The risk of male adult alcohol dependence: The role of the adverse childhood experiences and ecological executive function

The influence of adverse childhood experiences and depression on addiction severity among methamphetamine users: exploring the role of perseveration

Aims

This investigation aimed to clarify the intricate relationship among depression, cognitive function, adverse childhood experiences (ACEs), and their combined influence on methamphetamine use disorder (MUD).

Methods

Utilizing a battery of psychological tests, this study ascertained the impact of ACEs on the condition of 76 people with MUD who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, aged 42.17 on average. The Iowa Gambling Task (IGT), Conners' Continuous Performance-II (CPT-II), the self-report Severity of Dependence Scale (SDS), and the Beck Depression Inventory-II (BDI-II) were used for these evaluations. Individuals involved in the study were categorized into two discrete cohorts, mild (ME) and severe (SE), based on the extent of their ACEs exposure. This study employed the PROCESS regression, the independent t-test andχ2 tests for the analysis.

Results

The findings revealed notable discrepancies in the psychological consequences between the two groups with different degrees of ACEs; however, no substantial differences were observed in the demographic parameters. The SE group exhibited elevated BDI-II scores, more evident indications of MUD, and a higher degree of CPT-II cognitive perseveration. The PROCESS model revealed that cognitive perseveration moderated the impact of depression on ACEs and subjective MUD severity, explaining 20.2% of the variance. The ACEs and depression predicted 28.6% of the variance in MUD symptoms. However, no statistically significant differences were detected between the two groups regarding the parameters in the IGT-2 assessment.

Conclusions

These results indicate that the interaction between cognitive and depressive factors mediates the effect of ACEs on subjective MUD severity but not on MUD symptoms. The ACEs significant impact on mental health severity perception is explained by cognitive and depressive factors. This implies that MUD treatment and rehabilitation should address cognitive dysfunction and developmental trauma.

Psychosocial characteristics pattern correlated with HIV-related risky sexual behavior among HIV-negative men who have sex with men: a latent profile analysis

BACKGROUND

Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM.

METHOD

Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data.

RESULTS

Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive.

CONCLUSIONS

Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.

The relevant research of adverse childhood experiences and "risky drinking" in children of alcoholics in China

OBJECTIVE

To determine whether adverse childhood experiences (ACEs) of children of alcoholics (COA) in male were associated with their current "risky drinking".

METHODS

This case-control study used the Alcohol Use Disorder Identification Test (AUDIT, cutoff is 7) to divide the participants into two groups, a "risky drinking" group (N = 53) and a "non-risky drinking" group (N = 97). Demographic data, Adverse Childhood Experiences-International Questionnaire (ACE-IQ), the Hamilton Anxiety Rating Scale (HAMA), the Hamilton Depression Rating Scale (HAMD) and the Mini-International Neuropsychiatric Interview (MINI) were used for assessment. The specific relationships between ACEs and "risky drinking" were explored.

RESULTS

Respondents ranged in age from 29.70 ± 6.72 years; 74.5% were females; 94.7% were of Han nationality; 56.7% had a level of education above high school; 12% had no formal or stable job. There was difference in attitude to self-drinking between two groups (P < 0.001). The "risky drinking" group was more likely to have experienced a major depressive episode (P < 0.05), nonalcohol psychoactive substance use disorder (P < 0.01) and bulimia nervosa (P < 0.05), and they also experienced more physical abuse (P < 0.05), community violence (P < 0.001) and collective violence (P < 0.01). In a single factor logistic regression, physical abuse, community violence and collective violence were associated with a two to 11- fold increase in "risky drinking" in the adult COA, and in multiple factor logistic regression, community violence showed a graded relationship with "risky drinking".

CONCLUSION

The childhood adverse experiences contribute to "risky drinking" in COA. This finding in the Chinese context have significant implications for prevention not only in China but in other cultures. There must be greater awareness of the role of ACEs in the perpetuation of alcoholism.

Adverse childhood experiences, recent negative life events, and non-suicidal self-injury among Chinese college students: the protective role of self-efficacy

BACKGROUND

Non-suicidal self-injury (NSSI) is a severe health problem closely related to adverse childhood experiences (ACEs). However, the underlying mechanisms by which ACEs may affect NSSI are largely unknown. Self-efficacy (NSSI-SE) and recent negative life events (RNLEs) may play important roles in this relationship. This study aimed to clarify the relationship between ACEs and NSSI among college students by examining the role of self-efficacy (NSSI-SE) and RNLEs in this process.

METHOD

Relevant self-report questionnaires were used to evaluate ACEs, RNLEs, NSSI-SE, and NSSI. A questionnaire of 1036 Chinese undergraduates (M_age = 19.65, 28.9% males, 71.1% females) was collected in a cross-sectional manner. The associations between ACEs, RNLEs, NSSI-SE and NSSI were assessed using Pearson correlation analyses. Then, hierarchical multiple linear regressions were used to analyze the effects of ACEs and RNLEs on NSSI, as well as the protective effect of NSSI-SE on the above relations.

RESULTS

NSSI was associated with both ACEs and RNLEs. ACEs and RNLEs could directly increase the risks of participating in NSSI, and the effects of ACEs and RNLEs on NSSI were independent without an interactive effect. NSSI-SE buffered the relationship between ACEs and NSSI, as well as between RNLEs and NSSI. Compared to individuals with a low level of NSSI-SE, ACEs and RNLEs were not significantly associated with NSSI in persons with a high level of NSSI-SE.

CONCLUSION

NSSI-SE may buffer the effect of ACEs and RNLEs on NSSI, indicating that future interventions can be enhanced by targeting NSSI-SE among college students with ACEs or RNLEs to prevent their engagement in NSSI.

Adverse Childhood Experiences: Mental Health Consequences and Risk Behaviors in Women and Men in Chile

Studies conducted worldwide indicate that adverse childhood experiences (ACEs) are among the most intense and frequent sources of stress, considerably influencing mental and physical health while also resulting in risk behaviors in adulthood.

METHODOLOGY

We used data from the Pilot National Survey of Adversity and Sexual Abuse in Childhood (2020), conducted by CUIDA UC, which comprises the Adverse Childhood Experiences International Questionnaire [ACE-IQ] (Adapted). The cross-sectional methodology used made it possible to directly calculate the prevalence of adverse childhood experiences in the population sampled, at a single point in time. We performed a bivariate and univariate descriptive analysis, a correlation analysis, and a multivariate analysis, all of which will be detailed in the section entitled "General Data Analysis Procedure".

RESULTS

We found equally high rates of adverse childhood experiences in men and women, with community violence exhibiting the highest prevalence. We found significant low- to moderate-sized associations between the multiple types of ACEs considered and mental health problems, substance use problems, criminal behaviors, and intrafamily violence (IFV), which differed between men and women. Significant correlations were detected between the ACE score and mental health, substance use, criminal behaviors, and IFV in both men and women. Importantly, ACEs were found to be predictors of all of these variables, with differences observed between men and women.

CONCLUSIONS

Nearly all participants reported having had at least one ACE and more than half reported had four or more ACEs. Those who had had four or more ACEs were more likely to report problems throughout their life. Having an ACE of any type was found to be a better predictor of mental health problems and IFV in men than in women and might be a stronger risk factor for substance use and criminal behaviors in women than in men.

Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia

El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.

Family alcohol use, rather than childhood trauma, is more likely to cause male alcohol use disorder: findings from a case-control study in northern China

OBJECTIVE

To explore the influence of childhood trauma and family alcohol use on male alcohol use disorder.

METHODS

We conducted a case-control study using Childhood Trauma Questionnaire (CTQ) and a structured interview involving 129 men with alcohol use disorder and 129 healthy male volunteers. The two groups were compared in terms of childhood trauma, parental drinking behavior, and attitudes toward childhood drinking.

RESULTS

Patients showed higher scores of CTQ than controls on childhood trauma experiences, including on the subscales of physical abuse, emotional abuse, sexual abuse, and emotional neglect. Higher proportions of patients than controls had fathers who drank seven or more times a week, and had mothers who were opposed to childhood drinking. Conversely, a smaller proportion of patients than controls had fathers who opposed childhood drinking. Patients were more likely than controls to have been induced to drink as children. Logistic regression analysis identified three risk factors for alcohol use disorder: induced drinking during childhood [odds ratio (OR) 6.09, 95% confidence interval (CI) 2.56-14.51], the father's weekly alcohol consumption during the respondent's childhood (OR 4.40, 95%CI 2.94-6.58) and history of smoking (OR 3.39, 95%CI 1.48-7.77). Conversely, more years of education were a protective factor against alcohol use disorder (OR 0.88, 95% CI 0.78-0.99).

CONCLUSIONS

Men whose fathers drank frequently during their childhood and were encouraged to drink may be at increased risk of alcohol use disorder in adulthood. In fact these factors of family alcohol use appear to increase risk of alcohol use disorder among adult men more than exposure to childhood trauma does.

Childhood adversity and mental health among Chinese young adults: The protective role of resilience

AIM

The aims of this study were to examine the prevalence of adverse childhood experiences (ACEs) among health science students in China; associations between the number of ACE exposures and severity of depressive and anxiety symptoms; and the extent to which resilience moderates the effect of ACEs on mental health outcomes.

DESIGN

This descriptive, cross-sectional study was conducted May-August 2020.

METHODS

Five hundred and sixty-six health science students (18-38 years) from China completed online surveys measuring ACEs using the Simplified Chinese version of the ACE-International Questionnaire, depressive and anxiety symptoms and resilience. Descriptive statistical analysis, ANOVA with Tukey HSD post hoc tests and multiple regression analysis were performed using SPSS 27.

RESULTS

88.5% of participants reported at least one ACE; 42.6% reported four or more ACEs. Higher number of ACEs was associated with more symptoms of depression and anxiety. Four or more ACEs were associated with significantly worse mental health outcomes than those with no ACEs and those with one to three ACEs. Greater resilience significantly attenuated the effects of ACEs on mental health symptoms.

CONCLUSIONS

ACEs are highly prevalent among Chinese health science students but their impact on mental health can be buffered by higher levels of resilience.

IMPACT

Screening for ACEs and strength-based, trauma-informed interventions on fostering resilience is needed to promote mental health among Chinese young adults.

Childhood Adversity, Resilience, and Mental Health: A Sequential Mixed-Methods Study of Chinese Young Adults

Resilience is a key health protective factor for those with adverse childhood experiences (ACEs), but little research has explored how it manifests in early adulthood or across cultures. The purpose of this study was to generate a fuller understanding of resilience and its contribution to the relationships between mental health problems and ACEs among Chinese young adults in Hong Kong. Using a sequential explanatory mixed-methods design, 433 Chinese young adults aged 18 to 24 years were surveyed online to examine the relationships between ACEs, resilience, and mental health problems (depression, anxiety, maladjustment, and posttraumatic stress symptoms). Among them, 34 participants with ACEs were purposively selected and interviewed to explore cultural factors that influenced their resilience. Quantitative data were analyzed using multiple hierarchical regression analyses; qualitative data were analyzed using a qualitative descriptive approach. Higher cumulative ACE exposure was associated with higher severity of adjustment disorder and odds for screening positive for posttraumatic stress disorders, but not for symptoms of depression or anxiety. Resilience significantly contributed to explaining variances across all mental health outcomes over and beyond ACEs and in a protective fashion. Four themes emerged from qualitative interviews: (a) Privacy, emotional restraint, and "saving face"; (b) Conforming to preserve harmony; (c) A will to excel; and (d) Viewing adversity as a matter of luck. These findings suggest Chinese young adults' resilience was influenced by cultural norms of restraint, conformity, competition, and superstition. The present study provides a model for future studies using a mixed-methods design to deeply examine resilience among younger people exposed to early adversities within sociocultural, historical, or geographical contexts.

The Mediated Moderation Model of Depressive Symptoms, Alcohol Use, and Consequences: The Protective Role of Executive Function

Heavy episodic drinking (HED) and negative drinking consequences represent prevalent and serious health concerns for college students. Depressive symptoms may elevate students' risk for engaging in HED and experiencing negative consequences, but levels of risk may vary by executive function (EF) capabilities. Growing evidence suggests that EF deficits are associated with comorbid depressive symptoms and alcohol misuse. Nevertheless, little is known about unique and shared risks that depressive symptoms and EF may interactively pose for HED and negative drinking consequences. Methods: To address these gaps, the study assessed depressive symptoms, multiple domains of EF via multimethod approach, HED, and negative drinking consequences in a sample of 446 undergraduate students. Mediated moderation models were conducted to examine associations between depressive symptoms and alcohol use behaviors and modulating roles of EF. Results: Depressive symptoms, poor planning, and self-reported executive dysfunction were significantly associated with HED and negative drinking consequences. HED mediated the effect of depressive symptoms and executive dysfunction on negative consequences. A significant interaction indicated that better EF (i.e. low or average self-reported executive dysfunction) may buffer the risk depressive symptoms present for negative drinking consequences. Conclusions: The current findings suggest that among college students, risk and resilience factors for HED and negative drinking consequences may vary. Effective EF capabilities may be especially helpful for reducing students' risk for more serious drinking consequences.

Association of Adverse Childhood Experience and Attention Deficit Hyperactivity Disorder with depressive symptoms among men who have sex with men in China: moderated mediation effect of resilience

Background

Adverse childhood experience (ACE), attention deficit hyperactivity disorder (ADHD), and resilience can all contribute to depressive symptoms. However, little is known regarding the complex relationships between these factors and their joint effects on depressive symptoms. This study aimed to explore the underlying mechanism of ACE, ADHD, and resilience on depressive symptoms among men have sex with men (MSM) in China.

Methods

A total of 714 MSM were recruited from gay/bisexual men-serving venues in Wuhan, Changsha, and Nanchang of China. The data was collected using computer-assisted self-interview. The mediated and moderated mediation models were employed to explore the underlying mechanisms between ACE, ADHD, resilience, and depressive symptoms.

Results

Among 714 MSM, 51.4% reported at least one ACE and 13.0% reported three or more. ACE had a direct (β = 1.01, 95% CI: 0.45–1.57) effect on depressive symptoms. ADHD partially mediated the correlation between ACE and depressive symptoms (indirect effect: 0.55; 95% CI: 0.34–0.79). Additionally, the effect of ACE on depressive symptoms was moderated and buffered by resilience (β = −0.09, 95% CI: -0.15 - −0.03).

Conclusion

The findings suggested that, programs and policies that promote resilience and address ADHD might protect Chinese MSM exposed to ACE from depressive symptoms.

Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years

Background

Adverse childhood experiences (ACEs) have been associated with poor health status later in life. The objective of the present study was to examine the relationship between ACEs and health-related behaviors, chronic diseases, and mental health in adults.

Methods

A cross-sectional study was performed with 1501 residents of Macheng, China. The ACE International Questionnaire (ACE-IQ) was used to assess ACEs, including psychological, physical, and sexual forms of abuse, as well as household dysfunction. The main outcome variables were lifetime drinking status, lifetime smoking status, chronic diseases, depression, and posttraumatic stress disorder. Multiple logistic regression models were used to examine the associations between overall ACE score and individual ACE component scores and risk behaviors/comorbidities in adulthood after controlling for potential confounders.

Results

A total of 66.2% of participants reported at least one ACE, and 5.93% reported four or more ACEs. Increased ACE scores were associated with increased risks of drinking (adjusted odds ratio [AOR] = 1.09, 95% confidence intervals [CI]: 1.00–1.09), chronic disease (AOR = 1.17, 95% CI: 1.06–1.28), depression (AOR = 1.37, 95% CI: 1.27–1.48), and posttraumatic stress disorder (AOR = 1.32, 95% CI: 1.23–1.42) in adulthood. After adjusting for confounding factors, the individual ACE components had different impacts on risk behavior and health, particularly on poor mental health outcomes in adulthood.

Conclusions

ACEs during childhood were significantly associated with risk behaviors and poor health outcomes in adulthood, and different ACE components had different long-term effects on health outcomes in adulthood.

Examining patterns of adversity in Chinese young adults using the Adverse Childhood Experiences-International Questionnaire (ACE-IQ)

Ample evidence supports significant and enduring associations between adverse childhood experiences (ACEs) and negative outcomes later in life. Subsets of ACEs (e.g. childhood maltreatment and household dysfunction) have been examined in Chinese populations, but no known study has comprehensively examined the full constellation of different types of ACEs or patterns of ACE exposure in Chinese samples. As a direct response to the call to establish a global ACEs surveillance framework, this study provides the first translation and validation of the World Health Organization ACE - International Questionnaire (ACE-IQ). Further, patterns of ACE exposure were identified through latent class analysis. The 29-item ACE-IQ was translated and back-translated from English to traditional Chinese to measure exposure to 13 categories of ACEs. The Chinese ACE-IQ demonstrated good content validity; the ACE-IQ domain subscales also showed satisfactory test-retest reliability and semantic equivalence. In a sample of 433 Chinese young adults, three patterns of ACE exposure were uncovered: Low ACEs (65.82%), Household Violence (24.94%), and Multiple ACEs (9.24%). Concurrent exposure to physical abuse, domestic violence, and emotional abuse (i.e. Household Violence) was a novel pattern found in this study sample, and suggests there may be traditional Chinese norms that potentiate risks for violent household environments in the absence of other household risk factors. Findings underscore the importance of examining ACE exposure within local contexts, as children's adverse experiences may be idiosyncratic to geographic, social, and cultural norms.