Comparative Application of ESPAD in Northern Cyprus: Reliability Analysis of Psychosocial Factors
Abstract
This study aimed to administer the European School Survey Project on Alcohol and Other Drugs (ESPAD) questionnaire to adolescents aged 15–16 in the northern part of Cyprus, an island in the Eastern Mediterranean. During the ESPAD implementation process, the reliability of the subscales "Family Support," "Peer Support," "Social Pressure," "School Absenteeism," and "Time Spent on Social Media" was tested. The study was based on a descriptive model consistent with a quantitative approach. Reliability analyses were separately conducted for the ESPAD scale across the five dimensions mentioned above. Cronbach's alpha coefficient was calculated for the reliability analysis. The internal consistency level of each dimension identified in the ESPAD was calculated. The results showed that Family Support (.93) and Peer Support (.96) items were highly reliable. The Time Spent on Social Media questions also demonstrated a satisfactory reliability of .85. Social Pressure (.68) demonstrated moderate reliability, while the School Absenteeism questions (.55) demonstrated lower internal consistency. These results suggest that some of the ESPAD questions need to be revised or restructured. Improvements should be made to the low-reliability school absence questions. Qualitative research should be used to prepare preliminary studies for the development of new items. Consequently, it is crucial to test similar measurements based on ESPAD data in different cultural contexts. Research of this nature can bolster the robustness of ESPAD and its reliability analyses, enabling advanced modelling in future studies.
Keywords: ESPADreliabilitypsychosocial factorsNorthern Cyprus
Introduction
Substance use is one of today's most significant problems, with adolescent substance use of great public health importance. Adolescent substance use is a significant, multifaceted issue that can impact the students’ psychological, sociological, and academic development (Gray & Squeglia, 2018). The reliability of data collection tools focused on determining substance use is crucial in terms of the objectivity, validity, and acceptability of the measurements. The European School Survey Project on Alcohol and Other Drugs, or ESPAD, was implemented in Europe since 1995. ESPAD is one of the comprehensive measurement tools assessing adolescents' substance use (Sunday et al., 2020). ESPAD examines adolescents' use of addictive substances such as alcohol, tobacco, and drugs, as well as their risky behaviors. However, when ESPAD is applied, it also yields data that includes all the conditions and variables related to the adolescent's social environment, such as family support, educational attainment at school, and the influence of peers (Hanafin et al., 2022; Novak et al., 2022). The use of the scale in different European countries, that is, in different contexts and cultural settings, necessitates reliability analyses of the scale items. Reliability analyses were conducted on data obtained from Europe using the ESPAD or by applying scales on other related topics together with the ESPAD. When data on the application of the ESPAD in different European countries were examined, Cronbach's alpha values were above the acceptable limit. For many years, ESPAD usage in different countries were compared and reliability tested. According to data from 1995 and 1999, ESPAD data on alcohol use showed a correlation of over 75% between genders. Data on lifetime drinking experience showed a correlation of over 45%. In a 2004 study with Italian youth, the test-retest reliability of responses regarding substances such as cigarette, cannabis, cocaine, and ecstasy use was rated as "excellent." The ESPAD questionnaire was widespread and reliable throughout Europe. Recent studies (Bjarnason et al., 2010; Bucur et al., 2020; Hibell et al., 2015; Muslić et al., 2025; Savolainen, 2020) found the ESPAD to yield reliable results, with Cronbach's alpha values exceeding .70. These results indicate that the ESPAD has a high level of reliability when applied across different countries, languages, and cultures in Europe. Contrary to the above studies, a significant finding stands out in the ESPAD questionnaire validity study conducted by Hibell and colleagues (2015). According to the findings of this study, ESPAD data obtained from many European countries yield valid and reliable results, but in one or two countries, these results were lower. Based on this finding, it should be emphasized that further and more current research is needed in different countries. It is believed that data obtained from these countries will contribute to the development of the ESPAD scale. A review of the literature reveals various reasons for the low reliability results of the ESPAD scale. Bless and Muscat's study (2005) evaluated use of the ESPAD in Arab countries. Different results regarding the reliability of the scale were obtained in ESPAD applications in Algeria, Libya, and Morocco. Participants did not understand the questions, and consequently, many questions were left unanswered and skipped. Some questions had a non- response rate of more than 50%. Logical contradictions were identified in the responses to consecutive questions, such as lifetime and last month use of the same item. Problems such as inconsistencies among the responses were observed. This was attributed to the fact that education level and socioeconomic variables affect the reliability of the ESPAD. Consequently, it was emphasized that the current implementation of the ESPAD in these countries is problematic in terms of both validity and reliability and requires significant adaptations. Molinaro et al. (2012) conducted validity and reliability analyses of the ESPAD in Italy. A test-retest analysis was conducted for the reliability analysis. The test was administered and then re-administered to the same group three weeks later. According to the reliability results, responses to questions regarding cigarette, alcohol, and cannabis use demonstrated a high level of consistency (Cohen's k ≥ 0.80). Consistency was low for responses to certain substances, such as tranquilizers and hallucinogens. The most significant finding of the study is that, based on the ESPAD data, 15-year-old participants provided less consistent results than 19-year-olds. This study demonstrates that age can be a significant factor in the reliability analysis of the ESPAD scale. It demonstrates that age can be a crucial variable in terms of an individual's cognitive maturity and understanding of the questionnaire. In summary, the ESPAD was evaluated as a reliable measurement tool in this study, but reliability decreased for some items and age groups. This is an important finding to consider. A review of the literature indicates that research on ESPAD reliability analysis was conducted in specific countries. These countries include Western Europe, Scandinavian countries, and some Arab countries. Expanding reliability studies on ESPAD across diverse sociocultural contexts was deemed worthy of research. For example, it would be important to collect data and conduct a reliability analysis from a small, less-well-known country like the Eastern Mediterranean and Northern Cyprus. This would provide specificity for testing ESPAD's cultural suitability. Reliability studies were conducted in the literature by considering age, socioeconomic status, and trends in substance use. However, this study aimed to conduct a reliability analysis based on important factors such as sociopsychological factors, education, and social media. In summary, this study aimed to administer the ESPAD to adolescents aged 15–16 in the northern part of Cyprus. During the ESPAD implementation process, the reliability of the subscales "Family Support," "Peer Support," "Social Pressure," "School Absenteeism," and "Time Spent on Social Media" was tested. Given that no previous reliability study was conducted on the ESPAD in Northern Cyprus, this research is unique. The aim is to provide data- based contributions to all future activities, particularly those related to national education policies, digital media use, and social support mechanisms.
Literature Review
An evaluation of current scientific research on substance use reveals that psychosocial factors are at the center of research. Psychosocial factors are considered risk factors when it comes to substance use. Risk factors are included in research because they predispose individuals to substance use. These risk factors are crucial in determining whether individuals experiment with and use substances (Alwan et al., 2011; Nation & Heflinger, 2006). Individual characteristics, family characteristics, peer group influences, school environment, the wider community, and the media are considered risk factors for substance use (Whitesell et al., 2013; Woodward et al., 2023).
Understanding Substance Use Based on Psychosocial Theories
This section focuses on the psychological and social processes of adolescent substance use and provides a theoretical description. Based on Bandura's Social Learning Theory, it can be argued that adolescents can learn to use substances through observation and modelling. As adolescents observe their immediate role models—family and friends—they may turn to cigarettes, alcohol, or other substances (Bandura, 1977; Hoffmann, 2021). Hirschi's Social Bond Theory emphasizes the protective role of an individual's bonds with their social environment. If an adolescent's bonds with school or community are strong, these bonds can protect them against crime and deviance. Conversely, if these bonds are weak, the likelihood of non- normative behavior increases. For example, the likelihood of substance abuse may increase (Hirschi, 1969; Rodríguez-Ruiz et al., 2023). Durkheim's Theory of Anomie is a theory that explains individual substance use in relation to social norms and values. If social norms and values weaken, an individual can become alienated from their own society. This translates to a lack of norms, and such feelings can lead to deviant behavior. According to researchers based on this theory, a sense of anomie can lead adolescents to substance use. An adolescent's alienation from their society, a sense of hopelessness about the future, or an embrace of anomie can lead them to engage in harmful habits (Marks, 1974; Rahmani et al., 2022; Sârbu et al., 2022). Finally, Khantzian's Self-Medication Hypothesis is a hypothesis that can explain adolescents' personal moods and behavioral patterns in the context of substance use. Adolescents experiencing depressive symptoms, high stress, low self-confidence or a low self-esteem may turn to substances for self- medication. Adolescents who are unable to cope with their problems, frequently experience sadness, and depression often seek temporary relief by using substances. Adolescents also attempt to gain social approval or strengthen their sense of belonging. In summary, psychological and sociological theories in the literature suggest that substance use during adolescence is linked to multidimensional psychosocial factors (Broman et al., 2019; Khantzian, 1997; Klein et al., 2022).
Substance Use and Psychosocial Factors
In this study, psychosocial factors such as "Family Support," "Peer Support," "Social Pressure," "School Absenteeism," and "Time Spent on Social Media" were considered as risk factors in the ESPAD application regarding adolescent substance use and were explained in their theoretical and conceptual context.
Family Support and Substance Use
Family factors play a critical role in substance use. Parents' attitudes and behaviors toward adolescents, family relationships, and family supervision can all influence adolescent substance use. Inconsistent, oppressive, or lax parental attitudes, family conflict, inadequate parental supervision, and weak emotional bonds within the family are all familial factors that increase adolescent substance use. Substance use within the family, the presence of mental health problems, neglect, or abuse are also risk factors for adolescent substance use (Escamilla et al., 2024; Parveen & Jan, 2024; Shahzadi et al., 2023). Conversely, strong emotional bonds within the family and parental support are factors that reduce substance use (Fisher et al., 2025; Patwardhan et al., 2024). Family support protects adolescents from substance use and fosters resilience. For example, in the research of She et al. (2022), they revealed that family support is important in coping with internet addiction experienced by adolescents during the Covid-19 period.
Peer Support and Substance Use
Peer relationships are especially vital during adolescence. Peer relationships, which shape social development, also have a decisive influence on substance use (Marziali et al., 2022; Watts et al., 2024). If peer relationships are positive, adolescents are less likely to turn to substance use. Conversely, adolescents who are excluded, ridiculed, or who feel they don't belong in a peer group are at increased risk for substance use. Under the influence of their peers, adolescents may experiment with cigarettes, alcohol, or other substances. They do this to gain acceptance or to fit in easily with their peer group. It is known that adolescents turn to substance use, particularly to appear popular or cool (Henneberger et al., 2021; Nawi et al., 2021; Trucco et al., 2011). A study conducted in Estonia using the ESPAD (Vorobjov et al., 2017) revealed that adolescents with low social skills are more prone to substance use. In this context, as stated by Cheetham and Lubman (2017), it is important to recognize the preventive effect of peer- based intervention programs in preventing substance use.
Social Pressure and Substance Use
The society in which an adolescent lives influences their social and emotional development. The norms within that society shape their emotional and intellectual world. Based on social influence theory, it is emphasized that the social networks within an adolescent's immediate environment are directly related to their behavioral patterns (Dudovitz et al., 2017). For example, group pressure has a significant impact on adolescents. An adolescent may experiment with substance use simply out of a desire for acceptance by their peer group and attempt to fit in. In environments where substance use is normalized, it is expected that adolescents will engage in risky behaviors and substance use. Recently, digital environments such as social media became a new form of social pressure, leading adolescents to use substances (Roberts et al., 2024).
School Absenteeism and Substance Use
School absenteeism doesn't just negatively impact academic achievement. Attendance is also linked to a student's level of social connectedness. Adolescents who miss school may become vulnerable to dangers and risky behaviors. Research shows that as rates of school absenteeism increase; rates of substance use also increase. This suggests a positive correlation between absenteeism and substance use (Pearson et al., 2006). School is a protective environment for adolescents, and withdrawing from this environment makes them more vulnerable to risky behaviors (Eggert et al., 1990).
Time Spent on Social Media and Substance Use
Social media became a crucial tool in shaping adolescents' personalities. Content encouraging substance use on social media can lead adolescents to resort to substance use. Behavioral models on social media during the identity- forming process make social media a risky environment for adolescents. Social media addiction increases feelings of loneliness, which can lead to problems with emotional regulation. Consequently, as Roberts and colleagues (2024) emphasize, substance use increases with increasing duration of social media use. There is a significant relationship between the two variables.
Methodology
In the Method section, the research model, sample, data collection tool, procedure and data analysis sections are presented.
Research Case and Rationale
ESPAD was previously implemented in the Northern Cyprus context, but its reliability analysis was not previously conducted. Therefore, this study did not limit itself to data collection; its primary objective was to conduct reliability analyses of ESPAD. In short, the aim was to test the applicability of ESPAD in the Northern Cyprus context, where no reliability analysis was previously conducted. The aim was to determine ESPAD's internal consistency by conducting a reliability analysis on the obtained data. Analysis was conducted on the ESPAD based on questions related to the following five sub- headings: Family Support, Peer Support, Social Pressure, School Absence, and Social Media Use. The multi-dimensional ESPAD was specifically identified, and reliability analyses were conducted for each sub-heading. Thus, it was anticipated that ESPAD could be used in future studies to obtain more reliable findings. Cronbach's alpha coefficients were calculated separately for each dimension.
Research Model
The study was based on a descriptive model consistent with a quantitative approach. Reliability analyses were separately conducted for the ESPAD scale across the five dimensions mentioned above. Cronbach's alpha coefficient was calculated for the reliability analysis. The internal consistency level of each dimension identified in the ESPAD was calculated. The reliability of the ESPAD in the context of Northern Cyprus means that it produces consistent and repeatable results for the concept it measures. Cronbach's alpha is a critical indicator for researchers who use the scale to support confidence in the obtained scores. An alpha value of .70 or above indicates that the scale has sufficient internal consistency for the relevant sample (Nunnally & Bernstein, 1994).
Participants
Secondary school students aged 15-16 in the northern part of Cyprus were the target participants in the study. The total number of students in the study population was 3,901. Students were reached using a random sampling technique. The sample sizes for each dimension of the study were as follows: Family Support 1,369, Peer Support 1,391, Social Pressure 1,424, School Absenteeism 1,203, and Time Spent on Social Media 1,370.
Data Collection Tool and Procedure
Permission was obtained from the Ministry of Education to implement ESPAD in schools in Northern Cyprus. After the Ministry of Education granted approval, school administrations were informed about the process. Both written and verbal information was provided. Consent forms detailing the research's conduct were distributed to parents through the school administration. Children whose parents signed and submitted the consent forms were included in the study. On data collection days, students were asked if they would like to participate in the study. Only students who volunteered were allowed to participate. Ethical principles were adhered to during data collection, and no directives were directed towards students. Data collection was conducted under the supervision of Dr. Zafer Bekiroğulları and the guidance of a team of experts trained in ESPAD. The team, or team members, visited each school, and the data collection process was conducted in a controlled environment. Consistency was ensured across the schools where data were collected. Confidentiality was maintained, and anonymity was requested. At each school, the scales were distributed simultaneously to the students participating in the study, who then completed the questionnaires simultaneously. Students were informed that their responses would be confidential, based on anonymity, and would not be used for purposes other than scientific research. They were also informed that their responses would not be shared with school staff or families. The guidelines and methodology established by ESPAD were strictly adhered to. Data collection began in October 2024 and concluded in December 2024.
Analysis of Data
Reliability analysis in this study was carried out by calculating Cronbach alpha and determining the level of internal consistency based on the sub-dimensions of ESPAD.
Ethical Consideration
The study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the Northern Cyprus Prime Minister’s Anti-Drug Commission (No. 2024-09-30), which comprises members who are experts in their respective fields. All participants and their legal guardians were thoroughly informed about the study's purpose and procedures, and written consent was obtained from the guardians prior to participation. The data collected for the study were anonymized and processed to safeguard the privacy of participants and prevent the inclusion of any personal information.
Findings
Reliability analysis was conducted for “Family Support” over 4 items in total. As a result of the analysis, Cronbach's alpha value for Family Support was .93. This shows a high level of internal consistency and indicates that the reliability of the related scale is at a high level. Reliability analysis was conducted for “Peer Support” over 4 items in total. As a result of the analysis, Cronbach's Alpha value for Peer Support was .96. This shows that the items in the scale are quite consistent and the scale is highly reliable. Reliability analysis was conducted over 3 items in total for “Social Pressure”. As a result of the analysis, Cronbach's Alpha value for Social Pressure is .68. This value is slightly below the acceptable lower limit and indicates a moderate level of consistency among the items in the scale. However, this low level may be partially understandable due to the low number of items. To increase the reliability of the scale, item revision can be suggested. For “School Absenteeism”, reliability analysis was conducted over 3 items in total. As a result of the analysis, Cronbach's Alpha value for School Absenteeism is .55. This value shows that internal consistency is low. This level, which can be considered insufficient in terms of the reliability of the scale, may require re-evaluation and, if necessary, restructuring of the related items. Reliability analysis was conducted for “Time Spent on Social Media” over 2 items in total. As a result of the analysis, the Cronbach's Alpha value for Time Spent on Social Media is .85. Although the scale consists of two items, it has a high level of internal consistency, which shows that the items are compatible with each other in terms of the concept measured. Table 2.1 shows the variables, total of items and Cronbach alpha values of ESPAD in North Cyprus.
Discussion
The ESPAD is a standardized scale and has a data collection protocol. It is one of the most used scales in substance use research in many European countries (ESPAD, 2025). While the ESPAD items required some modifications and cultural adaptations over time, it is considered a valid and reliable measurement tool. Cronbach's alpha values for the ESPAD were above .70 in many studies. In this context, this study, using data from Northern Cyprus, contributes to the scale's regional reliability analysis by assessing the relevance of some ESPAD questions in the local context. According to the findings of this study, the four-item "Family Support" questions, with a Cronbach's alpha of .93, demonstrated a high level of internal consistency. This value is close to the upper limit of the .70–.95 range suggested by Nunnally (1978). ESPAD scale items related to family support were strongly correlated with each other in the Northern Cyprus sample. In one recent study, Piko's (2023) study found an α = .93 value in the familial subscale of the Multidimensional Scale of Perceived Social Support. This result demonstrates that the items related to the family dimension in the scale are consistent and yield reliable results. In another study, She et al. (2022) demonstrated that the items related to perceived family support provided a reliable measure. In that study, Cronbach's alpha was .79. Therefore, the items related to family support in this study appear to yield reliable results, as in similar studies. The four questions related to Peer Support, just like the Family Support questions, yielded a Cronbach's alpha of = .96. This value is also high and indicates internal consistency. This result indicates that the scale items strongly reflect the targeted peer support construct. A high level of reliability indicates that random results due to inconsistency will not be obtained. The reliability result in this study is like Piko's (2023) study, with α = .95, confirming the reliable measurement of peer support. According to the research findings, the reliability analysis and Cronbach's alpha value of the "Social Pressure" scale were .68. This value is below the minimally acceptable level of .70 in psychological measurements. The small number of items (3) is one of the factors that lowers the α value (Streiner, 2003). The internal consistency of the scale may be considered weak due to the low number of items. Another reason may be related to the content of the scale. Measuring a complex construct such as social pressure is not easy. In the study by Gonzálvez et al. (2019), the subdimensions of the social adaptation scale were at levels between .71 and .76. This study revealed the need for restructuring in some subscales. Consequently, the scale items related to social pressure could be revised in this study. The scope of this dimension could be expanded, and new items could be added. It is believed that conducting an exploratory factor analysis would contribute to the clarification of the item analyses. The dimension with the lowest reliability in this study was "School Absence," consisting of three items. The Cronbach's Alpha value for the school absence questions was found to be .55. This result indicates low internal consistency (α < .60). A relationship between school absence and substance use was established in many studies in the literature (Bucur et al., 2020; Canady, 2025; Gonzálvez et al., 2019). However, the low reliability in this study may not yield reliable results in terms of revealing this relationship. The items related to school absenteeism should be revised. The content coverage of the ESPAD items regarding school absenteeism should be increased, or reliability should be increased with additional items. The scale needs to be restructured. The reliability analysis of the item on social media use in the ESPAD resulted in α = .85. The two-item social media use question demonstrated a high level of correlation and yielded consistent results. Other studies measuring social media use associated with the ESPAD (Bányai et al., 2017; Klingemann & Sierosławski, 2018) also showed high reliability for the scale items. As with the studies cited in the results of this study, it should be noted that the ESPAD items related to social media use in the Northern Cyprus sample measured the same construct and achieved a high level of internal consistency.
Conclusion and Recommendations
In this study, data were collected in accordance with ESPAD principles, and the internal consistency of the scale items was analyzed using Cronbach's alpha. The results showed that Family Support (.93) and Peer Support (.96) items were highly reliable. The Time Spent on Social Media questions also demonstrated a satisfactory reliability of .85. Social Pressure (.68) demonstrated moderate reliability, while the School Absenteeism questions (.55) demonstrated lower internal consistency. These results suggest that some of the ESPAD questions need to be revised or restructured. Based on data obtained from the Northern Cyprus sample, ESPAD had a high level of reliability in questions such as family support, peer support, and duration of social media use. It can be said that the data obtained from these questions will yield reliable results with a high level of internal consistency. However, the reliability results for the questions on social pressure and school absence were below the expected values. There may be several possible reasons for these results. Most fundamentally, an increase in the number of items is recommended. A broader conceptual framework should be sought. Another recommendation is to conduct construct validity analyses. The limitations of the study are as follows: Adolescents used a self- reporting technique when answering the ESPAD questionnaire. Adolescents responded to questions based on their own perceptions, which may indicate a social desirability effect. Adolescents may have misrepresented their attitudes regarding family and peer support. The study was conducted with a specific sample and over a specific period. A cross-sectional design may limit causal inferences. Finally, the limited adolescent population in Northern Cyprus restricts the generalizability of the findings. The following recommendations for future research were developed: 1. Longitudinal studies should be conducted. Observing issues such as social pressure and social media use requires a long time. In this case, more reliable data can be obtained. 2. Improvements should be made to the low-reliability school absence questions. Qualitative research should prepare preliminary studies for the development of new items. 3. It is recommended that the reliability analysis be conducted in the southern part of Cyprus, where there are similar cultural characteristics but also some differences (such as language and religion). This allows for comparative reliability analyses. 4. The nature of social media use should be assessed as well as the duration of social media use. The purpose for which social media tools are used is also crucial. 5. Research methods other than quantitative research approaches should also be employed. Concepts such as social pressure can be better understood through a mixed-use research approach. Experimental research can be conducted by providing digital media training. School policies and parental involvement issues can be studied through action research. Consequently, it is crucial to test similar measurements based on ESPAD data in different cultural contexts. Research of this nature can bolster the robustness of ESPAD and its reliability analyses, enabling advanced modelling in future studies.
References
Alwan, H.Viswanathan, B.Rousson, V.Paccaud, F.Bovet, P. (2011). Association between substance use and psychosocial characteristics among adolescents of the Seychelles. BMC Pediatrics, 11(1)
Bandura, A. (1977). Social learning theory, Prentice-Hall.
Bányai, F.Zsila, Á.Király, O.Maraz, A.Elekes, Z.Griffiths, M. D.Andreassen, C. S.Demetrovics, Z. (2017). Problematic social media use: Results from a large-scale nationally representative adolescent sample. PLoS One, 12(1)
Bjarnason, T.Steriu, A.Kokkevi, A. (2010). Cannabis supply and demand reduction: Evidence from the ESPAD study of adolescents in 31 European countries. Drugs: Education, prevention and policy, 17(2), 123-134
Bless, R.Muscat, R. (2005). Validity and reliability of school surveys based on the European ESPAD methodology in Algeria, Libya and Morocco (MedSPAD pilot school survey project). Council of Europe. https://www.drugsandalcohol.ie/6220/1/2004Med2EFinal_en%5B1%5D .pdf Broman, C. L., Wright, M. K., Broman, M. J., & Bista, S. (2019). Self-medication- and substance use: A test of the hypothesis. Journal of Child & Adolescent Substance Abuse, 28(6), 494-504
Bucur, A.Ursoniu, S.Caraion-Buzdea, C.Ciobanu, V.Florescu, S.Vladescu, C. (2020). Aggressive behaviors among 15–16-year-old Romanian high school students: Results from two consecutive surveys related to alcohol and other drug use at the European level. International Journal of Environmental Research and Public Health, 17(10)
Canady, R. C. (2025). The relationships between social stress, anxiety, and school attendance/absenteeism among middle school students with high-incidence disabilities. [Doctoral dissertation, Walden University]. ProQuest Dissertations & Theses Global. https://www.proquest.com/dissertations- theses/relationships-between-social-stress- anxiety/docview/3166104969/se-2?accountid=141847 Cheetham, A., & Lubman, D. I. (2017). The role of peers on school-based prevention programs targeting adolescent substance use. Current Addiction Reports, 4, 379-385
Dudovitz, R. N.Perez-Aguilar, G.Kim, G.Wong, M. D.Chung, P. J. (2017). How urban youth perceive relationships among school environments, social networks, self-concept, and substance use. Academic Pediatrics, 17(2), 161-167
Eggert, L. L.Seyi, C. D.Nicholas, L. J. (1990). Effects of a school-based prevention program for potential high school dropouts and drug abusers. International Journal of the Addictions, 25(7), 773-801
Escamilla, I.Juan, N.Benito, A.Castellano-García, F.Rodríguez-Ruiz, F.Haro, G. (2024). Substance addiction in adolescents: Influence of parenting and personality traits. Brain Sciences, 14(5)
Fisher, S.Hsu, W. W.Zapolski, T. C.Malone, C.Caldwell, B.Barnes-Najor, J. (2025). The role of parents in early adolescent substance use: A longitudinal investigation. The Journal of Early Adolescence, 45(6), 746-768
Gonzálvez, C.Inglés, C. J.Martínez-Palau, A.Sanmartín, R.Vicent, M.García-Fernández, J. M. (2019). Child and Adolescent Social Adaptive Functioning Scale: Factorial invariance, latent mean differences, and its impact on school refusal behavior in Spanish children. Frontiers in Psychology, 10
Gray, K. M.Squeglia, L. M. (2018). Research Review: What have we learned about adolescent substance use? Journal of child psychology and psychiatry, 59 (6), 618-627
Hanafin, J.Sunday, S.Clancy, L. (2022). Sociodemographic, personal, peer, and familial predictors of e-cigarette ever use in ESPAD Ireland: A forward stepwise logistic regression model. Tobacco induced diseases, 20
Henneberger, A. K.Mushonga, D. R.Preston, A. M. (2021). Peer influence and adolescent substance use: A systematic review of dynamic social network research. Adolescent research review, 6
Hibell, B.Molinaro, S.Siciliano, V.Kraus, L. (2015). The ESPAD validity study in four countries in 2013, European Union Drugs Agency. https://data.europa.eu/doi/10.2810/363531
Hirschi, T. (1969). Causes of delinquency, University of California Press.
Hoffmann, J. P. (2021). Social learning, social bonds, self-control and adolescent nicotine vaping. Substance Use & Misuse, 56(6), 819-830
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard review of psychiatry, 4(5), 231-244
Klein, R. J.Gyorda, J. A.Jacobson, N. C. (2022). Anxiety, depression, and substance experimentation in childhood. PLoS One, 17(5)
Klingemann, J. I.Sierosławski, J. (2018). Social media use among the youth. Results of the ESPAD study in Poland with reference to other European countries. Alcoholism and Drug Addiction, 31(2), 87-106
Marks, S. R. (1974). Durkheim's theory of anomie. American Journal of Sociology, 80(2), 329-363
Marziali, M. E.Levy, N. S.Martins, S. S. (2022). Perceptions of peer and parental attitudes toward substance use and actual adolescent substance use: The impact of adolescent-confidant relationships. Substance Abuse, 43(1), 1085-1093
Molinaro, S.Siciliano, V.Curzio, O.Denoth, F.Mariani, F. (2012). Concordance and consistency of answers to the self - delivered ESPAD questionnaire on use of psychoactive substances. International Journal of Methods in Psychiatric Research, 21(2), 158-168
Muslić, L.Rukavina, T.Markelić, M.Musić Milanović, S. (2025). Substance use, internet risk behavior, and depressive symptoms as predictors of self- harm thoughts in adolescents: Insights from the 2019 ESPAD survey in Croatia. Child Psychiatry & Human Development, 56, 481-491
Nation, M.Heflinger, C. A. (2006). Risk factors for serious alcohol and drug use: the role of psychosocial variables in predicting the frequency of substance use among adolescents. The American journal of drug and alcohol abuse, 32(3), 415-433
Nawi, A. M.Ismail, R.Ibrahim, F.Hassan, M. R.Manaf, M. R. A.Amit, N.Ibrahim, N.Shafurdin, N. S. (2021). Risk and protective factors of drug abuse among adolescents: A systematic review. BMC public health, 21(1)
Novak, M.Maglica, T.Radetic Paic, M. (2022). School, family, and peer predictors of adolescent alcohol and marijuana use. Drugs: Education, Prevention and Policy, 30(5), 486-496
Nunnally, J. C. (1978). An overview of psychological measurement, In B. B. Wolman (Ed.), Clinical diagnosis of mental disorders: A handbook (pp. 97– 146). Springer US.
Nunnally, J. C.Bernstein, I. H. (1994). Psychometric theory (3rd ed.), McGraw- Hill.
Parveen, A.Jan, S. (2024). Parent-child conflict: A risk factor for substance abuse among adolescents. Education Mind, 3(1), 19-30
Patwardhan, I.Guo, Y.Fleming, C. B.James, T. D.Nelson, J. M.Espy, K. A.Nelson, T. D.Mason, W. A. (2024). Childhood executive control and adolescent substance use: Mediation via parent–child relationship quality. Family Relations, 73(5), 3513-3529
Pearson, M.Sweeting, H.West, P.Young, R.Gordon, J.Turner, K. (2006). Adolescent substance use in different social and peer contexts: A social network analysis. Drugs: education, prevention and policy, 13(6), 519-536
Piko, B. F. (2023). Adolescent life satisfaction: Association with psychological, school-related, religious and socially supportive factors. Children, 10(7)
Rahmani, M.Pumariega, A. J.Prajapati, P.Dalkilic, A.Burakgazi-Yilmaz, H.Unlu, A. (2022). Anomie, loneliness, and psychopathology: Results from the study of youth in Istanbul. World Social Psychiatry, 4(2), 121-131
Roberts, E. R.Odumodu, C. N.Uye, E. E. (2024). Substance abuse behaviour among youths: The predictive effects of social media and peer pressure. Happiness: Journal of Psychology and Islamic Science, 8(2), 113-124
Rodríguez-Ruiz, J.Zych, I.Llorent, V. J.Marín-López, I.Espejo-Siles, R.Nasaescu, E. (2023). A longitudinal study of protective factors against substance use in early adolescence. An ecological approach. International Journal of Drug Policy, 112
Sârbu, E. A.Nadolu, B.Runcan, R.Tomiță, M.Lazăr, F. (2022). Social predictors of the transition from anomie to deviance in adolescence. PLoS One, 17(6)
Savolainen, I. (2020). Addiction by identification: A social psychological perspective on youth addictive behaviors. [Doctoral dissertation, Tampere University]. https://trepo.tuni.fi/bitstream/handle/10024/123517/978-952-03-1718- 8.pdf?sequence=2 Shahzadi, M., Hafeez, S., Jabeen, M., Ehsaan, S., & Asif, N. (2023). Parental influence on adolescent substance use: A systematic review. Pakistan Journal of Applied Psychology (PJAP), 3, 337-355
She, R.Wong, K.Lin, J.Zhang, Y.Leung, K.Yang, X. (2022). Profiles of stress and coping associated with mental, behavioral, and internet use problems among adolescents during the COVID-19 pandemic: A stratified random sampling and cluster analysis. Frontiers Public Health, 10
Streiner, D. L. (2003). Starting at the beginning: an introduction to coefficient alpha and internal consistency. Journal of personality assessment, 80(1), 99-103
Sunday, S.Keogan, S.Hanafin, J.Clancy, L. (2020). ESPAD 2019 Ireland: Results from the European Schools Project on Alcohol and Other Drugs in Ireland, TFRI
Trucco, E. M.Colder, C. R.Wieczorek, W. F. (2011). Vulnerability to peer influence: A moderated mediation study of early adolescent alcohol use initiation. Addictive behaviors, 36(7), 729-736
Vorobjov, S.Saat, H.Kull, M. (2017). Social skills and their relationship to drug use among 15-16-year-old students in Estonia: An analysis based on the ESPAD data. Nordic Studies on Alcohol and Drugs, 31(4), 401-412
Watts, L. L.Hamza, E. A.Bedewy, D. A.Moustafa, A. A. (2024). A meta- analysis study on peer influence and adolescent substance use. Current Psychology, 43, 3866-3881
Whitesell, M.Bachand, A.Peel, J.Brown, M. (2013). Familial, social, and individual factors contributing to risk for adolescent substance use. Journal of addiction, 1
Woodward, T. C.Smith, M. L.Mann, M. J.Kristjansson, A.Morehouse, H. (2023). Risk & protective factors for youth substance use across family, peers, school, & leisure domains. Children and Youth Services Review, 151
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About this article
Publication Date
09 January 2026
Article Doi
eBook ISBN
978-625-98059-6-2
Publisher
Emanate Publishing House Ltd.
Volume
-
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978-625-98059-7-9
Edition Number
1st Edition
Pages
1-170
Subjects
Addiction, adolescents, ESPAD, Northern Cyprus, substance use
Cite this article as:
Tecel Hatipoğlu, T. (2026). Comparative Application of ESPAD in Northern Cyprus: Reliability Analysis of Psychosocial Factors. In M. A. Huestis (Ed.), Substance Use Among Adolescents in Northern Cyprus, vol -. (pp. 27-47). Emanate Publishing House Ltd.. https://doi.org/10.70020/BI.20260101.2