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Sezer Katar K, Kurtoğlu MB, Zengin İspir G, Danışman M. Resilience and traumatic childhood experiences of patients with opioid use disorder. J Ethn Subst Abuse 2023:1-13. [PMID: 37942773 DOI: 10.1080/15332640.2023.2278469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
We aim to explore childhood traumatic experiences and resilience of patients with OUD and compare these variables to healthy controls. Ninety-five patients and 83 healthy controls completed the Sociodemographic Data Form, Connor Davidson Psychological Resilience Scale (CDRS), and Childhood Trauma Questionnaire-33 (CTQ-33). We found that CTQ correlated negatively with CDRS in patients. T-test results showed significant differences between both groups regarding total and subscales' scores of CTQ-except overprotection-over control. Physical neglect predicted a decrease in resilience in patients with OUD. In conclusion, childhood traumas and resilience could be essential factors during patients' follow-up and treatment process with OUD.
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Affiliation(s)
- Kübra Sezer Katar
- University of Health Sciences, Ankara Training and Research Hospital, Altindag-Ankara, Turkey
| | | | - Gamze Zengin İspir
- University of Health Sciences, Ankara Training and Research Hospital, Altindag-Ankara, Turkey
| | - Mustafa Danışman
- University of Health Sciences, Ankara Training and Research Hospital, Altindag-Ankara, Turkey
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Picci G, Linden-Carmichael AN, Rose EJ. Resilience profiles predict polysubstance use in adolescents with a history of childhood maltreatment. ADDICTION RESEARCH & THEORY 2022; 31:137-147. [PMID: 36935733 PMCID: PMC10021075 DOI: 10.1080/16066359.2022.2132237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 09/19/2022] [Accepted: 09/30/2022] [Indexed: 06/18/2023]
Abstract
Background Childhood maltreatment (CM) can be an impediment to normative development and consistently predicts increased risk for substance misuse and polysubstance use (polySU). Yet, a subset of individuals who experience CM exhibit successful adaptations across the lifespan. Although there is an expansive literature on socioemotional and cognitive protective factors that mitigate impacts of CM, less is known about other, intra-individual resilience-promoting factors (e.g., positive future orientation) known to assuage high-risk SU patterns during adolescence. Method This study examined heterogeneity in individual-level resilience characteristics in maltreated youth as it related to CM characteristics and SU patterns during adolescence. Participants included maltreated youth from the longitudinal LONGSCAN sample (N=355; 181 females). Latent Profile Analysis was used to identify subgroups of CM-exposed individuals based on 5 resilience indicator variables (i.e., commitment to goals, engaging in demanding activities, self-reliance, positive future orientation, and externalizing behaviors). Tests for differences in SU patterns and CM characteristics between the resultant profiles were performed. Results Data models revealed 3 latent profiles based on participants' resilience traits (i.e., Low Resilience, Average Resilience, and High Resilience). There were no profile differences on the basis of CM characteristics. Those in the High Resilience profile were less likely to engage in polySU compared to the Average Resilience profile. Implications These findings highlight the promise of individual-level resilience factors that are not necessarily dependent upon caregiver or environmental inputs as protective against polySU following CM. This work represents a promising avenue for future preventative intervention efforts targeting emergent SU behaviors in high-risk youth.
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Affiliation(s)
- Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Ashley N. Linden-Carmichael
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Emma J. Rose
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Kim S. Exploring the Patterns of Substance Use Behaviors in a Nationally Representative Sample of Pregnant Women: a Latent Class Approach. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00886-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Aronson ID, Zhang J, Rajan S, Marsch LA, Bugaighis M, Ibitoye MO, Chernick LS, Des Jarlais DC. Automated Substance Use/Sexual Risk Reporting and HIV Test Acceptance Among Emergency Department Patients Aged 13-24 Years. AIDS Behav 2022; 26:1544-1551. [PMID: 34705152 PMCID: PMC9007819 DOI: 10.1007/s10461-021-03507-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/28/2022]
Abstract
Despite federal guidelines, many adolescents and emerging adults are not offered HIV testing by their healthcare providers. As such, many-including those who may be at high-risk for contracting HIV given their sexual and/or substance use risk-are not routinely tested. The current study examines sexual risk and substance use among emergency department patients aged 13-24 years (n = 147), who completed an automated screening as part of a tablet-based intervention designed to increase HIV testing. Twenty seven percent (n = 39) of participants chose to test for HIV after completing the tablet-based intervention. Among this sample, sexual risk was a significant independent predictor of HIV testing (χ2 = 16.50, p < 0.001). Problem substance use (e.g. trying but failing to quit) also predicted testing (χ2 = 7.43, p < 0.01). When considering these behaviors together, analyses indicated that the effect of problem substance use (ß = 0.648, p = 0.154) on testing is explained by sexual risk behavior (ß = 1.425, p < 0.01). The study's findings underscore the value of using routine automated risk screenings to collect sensitive data from emergency department patients, followed by computer-based HIV test offers for adolescent youth. Our research indicates tablet-based interventions can facilitate more accurate reporting of sexual behavior and substance use, and can also potentially increase HIV test uptake among those at risk.
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Affiliation(s)
- Ian David Aronson
- Digital Health Empowerment, Brooklyn, NY, USA.
- School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA.
| | - Jingru Zhang
- Teachers College, Columbia University, New York, NY, USA
| | - Sonali Rajan
- Teachers College, Columbia University, New York, NY, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, USA
| | - Mona Bugaighis
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Lauren S Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Don C Des Jarlais
- School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
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Ordway MR, Wang G, Jeon S, Owens J. Role of Sleep Duration in the Association Between Socioecological Protective Factors and Health Risk Behaviors in Adolescents. J Dev Behav Pediatr 2021; 41:117-127. [PMID: 31524842 PMCID: PMC7007325 DOI: 10.1097/dbp.0000000000000721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the associations of sleep duration and socioecological protective factors with patterns of adolescent risk behaviors in Fairfax County, VA-one of the largest public school districts in the United States. METHODS A total of 21,360 and 20,330 students in 10th and 12th grades who completed the Youth Risk Behavior Survey were included in this cross-sectional analysis. Sleep duration was measured by self-report of the average number of hours of sleep on a school night. Ten socioecological protective factors included peer-individual, family, school, and community domains. Latent class analysis was used to classify 7 risk behaviors (alcohol use, cigarette use, illicit drug use, inappropriate prescription drug use, risky sexual behavior, deviant behavior, and academic failure) into 4 class memberships (low, some, moderate, and high). Multinomial regression models were adjusted for age, sex, and race. RESULTS Adolescents who reported sleeping the recommended 8 to 9 hours were significantly less likely to belong to the class memberships of greater risk behaviors compared with those who reported short and long sleep duration after controlling for age, sex, race, and survey year. There was a significant inverse relationship between the number of socioecological protective factors and risk behaviors for both 10th and 12th graders. Potential risks of age, sex, and race on risk behaviors were observed. No significant interaction between sleep duration and protective factors was found in either grade. CONCLUSION This study highlights the significant associations between sleep duration and risk behaviors in adolescents with diverse socioecological protective factors. Prioritization of prevention-focused resources should consider sleep duration in addition to the socioecological protective factors commonly cited in the literature when addressing adolescent risk behaviors.
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Affiliation(s)
- Monica Roosa Ordway
- Yale University School of Nursing, 400 West Campus Drive, West Haven, CT 06516
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai 200092, China
- Key Laboratory of Child Development and Learning Science (Ministry of Education), Southeast University, Nanjing 210096, China
| | - Sangchoon Jeon
- Yale University School of Nursing, 400 West Campus Drive, West Haven, CT 06516
| | - Judith Owens
- Boston Children’s Hospital, 333 Longwood Avenue, Boston, MA 02115
- Harvard Medical School
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Doherty IA, Browne FA, Wechsberg WM. Think Inside the Box: the Heterogeneity of "in Risk" Among "at Risk" Female African American Adolescents in North Carolina. J Racial Ethn Health Disparities 2020; 7:1150-1159. [PMID: 32297304 PMCID: PMC10961606 DOI: 10.1007/s40615-020-00739-1] [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: 11/04/2019] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION An abundance of research investigates the health of often referred to as "at risk" or "high risk" youth from underserved communities and usually racial/ethnic minorities. These ubiquitous terms relate to poverty, violence, and unsafe behaviors (e.g., sex without condoms, alcohol, and drug use). METHODS This analysis distinguished the heterogeneity of risks among African American female adolescents recruited for an intervention study from underserved communities in North Carolina. Eligibility included: ages 16-19, considered or dropped out of school, never completed high school, and during the past 3 months had sex with a male partner and used drugs or alcohol. A variable was created to represent the continuum of risk comprised of history of homelessness, or trading sex, or current heavy alcohol and marijuana use. Participants fell into 0, 1, or 2-3 categories. Ordinal logistic regression estimated the odds of adverse poor outcomes by category. Linear regression estimated reduction in material and emotional support by category. RESULTS Of the 237 participants, 59.5%, 27.8%, and 12.7% were in 0, 1, or 2-3 categories, respectively. Relative to adolescents in 0 categories, participants in other categories were more likely to report food insecurity (OR = 3.27, 95%CI [1.8, 5.94]); past arrest (OR = 3.56 [2.08, 6.09]); run away (OR = 3.30 [1.79, 6.10]); multiple sex partners (2.97 [1.61, 5.48]); and vaginal/anal sexual abuse (OR = 3.21[1.73, 5.96]). Material and emotional support was significantly lower for participants in 2-3 risk categories. CONCLUSIONS Vague use of "at risk" fails to recognize the heterogeneity of experiences and needs of underserved African American youth.
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Affiliation(s)
- Irene A Doherty
- RTI International, Research Triangle Park, Durham, NC, USA.
- Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, NC, USA.
| | - F A Browne
- RTI International, Research Triangle Park, Durham, NC, USA
| | - W M Wechsberg
- RTI International, Research Triangle Park, Durham, NC, USA
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Halladay J, Woock R, El-Khechen H, Munn C, MacKillop J, Amlung M, Ogrodnik M, Favotto L, Aryal K, Noori A, Kiflen M, Georgiades K. Patterns of substance use among adolescents: A systematic review. Drug Alcohol Depend 2020; 216:108222. [PMID: 32971420 DOI: 10.1016/j.drugalcdep.2020.108222] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This review characterizes empirically derived patterns of multiple (multi-) substance use among adolescents. A secondary objective was to examine the extent to which mental health symptomatology was included in the empirical analyses examining substance use patterns. METHODS Eligible studies included those that used cluster-based approaches, included the assessment of at least two different substances, and were based on study samples with mean ages between 11 and 18 years. 4665 records were screened including 461 studies for full-text screening. RESULTS 70 studies were included with common clusters being: low use, single or dual substance use, moderate general multi-use, and high multi-use. The most common patterns of single or multi-substance use were: alcohol only, alcohol with cannabis and/or tobacco, and use of alcohol, tobacco, and cannabis with and without other drugs. Lower socioeconomic status, older age, and male gender were consistent predictors of multi-use clusters. Only 37 % of studies compared differences in levels of mental health across clusters with symptoms consistently associated with a greater likelihood of multi-use. Only 29 % of studies included mental health indicators in cluster-based analyses, with over half identifying distinct mental health and substance use clusters. Fit indices in cluster analyses and measurement properties of substance use were heterogeneous and inconsistently reported across studies. CONCLUSIONS Distinct patterns of substance use were derived but methodological differences prevented direct comparison and reduced capacity to generalize across studies. There is a need to establish standardized methodological approaches to identify robust patterns of substance use to enhance etiological, prognostic, and intervention research.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - R Woock
- Department of Social Sciences, McMaster University, Canada.
| | - H El-Khechen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - C Munn
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - J MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Ogrodnik
- NeuroFit Lab, Department of Kinesiology, McMaster University, Canada.
| | - L Favotto
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - K Aryal
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - A Noori
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - M Kiflen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Population Health Research Institute, Hamilton, ON, Canada.
| | - K Georgiades
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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Diaz A, Shankar V, Nucci-Sack A, Linares LO, Salandy A, Strickler HD, Burk RD, Schlecht NF. Effect of child abuse and neglect on risk behaviors in inner-city minority female adolescents and young adults. CHILD ABUSE & NEGLECT 2020; 101:104347. [PMID: 31884248 PMCID: PMC7059863 DOI: 10.1016/j.chiabu.2019.104347] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Over six million children each year are referred to child protective services for child abuse (sexual, physical and emotional) and neglect (physical and emotional). OBJECTIVE While the relationship between child sexual abuse and sexually transmitted infections has been documented, there has been little research regarding the effects of other forms of maltreatment. PARTICIPANTS AND SETTING 882 inner-city females aged 12-20 years of age seen at a large adolescent and young adult (AYA) health center in New York City between 2012-2017. METHODS History of maltreatment was assessed using the Childhood Trauma Questionnaire. Associations with depressive symptoms, antisocial behavior, peer deviancy, drug/alcohol use, and risky sexual behaviors were assessed. RESULTS History of maltreatment was common in our cohort of inner-city AYA females, with 59.6 % reporting any type of maltreatment, including sexual abuse (17.5 %), physical abuse (19.5 %) or neglect (26.2 %), and emotional abuse (30.7 %) or neglect (40.4 %). We observed significant associations between all forms of maltreatment and risk of depression, drug/alcohol use, antisocial behaviors, peer deviancy, and risky sexual risk behaviors (including having a higher number of sexual partners, having a sexual partner 5+ years older, and anal sex). Physical and emotional abuse were associated with having unprotected sex while under the influence of drugs/alcohol. CONCLUSIONS AND RELEVANCE Reporting a history of maltreatment was associated with an increased likelihood of engaging in risky sexual and antisocial behaviors, as well as depression in inner-city female youth. These data highlight the broad, lingering repercussions of all types of child maltreatment.
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Affiliation(s)
- Angela Diaz
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA.
| | - Viswanathan Shankar
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anne Nucci-Sack
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Lourdes Oriana Linares
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Anthony Salandy
- Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - Howard D Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Departments of Pediatrics, Microbiology & Immunology, and Obstetrics, Gynecology & Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicolas F Schlecht
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Myers B, Carney T, Browne FA, Wechsberg WM. Development of a trauma-informed substance use and sexual risk reduction intervention for young South African women. Patient Prefer Adherence 2018; 12:1997-2006. [PMID: 30323569 PMCID: PMC6174905 DOI: 10.2147/ppa.s175852] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To develop a trauma-informed substance use and sexual risk reduction intervention for young South African women at risk of HIV. PATIENTS AND METHODS Guided by the ADAPT-ITT framework for intervention development, we selected four focus groups (n=26) to assess the service needs and preferences of trauma-exposed young women (aged 18-25 years) who use substances. We used findings to develop a needs-based and contextually appropriate intervention. In addition four focus groups (n=30) were selected to explore potential service users' views of this intervention and recommendations for improving acceptability and appeal. Expert stakeholders were also consulted. RESULTS Young women described therapeutic, self-care, and social support needs for coping with traumatic experiences and reducing substance- and sexual-related risks for HIV and further trauma. To address these needs, we expanded the Women's Health Co-Operative (WHC; an evidence-based HIV prevention program) to include trauma-related psychoeducation; cognitive-behavioral strategies for coping with the emotional impact of trauma, stress, and substance use craving; social support strategies; and self-care components to help young women create a life with purpose. This novel and expanded six-session group-based intervention is called the trauma-informed WHC. Focus group participants and expert stakeholders viewed the trauma-informed WHC as highly relevant and acceptable. They provided recommendations for modifications to the intervention structure and reformatting of intervention materials to enhance the intervention's appeal and the feasibility of reaching and retaining young women in the program. CONCLUSION Engaging women as potential service users in the process of developing a trauma-informed substance use and sexual risk reduction intervention helped identify service needs not commonly addressed in trauma-informed substance use interventions but critical for recovery and local relevance. It also enhanced the acceptability and appeal of the intervention. While potentially acceptable, the trauma-informed WHC requires feasibility testing before establishing its efficacy in a larger trial.
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Affiliation(s)
- Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa,
- Division of Addiction Psychiatry, Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,
| | - Tara Carney
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, Cape Town, South Africa,
- Division of Addiction Psychiatry, Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,
| | - Felicia A Browne
- Substance Use and Gender Research (SUGAR) Program, RTI International, Research Triangle Park, NC, USA
| | - Wendee M Wechsberg
- Substance Use and Gender Research (SUGAR) Program, RTI International, Research Triangle Park, NC, USA
- Department of Public Health, Health Policy and Administration, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, USA
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
- Department of Psychiatry and Behavioral Medicine, Duke University School of Medicine, Durham, NC, USA
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