Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California

Adverse Childhood Experiences and Tobacco Use among Latinx Parents in the USA

The current study aimed to understand the effects of adverse childhood experiences (ACEs) and cultural factors on Latinx parents' tobacco use. Tobacco use is the leading cause of death among Latinx individuals in the USA, and parental use has long-term secondary harm for children. Thus, it is important to examine cultural protective factors that could prevent Latinx parents and children from the negative health effects of tobacco use. Data came from 2813 18- to 50-year-old Latinx respondents who participated in the Wave 3 of the National Epidemiological Survey on Alcohol and Related Conditions. They reported having children living in their household and had complete data for the variables of interest. In this sample (mean age = 33.5 years, 53.7% female), 16.4% (95%CI = 14.7%, 18.4%) and 7.4% (95%CI = 6.4%, 8.6%) were current and former smokers, respectively. The multivariate multinomial logistic regression analysis showed that experiencing more ACEs categories was associated with increased likelihood of current and former tobacco use compared to never use. Past year discrimination experiences and being US born (2nd and 3rd-generation parents) also increased the likelihood of current use. Differences in risk of current and former tobacco use were found based on respondents' country of origin, with protection against tobacco use found for most countries compared to being from Puerto Rico. Stronger ethnic-racial identity was not protective against tobacco use. Findings show the importance of considering ACEs and cultural factors when designing and implementing tobacco cessation programs for Latinx parents and increasing awareness of the impact of parents' tobacco use on their children.

Tobacco use, trauma exposure and PTSD: a systematic review

Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.

An examination of questioning methods and the influence of child maltreatment on paediatric pain assessments: Perspectives of healthcare providers

AIMS AND OBJECTIVES

Children with a history of maltreatment have underestimated and undertreated pain; however, it is unknown if healthcare providers consider maltreatment when assessing children's pain. The current study aimed to address this issue by investigating healthcare providers' pain assessment practices, and specifically, their consideration of child maltreatment.

METHOD

Healthcare providers (N = 100) completed a survey, asking them to reflect upon their pediatric pain assessment practices (e.g., methods and questions used to assess pain) through self-report and case vignette questions.

RESULTS

Participants who received continuing education about child maltreatment were more likely to consider maltreatment in several areas of their pediatric pain assessment practice, whereas participants who received continuing education about pediatric pain, were not. Participants were also more likely to report that they would consider maltreatment in vignette responses than in questions regarding their daily practice.

CONCLUSION

Findings indicate healthcare providers use multidimensional methods when assessing children's pain, although it is unclear when or how they use open-ended vs. option posing questions. Healthcare providers also tended to consider the effects of child maltreatment on children's ability to communicate their pain more so when the history of maltreatment was known to them.

Coping with Community Violence: Perspectives of African American Young Adult Men and Hispanic/Latino Young Adult Men

Further study is needed regarding the intersection of community violence exposure, coping strategies, and health behaviors among young adult African American men and Hispanic/Latino men. This study did so in Lake County, Indiana, which contains multiple areas with disproportionate prevalence of violence relative to population size. Approximately 22 miles from Chicago, Lake County includes noteworthy mid-sized cities such as Gary, Hammond, and East Chicago. This study explored the perceptions of African American men and Hispanic/Latino men ages 18 to 25 regarding coping strategies and both healthy and health risk behaviors after directly witnessing or indirectly experiencing a violent act or event. We used aspects of social cognitive theory to design this community-based participatory research study. Thirteen males who self-identified as African American, Hispanic/Latino, or both, completed 34- to 80-minute, audio-recorded phone interviews. Audio recordings were transcribed, and NVivo 12 Windows was used by the research team (primary researchers and two coders) to complete transcript analysis. Findings from this study provided insight around African American men and Hispanic/Latino men regarding (a) witnessing violence directly or indirectly experiencing violence; (b) changes in everyday life experiences; (c) coping strategies that involved socio-emotional health, spiritual health, social health, and risky health behaviors; (d) rationales for not asking for help; (e) observations of significant others' coping; (f) what to do differently in the future; (g) beliefs about mentors; and (h) beliefs about mental health providers. Delving into participants' experiences revealed that African American men and Hispanic/Latino men in Lake County, Indiana chose to adopt a range of health risk and health positive strategies after directly witnessing or indirectly experiencing violence. Becoming knowledgeable about African American men's and Hispanic/Latino men's diverse coping strategies and health behaviors may help inform the community about how best to cocreate spaces that aim to alleviate the traumatic experience of having directly or indirectly experienced community violence.

Does biological age mediate the relationship between childhood adversity and depression? Insights from the Detroit Neighborhood Health Study

The link between childhood adversity and adulthood depression is well-established; however, the underlying mechanisms are still being explored. Recent research suggests biological age may mediate the relationship between childhood adversity and depression in later life. This study examines if biological age mediates the relationship between childhood adversity and depression symptoms using an expanded set of biological age measures in an urban population-based cohort. Data from waves 1-3 of the Detroit Neighborhood Health Study (DNHS) were used in this analysis. Questions about abuse during childhood were coded to form a childhood adversity score similar to the Adverse Childhood Experience measure. Multiple dimensions of biological age, defined as latent variables, were considered, including systemic biological age (GrimAge, PhenoAge), epigenetic age (Horvath, SkinBlood), and immune age (cytomegalovirus, herpes simplex virus type 1, C-reactive protein, interleukin-6). Depression symptoms, modeled as a latent variable, were captured through the Patient Health Questionnaire-9 (PHQ-9). Models were adjusted for age, gender, race, parent education, and past depressive symptoms. Total and direct effects of childhood adversity on depression symptoms and indirect effects mediated by biological age were estimated. For total and direct effects, we observed a dose-dependent relationship between cumulative childhood adversity and depression symptoms, with emotional abuse being particularly influential. However, contrary to prior studies, in this sample, we found few direct effects of childhood adversity on biological age or biological age on depression symptoms and no evidence of mediation through the measures of biological age considered in this study. Further research is needed to understand how childhood maltreatment experiences are embodied to influence health and wellness.

Adverse Childhood Experiences, Acculturation, and Risky Sexual Behaviors in Hispanic Young Adults: Findings from Project RED

While adverse childhood experiences (ACE) are well-documented predictors of maladaptive behaviors in adulthood, including risky sexual behaviors (RSB), the influence of acculturation in this association remains unknown. Although Hispanics are a rapidly growing population in the United States and are disproportionately affected by adverse sexual health outcomes, there is a paucity of research examining the interplay of ACE, acculturation, and RSB in this population. We observed the ACE-RSB association and how this relationship varies across U.S. and Hispanic acculturation levels, in a sample of Hispanic young adults (n = 715). Data for this study were from Project RED, a longitudinal study of Hispanic health. We ran regression models to test associations between ACE (0, 1-3, 4+) and several RSB (e.g., early sexual initiation (≤14 years), condomless sex, lifetime sexual partners, and alcohol/drug use before intercourse), and assessed moderation by U.S./Hispanic acculturation. Compared with those without ACE, individuals with 4 + ACE had higher odds of early sexual initiation (AOR: 2.23), alcohol/drug use before last intercourse (AOR: 2.31), and condomless sex (AOR: 1.66), as well as a higher number of lifetime sexual partners (β: 0.60). For those reporting 4 + ACE, high U.S. acculturation was protective in the association between ACE and using alcohol/drugs before intercourse. Future research implications are discussed.

Craving among patients seeking treatment for substance use disorder

BACKGROUND

Craving has been implicated as a central feature of addiction and a predictor of relapse. However, a complete understanding of how craving varies across patient populations is lacking. This study aimed to better inform the effective and accurate use of craving as a clinical prognostic tool for patients with substance use disorders (SUD).

METHODS

This cross-sectional study utilized information gathered on patients (n = 112) entering specialty treatment for a SUD. Craving in the prior 30 days was assessed with a single item with other intake questionnaires.

RESULTS

Patients who reported substance use in the last 30 days were more likely to report craving compared to patients who did not report substance use in the last 30 days (AOR = 6.86 [95% CI 2.17-21.7], p-value = 0.001). Patients who reported Hispanic/Latinx ethnicity were less likely to report craving compared to patients who did not report Hispanic/Latinx ethnicity (AOR = 0.28 [95% CI 0.08-0.95], p-value = 0.04). There was no association between craving and Adverse Childhood Events (OR = 1.03 [95% CI 0.84-1.25], p-value = 0.81).

CONCLUSION

The association between recent substance use and craving supports previous findings. The observed variation in craving among patients who report Hispanic/Latinx ethnicity is novel and suggests socio-cultural influences and possibly genetic factors influencing reported craving amongst patients. Additional research is needed to further understand the underlying factors leading to this finding, in order for better utilization of craving as a clinical indicator across patient populations.

The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review

Introduction

Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years.

Methods

The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022.

Results

The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review.

Conclusion

This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.

Adverse Childhood Experiences and Electronic Cigarette Use among U.S. Young Adults

(1) Background: Adverse childhood experiences (ACEs), which are potentially traumatic childhood events, have been associated with increased tobacco product use. Less is known about electronic cigarette (e-cigarette) use during young adulthood. This study explored the associations between ACEs and current e-cigarette use among U.S. young adults. (2) Methods: This study was a secondary analysis of 2021 Behavioral Risk Factor Surveillance System data including 2537 young adults aged 18-24 years. Unadjusted and adjusted logistic regression analyses were conducted. (3) Results: Of the participants, 19.2% currently used e-cigarettes, and 22.1% reported 1 ACE, 13.0% reported 2 ACEs, 10.7% reported 3 ACEs, and 30.6% reported ≥4 ACEs. Unadjusted results indicated that participants who experienced 1 ACE (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.01-3.07), 2 ACEs (OR = 2.18, 95%CI = 1.24-3.83), 3 ACEs (OR = 2.63, 95%CI = 1.41-4.90), and ≥4 ACEs (OR = 3.69, 95%CI = 2.23-6.09) were at increased odds of reporting current e-cigarette use than participants who experienced 0 ACEs. Adjusted results indicated that participants who experienced 3 ACEs were at 2.20 times higher odds (95%CI = 1.15-4.23) and participants who experienced ≥4 ACEs were at 2.73 times higher odds (95%CI = 1.58-4.71) of reporting current e-cigarette use than participants who experienced 0 ACEs. (4) Conclusions: Young adults exposed to ACEs are at risk of using e-cigarettes.

Adverse Childhood Experiences and alcohol use among U.S.-born and immigrant Latinx youth: the roles of social support and stress hormones

The biobehavioral correlates of Adverse Childhood Experiences (ACEs) among Latinx youth have been strikingly understudied. The purpose of this study was to 1) examine the effects of T-ACEs (e.g., maltreatment, family dysfunction) and E-ACEs (e.g., family deportation, community violence) in alcohol use, 2) test whether social support moderated these associations and 3) explore whether ACEs and alcohol use were related via adrenocortical hormones (i.e., cortisol, dehydroepiandrosterone [DHEA]). A total of 100 Latinx youth, between the ages of 13 and 19, participated in this study (53% female). Community samples of United States (U.S.)-born (N = 54) and immigrant Latinx (N = 46) youth provided morning saliva samples and completed self-report questionnaires. Results highlighted that for immigrant youth, social support buffered the effects of E-ACEs on alcohol use, F(9,89)= 3.34, p = .01, R2 = .25. Although our mediation hypothesis was not supported, the direct effects of T-ACEs (β = .25, t (94) = 2.21, p = .03) and E-ACES (β = -.24, t (94) = -2.23, p = .03) on DHEA were significant for the entire sample. Preventing maltreatment and reducing community-level adversities seem critical for optimal child development, as exposure to these may increase alcohol use risk and affect HPA Axis functioning. Increasing extrafamilial support may be particularly salient for immigrant Latinx youth, as many experience extended immigration-related periods of separation from family members.

Adverse Childhood Experiences and Risk Patterns of Alcohol and Cannabis Co-Use: A Longitudinal Study of Puerto Rican Youth

PURPOSE

Adverse childhood experiences (ACEs) are common in Puerto Rican youths. Few large longitudinal studies of Latine youth examined what predicts co-use of alcohol and cannabis in late adolescence and young adulthood. We investigated the prospective association between ACEs with alcohol/cannabis co-use in Puerto Rican youth.

METHODS

Participants from a longitudinal study of Puerto Rican youth (n = 2,004) were included. Using multinomial logistic regressions to test associations between prospectively reported ACEs (11 types, reported by parents and/or children, categorized as 0-1, 2-3, and 4+ ACEs) with young adult alcohol/cannabis use patterns in the past month (i.e., no lifetime use, low-risk [no binge drinking and cannabis use < 10], binge-drinking only, regular cannabis use only, and alcohol/cannabis co-use). Models were adjusted for sociodemographic variables.

RESULTS

In this sample, 27.8% reported 4+ ACEs, 28.6% endorsed binge drinking, 4.9% regular cannabis use, and 5.5% alcohol/cannabis co-use. Compared to individuals with no lifetime use, those reporting 4+ (vs. 0-1) ACEs had greater odds of low-risk use (adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI] = 1.04-2.45), regular cannabis use (aOR 3.13 95% CI = 1.44-6.77), and alcohol/cannabis co-use (aOR 3.57, 95% CI = 1.89-6.75). In relation to low-risk use, reporting 4+ ACEs (vs. 0-1) was associated with 1.96 odds (95% CI = 1.01-3.78) of regular cannabis use and 2.24 odds (95% CI = 1.29-3.89) of alcohol/cannabis co-use.

DISCUSSION

Exposure to 4+ ACEs was associated with the occurrence of adolescent/young adulthood regular cannabis use and alcohol/cannabis co-use. Importantly, ACEs exposure differentiated young adults who were co-using compared to those engaged in low-risk use. Preventing ACE or interventions for Puerto Rican youth experiencing 4+ ACEs may mitigate negative consequences associated with alcohol/cannabis co-use.

Associations of childhood maltreatment with binge eating and binge drinking in emerging adult women

Background

Binge drinking and binge eating are prevalent, frequently co-occurring, high-risk behaviors among emerging adult women, each with physical and psychological consequences. The mechanisms driving their co-occurrence are not well understood, though a history of adverse childhood experiences (ACEs) may increase the risk for both binge behaviors.

Objective

To assess the association between ACE subtypes and individual and co-occurring binge drinking and eating in emerging adult women.

Participants and Setting

A diverse sample of women participating in the population-based study EAT 2018: Eating and Activity over Time (N = 788; aged 18-30; 19% Asian, 22% Black, 19% Latino, and 36% White).

Methods

Multinomial logistic regression estimated associations among ACE subtypes (i.e., sexual abuse, physical abuse, emotional abuse, household dysfunction), and binge drinking, binge eating, and their co-occurrence. Results are reported as predicted probabilities (PP) of each outcome.

Results

Over half of the sample (62%) reported at least one ACE. In models mutually adjusted for other ACEs, physical and emotional abuse showed the strongest associations with binge behaviors. Experiences of physical abuse had the strongest association with a ten-percentage point higher predicted probability of binge drinking (PP = 37%, 95% [CI 27-47%]) and seven-percentage point higher PP of co-occurring binge eating and drinking (PP = 12%, 95% CI [5-19%]). Emotional abuse had the strongest association with an 11-percentage point higher PP binge eating only (PP = 20%, 95% CI [11-29%]).

Conclusions

This study found childhood physical and emotional abuse to be particularly relevant risk factors for binge drinking, binge eating, and their co-occurrence among emerging adult women.

Impacts on children's health of adverse childhood experiences of their mothers: A gender-specific mediation analysis using data from the China Health and Retirement Longitudinal Study

BACKGROUND

Numerous people have suffered adverse childhood experiences (ACEs) that can have lasting negative consequences. However, few studies have focused on maternal ACEs' effect on their children's health. This study aimed to evaluate the impact on children's health of ACEs that their mothers experienced.

METHODS

Data from the China Health and Retirement Longitudinal Study (CHARLS) 2018 combined with the CHARLS 2014 Life History Survey were analyzed. The logistic regression was used to investigate maternal ACEs' impact on their children's health. Based on the stepwise regression model and bias-corrected bootstrap, we estimated the mediating effects.

RESULTS

Maternal ACEs could result in harm to the health of children (P < 0.05). If the types of maternal ACEs increased by one unit, the odds ratio of their children's poor health would rise by 9.6 %. Moreover, if the types of maternal ACEs increased by one unit, the odds ratio of daughters' and sons' poor health would increase by 8.3 % and 10.2 %, respectively. Three mediating mechanisms of mothers' education, physical health, and mental health were confirmed by empirical tests.

LIMITATIONS

We could not employ objective indicators to measure children's health. Meanwhile, maternal ACEs were all self-reported from the mothers' recollection, which might descend the accuracy due to memory bias.

CONCLUSION

Maternal ACEs harmed the health of both their sons and daughters. The children's health would deteriorate as the maternal ACEs increased. Mother's education, physical health, and mental health mediated the relationships between maternal ACEs and children's health.

Adverse childhood experiences, sexual orientation, and depressive symptoms among Chinese college students: An ecological framework analysis

BACKGROUND

Extensive evidence has demonstrated that adverse childhood experiences (ACEs) predict a high risk of negative health and behavioral outcomes in later life. However, the influence of individuals' psychosocial characteristics and environmental stressors have been mostly omitted in previous research.

OBJECTIVE

This study aimed to examine the prevalence of ACEs among LGB (lesbian, gay, and bisexual) and heterosexual emerging adults, and the associations between different patterns of ACE exposure and depressive symptoms after adjusting for factors at different levels.

PARTICIPANTS AND SETTING

A representative sample of 928 college students in Xiamen city, China was recruited.

METHODS

Latent class analysis was applied to identify the patterns of ACEs. A series of regression analyses were conducted to examine the associations between ACEs and depression and whether ACEs interacted with sexual identity to influence depression, after controlling for individual characteristics, family, school, and society-level factors.

RESULTS

Over 35 % of the participants reported they had experienced at least one type of moderate to extreme childhood maltreatment, and those who identified as LGB reported a higher level of ACE exposure. Higher levels of ACE exposure based on score and clustering approaches were associated with higher risks of depression among Chinese emerging adults. However, the associations between ACEs and depression were not significantly moderated by sexual identity.

CONCLUSIONS

The findings highlighted the importance of early screening for ACEs particularly among sexual minorities and of delivering tailored interventions based on ecological backgrounds. Both the traditional scoring approach and a data-driven approach can be effective in detecting the cumulative effect of ACEs.

Association Between Adverse Childhood Experiences, Resilience and Mental Health in a Hispanic Community

This study explores the relations between adverse childhood experiences (ACEs), mental health and resilience among Hispanic adults living in the United States - Mexico Border region. Numerous studies have investigated the negative impact of ACEs on adult mental health, but the concept of resilience as a protective factor for mental health in the Hispanic communities has limited consideration in ACE treatment interventions. The proposed study addresses this gap in knowledge by investigating relations between ACEs, resilience, and mental health. An online survey was administered to 221 university students to assess the relationship between ACEs, mental distress and resilience. Using hierarchical linear regression, three models were estimated. First, including demographics, second including ACEs and low resilience, followed by the interaction of ACEs and resilience. Analyses indicate that ACEs were associated with mental distress (B = 1.02, 95% CI 0.37 - 1.68, p < 0.01) and low resilience was associated with mental distress (B = 5.37, 95% CI 3.15 - 7.59, p < .01). The interaction between ACEs and low resilience was also related to mental distress (B = 1.32, 95% CI 0.17 - 2.47, p = 0.03), indicating that ACEs had a larger association with mental distress among respondents with low resilience. Findings highlight the importance of the direct association between resilience and mental distress, along with the moderating influence of resilience on the relation between ACEs and mental health. Interventions promoting resilience may be effective in reducing mental distress, especially among individuals with a history of ACEs.

The mediating role of impulsivity in the associations between child maltreatment types and past month substance use

BACKGROUND

Child maltreatment has emerged as an important risk factor for substance use. However, despite evidence consistently demonstrating that substance use peaks during emerging adulthood, less is known about the specificity of maltreatment effects on substance use during this critical developmental period. Further, the factors that might play a role in these associations are not well understood.

OBJECTIVE

The current study examined the associations between child maltreatment types (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) and past month marijuana, alcohol, and tobacco use among emerging adults, and tested whether impulsivity accounted for these associations.

METHODS

Participants were 500 emerging adults ranging in age between 18 and 25 years old (M = 18.96, SD = 1.22, 49.6% male) recruited from a large, public university in the Midwest United States.

RESULTS

Tests of indirect effects suggested that impulsivity accounted for associations between emotional abuse and past month marijuana, alcohol, and tobacco use.

CONCLUSIONS

Current findings provide support for impulsivity as a mechanism linking childhood emotional abuse to substance use among emerging adults, highlighting the need for targeted screening and intervention.

Effects of multiple adverse childhood experiences on substance use in young adults: A review of the literature

BACKGROUND

Adverse childhood experiences (ACE), including maltreatment and household dysfunction, are consistent predictors of health compromising behaviors in adulthood. While most ACE studies have focused on adults, there is an emerging body of research focusing on young adulthood.

METHODS

This review describes research focused on the relationship between ACE and substance use among young adults. Two databases were searched for studies published from 1998 to 2021 that assess the relationship between ACE and substance use among young adults. Of the 1474 articles identified in the search, 43 met the inclusion criteria.

RESULTS

Consensus across reviewed studies is that the relationship between ACE and substance use demonstrated in the general adult population is evident in young adults, although effects varied by demographic variables such as gender and ethnic background.

CONCLUSIONS

The need for standardized measures across studies, racial/ethnic considerations, and the importance of building trauma informed prevention programs targeting this age group are discussed.

The Intergenerational Impact of Adverse Childhood Experiences on Hispanic Families: The Mediational Roles of Parental Depression and Parent-Adolescent Communication

Parental exposure to adverse childhood experiences (ACEs) has been documented as a strong risk factor for subsequent externalizing behaviors in their youth. Although studies have investigated ACEs and their intergenerational association with youth externalizing behaviors, this association has not been investigated in Hispanic families. Additionally, substantial gaps in the literature exist explaining the mechanisms by which this association occurs. The purpose of this study was to examine whether parent-adolescent communication and parental depressive symptomatology explain the relationship between parent's ACE score and adolescent externalizing behaviors. This secondary data analysis utilized baseline data from an ongoing randomized controlled trial evaluating the relative effectiveness of an online parenting intervention for Hispanic adolescents. The sample consisted of 456 parents and their adolescents between the ages of 12-16. Using path modeling, parental depressive symptomatology and parent-adolescent communication were simultaneously examined as mechanisms that may explain the intergenerational relationship between parental exposure to ACEs and externalizing behaviors in Hispanic youth. Parental depressive symptomatology and parent-adolescent communication both significantly mediated the association between parental exposure to ACEs and adolescent externalizing behaviors. Understanding the mechanisms explaining the intergenerational association between parental exposure to ACEs and adolescent externalizing behaviors may aid future research examining problematic behaviors in Hispanic youth.

The influence of childhood and early adult adversities on substance use behaviours in racial/ethnically diverse young adult women: a latent class analysis

Childhood and adult adversities occur more frequently among women and persons of colour, possibly influencing racial/ethnic disparities in substance use behaviours. This study investigates how childhood and adult adversities cluster together by race/ethnicity and how these clusters predict binge drinking, tobacco, e-cigarette, and marijuana use. Latent class analysis (LCA) was used in a combined sample from the 2015 to 2018 Minnesota College Student Health Survey to identify clusters of childhood and adult adversities among Asian, Black, Latina, and White women aged 18-25. Each substance use outcome was regressed on each adversity cluster across each race/ethnicity group. Across all racial/ethnic groups and substance use outcomes, the high adversity cluster exhibited the greatest risk. Significant racial/ethnic disparities were observed across several substance use behaviours; these were attenuated among women with fewer adversities. The reduced substance use disparities found among those with lower adversities suggest that prevention of adversities may advance health equity.

Adverse Childhood Experiences and Depressive Symptoms among Young Adult Hispanic Immigrants: Moderating and Mediating Effects of Distinct Facets of Acculturation Stress

Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test theoretically-based mediating and moderating effects of acculturation stress on the relationship between ACEs and depression in a sample of young adult Hispanic immigrants (N = 391). Results indicated ACEs predicted depressive symptoms. Mediation and moderation effects were significant for cumulative and distinct facets of acculturation stress. Implications for mental health nurses are discussed.

Adverse childhood experiences and other risk factors associated with adolescent and young adult vaping over time: a longitudinal study

BACKGROUND

Vaping among adolescents and young adults is a significant public health concern worldwide. Understanding which risk factors are associated with vaping is important to help inform evidence-based prevention and intervention strategies. There are several gaps in the current literature examining these associations such as limited longitudinal research. We examined the association between parental smoking/vaping, adolescent sex, mental disorders in adolescence, 13 adverse childhood experiences (ACEs) and a) any vaping and b) course of vaping across two time points among adolescents and young adults.

METHODS

Data were from Waves 1 and 2 of the longitudinal Well-Being and Experiences Study (The WE Study) in Manitoba, Canada which collected data from a community sample of adolescents (14 to 17 years) and their parent/caregiver in Wave 1 in 2017-18 and the adolescents/young adults only in Wave 2 in 2019. A total of 752 adolescents/young adults (72.4% of the original cohort) completed both waves of the study. Binary and multinomial logistic regressions were conducted to understand the relationship between the 16 risk factors and the two vaping outcomes.

RESULTS

Vaping prevalence was 45.5% for any vaping, 2.7% for Wave 1 vaping only, 19.7% for new onset Wave 2 vaping, and 21.2% for vaping at both waves. After adjusting for covariates, the majority of risk factors examined were associated with any adolescent or young adult vaping, including: parental smoking or vaping, emotional abuse, emotional neglect, exposure to verbal intimate partner violence, household substance use, household mental illness, parental separation/divorce, parental problems with police, foster care or contact with a child protective organization, an unsafe neighbourhood, and peer victimization. The majority of these risk factors, as well as adolescent mental health and parental gambling, were associated with different courses of vaping across the two time points.

CONCLUSIONS

The findings emphasize the need for early vaping prevention and identified several ACEs and other factors that were associated with adolescent and young adult vaping and course of vaping. These identified ACEs and risk factors can help inform programs, strategies, and potential groups to target for vaping interventions.

Adverse childhood experiences are associated with increased overdose risk in predominately Latinx adults seeking treatment for substance use disorders

INTRODUCTION

Almost no previous studies explored the relationship between adverse childhood experiences (ACEs) and overdose risk for individuals with substance use disorders (SUDs), and these did not focus on a Latinx population. This study examined the relationship between ACEs, reporting PTSD symptoms, and lifetime experience of overdose in a sample (n = 149) of primarily Latinx adults seeking treatment for substance use disorder (SUD).

MATERIALS AND METHODS

Administrative data from an integrated behavioral health and primary care treatment system in Massachusetts were analyzed through bivariate analyses and multiple logistic regression. The final model examined the association between self-reported ACEs, PTSD screen, and lifetime drug overdose. We controlled for demographic characteristics and heroin use and explored alternative measure specifications.

RESULTS

ACEs scores were high with 58% having experienced 4+ ACEs. Female gender was associated with a 24% higher ACE score than male gender (p < 0.01). In the multiple logistic model each additional ACE was associated with 1.3 times greater odds of overdose (p < 0.01). Those reporting heroin use had 8.8 times greater odds of reporting overdose compared to those reporting no heroin use (p < 0.001). Gender, age, Puerto Rican ethnicity, years of cocaine use, receiving public assistance income, and a positive initial PTSD screen were not significant. Findings were robust in sensitivity testing.

DISCUSSION AND CONCLUSION

We found the number of ACEs and reported heroin use significantly and positively associated with self-report of overdose in both bivariate and multiple logistic regression analyses. In contrast, a positive initial screen for PTSD was only significantly associated with overdose in the bivariate analysis. Increased screening for ACEs is warranted and ACE-specific treatment is suggested for SUD treatment programs offering trauma-informed services for adults.

Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia

El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.

The Differential Contribution of Adverse Childhood Experiences and Perceived Discrimination on Substance Use among Hispanic Emerging Adults

Adverse childhood experiences (ACE) are widely documented risk factors for substance use among Hispanic emerging adults. Studies seldom examine whether distinct ACEs differentially relate to substance use in emerging adulthood, and if said association varies in the context of additional stressors disproportionately experienced by Hispanic people. This examination is necessary for understanding the etiology of substance use disorders and related outcomes among Hispanic individuals. Using a sample of Hispanic emerging adults, the goals of this study were two-fold. First, it examined differences in substance use between subgroups of varying ACEs. Second, it assessed whether substance use in the presence of discrimination differed between ACE subgroups. Latent class analysis identified two emerging ACE subgroups: [1] Parental Separation and [2] Physical & Emotional. On average, individuals in the Physical & Emotional subgroup endorsed a higher likelihood of tobacco, cannabis, and illegal drug use than those in the Parental Separation subgroup. For the latter, the likelihood of binge drinking was higher than that of the Physical & Emotional subgroup if they also perceived discrimination in emerging adulthood. These findings highlight the importance of considering the intersection of multiple social determinants of health for understanding the lifetime risk of substance use among Hispanic individuals.

Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study

Trauma exposure across the lifespan produces risks for posttraumatic stress disorder (PTSD), depression, anxiety, as well as global disability in functioning. This retrospective clinical chart review is the first of its kind to assess the utility of sublingual ketamine-assisted body-centered psychotherapy in trauma-exposed patients in a real world clinic setting. De-identified clinical records data on self-reported symptom measures were retrospectively analyzed for patients (N = 18; M age = 45.22, SD = 12.90) entering ketamine-assisted psychotherapy treatment in an outpatient clinic between 2018 and 2020. Patients who completed six sessions of ketamine therapy reported meaningful (e.g., medium effect size) improvements in PTSD symptoms (P = 0.058; d = −0.48) and global disability in functioning (P = 0.050; d = −0.52) and statistically significant and meaningful improvements in depression (P = 0.019; d = −0.53). There were no improvements in anxiety symptoms. Sublingual ketamine-assisted psychotherapy was associated with heterogenous clinical utility among patients with trauma-exposure in an outpatient setting. This study was underpowered and unrepresentative of the population of ketamine patients in the United States. Replication of these findings is needed with larger and more diverse patient samples.

The impact of childhood trauma on substance use trajectories from adolescence to adulthood: Findings from a longitudinal Hispanic cohort study

BACKGROUND

Adverse Childhood Experiences (ACE) are associated with substance use in adolescence and adulthood. However, there is a lack of longitudinal research examining the effect of ACE on substance use trajectories from adolescence through emerging adulthood.

OBJECTIVE

This study examined the role of ACE in substance use trajectories among Hispanic emerging adults.

PARTICIPANTS

We surveyed a cohort of Hispanic adolescents (n = 1399) in Southern California across eight survey waves (beginning in 9th grade and continuing through emerging adulthood).

METHODS

Growth curve models were used to examine the effect of ACE on past 30-day cigarette, marijuana, and alcohol use over seven time points, and an interaction term of ACE ∗ time was included to investigate the cross-level effect of ACE.

RESULTS

ACE was a significant predictor at 9th grade across all substances. Every additional ACE was associated with significantly higher past 30-day cigarette use (β = 0.05, 95%CI = 0.01, 0.10), marijuana use, (β = 0.15, 95%CI = 0.06, 0.25) and alcohol use (β = 0.14, 95%CI = 0.06, 0.21). Across all models, cross level interactions between ACE and time indicated that young adults exposed to more ACE experience significantly steeper inclining trajectories of 30-day cigarette use (β = 0.05, 95%CI = 0.02, 0.68), marijuana use (β = 0.07, 95%CI = 0.03, 0.11), and alcohol use (β = 0.02, 95%CI = 0.02, 0.68) than young adults with fewer ACE.

CONCLUSION

ACE continue to have an impact on substance use trends through emerging adulthood. Results highlight the graded effect of ACE on substance use during and beyond adolescence and illustrate that ACE exposure is linked to an escalation of substance use frequency.

Understanding Adverse Childhood Experiences as Predictors of Cigarette and E-Cigarette Use

INTRODUCTION

Adverse childhood experiences contribute to both short- and long-term health issues and negative health behaviors that affect the individual as well as families and communities. Exposure to ≥4 of the 11 adverse childhood experiences (high adverse childhood experiences) compounds the problems in later life. This study assesses the associations among tobacco use, adverse childhood experiences, mental health, and community health.

METHODS

This study was a secondary data analysis utilizing a large 2019 data set from a Community Health Needs Assessment in Florida (N=14,056). Investigators utilized inferential statistics to determine adverse childhood experiences as a predictor of tobacco use (vaping and cigarette use). In addition, they examined whether a shorter, 2-question adverse childhood experience scale was equivalent to the full scale when predicting tobacco use.

RESULTS

The results indicated that parental divorce was the most common household stressor, followed by mental illness and alcoholism. High adverse childhood experiences were found to be most prominent in marginalized individuals. For those individuals experiencing ≥4 adverse childhood experiences, parental divorce continued to rank high, followed by mental illness. Household stressors included emotional and physical abuse as the most prevalent in the ≥4 adverse childhood experience group. High adverse childhood experiences were associated with current cigarette smoking (AOR=1.56) after controlling for individual mental health and social/community health variables. High adverse childhood experiences were also associated with E-cigarette use (AOR=1.81) but not dual cigarette/E-cigarette use. Social and community health was inversely associated with tobacco use. A 2-item adverse childhood experiences measure was sufficient in identifying tobacco users.

CONCLUSIONS

Including adverse childhood experiences in community needs assessments provides important information for tobacco control efforts and prevention of chronic disease.

The Cumulative and Differential Relation of Adverse Childhood Experiences and Substance Use During Emerging Adulthood

Adverse childhood experiences (ACEs) have far-reaching effects on a wide range of health outcomes in adulthood, however, less is known about their consequences in emerging adulthood or in a geographically distinct sample. We examined the cumulative and individual relation of ACEs and two risky behaviors: alcohol and illegal drugs consumed by 490 Spanish emerging adults (mean age = 18.9). Participants answered the ACEs questionnaire, and two items about alcohol and illegal drugs consumption. Results showed that the overall experience of suffering different ACEs was a significant predictor of drug but not of alcohol consumption. Moreover, ACEs subtypes presented differential effects on substance use. Whereas some increased the likelihood of either drug or alcohol use, others reduced it. This study supports the importance of examining specific adverse experiences rather than only using an overall measure and provides some counterintuitive results that may be linked to resilient mechanisms.

Confía en mí, Confío en ti: Applying developmental theory to mitigate sociocultural risk in Latinx families

Ed Zigler was a champion for underprivileged youth, one who worked alongside communities to fight for long-lasting systemic changes that were informed by his lifespan and ecological perspective on the development of the whole child. This paper reports on the development, implementation, and preliminary outcomes of an intervention that embodied the Zigler approach by adopting a community participatory research lens to integrate complementary insights across community-based providers (promotoras), Latinx immigrant families, and developmental psychologists in the service of promoting parent-child relationship quality and preventing youth aggression and violence. Analyses from the first 112 Latinx mother-youth dyad participants (46% female children, ages 8-17) in the resultant, Confía en mí, Confío en ti, eight-week intervention revealed significant pre-post increases in purported mechanisms of change (i.e., attachment security, reflective functioning) and early intervention outcomes (i.e., depressive, anxiety, and externalizing problems). Treatment responses varied by youth age. A case analysis illustrated the lived experiences of the women and children served by this intervention. We discuss future directions for the program, as well as challenges to its sustainability. Finally, we consider Ed's legacy as we discuss the contributions of this work to developmental science and our understanding of attachment relationships among low-income immigrant Latinx families.

"This Is the Result of Something Else": Experiences of Men That Abused Drugs and Had Experienced Childhood Trauma

Drug abuse is a serious public health issue that may have irreversible consequences. Research has revealed that childhood psychological trauma can promote addictive behaviors in adulthood and that drugs are often used as a coping mechanism. Men are less likely to report trauma and seek help than women. The purpose of this qualitative study was to explore the experience of men in Iceland who have abused drugs and experienced childhood psychological trauma, to increase knowledge and deepen the understanding of trauma and addiction. Participants were seven men who had both experienced childhood trauma and had a history of drug abuse. Two interviews were conducted with each participant. The main findings suggest that participants abused drugs as a coping mechanism due to the trauma experienced in childhood. For some participants, seeking companionship was a key component of their drug use. Participants were mostly dissatisfied with treatment resources in Iceland; waiting lists were long and too much focus was on religion. Five main themes were identified: emotional impact, self-medication for pain, gender expectations, impermanence of thoughts, and loss of a sense of wholeness. Increased societal and professional awareness of the linkage between trauma and drug abuse is needed, as are additional resources specific to men who have experienced childhood trauma and drug abuse. It is important to integrate trauma focused services into health-care settings to educate health-care professionals on trauma and the consequences thereof, in addition to utilizing screening tools such as the Adverse Childhood Experience Questionnaire for those seeking assistance.

Adverse childhood experiences: Mechanisms of risk and resilience in a longitudinal urban cohort

There is an extensive literature describing the detrimental effects of adverse childhood experiences (ACE; e.g., abuse, neglect, and household dysfunction) on physical and mental health. However, few large-scale studies have explored these associations longitudinally in urban minority cohorts or assessed links to broader measures of well-being such as educational attainment, occupation, and crime. Although adversity and resilience have long been of interest in developmental psychology, protective and promotive factors have been understudied in the ACE literature. This paper investigates the psychosocial processes through which ACEs contribute to outcomes, in addition to exploring ways to promote resilience to ACEs in vulnerable populations. Follow-up data were analyzed for 87% of the original 1,539 participants in the Chicago Longitudinal Study (N = 1,341), a prospective investigation of the impact of an Early Childhood Education program and early experiences on life-course well-being. Findings suggest that ACEs impact well-being in low-socioeconomic status participants above and beyond the effects of demographic risk and poverty, and point to possible mechanisms of transmission of ACE effects. Results also identify key areas across the ecological system that may promote resilience to ACEs, and speak to the need to continue to support underserved communities in active ways.

Frequent Marijuana or Alcohol Use in Low-Income Emerging Adults: Impact of Adverse Life Experiences

The transition to adulthood may be especially difficult for those who use drugs and alcohol regularly. While research clearly links adverse childhood experiences (ACEs) with later substance use, many studies have explored only a limited range of ACEs, and have focused on the number instead of specific types of ACE. Objectives: The current study examined the role of ACEs on the likelihood of frequent marijuana and alcohol use among a community sample of emerging adults (N = 185). This research builds on and extends previous work by focusing on a low-income sample, examining specific types of ACEs, and expanding categories to include some less studied ACEs. Logistic regression models examined the relationships between ACEs and frequent alcohol or marijuana use. Results: The emerging adults in the current sample experienced many ACEs in childhood, and roughly a third reported frequent (defined as using once a week or more for the past 90 days) alcohol or marijuana use. ACEs associated with both frequent marijuana and alcohol use were time spent in foster care, childhood emotional abuse, and having a close family member or friend who died violently. Alcohol use was further predicted by childhood sexual abuse and witnessing a serious injury or death, while marijuana use was further predicted by childhood physical abuse. Conclusions: Findings highlight the importance of thoroughly assessing for ACEs when addressing substance use issues in young adults. The negative impact of being in foster care may be overlooked as a trauma beyond the experiences that contributed to entering care.

Adverse Childhood Experiences Among 3 Generations of Latinx Youth

INTRODUCTION

The U.S. immigrant paradox shows worsening health across generations, with U.S.-born Latinx having poorer health outcomes than immigrants. Adverse childhood experiences are associated with increased health risk over the life course, warranting further investigation. This study examines adverse childhood experience distribution across generations in a community sample of first-, second-, and +third-generation Latinx youth.

METHODS

Survey data were collected at 7 timepoints from 2005 to 2016; 1,303 participants completed follow-ups, including adverse childhood experiences, at Timepoint 5 (mean age=21.6 years). These analyses were performed in 2019. Adverse childhood experiences measured psychological, physical, and sexual abuse, and parental domestic violence, divorce, alcohol/drug use, mental illness, and incarceration. Adverse childhood experiences were operationalized as a continuous variable (number) and by 2 groups: household dysfunction and maltreatment. Associations between immigrant generation and adverse childhood experiences were analyzed in adjusted logistic and multiple regression models.

RESULTS

Compared with +third-generation youth, first- (OR=0.49, 95% CI=0.27, 0.89) and second- (OR=0.43, 95% CI=0.26, 0.72) generation youth had lower odds of reporting household dysfunction. For first-generation youth, this was specific to living with an alcohol/drug user (OR=0.49, 95% CI=0.29, 0.81). In contrast to other adverse childhood experiences, first-generation youth had twice the odds of reporting sexual abuse (OR=2.01, 95% CI=1.04, 3.88) compared with +third-generation youth.

CONCLUSIONS

Preventing health disparities among immigrant-origin youth requires understanding the impact of adverse childhood experiences on Latinx youth across generations. Results highlight associations among a Latinx youth community sample, suggesting variations in experiences across generations. Household factors in childhood may be key targets for interventions aimed at improving the outcomes observed in later generations for Latinx families.

Adverse Childhood Experiences, Resilience, and Emotional Problems in Latinx Immigrant Youth

Although research suggests that Adverse Childhood Experiences (ACEs) are associated with emotional problems, individuals with higher resilience experience less emotional problems. This relation has yet to be examined in the growing Latinx immigrant youth population in the United States. To study the relation between ACEs, emotional problems, and resilience, recently immigrated Latinx youth (N=85) were interviewed using the Adverse Childhood Experiences Study questionnaire, the Strengths and Difficulties Questionnaire, and the Resilience Scale. Moderation analyses revealed ACEs were directly associated with emotional problems, as was resilience. While the interaction effect was not significant, conditional effects indicated a buffering effect such that the relation between ACEs and emotional problems was non-significant at high levels of resilience. In addition to the relatively small sample size, available measures for assessing ACEs and emotional problems are limited in capturing difficulties experienced by Latinx immigrants. Results indicate that individuals with higher resilience do not experience higher emotional problems in the context of childhood adversity. This study contributes to the growing literature on protective factors in Latinx immigrant youth, indicating that assessment of resilience may be beneficial in treating individuals exposed to adversity to mitigate the development of emotional problems.

Childhood polyvictimization and marijuana use trajectories

Despite public sentiment to the contrary, recreational marijuana use is deleterious to adolescent health and development. Prospective studies of marijuana use trajectories and their predictors are needed to differentiate risk profiles and inform intervention strategies. Using data on 15,960 participants in the National Longitudinal Study of Adolescent to Adult Health, variable-centered approaches were used to examine the impact of childhood polyvictimization on marijuana onset, marijuana use from age 15 to 24 years, and marijuana dependence symptoms. Zero-Inflated Poisson latent class growth analysis (ZIP-LCGA) was used to identify marijuana use subgroups, and their associations with childhood polyvictimization were tested via multinomial logit regression within ZIP-LCGA. Results showed that the overall probability and frequency of marijuana use increased throughout adolescence, peaked in early adulthood, and diminished gradually thereafter. Polyvictimization was associated with earlier onset and greater overall use, frequency of use, and dependence symptoms. ZIP-LCGA uncovered four subgroups, including non-users and three classes of users: adolescence-limited users, escalators, and chronic users. Polyvictimization distinguished non-users from all classes of marijuana users. The findings underscore the lasting developmental implications of significant childhood trauma. Children who experience polyvictimization represent a group that may benefit from selective interventions aimed at preventing early, frequent, chronic, and dependent marijuana use.

Examining the Role of Childhood Adversity on Excess Alcohol Intake and Tobacco Exposure among US College Students

BACKGROUND

Adverse childhood experiences (ACEs) are often associated with substance use behaviors such as drinking excess alcohol and tobacco use. Resilience may protect individuals from engaging in these maladaptive behaviors following ACEs. Objectives: We examined the associations between ACEs and excessive alcohol consumption, and ACEs and tobacco intake and exposure among diverse college students, and whether resilience buffered this relationship. Methods: We conducted a cross-sectional online survey in October 2018 with students at a large Southern university to assess ACEs, levels of resilience, and students' health behaviors. We used the Adverse Childhood Experiences - International Questionnaire (ACE-IQ) and the Brief Resilience Scale. Logistic regression modeled the relationship between ACEs and students' substance use behaviors. We adjusted for demographics, other health behaviors, and emotional health and we tested resilience as a possible buffer. Results: Participants (n = 568) were in their early twenties, almost three-fourths were female. We had a racially/ethnically diverse sample. Over two-thirds had experienced 1-4 ACEs. ACE exposure was not associated with excess alcohol consumption but exhibited a consistent dose-response relationship in unadjusted and adjusted models. Moderate ACEs increased the odds of tobacco exposure by 227% (OR: 3.27, 95% CI: 1.17-9.11) in adjusted models. Resilience was unrelated to either behavior. Black respondents had significantly reduced odds for both substance use outcomes. Tobacco exposure and excess alcohol intake were comorbid behaviors. Conclusion: Childhood adversity was a significant predictor for tobacco exposure among diverse US college students. Resilience did not buffer this relationship. Age, gender, and race/ethnicity were differentially associated with substance use.

The Role of Adverse Childhood Experiences on Perinatal Substance Use Behaviour in KwaZulu-Natal Province, South Africa

The role of risky sexual behaviour has been widely investigated across the sub-Saharan African HIV hyperendemic setting, with few studies having focused on the behaviour attributed to the deep-rooted, neurodevelopmentally-driven adverse childhood experiences (ACE) that sustain the endemic. We investigated the role of ACE on perinatal substance use outcomes in KwaZulu-Natal Province, South Africa, with 223 women being interviewed within one-week post-partum at a general hospital. Our secondary outcome was the occurrence of preterm birth delivery, which is understood to be linked to ACE. Study results suggest that the most common perinatal substance use was alcohol (n = 27, 12.11%), followed by tobacco (n = 18, 8.07%), with the prevalence of preterm birth delivery being 8.97% (n = 20, 8.97%). Regression analyses indicated increased ACE being significantly associated with perinatal alcohol (aOR = 1.45, 95% CI 1.22-1.72), tobacco use (aOR = 1.56, 95% CI 1.23-1.97) and preterm birth delivery (aOR = 1.21, 95% CI 1.03-1.43), independent of socio-economic status. When the model was further adjusted by HIV status, suppressed viral load was more significantly associated with lower odds of preterm birth delivery (aOR = 0.06, 95% CI: 0.01-0.24) than an unsuppressed status. Risk-behaviour reduction strategies should address the role of ACE on substance use and viral load, and hence possibly ART adherence, in HIV hyperendemic settings.

Confronting the opioid epidemic: public opinion toward the expansion of treatment services in Virginia

BACKGROUND

Public opinion polls have consistently shown Americans prefer treatment over arrest policies for opioid users. As the opioid epidemic remains a major health problem in the United States, it is important to determine the type of treatment policies the public would support. Theoretically, government should take into consideration the opinion of its constituents when deciding how to act. As such, the 2018 Virginia Commonwealth Public Policy Poll determined levels of support for the expansion of community-based treatment in one's community.

RESULTS

Overall, the results showed 80% of Virginians (n = 788) supported the expansion of community-based treatment centers in their neighborhood, 69% supported the use of housing in their community, while less than half supported the provision of clean needles to IV drug users so they do not use dirty needles that could spread infection. Multivariate analyses revealed education, sex, and political party affiliation are significant factors in predicting support for the expansion of services.

CONCLUSIONS

Given the lack of progress made by the government in reducing the supply and demand of drugs over the course of the war on drugs, it is time to move away from punitive policies to responsible and pragmatic approaches that include the expansion of community-based treatment.

Impact of Adverse Childhood Experiences on Alcohol Use in Emerging Adults in Montenegro and Romania

Background

Aiming at generating evidence for formulating targeted and cost-effective public health interventions for the effective control of alcohol use (AU) in emerging adults in South Eastern Europe. The study’s objective was to assess if alcohol users experience adverse childhood experiences (ACE) more often than non-users, and to identify which ACE victims are the most vulnerable to AU.

Methods

The data was collected in 2010–2012 in two cross-sectional studies conducted in university settings in Montenegro and Romania (overall response rate 89.1%). In the present study, 3,283 students were included. The international ACE Study Questionnaires were used as a base for study instruments for collecting information on ACEs, health behaviours, and socio-economic factors. The association between AU and individual ACEs, adjusted to background factors, was assessed by using logistic regression.

Results

From the child maltreatment group, three ACEs were included in the final model as statistically significantly associated with AU, all of them from physical neglect/abuse types: frequently being hit so hard to have marks or being injured (OR=1.68; p=0.012), frequently being spanked (OR=1.38; p=0.012), and frequently having no person to take to the doctor if necessary (OR=0.58; p=0.031). From the household dysfunction group, two ACEs were included in the final model: exposure to mental health problems in the household (OR=2.85; p<0.001), and living with a problematic drinker/alcoholic (OR=1.51; p=0.019).

Conclusions

The effect of exposure to ACEs on AU persists into emerging adulthood. This should be considered when developing cost-effective response to AU burden through targeted interventions, in particular in settings with scarce resources.

The role of emotion dysregulation in the relation of childhood trauma to heroin craving in individuals with heroin dependence

OBJECTIVES

Difficulties in emotion regulation (DER) may be important in heroin craving in individuals with heroin dependence who have experienced childhood trauma (CT). However, no research has been performed on DER in the context of heroin dependence. The aim of this study was to evaluate direct and indirect relations of CT to the subscales of heroin craving (i.e., heroin thoughts and interference, intention to use heroin and control of its consumption, and resistance to thoughts and decisions to use heroin) via DER dimensions in individuals with a DSM diagnosis of heroin dependence.

METHODS

In a cross-sectional design, 330 males with heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS).

RESULTS

The results revealed that CT had no direct relations to the subscales of heroin craving, but it indirectly was related to all three subscales of heroin craving via one of the DER dimensions named limited access to emotion regulation strategies (Strategies) after adjusting for demographic and clinical factors.

CONCLUSIONS

The findings suggest that Strategies may be related to heroin craving in individuals with heroin dependence who have CT. This proposes that treatment and prevention attempts focused on training the use of effective emotion regulation strategies may be useful to reduce heroin craving in individuals with heroin dependence who have experienced a history of CT.

Demographic Moderators of the Relationship Between Adverse Childhood Experiences and Cigarette Smoking

Background: Research suggests that there is a dose-response relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking, such that as ACE score increases, so do the odds of smoking behavior, but little is known about what factors moderate this relationship. Objectives: The goal of this study was to examine demographic characteristics as potential moderators of relationship between ACE score and cigarette smoking. Methods: A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10). We used multinomial logistic regression to test sex, race, income, and education as moderators of the relationship between ACE score and smoking. Results: ACEs were not significantly associated with smoking behavior. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. Conclusions/Importance: Results suggest that there may not be a relationship between ACEs and smoking later in life. Additionally, the relationship between ACEs and smoking in adulthood may not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.

Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015

Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.

Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample

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.

Childhood Abuse and Adulthood IPV, Depression, and High-Risk Drinking in Latinas

Little is known about relationships between child maltreatment and adulthood intimate partner violence (IPV), depression, and risky drinking in Latinas. 548 Latinas in a sexual health randomized control trial (RCT) self-reported childhood physical, sexual, and emotional abuse, IPV, depression, and risky drinking. Childhood abuse was related to adulthood IPV, OR = 1.27, depression, OR = 2.02, and high-risk drinking, OR = 2.16. Childhood emotional abuse was linked to depression, OR = 2.19; childhood physical abuse to risky drinking, OR = 2.62; and childhood sexual abuse to depression, OR = 2.78 and risky drinking, OR = 2.38. Results may inform prevention/intervention efforts for mental health nurses.

Substance Use Outcomes for Hispanic Emerging Adults Exposed to Incarceration of a Household Member during Childhood

This study investigates whether Hispanic emerging adults exposed to household incarceration before age 18 report higher rates of past 30-day cigarette, alcohol, binge drinking, marijuana use, and negative substance use consequences, relative to participants not exposed to incarceration of a household member. Respondents were matched on key characteristics to create balanced groups of exposed and nonexposed respondents. Negative binomial regression models assessed primary research questions. There were significant long-term associations between household incarceration and the frequency of past 30-day binge drinking, marijuana use, and number of negative substance use consequences. Policies and health programs addressing household incarceration may be a promising prevention approach to reduce negative substance use outcomes among Hispanic emerging adults.

Substance use and use disorders and treatment receipt among adults in families receiving Temporary Assistance for Needy Families (TANF), 2003-2014

BACKGROUND/PURPOSE

Legalization of marijuana for medical and/or recreational use in some U.S. states has increased attention to substance use and related problems. However, little attention has been paid to these phenomena among adults in families receiving Temporary Assistance for Needy Families (TANF) whose adverse life experiences may put them at elevated risk of substance use disorders (SUDs).

METHODS

Data from the 2003-2014 National Survey on Drug Use and Health (NSDUH) were used to test trends in past-month binge drinking and past-year marijuana, other illicit drug, and any illicit drug use and to examine SUD prevalence and treatment correlates among adults in TANF families.

RESULTS

While rates of binge drinking and any illicit drug use remained steady, marijuana use increased from 15.8% in 2003/2004 to 21.6% in 2013/2014, a 36.7% increase. Increased marijuana use was strongly related to changes in marijuana risk perception. Among adults in TANF families, 19.5% of men and 10.8% of women had a past-year SUD, but only one in five received treatment. Those aged 18-25, Black or Hispanic women, and those who had children at home when surveyed were less likely to have received treatment.

DISCUSSION

Preventive efforts to address substance use, especially marijuana use, among adults in TANF families are needed. Moreover, given greater odds of unmet SUD treatment need among these economically disadvantaged adults, particularly racial/ethnic minority women and those who are in emerging adulthood, uninsured, and have children at home, measures to provide more inclusive services such as integrated behavioral health care are needed.