Banca de DEFESA: RENATA MACEDO DOS REIS

Psychoactive substance use among students at a public university: associated psychosocial factors and coping

Psychoactive Substances, Stress, University students

The use of psychoactive substances (PAS) among university students, particularly young adults, constitutes a public health concern associated with individual, academic, and social factors. The university environment, characterized by multiple demands and challenges, may increase stress levels and contribute to the adoption of maladaptive coping strategies, including PAS use. In this context, the present doctoral thesis aimed to analyze patterns of PAS use among young university students and their relationship with stress and coping strategies. The study was conducted in two stages. In the first stage, which adopted a descriptive and quantitative approach, patterns of PAS use were investigated among 103 students aged 18 to 25 years who were enrolled in undergraduate programs at a public university located in the Baixada Fluminense region of Rio de Janeiro, Brazil. Data were collected online using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the short version of the Drug-Taking Confidence Questionnaire (DTCQ-8), which enabled the characterization of substance use patterns in this population. Associations between PAS use and levels of self-perceived stress were also investigated using the Stress Scale for Students (N.I.S.E.S.T.E.). In the second stage, which adopted a qualitative approach, PAS use as a coping strategy was analyzed. Twenty-one students who presented high levels of stress and PAS use completed the Folkman and Lazarus Ways of Coping Questionnaire; however, only seven completed this stage in its entirety, which also included semi-structured interviews and a self-observation diary. The results showed a high prevalence of PAS use among participants, particularly alcohol, cannabis, tobacco, and hypnotics. All participants reported academic stress, with predominantly high levels. The analyses revealed significant associations between PAS use, academic stress, and mental health-related factors, suggesting that substance use is related to the demands and pressures experienced within the university environment. The qualitative analyses revealed that academic overload, assessment periods, difficulties in balancing study, work, and personal life, as well as financial and interpersonal problems, constituted important sources of stress. Regarding coping strategies, avoidant mechanisms predominated, particularly escape-avoidance and distancing, indicating that PAS use was frequently employed as a means of temporarily relieving anxiety, emotional tension, and exhaustion resulting from academic demands. These findings reinforce the need for institutional strategies aimed at health promotion and prevention within the university environment, with an emphasis on stress management and the development of adaptive coping strategies.