Unique versus cumulative effects of physical and sexual assault on patterns of adolescent substance use

Substance use patterns, quantities, and associated risk factors in women with polysubstance misuse

Polysubstance use (PSU), the use of two or more substances proximally, is highly prevalent and has amplified the risk for morbidity and mortality. However, PSU patterns and associated risk factors are not well characterized. This may be especially relevant to women who are known to be vulnerable to stress/trauma, craving, pain, and anxious and depressive symptoms as associated risk factors for PSU. A cross-sectional observational study was conducted to characterize substance use patterns in women who regularly used cocaine, opioids, marijuana, alcohol, benzodiazepines and/or nicotine and were being assessed for a placebo-controlled study of guanfacine treatment (n = 94; ages 19-65). Data on stress/traumatic life events, drug cravings for each substance, pain ratings, and anxiety and depressive symptoms were also obtained using standardized well-validated surveys. High use per day of two or more drugs was observed (72.7% ± 33.3%) and opioid amounts were high relative to other drug amounts (p's < 0.001). Notably, higher stress/trauma events and higher cravings are each associated with cumulative PSU days, amounts and probability of an individual PSU day (p's < 0.02). This remained when PSU versus single substance use was compared. Pain, anxiety and depressive symptoms were not associated with PSU metrics. These findings characterize specific patterns of PSU in women and show that average drug craving and stress/trauma events are associated with PSU. Interventions that focus on stress/trauma and craving management could be of benefit in reducing PSU risk in women.

Examining interactions between polygenic scores and interpersonal trauma exposure on alcohol consumption and use disorder in an ancestrally diverse college cohort

Introduction: Genetic factors impact alcohol consumption and use disorder (AUD), with large-scale genome-wide association studies (GWAS) identifying numerous associated variants. Aggregate genetic methods in combination with important environmental factors (e.g., interpersonal trauma [IPT]) can be applied to expand our understanding of the ways by which genetic and environmental variables work together to influence alcohol consumption and disordered use. The present study aimed to detail the relationships between genome-wide polygenic scores (PGS) for alcohol phenotypes (i.e., alcohol consumption and AUD status) and IPT exposure as well as the interaction between them across ancestry. Methods: Data were drawn from the Spit for Science (S4S) study, a US college student population, where participants reported on IPT exposure prior to college and alcohol consumption and problems during college (N = 9,006; ancestry: 21.3% African [AFR], 12.5% Admixed Americas [AMR], 9.6% East Asian [EAS], 48.1% European [EUR], 8.6% South Asian [SAS]). Two trans-ancestry PGS were constructed, one for alcohol consumption and another for AUD, using large-scale GWAS summary statistics from multiple ancestries weighted using PRS-CSx. Regression models were applied to test for the presence of associations between alcohol-PGS and IPT main and interaction effects. Results: In the meta-analysis across ancestry groups, IPT exposure and PGS were significantly associated with alcohol consumption (βIPT = 0.31, P IPT = 0.0002; βPGS = 0.09, P PGS = 0.004) and AUD (ORIPT = 1.12, P IPT = 3.5 × 10-8; ORPGS = 1.02, P PGS = 0.002). No statistically significant interactions were detected between IPT and sex nor between IPT and PGS. When inspecting ancestry specific results, the alcohol consumption-PGS and AUD-PGS were only statistically significant in the EUR ancestry group (βPGS = 0.09, P PGS = 0.04; ORPGS = 1.02, P PGS = 0.022, respectively). Discussion: IPT exposure prior to college was strongly associated with alcohol outcomes in this college-age sample, which could be used as a preventative measure to identify students at high risk for problematic alcohol use. Additionally, results add to developing evidence of polygenic score association in meta-analyzed samples, highlighting the importance of continued efforts to increase ancestral representation in genetic studies and inclusive analytic approaches to increase the generalizability of results from genetic association studies.

Childhood Polyvictimization and Associated Health Outcomes: A Systematic Scoping Review

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.

Association between Sexual Violence Victimization and Electronic Vaping Product Use among Adolescents: Findings from a Population-based Study

BACKGROUND

Although studies have investigated the association between sexual violence (SV) victimization and substance use, few studies have examined the association between SV victimization and electronic vaping product (EVP) use among adolescents in the United States. The objective of this study was to examine the cross-sectional association between SV victimization and EVP use among adolescents.

METHODS

Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The outcome variable investigated was EVP use, and the main explanatory variable was SV victimization.

RESULTS

Of the 28,135 adolescents, the prevalence of past 30-day EVP use and SV victimization was 22.7% and 10.8%, respectively. Controlling for other factors, adolescents who experienced SV had 1.52 times higher odds of being EVP users when compared to their counterparts who did not experience SV (AOR = 1.52, p < .001, 95% CI = 1.27-1.82). Other factors associated with EVP use included cyberbullying victimization, symptoms of depression, and current use of cigarettes, alcohol, and marijuana.

CONCLUSIONS

Experiencing SV was associated with EVP use. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying the association between SV victimization and EVP use. In addition, school-based interventions that focus on sexual violence prevention and reducing substance use among adolescents are warranted.

Substance use and victimization experiences among college students in Spain

OBJECTIVE

We examined relationships between different types and patterns of substance use and victimization experiences.

PARTICIPANTS

College students from two universities in Spain completed an online, cross-sectional survey.

METHOD

A series of tetrachoric correlations were estimated to examine the bivariate associations between different types of substances and victimization experiences. Regression analyses then examined relationships between patterns of substance use (non-users, mono-users, and poly-users), and victimization.

RESULTS

Slightly over half (57.7%) of students reported any form of victimization during the previous year, and most students (87.0%) reported using substances during the last three months. Polysubstance users were more likely than non-users to experience any victimization, as well as multiple forms of victimization.

CONCLUSIONS

Findings highlight the importance of differentiating types and patterns of substance use when developing prevention and intervention programs. Implementing intervention strategies that target polysubstance users and decrease substance use could reduce rates of victimization among college students.

Associations Among Age of First Experience of Violence, Type of Victimization, Polyvictimization, and Mental Distress in Nigerian Females

This study explored associations of age of first victimization, sexual violence (SV), physical violence (PV), polyvictimization, and mental distress among females in Nigeria (n = 1,766, 13-24 years old) using the nationally representative 2014 Nigeria Violence Against Children Survey. Multinomial logistic regressions were performed. Nigerian females reporting SV victimization and polyvictimization were more likely to experience higher mental distress. The older the female was at the time of PV victimization, the greater the risk for mental distress. Violence is prevalent in Nigeria and its impact on youth's health is severe. However, evidence-based and data-driven policies and programs can reduce and prevent violence.

The Moderating Roles of Resilience and Coping Strategy on Well-Being of Victimized Forensic Workers

Previous research on workplace victimization has often disregarded forensic psychiatric populations and not yet been extended to the coronavirus pandemic. The present study expected the isolation of the government-issued lockdown to increase aggressive behavior in forensic patients, ultimately decreasing the general well-being of victimized forensic workers. Possible buffering protective factors (resilience and active coping) and enhancing risk factors (avoidant coping and passive coping) were investigated with the intention of optimizing the general well-being of at-risk forensic workers. The valid sample (N = 311) consisted of Dutch and Belgian forensic workers (74.6% females) with at least 9 hours of weekly patient contact, and with a mean age of 37.99 (SD = 12.20). Participants reported the number of violent incidents in the past 2 months, as well as completed a questionnaire battery including measures of well-being, resilience, and coping strategies. A significant increase of victimization during the lockdown compared to after it was lifted was found, however, the study did not find evidence to support that this negatively influenced the worker's general well-being. Active coping was found to be a significant moderator and protective factor for the general well-being of victimized forensic workers. In contrast, resilience, avoidant and passive coping were not significant moderators in this association. The present study has valuable clinical implications that could lead to preparatory and preventative measures for forensic workers at risk of being victimized. Future research may investigate constructs such as life satisfaction and post-traumatic growth, as well as be broadened into prison populations.

Relationship between Adverse Childhood Experiences and substance use in youth offenders in Singapore

BACKGROUND

Adverse Childhood Experiences are associated with worse outcomes in delinquency and substance use.

OBJECTIVE

Current research is overwhelmingly from Western perspectives, leaving a gap in non-Western, low crime-rate jurisdictions. Moreover, there exists a gap in characterizing the effect of ACE frequency on delinquency. We extend existing research by examining relationships between ACE and substance use in youth offenders in Singapore.

PARTICIPANTS AND SETTING

The study included 790 youth offenders (669 males, M_age = 17.59 years) from a longitudinal study on youth offending.

METHODS

Multiple regression was performed to examine relationships between self-reported ACEs and substance use. Latent Class Analysis was conducted to identify classes of substance use onset. The relationship between these classes and cumulative ACEs and ACE frequency were then tested using multiple regression.

RESULTS

Youth offenders who consume alcohol (B = 0.66, p = .002) and illicit drugs (B = 0.38, p = .02) had more cumulative and more frequent ACEs than those who do not. Moreover, we found a positive relationship between ACEs and substance use frequency. Those who started taking substances in childhood had significantly more ACEs and had worse drug dependency problems than those who started later (t = 5.93, p < .0001). Additionally, there was a positive relationship between ACEs and drug use dependency (B = 0.11, p = .03).

CONCLUSIONS

Our findings highlight the importance of ACEs as risk factors for substance use. This underscores the need for comprehensive screening and treatment of ACEs and substance use in the rehabilitative context.

Assessing the Mediating Role of Social Support in Childhood Maltreatment and Psychopathology Among College Students in Northern Ireland

The detrimental impact of early trauma, particularly childhood maltreatment, on mental health is well documented. Although it is understood that social support can act as a protective factor toward mental health for children who experience such adversity, few studies have addressed the experience of childhood maltreatment and the important function of social support in adulthood. The current study aimed to assess the mediating role of social support in the relationship between childhood experiences of maltreatment and mental health outcomes including anxiety, depression, posttraumatic stress disorder (PTSD), and problematic alcohol use in a sample of university students (N = 640) from Northern Ireland. Results of binary logistic regression analyses indicated that those reporting experiences of childhood maltreatment were at increased odds of mental health outcomes of PTSD, anxiety, and depression, but not alcohol use. Those reporting greater social support were significantly less likely to report on these mental health outcomes. In addition, the indirect paths from childhood maltreatment through social support to PTSD, depression, and anxiety were all significant, suggesting that social support, particularly family support, is a significant mediator of these relationships. Such findings have important implications for the social care response to children experiencing maltreatment and future support for such children as they transition to adolescence and adulthood.

Patterns of substance use among adolescents: A systematic review

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.

Association Between Dating Violence and Behavioral and Health Outcomes Among Early Adolescents From Denmark: The Role of Exposure to Childhood Maltreatment

AIM

To examine the unique contribution of child maltreatment victimization on the association between adolescent dating violence (ADV) and four negative behavioral and health-related factors.

METHOD

In total, 2,934 7th grade students (M = 13.5, SD = .5) filled out questionnaires at school. Binominal logistic regression was performed to assess the impact of child maltreatment on the relationship between ADV and behavioral and health-related factors.

RESULTS

After child maltreatment was taken into account, associations between ADV and the negative behavioral and health-related factors became weaker.

CONCLUSIONS

The findings from the present study suggest that focusing on one victimization type (such as ADV) when examining psychological outcomes, can be problematic as the causal relationship may be misrepresented when an adolescent's broader victimization profile and context is not considered.

Lifetime Interpersonal Victimization Profiles and Mental Health Problems in a Nationally Representative Panel of Trauma-Exposed Adults From the United Kingdom

Traumatic event exposure has been associated with negative psychological outcomes. There is, however, a dearth of research on revictimization. The current study examined patterns of lifetime interpersonal victimization based on six types of childhood maltreatment, physical and sexual assault, and assault with a weapon during adulthood via latent class analysis (LCA), with gender as covariate. Using a three-step approach, we assessed differences across the latent classes in symptoms and diagnosis of depression, anxiety, and DSM-5 posttraumatic stress disorder (PTSD). A trauma-exposed adult sample representative of the United Kingdom population (N = 1,051) was recruited online through a research panel. The mean participant age 47.18 years (SD = 15.00, range: 18-90 years; 68.4% female). The LCA identified five classes: lifetime polyvictimization (8.3%; 69.5% female), sexual revictimization (13.7%; 96.5% female), physical revictimization (12.5%; 1.5% male), childhood trauma (25.9%; 85.6% female), and limited victimization (39.7%; 40.3% female). Compared to the other classes, the polyvictimization class, followed by the childhood trauma class, demonstrated the highest scores on anxiety, depression, and posttraumatic stress symptoms. The polyvictimization class had nearly a nine- to 33-fold increase in risk of depression, OR = 9.48, 95% CI [3.34, 26.87]; anxiety, OR = 12.10, 95% CI [5.36, 27.36]; and PTSD diagnoses, OR = 33.63, 95% CI [16.35, 69.43], compared to the limited victimization class. The findings facilitate the identification of individuals at risk for revictimization and indicate that evidence-based clinical interventions should be targeted toward those with exposure to revictimization and childhood trauma exposure to alleviate mental health challenges.

History of sexual assault, past-year alcohol use, and alcohol-related problems in American Indian adolescents

American Indian (AI) adolescents have been found to experience higher rates of sexual violence, alcohol misuse, and alcohol-related consequences compared to other racial and ethnic groups. Adolescent alcohol use and sexual assault experiences have been linked to increased negative consequences across physical and mental health, school, work, and legal domains. The purpose of the present study was to examine the associations among endorsing a history of experiencing sexual assault, past-year alcohol use, and experiences of alcohol-related problems, and to examine how these associations differed across sex, using a large, nationally-representative sample of reservation-dwelling AI adolescents. The present study utilized secondary data analysis of a sample of 3498 AI 7th to 12th grade students from a larger national epidemiological study. Participants completed The American Drug and Alcohol Survey™ to assess their alcohol use, sexual assault history, and alcohol-related consequences. Multilevel regression analyses revealed a significant effect of an alcohol use by sex by sexual assault history interaction on experiencing alcohol-related problems (b = -0.88, 95%CI [-1.55, -0.22], p = .009). Furthermore, results revealed that males who endorsed a history of experiencing sexual assault demonstrated the strongest relationship between past-year alcohol use and alcohol-related consequences (b = 2.60, p < .001). Results indicate the importance of early intervention for alcohol use, alcohol-related problems, and sexual assault, perhaps particularly among adolescent males. Future research should examine the directionality between alcohol-use and sexual assault among AI adolescents.

Unique and Cumulative Effects of Intimate Partner Cybervictimization Types on Alcohol Use in Lesbian, Gay, and Bisexual Emerging Adults

The use of modern technology has inadvertently created newer platforms for intimate partner victimization to take place. The present study investigated (1) whether psychological, sexual, and stalking cyber intimate partner victimization (cyber IPV) types were uniquely associated with alcohol use, and (2) whether there was additive effect of cyber IPV types on alcohol use, after controlling for histories of childhood maltreatment types and face-to-face intimate partner victimization among lesbian, gay, and bisexual (LGB) emerging adults. Participants were 277 self-identifying LGB individuals in the age range of 18-29 years (M = 25.39, SD = 2.77; 16.6% lesbian, 25.6% gay, 43% bisexual women). Participants completed an online questionnaire assessing cyber IPV types, namely, psychological, sexual, and stalking, five forms of childhood maltreatment, face-to-face IPV types (i.e., physical, psychological, and sexual), and alcohol use. Findings indicated that 29.2% (n = 81) endorsed all three types of cyber IPV. Hierarchical regression analysis showed that only sexual cyber IPV was uniquely associated with alcohol use. In support of the cumulative risk hypothesis, those with exposure to three types of cyber IPV were more likely to have greater alcohol use compared to those with exposure to any one type of cyber IPV. Findings indicate that cyber IPV can lead to behavioral health challenges, such as an increase in alcohol use among LGB emerging adults. Findings call for interventions focusing on generating awareness regarding the ill effects of cyber IPV and for mental health professionals to develop treatment programs to aid in the well-being of the victim.

Relations among Externalizing Behaviors, Alcohol Expectancies and Alcohol Use Problems in a Multi-Ethnic Sample of Middle and High School Students

BACKGROUND

Alcohol expectancies and externalizing behaviors, that is, aggression and rule-breaking behaviors, are associated with underage alcohol use. The interactive influence of these risk factors on problem alcohol use among minority adolescents is investigated in the present study.

OBJECTIVES

This study examined the unique and interactive influences of alcohol expectancies and externalizing problems on specific measures of adolescents' (a) past three-month binge drinking episodes and (b) negative consequences of alcohol use.

METHODS

Cross-sectional self-report data were collected in 2014 via tablet-based computerized assessments from a predominantly minority sample of 762 (404 females, Mage = 13.73 years, SDage =1.59) 6th, 8th, and 10th grade students recruited from public middle and high schools in Miami-Dade County, FL and Prince George's County, MD. Students completed surveys on tablets in school settings regarding alcohol expectancies, expectancy valuations, externalizing problem behaviors, past 3-month binge drinking episodes, and experiences of alcohol-related negative consequences.

RESULTS

Zero-inflated negative binomial regressions indicated: (1) older adolescents were more likely to report binge drinking; and (2) a significant main effect for externalizing problem behaviors on binge use. Logistic regressions indicated (1) older adolescents were more likely to endorse an alcohol-related negative consequence and (2) the interaction between positive alcohol expectancies and externalizing behaviors was associated with endorsing an alcohol-related negative consequence.

CONCLUSIONS

Engaging adolescents who exhibit serious externalizing behaviors and report positive alcohol expectancies via developmentally appropriate, tailored interventions is one feasible strategy to address escalation of binge alcohol use and related negative consequences among minority youth.

Associations of specific and multiple types of childhood abuse and neglect with personality pathology among adolescents referred for mental health services

The present study investigated the unique association between five types of childhood abuse and neglect and 18 lower-order dimensions of personality pathology, and using latent classes analysis (LCA) explored patterns of childhood abuse or neglect experiences. Further differences across latent classes on personality pathology traits, personality disorder symptom count and a diagnosis of personality disorder were examined. Participants were 178 adolescents and young adults (12-22 years; M = 16.02, 65.7% girls; 83% Axis I/II disorder) from the Netherlands referred for mental health services. Emotional abuse was uniquely associated with 11 personality pathology traits; sexual and physical were associated with three and four traits, respectively. LCA yielded three classes, namely, severe maltreatment (class 1), low-moderate emotional maltreatment and sexual abuse (class 2), and least maltreatment (class 3). After controlling for age, gender, presence of any Axis I disorder, multivariate analysis of covariance indicated that classes with more types of maltreatment experiences and higher severity (classes 1 and 2) endorsed more personality pathology traits, personality disorder symptom counts and a diagnosis of a personality disorder than the least maltreatment class. Findings have theoretical and clinical implications entailing the identification of patterns of maltreatment types and related personality pathology traits among youth.

Childhood maltreatment profiles among incarcerated Chinese males and their associations with personality disorder symptoms and criminal behaviors

Few studies have investigated how multiple childhood maltreatment experiences co-occur and influence personality disorder symptoms and criminal behaviors in Chinese population. Using a large sample of 1001 incarcerated Chinese males (M_age = 30.86 years), the current study identified profiles of self-reported childhood maltreatment experiences and examined their associations with Axis II personality disorder symptoms and criminal behaviors. Latent profile model was built on five types of maltreatment (emotional, physical, and sexual abuse; emotional and physical neglect). Results showed high prevalence and co-occurrence of maltreatment, and revealed four profiles: Minimal Maltreatment (61.5%), Low Abuse and High Neglect (26.6%), High Sexual Abuse with Multiple Maltreatment (4%), and High Physical and Emotional Maltreatment (7.8%). Profiles with high neglect level showed higher Cluster A personality disorder symptoms as well as borderline, avoidant, and dependent symptoms than those with minimal maltreatment. The two profiles with moderate to high abuse level showed elevated symptoms in all clusters of personality disorder and higher prevalence of juvenile offense than the other two profiles. High Physical and Emotional Maltreatment profile also had higher prevalence of violent offending and recidivism. These findings revealed the importance and utility of identifying profiles of co-occurring maltreatment to tailor treatment based on specific maltreatment experiences and their co-occurrence to address negative outcomes associated with each maltreatment profile.

Assessing the factor structure of the Childhood Trauma Questionnaire, and cumulative effect of abuse and neglect on mental health among adolescents in conflict-affected Burundi

The present study aimed to examine the factor structure of the Childhood Trauma Questionnaire (CTQ; Bernstein & Fink, 1998), highlight rates of abuse and neglect among Burundian adolescents, compare these rates with those found in high-income nations, and examine the cumulative effect of multiple types of abuse and neglect on depression and PTSD symptoms. Participants were 231 adolescents and youth (M=14.9, SD=1.99, 58.4% female) from five provinces of Burundi, a country in Central Africa affected by war and political violence. Translation and back-translation of the CTQ was carried out to obtain an adaptation of CTQ in Kirundi, the native language of Burundi. With the exception of one item on 'molestation' in the factor of sexual abuse, the five-factor structure of CTQ was obtained comprising latent factors, namely emotional, physical, and sexual abuse, and emotional and physical neglect. The rate of abuse and neglect ranged from 14.7-93.5% with more than 37% reporting 4 or more types of abuse and neglect experiences. Emotional abuse and neglect, and physical neglect were 2-3 times higher among Burundian adolescents when compared with studies from high-income countries using the CTQ. A cumulative effect of multiple types of abuse and neglect was found, such that, those with 4 or more types of maltreatment were higher on symptoms of depression and posttraumatic stress. Findings highlight the need for culturally sensitive, standardized, and validated measures and norms for gauging childhood maltreatment in Burundi and related need for preventative interventions on childhood maltreatment.

Latent classes of childhood poly-victimization and associations with suicidal behavior among adult trauma victims: Moderating role of anger

The aims of the present study were first to identify discrete patterns of childhood victimization experiences including crime, child maltreatment, peer/sibling victimization, sexual violence, and witnessing violence among adult trauma victims using latent class analysis; second, to examine the association between class-membership and suicidal behavior, and third to investigate the differential role of dispositional anger on the association between class-membership and suicidal behavior. We hypothesized that those classes with accumulating exposure to different types of childhood victimization (e.g., poly-victimization) would endorse higher suicidal behavior, than the other less severe classes, and those in the most severe class with higher anger trait would have stronger association with suicidal behavior. Respondents were 346 adults (N=346; M_age=35.0years; 55.9% female) who had experienced a lifetime traumatic event. Sixty four percent had experienced poly-victimization (four or more victimization experiences) and 38.8% met the cut-off score for suicidal behavior. Three distinct classes emerged namely, the Least victimization (Class 1), the Predominantly crime and sibling/peer victimization (Class 2), and the Poly-victimization (Class 3) classes. Regression analysis controlling for age and gender indicated that only the main effect of anger was significantly associated with suicidal behavior. The interaction term suggested that those in the Poly-victimization class were higher on suicidal behavior as a result of a stronger association between anger and suicidal behavior in contrast to the association found in Class 2. Clinical implications of findings entail imparting anger management skills to facilitate wellbeing among adult with childhood poly-victimization experiences.