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Collazos KSG, Havanur A, De Santis J, Baral A, Vidot DC. Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review. CHILD ABUSE & NEGLECT 2024; 154:106889. [PMID: 38889556 DOI: 10.1016/j.chiabu.2024.106889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. OBJECTIVE The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. METHODS Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. RESULTS Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. CONCLUSIONS This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.
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Affiliation(s)
- Kathryn S G Collazos
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA.
| | - Amogh Havanur
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joseph De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Amrit Baral
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA
| | - Denise C Vidot
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA
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Hitch AE, Brown JL, DiClemente RJ. Interpersonal abuse and alcohol use among African American young women: the mediating role of emotion dysregulation. J Ethn Subst Abuse 2023; 22:433-452. [PMID: 34339342 PMCID: PMC8807765 DOI: 10.1080/15332640.2021.1952130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
African American women experience a high prevalence of alcohol-related consequences, and no studies have explicitly examined the associations among lifetime interpersonal abuse, emotion dysregulation, and alcohol-related outcomes during the critical period of young adulthood within this population. This study used baseline data from a sample of African American young women (N = 560) who use alcohol, aged 18 to 24, enrolled in an HIV prevention intervention trial to examine whether emotion dysregulation mediated the relation between lifetime history of abuse and problematic alcohol use. Further, we sought to examine whether there were potential differential levels of problematic alcohol use based on the number of abuse types experienced. Multiple regression analyses showed that exposure to two or more forms of abuse was associated with problematic alcohol use, β = .24, p < .001, and heavy alcohol consumption, β = .23, p < .001, whereas history of a single form was not. Indirect effects of both single and multiple forms of abuse on problematic alcohol use (95% confidence interval [CI] [.16, 1.02]; [.46, 1.64]) and heavy alcohol consumption (95% CI [.02, .26]; [.05, .45]) via emotion dysregulation severity were found. Abuse and emotion dysregulation were associated with frequency of alcohol use and binge drinking, but not typical amount consumed. Hazardous alcohol consumption was prevalent among this sample of African American young women who use alcohol. This study provides preliminary evidence that emotion dysregulation may be an important mechanism buttressing the association between lifetime history of interpersonal abuse and problematic alcohol use among African American young women who use alcohol.
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Affiliation(s)
- Anthony E. Hitch
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
| | - Jennifer L. Brown
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299, Cincinnati, OH
- Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, New York University, 715/719 Broadway, New York, NY, 10003
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3
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Norris A, Rich C, Kaplan C, Krieger N, Carey KB, Carey MP. Intersections between Young Women's Racial/Ethnic Identities and Sexual Orientation on Rates of Sexual Violence and Substance Use. PSYCHOLOGY & SEXUALITY 2021; 12:141-161. [PMID: 33738042 DOI: 10.1080/19419899.2020.1729848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background Little is known about whether there are differences in rates of sexual violence and its association with substance use based on women's identities, specifically the intersection of their race/ethnicity and sexual orientation. Method Women (N = 546; 18 to 29 years of age) recruited from a reproductive healthcare clinic reported their race, ethnicity, sexual orientation, sexual violence history and substance use. Five logistic regressions examined (a) rates of sexual violence, and (b) the strength of the associations between sexual violence and four substance use outcomes (heavy alcohol use, marijuana use, cigarette use, number of cigarettes used) based on sexual orientation. Subsequent logistic regressions examined race/ethnicity as a moderator of the associations between sexual orientation and (a) rates of sexual violence and (b) substance use. Results Most women surveyed were heterosexual (64%), and 35% of all women reported unwanted sex. Sexual minority women (SMW) reported higher rates of sexual violence and substance use than heterosexual women. Sexual violence was more strongly associated with heavy alcohol use, but not with marijuana or cigarette use, for SMW than heterosexual women. Rates of sexual violence varied based on the intersection of sexual orientation and race/ethnicity. Although SMW were more likely to report sexual violence than heterosexual women, this association was weaker for Black/Latinx women than for non-Hispanic White women (aOR = 0.39, 95%CI [0.18, 0.82]). Race/ethnicity did not moderate the strength of associations between sexual violence and substance use. Conclusions SMW exhibit increased risk for sexual violence and substance use, and victimization was associated with heavy alcohol use. Few racial/ethnic differences emerged as a function of sexual orientation, so SMW are a group with unique needs around sexual violence experiences and substance use, regardless of race/ethnicity. Healthcare providers should be aware of the link between substance use and prior victimization when treating SMW.
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Affiliation(s)
- Alyssa Norris
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903.,Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI 02903
| | - Carla Rich
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903
| | - Clair Kaplan
- Department of Clinical Research, Planned Parenthood of Southern New England, 345 Whitney 15 Avenue, New Haven, CT, 06511.,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT 06510
| | - Naomi Krieger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903
| | - Kate B Carey
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence RI 02903.,Center for Alcohol and Addiction Studies, Brown University, Providence RI 02903
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903.,Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI 02903.,Department of Behavioral and Social Science, School of Public Health, Brown University, Providence RI 02903
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Blair RJ. Modeling the Comorbidity of Cannabis Abuse and Conduct Disorder/Conduct Problems from a Cognitive Neuroscience Perspective. J Dual Diagn 2020; 16:3-21. [PMID: 31608811 DOI: 10.1080/15504263.2019.1668099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: A cognitive neuroscience perspective seeks to understand behavior, in this case the comorbidity of cannabis abuse and conduct disorder/conduct problems, in terms of dysfunction in cognitive processes underpinned by neural processes. The goal of this review is to articulate a cognitive neuroscience account of this comorbidity. Methods: Literature on the following issues will be reviewed: (i) the longitudinal relationship between cannabis abuse and conduct disorder/conduct problems (CD/CP); (ii) the extent to which there are genetic and environmental (specifically maltreatment) factors that underpin this relationship; (iii) forms of neurocognitive function that are reported dysfunctional in CD/CP and also, when dysfunctional, appear to be risk factors for future cannabis abuse; and (iv) the extent to which cannabis abuse may further compromise these systems leading to increased future abuse and greater conduct problems. Results: CD/CP typically predate cannabis abuse. There appear to be shared genetic factors that contribute to the relationship between CD/CP and cannabis abuse. Moreover, trauma exposure increases risk for both cannabis abuse and CP/CD. One form of neurocognitive dysfunction, response disinhibition, that likely exacerbates the symptomatology of many individuals with CD also appears to increase the risk for cannabis abuse. The literature with respect to other forms of neurocognitive dysfunction remains inconclusive. Conclusions: Based on the literature, a causal model of the comorbidity of cannabis abuse and CD/CP is developed.
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Affiliation(s)
- R James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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Abstract
BACKGROUND Prescription opioid misuse (POM) is a significant problem among U.S. adults, including Blacks, as indicated by past research. Despite potential gender differences in POM among Black adults, previous research has yet to examine this possibility. OBJECTIVES This study identified the prevalence and unique correlates of POM among both Black men and Black women. Results were compared to those of Whites. METHODS We used data from 2015-2016 National Survey on Drug Use and Health (N = 60,133). Weighted logistic regression models stratified by race and gender were estimated. One model was stratified by gender only, with race serving as the primary predictor. RESULTS Findings revealed 3.4% of Black women, 4.9% of Black men, 4.1% of White women, and 5.4% of White men reported past-year POM; although, no significant differences were found. Among Black women only, lower socioeconomic status increased odds of POM. Higher educational attainment, residence in rural areas and older age lowered odds of POM. Encounters with drug dealers, illicit drug, marijuana, and tobacco use, other prescription drug misuse, and poor health were associated with increased odds of POM among Black men. In the gender stratified models, White men were more likely to report POM than Black men. However, White women were not more likely to report POM compared to Black women. CONCLUSIONS Clear gender differences exist in the prevalence and correlates of POM among Black adults. Prevention and intervention strategies must be cognizant of these differences when developing programs to decrease POM.
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Affiliation(s)
- Harvey L Nicholson
- a Department of Sociology , University of Central Florida , Orlando , Florida , USA
| | - Jolene Vincent
- b Department of Sociology , College of William and Mary , Williamsburg , Virginia , USA
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Werner KB, Cunningham-Williams RM, Sewell W, Agrawal A, McCutcheon VV, Waldron M, Heath AC, Bucholz KK. The Impact of Traumatic Experiences on Risky Sexual Behaviors in Black and White Young Adult Women. Womens Health Issues 2018; 28:421-429. [PMID: 29903544 PMCID: PMC6143429 DOI: 10.1016/j.whi.2018.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/20/2018] [Accepted: 04/27/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race. PURPOSE The objective of the current study was to examine the contribution of trauma exposure types to RSB-substance-related RSB and partner-related RSB identified through factor analysis-in young Black and White adult women. METHODS We investigated the associations of multiple trauma types and RSB factor scores in participants from a general population sample of young adult female twins (n = 2,948). We examined the independent relationship between specific traumas and RSB, adjusting for substance use, psychopathology, and familial covariates. All pertinent constructs were coded positive only if they occurred before sexual debut. RESULTS In Black women, sexual abuse was significantly associated with substance-related and partner-related RSB, but retained significance only for partner-related RSB in a fully adjusted model. For White women, sexual abuse and physical abuse were associated with both RSB factors in the base and fully adjusted models. Witnessing injury or death was only associated with RSBs in base models. For both groups, initiating alcohol (for Black women), alcohol, or cannabis (for White women) before sexual debut (i.e., early exposure) was associated with the greatest increased odds of RSB. CONCLUSIONS Data highlight the contribution of prior sexual abuse to RSBs for both White and Black women, and of prior physical abuse to RSBs for White women. Findings have implications for intervention after physical and sexual abuse exposure to prevent RSB, and thus, potentially reduce sexually transmitted infection/human immunodeficiency virus infection and unintended pregnancy in young women.
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Affiliation(s)
- Kimberly B Werner
- Missouri Institute of Mental Health, University of Missouri, St. Louis, Missouri.
| | | | - Whitney Sewell
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Arpana Agrawal
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Vivia V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Mary Waldron
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Counseling and Educational Psychology, Indiana University School of Education, Bloomington, Indiana
| | - Andrew C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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Meyers JL, Sartor CE, Werner KB, Koenen KC, Grant BF, Hasin D. Childhood interpersonal violence and adult alcohol, cannabis, and tobacco use disorders: variation by race/ethnicity? Psychol Med 2018; 48:1540-1550. [PMID: 29310741 PMCID: PMC6545193 DOI: 10.1017/s0033291717003208] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Exposure to child maltreatment has been shown to increase lifetime risk for substance use disorders (SUD). However, this has not been systematically examined among race/ethnic groups, for whom rates of exposure to assaultive violence and SUD differ. This study examined variation by race/ethnicity and gender in associations of alcohol (AUD), cannabis (CUD), and tobacco (TUD) use disorders with three types of childhood interpersonal violence (cIPV): physical abuse, sexual abuse, and witnessing parental violence. METHOD Data from the National Epidemiologic Survey of Alcohol-Related Conditions-III (N: 36 309), a US nationally representative sample, was utilized to examine associations of DSM-5 AUD, CUD and TUD with cIPV among men and women of five racial/ethnic groups. Models were adjusted for additional risk factors (e.g. parental substance use problems, participant's co-occurring SUD). RESULTS Independent contributions of childhood physical and sexual abuse to AUD, CUD, and TUD, and of witnessing parental violence to AUD and TUD were observed. Associations of cIPV and SUD were relatively similar across race/ethnicity and gender [Odds Ratios (ORs) ranged from 1.1 to 1.9], although associations of physical abuse with AUD and TUD were greater among males, associations of parental violence and AUD were greater among females, and associations of parental violence with AUD were greater among Hispanic women and American Indian men. CONCLUSIONS Given the paucity of research in this area, and the potential identification of modifiable risk factors to reduce the impact of childhood interpersonal violence on SUDs, further research and consideration of tailoring prevention and intervention efforts to different populations are warranted.
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Affiliation(s)
| | - Carolyn E. Sartor
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Alcohol Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Kimberly B. Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Deborah Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Grant JD, Agrawal A, Werner KB, McCutcheon VV, Nelson EC, Madden PA, Bucholz KK, Heath AC, Sartor CE. Phenotypic and familial associations between childhood maltreatment and cannabis initiation and problems in young adult European-American and African-American women. Drug Alcohol Depend 2017; 179:146-152. [PMID: 28779616 PMCID: PMC5599374 DOI: 10.1016/j.drugalcdep.2017.06.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood maltreatment is a known risk factor for cannabis initiation and problem use, but the extent to which this association is attributable to shared familial influences is unknown. We estimate the magnitude of associations between childhood maltreatment, timing of cannabis initiation, and cannabis-related problems, in European-American (EA) and African-American (AA) women, and parse the relative influence of additive genetic (A), shared environmental (C), and individual-specific environmental (E) factors on these constructs and their covariation. METHODS Data were from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a population-based study of female twins. Logistic regression analyses and twin modeling were used to test for associations, and estimate the relative contributions of genetic and environmental influences to childhood maltreatment and cannabis outcomes and their covariation. RESULTS Maltreatment was significantly associated with increased likelihood of cannabis initiation before age 15 among EAs (OR=6.33) and AAs (OR=3.93), but with increased likelihood of later initiation among EAs only (OR=1.68). Maltreatment was associated with cannabis problems among both groups (EA OR=2.32; AA OR=2.03). Among EA women, the covariation between maltreatment and cannabis outcomes was primarily attributable to familial environment (rC=0.67-0.70); among AAs, only individual-specific environment contributed (rE=0.37-0.40). CONCLUSION Childhood maltreatment is a major contributor to early initiation of cannabis as well as progression to cannabis problems in both AA and EA women. Distinctions by race/ethnicity are not in the relative contribution of genetic factors, but rather in the type of environmental influences that contribute to stages of cannabis involvement.
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Affiliation(s)
- Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Kimberly B. Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, 63110, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Elliot C. Nelson
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Pamela A.F. Madden
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Carolyn E. Sartor
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA,Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
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Bogdan R, Winstone JMA, Agrawal A. Genetic and Environmental Factors Associated with Cannabis Involvement. CURRENT ADDICTION REPORTS 2016; 3:199-213. [PMID: 27642547 PMCID: PMC5019486 DOI: 10.1007/s40429-016-0103-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Approximately 50-70% of the variation in cannabis use and use disorders can be attributed to heritable factors. For cannabis use, the remaining variance can be parsed in to familial and person-specific environmental factors while for use disorders, only the latter contribute. While numerous candidate gene studies have identified the role of common variation influencing liability to cannabis involvement, replication has been elusive. To date, no genomewide association study has been sufficiently powered to identify significant loci. Despite this, studies adopting polygenic techniques and integrating genetic variation with neural phenotypes and measures of environmental risk, such as childhood adversity, are providing promising new leads. It is likely that the small effect sizes associated with variants related to cannabis involvement will only be robustly identified in substantially larger samples. Results of such large-scale efforts will provide valuable single variant targets for translational research in neurogenetic, pharmacogenetic and non-human animal models as well as polygenic risk indices that can be used to explore a host of other genetic hypotheses related to cannabis use and misuse.
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Affiliation(s)
- Ryan Bogdan
- BRAIN lab, Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Jonathan MA Winstone
- BRAIN lab, Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Arpana Agrawal
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
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Werner KB, McCutcheon VV, Agrawal A, Sartor CE, Nelson EC, Heath AC, Bucholz KK. The association of specific traumatic experiences with cannabis initiation and transition to problem use: Differences between African-American and European-American women. Drug Alcohol Depend 2016; 162:162-9. [PMID: 27012434 PMCID: PMC4833569 DOI: 10.1016/j.drugalcdep.2016.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/12/2016] [Accepted: 03/04/2016] [Indexed: 01/17/2023]
Abstract
INTRODUCTION To examine the contribution of trauma exposure to cannabis initiation and transition to first cannabis use disorder (CUD) symptom in African-American (AA) and European-American (EA) emerging adults. METHODS Data are from the Missouri Adolescent Female Twins Study [(N=3787); 14.6% AA; mean age=21.7 (SD 3.8)]. Trauma exposures (e.g. sexual abuse, physical abuse, witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of cannabis initiation and transition to CUD symptom using Cox proportional hazards regression. Other substance involvement and psychiatric disorders were considered as time-varying covariates. RESULTS Analyses revealed different trauma-related and psychiatric predictors for cannabis use supporting racially distinct etiologic models of cannabis involvement. For AA women, history of witnessing injury/death or experiencing a life-threatening accident was associated with cannabis initiation across the complete emerging adult risk period while sexual abuse predicted cannabis initiation only before 15 years old. For EA women, history of sexual or physical abuse and major depressive disorder (MDD) predicted cannabis initiation and physical abuse and MDD predicted transition from initiation to first CUD symptom. No association was discovered between trauma exposures and transition to first CUD symptom in AA women. CONCLUSIONS Results reveal trauma exposures as important contributors to cannabis initiation and to a lesser extent transition to CUD symptom, with different trauma types conferring risk for cannabis involvement in AA and EA women. Findings suggest the importance of considering racial/ethnic differences when developing etiologic models of cannabis involvement.
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Affiliation(s)
- K B Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA.
| | - V V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - A Agrawal
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - C E Sartor
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - E C Nelson
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - A C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - K K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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