Given the breadth of exposures and outcomes assessed in the current study, it was beyond the scope of this article to assess the multiple possible mechanisms by which PTEs are associated with adolescent substance use. Future studies, ideally using longitudinal data, should continue to explore these patterns by conducting formal tests of mediation, assessing indirect effects of PTEs through distress and behavior disorders on substance use among both boys and girls. Additional avenues for future work include examination of the ways in which social norms, peer groups, sociodemographic factors, and drug availability affect these associations, and whether any protective factors exist that could be used to design interventions and educational campaigns for adolescents.
