Young Adults Coping with Sibling Loss: Risk and Protective Factors for Substance Use Disorder

Purpose: Although significant progress has been made in understanding substance use disorder (SUD), little research has specifically examined risk and protective factors among young adults coping with sibling loss. While some bereaved individuals develop SUD, others successfully implement protective strategies. Methods: The current study (N = 490; 260 bereaved, 230 non-bereaved) explored the associations of risk and protective factors with SUD, grouped into three categories: psychopathology (depression, anxiety, stress), grief-related aspects (personal growth, guilt, self-blame, regret, inadequacy, self-hatred, self-reassurance, stigma toward loss), and interpersonal relationships (quality of parental communication). Results: Higher-quality communication with parents was associated with a lower likelihood of developing SUD. Additionally, the relationships between depression, stress, and SUD were significantly moderated by sibling loss. Specifically, among bereaved young adults, increased guilt (mediated by anxiety and depression) heightened SUD risk, whereas increased feelings of inadequacy and stigma toward loss were associated with reduced risk. Conclusions: These findings underscore the importance of targeted support and interventions for young adults experiencing sibling loss, highlighting pathways that can reduce vulnerability to SUD.