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Assim A, Kaminer D, Hogarth L, Magner-Parsons B, Seedat S. Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents. CHILD ABUSE & NEGLECT 2024; 154:106885. [PMID: 38850749 DOI: 10.1016/j.chiabu.2024.106885] [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: 08/22/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts. OBJECTIVE The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents. PARTICIPANTS AND SETTING A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey. METHODS Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems. RESULTS CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives. CONCLUSIONS The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.
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Affiliation(s)
- Ayesha Assim
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa
| | - Debra Kaminer
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa.
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Bella Magner-Parsons
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Faculty of Medicine and Health Sciences, 241, Cape Town, South Africa
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Zaorska J, Skrzeszewski J, Kobyliński P, Trucco EM, Wojnar M, Kopera M, Jakubczyk A. From childhood trauma to alcohol use disorder severity - significance of depressive symptoms and expectations towards analgesic effects of alcohol. Alcohol Alcohol 2024; 59:agae041. [PMID: 38864292 DOI: 10.1093/alcalc/agae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/13/2024] Open
Abstract
AIMS The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD). METHODS A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity. RESULTS There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. CONCLUSIONS It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs.
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Affiliation(s)
- Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Jakub Skrzeszewski
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Paweł Kobyliński
- National Information Processing Institute, Laboratory of Interactive Technologies, al. Niepodległości 188B, 00-608 Warsaw, Poland
| | - Elisa Maria Trucco
- Department of Psychology, Florida International University, 11200 SW 8th Street, AHC 1 Miami, FL 33199, USA
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC 1 Miami, FL 33199, USA
- Department of Psychiatry, Addiction Center, University of Michigan, 4250 Plymouth Road Ann Arbor, MI 48109, USA
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
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Niu L, French DC, Wang Y, Sun J, Lin D. Childhood maltreatment and alcohol and tobacco use trajectories in rural Chinese adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:51. [PMID: 38702797 PMCID: PMC11067222 DOI: 10.1186/s13034-024-00744-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND There is a high prevalence of childhood maltreatment among Chinese children and adolescents, but little is known about its impact on alcohol and tobacco use trajectories and how positive school and neighborhood environments moderate the associations. The objective of this study was to assess the association between multiple forms of childhood maltreatment and longitudinal alcohol and tobacco use trajectories, and to assess the possibility that perceived connections to school and neighborhood moderate these associations. METHODS This longitudinal cohort study included 2594 adolescents (9 to 13 years) from a low-income rural area in China. Childhood exposure to abuse and neglect was assessed using the Childhood Trauma Questionnaire. Participants reported past-month alcohol and tobacco use at three time points over 1 year. RESULTS Growth curve models revealed that childhood sexual abuse was associated with a higher risk of past-month drinking (OR = 1.53, 95% CI 1.19-2.03, p < 0.001) and smoking (OR = 1.82, 95% CI 1.30-2.55, p < 0.001). Neglect was associated with a higher risk of past-month drinking (OR = 1.52, 95% CI 1.06-1.90, p < 0.05) and smoking (OR = 2.02, 95% CI 1.34-3.02, p < 0.001). None of the maltreatment forms predicted a faster increase in either drinking or smoking. These associations were found independent of personal, family, and contextual characteristics. School and neighborhood connection moderated the association between physical abuse and past-month drinking, such that physical abuse was associated with a greater risk of drinking only for youth who perceived low school or neighborhood connections. CONCLUSIONS Findings demonstrate the importance of early experiences of childhood maltreatment for adolescent alcohol and tobacco use. Enhancing school and neighborhood connectedness for physically abused youth may help protect them from alcohol use.
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Affiliation(s)
- Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Doran C French
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Yuyan Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianing Sun
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, 19 XinJieKouWai St., Haidian District, Beijing, China.
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Wang SS, Walsh K, Li JJ. A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories. Dev Psychopathol 2024; 36:750-764. [PMID: 36794372 DOI: 10.1017/s0954579423000032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.
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Affiliation(s)
- Sharon S Wang
- Department of Psychology, University of Washington, Washington, DC, USA
| | - Kate Walsh
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - James J Li
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
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Julian K, Allbaugh LJ. Shame, guilt, and drinking motives as mediators between child maltreatment and problematic alcohol use in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38626427 DOI: 10.1080/07448481.2024.2338412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/22/2024] [Indexed: 04/18/2024]
Abstract
Objective: Drinking for emotion regulation may be a concern for college students who have experienced childhood maltreatment, due to high levels of shame and guilt. The present cross-sectional survey study tested how trait shame-proneness, trait guilt-proneness, and trauma-related guilt are differently related to drinking motives and how these pathways mediate the links between maltreatment severity and alcohol outcomes. Participants: Undergraduate student drinkers (n = 464; M age = 19.50, SD = 2.20) from a midsized midwestern University. Methods: Participants completed an online survey inquiring about demographics, childhood maltreatment, shame, guilt, drinking motives, alcohol use, and alcohol-related consequences. Results: There were several significant serial indirect effects of maltreatment on alcohol consumption and related consequences, through trauma-related guilt, shame-proneness, guilt-proneness, drinking-to-cope, and drinking for mood enhancement. Conclusions: On college campuses, to address problematic drinking among childhood maltreatment survivors, interventions may target maladaptive feelings of shame and guilt stemming from trauma exposure.
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Affiliation(s)
- Kelsey Julian
- Department of Psychology, University of Dayton, Dayton, Ohio, USA
| | - Lucy J Allbaugh
- Department of Psychology, University of Dayton, Dayton, Ohio, USA
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Etami Y, Lildharrie C, Manza P, Wang GJ, Volkow ND. Neuroimaging in Adolescents: Post-Traumatic Stress Disorder and Risk for Substance Use Disorders. Genes (Basel) 2023; 14:2113. [PMID: 38136935 PMCID: PMC10743116 DOI: 10.3390/genes14122113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Trauma in childhood and adolescence has long-term negative consequences in brain development and behavior and increases the risk for psychiatric disorders. Among them, post-traumatic stress disorder (PTSD) during adolescence illustrates the connection between trauma and substance misuse, as adolescents may utilize substances to cope with PTSD. Drug misuse may in turn lead to neuroadaptations in learning processes that facilitate the consolidation of traumatic memories that perpetuate PTSD. This reflects, apart from common genetic and epigenetic modifications, overlapping neurocircuitry engagement triggered by stress and drug misuse that includes structural and functional changes in limbic brain regions and the salience, default-mode, and frontoparietal networks. Effective strategies to prevent PTSD are needed to limit the negative consequences associated with the later development of a substance use disorder (SUD). In this review, we will examine the link between PTSD and SUDs, along with the resulting effects on memory, focusing on the connection between the development of an SUD in individuals who struggled with PTSD in adolescence. Neuroimaging has emerged as a powerful tool to provide insight into the brain mechanisms underlying the connection of PTSD in adolescence and the development of SUDs.
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Affiliation(s)
| | | | | | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (Y.E.); (C.L.); (P.M.); (N.D.V.)
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Sebalo I, Königová MP, Sebalo Vňuková M, Anders M, Ptáček R. The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review. Subst Abuse 2023; 17:11782218231193914. [PMID: 38025908 PMCID: PMC10631312 DOI: 10.1177/11782218231193914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023]
Abstract
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.
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Affiliation(s)
- Ivan Sebalo
- Centre of Research and Education in Forensic Psychology, School of Psychology, University of Kent, Canterbury, UK
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Michaela Poslt Königová
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Martina Sebalo Vňuková
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Martin Anders
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
| | - Radek Ptáček
- Department of Psychiatry, Charles University and General University Hospital, Prague, Czechia
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8
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Dyar C, Kaysen D. Event-level positive and negative reinforcement risk factors for alcohol use: Moderation by individual-level alcohol consequences and post-traumatic stress disorder symptom severity. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2068-2080. [PMID: 38226757 PMCID: PMC10794026 DOI: 10.1111/acer.15188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND The multistage model of drug addiction posits that risk processes contributing to alcohol use change as individuals develop alcohol use disorders. However, few studies have tested this theory outside of the lab or at the event level. We assessed whether event-level associations between positive reinforcement (e.g., positive affect, sociability expectancies) and negative reinforcement risk factors (e.g., negative affect, tension reduction expectancies) and same-/next-day alcohol consumption varied as a function of an individual's level of alcohol consequences. Given elevated alcohol use consequences among individuals with post-traumatic stress disorder (PTSD) and disruptions in reward processing that affect this population, we also tested whether these processes differed based on the presence and severity of PTSD. METHODS We used data from a 30-day ecological momentary assessment study with 174 undergraduate women who regularly engaged in heavy episodic drinking. A majority (78%) of the sample had experienced sexual assault and 44% had current PTSD. Analyses used Bayesian multilevel structural equation modeling with diffuse (non-informative) priors. We used markov chain monte carlo (MCMC) algorithms to generate a series of 10,000 random draws from the multivariate posterior distribution of our sample for each model. RESULTS Results partially supported the multistage model. Event-level negative reinforcement risk factors only predicted more alcohol consumption among individuals who experienced more alcohol consequences. Findings for positive reinforcement risk factors were partially consistent with hypotheses. Overall, findings appear to operate similarly across PTSD symptom severity. CONCLUSIONS Results suggest that interventions for heavy episodic drinking could benefit from attending to an individual's level of alcohol consequences. For example, preventive interventions for individuals who tend to experience few consequences may benefit more from addressing positive reinforcement risk factors, while treatment interventions for those who experience more consequences may benefit from attending to both positive and negative reinforcement.
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Affiliation(s)
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
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Freichel R, Pfirrmann J, Cousjin J, de Jong P, Franken I, Banaschewski T, Bokde ALW, Desrivières S, Flor H, Grigis A, Garavan H, Heinz A, Martinot JL, Martinot MLP, Artiges E, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Vaidya N, Whelan R, Schumann G, Walter H, Veer IM, Wiers RW. Drinking motives, personality traits and life stressors-identifying pathways to harmful alcohol use in adolescence using a panel network approach. Addiction 2023; 118:1908-1919. [PMID: 37157052 DOI: 10.1111/add.16231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND AIMS Models of alcohol use risk suggest that drinking motives represent the most proximal risk factors on which more distal factors converge. However, little is known about how distinct risk factors influence each other and alcohol use on different temporal scales (within a given moment versus over time). We aimed to estimate the dynamic associations of distal (personality and life stressors) and proximal (drinking motives) risk factors, and their relationship to alcohol use in adolescence and early adulthood using a novel graphical vector autoregressive (GVAR) panel network approach. DESIGN, SETTING AND CASES We estimated panel networks on data from the IMAGEN study, a longitudinal European cohort study following adolescents across three waves (aged 16, 19 and 22 years). Our sample consisted of 1829 adolescents (51% females) who reported alcohol use on at least one assessment wave. MEASUREMENTS Risk factors included personality traits (NEO-FFI: neuroticism, extraversion, openness, agreeableness and conscientiousness; SURPS: impulsivity and sensation-seeking), stressful life events (LEQ: sum scores of stressful life events), and drinking motives [drinking motives questionnaire (DMQ): social, enhancement, conformity, coping anxiety and coping depression]. We assessed alcohol use [alcohol use disorders identification test (AUDIT): quantity and frequency] and alcohol-related problems (AUDIT: related problems). FINDINGS Within a given moment, social [partial correlation (pcor) = 0.17] and enhancement motives (pcor = 0.15) co-occurred most strongly with drinking quantity and frequency, while coping depression motives (pcor = 0.13), openness (pcor = 0.05) and impulsivity (pcor = 0.09) were related to alcohol-related problems. The temporal network showed no predictive associations between distal risk factors and drinking motives. Social motives (beta = 0.21), previous alcohol use (beta = 0.11) and openness (beta = 0.10) predicted alcohol-related problems over time (all P < 0.01). CONCLUSIONS Heavy and frequent alcohol use, along with social drinking motives, appear to be key targets for preventing the development of alcohol-related problems throughout late adolescence. We found no evidence for personality traits and life stressors predisposing towards distinct drinking motives over time.
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Affiliation(s)
- René Freichel
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Janine Pfirrmann
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Janna Cousjin
- Center for Substance Use and Addiction Research. (CESAR), Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Peter de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Ingmar Franken
- Center for Substance Use and Addiction Research. (CESAR), Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, SGDP Centre, King's College London, UK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- AP-HP, Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, Kiel University, Kiel, Germany
| | | | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ilya M Veer
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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10
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Kosted R, Kirsch DE, Le V, Fromme K, Lippard ETC. Subjective response to alcohol: Interactive effects of early life stress, parental risk for mood and substance use disorders, and drinking context. Pharmacol Biochem Behav 2023; 229:173591. [PMID: 37353164 PMCID: PMC10902860 DOI: 10.1016/j.pbb.2023.173591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023]
Abstract
Early life stress, specifically childhood maltreatment, and parental risk for mood and substance use disorders (SUDs) are associated with increased risk for alcohol use disorder (AUD). There is limited data on how these factors interact to contribute to alcohol-related outcomes. Prior work has suggested early life stress may increase sensitivity to psychostimulants and that subjective response to alcohol is heritable. It is unclear if early life stress alters sensitivity to alcohol and interacts with parental risk for mood/SUDs, which in turn may act as a risk factor for AUD. The current study uses within-subjects placebo-controlled alcohol administration methods to investigate the effects of childhood maltreatment on subjective response to alcohol in young adults with and without parental risk of mood/SUDs. Additionally, we explored interactions with drinking context (i.e., drinking in a bar vs. non-bar context). Within individuals with parental risk for mood/SUDs, there was a positive relation between total Childhood Trauma Questionnaire (CTQ) score and how drunk individuals reported feeling across both alcohol and placebo conditions (parental risk group-by-CTQ interaction p = .01; main effect of CTQ within individuals with parental risk for mood/SUDs p = .005). When exploring interactions with drinking context (bar vs. non-bar context), we observed a significant drinking context-by-parental risk-by-CTQ interaction (p = .03), with CTQ score positively associated with greater positive valence/positive arousal feelings in the parental risk group if they consumed their beverages in the bar context (p = .004) but not if they consumed their beverages in the non-bar context. Results suggest childhood maltreatment may contribute to variation in subjective response to the positive effects of alcohol-possibly mediated by alcohol cues and/or expectancies-in young adults with parental risk for mood/SUDs.
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Affiliation(s)
- Raquel Kosted
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Dylan E Kirsch
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Vanessa Le
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Kim Fromme
- Department of Psychology, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA
| | - Elizabeth T C Lippard
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA; Department of Psychology, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Institute for Neuroscience, University of Texas, Austin, TX, USA; Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA.
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11
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Davis RS, Halligan SL, Meiser-Stedman R, Elliott E, Ward G, Hiller RM. A Longitudinal Investigation of the Relationship Between Trauma-Related Cognitive Processes and Internalising and Externalising Psychopathology in Young People in Out-of-Home Care. Res Child Adolesc Psychopathol 2023; 51:485-496. [PMID: 36525227 PMCID: PMC10017561 DOI: 10.1007/s10802-022-01005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 12/23/2022]
Abstract
Young people in out-of-home care are at increased risk of developing a range of posttrauma mental health difficulties, including PTSD, but more commonly anxiety, depression and externalising symptoms. Cognitive models of PTSD indicate that trauma-related maladaptive appraisals, coping strategies and trauma memory qualities are key processes in the development and maintenance of PTSD, yet there has been limited investigation of the potential role of these processes in broader posttrauma psychopathology, particularly in young people who have been exposed to complex, rather than acute, trauma. We recruited 120 10-18 years olds in out-of-home care, and their caregivers, who completed assessments at two time points: baseline and 12-month follow-up. Young people completed self-report measures of trauma-related maladaptive appraisals, coping strategies and trauma-memory qualities, as well as reporting on PTSD, anxiety, depression and externalising symptoms. Carers also reported on internalising and externalising symptoms. We found that all three cognitive processes were associated with baseline self-reported internalising symptoms, with maladaptive appraisals most robustly associated with both anxiety and depression. Changes in all three processes over 12-months predicted a change in self-reported internalising and externalising symptoms, with maladaptive appraisals and coping predicting anxiety symptoms, and coping uniquely predicting depression and externalising symptoms. Effects remained after controlling for co-occurring PTSD symptoms. Findings were not replicated when using carer-reported symptoms. These findings suggest that existing cognitive models of PTSD may also usefully explain broader posttrauma depression, anxiety and externalising symptoms in young people who have experienced maltreatment and live in out-of-home care. Clinical implications are discussed.
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Affiliation(s)
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | | | - Georgina Ward
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Rachel M Hiller
- Department of Psychology, University of Bath, Bath, UK. .,Division of Psychology and Language Sciences, University College London, London, UK. .,Anna Freud National Centre for Children and Families, London, UK.
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12
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Norton EO, Hailemeskel R, Bravo AJ, Pilatti A, Kaimner D, Conway CC, Mezquita L, Hogarth L. Childhood Traumatic Experiences and Negative Alcohol-Related Consequences in Adulthood: A Cross-Cultural Examination of Distress Tolerance and Drinking to Cope. Subst Use Misuse 2023; 58:804-811. [PMID: 36935590 PMCID: PMC10124750 DOI: 10.1080/10826084.2023.2188563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Background: Prior research has established that Adverse Childhood Experiences (ACEs) predict harmful alcohol use outcomes. However, underlying mechanisms that could explain these associations are less clear. The present study examined if ACEs are indirectly related to alcohol negative consequences through their associations with distress tolerance and drinking to cope. Method: A sample of 3,763 (71.9% female) college students who drink alcohol from seven countries (U.S., Argentina, Canada, Uruguay, Spain, South Africa, and England) completed online surveys. Path analysis was performed within the whole sample testing the serial unique associations between ACEs→distress tolerance→drinking to cope→negative alcohol-related consequences. Multi-group analysis was performed to determine if the proposed pathways were invariant across gender and countries. Results: Both distress tolerance and drinking to cope uniquely accounted for the relationship between ACEs and negative alcohol-related consequences. Additionally, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher drinking to cope, which in turn was associated with more negative alcohol-related consequences. These effects were invariant across countries and gender groups. Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic alcohol use across nations. Our data are consistent with the idea that intervening on distress tolerance and drinking motives could mitigate downstream alcohol-related consequences related to ACEs in college student populations around the world.
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Affiliation(s)
| | | | | | - Angelina Pilatti
- Universidad Nacional de Córdoba, Facultad de Psicología, Instituto de Investigaciones Psicológicas, IIPsi, CONICET. Córdoba, Argentina
| | - Debra Kaimner
- Department of Psychology, University of Cape Town, South Africa
| | | | - Laura Mezquita
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - Lee Hogarth
- School of Psychology, University of Exeter, United Kingdom
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13
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Bitsoih J, Patock-Peckham JA, Canning JR, Ong A, Becerra A, Broussard M. Do Coping Motives and Perceived Impaired Control Mediate the Indirect Links from Childhood Trauma Facets to Alcohol-Related Problems? Behav Sci (Basel) 2023; 13:197. [PMID: 36975222 PMCID: PMC10044871 DOI: 10.3390/bs13030197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION The Self-Medication Hypothesis suggests that individuals drink to alleviate undesirable affective states. Behavioral Economics Theory states that individuals deprived of resources (i.e., physically neglected) consume more reinforcing substances when they are available than others. Childhood trauma may indirectly increase impaired control over alcohol (IC; drinking beyond one's own intentions) and thereby increase alcohol use and problems through the employment of coping-motives. METHOD A structural equation model that included sex as a covariate examined mediated paths with 612 university students. RESULTS Men were less likely to be emotionally abused and were more likely to use greater amounts of alcohol than women did. Physical neglect was directly linked to both more IC and alcohol use. Emotional and sexual abuse were directly linked to more coping motives. Both emotional and sexual abuse were indirectly linked to more alcohol use and its related problems through increased coping motives and IC. CONCLUSIONS Consistent with Behavioral Economics Theory, there was a direct link between physical neglect and IC. We also found partial support for the Self-Medication Hypothesis regarding the emotional and sexual abuse trauma dimensions; they indirectly contributed to alcohol use and its related problems via the mediating mechanisms of more coping motives and IC. Our findings suggest coping motives could be a therapeutic target for intervention among those sexually or emotionally abused.
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Affiliation(s)
- Jai Bitsoih
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
| | | | - Jessica R. Canning
- Department of Psychology, University of Washington, Seattle, WA 98195-1525, USA
| | - Annie Ong
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
| | - Allison Becerra
- Department of Counseling, Loma Linda University, Loma Linda, CA 92350, USA
| | - Matthew Broussard
- Department of Psychology, Arizona State University, Tempe, AZ 85287-1104, USA
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14
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Basedow LA, Wiedmann MF, Roessner V, Golub Y, Kuitunen-Paul S. Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders. Addict Sci Clin Pract 2022; 17:46. [PMID: 36057623 PMCID: PMC9441101 DOI: 10.1186/s13722-022-00329-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/17/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms. METHODS German adolescent patients (aged 13-18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as 'no traumatic experiences ('noTEs' but SUD), 'traumatic experiences but no current PTSD diagnosis' ('TEs' with SUD), and 'PTSD' with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework. RESULTS The past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η2 = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η2 ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η2 = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency. CONCLUSIONS In adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.
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Affiliation(s)
- Lukas Andreas Basedow
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Division of Clinical Psychology and Psychotherapy, Dept. of Psychology, Philipps-University of Marburg, Marburg, Germany.
| | - Melina Felicitas Wiedmann
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Chair for Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
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15
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Savell SM, Womack SR, Wilson MN, Lemery-Chalfant K, Shaw DS. Indirect Associations between Middle-Childhood Externalizing Behaviors and Adolescent Substance Use through Late-Childhood Exposure to Violence. J Youth Adolesc 2022; 51:628-642. [PMID: 35107744 PMCID: PMC8994499 DOI: 10.1007/s10964-022-01575-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
Longitudinal research to understand individual risk factors in childhood associated with exposure to violence and substance use is needed to inform prevention efforts. The present study tested indirect associations between age 8.5 externalizing behaviors and age 16 substance use through age 9.5 violence victimization and witnessing. Participants were 650 racially diverse (48.6% European American, 28.1% African American, 13.3% multiracial, and 10.0% other), predominantly socioeconomically disadvantaged youth (49% female). Externalizing behaviors were associated with higher levels of violence victimization and witnessing. The indirect path from externalizing behaviors to substance use was significant through victimization but not witnessing violence. Interventions aimed at reducing early externalizing behaviors may reduce risk for violence victimization, which may, in turn, reduce risk for adolescent substance use.
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Affiliation(s)
- Shannon M Savell
- Department of Psychology, University of Virginia, Charlottesville, USA.
| | - Sean R Womack
- Department of Psychology, University of Virginia, Charlottesville, USA
| | - Melvin N Wilson
- Department of Psychology, University of Virginia, Charlottesville, USA
| | | | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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16
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Kirsch DE, Lippard ET. Early life stress and substance use disorders: The critical role of adolescent substance use. Pharmacol Biochem Behav 2022; 215:173360. [PMID: 35219756 PMCID: PMC8983562 DOI: 10.1016/j.pbb.2022.173360] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 12/06/2021] [Accepted: 02/20/2022] [Indexed: 12/12/2022]
Abstract
Early life stress (ELS) is a well-established risk factor for many psychiatric and medical disorders, including substance use disorders (SUDs). The relationship between ELS and SUDs is complex and there are likely multiple pathways from ELS to adverse substance use outcomes. The association between ELS and substance use emerges in adolescence. Adolescence is a critical period in development during which substance exposure markedly increases risk for SUDs. Therefore, this review focuses on the literature supporting the hypothesis that ELS increases risk for the development of SUDs through its influence on adolescent substance use. We discuss studies substantiating the role of ELS in adolescent substance use and explore how internalizing and externalizing psychopathology may be antecedents of substance use in adolescence. We examine clinical work suggesting ELS sculpts the Hypothalamic-Pituitary-Adrenal (HPA) Axis and developing brain-particularly subcortical brain regions that underlie stress response, mesocorticolimbic brain systems associated with reward sensitivity, and prefrontal regions that underlie executive control-in a way that increases risk for adolescent substance use and SUDs. We further explore how substance use during adolescence alters structure and function of these same systems, and how brain changes following ELS and adolescent substance use may independently, additively, or interactively contribute to risk for addiction. We conclude by discussing how the current literature can inform interventions aimed at reducing risk for SUDs in individuals with a history of ELS.
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17
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Shin SH, Bouchard LM, Montemayor B. An Exploration of Practitioners' Perceptions and Beliefs About Trauma-Informed Youth Drug Prevention Programs: a Qualitative Study. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:636-647. [PMID: 34714501 DOI: 10.1007/s11121-021-01300-0] [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] [Accepted: 09/14/2021] [Indexed: 01/14/2023]
Abstract
Adverse childhood experiences (ACEs), such as childhood maltreatment and household dysfunction, have been linked to adolescent substance use. As a result, there exists a pressing need for trauma-informed, substance use preventive intervention for adolescents with a history of ACEs. The primary aim of this qualitative study is to increase our understanding of practitioners' perceptions of substance use among ACE-exposed youth and their views on trauma-informed adolescent substance use prevention programs. The present study conducted six focus groups (N = 32) among current child and adolescent health and human service providers in a mid-Atlantic urban area. The focus groups explored the practitioners' views on the main reasons that youth with a history of ACEs use illicit substances and suggestions on components, constructs, or techniques of trauma-informed substance use prevention programs and perceived barriers in implementing such programs. Transcripts of the focus groups were analyzed using open coding and subsequent axial coding, which was followed by thematic analysis. Thematic analysis identified ten themes within three categories, including the etiology of substance use among ACE-exposed youth, barriers to preventing substance use among ACEs-exposed youth, and suggested program components for trauma-informed prevention programs. These findings provide support for developing a preventive intervention that addresses trauma symptoms and overall skill buildings to prevent substance use among ACE-exposed youth. Teaching skills to cope with trauma symptoms, enhancing knowledge about the signs and symptoms of trauma, and improving key social and emotional learning competencies might be important and effective strategies to curb substance use among ACE-exposed youth.
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Affiliation(s)
- Sunny H Shin
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA. .,Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
| | - Leah M Bouchard
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
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