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García-Cabrerizo R, Cryan JF. A gut (microbiome) feeling about addiction: Interactions with stress and social systems. Neurobiol Stress 2024; 30:100629. [PMID: 38584880 PMCID: PMC10995916 DOI: 10.1016/j.ynstr.2024.100629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/29/2024] [Accepted: 03/17/2024] [Indexed: 04/09/2024] Open
Abstract
In recent years, an increasing attention has given to the intricate and diverse connection of microorganisms residing in our gut and their impact on brain health and central nervous system disease. There has been a shift in mindset to understand that drug addiction is not merely a condition that affects the brain, it is now being recognized as a disorder that also involves external factors such as the intestinal microbiota, which could influence vulnerability and the development of addictive behaviors. Furthermore, stress and social interactions, which are closely linked to the intestinal microbiota, are powerful modulators of addiction. This review delves into the mechanisms through which the microbiota-stress-immune axis may shape drug addiction and social behaviors. This work integrates preclinical and clinical evidence that demonstrate the bidirectional communication between stress, social behaviors, substance use disorders and the gut microbiota, suggesting that gut microbes might modulate social stress having a significance in drug addiction.
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Affiliation(s)
- Rubén García-Cabrerizo
- IUNICS, University of the Balearic Islands, Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Department of Medicine, University of the Balearic Islands, Palma, Spain
| | - John F. Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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2
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Faber SC, Metzger IW, La Torre J, Fisher C, Williams MT. The illusion of inclusion: contextual behavioral science and the Black community. Front Psychol 2023; 14:1217833. [PMID: 38022926 PMCID: PMC10643524 DOI: 10.3389/fpsyg.2023.1217833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023] Open
Abstract
Anti-racism approaches require an honest examination of cause, impact, and committed action to change, despite discomfort and without experiential avoidance. While contextual behavioral science (CBS) and third wave cognitive-behavioral modalities demonstrate efficacy among samples composed of primarily White individuals, data regarding their efficacy with people of color, and Black Americans in particular, is lacking. It is important to consider the possible effects of racial stress and trauma on Black clients, and to tailor approaches and techniques grounded in CBS accordingly. We describe how CBS has not done enough to address the needs of Black American communities, using Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) as examples. We also provide examples at the level of research representation, organizational practices, and personal experiences to illuminate covert racist policy tools that maintain inequities. Towards eradicating existing racism in the field, we conclude with suggestions for researchers and leadership in professional psychological organizations.
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Affiliation(s)
- Sonya C. Faber
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Isha W. Metzger
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Joseph La Torre
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Carsten Fisher
- Behavioral Wellness Clinic, LLC, Tolland, CT, United States
| | - Monnica T. Williams
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Behavioral Wellness Clinic, LLC, Tolland, CT, United States
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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3
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Walter ZC, Carlyle M, Kerswell N, Mefodeva V, Nixon RDV, Cobham VE, Hides L. Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders. Front Psychiatry 2023; 14:1169794. [PMID: 37840800 PMCID: PMC10572352 DOI: 10.3389/fpsyt.2023.1169794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Comorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18-35 years) residential substance use treatment service. Methods and analysis A single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes. Ethics and dissemination The study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.
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Affiliation(s)
- Zoe C. Walter
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- National Center for Youth Substance Use Research, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Lives Lived Well, Brisbane, QLD, Australia
| | - Molly Carlyle
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- National Center for Youth Substance Use Research, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Lives Lived Well, Brisbane, QLD, Australia
| | - Nick Kerswell
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Lives Lived Well, Brisbane, QLD, Australia
| | - Valeriya Mefodeva
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Lives Lived Well, Brisbane, QLD, Australia
| | - Reg D. V. Nixon
- Flinders University Institute for Mental Health and Wellbeing, Flinders University, Adelaide, SA, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Vanessa E. Cobham
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Children’s Health Queensland, Child and Youth Mental Health Service, Brisbane, QLD, Australia
| | - Leanne Hides
- School of Psychology, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- National Center for Youth Substance Use Research, Faculty of Health and Behavioral Sciences, University of Queensland, Brisbane, QLD, Australia
- Lives Lived Well, Brisbane, QLD, Australia
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Kessler CL, Vrshek-Schallhorn S, Mineka S, Zinbarg RE, Craske M, Adam EK. Experiences of adversity in childhood and adolescence and cortisol in late adolescence. Dev Psychopathol 2023; 35:1235-1250. [PMID: 34743763 DOI: 10.1017/s0954579421001152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Early life adversity influences the diurnal cortisol rhythm, yet the relative influence of different characteristics of adversity remains unknown. In this study, we examine how developmental timing (childhood vs. adolescence), severity (major vs. minor), and domain of early life adversity relate to diurnal cortisol rhythms in late adolescence. We assessed adversity retrospectively in early adulthood in a subsample of 236 participants from a longitudinal study of a diverse community sample of suburban adolescents oversampled for high neuroticism. We used multilevel modeling to assess associations between our adversity measures and the diurnal cortisol rhythm (waking and bedtime cortisol, awakening response, slope, and average cortisol). Major childhood adversities were associated with flatter daily slope, and minor adolescent adversities were associated with greater average daily cortisol. Examining domains of childhood adversities, major neglect and sexual abuse were associated with flatter slope and lower waking cortisol, with sexual abuse also associated with higher cortisol awakening response. Major physical abuse was associated with higher waking cortisol. Among adolescent adversities domains, minor neglect, emotional abuse, and witnessing violence were associated with greater average cortisol. These results suggest severity, developmental timing, and domain of adversity influence the association of early life adversity with stress response system functioning.
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Affiliation(s)
- Courtenay L Kessler
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | | | - Susan Mineka
- Psychology Department, Northwestern University, Evanston, IL, USA
| | - Richard E Zinbarg
- Psychology Department, Northwestern University, Evanston, IL, USA
- The Family Institute at Northwestern University, Evanston, IL, USA
| | | | - Emma K Adam
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
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5
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Adverse Experiences in Late Adolescence and Young Adulthood Disadvantages. J Youth Adolesc 2023; 52:585-597. [PMID: 36449209 DOI: 10.1007/s10964-022-01714-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
Despite extensive research documenting associations between adverse early-life experiences and negative outcomes in later life, little is known about how adverse experiences in late adolescence relate to young adulthood disadvantages. This study examines the role of adverse experiences during late adolescence on young adults' education and work trajectories in Taiwan. Drawing theories and research from human development and sociology, the study links indicators of disadvantages in young adulthood to measures of adverse experiences in late adolescence using data from the Taiwan Youth Project data (n = 1221; median ages 18, 20, and 22; 49.4% female). The analysis found that running away from home was associated with instability in education or employment and that having cumulative adverse experiences was associated with graduating with debt and instability in education or employment. Some associations were explained by financial pressure, however, taken together, the findings suggest that certain adverse experiences in late adolescence have a significant impact on disadvantaged education and work trajectories in young adulthood.
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de la Torre-Luque A, Borges G, Benjet C, Orozco R, Medina-Mora ME, Ayuso-Mateos JL. Diagnostic profiles in adolescence and emerging adulthood: Transition patterns and risk factors. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:42-50. [PMID: 37916572 DOI: 10.1016/j.rpsm.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Complex diagnostic profiles (i.e., clusters of comorbid disorders) may be present in adolescence with long-lasting effects later in life. Little is known about their developmental transitions to adulthood as well as potential risk factors. This study aimed to identify the diagnostic profiles in adolescence and emerging adulthood, patterns of transitions and risk factors. MATERIAL AND METHODS A sample of 1062 Mexican adolescents (43.22% men, M=14.19 years at baseline, SD=1.68) was assessed for psychiatric disorders at adolescence and emerging adulthood. Latent class analysis was used to identify diagnostic profiles. Profile transition was studied using multi-state modeling between the life periods. Logistic regression was utilized to study risk factor influence on profile development in adulthood. RESULTS Three diagnostic profiles (i.e., minimal disorder/no-psychopathology; and two clinical profiles: internalizing and externalizing) were identified in both periods. Anxiety disorders were the most frequent psychiatric presentation in adolescence, while depression was the most prevalent disorder in adulthood. More than 15% of participants showed a clinical profile regardless life period. Comorbidity was present in 57% of participants with a clinical psychiatric profile. Finally, common (suicidal behavior) and specific risk factors (sex, parents' education and income) predicted transitions to profiles from adolescence to emerging adulthood. CONCLUSIONS Psychiatric disorders are frequently observed adopting a complex diagnostic profile in both adolescence and emerging adulthood. Comorbidity seems to be common in both life periods. Developmental issues and comorbidity should be considered for health service provision and treatment choice.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain.
| | - Guilherme Borges
- Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico
| | - Corina Benjet
- Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico
| | | | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain
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7
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Hoover LV, Yu HP, Duval ER, Gearhardt AN. Childhood trauma and food addiction: The role of emotion regulation difficulties and gender differences. Appetite 2022; 177:106137. [PMID: 35738482 DOI: 10.1016/j.appet.2022.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Childhood trauma has been associated with substance use disorders (SUDs), but less research has investigated its association with food addiction (i.e., compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). Existing research on childhood trauma and food addiction has focused primarily on women from restricted samples. Further, emotion dysregulation difficulties are implicated in both childhood trauma and food addiction, but research has not explored whether it may play a mediating role. METHOD Thus, the current study utilizes a sample of 310 participants recruited from Amazon Mechanical Turk (mean age = 41.3 years old, 47.4% men, 78.7% white) to investigate the mediating role of emotion dysregulation in the association between childhood trauma and food addiction. We also conducted exploratory analyses to investigate for gender differences in these associations. Gender-stratified correlational matrixes were conducted to investigate association between childhood trauma, food addiction, and emotional dysregulation. Moderated mediation models and multilevel regressions were also conducted to identify the role of gender in the association between childhood trauma, food addiction, and emotion dysregulation. RESULTS Emotion dysregulation was found to partially mediate the associations between food addiction and childhood trauma and gender was found to moderate associations between childhood trauma and emotion dysregulation, as well as childhood trauma and food addiction. Both moderating pathways were significantly stronger for men compared to women. DISCUSSION Results suggests that emotion dysregulation may be one important mediator in the association between childhood trauma and food addiction, particularly for men. The identification of other potential mechanisms contributing to the association between childhood trauma and food addiction and the use of longitudinal measurement strategies will be important in future research.
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Affiliation(s)
- Lindzey V Hoover
- Department of Psychology, University of Michigan, Ann Arbor, USA.
| | - Hayley P Yu
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Elizabeth R Duval
- Department of Psychology, University of Michigan, Ann Arbor, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA
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8
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Sun S, Sheridan M, Tyrka A, Donofry SD, Erickson K, Loucks E. Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence. Neurosci Biobehav Rev 2022; 134:104526. [PMID: 34998833 PMCID: PMC8844271 DOI: 10.1016/j.neubiorev.2022.104526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Early life adversities (ELA) are prevalent and have a profound and adverse impact across the lifespan, including on age-related health outcomes, yet interventions to remediate its adverse impact are scarce. This paper presents evidence for mindfulness training to reduce the elevated mental and physical health risks linked to ELA among adults by targeting biological mechanisms of ELA leading to these adverse health outcomes. We first provide a brief overview of ELA, its adverse health impacts, and mechanisms that might be responsible. Next, we review converging evidence that demonstrates that mindfulness training influences key biological pathways involved in ELA-linked negative health consequences, including (a) brain networks involved in self-regulation, (b) immunity and inflammation, (c) telomere biology, and (d) epigenetic modifications. Further, we review preliminary evidence from mindfulness-based trials that focused on populations impacted by ELA. We discuss limitations of this review and provide recommendations for future research. If effective, a mindfulness-based approach could be an important public health strategy for remediating the adverse mental and physical health consequences of ELA.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, United States; Mindfulness Center at Brown University, United States.
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Audrey Tyrka
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Brown University Alpert Medical School
| | | | - Kirk Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA,Center for the Neural Basis of Cognition, Pittsburgh, PA
| | - Eric Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health,Mindfulness Center at Brown University
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Na PJ, Stefanovics EA, Rhee TG, Rosenheck RA. A population-wide perspective on the reach of substance use disorders: Parental exposure, diagnostic remission, and current disorders. Am J Addict 2021; 31:69-79. [PMID: 34921471 DOI: 10.1111/ajad.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/22/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Parental substance use disorder (SUD) increases the risk for childhood adversities. Lifetime and current SUDs are associated with functional impairment and psychiatric comorbidity. Research shows that these abate with diagnostic remission. However, a hierarchically ordered heuristic profile of adult subpopulations affected by SUDs has not been explored. METHODS We used data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III (NESARC-III; N = 36,309) to compare four subpopulations defined by the following hierarchy: (1) neither parental nor lifetime SUD (un-affected group); (2) parental SUD but no personal SUD; (3) past but not current SUD (diagnostic remission); and (4) current SUD. We conducted bivariate comparisons and multivariable-adjusted logistic regression to identify characteristics independently differentiating each group. RESULTS Almost half of the US adult population (108.9 million) were at risk from SUDs. Relative to the unaffected group (56.1%), the parental-exposure-only group (13.9%) experienced diverse parental and childhood adversities and increased risk for psychiatric disorders. Compared to the parental-exposure-only group those in the remitted group (14.1%) were more likely to report behavioral problems and lifetime psychiatric multimorbidities. Those with current SUD (15.9%) had a poorer mental health-related quality of life. DISCUSSION AND CONCLUSIONS This heuristic SUD hierarchy is associated with increasing adversities affecting almost half the US population, although only 15.9% meet the criteria for a current disorder. SCIENTIFIC SIGNIFICANCE Our findings provide a rigorous population-based estimate of the staggering public health impact of SUDs in the United States and suggest that almost half of the US population is either directly or indirectly affected by SUDs.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Elina A Stefanovics
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Public Health Sciences, University of Connecticut, Farmington, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, Connecticut, USA
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10
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Wang Z, Buu A, Lohrmann DK, Shih PC, Lin HC. The role of family conflict in mediating impulsivity to early substance exposure among preteens. Addict Behav 2021; 115:106779. [PMID: 33360278 DOI: 10.1016/j.addbeh.2020.106779] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/16/2020] [Accepted: 12/05/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Preadolescence substance exposure, which increases the risk of regular substance use, has been a public health concern. Although studies found that impulsivity is a predisposing factor of early substance exposure, the pathways through which impulsivity is associated with early substance exposure remain unclear. This study examined how family conflict mediates this association among U.S. preteens as family environment plays an essential role in pre-adolescent development. METHODS Respondents (N = 11,800, 9-10 years old) from the Adolescent Brain Cognitive Development (ABCD) Study Release 2.01 (July 2019) were included in this study. Generalized structural equation modeling was performed to investigate the mediation effects of family conflict on the associations between childhood impulsivity and early exposure to alcohol and tobacco use, controlling for covariates based on the Problem Behavior Theory. RESULTS Pre-adolescents with high impulsivity levels (≥90th percentile) were more likely to report early alcohol and tobacco exposure (total effect: ORs = 1.49 and 1.70, respectively), where 4.13% and 12.41% of the associations, respectively, were meditated by family conflict (indirect effect: ORs = 1.02 and 1.07; Sobel test ps = 0.022 and 0.005, respectively). CONCLUSIONS Family conflict mediates the associations between childhood impulsivity and early substance exposure among preteens, with higher impulsivity leading to more severe family conflicts that are, in turn, associated with a higher likelihood of early substance exposure. To prevent preteens with high impulsivity level from early use of substances, interventions may focus on reducing family conflicts such as parenting counseling that guides parents to strengthen conflict-resolution skills and create a stable home environment for preteens.
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11
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Shubayr MA, Mattoo KA. Parental neglect of feeding in obese individuals. A review of scientific evidence and its application among Saudi population. Saudi Med J 2021; 41:451-458. [PMID: 32373910 PMCID: PMC7253827 DOI: 10.15537/smj.2020.5.25049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Human beings encountered malnutrition during the twentieth century and obesity in the very next century. This is how the future will look when the present becomes a slice of history. Obesity is threatening the healthy being of many youngsters throughout the world. Environmental influences have indicated to effect even genetically safe subjects among which parental neglect seems to be most alarming. Two extensively and globally investigated variables, the feeding style and the physical activity, provide some hope in its prevention. Despite the high rise of obesity prevalence in Saudi Arabia, there is scant research on these topics. The purpose of this review is to present a comprehensive assessment of these 2-obesity associated parental variables. The composed literature could provide an insight to the dominant surge of obesity in the Arab nations and stimulate research on current parenting practices in the Kingdom.
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Affiliation(s)
- Mosa A Shubayr
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia. E-mail.
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12
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Huang Y, Liu H, Masum M. Adverse Childhood Experiences and Physical and Mental Health of Adults: Assessing the Mediating Role of Cumulative Life Course Poverty. Am J Health Promot 2020; 35:637-647. [PMID: 33356410 DOI: 10.1177/0890117120982407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Research has linked adverse childhood experiences (ACEs) to a host of negative health outcomes in adulthood. However, most existing studies focused on traumatic ACEs and used samples collected from a specific geographic unit (e.g., region, city, or state). This study examines the association between non-traumatic ACEs and health outcomes (i.e., self-rated health and psychological well-being) in adulthood, and assesses the extent to which the cumulative life course poverty accounts for these associations between ACEs and health. DATA SOURCE Public and de-identified data from Panel Study of Income Dynamics (PSID) (1968-2013) and its Childhood Retrospective Circumstances Study (CRCS) (2014) (N = 7,126) were used. Episode and severity of childhood adversities of respondents were determined by using comprehensive retrospective circumstance measures. METHODS Multivariate regression models were used to analyze the associations between ACEs and adult health. Mediation analysis was employed to assess the extent to which the associations were explained by cumulative life course poverty. Data analysis was carried out in 2019 using STATA 15. RESULTS We found that episode and severity of ACEs were associated with increased risk of poor health and psychological distress. Compared to individuals with no ACEs, one unit increase in the ACE index is associated with 8 and 18 percent increase in the risk of poor health and psychological distress, respectively. A small proportion (4%) of the impact of early adversities on health is attributable to the proportion of adult lifetime spent in poverty. CONCLUSIONS Non-traumatic ACEs are associated with increased risk for poor health and psychological distress. Life course cumulative experience in poverty accounts for a small portion of the associations. Providing support to prevent ACEs may have long-term health benefits.
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Affiliation(s)
- Ying Huang
- Department of Demography, 12346University of Texas at San Antonio, San Antonio, TX, USA
| | - Han Liu
- Department of Sociology, 1084University at Albany, State University of New York, New York, NY, USA
| | - Muntasir Masum
- Department of Demography, 12346University of Texas at San Antonio, San Antonio, TX, USA
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13
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Carlson HN, Weiner JL. The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:69-142. [PMID: 33648676 DOI: 10.1016/bs.irn.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.
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Affiliation(s)
- Hannah N Carlson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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14
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Stephens JE, Kessler CL, Buss C, Miller GE, Grobman WA, Keenan-Devlin L, Borders AE, Adam EK. Early and current life adversity: Past and present influences on maternal diurnal cortisol rhythms during pregnancy. Dev Psychobiol 2020; 63:305-319. [PMID: 32572946 DOI: 10.1002/dev.22000] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/13/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Abstract
Stress during pregnancy affects maternal health and well-being, as well as the health and well-being of the next generation, in part through the hypothalamic-pituitary-adrenal (HPA) axis. Although most studies have focused solely on proximal experiences (i.e., during the pregnancy) as sources of prenatal stress, there has been a recent surge in studies that examine maternal early life adversity as a source of stress system dysregulation during pregnancy. The current study of 178 pregnant women examined the association of economic and life stress experienced during two time periods (i.e., childhood and pregnancy) with maternal HPA axis activity during the third trimester of pregnancy. Findings indicated that a current annual income of less than $15,000 and greater childhood disadvantage were associated with a flatter diurnal cortisol slope. Childhood maltreatment, particularly sexual abuse, was associated with a higher cortisol awakening response (CAR), even when controlling for recent adversity. We found some evidence that past adversity moderates the relationship between current adversity and diurnal cortisol, specifically for economic adversity and waking cortisol. Overall, our findings indicate that early life stressors play an important and underappreciated role in shaping stress biology during pregnancy.
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Affiliation(s)
- Jacquelyn E Stephens
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Courtenay L Kessler
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Claudia Buss
- University of California Irvine, Irvine, CA, USA.,Charité University Medicine Berlin, Berlin, Germany
| | - Gregory E Miller
- Department of Psychology, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - William A Grobman
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Ann E Borders
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,NorthShore University HealthSystem, Evanston, IL, USA
| | - Emma K Adam
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA.,Institute for Policy Research, Northwestern University, Evanston, IL, USA
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15
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Substance Dependence Comorbidity With Mental Disorders in Egyptian Young Adults. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Kidman R, Smith D, Piccolo LR, Kohler HP. Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents. CHILD ABUSE & NEGLECT 2019; 92:139-145. [PMID: 30974257 PMCID: PMC6513701 DOI: 10.1016/j.chiabu.2019.03.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). OBJECTIVE In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. PARTICIPANTS AND SETTING Four hundred and ten adolescents (age 10-16 years old) from Malawi. METHODS The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). RESULTS Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01). CONCLUSION Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States.
| | - Dylan Smith
- Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States
| | - Luciane R Piccolo
- Program in Public Health, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States
| | - Hans-Peter Kohler
- Department of Sociology and Population Studies Center, University of Pennsylvania, 3718 Locust Walk (272 McNeil Building), Philadelphia, PA 19104-6298, United States
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17
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Forster M, Rogers CJ, Benjamin SM, Grigsby T, Lust K, Eisenberg ME. Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample. Subst Use Misuse 2019; 54:2368-2379. [PMID: 31407958 DOI: 10.1080/10826084.2019.1650772] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Despite college students reporting high rates of substance use and adverse childhood experiences (ACE), few studies have examined ACE-related substance use patterns with diverse student samples. We estimated the prevalence of ACE and substance use and investigated ethnic differences in the relationship between ACE and substance use among college students from two states. Design: Data are responses (N = 7,148) on the National College Health Assessment (in California) and the College Student Health Survey (in Minnesota). Multivariable regression models assessed the associations between individual and accumulated ACE and alcohol, tobacco, marijuana, and illicit substance use and binge drinking (adjusting for age, gender, depression, and state) among non-Hispanic White, Hispanic, African American/Black, Asian Pacific Islanders, multiracial, and other students. Interaction terms were calculated to test for ethnic differences. Results: In the month preceding the survey, 22% of students used marijuana, 28% used tobacco, 75% drank alcohol; 6% used an illicit drug in the past year and 30% acknowledged past 2-week binge drinking. Although ACE were associated with all substance use behaviors (AORs ranged from 1.19 to 1.54, p < .001), there was significant ethnic variation in ACE exposure (40-52%) and the dose-response relationship between ACE and marijuana and tobacco use and binge drinking. Conclusions: The variability in ACE-related substance use patterns across ethnic groups highlights the need for research that advances our understanding of sociocultural influences in trauma response and the role that campus communities could have in the development of culturally sensitive services that address this issue.
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Affiliation(s)
- Myriam Forster
- Department of Health Sciences, California State University, Northridge, California, USA
| | - Chris J Rogers
- Institute for Health Promotion and Disease Prevention, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Stephanie M Benjamin
- Department of Health Sciences, California State University, Northridge, California, USA
| | - Timothy Grigsby
- Department of Kinesiology, Health, & Nutrition, University of Texas, San Antonio, Texas, USA
| | - Katherine Lust
- Boynton Health, and School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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18
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Olvera Alvarez HA, Kubzansky LD, Campen MJ, Slavich GM. Early life stress, air pollution, inflammation, and disease: An integrative review and immunologic model of social-environmental adversity and lifespan health. Neurosci Biobehav Rev 2018; 92:226-242. [PMID: 29874545 PMCID: PMC6082389 DOI: 10.1016/j.neubiorev.2018.06.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 01/21/2023]
Abstract
Socially disadvantaged individuals are at greater risk for simultaneously being exposed to adverse social and environmental conditions. Although the mechanisms underlying joint effects remain unclear, one hypothesis is that toxic social and environmental exposures have synergistic effects on inflammatory processes that underlie the development of chronic diseases, including cardiovascular disease, diabetes, depression, and certain types of cancer. In the present review, we examine how exposure to two risk factors that commonly occur with social disadvantage-early life stress and air pollution-affect health. Specifically, we identify neuroimmunologic pathways that could link early life stress, inflammation, air pollution, and poor health, and use this information to propose an integrated, multi-level model that describes how these factors may interact and cause health disparity across individuals based on social disadvantage. This model highlights the importance of interdisciplinary research considering multiple exposures across domains and the potential for synergistic, cross-domain effects on health, and may help identify factors that could potentially be targeted to reduce disease risk and improve lifespan health.
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Affiliation(s)
- Hector A Olvera Alvarez
- School of Nursing, University of Texas at El Paso, Health Science and Nursing Building, Room 359, 500 West University Avenue, El Paso, TX, USA.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico, Albuquerque, NM, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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19
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Barbic SP, Jones AA, Woodward M, Piercy M, Mathias S, Vila-Rodriguez F, Leonova O, Smith GN, Buchanan T, Vertinsky AT, Gillingham S, Panenka WJ, Rauscher A, Barr AM, Procyshyn RM, MacEwan GW, Lang DJ, Thornton AE, Heran MK, Leon AM, Krausz M, Honer WG. Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2018; 109:204-214. [PMID: 29981045 PMCID: PMC6964603 DOI: 10.17269/s41997-018-0087-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/10/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Young adults living in single room occupancy (SRO) hotels, a form of low-income housing, are known to have complex health and substance problems compared to their peers in the general population. The objective of this study is to comprehensively describe the mental, physical, and social health profile of young adults living in SROs. METHODS This study reports baseline data from young adults aged 18-29 years, as part of a prospective cohort study of adults living in SROs in Vancouver, British Columbia, Canada. Baseline and follow-up data were collected from 101 young adults (median follow-up period 1.9 years [IQR 1.0-3.1]). The comprehensive assessment included laboratory tests, neuroimaging, and clinician- and patient-reported measures of mental, physical, and social health and functioning. RESULTS Three youth died during the preliminary follow-up period, translating into a higher than average mortality rate (18.6, 95% CI 6.0, 57.2) compared to age- and sex-matched Canadians. High prevalence of interactions with the health, social, and justice systems was reported. Participants were living with median two co-occurring illnesses, including mental, neurological, and infectious diseases. Greater number of multimorbid illnesses was associated with poorer real-world functioning (ρ = - 0.373, p < 0.001). All participants reported lifetime alcohol and cannabis use, with pervasive use of stimulants and opioids. CONCLUSION This study reports high mortality rates, multimorbid illnesses, poor functioning, poverty, and ongoing unmet mental health needs among young adults living in SROs. Frequent interactions with the health, social, and justice systems suggest important points of intervention to improve health and functional trajectories of this vulnerable population.
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Affiliation(s)
- Skye P Barbic
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Department of Occupational Science and Occupational Therapy, UBC, Vancouver, BC, Canada.
- Department of Psychiatry, UBC, Vancouver, BC, Canada.
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada.
- Foundry, Vancouver, BC, Canada.
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, The University of British Columbia St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
| | - Andrea A Jones
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Melissa Woodward
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, UBC, Vancouver, BC, Canada
| | | | - Steve Mathias
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
- Foundry, Vancouver, BC, Canada
- St. Paul's Hospital, Vancouver, BC, Canada
| | - Fidel Vila-Rodriguez
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Olga Leonova
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Geoffrey N Smith
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Tari Buchanan
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | | | | | - William J Panenka
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Alexander Rauscher
- Foundry, Vancouver, BC, Canada
- Department of Pediatrics, UBC, Vancouver, BC, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology & Therapeutics, UBC, Vancouver, BC, Canada
| | - Ric M Procyshyn
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - G William MacEwan
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- St. Paul's Hospital, Vancouver, BC, Canada
| | - Donna J Lang
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, UBC, Vancouver, BC, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Manraj K Heran
- Foundry, Vancouver, BC, Canada
- Vancouver General Hospital, Vancouver, BC, Canada
| | - Adelena M Leon
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, UBC, Vancouver, BC, Canada
| | - Michael Krausz
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - William G Honer
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
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20
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Forster M, Grigsby TJ, Rogers CJ, Benjamin SM. The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. Addict Behav 2018; 76:298-304. [PMID: 28889058 DOI: 10.1016/j.addbeh.2017.08.037] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/22/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Research suggests that college students are an especially vulnerable subset of the population for substance use and misuse. However, despite evidence of the high prevalence of adverse childhood experiences (ACE) among students and the link between family-based ACE and substance use among older adults, this relationship remains understudied in college populations. Moreover, whether ACE represents a shared risk across substance use behaviors and ethnic groups is unknown. METHODS Data are student responses (n=2953) on the 2015 American College Health Association's National College Health Assessment II (ACHA-NCHA II) administered at one of the largest, most diverse public universities in California. Multivariable logistic and negative binomial regression models tested the association between individual and accumulated ACE and past 30-day alcohol, tobacco, marijuana, and illicit drug use, past 12-month prescription medication misuse and polysubstance use. RESULTS Between 50% and 75% of students involved in substance use were ACE exposed. There was a significant dose-response relationship between ACE and substance use and polysubstance use. Although accumulated ACE increased risk for substance use, there was considerable ethnic variability in these associations. CONCLUSIONS The graded effects of ACE for substance use underscore the link between family-based stressors and these behaviors in emergent adult college students. Our findings make a compelling case for investing in health initiatives that prioritize ACE screening and access to trauma-informed care in campus communities. Continued research with college populations is needed to replicate findings and clarify the role of ethnicity and culture in trauma response and help seeking behaviors.
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21
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Mitchell KJ, Nolte K, Turner HA, Hamby S, Jones LM. Exposure to Medication Overdose as an Adversity in Childhood. J Pediatr Nurs 2018; 38:127-132. [PMID: 28958454 DOI: 10.1016/j.pedn.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the prevalence of youth exposure to medication or pill overdose by someone close to them, as well as how common this is within the spectrum of major stressful events and child victimization experienced by youth. DESIGN AND METHODS Data were collected as part of the Third National Survey of Children's Exposure to Violence, a nationally representative telephone survey of youth, ages 2-17years (N=3738) conducted in 2013. The analytical subset for the current paper is youth ages 10-17years (n=1959). RESULTS Estimates indicate that approximately 1 in 12 youth (8%), ages 10-17 have been exposed to medication overdose by someone close to them in their lifetimes. Overdose exposure is related to recent trauma symptoms, alcohol and other substance use. However, these relationships appear to be largely driven by the co-existence of major stressful events these youth are experiencing. Alcohol use is the exception; exposure to medication overdose continues to be related to past year personal alcohol use even after adjusting for other lifetime stressful events. CONCLUSIONS Having a close family member or friend overdose on a medication is a common experience among U.S. youth and related to high rates of co-occurring stressful events. PRACTICE IMPLICATIONS Health care providers should be aware that youth exposure to medication overdoses likely indicates exposure to other recognized adversities. Youth with a caregiver who has had an overdose may require an urgent response including referral to crisis intervention through child and family services.
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Affiliation(s)
- Kimberly J Mitchell
- Crimes against Children Research Center, University of New Hampshire, Durham, NH, USA.
| | - Kerry Nolte
- Department of Nursing, University of New Hampshire, USA
| | - Heather A Turner
- Department of Sociology, University of New Hampshire, Durham, NH, USA
| | - Sherry Hamby
- Life Paths Appalachian Research Center, Sewanee, TN, USA
| | - Lisa M Jones
- Crimes against Children Research Center, University of New Hampshire, Durham, NH, USA
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22
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Salem BE, Ma-Pham J, Chen S, Brecht ML, Antonio AL, Ames M. Impact of a Community-Based Frailty Intervention Among Middle-Aged and Older Prefrail and Frail Homeless Women: A Pilot Randomized Controlled Trial. Community Ment Health J 2017; 53:688-694. [PMID: 28540538 PMCID: PMC5657482 DOI: 10.1007/s10597-017-0147-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
Abstract
Interventions are needed to address frailty and other behaviors (e.g., drug and alcohol use) among prefrail and frail homeless women (P/FHW). The purpose of this pilot randomized controlled trial (RCT) was to compare the efficacy of a Frailty Intervention (FI) versus a Health Promotion (HP) program among P/FHW (N = 32). Structured instruments assessed sociodemographics, individual, situational, health-related, and behavioral factors. While program differences were not statistically significant with the main outcome variables, medium-to-large effect sizes were found in favor of the HP program as it relates to physical and overall frailty, as well as, any drug use, alcohol use, and drug dependency. Based on these findings, it is critical to strengthen the HP program to optimize all domains of frailty (e.g., physical, psychological, and social) and substance use for P/FHW.
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Affiliation(s)
- Benissa E Salem
- UCLA School of Nursing, University of California, Los Angeles, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA.
| | | | - Stephanie Chen
- Los Angeles County Department of Health Services (LACDHS), Los Angeles, CA, USA
| | | | | | - Masha Ames
- Glendale Adventist Medical Center, Glendale, CA, USA
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