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Becker TD, Castañeda Ramirez S, Bruges Boude A, Leong A, Ivanov I, Rice TR. Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02265-x. [PMID: 37480386 DOI: 10.1007/s00787-023-02265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10-24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell, 525 E. 68th Street, Box 140, New York, NY, 10065, USA.
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, New York, USA.
| | | | - Adriana Bruges Boude
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alicia Leong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Davis JP, Pedersen ER, Tucker J, Dunbar M, Rodriguez A, Seelam R, D'Amico EJ. Childhood adversity and developmental trajectories of alcohol and cannabis co-use. CHILD ABUSE & NEGLECT 2023; 141:106238. [PMID: 37172531 PMCID: PMC10304305 DOI: 10.1016/j.chiabu.2023.106238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/03/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE A large body of literature has noted detrimental effects of childhood adversity on young adult behavioral health, yet few studies have assessed how early childhood adversity influences the development of alcohol and cannabis co-use. METHOD In the present study we use data from an ongoing longitudinal cohort (N = 2507) to understand how early childhood adversity influences transitions into alcohol and cannabis co-use trajectories. We also explore how sex, depression, and anxiety are associated with transition probabilities. We used latent transition analysis to examine transitions from emergent childhood adversity classes to classes of parallel alcohol and cannabis co-use from ages 17 to 24 years. RESULTS Those who reported high levels of childhood adversity were more likely to transition into classes with relatively chronic and rapidly increasing alcohol and cannabis co-use during young adulthood. Young adults who both experienced high levels of childhood adversity and transitioned into increasing alcohol and cannabis co- use trajectories were more likely to be male and meet clinical cutoff for depression. CONCLUSION Our results indicate an incrementally more nuanced set of risk profiles, with differential risk of alcohol and cannabis co-use trajectories, dependent on one's experience of childhood adversity. PUBLIC HEALTH SIGNIFICANCE Results of the present study note important heterogeneity in alcohol and cannabis co-use throughout young adulthood, with general trends showing increases in co-use. The present study also shows differential risk of alcohol and cannabis co-use dependent on prior experience of childhood adversity.
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Affiliation(s)
- Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States of America.
| | - Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
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Lee N, Pigott TD, Watson A, Reuben K, O'Hara K, Massetti G, Fang X, Self-Brown S. Childhood Polyvictimization and Associated Health Outcomes: A Systematic Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1579-1592. [PMID: 35220817 DOI: 10.1177/15248380211073847] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background: Polyvictimization, the experience of multiple types of victimization, is associated with detrimental health outcomes. Despite extensive research on the health consequences of polyvictimization, one challenge in understanding this literature lies in the varied operationalized definitions of polyvictimization and health outcomes. This scoping review provides the volume of the current literature on this topic, documents the varied constructs of polyvictimization and associated health outcomes, identifies knowledge gaps, and guides future research directions. Method: A systematic search of English-language original articles that presented quantitative associations of childhood polyvictimization and health outcomes was performed through six-database searches, a gray literature search, and citation mining from June 2020 to January 2021. The varied constructs of polyvictimization, health outcomes, and other study characteristics were extracted. Results: A total of 96 studies were included. Two ways of creating continuous variables (30.21%) and four ways of constructing categorical variables (72.92%) were identified for operationalizing polyvictimization. The majority of health outcomes were mental, behavioral, or social (96.88%), while slightly more than 10% of studies examined physical health (11.46%) or general health conditions (10.42%), respectively. More than half of studies used U.S. samples (56.25%). Conclusions: The varied constructs of polyvictimization suggests that there is a need to establish a valid polyvictimization construct that is consistently agreed upon in the research community. Findings summarize the specific health outcomes that can be targeted for further investigation and prevention efforts. Findings also suggest that the study of resilience and coping education for childhood polyvictims is sorely needed.
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Affiliation(s)
- NaeHyung Lee
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Terri Deocampo Pigott
- School of Public Health, Georgia State University, Atlanta, GA, USA
- College of Education & Human Development, Georgia State University, Atlanta, GA, USA
| | - Ashley Watson
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Katherine Reuben
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Kathryn O'Hara
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Greta Massetti
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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DiGuiseppi GT, Ring CR, Rice ER, Davis JP. Sex differences in poly-victimization among youth experiencing homelessness prior to substance use treatment. CHILD ABUSE & NEGLECT 2022; 129:105670. [PMID: 35569181 PMCID: PMC9228819 DOI: 10.1016/j.chiabu.2022.105670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/26/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Poly-victimization is common among youth experiencing homelessness (YEH) and youth in substance use treatment. To date, studies have not examined poly-victimization among these two intersecting populations. OBJECTIVE To examine heterogeneity in lifetime victimization experiences among youth reporting homelessness at substance use treatment entry; identify demographic predictors of victimization class membership; and associations between victimization and clinical characteristics at treatment intake. PARTICIPANTS AND SETTING 1270 adolescents and young adults reporting past 90-day homelessness in a nationwide substance use treatment data set. METHODS Latent Class Analysis (LCA) and logistic regression were used to examine heterogeneity in poly-victimization experiences, and associations with demographics and clinical characteristics for males and females. RESULTS Four victimization classes emerged for males, and five victimization classes emerged for females. The prevalence of victimization and trauma characteristics were higher for females, except physical victimization, which was higher for males. Age, race/ethnicity, and sexual minority status were related to poly-victimization class membership, but not consistently across classes. Compared to low or single victimization classes, youth in the poly-victimization class had higher odds of post-traumatic stress disorder, major depressive disorder, and exchange sex (among females); Poly-victimization class membership was not associated with duration of recent homelessness or substance use disorder diagnoses, when compared to low/less complex victimization. CONCLUSION High rates of lifetime victimization were found for YEH in substance use treatment, with rates generally higher among females. Trauma-informed interventions are needed to address complex victimization experiences and poor mental health among unstably housed youth in treatment.
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Affiliation(s)
- Graham T DiGuiseppi
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34th Street, Los Angeles, CA, USA.
| | - Colin R Ring
- Loma Linda University, School of Behavioral Health, 11065 Campus St., Loma Linda, CA. USA
| | - Eric R Rice
- University of Southern California, Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, 669 W. 34th Street, Los Angeles, California, USA
| | - Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute of Addiction Science, 669 W. 34th Street, Los Angeles, California, USA
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Hermes G, Fogelman N, Seo D, Sinha R. Differential effects of recent versus past traumas on mood, social support, binge drinking, emotional eating and BMI, and on neural responses to acute stress. Stress 2021; 24:686-695. [PMID: 33595411 DOI: 10.1080/10253890.2021.1877271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Traumatic stress is associated with risk of psychiatric and physical illnesses. However, the differential and separable effects of past versus recent traumas on maladaptive coping and neural responses are not known. We conducted two studies to assess separate and combined effects of cumulative recent and past trauma on health outcomes (study 1) and on neural responses to acute stress exposure in a subsample of individuals (study 2). Study 1 assessed a large cohort of 677 community adults cross-sectionally, and findings indicated that both high recent (within the last 12 months) and past trauma (prior to the last twelve months) were associated with more physical and psychological symptoms, including increased depression (all p's < .05). However, recent trauma alone was associated with higher problematic alcohol use, a greater maximum number of alcohol drinks consumed, greater emotional eating scores, higher state and trait anxiety scores, and poorer lifestyle habits (all p's < .05). Past trauma alone was associated with higher BMI, decreased social support, and a lower average cortisol relative to ACTH ratio (all p's < .02). Study 2 involving a functional brain scan on a subsample (N = 75) indicated greater recent trauma was associated with a hyperactive response in the ventromedial prefrontal cortex (VmPFC) to neutral-relaxed exposure, but blunted VmPFC response to acute stress exposure (p < .05: whole brain corrected-WBC). By contrast, high past trauma was associated with a hyper-sensitized neural response to stress in the cortico-limbic-striatal regions (p < .05, WBC) critical for reward and emotion processing. Together, these findings suggest differential neurobehavioral and health effects of cumulative past versus recent trauma exposure.
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Affiliation(s)
- Gretchen Hermes
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, CT, USA
| | - Nia Fogelman
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, CT, USA
| | - Dongju Seo
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, CT, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, CT, USA
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Davis JP, Tucker JS, Dunbar MS, Pedersen ER, D'Amico EJ. Effects of homophobic name-calling and verbal sexual harassment on substance use among young adults. Aggress Behav 2021; 47:5-16. [PMID: 32818294 DOI: 10.1002/ab.21925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 01/07/2023]
Abstract
Verbal aggression victimization, such as homophobic name-calling, has been linked to heavier substance use among young people, but little longitudinal research has examined how different types of victimization may affect substance use or whether certain psychosocial factors moderate these risks. In a diverse cohort (N = 2,663), latent transition analysis was used to model heterogeneity in victimization (age 19) and substance use (age 20). Four victimization (high victimization, homophobic name-calling only, verbal sexual harassment only, and low victimization) and three substance use (poly-substance use, alcohol, and cannabis only, low all) classes were identified. The high victimization and homophobic name-calling only classes had the highest probabilities of transitioning into the poly-substance use class, and the high victimization class had the highest probability of transitioning into the alcohol and cannabis only class. The probability of transitioning into the low all substance use class was highest in the low victimization class and lowest in the high victimization class. For the high victimization class, greater depressive symptoms increased the odds, and better peer relationship quality decreased the odds, of transitioning into the poly-substance use and alcohol and cannabis only classes. For the homophobic name-calling only class, greater depressive symptoms increased the odds of transitioning into the poly-substance use class. Homophobic name-calling, alone or in combination with verbal sexual harassment, is a risk factor for escalating substance use in young adulthood, especially among victims with depressive symptoms.
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Affiliation(s)
- Jordan P. Davis
- Suzanne Dworak‐Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science University of Southern California Los Angeles California
| | | | | | - Eric R. Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine University of Southern California Los Angeles California
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