The MeSHe epidemiology projects 

Early identification of adolescent substance use is the only possibility to prevent the development of permanent psychiatric ill-health, the establishment of persistent criminal lifestyle and drastic social marginalization. Today most of the biosocial and societal risk factors that lead to adolescent substance abuse are mapped, however the cultural context of these risk factors is rarely studied.

Immigration rate (including all different reasons) is increased exceptionally in today’s world. Acknowledging and learning more about culture-specific patterns of psychiatric ill-health is the only way to offer equal and patient-centred care to those in need without discriminating by their origin.

With the help of a structured and standardized survey the present project aims to enable the identification of culture-specific indicators and risk factors of substance abuse and aggressive antisocial or self-harm behaviors.  


General aim

The project aims to identify culture-specific personality and behavioral-, physical- or psychiatric symptoms to improve upon possibilities for an early identification of those adolescents who may require help and support with their substance use and/or aggressive antisocial or self-harm behaviors to prevent persistence in these destructive behavior patterns in their own natural culture and even in case immigration based on their original cultural matrix even in the host lands.


Specific aims:

1.   In an international matrix map the prevalence of basic psychiatric and somatic health problems, self-rated levels of substance use and aggression in samples of high school students and to analyze the associations between these factors.

2.  To define the relationships between adolescents’ affect, their involvement in leisure time physical activity and their substance use, level of overt aggressive and self-harm behaviours, and investigate eventual cultural differences.

3.  To describe personality profiles of those who have the highest problem load (most psychiatric and somatic health problems, and highest scores in substance use and aggression measures), and compare these descriptors between the different cultures. Investigate their basic social background factors. 

4. Define culture-specific symptoms and signs predicting negative outcome in adolescents’ behavior with the help of comparison between data collected from adolescents and data collected from addict from outpatient – clinics, in each nation separately.

The MeSHe Survey


The present project is created and led by Nóra Kerekes (University West, Department of Health Sciences, Trollhättan, Sweden). The survey includes the following instruments:


1.     A background questionnaire about: somatic and mental health, psychosocial factors.

2.     Life history of aggression (LHA). The LHA scale assesses trait aggression and antisocial behavior. The LHA scale consists of eleven items. The items are distributed over three subscales: Aggression scale, Consequences/Antisocial Behavior scale and Self-directed Aggression scale.

3.     Brief Symptom Inventory (BSI). BSI is a self-report inventory used to measure psychological distress and psychiatric symptoms. Higher scores are associated with greater psychological distress, whereas lower scores indicate better psychological well-being. 

4.     Alcohol Use Disorder Identification Test (AUDIT) The AUDIT was developed by the collaborative World Health Organization project and asks to self-report alcohol-related behaviour during the last 12 months.

5.     Drug Use Disorder Identification Test (DUDIT) The DUDIT is a screening instrument composed of 11 items identifying consumption patterns and different problems related to the use of drugs in general or clinical populations.

6.     Positive Affect and Negative Affect Schedule Expanded Form 30 items (PANAS-X30). PANAS is an instrument used to measure two general affective state dimensions: positive and negative affect.

7.     Godin Leisure-Time Exercise Questionnaire (LTEQ). It is a 3+1-item scale for assessing the frequency and intensity of physical exercise during a typical seven-day period. 

8.     Temperament and Character Inventory (TCI). The TCI is a wellknow instrument that was developed by Prof Cloninger based on the bio-psychosocial model of personality.