Cultural Selfhood, Stress Coping, and the Logic of Self-Medication among Japanese Adolescents

Abstract

Concerns over hidden kinds of psychological discomfort have increased as a result of the constraints placed on Asian adolescents by their strict societal standards and exam-driven educational system. The present study employs Self-Medication Hypothesis, Stress and Coping Theory, and cultural self-construal theory to analyze non-prescription drug misuse among Japanese adolescents. Findings of this study reveal that Japan’s interdependent self-construal—emphasizing group harmony and private/public dissociation—triggers adolescents’ appraisal of academic stressors (“examination hell”) and relational stressors (“ignoring-type bullying”) as collective shame. Consequently, professional psychological support is deemed “culturally unavailable,” leading adolescents to adopt covert self-medication as a culturally congruent coping strategy. Notably, over-the-counter (OTC) drug misuse exceeds stimulant use in this cohort. Substances (e.g., diphenhydramine, dextromethorphan) function as “biochemical armor” against specific relational traumas, enabling “pseudo-participation” while preserving social face. The study elucidates a triadic reinforcement mechanism where cognitive, cultural, and stress-coping dimensions interact cyclically. Interventions must concurrently target all three dimensions.