Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms

A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories

The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.

Early life stress and substance use disorders: The critical role of adolescent substance use

Early life stress (ELS) is a well-established risk factor for many psychiatric and medical disorders, including substance use disorders (SUDs). The relationship between ELS and SUDs is complex and there are likely multiple pathways from ELS to adverse substance use outcomes. The association between ELS and substance use emerges in adolescence. Adolescence is a critical period in development during which substance exposure markedly increases risk for SUDs. Therefore, this review focuses on the literature supporting the hypothesis that ELS increases risk for the development of SUDs through its influence on adolescent substance use. We discuss studies substantiating the role of ELS in adolescent substance use and explore how internalizing and externalizing psychopathology may be antecedents of substance use in adolescence. We examine clinical work suggesting ELS sculpts the Hypothalamic-Pituitary-Adrenal (HPA) Axis and developing brain-particularly subcortical brain regions that underlie stress response, mesocorticolimbic brain systems associated with reward sensitivity, and prefrontal regions that underlie executive control-in a way that increases risk for adolescent substance use and SUDs. We further explore how substance use during adolescence alters structure and function of these same systems, and how brain changes following ELS and adolescent substance use may independently, additively, or interactively contribute to risk for addiction. We conclude by discussing how the current literature can inform interventions aimed at reducing risk for SUDs in individuals with a history of ELS.

An Exploration of Practitioners' Perceptions and Beliefs About Trauma-Informed Youth Drug Prevention Programs: a Qualitative Study

Adverse childhood experiences (ACEs), such as childhood maltreatment and household dysfunction, have been linked to adolescent substance use. As a result, there exists a pressing need for trauma-informed, substance use preventive intervention for adolescents with a history of ACEs. The primary aim of this qualitative study is to increase our understanding of practitioners' perceptions of substance use among ACE-exposed youth and their views on trauma-informed adolescent substance use prevention programs. The present study conducted six focus groups (N = 32) among current child and adolescent health and human service providers in a mid-Atlantic urban area. The focus groups explored the practitioners' views on the main reasons that youth with a history of ACEs use illicit substances and suggestions on components, constructs, or techniques of trauma-informed substance use prevention programs and perceived barriers in implementing such programs. Transcripts of the focus groups were analyzed using open coding and subsequent axial coding, which was followed by thematic analysis. Thematic analysis identified ten themes within three categories, including the etiology of substance use among ACE-exposed youth, barriers to preventing substance use among ACEs-exposed youth, and suggested program components for trauma-informed prevention programs. These findings provide support for developing a preventive intervention that addresses trauma symptoms and overall skill buildings to prevent substance use among ACE-exposed youth. Teaching skills to cope with trauma symptoms, enhancing knowledge about the signs and symptoms of trauma, and improving key social and emotional learning competencies might be important and effective strategies to curb substance use among ACE-exposed youth.