Adverse childhood experiences and adolescent nicotine and marijuana vaping: Findings from a statewide sample of Florida youth

Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis

Importance

Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability.

Objective

To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates.

Design, Setting, and Participants

Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024.

Main Outcomes and Measures

ACEs.

Results

The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90).

Conclusions

In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.

Co-occurring experiences of traumatic events and substance use among young people

OBJECTIVE

Harmful substance use among young people is concerningly prevalent. Substance use disorder (SUD) and post-traumatic stress disorder (PTSD) frequently co-occur in treatment settings and are well researched among adults but lacking among young community cohorts. The aim of this study was to explore the prevalence and relationship between substance use, SUD, trauma, and PTSD among a community sample of young people in Australia.

METHOD

A cross-sectional examination of data collected from participants (n = 1007, 48.9 % male) aged 18-22 years (M = 20 years, SD = 0.44), who took part in the 7-year follow-up of a cluster RCT of school-based substance use prevention interventions: The Climate and Preventure (CAP) study. A series of regressions were conducted to examine the relationship between trauma-related variables and substance use outcomes.

RESULTS

48.3 % experienced a traumatic event (median = 2, range = 1-11) and of those 10.9 % met a probable PTSD diagnosis. Median age of first trauma exposure was 14 years (range = 0-21). 89.9 % used substances; 73.1 % reported binge drinking, and 35.6 % met a probable diagnosis of SUD (alcohol/cannabis). Those who experienced any traumatic event had almost 1.5 times greater odds of binge drinking. Cannabis use was significantly associated with most trauma-related variables. Sexual trauma exposure was the only trauma type significantly associated with all substance use variables.

CONCLUSIONS

This study demonstrated that substance use/SUD and experiences of trauma/PTSD are prevalent among a community sample of young people. Importantly, substance use among young people is associated with experiencing a traumatic event, particularly sexual and physical types of traumatic events, and developing PTSD.

Adverse childhood experiences, gender, and suicidality among Florida high school students: Examining intervening mechanisms

BACKGROUND

Adverse childhood experiences (ACEs) represent a key risk factor for suicidal thoughts and behaviors among adolescents. However, the intervening mechanisms linking ACEs and suicidality, and whether such processes vary by gender, remain underexplored.

OBJECTIVE

The present study examines whether the relationships between ACEs and the likelihood of experiencing suicidal thoughts and attempting suicide are indirect through depressive symptoms and low self-control. This study also investigates whether these direct and indirect paths might be moderated by gender.

PARTICIPANTS AND SETTING

The analyses make use of data on a statewide representative sample of students enrolled in public high schools in Florida (N = 23,078) from the 2022 Florida Youth Substance Abuse Survey (FYSAS).

METHODS

Generalized structural equation modeling (GSEM) was used to estimate the direct and indirect effects of ACEs on the likelihood of suicidal thoughts and attempting suicide. The indirect effects were assessed using bootstrapping, and between-gender differences in the coefficients were tested.

RESULTS

ACEs has direct associations with depressive symptoms, low self-control, and both suicidality outcomes. The effects of ACEs on suicidal thoughts are indirect through both depressive symptoms and low self-control, and the effects of ACEs on suicide attempts are indirect through depressive symptoms. Limited gender differences in these pathways emerge.

CONCLUSIONS

For male and female youth, ACEs are associated with heightened depression symptoms and reduced self-control, and both of these factors partially explain the previously established relationship between ACEs and suicidality.

Bullying victimization and nicotine and marijuana vaping among Florida adolescents

PURPOSE

Previous research links bullying victimization with the use of illicit substances in adolescence. In addition, recent research has linked bullying victimization with vaping. Very limited research, however, has explored how different forms of bullying may be linked with nicotine and marijuana vaping specifically.

PROCEDURES

This study addresses this gap in the literature by utilizing logistic regression to examine the relationships between verbal, physical, and cyber bullying victimization and nicotine and marijuana vaping in a sample of Florida adolescents.

FINDINGS

Our findings reveal that all three forms of bullying victimization are linked with recent nicotine vaping, and these associations differ somewhat by youth gender. In addition, our findings indicate that cyber bullying victimization is linked with marijuana vaping.

CONCLUSIONS

In conclusion, our findings suggest that bullying victimization is linked with greater odds of vaping activity in adolescents. The implications of these findings for future research and policy are discussed.