However, there is inconsistency: not every individual using substances experiences mental health concerns, and not every individual struggling with a mental health disorder initiates substance use. A knowledge gap exists regarding what mechanisms cause these differences. Literature presupposes that social support and performance pressure are likely to be of influence within the context of Dutch youth. Therefore, the current study investigated the moderating role of social support and performance pressure in the relationship between substance use (i.e., alcohol, cannabis and hard drugs) and mental health. Data of the young adult health monitor 2021 were used. This monitor was conducted within the municipality of Utrecht (N = 1913) among youth aged 16-25 years. Based on these data, regression analyses were conducted, in which social support and performance pressure were singly included as interaction terms. Results show that levels of social support do not modify the relationship between substance use and mental health. In contrast, the level of performance pressure does matter, but opposite to what was expected: the combination of the use of alcohol or hard drugs and high performance pressure results in better mental health, compared to those that experience high performance pressure and do not use alcohol or hard drugs. Based on additional literature, it seems plausible that using these substances buffers the negative relationship between performance pressure and mental health, at least on the short term. However, future research with a longitudinal approach is needed to confirm and clarify this explanation. The findings of the current study imply that within a population of high educated students, one should be aware that targeting social support and performance pressure, although beneficial for mental health, will not necessarily result in reduced substance use.