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Journal of Ethnicity in Substance Abuse

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Psychometric evaluation of the Turkish version ofthe Substance Use Risk Profile Scale in adolescents

Sabide Duygu Uygun, Esra Cop, Ozden Sukran Uneri, Kadir Ozdel, EmrahAtar & Kerim M. Munir

To cite this article: Sabide Duygu Uygun, Esra Cop, Ozden Sukran Uneri, Kadir Ozdel,Emrah Atar & Kerim M. Munir (2019): Psychometric evaluation of the Turkish version of theSubstance Use Risk Profile Scale in adolescents, Journal of Ethnicity in Substance Abuse, DOI:10.1080/15332640.2019.1657542

To link to this article: https://doi.org/10.1080/15332640.2019.1657542

Published online: 02 Sep 2019.

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Psychometric evaluation of the Turkish version of theSubstance Use Risk Profile Scale in adolescents

Sabide Duygu Uyguna , Esra Copb, Ozden Sukran Uneric, Kadir Ozdeld ,Emrah Atare, and Kerim M. Munirf

aDepartment of Child and Adolescent Psychiatry, University of Health Sciences, Dr. Sami UlusMaternity and Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey;bDepartment of Child and Adolescent Psychiatry, University of Health Sciences, Ankara ChildHealth and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey;cDepartment of Child and Adolescent Psychiatry, Ankara Child Health and Diseases HematologyOncology Training and Research Hospital, Yildirim Beyazit University School of Medicine, Ankara,Turkey; dDepartment of Psychiatry, University of Health Sciences, Ankara Diskapi Yildirim BeyazitTraining and Research Hospital, Ankara, Turkey; eRepublic of Turkey, Ministry of Youth andSports, Ankara, Turkey; fDepartments of Pediatrics and Psychiatry, Boston Children’s Hospital,Harvard Medical School, Boston, Massachusetts

ABSTRACTThe Substance Use Risk Profile Scale (SURPS) was developedas a self-report measure to screen four high-risk personalitydimensions (hopelessness, anxiety sensitivity, impulsivity, andsensation seeking) that predict specific patterns of vulnerabil-ity to substance use and other problematic behavior. Thescale has previously been shown to have adequate psycho-metric properties in various other languages. The aim of thepresent study was to evaluate the psychometric properties ofthe Turkish version of the SURPS. A cross-sectional total sam-pling design was adopted in which 875 Turkish participantstook part (mean age 15.58 years, SD ¼ 1.03). Using exploratoryfactor and correlational analyses, the internal consistency, tes-t–retest reliability, construct validity, and concurrent validitywere evaluated. The SURPS demonstrated good psychometricand construct validity. The results provide clear evidence thatthe Turkish version of the SURPS is valid and reliable. TheTurkish version of the SURPS may become an important toolfor daily clinical practice and clinical research.

KEYWORDSAdolescent; substance use;personality

Introduction

The increasing prevalence of adolescent substance abuse over the past 25 yearshas made it one of the major global health problems faced today (Peiper,Ridenour, Hochwalt, & Coyne-Beasley, 2016). Adolescence is a period ofdynamic biological, psychological, and social growth. Substance use during thisperiod can disrupt growth significantly, impairing an otherwise natural course

CONTACT Sabide Duygu Uygun st.duygu@hotmail.com University of Health Sciences, Dr. Sami UlusMaternity and Children’s Health and Diseases Training and Research Hospital, Department of Child andAdolescent Psychiatry, Babur Cd., No:41, 06080, Altindag, Ankara, Turkey.� 2019 Taylor & Francis Group, LLC

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSEhttps://doi.org/10.1080/15332640.2019.1657542

of cognitive, emotional, and social development. The deleterious effects of sub-stance abuse on the individual, families, and the larger community are welldocumented and have proved costly. Compared to their nonabusing counter-parts, substance-abusing adolescents underperform academically, are lessemployable, and lack the necessary family and social support during a criticalperiod of social development. Moreover, there are strong associations amongsubstance abuse, comorbid mental illness, and problematic behavior (e.g., vio-lence and criminal and risky sexual behavior) (Borus, Parhami, & Levy, 2016).The significant social and economic costs of substance abuse to national econo-mies has therefore led to large health initiatives to relieve the burden and elim-inate clinical onset, making substance abuse prevention paramount (LeNoue &Riggs, 2016).Substance abuse prevention begins with assessment. One promising

approach to risk assessment has been to identify personality vulnerability.Individuals would use substances to obtain a positive outcome or to avoida negative outcome. According to Cooper’s motivational model, these twomotives (enhancement or coping) are explained by positive (e.g., positivemood change and social approval) and negative (e.g., avoiding negativeemotions and social censure) reinforcement processes in conditioning.Motives for substance use appear to be the final common pathway to sub-stance abuse through which more distal risk variables, such as personalityfactors, apply their influences (Cooper, 1994). Motivation and reinforce-ment-specific personality profiles (Comeau, Stewart, & Loba, 2001;Woicik, Stewart, Pihl, & Conrod, 2009) have been shown to be particu-larly predictive of subsequent development of substance abuse(Castellanos-Ryan & Conrod, 2011; Conrod & Woicik, 2002). Woiciket al. (2009) found that four personality traits (hopelessness, anxiety sensi-tivity, impulsivity, and sensation seeking) explained drug abuse vulner-ability. The relationship between these personality traits and substanceabuse is mediated by different motivational patterns and reinforcementprocesses (Castellanos-Ryan, O’Leary-Barrett, Sully, & Conrod, 2013;Conrod, Pihl, Stewart, & Dongier, 2000; Conrod, Stewart, et al., 2000). Intheir model, individuals who score high on either of the internalizingtraits (anxiety sensitivity or hopelessness) are susceptible to negativereinforcement from alcohol and drug use. However, the reinforcementpatterns are different; while individuals high in anxiety sensitivity usealcohol and drugs to cope and reduce anxiety and panic symptoms, thosehigh in hopelessness are differentially reinforced by alcohol and drugs,using them instead to relieve negative affective states (e.g., negativethinking, depressive thoughts) (Comeau et al., 2001; Krank et al., 2011).Individuals scoring high on the externalizing traits of the model(sensation seeking and impulsivity) are thought to be more susceptible to

2 S. D. UYGUN ET AL.

positive reinforcement related to intense novelty desire (seeking noveland thrilling experiences), risk taking, and poor behavioral inhibition toenhance positive affective states (Castellanos-Ryan & Conrod, 2011; Sher,Bartholow, & Wood, 2000; Woicik et al., 2009). These findings are rele-vant in the context of the Research Diagnostic Criteria framework, whichintegrates many levels of information (from genomics and circuits tobehavior and self-reports) for understanding negative and positive valencesystems and developing new approaches for prevention of mental disor-ders associated with substance use exposure (Kozak & Cuthbert, 2016).The Substance Use Risk Profile Scale (SURPS) was developed to screen

for the four high-risk personality traits (hopelessness, anxiety sensitivity,impulsivity, and sensation seeking) for substance abuse (Conrod & Woicik,2002; Woicik et al., 2009). The SURPS is a self-report instrument of 23items rated on a Likert scale (1¼ strongly disagree to 4¼ strongly agree). Ithas demonstrated satisfactory internal consistency, test–retest reliability,and construct, concurrent, and predictive validity while measuring thesepersonality variables for the goal of predicting the development of sub-stance misuse (Castellanos-Ryan et al., 2013; Woicik et al., 2009).Psychometric properties of the SURPS have been evaluated with adequateresults in English (Castellanos-Ryan et al., 2013; Krank et al., 2011; Newtonet al., 2016; Woicik et al., 2009), Dutch (Malmberg et al., 2010), Sinhala(Chandrika Ismail, De Alwis Seneviratne, Newcombe, & Wanigaratne,2009), French-Quebequois (Castonguay-Jolin et al., 2013), Spanish-speakingMexican (Robles-Garcia et al., 2014), Japanese (Omiya, Kobori, Tomoto,Igarashi, & Iyo, 2015), Korean (Saliba, Moran, & Yoo, 2014), Chinese (Siu,2011), German (Jurk et al., 2015), Portuguese-speaking Brazilian (Canfield,Gilvarry, & Koller, 2015), clinical (Schlauch et al., 2015), and adolescentpopulation–based samples (Castonguay-Jolin et al., 2013; Chandrika Ismailet al., 2009; Jurk et al., 2015; Krank et al., 2011; Malmberg et al., 2010;Newton et al., 2016; Siu, 2011; Woicik et al., 2009).Cross-cultural differences are able to influence adolescents’ decisions about

substance use. It is not clear what mediates this influence. The associationbetween acculturation and substance use behavior suggests that traditionalcultural values could be protective or risk factors for substance abuse(Johnson et al., 2006). For example, especially in Asian cultures, filial piety,which emphasizes obedience to parents, may protect adolescents from sub-stance use. Similarly, in Latin American cultures, familism, a sense of obliga-tion to, and connectedness with, one’s immediate and extended family, maybe associated with a lower risk of substance use. Conversely, in Hispanic cul-tures, machismo, which prescribes differentiated gender roles (unlike women,the qualities associated with men are believed to be masculinity, male domin-ance, sexual prowess, physical strength, and honor), may be related to a

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higher risk of substance use among boys (Unger et al., 2002). In addition tocultural values, there are also studies that revealed cross-cultural differenceson personality traits (Eysenck & Haapasalo, 1989). English and French ado-lescents scored higher than German adolescents in the Hopelessness,Impulsivity, and Sensation Seeking subscales of the SURPS (Jurk et al., 2015).Koreans consistently scored higher than Australians in all subscales. Bothnations nevertheless demonstrated a similar relationship between the person-ality traits and substance use (Saliba et al., 2014). Although the SURPS is sen-sitive to national differences in terms of subscale scores, the four personalitydimensions were found to be usually correlated with substance use in differ-ent nations (Omiya et al., 2015). These personality traits have not yet beenevaluated in Turkish adolescents.Main effects for gender were found on anxiety sensitivity (females scored

significantly higher) and sensation seeking (males reported significantlyhigher) in the other studies of gender associations with personality and inthe original study that informed construction of the SURPS (Canfield et al.,2015; Siu, 2011; Woicik et al., 2009). Males are thought to be more proneto personality traits related to externalizing, whereas predominant personal-ity traits in females are associated with internalizing (Muris, Meesters, &Blijlevens, 2007). Gender effects on the personality traits related to sub-stance use have not yet been replicated in Turkish adolescents.Taken together, the previous studies have shown that the SURPS is a

reliable instrument in assessing high-risk personality traits and developingearly interventions for prevention of substance use disorders. There is cur-rently no Turkish version of SURPS. Therefore, the aim of the presentstudy was to evaluate the psychometric properties of a Turkish version ofSURPS and to establish normative scores in this population. We hypothe-size that the Turkish version of the SURPS will be a suitable and validmeasure of personality in Turkish adolescents.

Methods

Procedure

Permission to validate the SURPS in Turkey was obtained from P. Woicik,who developed the scale. The SURPS was translated into Turkish by threechild and adolescent psychiatrists proficient in English [SDU, OSU, andEC]. The scale was then blindly back-translated to English by a bilingualtranslator in the Department of Linguistics at Stony Brook University [AY].Finally, Woicik and her colleagues compared the translated and back-trans-lated versions with the original English version. There were a few discrep-ancies. Minor corrections were made by consensus.

4 S. D. UYGUN ET AL.

Measures

The assessment consisted of the Turkish version of SURPS and four add-itional self-administered instruments: the Beck Hopelessness Scale, the StateTrait Anxiety Inventory, the Barratt Impulsivity Scale, and the ArnettInventory of Sensation Seeking. These measures were used to determineconcurrent validity of the SURPS subscales.

1. The SURPS is a 23-item (4-point Likert scale: 1 ¼ strong disagree to 4¼ strongly agree) instrument designed to assess the personality dimen-sions such as anxiety sensitivity, hopelessness, impulsivity, and sensationseeking (items of the SURPS are presented in Table 1). The SURPS hasdemonstrated good psychometric properties in nonclinical samples,

Table 1. Factor Loadings of the SURPS Items.

Item

Factor

Lack ofself-contentment

(formerlyhopelessness) Impulsivity

Sensationseeking

Anxietysensitivity

1 I am content .7514 I am happy .8457 I have faith that my future holds great promise .66213 I feel proud of my accomplishments .44717 I feel that I’m a failure .338 .38320 I feel pleasant .74923 I am very enthusiastic about my future .5992 I often don’t think things through before I speak .5675 I often involve myself in situations

that I later regret being involved in.546

11 I usually act without stopping to think .76815 Generally, I am an impulsive person .74022 I feel I have to be manipulative to get what

I want.343

3 I would like to skydive .6746 I enjoy new and exciting experiences even if

they are unconventional.661

9 I like doing things that frighten me a little .66012 I would like to learn how to drive a motorcycle .61416 I am interested in experience for its own sake,

even if it is illegal.348 .558

19 I would enjoy hiking long distances in wild anduninhabited territory

.551

8 It’s frightening to feel dizzy or faint .66810 It frightens me when I feel my heartbeat change .63214 I get scared when I’m too nervous .49518 I get scared when I experience unusual body

sensations.547

21 It scares me when I’m unable to focus on a task .617Eigenvalue 3.77 2.96 2.24 1.41Variance (%)45.18 16.42 12.87 9.75 6.13Cronbach’s alpha.728 .758 .668 .707 .658Mean 13.96 10.57 16.28 11.00SD 4.34 3.46 4.36 3.50

Note. SURPS¼ Substance Use Risk Profile Scale.

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE 5

including convergent, discriminant, and predictive validity (Krank et al.,2011; Woicik et al., 2009).

2. The Beck Hopelessness Scale (BHS), a 20-item instrument rated on a“yes” or “no” response (Beck, Weissman, Lester, & Trexler, 1974), hasshown adequate internal consistency in the Turkish population(Cronbach’s alpha ¼ .93) (Durak & Palabıyıko�glu, 1994; Seber, Dilbaz,Kaptano�glu, & Tekin, 1993).

3. The State Trait Anxiety Inventory (STAI) State subscale consists of 20items describing how a person feels at a particular moment rated on aLikert scale (1–4 points) (Spielberger, Gorsuch, & Lushene, 1970). TheSTAI Trait subscale consists of 20 items describing how a person gener-ally feels rated on a Likert scale (1–4 points) (Spielberger et al., 1970).The State and Trait subscales of STAI have been validated with alphavalues of .83–.87 and .94–.96, respectively, in the Turkish population(Oner & Le Compte, 1985).

4. The Barratt Impulsivity Scale (BIS), which comprises 30 items scoredon a 4-point Likert instrument ranging from 1 (rarely/never) to 4(almost always/always), includes three subscales labeled Attentional,Non-planning, and Motor (Patton, Stanford, & Barratt, 1995). The val-idation of the BIS has been replicated in Turkey (G€ulec et al., 2008). Inthe current study, Cronbach’s alpha for internal consistency was .78.

5. The Arnett Inventory of Sensation Seeking (AISS), composed of 20items rated on a Likert scale (1–4 points) (Arnett, 1994), has adequateinternal consistency in the Turkish population (with alpha values of .84and .75) (S€umer, 2003).

Participants

Approval for the design and data collection procedures was obtained fromthe ethics review committee at the Yildirim Beyazit University, Ankara.The study sites included two public high schools in the Altindag district ofAnkara from low and high socioeconomic income census areas, respect-ively. Additional approvals were elicited from the school authorities.To minimize selection bias, a total sample of students from the two schools

(n¼ 1,074) was approached, and 905 (84%) students returned the distributedscales with informed consent, including the additional self-report studymeasures with similar response rates between grades. Participant question-naires that were incomplete were removed from the analyses (n¼ 30), yield-ing the final study sample of 875 participants (81.5%; n¼ 349 from a lowsocioeconomic neighborhood school, and n¼ 526 from a high socioeco-nomic neighborhood school). All the survey data were collected on a classbasis during the guidance hours. The student ages were 14 to 19 years (mean

6 S. D. UYGUN ET AL.

15.58, SD ¼ 1.03; 502 males, 369 females, and 4 adolescents who left the gen-der question blank in self-reports). The grade distribution for the combinedschools was 350 in ninth grade; 271 in 10th grade; 171 in 11th grade; 83 in12th grade. Seventy-five students were randomly selected and furtherrequested to complete the SURPS a second time after one month to examinetest–retest reliability of the SURPS subscales.

Statistical analyses

First, a principal-component analysis with varimax rotation was performedto assess the construct validity of the Turkish version of the SURPS.Kaiser–Meyer–Olkin’s measure of sampling adequacy and Bartlett’s test ofsphericity were calculated to verify the appropriateness of using the factoranalysis. The exploratory factor analysis was completed to explore the fac-tor structure of the SURPS. Interpretation of the factor loadings for allanalyses was based on the guidelines set forth by Comrey and Lee. Theysuggested that loadings greater than .71 should be considered excellent, .63very good, .55 good, .45 fair, and .32 poor (Comrey & Lee, 1992). Itemswhose factor loadings were greater than .32 were retained and allocated tofactors. The factor extraction was performed with Eigenvalues set at greaterthan 1. The scree plot graph was utilized to determine the number of fac-tors by counting the number of points where the slope of the curve clearlyleveled off. Second, to evaluate the internal consistency, Cronbach’s alphacoefficients of the Turkish version of SURPS and all four subscales,Cronbach’s alpha if item deleted, and item total correlation coefficients ofall 23 items were calculated. Third, Pearson correlation coefficients for thetest–retest reliabilities of all four subscales were also calculated. Fourth, theconcurrent validity of the SURPS subscales was obtained by determiningtheir association with BHS (for the Hopelessness subscale), STAI (for theAnxiety Sensitivity subscale), BIS (for the Impulsivity subscale), and AISS(for the Sensation Seeking subscale) with Pearson correlation coefficients.Statistical analyses were carried out using SPSS 17.0 software. A significancelevel of p� .05 was set for all analyses.

Results

Factor structure of the Turkish version of SURPS

Five factors (instead of the expected four) accounted for 49.67% of the vari-ance in item scores. Eigenvalues (>1) were 3.77, 2.96, 2.24, 1.41, and 1.03.All item loadings were above .32 and none was excluded. Observation of theinflexion point after fourth factor in the scree plot graph suggested a four-factor model (Figure 1). Four of the factors resembled the original defined

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE 7

structure. Among the 23 items, only three (items 7, 13, and 23) loaded on aseparate fifth factor. All other items replicated the expected factor structureas reported in the literature. Therefore, the four-factor model was “forced” inthe second factor analysis. In addition to items 7, 13, and 23 (with factorloading of .662, .447, and .599 on the hopelessness factor, respectively), allitems loaded on the original defined factors at greater than .32. Four factorsaccounted for 45.18% of the variance, and eigenvalues (>1) were 3.77, 2.96,2.24, and 1.41 representing hopelessness, impulsivity, sensation seeking, andanxiety sensitivity, respectively (presented in Table 1).A common feature of items 7 (“I have faith that my future holds great

promise”) and 23 (“I am very enthusiastic about my future”) is that theyare positive statements about the future, so they may have diverged fromthe other statements that comprise the Hopelessness subscale. When assess-ing the contextual meaning of items 7 and 23, they were included in theHopelessness subscale (as in the original SURPS) because future orientationincreases during adolescence, and thus, viewing the future in a negativelight, such as giving a low endorsement to these items, may be more rele-vant to adolescents’ hopelessness. The content for item 13 (“I feel proud ofmy accomplishments”), which loaded at .447 on the hopelessness factor,

Figure 1. The Scree Plot Graph of the Five-Factor Structure.

8 S. D. UYGUN ET AL.

was interpreted as lack of self-contentment rather than hopelessness, simi-lar to item 17 (“I feel that I’m a failure”), whose factor loading was .338 onthe same factor. When the meanings of hopelessness items (items 1, 4, 7,13, 17, 20, and 23) and factor loadings for this factor were examined,although those for items 13 and 17 were interpreted as poor, replacing thesubscale name of “Hopelessness” with “Lack of Self-Contentment” made itmore inclusive by supporting the original four-factor structure. Therefore,the name “Lack of Self-Contentment” was used instead of the“Hopelessness” subscale for the Turkish version of the SURPS.Only items 16 and item 17 cross-loaded on to another factor as well as

the expected factor of the original SURPS (Table 1). The factor loadings foritem 16 (“I am interested in experience for its own sake, even if it is ille-gal”) were .348 and .558 on impulsivity and sensation seeking, respectively.As in the original SURPS, item 16 was considered a sensation-seeking fac-tor rather than an impulsivity factor when graded on loading according toComrey and Lee (1992). Although the factor loadings on lack of self-con-tentment (formerly hopelessness) and anxiety sensitivity (.338 and .383,respectively) for item 17 were interpreted as poor, we preferred to considerit in the intended factor (lack of self-contentment [formerly hopelessness])rather than anxiety sensitivity in terms of meaning.Mean subscale scores of the Turkish version of the SURPS fell within the

normative scores found in English versions: Lack of Self-Contentment (for-merly Hopelessness) subscale, 13.96, SD ¼ 4.34 points; Anxiety Sensitivitysubscale, 11.00, SD ¼ 3.50 points; Impulsivity subscale, 10.57, SD ¼ 3.46points; and Sensation Seeking subscale, 16.28, SD ¼ 4.36 points. Malesscored significantly higher on the sensation seeking [t(805) ¼ 2.736,p< .05] and the impulsivity [t(827) ¼ 2.038, p< .05] subscales, and femalesscored significantly higher on the anxiety sensitivity subscale [t(815) ¼�3.960, p< .001].

Internal consistency

The Turkish version of SURPS showed adequate to good internal consist-ency (Cronbach’s alpha coefficient¼ .728). Alpha coefficients were .758,

Table 2. Test–Retest Reliabilities of the SURPS Subscales.SURPS

Lack of self-contentment(formerly hopelessness) Impulsivity

Sensationseeking

Anxietysensitivity

Test mean (±SD) 13.94 ± 4.73 11.41 ± 3.35 17.08 ± 4.25 11.04 ± 3.86Retest mean (±SD) 14.91 ± 4.99 11.38 ± 3.14 17.10 ± 4.57 11.42 ± 3.41Pearson correlation coefficient .779�� .608�� .703�� .646��Note. SURPS¼ Substance Use Risk Profile Scale.��p< .01; �p< .05.

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE 9

.658, .668, and .707 for the Lack of Self-Contentment (formerlyHopelessness), Anxiety Sensitivity, Impulsivity, and Sensation Seeking sub-scales, respectively (Table 1). These values were similar to those reported inthe previous validation studies and the original study (Chandrika Ismailet al., 2009; Jurk et al., 2015; Krank et al., 2011; Robles-Garcia et al., 2014;Siu, 2011; Woicik et al., 2009).

Test–retest reliability

For the test–retest reliability, we randomly selected 75 adolescents, whocompleted the Turkish version of the SURPS a second time one monthafter the initial evaluation. Pearson correlation coefficients for the test–ret-est reliabilities of the Lack of Self-Contentment (formerly Hopelessness),Sensation Seeking, Impulsivity, and Anxiety Sensitivity subscale scores were.779, .703, .608, and .646, respectively (p< .01) (Table 2). Similar to theother versions and the original SURPS (Omiya et al., 2015; Siu, 2011;Woicik et al., 2009), the Turkish version of SURPS showed quite strongtest–retest reliability estimates.

Concurrent validity

Consistent with the results from the original study by Woicik et al. (2009),we found significantly low-moderate correlations in the range of .252–.589between the SURPS subscales and other scales measuring the similar con-structs (Table 3).

Discussion

The psychometric evaluation of the Turkish version of SURPS among 14-to 18-year-old adolescents attending two public high schools in Ankarasupports the reliability and validity of this version and the cross-culturaluse of the SURPS.

Table 3. Correlation between the SURPS Subscales and Other Instruments.

Pearson correlation coefficient

SURPS

Lack of self-contentment(formerly hopelessness) Impulsivity

Sensationseeking

Anxietysensitivity

BHS score 0.589��BIS total score 0.530��AISS score –0.525��STAI State subscale score 0.252��STAI Trait subscale score 0.386��Note. SURPS¼ Substance Use Risk Profile Scale; BHS¼ Beck Hopelessness Scale; STAI¼ State Trait AnxietyInventory; BIS¼ Barratt Impulsivity Scale; AISS¼Arnett Inventory of Sensation Seeking.��p< .01; �p< .05.

10 S. D. UYGUN ET AL.

According to the present data, the factor structure of the Turkish versionof the SURPS corresponded to the original (Woicik et al., 2009), includingfour dimensions: Lack of Self-Contentment (formerly Hopelessness),Anxiety Sensitivity, Impulsivity, and Sensation Seeking. The name “Lack ofSelf-Contentment” was suggested to replace “Hopelessness” for the subscaleto make it include all of the intended items and maintain the originalfour-factor structure. This difference was raised from the contextual mean-ing triggered by Turkish language. In Turkish, expressions such as “I amcontent,” “I am happy,” “I feel proud of my accomplishments,” “I feel thatI’m a failure,” and “I feel pleasant” are incapable of assessing negativeexpectancies that indicate hopelessness. In addition to the expressionsregarding attitudes toward the future such as “I have faith that my futureholds great promise” and “I am very enthusiastic about my future,” theaforementioned expressions appear to be closely related to the level of self-satisfaction.Internal consistencies for the four subscales were all adequate to good,

indicatingg that all of the items within each of the subscales acted as indi-cators of the same construct without redundancy. Items 22, 16, and 17were carefully evaluated. The factor loading of item 22 (“I feel I have to bemanipulative to get what I want”) on the Impulsivity subscale was inter-preted as poor according to Comrey and Lee’s grading (Comrey & Lee,1992); this was also noted with the Japanese and Spanish versions (Omiyaet al., 2015; Robles-Garcia et al., 2014). Even so, item 22 was adopted as inthe other validation studies and the original study (Canfield et al., 2015;Woicik et al., 2009). In terms of content in Turkish, manipulation of a situ-ation or person for gain could be perceived as the result of more complexplanning before action rather than acting without considering the result.Including item 22, all of the impulsivity items appear to measure deficits inbehavioral response inhibition when an individual chooses immediaterewards in the environment despite longer term negative consequences(Woicik et al., 2009).Only item 16 and item 17 cross-loaded on to another factor as well as the

expected factor of the original SURPS. In the original study, Woicik et al. founditem 16 to correspond to the intended factor (sensation seeking) by using bothexploratory and confirmatory factor analyses (Woicik et al., 2009). However,Krank et al. and Castellanos-Ryan et al. removed this item in the other valid-ation studies because it was not included in the proposed model as a sensation-seeking item (Castellanos-Ryan et al., 2013; Krank et al., 2011). As in the ori-ginal SURPS, item 16 was included as a sensation-seeking factor in the explora-tory factor analysis because the communality of item 16 was interpreted asgood in comparison with the impulsivity factor according to Comrey and Lee’sgrading (Comrey & Lee, 1992). Although they are known to be significantly

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE 11

related to each other, sensation seeking, or the desire for intense and novelexperiences, can be distinguished from impulsivity, described as the inability tocontrol behavior in the face of cues for reward and/or punishment (Conrod,Pihl, et al., 2000). While impulsivity reflects deficits in response inhibition, sen-sation seeking shows the tendency to seek out stimuli that enhance experience(Woicik et al., 2009). Nevertheless, the meaning of item 16 (“I am interested inexperience for its own sake, even if it is illegal”) includes both a long-term pun-ishment and a new experience.The content of item 17 (“I feel that I’m a failure”) overlapped on nega-

tive affectivity (including anxiety sensitivity and lack of self-contentment[formerly hopelessness]) in the present study. Similarly, item 17 modestlycross-loaded onto anxiety sensitivity in the original study that high schoolstudents who ranged in age from 14 to 18 years participated in; it was pre-ferred to be kept in the intended factor (hopelessness) (Woicik et al.,2009). Item 17 was also accepted in the Turkish version according to theoriginal SURPS, although the factor loadings on both lack of self-content-ment (formerly hopelessness) and anxiety sensitivity were interpreted aspoor according to Comrey and Lee’s grading (Comrey & Lee, 1992). Bothhopelessness and anxiety sensitivity have already been shown to be associ-ated with higher depression scores in the previous studies (Newton et al.,2016). The statement “I’m a failure” can be interpreted as a negative corebelief about oneself in depression.Reliability was also demonstrated by a test–retest analysis that revealed

significant relationships between test and retest scores. Correlationsbetween the SURPS subscales and the other scales indicated that the Lackof Self-Contentment subscale (formerly Hopelessness) was related to theBeck Hopelessness Scale assessing feelings about the future, loss of motiv-ation, and expectations, and the impulsivity subscale of the BarrattImpulsivity Scale that assesses the personality/behavioral construct ofimpulsiveness. Surprisingly, the Arnett Inventory of Sensation Seeking,including 20 items such as “If I were to go to an amusement park, I wouldprefer to ride the rollercoaster or other fast rides” and “I would like totravel to places that are strange and far away” was inversely related to theSensation Seeking subscale. Sensation seeking can be expressed in a varietyof ways, some culturally and some socially acceptable or unacceptable,depending on the extent to which the individual’s socialization environ-ment guides or suppresses the sensation-seeking tendency. The reliablecompletion of the Arnett inventory may have been influenced by culturaland social factors in Turkish adolescents due to the various aspects of theitems such as “I can see how it would be interesting to marry someonefrom a foreign country” and “I would never like to gamble with money,even if I could afford it.”

12 S. D. UYGUN ET AL.

The results of this study should be considered in the light of severallimitations.First, the predictive and convergent validity could not be assessed in the

present study. The relationship between the personality traits and substanceuse have already been shown both concurrently and prospectively in adap-tations of SURPS in different languages and cross-cultural samples(Canfield et al., 2015; Castellanos-Ryan et al., 2013; Castonguay-Jolin et al.,2013; Chandrika Ismail et al., 2009; Jurk et al., 2015; Krank et al., 2011;Malmberg et al., 2010; Newton et al., 2016; Omiya et al., 2015; Robles-Garcia et al., 2014; Saliba et al., 2014; Schlauch et al., 2015; Siu, 2011;Woicik et al., 2009). Although the present study provides robust evidenceto support the sensitivity of SURPS in identifying adolescents at high riskby measuring the personality traits related to substance abuse, further stud-ies assessing its predictive and convergent validity in Turkish samples arenecessary to develop early interventions against the personality dimensionslinked to specific drug abuse.Second, the design of the present study involved a total school sample

with a completion rate of 81.5%. The variability of the personality traitscannot be fully appraised. Longitudinal studies are needed to address vari-ability in personality traits and subsequent development of substance abuse.Third, the data were collected through self-reports, which can be prob-

lematic. Nevertheless, given assurance of confidentiality, assessing only per-sonality dimensions instead of substance use directly seems to be areasonable approach.Fourth, the results comprise two school samples in a metropolitan area in

the capital of Turkey and cannot necessarily be generalized to other regionsand in particular more rural provinces in the country. Further studies shouldbe planned to evaluate additional samples, including individuals whouse substances.Despite these limitations, the current study provides strong support for

adequate reliability and validity of the Turkish version of the SURPS, whichappears to be a promising measure for assessing adolescent personalitydimensions related to substance abuse risk and for future use in predictionand prevention of substance use among high-risk youth in Turkey.

Acknowledgments

Special thanks are given to Patricia Woicik and Aydo�gan Yanılmaz, who contributed toour study.

Disclosure statement

None of the authors have any conflicts of interest or financial ties to disclose.

JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE 13

Funding

This study did not receive any specific grant from funding agencies in the public, commer-cial, or not-for-profit sectors.

ORCID

Sabide Duygu Uygun http://orcid.org/0000-0003-1177-7256Kadir Ozdel http://orcid.org/0000-0002-3712-9444

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