A Latent Class Analysis Study of Polyinhalant Use Among Incarcerated Youth

Background/Purpose: Adolescent inhalant use is a serious public health problem that disproportionally affects antisocial youth. The prevalence rates for antisocial youth approach 40% (Howard, Balster, Cottler, Wu, & Vaughn, 2008; Howard & Jenson, 1999), compared to nearly 8.8% of youth in the general population (Johnston, O’Malley, Bachman, & Schulenberg, 2015). Despite the pernicious nature of inhalant use, studies have yet to explore typologies of inhalant use among incarcerated youth to better understand how use of various inhalants may co-occur. As a result, it is unclear what individual characteristics (i.e., demographic characteristics, personality traits, health conditions, mental health conditions or substance use behaviors) are associated with the most severe polyinhalant use. Here polyinhalant use refers to using an assortment of inhalants over a period of time; the use can be simultaneous or successive.

The National Institute on Drug Abuse (NIDA; 2012) defines inhalants as “volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering effect” (p. 1). Examples of inhalants include glue, paint, gasoline, solvents, whipped cream dispensers, and nail polish remover (Johnston et al., 2015; NIDA, 2012a, 2012b). Inhalant users “sniff,” “huff,” or “snort” fumes from containers, paper or plastic bags, soaked rags, or directly from aerosol cans.  Effects of inhalant intoxication last only a few minutes and similar to alcohol, include slurred speech, ataxia, euphoria, and dizziness.  Inhalant use can have deleterious health consequences including brain damage, heart irregularities, optic nerve damage, hearing loss, liver damage, muscle atrophy, and death (Howard et al., 2011).  This study has two aims: (a) to determine typologies of polyinhalant use; (b) to explore differences among the groups based on demographic, psychiatric, personality, and substance use characteristics.

Methods: The study utilizes existing data from residents (N= 723) of 27 Missouri Division of Youth Services facilities. Interviews assessed psychiatric symptoms, antisocial traits, delinquency, trauma, suicidality, and substance use behaviors. The mean age of the mostly male, ethnically diverse sample was 15.5 (S.D. = 1.2) years old. Latent class analysis (LCA) was used to investigate patterns of lifetime inhalant use. LCA is a person-centered analytic approach that combs through a dataset to locate and group together individuals with similar patterns of survey question responses. Analysis was done in MPLUS 7.1.

Results: The study revealed the following classes of inhalant use: (1) severe polyinhalant use; (2) moderate polyinhalant use; (3) gas and permanent marker use; and (4) low-use. Compared to the low-use class, members of the severe polyinhalant use class had experienced more than double the rate of head injuries, the highest rates of traumatic experiences, and the highest rates of mental illness diagnoses. The gas and markers class had the highest rate of reporting hearing voices, followed by the severe polyinhalant use class, and the moderate polyinhalant use class.

Conclusion: Results of this study underscore the need to address underlying health and mental health factors that may contribute to polyinhalant use. Researchers, practitioners and policy makers should seek to address the relationships between head injuries and severe polyinhalant use.