A prospective examination of the path from child abuse and neglect to illicit drug use in middle adulthood: the potential mediating role of four risk factors

The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective

BACKGROUND

Gender-specific interventions are crucial in addressing substance use disorders -particularly cannabis use disorder - as they allow for tailored therapeutic approaches and increase the likelihood of successful outcomes. However, differences in therapeutic processes and outcomes between males and females are often not observed, making the prognosis and development of such interventions more difficult.

OBJECTIVE

This study aimed to examine the moderating role of sex in the relationship between treatment admission profile characterized by indicators of cannabis use and sociodemographic sources of gender inequality (e.g., employment status) and adherence and outcome at discharge.

METHOD

A multicentric retrospective observational study was conducted with a sample of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records were used for data analysis.

RESULTS

The interaction between sex and the number of children, as well as pre-treatment cannabis use, predicted lower treatment adherence, particularly among females. Additionally, the interaction between sex and the number of children predicted outcomes at discharge, with females showing a higher likelihood of dropout compared to males.

DISCUSSION AND CONCLUSION

Enhanced comprehensive treatment with intensified contingency management programs should be prioritized for females (especially those with children) who have consumed cannabis in the month before treatment. Adopting a treatment policy framework incorporating sex/gender-sensitive therapist training and evaluative measures is essential for optimizing treatment outcomes for all patients.

"Weeding out" violence? Translational perspectives on the neuropsychobiological links between cannabis and aggression

Recent shifts in societal attitudes towards cannabis have led to a dramatic increase in consumption rates in many Western countries, particularly among young people. This trend has shed light on a significant link between cannabis use disorder (CUD) and pathological reactive aggression, a condition involving disproportionate aggressive and violent reactions to minor provocations. The discourse on the connection between cannabis use and aggression is frequently enmeshed in political and legal discussions, leading to a polarized understanding of the causative relationship between cannabis use and aggression. However, integrative analyses from both human and animal research indicate a complex, bidirectional interplay between cannabis misuse and pathological aggression. On the one hand, emerging research reveals a shared genetic and environmental predisposition for both cannabis use and aggression, suggesting a common underlying biological mechanism. On the other hand, there is evidence that cannabis consumption can lead to violent behaviors while also being used as a self-medication strategy to mitigate the negative emotions associated with pathological reactive aggression. This suggests that the coexistence of pathological aggression and CUD may result from overlapping vulnerabilities, potentially creating a self-perpetuating cycle where each condition exacerbates the other, escalating into externalizing and violent behaviors. This article aims to synthesize existing research on the intricate connections between these issues and propose a theoretical model to explain the neurobiological mechanisms underpinning this complex relationship.

Relationship Between Sexual Abuse and Substance Use Among Students from Caribbean Colombian

Sexual abuse is a public health problem due to its negative impact on physical and mental health. This study aimed to determine the association between sexual abuse and the use of psychoactive substances among high-school adolescents in Colombia. A cross-sectional analytical study was designed in which tenth and eleventh-grade students were included. Overall, a history of sexual abuse was explored with the Trauma Symptom Checklist, and lifetime substance use was assessed with the United States Centers for Disease Control Youth Risk Behavior Questionnaire. The prevalence of sexual abuse was 17.4%, lifetime alcohol use was 77.4%, cigarette 22.4%, cannabis 11.6%, cocaine 2.7%, and other substances 5.1%. History of sexual abuse was associated with alcohol use (OR = 1.59, 95% CI 1.10-2.30), cigarette (OR = 2.08, 95% CI 1.51-2.85), cannabis (OR = 2.43, 95% CI 1.66-3.56), cocaine (OR = 2.51, 95% CI 1.25-5.04) and use of other substances (OR = 2.33, 95% CI 1.31-4.13). The history of sexual abuse is related to the use of substances in high school adolescents in the Caribbean Region of Colombia. More studies are needed to identify the impact of sexual abuse on short-term and lifelong mental health.

The associations among childhood trauma, loneliness, mental health symptoms, and indicators of social exclusion in adulthood: A UK Biobank study

AIMS

Childhood trauma has been associated with adult psychosocial outcomes linked to social exclusion. However, the strength of these associations in the general population is unknown. The emergence of the UK Biobank, with rich phenotypic characterization of the adult population, affords the exploration of the childhood determinants of adult psychopathology with greater statistical power. The current study aims to explore (1) the associations between childhood trauma and social exclusion in adulthood and (2) the role that self-reported loneliness and symptoms of distress play in the associations.

METHODS

This study was an analysis of 87,545 participants (mean [± SD] age = 55.68 [7.78], 55.0% female, 97.4% White) enrolled in the UK Biobank. Childhood trauma was determined by the five-item Childhood Trauma Screener. Current loneliness and symptoms of anxiety (Generalized Anxiety Disorder Scale-7) and depression (Patient Health Questionnaire-9) were also entered in analyses. Outcomes were "limited social participation," "area deprivation," "individual deprivation," and "social exclusion" from a previously determined dimensional measure of social exclusion in the UK Biobank.

RESULTS

Hierarchical multiple regression models indicated small associations between childhood trauma and social exclusion outcomes, explaining between 1.5% and 5.0% of the variance. Associations weakened but remained significant when loneliness, anxiety, and depression were entered in the models; however, anxiety symptoms demonstrated a negative association with "individual deprivation" and "social exclusion" in the final models. Depression was most strongly associated with "individual deprivation," "area deprivation," and "social exclusion" followed by childhood trauma. Loneliness was most strongly associated with "limited social participation."

CONCLUSIONS

Experiences of childhood trauma can increase the propensity for adulthood social exclusion. Loneliness and symptoms of depression attenuate but do not eliminate these associations. Anxiety symptoms have a potentially protective effect on the development of "individual deprivation." Findings add to the growing body of literature advocating for trauma-informed approaches in a variety of settings to help ameliorate the effects of childhood trauma on adult psychosocial outcomes. Further research, however, is required.

Child maltreatment and substances use throughout adolescence and adulthood: Data from a Brazilian Birth Cohort

BACKGROUND

Child maltreatment has been associated with substance use later in life, but few studies have used repeated measures.

OBJECTIVE

To assess the association between child maltreatment and use of psychoactive substances from adolescence to early adulthood, and whether this differs by sex.

PARTICIPANTS AND SETTING

3641 participants from the 1993 Pelotas Birth Cohort, Brazil.

METHODS

Child maltreatment (psychological, physical and sexual abuse, and physical neglect) was assessed up to age 15 and use of psychoactive substances (smoking, harmful use of alcohol and use of illicit drugs) was assessed at ages 15, 18, and 22 years. Associations between child maltreatment and use of substances at each time point were analyzed using logistic regression, adjusted for confounders.

RESULTS

Overall, child maltreatment was associated with substance use, and the strength of the associations decreased over time. E.g., the association between psychological abuse and harmful use of alcohol was OR 2.17 (95%CI 1.80, 2.62; p-value < 0.001) at 15 years, OR 1.61 (95%CI 1.31, 1.97; p-value < 0.001) at 18 years, and OR1.55 (95%CI 1.22, 1.96; p-value < 0.001) at 22 years. When sex differences were evident, stronger associations were observed among females. E.g., the association between physical abuse and smoking at 15 years was OR 3.49 (95%CI 2.17, 5.62) in females and OR 0.87 (95%CI 0.30, 2.52) in males (p-value for sex interaction = 0.041).

CONCLUSIONS

Child maltreatment was associated with psychoactive substance in adolescence and early adulthood. Strategies to prevent use of substances could benefit those who suffered maltreatment in childhood.

Preventing E-cigarette use among high-risk adolescents: A trauma-informed prevention approach

Exposure to childhood trauma increases the risk of tobacco use during adolescence. Recent studies have also reported potentially increased vulnerabilities to electronic cigarette (e-cigarette) use among youth with a history of childhood trauma. While empirical evidence supporting the relationship between childhood trauma and adolescent e-cigarette use is emerging, few effective preventive interventions are available to curb e-cigarette use among adolescent victims of childhood trauma. This article reviews current evidence with respect to how childhood trauma could increase risk for nicotine dependence and e-cigarette use in adolescent populations. Furthermore, this paper describes the development, design, and implementation of Rise Above (RA), a randomized, controlled trial of a trauma-informed, e-cigarette preventive intervention. Lessons learned are also discussed, including the challenges of implementing evidence-informed prevention work within communities vulnerable to traumatic events.

A Gender Perspective of Addictive Disorders

Purpose of Review

Substance use disorders (SUD) affect differentially women and men. Although the prevalence has been reported higher in men, those women with addictive disorders present a more vulnerable profile and are less likely to enter treatment than men. The aim of this paper is to present an overview of how sex and gender may influence epidemiology, clinical manifestations, social impact, and the neurobiological basis of these differences of women with SUD, based on human research.

Recent Findings

The differences in prevalence rates between genders are getting narrower; also, women tend to increase the amount of consumption more rapidly than men, showing an accelerated onset of the SUD (telescoping effect). In respect to clinical features, the most important differences are related to the risk of experience psychiatric comorbidity, the exposure to intimate partner violence, and the associated high risks in sexual and reproductive health; and those who are mothers and addicted to substances are at risk of losing the custody of children accumulating more adverse life events. Some of these differences can be based on neurobiological differences: pharmacokinetic response to substances, sensitivity to gonadal hormones, differences in neurobiological systems as glutamate, endocannabinoids, and genetic differences.

Summary

Specific research in women who use drugs is very scarce and treatments are not gender-sensitive oriented. For these reasons, it is important to guarantee access to the appropriate treatment of women who use drugs and a need for a gender perspective in the treatment and research of substance use disorders.

The hopelessness effect: Counsellors' perceptions of their female clients involved in sex work in Canada

This qualitative study explored how counsellors who work with women currently or formerly involved in sex work perceive these women's future. From May to July 2016, we conducted semi-structured interviews with 21 counsellors providing psychosocial services in Canadian agencies with recognized mandates to support such women. The interview protocol was based on the Possible Selves Mapping Interview, adapted to explore the counsellors' hopes and fears for these clients. We subjected the interview transcripts to an interpretive descriptive analysis. Our findings centred on three themes: the counsellors' hopes for their clients' future, in light of their personal and social resources; the counsellors' fears about the cumulative devastating effects that their clients' work environment might have on them; and the counsellors' fears that these women would lose hope for the future. This study clearly demonstrates the importance of addressing the safety and well-being of women involved in sex work and of recognizing the impacts of social inequalities and structural barriers on these women's life paths. The implications of these findings for policies and practices are discussed at the end of this paper.

The role of catecholamines in modulating responses to stress: Sex-specific patterns, implications, and therapeutic potential for post-traumatic stress disorder and opiate withdrawal

Emotional arousal is one of several factors that determine the strength of a memory and how efficiently it may be retrieved. The systems at play are multifaceted; on one hand, the dopaminergic mesocorticolimbic system evaluates the rewarding or reinforcing potential of a stimulus, while on the other, the noradrenergic stress response system evaluates the risk of threat, commanding attention, and engaging emotional and physical behavioral responses. Sex-specific patterns in the anatomy and function of the arousal system suggest that sexually divergent therapeutic approaches may be advantageous for neurological disorders involving arousal, learning, and memory. From the lens of the triple network model of psychopathology, we argue that post-traumatic stress disorder and opiate substance use disorder arise from maladaptive learning responses that are perpetuated by hyperarousal of the salience network. We present evidence that catecholamine-modulated learning and stress-responsive circuitry exerts substantial influence over the salience network and its dysfunction in stress-related psychiatric disorders, and between the sexes. We discuss the therapeutic potential of targeting the endogenous cannabinoid system; a ubiquitous neuromodulator that influences learning, memory, and responsivity to stress by influencing catecholamine, excitatory, and inhibitory synaptic transmission. Relevant preclinical data in male and female rodents are integrated with clinical data in men and women in an effort to understand how ideal treatment modalities between the sexes may be different.

Midlife reversibility of early-established biobehavioral risk factors: A research agenda

Epidemiological evidence links exposure to early life adversities-such as childhood maltreatment-with impaired health and well-being in adulthood. Since these effects are usually unrecognized or untreated in childhood, preventive and remediating interventions in adults are needed. Our focus on adulthood prompted three major questions. First, does our increased understanding of mechanisms accounting for the long-term effects of early life adversities help delineate underlying dimensions that underscore key similarities and differences among these adversities? Second, can adults accurately report on adversities they experienced in childhood? Third, can we identify malleable risk processes in adulthood that might be targets for preventive intervention? Supported by the National Institute on Aging, the U.K. Economic and Social and the Biotechnology and Biological Sciences Research Councils, a network of researchers in human and animal development addressed these questions through meetings and literature review. A small number of dimensions may adequately distinguish among a range of co-occurring childhood adversities. Widely used adult ascertainments of childhood adversity are poorly related to prospective ascertainment. Strategies for preventive interventions should be aimed both at adults who were actually exposed to adversity as well as those who recall adversity, but the targeted risk processes may be different. Now is an opportune time to support research on adult interventions based on unfolding research on critical periods of sensitivity to adversity in fetal and child development, on improved understanding of risk mechanisms that may persist across the life span, and on new insights on enhancing neuroplasticity in adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Sex-based differences in multidimensional clinical assessments of early-abstinence crack cocaine users

Crack cocaine use disorder (CUD) has been related to sex differences. This work aimed to compare the severity of drug use and the severity of other negative related outcomes in males and females with CUD. A total of 1344 inpatients (798 males and 546 females) with crack cocaine use disorder (CUD) were evaluated by a detailed multidimensional clinical assessment, including addiction severity and trauma exposure. Linear regression predicted higher drug use severity (β = 0.273, p < 0.001) and more problems in domains related to childcare issues (β = 0.321), criminal involvement (β = 0.108), work-related problems (β = 0.281) and social support impairments (β = 0.142) for females, all with p < 0.001. Alcohol problems were predicted to be higher in males (β = -0.206, P < 0.001). Females had higher rates of other mental disorders, particularly trauma and stress-related disorders (OR: 3.206, CI: 2.22, 4.61). Important sex differences also emerged in trauma history and HIV infection prevalence. CUD has a more severe clinical presentation among females facing early abstinence. Sex differences in the CUD course indicate the need for consideration of sex-specific interventions and research.

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

INTRODUCTION

Childhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.

METHOD

Young adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.

RESULTS

We found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.

CONCLUSION

The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.

Sex differences in neural mechanisms mediating reward and addiction

There is increasing evidence in humans and laboratory animals for biologically based sex differences in every phase of drug addiction: acute reinforcing effects, transition from occasional to compulsive use, withdrawal-associated negative affective states, craving, and relapse. There is also evidence that many qualitative aspects of the addiction phases do not differ significantly between males and females, but one sex may be more likely to exhibit a trait than the other, resulting in population differences. The conceptual framework of this review is to focus on hormonal, chromosomal, and epigenetic organizational and contingent, sex-dependent mechanisms of four neural systems that are known-primarily in males-to be key players in addiction: dopamine, mu-opioid receptors (MOR), kappa opioid receptors (KOR), and brain-derived neurotrophic factor (BDNF). We highlight data demonstrating sex differences in development, expression, and function of these neural systems as they relate-directly or indirectly-to processes of reward and addictive behavior, with a focus on psychostimulants and opioids. We identify gaps in knowledge about how these neural systems interact with sex to influence addictive behavior, emphasizing throughout that the impact of sex can be highly nuanced and male/female data should be reported regardless of the outcome.

Childhood Adversity and Hazardous Drinking: The Mediating Role of Attachment Insecurity

BACKGROUND

Harmful alcohol use is associated with disease and mortality. Identifying new determinants of harmful drinking may aid the 16.3 million adults who have alcohol use disorders. Childhood adversity is associated with alcohol use, but is not amenable to change. Attachment insecurity (anxiety and avoidance) may be associated with alcohol use and may be a target for modification or used to personalize interventions.

OBJECTIVES

This study aims to (a) identify the association between attachment insecurity and harmful drinking, (b) determine if attachment insecurity may mediate between childhood adversity and harmful drinking, and (c) test sex as a moderator between attachment insecurity and harmful drinking in the mediation relationship.

METHODS

Adult primary care patients (N = 348, 60% women) completed a cross-sectional survey study using validated measures in 2012. Statistical analyses were performed using Hayes's PROCESS macro in SPSS.

RESULTS

Childhood adversity was reported by 61% of the cohort and 18% endorsed harmful drinking. Attachment anxiety was associated with harmful drinking (p >.001), but attachment avoidance was not (p =.11). Attachment anxiety may mediate between childhood adversity and harmful drinking (95% CI:.03-.14). Sex did not moderate the relationships between attachment anxiety and harmful drinking in the mediation relationship (women: 95% CI:.031-.179; men: 95% CI:.003.-.182). Conclusions/Importance: Attachment anxiety may mediate between childhood adversity and harmful drinking in both men and women. Attachment anxiety may be a potential therapeutic target for people with a history of childhood adversity.

An Examination of the Impact of Childhood Emotional Abuse and Gender on Cannabis Use Trajectories among Community Youth

Cannabis is the most frequently used illicit substance among youth, with rates of cannabis use escalating across adolescence. One potential factor predicting cannabis use among youth is childhood emotional abuse (CEA), which has been associated with substance use behaviors more broadly. Although CEA may be associated with increased cannabis use in general, it is likely that sex may have an impact on these relations, given that girls are more likely to use substances following abuse experiences than boys. The purpose of the current study as to examine longitudinal relations between CEA and gender on cannabis use during adolescence. The current study included a sample of 206 9th grade community youth (120 boys; Mage = 14.10, 55% European-American) followed annually through the 12th grade. CEA was assessed with the Childhood Trauma Questionnaire and cannabis use was assessed with the Youth Risk Behavior Survey. A latent growth model was utilized to examine cannabis use trajectories from grades 9-12. Within our initial model, elevated baseline use was associated with male gender and more severe CEA. Significant predictors of increases in cannabis use over time included elevated baseline alcohol use and the interaction between gender and CEA, such that girls with the most severe CEA had the greatest increases in cannabis use over time. These results suggest the importance of addressing CEA among adolescent girls. Given that cannabis use during adolescence is associated with a host of negative outcomes, targeted efforts to reduce use, through prevention and intervention efforts, is critical.

Examining Africentric Cultural Values, Ethnic Identity, and Substance Use Abstinence in Low-Income, Early Adolescent, African American Girls

An examination of cultural protective factors that foster substance use abstinence among low-income, early adolescent, African American girls may be helpful in understanding how to promote resilience and reduce negative health outcomes. This study examined the relations between Africentric cultural values, ethnic identity, and substance use abstinence among 196 low-income African American early adolescent girls (age 11-14 years). Results of logistic regressions revealed that Africentric values were negatively linked to cigarette and alcohol abstinence. Results also showed a significant positive interaction between Africentric cultural values and ethnic identity exploration that contributed to increased cigarette and alcohol abstinence. Implications for research and practice with African American early adolescent girls are discussed.

Intergenerational Mobility and Changes in Drug Use Across the Life Course

The consequences of “falling from grace”—or experiencing downward intergenerational mobility—are indeed becoming an abrupt reality for many entering the labor force. Scholars of social mobility speculate that such life course trajectories can result in antisocial behavior, but few have examined whether these trajectories lead to drug use. Thus, with the United States in the midst of a drug epidemic, as well as recovering from an economic recession, the study of social mobility may contribute to a better understanding of what causes individuals to turn to drugs. Using data from The National Longitudinal Study of Adolescent to Adult Health (Add Health) and a series of logistic diagonal reference models, this study examines the association between intergenerational social mobility and drug use. Overall, I find evidence that downward mobility is associated with increases in drug use, with the relationship strongest among those experiencing the greatest loss in status.

Child Maltreatment, Problem Behaviors, and Neighborhood Attainment

Using data from a prospective cohort design study of a group of children with documented histories of abuse and neglect (n = 908) and matched controls (n = 667), this paper examines whether problem behaviors (e.g., prostitution, crime, school problems, and homelessness) in young adulthood explain the link between maltreatment in childhood and living in high-risk neighborhoods in middle adulthood. Problem behaviors were assessed at mean age of 29 and neighborhood characteristics were assessed at mean age of 40. Child maltreatment predicted living in less desirable neighborhoods in middle adulthood. Problem behaviors in young adulthood partially mediated the relationship between childhood maltreatment and residence in less desirable neighborhoods in middle adulthood. The direct paths from child maltreatment to neighborhoods were not significant for Black children. For White children, there was a direct relationship between child maltreatment and living in an economically disadvantaged neighborhood. Problem behaviors were a stronger mediator between child maltreatment and living in more disordered and less socially cohesive neighborhoods for Black children, while the problem behaviors were a stronger mediator for living in more economically disadvantaged and less socially cohesive neighborhoods for White children. Further research is needed to understand these racial differences. Interventions should focus on preventing problem behaviors to minimize the risk of residency in high-risk neighborhoods.

Sex differences, gender and addiction

This review discusses alcohol and other forms of drug addiction as both a sociocultural and biological phenomenon. Sex differences and gender are not solely determined by biology, nor are they entirely sociocultural. The interactions among biological, environmental, sociocultural, and developmental influences result in phenotypes that may be more masculine or more feminine. These gender-related sex differences in the brain can influence the responses to drugs of abuse, progressive changes in the brain after exposure to drugs of abuse and whether addiction results from drug-taking experiences. In addition, the basic laboratory evidence for sex differences is discussed within the context of four types of sex/gender differences. © 2016 Wiley Periodicals, Inc.

Assault in children admitted to trauma centers: Injury patterns and outcomes from a 5-year review of the national trauma data bank

IMPORTANCE

While assault is commonly reported or suspected in children with traumatic wounds, a recent overview of these injuries, especially those requiring trauma surgery consultation is lacking in the literature.

OBJECTIVES

Explore the incidence, demographics and injury patterns of children presenting to trauma centers following an assault.

DESIGN

Retrospective review of the National Trauma Data Bank 2007 to 2011.

SETTING AND PARTICIPANTS

Subjects up to 18 years old with "assault" reported as the intent of injury. Patients were divided into infants (<2 years), young children (2-5 years), children (6-11 years), and adolescents (12-18 years).

MAIN OUTCOMES AND MEASURES

Mechanism of injury, injury severity and mortality based on age groups and race.

RESULTS

Of 609,207 children, 58,299 (9.6%) were victims of an assault. The median age was 16 years and 81% were male, with a median injury severity score (ISS) of 8. The majority of patients were adolescents (76%), followed by infants (17%) and young children (4%). There was a stepwise increase in the proportion of assaulted Black children with increasing age (23.2% for infants and up to 46.7% for adolescents, trend p < 0.01, effect size: 0.175) while the opposite applied for White children (46.0% for infants and down to 19.5% for adolescents, trend p < 0.01, effect size: -0.230). With increasing age, White subjects had the highest trend of being assaulted during an unarmed fight or brawl (p < 0.01, effect size: 0.393), while for Black victims the highest trend was noted for assault with a firearm (p < 0.01, effect size: 0.323). Almost 2 out of 3 infants sustained severe head trauma (59%). The overall mortality was 8%, highest among young children, where it reached 16% (p < 0.01).

CONCLUSIONS

Up to 10% of children admitted following trauma are victims of assault with traumatic brain injuries predominant in infants and firearm injuries predominant in adolescents. Injury patterns largely correlate to age and race. Assault in children is associated with a high mortality risk. These data highlight the magnitude of the problem and calls for further involvement of trauma surgeons to improve outcomes, bring awareness and promote preventative strategies to eliminate assault in children.

Examining the Contemporaneous, Short-Term, and Long-Term Effects of Secondary Exposure to Violence on Adolescent Substance Use

The relationship between secondary exposure to violence-defined as witnessing violence in the home, community, or school-and adolescent substance use is well-documented. Yet, multi-wave empirical studies examining this relationship are sparse. In addition, studies have only begun to examine whether this relationship varies by the situational components of the violent event. Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), this study examines the contemporaneous, short-term, and long-term effects of secondary exposure to violence on substance use, and whether witnessing violence in which a weapon is present has a different impact on adolescent substance use than does witnessing violence without a weapon. Hierarchical logistic regression models on a racially and ethnically diverse sample of 1670 youth (51.5% female) residing in 79 neighborhoods indicated that: (1) the effects of secondary exposure to violence on alcohol and marijuana use were enduring, albeit attenuated, over time; (2) the effect of secondary exposure to violence on illicit drug use was suppressed in the short-term but significant in the long-term; (3) witnessing violence without a weapon was salient for alcohol and marijuana use at all time points; and (4) witnessing violence with a weapon impacted illicit drug use in the long-term. The results suggest that addressing the consequences of secondary exposure to violence requires prolonged intervention efforts and that the study of secondary exposure to violence requires a more nuanced approach that accounts for situational aspects of the violent event.

Increasing Overall Well-Being is Salient in Treating Homelessness

Homeless treatment programs have focused on physical solutions rather than attending to all aspects of well-being. Support services that address overall well-being have demonstrated effectiveness. Previous research suggests that overall well-being is defined as satisfaction within all life spheres. Objective life indices have been the primary evidence of success among various programs, which include food, housing, income, leisure, health, access to psychiatric and medical services, and maintenance of positive support networks. This does not account for other important subjective components, such as psychiatric symptoms and quality of life. This study was designed to assess quality of life and psychiatric symptoms among the people who were chronically and formerly chronically homeless. The people who were formerly chronically homeless are defined as individuals who were chronically homeless in the past but have successfully remained in housing for 6 months or more and have access to intensive case management services. People who are chronically homeless are homeless individuals who have lacked a residence for a year or more or have had four or more episodes in three years, are single, and have a persistent disability. Participants completed the Oxford Happiness Scale, Brief Symptom Inventory, and a brief questionnaire. All participants were disabled in accordance with the definition of chronic homelessness adopted by the U.S. Department of Housing and Urban Development. This researcher hypothesized that high quality-of-life scores, low frequency of psychiatric symptoms, and greater access to basic life indices indicate happiness overall. Additionally, it was hypothesized that people who are chronically homeless have a higher foster care rate than the general population.

Alcohol-Impaired Driving: The Influence of Adverse Rearing Environments, Alcohol, Cannabis Use, and the Moderating Role of Anxiety

BACKGROUND

The rate of alcohol-impaired driving (AID) increases during the college years and students who have reported adverse rearing environments appear to be at increased risk for the development of alcohol and drug use behaviors. Alcohol and cannabis are the most commonly used drugs by college students, and these substances are particularly predictive of substance-impaired driving.

OBJECTIVES

The present study aimed to investigate whether adverse rearing environment experiences and level of alcohol and cannabis use are related to the frequency of alcohol-impaired driving and whether anxiety might buffer or accelerate this effect.

METHODS

Data regarding adversity, drug use, anxiety, and AID were obtained from 1,265 students annually, from first to final year of college, over four waves (Mean Age at wave 1 = 18.5 years).

RESULTS

Structural equation modeling supported associations among childhood adversity, alcohol, cannabis, and anxiety symptoms. A significant mediation effect was found such that adversity was predictive of AID via alcohol use and cannabis use. Among men, anxiety symptoms accelerated the path from increased cannabis use and decelerated the path from increased alcohol use to AID frequency. Conclusions/Importance: Childhood adversity is a developmental risk precursor to drug use and AID, whereas anxiety might serve a risk or protective factor to AID, contingent on the drug used.

Gender Differences in Risk Factors for Adolescent Binge Drinking and Implications for Intervention and Prevention

Alcohol use, particularly binge drinking (BD), is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females' increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1) developmental-related neurobiological vulnerability to BD, (2) psychiatric comorbidity and risk phenotypes for BD, and (3) social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa. A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and impress others, while male gender role stereotypes regarding BD may be more of a risk factor for boys. Given these unique differences in male and female risk for BD, further research exploring risk factors, as well as tailoring intervention and prevention, is necessary. Although recent research has tailored substance use intervention to target males and females, more literature on gender considerations in treatment for prevention and intervention of BD in particular is warranted.

Sex differences in behavior and neural development and their role in adolescent vulnerability to substance use

Adolescents are especially prone to risky behavior and to the emergence of psychological disorders like substance abuse, anxiety and depression. However, there is a sex (or gender) difference in this vulnerability, with females being more prone to developing internalizing disorders and males being more likely to engage in risky behavior and drug use. While several researchers have proposed that there is a relationship between corticolimbic circuit development and adolescent vulnerability, the current proposed models do not take sex differences into account. In this review, we explore recent findings from both human and rodent studies of sex differences during adolescence. In particular, we consider epidemiological studies on the factors that contribute to the development of substance abuse and internalizing disorders, laboratory studies on reward-related and decision-making behavior, and neuroanatomical studies on the development of several structures in the corticolimbic circuit (i.e., prefrontal cortex [PFC], amygdala and striatum). We then integrate these recent findings into models of adolescent vulnerability to substance use that have previously not addressed sex differences. Lastly, we discuss methodological considerations for the interpretation and design of studies on sex (or gender) differences during adolescence while highlighting some opportunities for future investigations.

Childhood maltreatment and violence: mediation through psychiatric morbidity

Childhood maltreatment is associated with multiple adverse outcomes in adulthood including poor mental health and violence. We investigated direct and indirect pathways from childhood maltreatment to adult violence perpetration and the explanatory role of psychiatric morbidity. Analyses were based on a population survey of 2,928 young men 21-34 years in Great Britain in 2011, with boost surveys of black and minority ethnic groups and lower social grades. Respondents completed questionnaires measuring psychiatric diagnoses using standardized screening instruments, including antisocial personality disorder (ASPD), drug and alcohol dependence and psychosis. Maltreatment exposures included childhood physical abuse, neglect, witnessing domestic violence and being bullied. Adult violence outcomes included: any violence, violence toward strangers and intimate partners (IPV), victim injury and minor violence. Witnessing domestic violence showed the strongest risk for adult violence (AOR 2.70, 95% CI 2.00, 3.65) through a direct pathway, with psychotic symptoms and ASPD as partial mediators. Childhood physical abuse was associated with IPV (AOR 2.33, 95% CI 1.25, 4.35), mediated by ASPD and alcohol dependence. Neglect was associated with violence toward strangers (AOR 1.73, 95% CI 1.03, 2.91), mediated by ASPD. Prevention of violence in adulthood following childhood physical abuse and neglect requires treatment interventions for associated alcohol dependence, psychosis, and ASPD. However, witnessing family violence in childhood had strongest and direct effects on the pathway to adult violence, with important implications for primary prevention. In this context, prevention strategies should prioritize and focus on early childhood exposure to violence in the family home.

Characteristics of Child Maltreatment and Adolescent Marijuana Use: A Prospective Study

There has been increasing acceptance of marijuana use in the United States in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this article, we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with heavy use of marijuana. These findings suggest the importance of comprehensively assessing children's maltreatment experiences and their peers' drug use to help prevent or address possible marijuana use in these high-risk adolescents.

Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study

AIMS

Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking).

METHODS

Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n = 1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex.

RESULTS

In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample.

CONCLUSIONS

This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes.

Substance-Abusing Female Offenders as Victims: Chronological Sequencing of Pathways Into the Criminal Justice System

This study assesses the entrance of substance-abusing female offenders (N=1,209) into the criminal justice system through temporal patterns (using age of first victimization, drug use and arrest). Nine pathways were identified. Unexpectedly, the leading path was a sequence where drug use preceded arrest in absence of childhood victimization. However, women under a path inclusive of victimization possessed more risk factors. Findings support feminist pathway research, which states that childhood victimization is generally present in female offenders' lives. Nevertheless, results also revealed that a drug pathway without childhood abuse proved to be as important and even more dominant among criminal justice-involved women.

Delivery of a mainstreaming treatment model towards co-existing difficulties: a brief exploration of practitioners’ understanding, views and reported experiences

Purpose

– The purpose of this paper is to describe the delivery of a mainstreaming model within a public sector, mental health (National Health Service (NHS)) organisation. The model promotes the inclusivity of a spectrum of presentations from co-existing moderate anxiety and depression to severe mental disorder (psychosis) and problematic substance and alcohol use.

Design/methodology/approach

– This paper introduces the delivery of three collective approaches, termed the “three essential elements” to support a mainstreaming treatment model, facilitated by a “Dual Diagnosis Lead”. The model encompasses; a “direct access” referral pathway, joint collaboration with practitioners and the delivery of a “Dual Diagnosis” training programme. An independent evaluation was commissioned to explore eight mental health and substance misuse practitioners’ views and experiences in relation to the impact of the mainstreaming model. This paper also considers feedback from 230 course participants attending a one day “Dual Diagnosis” training programme.

Findings

– This paper suggests that practitioners may benefit from the implementation of the mainstreaming approach and the delivery of this approach could be moving “Dual Diagnosis” interventions closer to mainstream practice.

Research limitations/implications

– The limitations of the mainstreaming model are acknowledged in relation to the generalisation of practitioners’ views and reported experiences.

Originality/value

– This paper offers a description of the delivery of a mainstreaming model involving the “three essential elements”. The model provides a useful insight and demonstrates the possibilities which may be achieved when attempting to implement a mainstreaming treatment approach within mainstream mental health and drug and alcohol services.

Psychological, physical, and sexual abuse in addicted patients who undergo treatment

This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed.

Childhood victimization, attachment, psychological distress, and substance use among women on probation and parole

The present analysis was guided by a gendered pathways-based theoretical model and examined relationships between childhood victimization and current attachment, psychological distress, and substance use among 406 women with histories of victimization who were on probation and parole in an urban Kentucky county. Structural equation modeling examined relationships among childhood victimization, attachment, psychological distress, and substance use. Additionally, we examined the mediational role that attachment plays in relationships between childhood victimization and both psychological distress and substance use. The data fit the models properly. Psychological distress was significantly predicted by childhood victimization, and adult attachment partially mediated this relationship. Childhood victimization did not significantly predict substance use; however, attachment did. The findings suggest that attachment may be an important factor to further understand and address in relation to psychological distress and substance use among women with histories of victimization who are involved in the criminal justice system.

Existe-t-il des différences entre les hommes et les femmes en ce qui concerne les problèmes de toxicomanie ?

La consommation et la dépendance aux drogues furent longtemps considérées comme un problème typiquement masculin. Néanmoins, bien que l’abus et la dépendance à l’alcool, au cannabis et à la nicotine soient encore plus répandus chez les hommes, les différences de genre en ce qui concerne les stimulants et les opiacés ont largement disparu. Il semblerait également que les motivations pour commencer à consommer, l’escalade vers la dépendance et les taux de cessation diffèrent chez les hommes et les femmes. Les raisons qui expliquent ces différences sont multiples et complexes. Nous allons examiner ici les données des études épidémiologiques et cliniques concernant la consommation de diverses drogues chez des hommes et chez des femmes en contexte des facteurs socioculturels, psychologiques et neurobiologiques.

Rejection attitudes, poor parental bonding, and stressful life events in heroin addicts' families

BACKGROUND

The influence of family factors on the development and/or on maintenance of heroin addiction still remains unclear.

OBJECTIVES

The aim of this study was to investigate family factors, which might be associated with heroin addiction in a sample of male individuals.

METHODS

A group of 40 heroin addicts' families was compared with a group of 17 families with a member presenting schizophrenia and a group of 27 families with mentally healthy members in regard to (1) parents' rejection attitudes toward their adult child, (2) quality of parental bond, as perceived by the adult child, and (3) stressful life events in the nuclear family.

RESULTS

The main findings showed that the degree of rejection by the fathers in the heroin addicts' families as well as in the subjects with schizophrenia was significantly higher compared to the fathers' degree of rejection in the control group. Moreover, the degree of rejection by mothers in the heroin addicts' families was significantly higher compared to the mothers' degree of rejection in the control group. Heroin addicts reported that they had perceived less care from their fathers than healthy controls. The total number of stressful life events in the nuclear family was higher in the patients with schizophrenia in comparison to the healthy controls. Also, in the heroin addicts' group, a significantly higher number of fathers presented a current or past psychiatric disorder.

CONCLUSIONS

The findings of this study showed the importance of negative family factors in the course of heroin addiction.

VARIETIES OF VIOLENT BEHAVOR

There is an implicit assumption of homogeneity across violent behaviors and offenders in the criminology literature. Arguing against this assumption, I draw on three distinct literatures [child abuse and neglect (CAN) and violence, violence and post-traumatic stress disorder (PTSD), and CAN and PTSD] to provide a rationale for an examination of varieties of violent behaviors. I use data from my prospective cohort design study of the long-term consequences of CAN to define three varieties of violent offenders using age of documented cases of CAN, onset of PTSD, and first violent arrest in a temporally correct manner [CAN → to violence, CAN → PTSD → violence (PTSD first), and CAN → violence → PTSD (violence first)], and a fourth variety, violence only. The results illustrate meaningful heterogeneity in violent behavior and different developmental patterns and characteristics. There are three major implications: First, programs and policies that target violence need to recognize the heterogeneity and move away from a "one-size-fits-all" approach. Second, violence prevention policies and programs that target abused and neglected children are warranted, given the prominent role of CAN in the backgrounds of these violent offenders. Third, criminologists and others interested in violence need to attend to the role of PTSD, which is present in about one fifth (21 percent) of these violent offenders, and not relegate the study of these offenders to the psychiatric and psychological literatures.

Do incest, depression, parental drinking, serious romantic relationships, and living with parents influence patterns of substance use during emerging adulthood?

This study examined how incest, depression, parental drinking, relationship status, and living with parents affect patterns of substance use among emerging adults, 18 to 25 years old. The study sample included (n = 11,546) individuals who participated in Waves I, II, and III of the National Longitudinal Study of Adolescent Health (Add Health). The study used separate latent class analysis for males and females to determine how patterns of substance use clustered together. The study identified the following three classes of substance use: heavy, moderate, and normative substance use patterns. Multinomial logistic regression indicated that, for females only, incest histories also nearly doubled the risk of heavy-use class membership. In addition, experiencing depression, being single, and not living with parents serve as risk factors for males and females in the heavy-use group. Conversely, being Black, Hispanic, or living with parents lowered the likelihood of being in the group with the most substance use behaviors (i.e., heavy use). Findings highlight the need for interventions that target depression and female survivors of incest among emerging adults.

The relationship between substance use and sexual health among African-American female adolescents with a history of seeking mental health services

BACKGROUND

This study examined relationships between substance use patterns and problems and sexual health outcomes among low-income, urban, African-American female adolescents with a history of seeking mental health services.

METHODS

Participants were recruited from outpatient mental health clinics serving urban, primarily low-income youth and families in Chicago, Illinois, as part of a 2-year, longitudinal investigation of HIV risk behavior during which they completed interviews every 6 months (five time points). Girls who completed at least one follow-up interview were invited to participate in a sixth wave of assessment to assess trauma exposure, substance use problems, and sexual risk. The current study (n = 177) examined the association between sexual risk behavior and substance use problems reported at the most recent interview (ages 14-22) and substance use patterns and sexually transmitted infections (STI) reported at all six times points. Multiple regression examined the combined and unique effects of different patterns of substance use and substance use problems as correlates of sexual risk behavior and STIs.

FINDINGS

Substance use problems were associated with increased sexual risk behavior and increased likelihood of experiencing STIs. Substance use patterns were associated with sexual risk behavior.

CONCLUSIONS

Results suggest that specific patterns of substance use and substance use problems are important to address in sexual health promotion among low-income, urban, African-American girls with a history of seeking mental health services. Understanding the nuances of these relationships is important in informing how to best serve this vulnerable group of adolescents who experience significant sexual risk and mental health care disparities.

The role of gender in the association between child maltreatment and substance use behavior: a systematic review of longitudinal research from 1995 to 2011

This systematic review analyzes the role of gender in the association between childhood maltreatment and substance use outcomes, among longitudinal papers published between 1995 and 2011. Ten papers examined gender as a moderating variable. Results on gender differences were mixed. When studies that found no gender effects were compared with studies that did identify gender effects, differences in measurement, sample composition, and developmental timing of outcomes were identified. This review also examines how gender effects are assessed. Implications and limitations of these findings are discussed. Areas for future research are identified.

Prevalence and Demographic Distribution of Adult Survivors of Child Abuse in Japan

A cross-sectional study was conducted with a national epidemiological survey to investigate the prevalence and demographic distribution of adult survivors of child abuse in Japan. A self-administered questionnaire was used to measure the history of child abuse and the demographic characteristics. The participants reported the following 4 types of child abuse: physical abuse (3%), sexual abuse (0.6%), neglect (0.8%), and psychological abuse (4%). Significant unequal distribution of child abuse was found to be associated with sex, living region, marital status, job status, and educational status. We determined the prevalence of adult survivors of child abuse in Japan and found that their demographic characteristics were unequally distributed. Policy makers and public health providers should take these demographic disparities into account in considering effective public health interventions for survivors of child abuse.

Combined role of childhood maltreatment, family history, and gender in the risk for alcohol dependence

BACKGROUND

Studies of the relationship between childhood maltreatment and alcohol dependence have not controlled comprehensively for potential confounding by co-occurring maltreatments and other childhood trauma, or determined whether parental history of alcohol disorders operates synergistically with gender and maltreatment to produce alcohol dependence. We addressed these issues using national data. Method Face-to-face surveys of 27 712 adult participants in a national survey.

RESULTS

Childhood physical, emotional and sexual abuse, and physical neglect were associated with alcohol dependence (p<0.001), controlling for demographics, co-occurring maltreatments and other childhood trauma. Attributable proportions (APs) due to interaction between each maltreatment and parental history revealed significant synergistic relationships for physical abuse in the entire sample, and for sexual abuse and emotional neglect in women (APs, 0.21, 0.31, 0.26 respectively), indicating that the odds of alcohol dependence given both parental history and these maltreatments were significantly higher than the additive effect of each alone (p<0.05).

CONCLUSIONS

Childhood maltreatments independently increased the risk of alcohol dependence. Importantly, results suggest a synergistic role of parental alcoholism: the effect of physical abuse on alcohol dependence may depend on parental history, while the effects of sexual abuse and emotional neglect may depend on parental history among women. Findings underscore the importance of early identification and prevention, particularly among those with a family history, and could guide genetic research and intervention development, e.g. programs to reduce the burden of childhood maltreatment may benefit from addressing the negative long-term effects of maltreatments, including potential alcohol problems, across a broad range of childhood environments.

Childhood maltreatment and illicit drug use in middle adulthood: the role of neighborhood characteristics

This paper examined whether childhood maltreatment increases the risk of living in neighborhoods with less desirable characteristics (i.e., more disorder and disadvantage, less social cohesion, social control and advantage, and fewer resources) in middle adulthood and whether these neighborhood characteristics influence subsequent illicit drug use. Using a prospective cohort design study, court documented cases of childhood abuse and neglect and matched controls (n = 833) were first interviewed as young adults (mean age = 29 years) from 1989 to 1995 and again in middle adulthood from 2000 to 2002 (mean age = 40 years) and 2003 to 2005 (mean age = 41 years). In middle adulthood, individuals with histories of childhood abuse and neglect were more likely to live in neighborhoods with more disorder and disadvantage and less social cohesion and advantage compared to controls and to engage in illicit drug use during the past year. Path analyses showed an indirect effect on illicit drug use via neighborhood disorder among maltreated children, even after accounting for drug abuse symptoms in young adulthood, although this was sex specific and race specific, affecting women and Whites. Overall, child abuse and neglect places children on a negative trajectory that dynamically influences negative outcomes at multiple levels into middle adulthood.

Life-time risk for substance use among offspring of abusive family environment from the community

The current study examined the cumulative risk, age of initiation, and functional impairments among adults with substance use problems (N = 1748) by child abuse status. Child abuse was associated with earlier initiation of marijuana, cocaine, and heroin use, and had greater risks for all the drugs studied (hazard ratios, 1.7-3.2). Furthermore, child abuse was associated with increased medical and functional impairments, including ER visits, health problems, drug dealing, drug dependence, and drug cravings. Provision of social services and parenting education during the perinatal period may prevent the long-term impact of child abuse on substance use and related impairments. The study's limitations are noted.

Maternal early life risk factors for offspring birth weight: findings from the add health study

The aim of this study was to examine the pathways that link mothers' early life socio economic status (SES) and mothers' experience of childhood maltreatment with birth weight among their later born offspring. Data were drawn from a nationally representative longitudinal survey of school-aged respondents, initially enrolled during adolescence in Wave I (1994-1995) and Wave II (1996) of the National Longitudinal Study of Adolescent Health and followed-up in adulthood in Wave III (2001-2002). Data on offspring birth weight were obtained from nulliparous females (N = 1,897) who had given birth between Waves II and III. Analyses used structural equation modeling to examine the extent to which early life maternal risk predicted offspring birth weight, and demonstrated that maternal childhood SES and maternal childhood maltreatment predicted offspring birth weight through several mediated pathways. First, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood SES and offspring birth weight. Second, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Third, adult SES partially mediated the association between maternal childhood SES and offspring birth weight. Fourth, maternal adolescent substance use and prenatal cigarette use partially mediated the association between maternal childhood maltreatment and offspring birth weight. Finally, maternal adolescent depressive symptoms and adult SES partially mediated the association between maternal childhood maltreatment and offspring birth weight. To our knowledge, this is the first study to identify maternal childhood maltreatment as an early life risk factor for offspring birth weight among a nationally representative sample of young women, and to demonstrate the mechanisms that link childhood SES and maltreatment to offspring birth weight. These findings suggest the importance of designing and implementing prevention and intervention strategies to address early life maternal social conditions in an effort to improve inter generational child health at birth.

The influence of gene-environment interactions on the development of alcoholism and drug dependence

Alcoholism and drug dependence are common psychiatric disorders with a heritability of about 50%; therefore genetic and environmental influences are equally important. Early-life stress is a predictor of adolescent problem drinking/drug use and alcohol/drug dependence in adulthood, but moderating factors governing the availability of alcohol/drug are important. The risk-resilience balance for addiction may be due in part to the interaction between genetic variation and environment stressors (G × E); this has been confirmed by twin studies of inferred genetic risk. Measured genotype studies to detect G × E effects have used a range of alcohol consumption and diagnostic phenotypes and stressors ranging from early-life to adulthood past year life events. In this article, the current state of the field is critically reviewed and suggestions are put forth for future research.