Addictive Behaviors 28 (2003) 1159 – 1166

Short Communication
The associations of social self-control, personality disorders,
and demographics with drug use among high-risk youth
Steve Sussman*, William J. McCuller, Clyde W. Dent
Preventive Medicine and Psychology, Institute for Health Promotion and Disease Prevention Research,
University of Southern California/IPR, 1000 South Fremont, Unit No. 8 (Room 4124 in Building A-4),
Alhambra, CA 91803, USA

Abstract

A 10-item self-report measure of social self-control was examined for its association with substance
use, controlling for its associations with 12 personality disorder indices and 4 demographic variables
among a sample of 1050 high-risk youth. Social self-control was found to be associated with 30-day
cigarette smoking, alcohol use, marijuana use, and hard drug use, controlling for these other variables.
The most consistent concurrent predictors of substance use were male gender, antisocial personality
disorder, and social self-control. These results highlight the importance of social self-control as a
unique concurrent predictor of substance use and suggest that social self-control skill training is
relevant in substance abuse prevention programming.
D 2002 Elsevier Science Ltd. All rights reserved.

Keywords: Self-control; Substance use

1. Introduction

Some youth seem ‘‘out of control’’ in social situations. They do and say strange things,
and they may expect others to tolerate their behavior. Perhaps, they realize that they may
hurt others’ feelings, but they seem unable to stop their behavior. Lack of self-control is
thought to be centrally related to drug involvement (e.g., Gottfredson & Hirschi, 1990;

* Corresponding author. Tel.: +1-626-457-6635; fax: +1-626-457-4012.

E-mail address: ssussma@hsc.usc.edu (S. Sussman).

0306-4603/02/$ – see front matter D 2002 Elsevier Science Ltd. All rights reserved.
doi:10.1016/S0306-4603(02)00222-8
1160 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166

Jackson, Sher, & Wood, 2000). Lack of self-control among teens is a strong prospective
predictor of heavy drinking, tobacco use, other substance use, as well as perpetration of
personal and property crimes (Griffen, Botvin, Epstein, Doyle, & Diaz, 2000; Longshore,
1998; Longshore, Turner, & Stein, 1996; Sher, Bartholow, & Wood, 2000; Wills & Cleary,
1999; Wills, DuHamel, & Vaccaro, 1995; Wills, Sandy, & Sinar, 1999). In addition, lack of
self-control is strongly related to risky teen driving (Hartos, Eitel, Haynie, & Simons-
Morton, 2000).
Generally, behavioral under-control refers to one’s tendency to act without thinking
(Meichenbaum, 1977; Tarter, 1988) or act on immediate small rewards in preference over
delayed large rewards (O’Donoghue & Rabin, 1999; Vollmer, Borrero, Lalli, & Daniel,
1999). A variety of self-report measures of self-control have been used (e.g., see Jackson
et al., 2000; Kendall & Wilcox, 1979; Longshore et al., 1996; Wills, Gibbons, Gerrard, &
Brody, 2000). For example, Wills et al. use a 20-item five-point self-report measure based on
the Kendall–Wilcox scale (Kendall & Wilcox, 1979). Items assess subjects’ perceived
capability to recover from negative feelings quickly, their reliability in interpersonal situations,
focus on long-range goals, patience, tendency to think before acting, perceived need to be
reminded to do things, distractibility, and potential to annoy others. Longshore et al. (1996)
assess impulsiveness, preference for simple tasks, preference for physical activities, self-
centeredness, and volatile temper as dimensions of self-control. Jackson et al. (2000) look at
novelty seeking, psychoticism, and impulsivity as dimensions of self-control. While
dimensions used on these measures vary, it would appear that self-control is a multidimen-
sional construct (Amekley, Grasmick, & Bursik, 1999).
The present study used a measure that focuses on an interpersonal dimension of self-
control. The main assumption is that youth who tend to alienate others through lack of social
self-control skills may also differentially associate with peers who are more tolerant of their
deviant behavior (e.g., drug users; Sussman, 1996). It is possible that lack of social self-
control could reflect a skill deficit that may be amenable to educational programming. On the
other hand, it is possible that lack of social self-control merely reflects operation of
personality disorders that could require intense or long-term mental health treatment (Kandell
et al., 1997; Johnson, Bornstein, & Sherman, 1996). The present study assesses the
associations of a social self-control index with a measure of 12 personality disorders and 4
demographics measures.

2. Method

2.1. Subjects and data collection

A schoolwide survey was administered to 12 continuation high schools in southern

California. Data were collected from 1207 students. Ethnic distribution consisted of 61%
Latino students, 9% African American students, 19% White students, and 11% ‘‘other’’
ethnic groups. Participants were 59% male and 41% female. Mean age was 16.8 years
(S.D. = 0.80). Data collectors informed subjects that participation was completely voluntary
 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166 1161

and confidentiality was emphasized. Furthermore, students were advised that all surveys
would be conducted anonymously, with no identification code. Questionnaires took approx-
imately 30 min to complete.

2.2. Measures

Demographics were assessed using ethnic indicators (White and Latino), age, and gender.
In addition, a socioeconomic (SES) measure consisted of the mean of two 9-point items,
mother and father occupation levels (r=.24). Ten social self-control items were created based
on previous program development work (Sussman, 1996) and were administered to
participants. Available response options ranged on a four-point scale, from ‘‘1 = never’’ to
‘‘4 = always.’’ The 10 items were summed to form a social self-control index (alpha=.72).
This 10-item measure taps behavior in which one seems driven to social excitement even
though it distances oneself from social harmony. It also taps feeling driven to open expression
of whatever it is that one feels at the moment, which is likely to alienate others, and a desire
for the social world to adjust itself to one’s behavior. Items include: ‘‘I enjoy arguing with
people,’’ ‘‘If I think something someone says is stupid I tell them so,’’ ‘‘My mouth gets me in
trouble a lot,’’ ‘‘Sometimes I provoke people just for the fun of it,’’ ‘‘I express all of my
feelings,’’ ‘‘If I am angry I act like it,’’ ‘‘I do things just to get attention,’’ ‘‘My feelings get
hurt easily,’’ ‘‘I hate being wrong,’’ and ‘‘I say things I regret later.’’
The Personality Diagnostic Questionnaire (PDQ; e.g., Hyler, 1996; Johnson et al., 1996;
Quigley, 1997) consists of 98 true–false items designed to assess various behavioral patterns
associated with particular personality disorders, as defined by the DSM-IV (American
Psychiatric Association, 1994). Twelve subscales were produced. These were paranoid,
schizoid, schizotypal, histrionic, narcissitic, borderline, antisocial, avoidant, dependant,
obsessive–compulsive, negativistic, and depressive scales. Two items were deleted from
the questionnaire (‘‘I have tried to hurt or kill myself’’ and ‘‘Sex just doesn’t interest me’’) to
alleviate potential Human Subjects Committee concerns. Items on different scales were
simply summed to created indices, approximately six items per index.
Substance use was entered as the dependent variable and was assessed using single fill-in-
the-blank item measures. Participants were asked, ‘‘How many times have you used cigarettes
in the last 30 days?’’ Thirty-day use was also asked in regards to alcohol, marijuana, and hard
drugs (such as ‘‘cocaine, stimulants, inhalants, hallucinogens, depressants, PCP, or opiates’’).
Subjects were informed that they could report their use in the last 30 days as falling anywhere
between 0 and 100+ times.

3. Analysis and results

Preliminary analysis was completed by the use of a correlation matrix. The social self-
control index was examined with the substance use measures and the 12 personality scales.
The self-control measure was correlated with 30-day cigarette, alcohol, marijuana, and hard
drug use (.11–.18). It was associated with paranoid (.26), schizoid (.16), schizotypal (.19),
1162 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166

histrionic (.39), narcissistic (.33), borderline (.34), antisocial (.32), avoidant (.19), dependent
(.23), obsessive–compulsive (.24), negativity (.35), and depressive (.32) personality dis-
order diagnoses.
Next, four sets of models were examined through general linear model analysis. One set
of models examined social self-control as a concurrent predictor of cigarette smoking,
alcohol use, marijuana use, and hard drug use. A second set of models examined four
demographic variables (White ethnicity vs. all others, Latin ethnicity vs. all others, SES,
and gender) as concurrent predictors of the same four drug use categories. A third set of
models examined all 12 personality disorder scales as concurrent predictors of the four drug
use categories (Table 1).
Finally, any predictor that had been found to be significant predictor in the previous
sets of models (at P < .05) was retained for a final set of models, predicting any of the
same four drug use categories for which it previously was found to be a significant
concurrent predictor (Table 2). Thirty-day cigarette use was entered as the outcome

Table 1
Self-control, demographic, and PDQ scale sets as concurrent predictors of 30-day drug use
Cigarette smoking Alcohol use Marijuana use Hard drug use
Self-control 35.06*** 30.45*** 26.80*** 13.22***

Demographics
White 48.67*** 0.40 38.54*** 0.96
Latin 14.60*** 0.28 0.28 0.01
SES 2.68 5.99* 2.61 1.09
Male 15.46*** 24.07*** 39.77*** 6.63*

PDQ scales
Paranoid 3.70* 0.02 0.20 8.24***
Schizoid 1.75 0.16 0.24 0.07
Schizotypal 0.65 2.48 3.17+ 0.74
Histrionic 1.12 0.08 0.01 1.05
Narcissistic 0.72 0.08 0.17 0.07
Borderline 9.25*** 0.25 0.73 7.72***
Antisocial 35.40*** 47.38*** 68.55*** 11.21***
Avoidant 3.42+ 3.72* 4.51* 1.65
Dependent 0.06 10.39*** 0.08 0.42
Obsessive 2.19 1.14 1.98 1.63
Negativistic 2.36 0.02 0.10 2.43
Depressed 0.09 2.02 0.66 0.34
Three predictor sets are examined. The first one consists only of self-control as a concurrent predictor of recent use
of four different drug categories. The second set consists of four demographic predictors. The third set consists of
12 personality disorder scale predictors.
* P < .05.
*** P < .001.
+
P < .1.
 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166 1163

Table 2
Final multivariable concurrent predictor sets of 30-day drug use
Cigarette smoking Alcohol use Marijuana use Hard drug use
Self-control 5.09 * 6.39** 9.62*** 5.52**
White 45.47*** na 61.17*** na
Latin 15.67*** na na na
SES na 6.78*** na na
Male 8.88*** 8.57*** 26.68*** 5.46**
Paranoid 2.98 + na na 8.13***
Borderline 8.64*** na na 5.83**
Antisocial 19.31*** 33.91*** 30.34*** 4.23*
Avoidant na 3.57* 7.67*** na
Dependent na 8.08*** na na
* P < .05.
** P < .01.
*** P < .001.
+
P < .1.

variable for the first model shown in Table 2. Predictor variables were White, Latin, male,
borderline, antisocial, paranoid, and the self-control measure. The second model used 30-
day alcohol use as the outcome variable. SES, male, antisocial, avoidant, and dependent
personality disorders, and the self-control measure were entered as concurrent predictors.
A 30-day marijuana use model was constructed similarly, with White, male, antisocial,
avoidant, and self-control as predictors. Finally, the fourth model used male, paranoid,
borderline, antisocial, and self-control measures as concurrent predictors of 30-day hard
drug use.
In all models, self-control, male gender, and antisocial personality disorder were signific-
ant predictors. Regarding cigarette smoking, not being Latin and borderline personality
disorder also remained significant predictors. Regarding alcohol use, lower SES, avoidant,
and dependent personality disorders also remained significant predictors. Regarding mari-
juana use, White ethnicity and avoidant personality disorder alcohol also remained significant
predictors. Finally, regarding hard drug use, paranoid and borderline personality disorders
also remained significant predictors.

3.1. Summary of supplementary analyses

Three additional analyses were completed. First, all 10 demographic and personality
disorder variables listed in Table 2 were entered as concurrent predictors of drug use in all
four final models to provide a consistent set of predictors, even though some of them had
not been found to be significant predictors in the previous set of models (i.e., in Table 1).
The same pattern of results was obtained as in the current Table 2. Second, the personality
disorder variables were coded into categories (disordered, yes or no), according to a PDQ
scoring key, and analyses were rerun. For example, diagnosis of the paranoid personality
disorder is coded when four of the seven items are endorsed. Interestingly, scored into
1164 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166

categories, 48% of the sample would be categorized as paranoid, 24% of the sample would
be categorized as borderline, 41% of the sample would be categorized as antisocial, 22%
would be categorized as avoidant, and 9% would be categorized as dependent. The pattern
of the results were the same as indicated in Tables 1 and 2, except that, now, social self-
control was the relatively strongest predictor of drug use across models. Finally, social self-
control was coded into four categories [10–20 (little loss), 21–25 (mild loss), 26–30
(moderate loss), or 31–40 (high loss of social self-control), based on sums of the items],
and the analyses were rerun. The same pattern of results was obtained as with its use as a
quantitative measure.

4. Discussion

Behavioral self-control may be protective against drug use experimentation (e.g., Conduct
Problems Prevention Research Group, 1999; Sussman, Dent, Stacy, & Craig, 1998). High
social self-control, as measured herein, is inversely related to drug use, controlling for
relatively unchangeable disorders of personality. The fact that it does provide unique
predictive variance indicates that social self-control is not merely a facet of a problem
personality. One may speculate that it is amenable to social skills training.
There are various strategies one might conjecture would alter one’s social self-control.
One can be taught cognitive–behavioral strategies such as not to ‘‘sweat the small stuff,’’
that argumentation is best reserved for the right time and place, if necessary. One also can
be taught to try to frame statements made to others positively in most situations. Further,
one can be taught that as a participant in social interactions, one seeks to become part of a
flow of conversation. One studies the tempo, order of speaking, and conversation contents
of the group, and one adapts to the group interaction.
There are numerous limitations of this study including lack of prospective data to
discern order of precedence between social self-control and drug use, lack of direct overt
behavioral measures, and lack of multiple psychometric evaluations of the social self-
control measure (e.g., test–retest reliability). This measure is being used as part of a drug
abuse prevention education program that attempts to modify social self-control (Sussman
et al., 1998). A future evaluation will involve examination of change in self-control from
baseline to posttest, using the present measure, as a function or whether or not social self-
control education material is offered. Youth who learn not to alienate others frequently
in social interactions may be less likely to revert to drug use for comfort. Social self-
control skill instruction holds promise as one means of assisting in the prevention of drug
abuse.

Acknowledgements

This research was supported by grants from the National Institute on Drug Abuse
(DA07601) and Tobacco-Related Disease Research Program (6RT-0182 and 9HT-3201).
 S. Sussman et al. / Addictive Behaviors 28 (2003) 1159–1166 1165

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