The role of sex, executive functioning, and perceptions of safety on urban adolescent substance use

Background: Perceptions of safety within one's activity space (commonly frequented locations) reduces risk for adolescent substance use. Less is known about urban adolescents' neuropsychological vulnerabilities to substance use and how these may interact with activity space risk. Questions regarding how male and female adolescents respond to these interactions have yet to be sufficiently studied. Method: To examine these interactions, we conducted a moderated moderation analysis with a sample of 194 adolescents to determine whether executive functioning moderated the influence of activity space risk on substance use, and if this moderation varied by sex. Results: Results indicate that adolescents with low levels of executive functioning were more sensitive to dangerous activity spaces and had more substance use compared to adolescents with higher levels of executive functioning. Males were more vulnerable to substance use when they felt unsafe in their activity spaces; whereas for females, their perceptions of activity space risk was not associated with substance use. Conclusion: For these adolescents, executive functioning's moderation of the effect of activity space risk on substance use, is conditional on sex. Understanding the interaction of executive functioning, activity space, and sex could be useful for contextually sensitive substance use interventions with urban youth.