Adverse Childhood Experiences and Early Initiation of Marijuana and Alcohol Use: The Potential Moderating Effects of Internal Assets

The Impact of Childhood Adversity on Life Course Alcohol Use Patterns and Health Status Among People Living with HIV

Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) was applied to estimate both direct and indirect pathways between childhood hardship and physical and mental health. Participants were mostly male; Black (84%); and averaged 48 years of age. SEM results supported both direct and indirect pathways between childhood experiences and adult health. ACEs were connected to physical health directly and mental health both directly and indirectly through age at first drink and drinking heaviness during ages 10-20. Childhood economic hardship related to mental health indirectly through higher drinking levels during ages 10-20. Childhood adverse experiences, economic hardship, and early drinking patterns appear to accumulate, resulting in later life physical and mental health concerns for PWH. Findings support taking a life course approach to health. This includes considering individual trauma histories in HIV care engagement and taking preventative approaches which support the economic and social well-being of vulnerable children to improve health in subsequent decades.

The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact

A growing body of literature has documented high rates of adverse childhood experiences (ACEs) and their effects on behavioral health among adolescents impacted by the juvenile legal system. Most research with justice-impacted youth assesses the ten standard ACEs, encompassing abuse, neglect, and household dysfunction. This body of work has largely ignored the five expanded ACEs which assess social and community level adversity. Justice-impacted youth commonly experience expanded ACEs (racial discrimination, placement in foster care, living in a disadvantaged neighborhood, witnessing violence, bullying), and inclusion of these adversities may enhance predictive utility of the commonly used ACEs score. The current study examined the prospective impact of total ACEs (standard and expanded) on alcohol and cannabis use, substance-related consequences, and psychiatric symptoms during the year following first ever contact with the juvenile court. Results indicate justice-impacted youth experience multiple expanded ACEs prior to first court contact. The expanded ACEs did not predict any of the behavioral health outcomes assessed, over and above the standard ACEs. Inclusion of expanded ACEs in the standard ACEs score may not increase utility in identifying prospective behavioral health outcomes among youth in first time contact with the juvenile legal system.

Adverse childhood experiences, risk of opioid misuse and its pathway among students at a public university

OBJECTIVE

We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with ≥4 ACEs and 0-3 ACEs were 2.93 (95% CI: 1.95, 4.39; p < 0.001) and 1.96 (95% CI: 1.46, 2.65; p < 0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals.

Adverse childhood experiences and clustering of high-risk behaviors among high school students: a cross-sectional study

OBJECTIVES

This study assessed the association between adverse childhood experiences (ACEs) and clustering of high-risk behaviors in a sample of high school students.

STUDY DESIGN

This was a cross-sectional study.

METHODS

A sample of students who attended randomly selected classes in 99 high schools completed the 2019 Nevada Youth Risk Behavior Survey (N = 4959). The survey included six ACE measures: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) household physical abuse, (5) household mental illness, and (6) household substance abuse. Students were assigned a cumulative ACE score (range = 0-6). A count of high-risk behavior domains was created using multiple questions across the following domains: (1) violence behaviors, (2) suicidal indicators, (3) non-suicidal self-injury, (4) substance use, (5) high-risk sexual behaviors, (6) poor diet, (7) physical inactivity, and (8) high screen time (range = 0-8). The relationship between ACEs and the count of high-risk behavior domains was assessed using weighted negative binomial regression; incidence rate ratios (IRRs) were calculated adjusting for sociodemographic characteristics.

RESULTS

More than 40% of the sampled students reported high-risk behaviors across two or more domains. There was a strong, graded relationship between cumulative ACE score and the count of high-risk behavior domains. Compared with students who experienced zero ACEs, there was an increase in the count of high-risk behavior domains among students who experienced one ACE (adjusted IRR [aIRR] = 1.22, 95% confidence interval [CI] = 1.12-1.33), two ACEs (aIRR = 1.57, 95% CI = 1.42-1.73), three ACEs (aIRR = 1.73, 95% CI = 1.54-1.94), four ACEs (aIRR = 2.07, 95% CI = 1.84-2.33), five ACEs (aIRR = 2.69, 95% CI = 2.34-3.10), and six ACEs (aIRR = 2.91, 95% CI = 2.34-3.62).

CONCLUSION

Trauma-informed prevention efforts may be an efficient way to address multiple adolescent risk behaviors that cluster.

Associations between early childhood adversity and behavioral, substance use, and academic outcomes in childhood through adolescence in a U.S. longitudinal cohort

BACKGROUND

Childhood adversity is strongly associated with adolescent substance use, but few epidemiologic studies have investigated early childhood adversity (ECA) before age 5. This study investigated pathways by which ECA is associated with adolescent alcohol and cannabis use and high school completion through childhood behavioral and academic mediators and their reciprocal effects.

METHODS

Data were from the National Longitudinal Survey of Youth 1979-Child/Young Adult Cohort which surveyed children born 1984-1999 and followed through 2016 (n = 5521). Outcomes included alcohol and cannabis use frequency at ages 15-18, and high school completion by age 19. ECA at ages 0-4 was a cumulative score of maternal heavy drinking/drug use, low emotional support, low cognitive stimulation, and household poverty. Multilevel path models were conducted with ECA, childhood mediators (behavioral (externalizing and internalizing problems) and academics (reading and math scores), accounting for demographics and confounders.

RESULTS

ECA was indirectly associated with adolescent cannabis frequency through mediators of externalizing/internalizing problems, low academics, and early cannabis onset before age 14. ECA was also indirectly associated with alcohol frequency via the same mediators, but not early alcohol onset. Greater behavioral problems elevated substance use risk; whereas, low academics reduced risk. Reciprocal effects were evident between childhood behavioral problems and cannabis frequency to high school completion.

CONCLUSION

Adversity from birth to age 4 is associated with childhood behavioral problems and lower academics, which increased adolescent alcohol and cannabis use and lowered high school completion. Early childhood interventions with parents and preschools/daycare may reduce early onset and adolescent substance use.

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.

Adverse childhood experiences, psychological well-being, and substance use in Pakistani university students

Adverse childhood experiences are associated with risky health behaviors and adverse health outcomes worldwide, including substance use; yet, relatively fewer studies have examined linkages between adverse childhood experiences and health behaviors and outcomes in low- and middle-income countries, including countries in sub-Saharan Africa and large portions of Asia. Furthermore, fewer studies of adverse childhood experiences have examined the pathways or processes connecting adverse childhood experiences to health behaviors and outcomes. This study addressed these gaps by investigating three competing models of associations between adverse childhood experiences, psychological well-being, and substance use in 595 Pakistani University students (40.5% female; Meanage = 21.96, Standard deviation = 2.37) using path analysis. Controlling for the effects of age, sex, and socioeconomic status, adverse childhood experiences were associated with both diminished psychological well-being and higher levels of substance use. However, psychological well-being and substance use were unrelated and neither accounted for indirect effects of adverse childhood experiences on adjustment. Suggestions for furthering research on adverse childhood experiences, particularly in low- and middle-income countries, are discussed.

Cultural and psychosocial moderators of the association between adverse childhood experiences and alcohol and marijuana use among Latinx college students on the U.S./Mexico border

BACKGROUND

Adverse childhood experiences (ACEs) have been historically associated with negative life outcomes among the general population.

OBJECTIVE

With limited research among Latinx college students, this study assessed how specific constructs moderate the association between ACEs and alcohol and marijuana use.

PARTICIPANTS AND SETTING

Latinx participants recruited from a large U.S./Mexico border region university (Females: N = 283, Males: N = 168) completed an online survey which included: demographics, the Center for Youth Wellness Adverse Childhood Experience Questionnaire (CYW ACE-Q) Teen Self-Report, Drug Use Frequency (DUF), Experiences in Close Relationships Scale (ECR), General Self-Efficacy Scale (GSE), Attitudinal Familism Scale (AFS), The Machismo Measure or The Marianismo Beliefs Scale (MBS), and The Bicultural Self-Efficacy Scale (BSE).

METHODS

Hierarchical linear regressions were conducted to test for main and interactive effects and to determine if the individual moderators (i.e., attachment style, self-efficacy, familism, traditional gender norms, bicultural self-efficacy) affect the relationship between ACEs and alcohol and marijuana use.

RESULTS

Results indicated that among females, attachment style (β = 0.04, p = .03), MBS (β = -65.57, p = .01), and BSE (β = 0.34, p = .04) moderate the relationship between ACEs and alcohol and marijuana use. No moderation analyses were statistically significant among males.

CONCLUSIONS

Clinical implications include, for both substance use and trauma treatment among Latinx college students, the assessment of ACEs and attachment style to promote greater insight into the client's inner struggles and emotional processing in relation to marianismo beliefs and bicultural self-efficacy.

Concurrent Childhood Experiences Impact Underage Substance Use

Adverse and advantageous childhood experiences (ACEs and counter-ACEs) during adolescence are understudied. This study examined how childhood experiences affect youth tobacco/alcohol use. Participants included 489 U.S. adolescents (baseline 10-13 years; 51% female) from the first five waves of the Flourishing Families Project. Results of the cross-lagged model showed ACEs were predictive of early tobacco use only. Counter-ACEs in wave two and wave three predicted, respectively, decreased tobacco and decreased alcohol use in the following wave. Counter-ACEs were also correlated with reduced alcohol and tobacco use in later waves. These findings indicate the salience of counter-ACEs over ACEs in persistent and late adolescent substance use, though ACEs may be important to consider to prevent very early initiation of tobacco.

Adverse childhood experiences and past 30-day cannabis use among middle and high school students: The protective influence of families and schools

Exposure to adverse childhood experiences (ACEs) is a risk factor for adolescent cannabis use (CU). We explored whether family communication and school connectedness can offer direct protection (the compensatory model of resiliency) or moderating protection (the protective factors model of resiliency). Using cluster random sampling, a Youth Risk Behavior Survey (YRBS) was conducted with 5,341 middle school and 4,980 high school students in 2019. Generalized estimating equations were used to estimate whether family communication and school connectedness offered independent direct protection (multiple regression) or moderating protection (multiplicative interaction) in the relationship between ACEs and past 30-day CU. Adjusted prevalence ratios (APR) and 95% confidence intervals (95% CI) were calculated. There was a graded relationship between ACEs and past 30-day CU for all students that was particularly strong among middle school students: 1 ACE (APR = 2.37, 95% CI = 2.16, 2.62), 2 ACEs (APR = 2.89, 95% CI = 2.60, 3.23), 3 ACEs (APR = 5.30, 95% CI = 4.75, 5.90), 4 + ACEs (APR = 7.86, 95% CI = 7.13, 8.67). Results supported the compensatory model of resiliency with both family communication (middle school APR = 0.90, 95% CI = 0.88, 0.93; high school APR = 0.90, 95% CI = 0.87, 0.93) and school connectedness (middle school APR = 0.76, 95% CI = 0.72, 0.79; high school APR = 0.72, 95% CI = 0.68, 0.77) demonstrating a direct, independent protective relationship with past 30-day CU. There was no consistent evidence supporting the protective factors resiliency model.

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.

Internal developmental assets and substance use among Hispanic adolescents. A cross-sectional study

AIMS

To determine the associations between internal assets (planning and decision-making, interpersonal competence and commitment to learning) and substance use (tobacco, alcohol, binge drinking, marijuana use and other drugs).

DESIGN

A cross-sectional study was conducted in four countries (Chile, Mexico, Spain and Peru).

METHODS

Adolescents aged 12-18 self-completed a multi-purpose questionnaire between 2016 and 2019. Multiple logistic regressions and structural equation models were performed to analyse the association between internal assets (planning and decision-making, interpersonal competence, and commitment to learning) and substance use.

RESULTS

The results indicate that planning and decision-making and commitment to learning are conducive to the prevention of substance use. On the contrary, interpersonal competence was not associated with substance use.

CONCLUSION

The present study shows that planning and decision-making and commitment to learning can be relevant factors in explaining substance use during adolescence. Internal assets can be an important aspect to include in health promotion interventions with children, youth and families to prevent substance use. These findings may be useful for researchers, schools, paediatric nurse practitioners, and health professionals in general to design health programs focused on children and adolescents. Furthermore, the Developmental Assets framework has been proved as a suitable frame of reference for paediatric nurse practitioners to assess and develop child and adolescent positive development and design health promotion interventions to prevent substance use.

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

BACKGROUND

Adverse Childhood Experiences (ACE) are associated with substance use in adolescence and adulthood. However, there is a lack of longitudinal research examining the effect of ACE on substance use trajectories from adolescence through emerging adulthood.

OBJECTIVE

This study examined the role of ACE in substance use trajectories among Hispanic emerging adults.

PARTICIPANTS

We surveyed a cohort of Hispanic adolescents (n = 1399) in Southern California across eight survey waves (beginning in 9th grade and continuing through emerging adulthood).

METHODS

Growth curve models were used to examine the effect of ACE on past 30-day cigarette, marijuana, and alcohol use over seven time points, and an interaction term of ACE ∗ time was included to investigate the cross-level effect of ACE.

RESULTS

ACE was a significant predictor at 9th grade across all substances. Every additional ACE was associated with significantly higher past 30-day cigarette use (β = 0.05, 95%CI = 0.01, 0.10), marijuana use, (β = 0.15, 95%CI = 0.06, 0.25) and alcohol use (β = 0.14, 95%CI = 0.06, 0.21). Across all models, cross level interactions between ACE and time indicated that young adults exposed to more ACE experience significantly steeper inclining trajectories of 30-day cigarette use (β = 0.05, 95%CI = 0.02, 0.68), marijuana use (β = 0.07, 95%CI = 0.03, 0.11), and alcohol use (β = 0.02, 95%CI = 0.02, 0.68) than young adults with fewer ACE.

CONCLUSION

ACE continue to have an impact on substance use trends through emerging adulthood. Results highlight the graded effect of ACE on substance use during and beyond adolescence and illustrate that ACE exposure is linked to an escalation of substance use frequency.

Associations Between Adverse Childhood Experiences and Substance Use in Nursing Students

Adverse childhood experiences (ACEs) are a public health problem, and exposure to ACEs can lead to negative health consequences, including substance use. Little is known about ACEs and substance use in the nursing student population. The purpose of the current study was to describe the types of ACEs encountered by nursing students and the rate at which they occur; and examine associations between individual ACEs and alcohol and drug use. This study uses a cross-sectional, descriptive design. Measurements were used to assess and quantify ACEs and alcohol and drug use. There were small to medium associations between alcohol use and ACE items, and more modest associations found between drug use and ACE items (p < 0.001). Findings highlight the need for a trauma-informed approach to nursing education. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 43-47.].

The Relationship Between Childhood Physical and Sexual Abuse and Adolescent Cannabis Use: A Systematic Review

Background: Among adolescents, cannabis use is a health concern due to associations with drug addiction and mental health disorders across the life course. It has been shown that childhood maltreatment is associated with drug addiction in adulthood. However, a better understanding of the relationship between maltreatment and drug use may improve targeted prevention and interventions. The aim of this systematic review is to describe the association between exposure to childhood maltreatment, specifically physical and sexual abuse, with adolescent cannabis use. Methods: A systematic search strategy was applied to Embase, PsycINFO, and Ovid MEDLINE(R) databases. Methods followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Abstract and title screening was performed to identify papers which reported an estimate of the association between childhood physical or sexual abuse and adolescent cannabis use. Full text screening of each paper was performed, and data were extracted and study quality assessed. Weighted means meta-analysis was performed on studies reporting odds ratios as effect estimates. Results: Of 8,780 screened articles, 13 were identified for inclusion. Eight papers received a quality rating score indicating lower risk of bias. Eleven papers reported the relationship between childhood sexual abuse and adolescent cannabis use; effect estimates ranged from AOR 0.53-AOR 2.18 (weighted mean OR 1.29, 95% CI 1.08-1.49). The relationship between childhood physical abuse and adolescent cannabis use was reported in 7 papers; effect estimates ranged from AOR 1.25-AOR 1.87 (weighted mean OR 1.39, 95% CI 1.12-1.66). Differences in the strength of the evidence were observed by the method of exposure ascertainment, and there was some evidence of differences in association by gender, age of cannabis initiation, and the severity of the abuse. Conclusions: This systematic review indicates childhood physical or sexual abuse may increase risk of adolescent-onset cannabis use. Few studies considered variation in timing of onset, or by gender. Adolescent cannabis use precedes is strongly associated with increased risk of negative mental health outcomes; further exploration of adolescent cannabis use's place on the causal pathway between childhood abuse and adult mental health problems is warranted to improve intervention.

Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students

This study examined (a) differences between alcohol-only users and alcohol-marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives (p's < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives (p's < .001); greater Coping and Self-enhancement alcohol use motives (p's < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives (p's < .05); greater Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.

Initial use of tobacco or marijuana and later use profiles in young adults

INTRODUCTION

Given the relatively limited literature regarding risk factors for progression of alternative tobacco and marijuana use, this study examined initially-used tobacco or marijuana products and psychosocial risk factors such as adverse childhood events (ACEs), mental health (depression, ADHD), and parental substance use, in relation to young adult lifetime and current (past 30-day) tobacco and marijuana use.

METHODS

Using cross-sectional data from a 2014–2016 study of 3418 young adult college students in Georgia, we analyzed lifetime and current use of various tobacco products (cigarettes, cigar products, smokeless tobacco, e-cigarettes, hookah) and marijuana among lifetime tobacco or marijuana users (N=1451) in relation to initially-used product as well as sociodemographic characteristics and psychosocial risk factors.

RESULTS

Multivariable analyses indicated that more products ever used correlated with cigarettes being first used (vs cigars, B=-0.66; e-cigarettes, OR=-1.33; hookah, B=-0.99; and marijuana, B=-1.05; p<0.001), as well as being older (B=0.06), male (B=-0.72) and White (vs Black, B=-0.30; or Asian, B=-0.60), more adverse childhood events (ACEs, B=0.07), and parental marijuana use (B=0.47; p<0.05). Currently-used products correlated with cigarettes being first used (vs cigars, B=-0.18; e-cigarettes, B=-0.37; and hookah, B=-0.18; p<0.05), being younger (B=-0.04), male (B=-0.15), more depressive symptoms (B=0.01), and parental marijuana use (B=0.40; p<0.05). Current cigarette, smokeless tobacco, hookah and marijuana use demonstrated specificity to initially-used products.

CONCLUSIONS

Initially-used products, specifically cigarettes, with well-documented and communicated risks, correlated with using more products subsequently among young adults, underscoring needed research on such risks and risk communication, and early intervention strategies.

Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada

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1 in 5 middle school students had used EVPs and 5.1% initiated before age 11.

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A strong graded relationship between cumulative ACEs and early initiation of EVPs was observed.

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Hispanic, rural, and military family students were also at risk for early initiation of EVPs.

Introduction

The use of electronic vapor products (EVPs) among youth has increased significantly in recent years, yet little is known about factors associated with initiation of EVPs during early adolescence. The purpose of this study was to explore the relationship between chronic exposure to adverse childhood experiences (ACEs) and early initiation of EVPs in a representative sample of middle school students.

Methods

5,464 students from 113 middle schools (grades 6–8) completed the Nevada Youth Risk Behavior Survey (YRBS) in the spring of 2017. Six abuse and household dysfunction measures were used to calculate a cumulative ACE score (range 0–6). Initiation of EVPs (e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens) before age 11 was considered early initiation. Weighted logistic regression was used to assess the relationship between cumulative ACE exposure and early initiation of EVPs after controlling for sex, age, race/ethnicity, rurality, free or reduced lunch status, and military family involvement.

Results

Nearly 1 in 5 middle school students (18.6%) reported using EVPs, 6.7% had used EVPs during the past 30 days, and 5.1% started using EVPs before age 11. After controlling for sociodemographics, a strong graded relationship between cumulative ACE exposure and early initiation of EVPs was observed: 1 ACE (AOR = 1.60; 95% CI = 0.99–2.59), 2 ACEs (AOR = 2.29; 95% CI = 1.33–3.93), and 3–6 ACEs (AOR = 3.43, 95% CI = 2.20–5.36) compared to no ACEs.

Conclusions

Screening for ACEs in school-based settings may be a feasible approach for identifying students who may be at-risk for early initiation of EVPs.

Probability and correlates of transition from cannabis use to DSM-5 cannabis use disorder: Results from a large-scale nationally representative study

INTRODUCTION AND AIMS

It has been previously reported that more than 34% of individuals who use cannabis may qualify for a diagnosis of DSM-IV cannabis abuse or dependence throughout their lifetime. The introduction of the DSM-5 cannabis use disorder (CUD) diagnostic criteria reflects several intrinsic changes in the perception of substance use disorders. However, little is known about the probability of transition from cannabis use to CUD over time nor about the sociodemographic and clinical correlates associated with this transition.

DESIGN AND METHODS

Participants were individuals ≥18 years interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III in 2012-2013. Measurements included univariable and multivariable discrete-time survival analyses performed to examine the association between previously reported cannabis dependence predictors and the hazards of transitioning from cannabis use to CUD. Survival plots assessed the probability of transition from cannabis use to CUD over time since age of first use and differences in probability between predictor levels.

RESULTS

Among lifetime cannabis users (N = 11 272), lifetime probability of transition to CUD was approximately 27%. A higher probability of transition from cannabis use to CUD was observed in the following: men, participants belonging to an ethnic minority group, early-onset cannabis users and individuals who reported experiencing three or more childhood adverse events.

DISCUSSION AND CONCLUSIONS

This is the first study to explore transition from cannabis use to the DSM-5 CUD diagnosis. The current study identified specific predictors of this transition, which may assist in targeting at-risk populations.

Challenges to the parental brain: Neuroethological and translational considerations

Extending from research documenting adaptive parental responses in nonthreatening contexts, the influences of various neuroethological and physiological challenges on effective parenting responses are considered in the current review. In natural habitats, rodent family units are exposed to predators, compromised resources, and other environmental stressors that disrupt HPA axis functions. With the additional physiological demands associated with caring for offspring, alterations in stress-related neuroendocrine responsiveness contribute to adaptive responses in many challenging contexts. Some environmental contexts, however, such as restricted nesting resources, result in disrupted maternal responses that have a negative impact on offspring wellbeing. Additionally, parental dysregulation associated with exposure to environmental chemicals or pharmacological substances, also compromise maternal responses with effects that often extend to future generations. Continued preclinical and clinical research elucidating parental responses to various stressors and physiological disruptors is necessary to provide valuable translational information identifying threats to effective parenting outcomes.

Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample

Objectives: Despite college students reporting high rates of substance use and adverse childhood experiences (ACE), few studies have examined ACE-related substance use patterns with diverse student samples. We estimated the prevalence of ACE and substance use and investigated ethnic differences in the relationship between ACE and substance use among college students from two states. Design: Data are responses (N = 7,148) on the National College Health Assessment (in California) and the College Student Health Survey (in Minnesota). Multivariable regression models assessed the associations between individual and accumulated ACE and alcohol, tobacco, marijuana, and illicit substance use and binge drinking (adjusting for age, gender, depression, and state) among non-Hispanic White, Hispanic, African American/Black, Asian Pacific Islanders, multiracial, and other students. Interaction terms were calculated to test for ethnic differences. Results: In the month preceding the survey, 22% of students used marijuana, 28% used tobacco, 75% drank alcohol; 6% used an illicit drug in the past year and 30% acknowledged past 2-week binge drinking. Although ACE were associated with all substance use behaviors (AORs ranged from 1.19 to 1.54, p < .001), there was significant ethnic variation in ACE exposure (40-52%) and the dose-response relationship between ACE and marijuana and tobacco use and binge drinking. Conclusions: The variability in ACE-related substance use patterns across ethnic groups highlights the need for research that advances our understanding of sociocultural influences in trauma response and the role that campus communities could have in the development of culturally sensitive services that address this issue.