Predictive Role of Psychological Distress and Assertiveness in High-Risk Behaviors among Female Adolescents in Ahvaz, Iran

Abstract

Background: Adolescence is a period marked by increased vulnerability to high-risk behaviors, which pose substantial public health challenges due to a complex interplay of internal psychological and social factors. The present study sought to examine the predictive role of psychological distress and assertiveness in high-risk behaviors among female adolescents in Ahvaz, Iran.

Methods: This descriptive-correlational study was conducted during the 2024–2025 academic year. A sample of 272 female adolescents was selected via multistage cluster sampling. Instruments included the High-Risk Behavior Questionnaire, the Depression Anxiety Stress Scales-21 (DASS-21), and the Assertion Inventory. Data analysis involved Pearson correlation coefficients and simultaneous multiple regression.

Results: Psychological distress emerged as a significant positive predictor of high-risk behaviors, whereas assertiveness exhibited a significant negative association with such behaviors (p<0.001). The multiple regression model was statistically significant (F=51.04, p<0.001), with psychological distress and assertiveness jointly explaining 31.8% of the variance in high-risk behaviors among the participants.

Conclusion: Psychological distress and diminished assertiveness represent key determinants of high-risk behaviors in female adolescents. Accordingly, school-based interventions emphasizing emotional regulation strategies and assertiveness skills training are recommended to reduce behavioral risks and promote overall adolescent well-being.