Distinct paths to alcohol problems: Impacts of childhood maltreatment, attachment insecurity, and interpersonal problems

Attachment, Mental Health, and Alcohol Use by Men: The Mediating Role of Cumulative Lifetime Violence Severity

Cumulative lifetime violence (CLV) encompasses many different types and contexts of violence that occur across the lifespan and is associated with negative mental health outcomes in men; however, little attention has been paid to other factors that can influence these relationships such as attachment style. In this analysis, our focus is to understand how attachment styles directly and indirectly through CLV affect men's mental health, specifically depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol use. Data from 597 Canadian men with lifetime experiences of violence who participated in our national online survey focusing on violence and health were used for mediation analysis. Results indicated that CLV severity mediated the relationship between attachment anxiety (but not attachment avoidance) and depression, anxiety, PTSD, and alcohol use. Although attachment anxiety and attachment avoidance each directly affected depression, anxiety, and PTSD, neither directly affected alcohol use. Importantly, these findings provide the first evidence that the mechanism by which anxious attachment affects alcohol use is through CLV severity. These findings highlight the importance of anxious attachment on mental health outcomes for men who have experienced CLV.

Comparison of Attachment Styles, Family Functioning and Locus of Control in Individuals with and without Alcohol Use Disorder

This study aims to examine the variables of attachment styles , family functioning, and locus of control in individuals with and without alcohol use disorder. The 54 participants, including 51 male and 3 females with alcohol use disorder between the ages of 18-60s were chosen from the outpatients of xx service, the attendants of xx meetings, and the people referred by them. The control group consisted of 60 participants who were similar to the study group in terms of age and gender variables, without alcohol use disorder and psychological disorder. Data were collected through a questionnaire including Sociodemographic Data Form, Michigan Alcoholism Screening Test (MAST), Experiences in Close Relationships - Revised (ECR -R), Family Assessment Device (FAD), and Rotter’s Locus of Control Scale (LCS). In the results of the study, it was found that the participants with alcohol use disorder had a significantly higher ECR-R anxiety and avoidance score, and LCS score than the control group. Participants with the alcohol use disorder had a considerably lower FAD score than the control group. Finally, the effects of the applied scales on alcohol addiction are analyzed and it was concluded that the scores of FAD and LCS had a statistically significant effect on alcohol addiction. Accordingly, an increase in the FAD score by one unit reduces the alcohol addiction risk by %95, while an increase in the LCS score by one unit increases the alcohol addiction risk by %31.

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.

The association between child maltreatment and health risk behaviours and conditions throughout life in the Australian Child Maltreatment Study

OBJECTIVE

To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions.

DESIGN, SETTING, PARTICIPANTS

Nationally representative survey of Australian residents aged 16 years and older conducted by computer-assisted telephone interviewing.

MAIN OUTCOME MEASURES

Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self-harm in past 12 months, and suicide attempt in past 12 months.

RESULTS

A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16-24-year-olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self-harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment.

CONCLUSIONS

Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.

"She was willing to send me there": Intrafamilial child sexual abuse, exploitation and trafficking of boys

BACKGROUND

Boys subject to intrafamilial child sexual exploitation and abuse (CSEA) - in particular, cases which begin as incest and later evolve into child trafficking for sexual exploitation - face many barriers in disclosing their exploitation, often leaving victims and survivors feeling isolated from society and dismissed or mishandled by service providers such as law enforcement officers, child protection specialists, medical staff and mental health professionals.

OBJECTIVE

This study explores the unique characteristics of intrafamilial CSEA through the sex trafficking of boys, and the barriers to disclosure and recovery experienced by male victims and survivors.

PARTICIPANTS AND SETTING

Ten adult male survivors of intrafamilial child trafficking for sexual exploitation were interviewed multiple times to gain a deeper understanding of intrafamilial CSEA and how it compares and contrasts with non-familial CSEA. Participants in this study primarily came from North America.

METHODOLOGY

Multiple semi-structured online interviews were conducted with these 10 adult male survivors because they experienced 1) intrafamilial CSEA and 2) being trafficked by their families to be sexually exploited by non-familial perpetrators. The participants were then asked to compare and contrast intrafamilial and non-familial CSEA. The research team employed a descriptive phenomenological approach and interview transcripts were coded, analyzed, and compared to identify patterns of non-verbal CSEA indicators and thematic narratives. The study also explored the internal and external barriers to disclosure reported by participants. Trauma-informed, person-centered practices were used throughout the entirety of the study to minimize harm to participants. The research team employed a co-productive approach using participants' initial interviews and feedback to formulate new questions for later rounds of interviews and by having the participants confirm the accuracy of their respective quotes and case summaries.

RESULTS AND DISCUSSION

This study highlights several CSEA modalities, such as "boy-swap" events and local/national/transnational trafficking rings engaged in CSEA of boys. It also discusses how survivors' experiences differed between intrafamilial and non-familial CSEA and trafficking, and how familial settings may facilitate concealment of CSEA. Participants described various modus operandi used by abusers, traffickers, and buyers of all genders. While all 10 intrafamilial CSEA cases included male perpetrators, female perpetrators were also present in nine of them. In addition, participants identified various psychological and physiological CSEA and trafficking indicators that evidenced their victimization during their childhood years. All 10 survivors reported long-term health consequences into adulthood and scored highly on Adverse Childhood Experiences (ACEs) questionnaires.

RECOMMENDATIONS AND CONCLUSION

Findings underscore the importance of trauma-informed practices for identifying, liberating, and rehabilitating victims and survivors. Participants reported receiving more effective assistance from service providers that exhibited trauma-informed practices. Traditional gender stereotypes may hinder the ability of service providers to recognize and provide support to boys victimized and trafficked by their families for CSEA. Consequently, service providers may stand to benefit from training on 1) trauma-informed, person-centered practices and 2) conscious and unconscious biases, particularly those related to gender. Survivors in recovery require expanded support services, such as the provision of safe housing, online/in-person support communities, and professional/life skill training. Co-productive research methods that integrate the views and experiences of CSEA and trafficking survivors are also recommended.

Cultural and psychosocial moderators of the association between adverse childhood experiences and alcohol and marijuana use among Latinx college students on the U.S./Mexico border

BACKGROUND

Adverse childhood experiences (ACEs) have been historically associated with negative life outcomes among the general population.

OBJECTIVE

With limited research among Latinx college students, this study assessed how specific constructs moderate the association between ACEs and alcohol and marijuana use.

PARTICIPANTS AND SETTING

Latinx participants recruited from a large U.S./Mexico border region university (Females: N = 283, Males: N = 168) completed an online survey which included: demographics, the Center for Youth Wellness Adverse Childhood Experience Questionnaire (CYW ACE-Q) Teen Self-Report, Drug Use Frequency (DUF), Experiences in Close Relationships Scale (ECR), General Self-Efficacy Scale (GSE), Attitudinal Familism Scale (AFS), The Machismo Measure or The Marianismo Beliefs Scale (MBS), and The Bicultural Self-Efficacy Scale (BSE).

METHODS

Hierarchical linear regressions were conducted to test for main and interactive effects and to determine if the individual moderators (i.e., attachment style, self-efficacy, familism, traditional gender norms, bicultural self-efficacy) affect the relationship between ACEs and alcohol and marijuana use.

RESULTS

Results indicated that among females, attachment style (β = 0.04, p = .03), MBS (β = -65.57, p = .01), and BSE (β = 0.34, p = .04) moderate the relationship between ACEs and alcohol and marijuana use. No moderation analyses were statistically significant among males.

CONCLUSIONS

Clinical implications include, for both substance use and trauma treatment among Latinx college students, the assessment of ACEs and attachment style to promote greater insight into the client's inner struggles and emotional processing in relation to marianismo beliefs and bicultural self-efficacy.

Examining the alcohol-related consequences of adult drinkers who self-report medicating low mood with alcohol: An analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions survey data

The aim of this paper is to examine the alcohol-related consequences experienced by adults who reported a 2-week period of low mood and identified as a 'self-medicator' compared to those who do not. Our focus is on assessing whether the conceptualization of alcohol use disorder severity differs across adult drinkers who self-medicate with alcohol during a period of low mood, compared to those who do not. This study used secondary data from the NESARC survey. The analytic sample consisted of 5945 participants who answered questions from the alcohol abuse/dependence (alcohol experiences) section, in the last 12 months. The sample was split into four groups by whether they self-medicated with alcohol or not, drank alcohol in the last year, and their drinking class. The findings indicated that a one-factor model was the best fit, and all items were a strong indicator of alcohol use disorder. The two-parameter model had the best fit, indicating that the diagnostic criteria were placed as a good fit along a continuum of severity. It was revealed that the hazardous drinking group who self-medicated, experienced more consequences even at low levels of severity. As the self-medicating hazardous drinking group also showed the highest estimates for alcohol use disorder severity, this may indicate that this group is composed of high-functioning self-medicators who are trying to regulate their drinking, and may not be as clinically high risk as expected, due to their drinking patterns.