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

A scoping review of social determinants of health's impact on substance use disorders over the life course

BACKGROUND

Substance use is a public crisis in the U.S. Substance use can be understood as a series of events in the life course, from initiation to mortality. Social Determinants of Health (SDoH) have increasingly been recognized as essential contributors to individuals' health. This scoping review aims to examine available evidence of SDoH impact on the life course of substance use disorder (SUD).

METHODS

This study identified peer-reviewed articles that reported longitudinal studies with SDoH factors as independent variables and substance use and disorders as dependent variables from PubMed, Embase, and Web of Science. The reported associations between SDoH and substance use stages over the life course were narratively and graphically summarized.

RESULTS

Among the 50 studies identified, ten revealed parental monitoring/support and early childhood education as protective factors, while negative peer influences and neighborhood instability were risk factors of substance use initiation. Nineteen articles reported factors associated with escalation in substance use, including unemployment, neighborhood vulnerability, negative peer influence, violence/trauma, and criminal justice system (CJS) involvement. Ten articles suggested that employment, social support, urban living, and low-barrier medication treatment facilitated treatment participation, while stigma and CJS involvement had negative impact on treatment trajectory. Social support and employment could foster progress in recovery and CJS involvement and unstable housing deterred recovery. Four studies suggested that unemployment, unstable housing, CJS involvement, and lack of social support were associated with overdose and mortality.

CONCLUSIONS

This review underscores the influence of social networks and early life experiences on the life course of SUD. Future SDoH research should investigate overdose and mortality and the impact of broader upstream SDoH on SUD. Interventions addressing these social factors are needed to mitigate their detrimental effects on the trajectories of SUD over the life course.

Trauma Exposure and the Mental Health Needs of Latinx Youth: A Systematic Review of the Literature

Although trauma exposure is common among youth in the United States, it is not evenly distributed. In fact, Latinx youth have higher rates of trauma exposure than their non-Latinx White counterparts with approximately 78% of Latinx youth experiencing one traumatic event by the time they are 18 years old. Despite this, the impact of trauma exposure on Latinx youth's mental health needs is not well-established. This is largely because Latinx youth are vastly underrepresented in many of the large-scale, epidemiological studies on childhood trauma exposure. To address this gap in the literature, this study applied PRISMA protocol guidelines to systematically review the methodologies, participant characteristics, and findings from 22 studies examining the relation between Latinx youths' trauma exposure and their mental health needs. Results revealed that while trauma exposure is common among Latinx youth, its association to Latinx youth's mental health needs is not well understood. Indeed, while some studies found a positive association between Latinx youth's trauma exposure and their mental health risk, other studies found no such relation. An examination of the included studies' methodologies and participant characteristics revealed several limitations in the existing research that are likely contributing to these inconsistencies. Concrete recommendations for how future research can address these limitations are put forth. Taken together, the results of this study underscore the urgent need to understand the role that trauma exposure plays in contributing to and/or maintaining mental health disparities among Latinx youth.

Childhood maltreatment and substance use risk: A moderated mediation model of autonomic reactivity and distress tolerance

BACKGROUND/AIMS

The link between child maltreatment (CM) and substance use (SU) in young adulthood is established. The sympathetic nervous system (SNS) division of the autonomic nervous system may mediate this link. However, less is known on the indirect link between CM and SU via SNS functioning. Due to individual variability in the link between SNS functioning and SU risk, we aimed to examine the moderating role of distress tolerance (DT).

METHODS

A longitudinal sample of 118 young adults (YAs) from a low socioeconomic status background were assessed twice (between 9 and 12 months apart). CM, DT, and galvanic skin response (GSR) stress reactivity were measured during the initial study visit, while SU was assessed at both timepoints. Stress reactivity was assessed by measuring the GSR reactivity during a stress task. We tested the indirect associations between CM and changes in SU problems via GSR stress reactivity, and the moderation effects of DT on these indirect associations. A mediation model in the structural equation modeling (SEM) framework was then followed by a moderated mediation model to analyze these data.

RESULTS

YA's stress reactivity mediated the association between CM and alcohol use problems, and this indirect effect was weaker among YAs who had higher levels of DT. This pattern did not emerge with drug use problems.

CONCLUSIONS

Findings suggest that intervention and prevention efforts for SU outcomes should consider incorporating strategies that increase at-risk individuals' levels of DT. Providing strategies to help individuals stem their stress reactivity may reduce their risk for alcohol use.

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke

There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.

Indirect Associations Between PTSD Symptoms and Cannabis Problems in Young Adults: The Unique Roles of Cannabis Coping Motives and Medicinal Use Orientation

Background: Cannabis use in young adulthood has been associated with exposure to traumatic events and posttraumatic stress disorder (PTSD). Coping motives for cannabis use represent one mechanism linking PTSD with cannabis problems, yet some individuals with PTSD consider their cannabis use to be medicinal in nature. While a medicinal orientation to cannabis overlaps conceptually with coping motives, it could be associated with unique cannabis outcomes. Objectives: This study examined trauma-related coping motives and medicinal cannabis orientation as mediators of the association between PTSD symptoms and cannabis outcomes in young adults. Method: Data came from an online survey of 212 university students (M age = 19.41; 70.3% Women; 43.4% White) who used cannabis in the past month and endorsed a traumatic life event. Path analyses examined associations of PTSD symptoms with past month cannabis frequency and problems through medicinal cannabis orientation (i.e., number of mental health symptoms that cannabis is used to manage) and trauma-related coping motives. Results: PTSD symptoms were associated with trauma-related coping motives but not with medicinal cannabis orientation. Both trauma-related coping motives and medicinal cannabis orientation were uniquely associated with greater cannabis use frequency, but only trauma-related coping motives were associated with greater cannabis problems. There were significant indirect relationships from PTSD symptoms to cannabis use frequency and problems through trauma-related coping motives but not through medicinal cannabis orientation. Conclusions: Results support unique contributions of trauma-related coping motives and medicinal cannabis orientation to cannabis outcomes and suggest that trauma-related coping motives are specifically implicated in the link between PTSD and cannabis problems.

Association between adverse childhood experiences and self-reported health-risk behaviors among cancer survivors: A population-based study

AIMS

Existing evidence shows that people who report Adverse Childhood Experiences (ACEs) are more likely to exhibit health-risk behaviors. However, limited research on this topic pertains to oncology population. We aim to address this knowledge gap by estimating the prevalence of ACEs and investigating their association with self-reported health-risk behaviors among adult cancer survivors living in the U.S.

METHODS

We conducted a secondary analysis using cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System ACE module. We included 4,126 adults, aged ≥18 years, with a history of cancer. The outcome variable was self-reported health-risk behaviors, which included cigarette smoking, e-cigarette use, and binge alcohol drinking. Self-reported ACEs history was the primary independent variable, comprised of 11 questions regarding child abuse and dysfunctional households. We conducted descriptive statistics and multivariable logistic regression to describe the relationship between the ACE history and health-risk behaviors.

RESULTS

Overall, 84.2% of cancer survivors self-reported as White, 58.4% were women, and 76.6% were aged 65+ years. Nearly two-thirds of the sample (63.2%) self-reported at least one ACE (prior to age 18) and 21.7% engaged in ≥1 health-risk-behaviors, such as cigarette smoking, binge alcohol drinking, or e-cigarette use. Experiencing ≥3 ACEs was associated with 145% increased odds of reporting at least one health-risk behavior (OR = 2.45, 95% CI [1.78-3.38]) when compared to those without a history of ACEs. Besides, survivors who were younger, divorced, less educated, and had low income had higher odds of reporting at least one health-risk behavior.

CONCLUSIONS

Overall, a history of ACEs is associated with health-risk behaviors. These all can negatively impact cancer survivors' overall well-being. Early screening for ACE during oncologic visits can be a protective measure for preventing health-risk behaviors among cancer survivors.

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

OBJECTIVE

Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems.

METHODS

Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered.

RESULTS

The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema.

CONCLUSION

Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

The effect of smoking initiation in adolescence on the subsequent smoking trajectories of people who smoke, and the role of adverse childhood experiences: Results from the 1958 British cohort study

OBJECTIVE

To examine the association between smoking initiation in adolescence and subsequent different smoking trajectories of people who smoke, and to examine the combined effect of adverse childhood experiences (ACEs) and smoking initiation in adolescence on smoking trajectories of people who smoke.

DESIGN AND SAMPLE

Data are from 8757 individuals in Great Britain from the birth cohort National Child Development Study and who reported being smokers or former smokers by age 23.

MEASUREMENTS

Smoking initiation in adolescence was measured at 16 y and smoking trajectories were derived from smoking variables from ages 23 to 55. We modelled the relationship between smoking initiation in adolescence with or without ACEs and smoking trajectories.

RESULTS

Individuals who initiated smoking in adolescence were more likely to quit later than quitting in twenties (RRR quitting in thirties  = 3.43 [2.40; 4.89] p < .001; RRR quitting in forties  = 5.25 [3.38; 8.14] p < .001; RRR quitting in fifties  = 4.48 [2.95; 6.79] p < .001), to relapse (RRR Relapse  = 3.66 [2.82; 4.76] p < .001) and to be persistent smokers (RRR persistent  = 5.25 [3.81; 7.25] p < .001) compared to those who had initiated smoking in young adulthood. These effects were particularly pronounced in case of ACEs.

CONCLUSION

Smoking prevention programs aimed at reducing smoking initiation should be promoted to adolescents to limit the burden of smoking, especially for people who have suffered adversity during childhood.

Maternal childhood adversity and adolescent marijuana use at age 17 years: The role of parental mental health and parenting behaviors

INTRODUCTION

Children's risk for marijuana use may be linked to their parents' history of childhood adversity, yet little is known about the mechanisms underlying this link. This study examined whether maternal parenting behavior and mental health serve as mechanisms linking maternal childhood adversity to their children's marijuana use at age 17 years, by gender.

METHODS

Data were from the Young Women and Child Development Study (59% male), a longitudinal panel study, which began in 1988 and followed mother-child dyads for 17 years (n = 240). Participants were recruited from health and social services agencies located in a metropolitan region of Washington State. Hypotheses were tested using Structural Equation Modeling in Mplus. Multiple-group analysis was conducted to evaluate potential gender differences.

RESULTS

Results showed that maternal childhood adversity was associated with their mental health outcomes (β = .32, p < .001), which in turn was predictive of mothers' harsh parenting (β = .27, p < .01). Maternal harsh parenting behavior was then associated with their children's marijuana use at age 17 years (β = .34, p < .001). Multiple group analyses revealed that the path from harsh parenting to adolescent marijuana use differed across genders being only significant for boys (β = .42, p < .001).

CONCLUSIONS

The intergenerational impact of childhood adversity highlights the need for interventions that target both parents and children. This would support teen mothers with a history of childhood adversity to acquire skills and knowledge to help mitigate its impact on their parenting behaviors and offset risks for their children.

Problematic alcohol use in young adults exposed to childhood trauma: The Trøndelag Health (HUNT) Study

Problematic alcohol use (PAU) severely impacts the health, functioning, and long-term prospects of young people. Prior research indicates that childhood trauma exposure may be an important risk factor for PAU, but few longitudinal studies have looked at how specific trauma types influence this risk. The aim of this study was to investigate the association between childhood trauma exposure and PAU in a large, population-based cohort of young people. The study sample included 1,913 adolescents who participated in the Trøndelag Health Study (HUNT) between 2006 and 2008 (age range: 12-20) and completed follow-up 10 years later as young adults (age range: 22-32). The results revealed an increased risk of PAU in young adults exposed to childhood trauma, especially direct physical violence, OR = 2.38, [95% CI 1.56, 3.64]. Young adults who had witnessed violence, OR = 1.55, [95% CI 1.11, 2.17], or experienced an accident, disaster, or other traumatic event, OR = 1.60, [95% CI 1.19, 2.15], also had higher odds of PAU compared to those without such experiences. These associations remained consistent after adjusting for symptoms of headaches and pain as well as posttraumatic and general psychological distress as reported by the participants in adolescence. Future prevention efforts targeting PAU among adolescents and young adults should address violence and other trauma exposure as potential drivers of problematic drinking.

Does binge drinking mediate the relationship between four adverse childhood experiences and adult traumatic brain injury? Results from the National Longitudinal Survey of Youth 1979 Cohort

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with increased risk of sustaining a traumatic brain injury (TBI). Alcohol use may play an important role in this relationship. This study examines whether binge drinking mediates the relationship between four ACEs and TBIs sustained in adulthood.

METHODS

Using the National Longitudinal Survey of Youth, 1979 cohort, we conducted longitudinal mediation analyses (n=6317). Interviews occurred annually from 1979 to 1994 and biennially until 2016. We evaluated the direct and indirect effects of individual ACEs (ie, experiencing physical violence, low parental warmth, familial alcoholism and familial mental illness; reported retrospectively) and a cumulative ACEs score on mean level of binge drinking (calculated across waves) and having a TBI in adulthood. To establish temporality, we included binge drinking that was measured at age 18 or older and before any reported TBI.

RESULTS

Cumulative ACEs, familial alcoholism and physical abuse exposure were significantly associated with having a TBI through binge drinking, although this only explained a small part of the association between ACEs and TBI. Other ACEs were not significantly associated with binge drinking or TBI.

CONCLUSION

The results indicate that while ACEs and adult TBI risk were significantly associated, lifetime binge drinking explains only a small part of the association. Future research could examine alternative social, biological and behavioural mechanisms along the pathway between ACEs and TBI. Determining this mechanism will allow public health practitioners to design and implement effective TBI prevention programmes for those at higher risk of injury due to ACE exposure.

Heterogeneity In Women's Trauma Histories: Impact On Substance Use Disorder Severity

Trauma and substance use disorders (SUDs) frequently co-occur, especially in women. Previous studies have attempted to determine if individual differences in trauma histories could be meaningfully categorized but few studies have focused solely on women, especially those reporting substance use problems. A total of 130 women (M age = 30.7, SD = 7.9) self reporting past-year substance use problems completed comprehensive measures assessing lifetime exposure to a variety of traumatic events as well as substance use patterns and severity. Using latent class analysis, three classes emerged, a Low Lifetime Interpersonal Trauma class (40%, n = 52), a Moderate Lifetime Interpersonal Trauma class (23.8%, n = 31) and a High Lifetime Interpersonal Trauma class (36.2%, n = 47). Groups did not vary on daily/almost daily use of different types of substances and polysubstance use frequency but were significantly different on SUD severity, with the Moderate and the High Lifetime Interpersonal Trauma classes reporting severe SUD severity in comparison to moderate severity for the Low Interpersonal Trauma class. The findings of the current study indicate that women experiencing substance use problems should receive SUD treatment in a trauma-informed manner but that not all may require integrated trauma and substance use interventions.

The Impact of Childhood Trauma on Problematic Alcohol and Drug Use Trajectories and the Moderating Role of Social Support

Adverse childhood experiences (ACE) have a strong association with alcohol and drug use; however, more research is needed to identify protective factors for this association. The present study assesses the longitudinal impact of ACE on problematic alcohol and drug use and the potential moderating effect of perceived social support. Data (n = 1404) are from a sample of Hispanic youth surveyed in high school through young adulthood. Linear growth curve models assessed the effect of ACE and perceived social support over time on problematic alcohol and drug use. Results indicated youth with ACE (vs. those without ACE) report more problematic alcohol and drug use in adolescence and have increased rates into young adulthood. Additionally, findings suggest that social support in high school may moderate the effects of ACE on problematic use over time. Among youth with high levels of support, the association of ACE with problematic alcohol and drug use was diminished. Although ACE can have a persistent impact on problematic alcohol and drug use from adolescence into adulthood, high social support during adolescence may mitigate the negative effects of ACE, lowering early problematic alcohol and drug use, offering the potential for lasting benefits.

Racial/Ethnic Differences in the Effects of Adverse Childhood Experiences on Substance Misuse among Justice-Involved Children

Background: Adverse childhood experiences (ACEs) are linked to substance use (SU) and substance use disorders (SUD). However, this relationship has yet to be tested among justice-involved children (JIC), and it is unclear if racial/ethnic differences exist. This study aimed to determine: (1) whether ACEs are associated with increased risk of SU and SUD among JIC; and (2) if the effects of ACEs on SU and SUD are moderated by race/ethnicity. Methods: Bivariate and multivariate logistic regression analyses were employed to examine a statewide dataset of 79,960 JIC from the Florida Department of Juvenile Justice. Marginal odds were estimated to examine how race moderates the relationship between ACEs and SU and SUD. Results: Results showed higher ACEs scores were linked to SU and SUD. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report SU than white JIC. Specifically, Black and Latinx JIC with a higher average ACEs score were more likely to report SU but less likely to have ever been diagnosed with a SUD when compared to white JIC with equivalent ACEs. Conclusions: Study results highlight the need to develop trauma-informed and culturally appropriate interventions for SU and SUD among JIC.

The associations between traumatic experiences and subsequent onset of a substance use disorder: Findings from the World Health Organization World Mental Health surveys

AIM

Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, and variation in associations over time.

METHODS

Data come from World Mental Health surveys across 22 countries. Adults (n = 65,165) retrospectively reported exposure to 29 TEs in six categories: "exposure to organised violence"; "participation in organised violence"; "interpersonal violence"; "sexual-relationship violence"; "other life-threatening events"; and those involving loved ones ("network traumas"). Discrete-time survival analyses were used to examine associations with subsequent first SUD onset.

RESULTS

Most (71.0%) reported experiencing at least one TE, with network traumas (38.8%) most common and exposure to organised violence (9.5%) least. One in five (20.3%) had been exposed to sexual-relationship violence and 26.6% to interpersonal violence. Among the TE exposed, lifetime SUD prevalence was 14.5% compared to 5.1% with no trauma exposure. Most TE categories (except organised violence) were associated with increased odds of SUD. Increased odds of SUD were also found following interpersonal violence exposure across all age ranges (ORs from 1.56 to 1.78), and sexual-relationship violence exposure during adulthood (ORs from 1.33 to 1.44), with associations persisting even after >11 years.

CONCLUSION

Sexual and interpersonal violence have the most consistent associations with progression to SUD; increased risk remains for many years post-exposure. These need to be considered when working with people exposed to such traumas.

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.

Is Adversity in Childhood Linked to Marijuana Use in Adulthood?: Findings from the Behavioral Risk Factor Surveillance System

Background: Adverse childhood experiences (ACEs) are potentially traumatic events, which can have long-term, negative consequences. Few studies have examined ACEs' relationship to marijuana use. Objectives: We examined the association between ACEs and past-month marijuana use among adults and the pathways between childhood adversity and marijuana use. Methods: Adults from five states (n = 22,991) who responded to the 2019 Behavioral Risk Factors Surveillance System were included. We examined the prevalence of ACEs and marijuana use. We employed generalized structural equation modeling to assess the relationship between ACEs and marijuana use and the role of depression and poor mental and physical health as possible mediators. Results: Overall, 65.0% of the population reported 1+ ACE. Heavy marijuana use and past-month marijuana use prevalence rates were 10.3% and 5.0%, respectively. We found mediation effects for depression and poor mental health but not poor physical health. The number of ACEs was associated with a statistically significant increase in any past-month marijuana use-indirect effects ranged from 1.0 (95% CI, 1.0-1.0) to 1.4 (95% CI, 1.2-1.7), direct effects ranged from 1.1 (95% CI, 07-1.7) to 5.3 (95% CI 3.2-8.8), and total effects ranged from 1.1 (95% CI, 0.7-1.7) to 5.9 (95% CI, 3.6-9.8). Women, married persons, and middle aged and older adults had a lower odds of marijuana use. Reporting at least one HIV risk behavior was associated with an increased odds of marijuana use. Conclusion: ACE exposure was positively associated with marijuana use. Depression and poor mental health separately mediated this relationship.

Classes of lifetime adversities among emerging adult women by race/ethnicity and their associations with weight status in the United States

This cross-sectional study examines the association of childhood and adolescent/adult adversities with obesity across four racial/ethnic groups among emerging adult women aged 18 to 25 (n = 9310). Latent class analysis was used to identify racial/ethnicity-specific classes arising from childhood and adolescent/adult adversity indicators in the 2015 and 2018 College Student Health Surveys (sampled from Minnesota, U.S.) Distal outcome procedure and Bolck-Croon-Hagenaars methods were used to assess each class's association with body mass index (BMI) and obesity probability. Models were adjusted for post-secondary school type and parental education. We identified 7 classes for White women, 4 classes for Asian and Latina women, and 5 classes for Black women. Weight distributions of Black and Latina women leaned towards "overweight", whereas White and Asian women's BMI leaned towards "normal weight." Latina and Black women had a wider BMI range (~5 kg/m²) between classes with the highest versus lowest BMI than White and Asian women (~3 kg/m²), suggesting a stronger association between adversities and BMI. For Asian, Black, and White women, the "Low Adversities" class had the lowest obesity prevalence, while the "High Lifetime Adversities" class had the highest prevalence. In contrast, Latina women had the lowest obesity prevalence in the "High Adolescent/Adult Adversities & Low Childhood Adversities" class, and highest prevalence in the "Household Mental Illness" class. Results indicate that racial/ethnic disparities in obesity-related measures are reduced when racial/ethnic groups experience low adversity. Future research should explore tailored adversity interventions that consider adversity exposure differences across race/ethnicity as a strategy for reducing obesity risk.