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Whitten T, Tzoumakis S, Green MJ, Dean K. Global Prevalence of Childhood Exposure to Physical Violence within Domestic and Family Relationships in the General Population: A Systematic Review and Proportional Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1411-1430. [PMID: 37300288 PMCID: PMC10913340 DOI: 10.1177/15248380231179133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Efforts to identify and prevent childhood exposure to physical violence within domestic and family relationships must be underpinned by reliable prevalence estimates to ensure the appropriate allocation of resources and benchmarks for assessing intervention efficacy. We conducted a systematic review and meta-analysis of the global prevalence of childhood exposure to physical domestic and family violence separately as a victim or witness. Searches were conducted in Criminal Justice Abstracts, Embase, Scopus, PubMed, PsychInfo, and Google Scholar. Studies were included if they were peer-reviewed, published in English, had a representative sample, unweighted estimates, and were published between January 2010 and December 2022. One-hundred-and-sixteen studies comprising 56 independent samples were retained. Proportional meta-analysis was conducted to calculate the pooled prevalence for each exposure. Pooled prevalence estimates were also stratified by region and sex. The global pooled prevalence of childhood exposure to physical domestic and family violence as a victim or witness was 17.3% and 16.5%, respectively. Prevalence estimates were highest in West Asia and Africa (victim = 42.8%; witness = 38.3%) and lowest for the Developed Asia Pacific region (victim = 3.7%; witness = 5.4%). Males were 25% more likely than females to be the victim of physical domestic and family violence during childhood, while both were equally likely to have witnessed it. These findings suggest that childhood exposure to domestic and family violence is relatively common, affecting around one-in-six people by 18 years of age globally. Regional variations in prevalence estimates may reflect underlying economic conditions, cultural norms, and service availability.
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Affiliation(s)
- Tyson Whitten
- Center for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
| | - Stacy Tzoumakis
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- School of Criminology and Criminal Justice, Griffith University, Southport, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD, Australia
| | - Melissa J. Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, NSW, Australia
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
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Funchal GA, Schuch JB, Zaparte A, Sanvicente-Vieira B, Viola TW, Grassi-Oliveira R, Bauer ME. Cocaine-use disorder and childhood maltreatment are associated with the activation of neutrophils and increased inflammation. Acta Neuropsychiatr 2024; 36:97-108. [PMID: 36847141 DOI: 10.1017/neu.2023.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Cocaine-use disorder (CUD) has been associated with early life adversity and activated cellular immune responses. Women are most vulnerable to complications from chronic substance disorders, generally presenting an intense feeling of abstinence and consuming significant drug amounts. Here, we investigated neutrophil functional activities in CUD, including the formation of neutrophil extracellular traps (NETs) and related intracellular signalling. We also investigated the role of early life stress in inflammatory profiles. METHODS Blood samples, clinical data, and history of childhood abuse or neglect were collected at the onset of detoxification treatment of 41 female individuals with CUD and 31 healthy controls (HCs). Plasma cytokines, neutrophil phagocytosis, NETs, intracellular reactive oxygen species (ROS) generation, and phosphorylated protein kinase B (Akt) and mitogen-activated protein kinases (MAPK)s were assessed by flow cytometry. RESULTS CUD subjects had higher scores of childhood trauma than controls. Increased plasma cytokines (TNF-α, IL-1β, IL-6, IL-8, IL-12, and IL-10), neutrophil phagocytosis, and production of NETs were reported in CUD subjects as compared to HC. Neutrophils of CUD subjects also produced high levels of intracellular ROS and had more activated Akt and MAPKs (p38/ERK), which are essential signalling pathways involved in cell survival and NETs production. Childhood trauma scores were significantly associated with neutrophil activation and peripheral inflammation. CONCLUSION Our study reinforces that smoked cocaine and early life stress activate neutrophils in an inflammatory environment.
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Affiliation(s)
- Giselle A Funchal
- Laboratory of Immunobiology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Jaqueline B Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Aline Zaparte
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- LSU Health New Orleans School of Medicine, Pulmonary/Critical Care & Allergy/Immunology, New Orleans, LA, USA
| | - Breno Sanvicente-Vieira
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Thiago W Viola
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab, School of Medicine, Brain Institute of the Rio Grande do Sul (InsCer), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Moisés E Bauer
- Laboratory of Immunobiology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- National Institute of Science and Technology - Neuroimmunomodulation (INCT-NIM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasília, DF, Brazil
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Pirnia B, Soleimani A, Farhoudian A, Zahiroddin A. The contribution of childhood maltreatment to the incidence of heavy cannabis use in Iran (IRNS-CCI): A multicenter, matched-pairs, nested, case-control study. CHILD ABUSE & NEGLECT 2024; 149:106632. [PMID: 38368781 DOI: 10.1016/j.chiabu.2024.106632] [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: 07/13/2023] [Revised: 10/24/2023] [Accepted: 01/01/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Previous studies have shown the role of the interaction between the endocannabinoid system (ECS) and life's adversities in the formation of addiction, including alcohol abuse. OBJECTIVE Our objective was to identify childhood maltreatment (CM) patterns with the strongest impact on the probability of heavy cannabis use (THCCOOH concentrations ≥150 ng/mL) in Iran. PARTICIPANTS AND SETTING Using survivor sampling, 350 adult participants were selected, and they were then allocated to three categories based on an optimal algorithm: 1) Sexual abuse, 2) Physical abuse, and 3) Physical neglect. METHODS From 1 September 2019 to 1 May 2023, we implemented a multicenter, matched-pairs, nested, case-control study based on the wave 3-wave 6 data of a longitudinal, multicenter, cohort study. The cases and controls (n = 350 men) were defined according to the severity of CM. The THC potency was evaluated with the delta-9 carboxy tetrahydrocannabinol (THC-COOH) levels in urine using gas chromatography/mass spectrometry (GC/MS). We calculated the population attributable fractions (PAFs) to identify the patterns of maltreatment associated with the highest odds of high-potency cannabis use. RESULTS Accumulating CM, including sexual abuse, physical abuse, and physical neglect, carried more than three times the risk of heavy cannabis use (OR 3.4 95 % CI 2.9-4.1), and the combination of the three indicators of maltreatment and a high BMI (25-29.9) carried more than four times the risk of heavy cannabis use (OR 4.7 95 % CI 2.7-4.1) compared to the controls. We estimated that in the case of zero CM for each of the three indicators, over 20 % of new cases of heavy cannabis use can be prevented. CONCLUSIONS The findings show the significance of CM as a predicator of heavy cannabis use in adulthood and in the abstinence phase.
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Affiliation(s)
- Bijan Pirnia
- Department of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran
| | - Ali Soleimani
- Department of Psychology, Faculty of Humanities, University of Science and Culture, Tehran, Iran.
| | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Zahiroddin
- Department of Psychiatry, Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Meadows AL, Strickland JC, Hyder SM, Basconi RC, Stull ME, Wagner FP, Nguyen MN, Rayapati AO, Rush CR. Adverse childhood experiences and early initiation of substance use: A survival analysis. Int J Psychiatry Med 2024; 59:218-231. [PMID: 37594029 PMCID: PMC10843023 DOI: 10.1177/00912174231195751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. METHOD Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. RESULTS A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset ( hazard ratio (HR) = 1.14, 95% CI=1.02-1.28, p = 0.02, and HR=1.19, 95% CI = 1.04-1.37, p = 0.01, respectively. CONCLUSIONS A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood.
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Affiliation(s)
- Amy L. Meadows
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Justin C. Strickland
- Johns Hopkins University School of Medicine, Department of Psychiatry & Behavioral Sciences, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - S. Maela Hyder
- University of Kentucky, College of Medicine, 800 Rose Street, Lexington, KY 40536, USA
| | - Rita C. Basconi
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
| | - Margaret E. Stull
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Frances P. Wagner
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
| | - Mai N. Nguyen
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Abner O. Rayapati
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
| | - Craig R. Rush
- University of Kentucky, College of Medicine, Department of Psychiatry, 245 Fountain Court, Lexington, KY 40509, USA
- University of Kentucky, College of Medicine, Department of Behavioral Science, 1110 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536, USA
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Wray-Lake L, Dunn D, Freund V, Kloska DD. The contribution of community service during the transition to adulthood to health in adulthood. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024. [PMID: 38378910 DOI: 10.1111/jora.12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/22/2024]
Abstract
Prior studies have linked young people's community service to indicators of health, yet little research takes the long view by connecting youth's community service to health in the next decade of life. Using a lifespan developmental lens, this study examined community service over the transition to adulthood and uses change over time in community service to predict indicators of behavioral, physical, and psychological health at ages 35 and 40. Data were taken from Monitoring the Future U.S. national multi-cohort data spanning ages 18-40 in high school cohorts from 1976 to 1995 for age 40 (N = 4300) and 1976 to 2000 for age 35 (N = 5879). Models estimated a growth curve model for community service from ages 18 to 30 and found that the slope for community service was associated with alcohol use, binge drinking, marijuana use, healthy behaviors, and life satisfaction at ages 35 and 40, with cigarette use at age 35 only, and with self-esteem and depressive symptoms at age 40 only. Less decline in community service over the transition to adulthood was associated with lower substance use, more healthy behaviors, and higher psychological well-being in adulthood. This study contributes evidence that community service and health are linked across the lifespan and suggests the value of examining the long-term implications of developmental change across adolescence and the transition to adulthood.
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Affiliation(s)
- Laura Wray-Lake
- Department of Social Welfare, University of California, Los Angeles, California, USA
| | - Danielle Dunn
- Department of Social Welfare, University of California, Los Angeles, California, USA
| | - Valerie Freund
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Deborah D Kloska
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Iverson IA, Cook NE, Iverson GL. Adverse childhood experiences are associated with perceived cognitive difficulties among high school students in the United States. Front Psychol 2024; 15:1293013. [PMID: 38375116 PMCID: PMC10875032 DOI: 10.3389/fpsyg.2024.1293013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/04/2024] [Indexed: 02/21/2024] Open
Abstract
Objective Adverse childhood experiences (ACEs) are associated with mental health and cognitive problems, and mental health problems are associated with perceived cognitive difficulties among adolescents. The unique contribution of ACEs to cognitive difficulties after adjusting for poor mental health is not well understood and represents the purpose of this study. Methods The Adolescent Behaviors and Experiences Survey was conducted in 2021 with high school students in the United States. Cognitive difficulty was assessed with: 'Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?' Four ACEs were examined: sexual violence (lifetime and past 12 months), parental emotional abuse, and parental physical abuse. Students were asked about feeling sad or hopeless (past year), considering suicide (past year), and having poor mental health (past month). Binary logistic regressions examined the association between ACEs and cognitive problems, adjusting for mental health. Results Participants were 6,945 students. Students reporting poor mental health were very likely to endorse difficulty concentrating, remembering, or making decisions (girls = 81% and boys = 67%). Cognitive difficulty was uncommon among students who denied poor mental health (girls = 17% and boys = 12%). For boys [p < 0.001; R2 = 0.22] and girls [p < 0.001; R2 = 0.31], after adjusting for mental health problems, independent predictors of cognitive difficulties included parental verbal abuse and physical abuse. For girls, lifetime forced sexual intercourse and sexual violence during the past year were also independently associated. Conclusion ACEs are associated with perceived cognitive difficulty in both adolescent girls and boys, even after adjusting for poor mental health.
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Affiliation(s)
- Ila A. Iverson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nathan E. Cook
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Mass General for Children Sports Concussion Program, Boston, MA, United States
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
- Mass General for Children Sports Concussion Program, Boston, MA, United States
- Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, United States
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Kelly L, Meeker E, Zajac K, Bryan R, O’Connor B. Interactive effect of adverse child experiences and suicidal thoughts and behaviors on adolescent alcohol and cannabis use frequency. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1019-1029. [PMID: 37439752 PMCID: PMC10787036 DOI: 10.1037/adb0000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Adolescents with adverse childhood experiences (ACEs) and suicidality may engage in high levels of substance use to alleviate distress. Most studies of associations among ACEs, suicidality, and substance use rely on retrospective reports by adults. Comparatively less is known about concurrent relationships between ACEs, suicide risk, and substance use in adolescents, which is important for prevention. This study tested if the associations between ACEs and drinking and between ACEs and cannabis use would be even stronger among youth with suicidal ideation or attempt, relative to youth without suicidal ideation or attempt. METHOD High schoolers (N = 1,625; 50.8% male; 47.1% female; 2% nonbinary) from western New York completed the Youth Risk Behavior Survey. Ordinal regressions tested main effects and interactions of the number of ACEs and suicidal ideation/behavior (i.e., none, ideation/plan, attempt) on categories of past-month drinking and cannabis days of use, controlling for age, gender, and race/ethnicity. RESULTS Significant ACEs by suicide interactions on adolescent drinking indicate that the association between ACEs and drinking was stronger for adolescents with suicide attempt adjusted odds ratio (AOR = 2.63) compared to youth with no ideation or attempt (AOR = 1.56) and suicidal ideation/planning only (AOR = 1.58). Main effects of ACEs (AORs = 1.95-2.08) and suicide attempt (vs. no suicidal ideation/attempt [AOR = 2.11] and suicidal ideation/plan [AOR = 2.11]) were associated with greater cannabis use; interactions were not significant. CONCLUSIONS Associations between ACEs and drinking were particularly strong for adolescents with suicide attempt. Conversely, ACEs and suicide attempt were independently associated with cannabis use. Mitigating against ACEs may reduce both adolescent alcohol and cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Lourah Kelly
- University of Connecticut School of Medicine, Farmington, CT
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
| | - Elizabeth Meeker
- Coordinated Care Services Inc., Rochester, NY
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
| | - Kristyn Zajac
- University of Connecticut School of Medicine, Farmington, CT
| | | | - Briannon O’Connor
- Coordinated Care Services Inc., Rochester, NY
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
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Duka S, Rahman S, Hansen SE, Esernio-Jenssen D. The Effect of Maternal Adverse Childhood Experiences (ACEs) on Substance Use During Pregnancy. Matern Child Health J 2023; 27:153-165. [PMID: 37733152 PMCID: PMC10691987 DOI: 10.1007/s10995-023-03768-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES To analyze adverse childhood experiences (ACEs) among mothers of newborns referred to a hospital's child protection team (CPT) for suspected substance exposure. Researchers hypothesized that a higher prevalence of these mothers have ≥ 4 ACEs than female counterparts in the general population. The study team also explored whether associations existed between type of maternal ACEs and substance use in pregnancy. METHODS Retrospective review of infant referrals to the CPT in the 3 years after adding an ACEs questionnaire to the consultation process. Bivariate analyses and multivariate logistic regression models examined associations between prenatal substance use and maternal ACEs prevalence, controlling for demographics. RESULTS Data from 222 infants (four sets of twins) and 218 mothers were analyzed. Half (50.0%) the infants had withdrawal symptoms. Most (67.0%) women had positive toxicology screens, while 85.0% reported prenatal substance use. Half (50.9%) the mothers reported ≥ 4 ACEs and these individuals had significantly higher odds of cannabinoid use [adjusted odds ratio (aOR), 3.7; 95%CI 2.0, 6.9, p < 0.001) than those with < 4 ACEs. A significant association was found between substance use and ACEs in the household challenges category (p = 0.03), especially parental separation/divorce (p < 0.001). CONCLUSIONS FOR PRACTICE As hypothesized, a higher prevalence of mothers referred to the CPT had ≥ 4 ACEs than women in the general population (50.9% vs. 15.2%), and a large proportion had used substances while pregnant. Routine prenatal ACEs screening and universal, nonpunitive toxicology testing of infants and mothers at birth may provide opportunities for intervention while reducing the transgenerational impact of ACEs.
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Affiliation(s)
- Shae Duka
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, USA
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Sadeea Rahman
- Department of Pediatrics, Jacobi Medical Center, New York, USA
| | - Susan E Hansen
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, USA
- Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Debra Esernio-Jenssen
- Morsani College of Medicine, University of South Florida, Tampa, USA.
- Department of Pediatrics, Lehigh Valley Health Network, Allentown, USA.
- Lehigh Valley Reilly Children's Hospital, Cedar Crest Boulevard and I-78, Allentown, PA, 18103, USA.
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Folk JB, Ramaiya M, Holloway E, Ramos L, Marshall BDL, Kemp K, Li Y, Bath E, Mitchell DK, Tolou-Shams M. The Association Between Expanded ACEs and Behavioral Health Outcomes Among Youth at First Time Legal System Contact. Res Child Adolesc Psychopathol 2023; 51:1857-1870. [PMID: 36565372 PMCID: PMC10290175 DOI: 10.1007/s10802-022-01009-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
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.
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Evan Holloway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lili Ramos
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Yu Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Daphne Koinis Mitchell
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
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Clark SL, Dodd CG, Taylor L, Stewart S, Yang N, Shahidullah JD, Guzick AG, Richmond R, Aksan N, Rathouz PJ, Rousseau JF, Newport DJ, Wagner KD, Nemeroff CB. Characterizing patterns of substance use in trauma exposed youth. J Psychiatr Res 2023; 167:1-9. [PMID: 37778242 DOI: 10.1016/j.jpsychires.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Previous work investigating the impact of childhood trauma on substance use and co-occurring psychiatric disorders has primarily been conducted in adults or on specific trauma types. This limits understanding of traumas impact in childhood and how different types of traumas play a role. We sought to characterize substance use in a sample of trauma-exposed youth in the context of psychiatric comorbidities. METHOD 1152 youth from the Texas Childhood Trauma Research Network (TX-CTRN) that were exposed to at least one trauma meeting DSM-5 Criterion A were assessed for current substance use and psychiatric diagnoses. Latent class analysis was used to identify patterns of substance use. To characterize these patterns, we examined if demographics, number of trauma types experienced, or childhood psychiatric disorders predicted class membership. RESULTS We identified four primary patterns of substance use: Non-use (66.1%), predominantly alcohol use (19.7%), predominantly cannabis use (4.5%), and polysubstance use (9.7%). Compared to the non-users, polysubstance users tended to be older, Non-Hispanic White, have experienced more types of trauma. They were also more likely to have fulfilled diagnostic criteria for suicidality and ADHD. Comparisons among the substance using classes were more nuanced. CONCLUSION The findings highlight the need for universal assessments of trauma, substance misuse, and mental health symptoms in youth as the presence or absence of their co-occurrence has implications for treatment.
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Affiliation(s)
| | - Cody G Dodd
- University of Texas Medical Branch, United States
| | - Leslie Taylor
- University of Texas Health Science Center, United States
| | | | | | | | | | - Robyn Richmond
- Texas Tech University Health Sciences Center, United States
| | - Nazan Aksan
- University of Texas at Austin, United States
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Trovini G, Amici E, Bauco P, Matrone M, Lombardozzi G, Giovanetti V, Kotzalidis GD, De Filippis S. A comprehensive evaluation of adverse childhood experiences, social-emotional impairments, and neurodevelopmental disorders in cannabis-use disorder: Implications for clinical practice. Eur Psychiatry 2023; 66:e77. [PMID: 37702087 PMCID: PMC10594251 DOI: 10.1192/j.eurpsy.2023.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), social-emotional impairments (SEIs), and neurodevelopmental disorders (NDs) are frequent in psychiatric disorders, including substance-use disorders. We aimed to determine the prevalence of ACE, SEI, or ND in individuals with cannabis-use disorder (CUD). We compared individuals with preCUD-onset ACE, SEI, or ND to those without. METHODS We crosssectionally studied 323 inpatients or outpatients with a history of past or current CUD, aged 12-35 years (mean age 22.94 ± 4.79), 64.5% of whom were male. The sample was divided into two groups: the non-premorbid (N = 52) and the premorbid ACE/SEI/ND group (N = 271). Within the premorbid group, further subgroups were based on ACEs, SEI, and NDs. We also analyzed other substance use and psychiatric symptoms/diagnoses based on the non-premorbid-premorbid dichotomy in the CUD sample. RESULTS Pre-CUD ACE-SEI-ND had higher prevalence of bipolar, schizoaffective, borderline personality, and attention-deficit/hyperactivity disorders, and a history of agitation, hallucinations, and self-injury. The ACE group had higher rates of agitation, depression, delusions, hallucinations, eating disorders, and use of cocaine, amphetamines, and hallucinogens than the SEI or ND. Patients in the premorbid group initiated cannabis use at an earlier age, experienced the first comorbid psychiatric episode earlier, and were hospitalized earlier than those in the non- premorbid ACE-SEI-ND group. CONCLUSIONS PreCUD-onset ACE, SEI, or ND conditions in individuals with CUDare linked to earlier onset of comorbid mental illness. Furthermore, ACEs contribute to significant and potentially severe clinical symptoms, as well as the use of substances other than cannabis.
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Affiliation(s)
| | | | - Piergiorgio Bauco
- Department of Psychiatry, Università Politecnica delle Marche, Ancona, Italy
| | | | | | | | - Georgios D. Kotzalidis
- Clinica Villa Von Siebenthal, Rome, Italy
- NESMOS Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Rome, Italy
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12
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Pickens CM, Jones CM, Guy GP, Dailey Govoni T, Green JL. Associations between prescription stimulant use as prescribed, nonmedical use, and illicit stimulant use among adults evaluated for substance use treatment, 2017-2021. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100153. [PMID: 37123433 PMCID: PMC10133667 DOI: 10.1016/j.dadr.2023.100153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/16/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023]
Abstract
Background Limited data exist on risk factors for illicit stimulant use, including associations between prescription stimulant use/nonmedical use (NMU) and illicit stimulant use. Methods We used 2017-2021 data from adults assessed for substance use disorder (SUD) treatment using the National Addictions Vigilance Intervention and Prevention Program Addiction Severity Index-Multimedia Version® tool. Multivariable Poisson regression models analyzed associations between past 30-day prescription stimulant use as prescribed or NMU and past 30-day illicit stimulant use. Separate models examined past 30-day illicit stimulant, methamphetamine, and cocaine use. We explored problem severity across seven biopsychosocial domains (e.g., drug, psychiatric, family) by past 30-day prescription stimulant use/NMU and illicit stimulant use. Results Among 218,981 assessments, 1.8% reported prescription stimulant NMU; 1.6% reported use as prescribed. Past 30-day prescription stimulant NMU (vs. no use) was associated with past 30-day illicit stimulant use (adjusted prevalence ratio [aPR] [95% CI]: 2.67 [2.59, 2.75]), methamphetamine use (aPR: 2.81 [2.71, 2.92]), and cocaine use (aPR: 3.53 [3.33, 3.74]). Prescription stimulant use as prescribed (vs. no use) was associated with lower prevalence of past 30-day illicit stimulant use. Assessments reporting prescription stimulant NMU (vs. no use, or use as prescribed) appeared more likely to have moderate-to-extreme problem scores across biopsychosocial domains, indicating greater need for treatment or assistance. Assessments reporting prescription stimulant use as prescribed or NMU frequently reported opioids, alcohol, or other substances as their primary substance problem. Conclusions Adults using illicit stimulants/nonmedically using prescription stimulants may benefit from care addressing polysubstance use, mental health, social, and recovery support services.
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Affiliation(s)
- Cassandra M. Pickens
- Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway NE, Atlanta, GA 30341, United States
- Corresponding author.
| | - Christopher M. Jones
- Office of the Director, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway NE, Atlanta, GA 30341, United States
| | - Gery P. Guy
- Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway NE, Atlanta, GA 30341, United States
| | - Taryn Dailey Govoni
- Inflexxion, A Division of Uprise Health, 2 Park Plaza, Suite 1200, Irvine, CA 92614, United States
| | - Jody L. Green
- Inflexxion, A Division of Uprise Health, 2 Park Plaza, Suite 1200, Irvine, CA 92614, United States
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Schwartz A, Meschke LL, Tree JJ, Brown K, Coatsworth JD. Beating trauma: Physical activity to promote resilience against substance use. Drug Alcohol Depend 2023; 248:109942. [PMID: 37257325 DOI: 10.1016/j.drugalcdep.2023.109942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The relationship between adverse childhood experiences (ACEs) and frequent substance use (SU) is not well understood, impeding prevention efforts. METHODS We assessed the relationship between ACEs and frequent SU and investigated if different modalities of physical activity (PA) moderate this pathway. The analysis included persons enrolled in the National Longitudinal Study of Adolescent to Adult Health who responded to surveys at Waves I (11-20 years), III (18-27 years), and IV (24-33 years). The impacts of cumulative ACEs and PA modalities on daily cigarette smoking, daily cannabis use, and binge drinking ≥ 3 times a week in emerging and early adulthood were assessed through adjusted logistic regression models. RESULTS Among the sample (N=9451), 29.3%, 12.5%, and 7.8% experienced 1, 2, or 3 or more ACEs, respectively. With exception to binge drinking, cumulative ACEs (3+) were strongly associated with daily cannabis use in Wave III (aOR: 2.5; 95% CI: 1.6-3.6) and Wave IV (aOR: 2.1; 95% CI:1.3-3.3) and daily cigarette smoking in Wave III (aOR: 2.4; 95% CI: 1.9-3.0) and Wave IV (aOR: 2.3; 95% CI: 1.8-2.8). No PA modality moderated the ACEs to SU pathway; however, walking for exercise lowered the odds of current and prospective daily cannabis and cigarette use by 20-40%. Strength training, team sports, and individual sport participation were associated with 20-30% reduced risks of future daily cigarette use. CONCLUSION The impacts of ACEs exposure on frequent SU persist into emerging and early adulthood. Future research should investigate the potential of PA to improve SU prevention strategies.
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Affiliation(s)
- Ashlyn Schwartz
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU BordeauxBordeauxF-33000, France; Public Health, University of Tennessee-Knoxville, Knoxville, USA.
| | - Laurie L Meschke
- Public Health, University of Tennessee-Knoxville, Knoxville, USA
| | | | - Kathleen Brown
- Public Health, University of Tennessee-Knoxville, Knoxville, USA
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Kreim S, Marchand K, Mallia E, Dubras R, McMaster WR, Tee K, Mathias S, Barbic S. Identifying early intervention opportunities for illicit stimulant use: A cross-sectional study of factors associated with illicit stimulant use among young people accessing integrated youth services in British Columbia, Canada. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023:209076. [PMID: 37182544 DOI: 10.1016/j.josat.2023.209076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/12/2022] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Illicit stimulant (cocaine and/or amphetamine) use among young people aged 12-24 is a public health priority given that substance use initiation tends to peak in this developmental period and significant associated immediate and long-term harms are associated with its use. Young people using stimulants must be engaged in services as early as possible to reduce these harms. To inform early intervention opportunities, this study aimed to identify the risk/protective factors associated with illicit stimulant use among young people. METHODS We conducted a cross-sectional study on routinely collected self-reported data among young people accessing integrated youth services in British Columbia (Canada) between April 2018 and January 2022. Data were collected on young peoples' socio-demographic characteristics, and social, behavioral, and health profiles. Variable selection was guided by established risk/protective factors for substance use among young people. The study used multivariable logistic regression to identify risk/protective factors that were independently associated with past 30-day illicit stimulant use. RESULTS The analytic sample included n = 5620 young people aged 12-24 and a total of 163 (2.9 %) reported past 30-day illicit cocaine and/or amphetamine use. Demographic characteristics that were independently associated with illicit stimulant use included older age (aOR = 1.27, 95 % CI = 1.17-1.38) and gender identity as man vs woman (aOR = 1.71, 95 % CI = 1.10-2.70). Social and environmental risk factors included recently witnessing or experiencing violence (aOR = 2.32, 95 % CI = 1.47-3.68) and higher past-year crime/violent behaviors score (aOR = 1.39, 95 % CI = 1.13-1.69). Finally, regular alcohol (aOR = 6.90, 95 % CI = 2.36-25.42), regular (aOR = 3.74, 95 % CI = 1.95-7.54) or social (aOR = 3.06, 95 % CI = 1.44-6.60) tobacco use, and lifetime hallucinogen (aOR = 3.24, 95 % CI = 1.8-5.91) and ecstasy/MDMA (aOR = 2.53, 95 % CI = 1.48-4.39) use were also statistically significant risk factors. CONCLUSIONS These risk/protective factors support identification of young people who may benefit from further screening, assessment, and treatment for illicit stimulant use. This study also underscores the need to expand early intervention and harm reduction programs that can comprehensively respond to young peoples' stimulant use, health, and social needs.
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Affiliation(s)
- Sara Kreim
- Faculty of Science, University of British Columbia, 2207 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Kirsten Marchand
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
| | - Emilie Mallia
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - Richard Dubras
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - W Robert McMaster
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Department of Medical Genetics, Faculty of Medicine, University of British Columbia, C201-4500 Oak Street, Vancouver, BC V6H3N1, Canada
| | - Karen Tee
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - Steve Mathias
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Providence Research, 1190 Hornby Street, Vancouver, BC V6Z 1Y6, Canada; Department of Psychiatry, 2255 Wesbrook Mall, University of British Columbia, Vancouver, BC V6T 2A1, Canada
| | - Skye Barbic
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Providence Research, 1190 Hornby Street, Vancouver, BC V6Z 1Y6, Canada
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Serra V, Aroni S, Bortolato M, Frau R, Melis M. Endocannabinoid-dependent decrease of GABAergic transmission on dopaminergic neurons is associated with susceptibility to cocaine stimulant effects in pre-adolescent male MAOA hypomorphic mice exposed to early life stress. Neuropharmacology 2023; 233:109548. [PMID: 37080337 DOI: 10.1016/j.neuropharm.2023.109548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023]
Abstract
Vulnerability to cocaine use disorder depends upon a combination of genetic and environmental risk factors. While early life adversity is a critical environmental vulnerability factor for drug misuse, allelic variants of the monoamine oxidase A (MAOA) gene have been shown to moderate its influence on the risk of drug-related problems. However, data on the interactions between MAOA variants and early life stress (ES) with respect to predisposition to cocaine abuse are limited. Here, we show that a mouse model capturing the interaction of genetic (low-activity alleles of the Maoa gene; MAOANeo) and environmental (i.e., ES) vulnerability factors displays an increased sensitivity to repeated in vivo cocaine psychomotor stimulant actions associated with a reduction of GABAA receptor-mediated inhibition of dopamine neurons of the ventral tegmental area (VTA). Depolarization-induced suppression of inhibition (DSI), a 2-arachidonoylglycerol (2AG)-dependent form of short-term plasticity, also becomes readily expressed by dopamine neurons from male MAOANeo ES mice repeatedly treated with cocaine. The activation of either dopamine D2 or CB1 receptors contributes to cocaine-induced DSI expression, decreased GABA synaptic efficacy, and hyperlocomotion. Next, in vivo pharmacological enhancement of 2AG signaling during repeated cocaine exposure occludes its actions both in vivo and ex vivo. This data extends our knowledge of the multifaceted sequelae imposed by this gene-environment interaction in VTA dopamine neurons of male pre-adolescent mice and contributes to our understanding of neural mechanisms of vulnerability for early onset cocaine use.
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Affiliation(s)
- Valeria Serra
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Italy
| | - Sonia Aroni
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Italy
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, 84112, USA
| | - Roberto Frau
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Italy
| | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Italy.
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Cénat JM, Kogan CS, Kebedom P, Ukwu G, Moshirian Farahi SMM, Darius WP, Mulopo Bakombo S, Dalexis RD, Ndengeyingoma A, Noorishad PG, Labelle PR. Prevalence and risk factors associated with psychostimulant use among Black individuals: A meta-analysis and systematic review. Addict Behav 2023; 138:107567. [PMID: 36521424 DOI: 10.1016/j.addbeh.2022.107567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Psychostimulants (e.g., cocaine, amphetamine) are among the most widely used drugs globally with detrimental short and long-term physical, psychological and social consequences. There is limited data on psychostimulant use for various racial and ethnic groups, including Black people, and the challenges they face living as minorities overcoming historical challenges including increased incarceration associated with drug possession. METHODS Peer-reviewed articles were identified in five databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, MEDLINE). Eligible studies were published in French or English, provided empiral data on psychostimulant use in Black individuals living in a minority context. The PRISMA guideline was used for structuring the review. Random-effects meta-analyses were generated to estimate the pooled prevalence of lifetime and periodic psychostimulant use among Black individuals using STATA 16. RESULTS Sixty-three studies published from 1991 to 2022 with a sample size of 139,683 Black individuals were included in the current meta-analysis. Results indicate a pooled prevalence estimate of 11.4% for any form of psychostimulant use among Black individuals. The pooled prevalence estimates were 12.4% (95% CI, 8.4% - 16.4%) for cocaine, 8.3% (95% CI, 0% - 19.1%) for amphetamines, and 11.4% (95% CI, 4.6% - 18.1%) for other stimulants. Prediction intervals for all psychostimulant types were highly heterogenous ranging from 0% to as high as 51.2% for amphetamine suggesting prevalence of use in some studies of Black people could be found to be as low as zero. Subgroup analyses were conducted to examine differences between age groups, gender, reference period, and type of assessment. CONCLUSIONS High prevalence rates of psychostimulant use among Black people argues for greater access to evidence-based treatments. However, current psychosocial interventions are suboptimal, warranting further study. Consideration needs to be given to the challenges of the large range of prediction intervals, living in urban areas, racial discrimination experiences, race-based stress, and sociodemographic characteristics, including poverty, education level, age, gender.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Philmona Kebedom
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Gloria Ukwu
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Assumpta Ndengeyingoma
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
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Bassir Nia A, Weleff J, Fogelman N, Nourbakhsh S, Sinha R. Regular cannabis use is associated with history of childhood and lifetime trauma in a non-clinical community sample. J Psychiatr Res 2023; 159:159-164. [PMID: 36736285 PMCID: PMC10024801 DOI: 10.1016/j.jpsychires.2023.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Higher rate of substance use, including cannabis, has been reported in individuals with a history of childhood trauma, but less is known about the association between cannabis use with lifetime history of trauma and chronic stress, and potential gender differences in this association. This study systematically examined this association in a cross-sectional study of 841 individuals recruited between 2007 and 2012 from the community in New Haven, Connecticut. The Cumulative Adversity Index (CAI) was used to measure cumulative lifetime major life events, life trauma, and recent life events and chronic stress. Childhood Trauma Questionnaire (CTQ) was used to measure childhood trauma. Current and regular use of drugs were assessed using self-report questionnaires and objectively verified with urine drug testing. Higher rates of childhood trauma as well as lifetime trauma, and major life events were found in cannabis users, compared to non-users. The association between cannabis use with childhood trauma (total CTQ scores) was significant after controlling for age, gender, ethnicity and regular use of alcohol or cocaine. In logistic regression analysis, cannabis use had a significant positive association with major life events and lifetime trauma, but not with chronic stress, controlling for confounding factors including age, gender, ethnicity, and regular use of alcohol and cocaine. When analyzed separately, only in women the association between cannabis use and childhood trauma was significant. These associations point to further assessment of the impact of these gender differences on neurobiology of stress and cannabis misuse risk.
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Affiliation(s)
- Anahita Bassir Nia
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Jeremy Weleff
- Department of Psychiatry, Yale University School of Medicine, United States; Department of Psychiatry and Psychology, Cleveland Clinic, United States.
| | - Nia Fogelman
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Sormeh Nourbakhsh
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, United States
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18
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Banks DE, Duello A, Paschke ME, Grigsby SR, Winograd RP. Identifying drivers of increasing opioid overdose deaths among black individuals: a qualitative model drawing on experience of peers and community health workers. Harm Reduct J 2023; 20:5. [PMID: 36639769 PMCID: PMC9839206 DOI: 10.1186/s12954-023-00734-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Black individuals in the USA face disproportionate increases in rates of fatal opioid overdose despite federal efforts to mitigate the opioid crisis. The aim of this study was to examine what drives increases in opioid overdose death among Black Americans based on the experience of key stakeholders. METHODS Focus groups were conducted with stakeholders providing substance use prevention services in Black communities in St. Louis, MO (n = 14). One focus group included peer advocates and volunteers conducting outreach-based services and one included active community health workers. Focus groups were held at community partner organizations familiar to participants. Data collection was facilitated by an interview guide with open-ended prompts. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using grounded theory to abstract line-by-line codes into higher order themes and interpret their associations. RESULTS A core theme was identified from participants' narratives suggesting that opioid overdose death among Black individuals is driven by unmet needs for safety, security, stability, and survival (The 4Ss). A lack of The 4Ss was reflective of structural disinvestment and healthcare and social service barriers perpetuated by systemic racism. Participants unmet 4S needs are associated with health and social consequences that perpetuate overdose and detrimentally impact recovery efforts. Participants identified cultural and relationship-based strategies that may address The 4Ss and mitigate overdose in Black communities. CONCLUSIONS Key stakeholders working in local communities to address racial inequities in opioid overdose highlighted the importance of upstream interventions that promote basic socioeconomic needs. Local outreach efforts utilizing peer services can provide culturally congruent interventions and promote harm reduction in Black communities traditionally underserved by US health and social systems.
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Affiliation(s)
- Devin E. Banks
- grid.266757.70000000114809378Department of Psychological Sciences, University of Missouri—St. Louis, One University Blvd., 325 Stadler Hall, St. Louis, MO USA
| | - Alex Duello
- grid.266757.70000000114809378Missouri Institute of Mental Health, University of Missouri—St. Louis, One University Blvd., St. Louis, MO USA
| | - Maria E. Paschke
- grid.266757.70000000114809378Department of Psychological Sciences, University of Missouri—St. Louis, One University Blvd., 325 Stadler Hall, St. Louis, MO USA
| | - Sheila R. Grigsby
- grid.266757.70000000114809378College of Nursing, University of Missouri—St. Louis, One University Blvd., St. Louis, MO USA
| | - Rachel P. Winograd
- grid.266757.70000000114809378Department of Psychological Sciences, University of Missouri—St. Louis, One University Blvd., 325 Stadler Hall, St. Louis, MO USA ,grid.266757.70000000114809378Missouri Institute of Mental Health, University of Missouri—St. Louis, One University Blvd., St. Louis, MO USA
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Johnson ME, Rigg KK, Vroom EB, Akbari Z, Bristol SC. Racial/Ethnic Differences in the Effects of Adverse Childhood Experiences on Substance Misuse among Justice-Involved Children. Subst Use Misuse 2022; 58:54-65. [PMID: 36469650 PMCID: PMC9975643 DOI: 10.1080/10826084.2022.2148477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Adverse childhood experiences (ACEs) are linked to substance use (SU) and substance use disorders (SUD). However, this relationship has yet to be tested among justice-involved children (JIC), and it is unclear if racial/ethnic differences exist. This study aimed to determine: (1) whether ACEs are associated with increased risk of SU and SUD among JIC; and (2) if the effects of ACEs on SU and SUD are moderated by race/ethnicity. Methods: Bivariate and multivariate logistic regression analyses were employed to examine a statewide dataset of 79,960 JIC from the Florida Department of Juvenile Justice. Marginal odds were estimated to examine how race moderates the relationship between ACEs and SU and SUD. Results: Results showed higher ACEs scores were linked to SU and SUD. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report SU than white JIC. Specifically, Black and Latinx JIC with a higher average ACEs score were more likely to report SU but less likely to have ever been diagnosed with a SUD when compared to white JIC with equivalent ACEs. Conclusions: Study results highlight the need to develop trauma-informed and culturally appropriate interventions for SU and SUD among JIC.
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Affiliation(s)
- Micah E. Johnson
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Khary K. Rigg
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Enya B. Vroom
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Zahra Akbari
- Department of Economics, Martha and Spencer Love School of Business, Elon University, Elon, North Carolina, USA
| | - Skye C. Bristol
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
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Wiss DA, Prelip ML, Upchurch DM, von Ehrenstein OS, Tomiyama AJ, Shoptaw SJ. Perceived social support moderates the association between household dysfunction adverse childhood experiences (ACEs) and self-reported drug use among men who have sex with men in Los Angeles, California. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103899. [PMID: 36334318 DOI: 10.1016/j.drugpo.2022.103899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been shown to be associated with drug use in adulthood. The single ACE of household substance use history (part of the household dysfunction category) has frequently been associated with drug use. Resilience factors such as perceived social support appear to buffer the association between ACEs and drug use and may be particularly relevant for urban men who have sex with men (MSM). The current study of low-income mostly Black and Latino MSM aims to investigate whether the cumulative ACE score predicts self-reported drug use in a dose-response manner and whether this potential association differs by perceived social support. METHODS Data was utilized from a longitudinal study of MSM (mean age=34; SD=7.1) with varied substance use behaviors (n = 321) collected between August 2014 and April 2022. Cumulative, household dysfunction ACEs, and the single ACE of household substance use history were investigated as predictors of self-reported drug use (methamphetamine, ecstasy, cocaine/crack, heroin/fentanyl, party drugs [GHB, special K, mushrooms, LSD/acid], other drugs [bath salts, PCP]) during the past six months in mixed-effects logistic regression models, with moderation analyses by perceived social support (measured by the Multidimensional Scale of Perceived Social Support) across all models using stratified analysis and one model of multiplicative interaction. RESULTS There was no suggestion of a dose-response relationship between the number of ACEs and the predicted probability of self-reported drug use. Cumulative ACEs did not predict the outcome overall (aOR=1.99; 95% CI: 0.86-4.59), however, a positive association was estimated for individuals reporting lower levels of perceived social support (aOR=2.80; 95% CI: 0.97-8.06). The dimension of household dysfunction had a positive association with drug use (aOR=1.32; 95% CI: 1.00-1.74) whereas the dimension of childhood maltreatment did not. The association between household dysfunction and drug use was moderated by the perception of social support, with those reporting lower levels having greater odds of reporting drug use (aOR=2.94; 95% CI: 1.04-8.31). The association between household substance use history and self-reported drug use was similarly moderated by perceived social support in a multiplicative interaction model (p = .02). CONCLUSION Perceived social support emerged as a potential buffering factor for any reported drug use, particularly for the single ACE of household substance use history. Given that the association between ACEs and drug use was weak among those with higher levels of perceived social support, promotion of social ties in the community may help reduce the burden of substance use among MSM exposed to ACEs.
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Affiliation(s)
- David A Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA.
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Steven J Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, 10880 Wilshire Blvd., Los Angeles, CA 90024, USA
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An Illustrative Review of Substance Use-Specific Insights From the National Longitudinal Study of Adolescent to Adult Health. J Adolesc Health 2022; 71:S6-S13. [PMID: 36404020 DOI: 10.1016/j.jadohealth.2022.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this illustrative, thematic review was to demonstrate the utility of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) for substance use research and to describe substance use-specific insights gained from Add Health research over the past 2 decades. METHODS We searched multiple electronic databases (PubMed, PsycInfo, and Web of Science) and selected an illustrative sample of 40 articles that used Add Health data and longitudinally examined a measure of alcohol, marijuana, or illicit drug use or prescription drug misuse as the exposure or outcome in association with diverse domains of additional factors assessed (social, emotional, behavioral, contextual, biological, and genetic). RESULTS Included articles identified several key associations between substance use behaviors and additional factors from a wide range of domains. For example, results from several studies indicated that experiences of sexual violence, adolescent dating violence, and intimate partner violence are associated with an increased likelihood of later prescription opioid misuse, heavy drinking, and marijuana use, with some differences by biological gender and race/ethnicity. Results from other studies showed that bidirectional associations between substance use and mental health differ by specific type of substance and mental health condition. DISCUSSION Existing research using Add Health data has provided valuable insights regarding substance use by leveraging the study's longitudinal design, the prospective nature of data collection, the breadth and depth of substance use questions assessed from adolescence to adulthood, the size and diversity of the cohort, and the wide range of additional factors measured over time.
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22
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Reilly JJ, Naumann DN, Morris L, Blackburn L, Brooks A. Injury by knife crime amongst children is associated with socioeconomic deprivation: an observational study. Pediatr Surg Int 2022; 39:8. [PMID: 36441280 PMCID: PMC9705482 DOI: 10.1007/s00383-022-05298-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Children who live in areas of socioeconomic deprivation may be at higher risk of being victims of violent crime such as knife wounds. The current study investigated whether socioeconomic disparity was associated with higher risk of knife crime. METHODS An observational study included patients aged ≤ 17 years at a UK Major Trauma Centre injured by knife trauma from 2016 to 2022. Indices of deprivation were recorded according to the zip code of residence and compared with those of all of England. These included Index of Multiple Deprivation (IMD); income; employment; education and skills; health and disability; crime; barriers to housing and services; living environment; and Income Deprivation Affecting Children Index (IDACI). RESULTS There were 139 patients (96% male) with median age of 16 years. When compared with the whole of England, patients had worse indices of IMD (p = 0.021); income (p < 0.001); employment (p < 0.001); education and skills (p < 0.001); health and disability; and IDACI (p < 0.001). There were no significant differences in indices of crime, barriers to housing and services or living environment. CONCLUSIONS Paediatric knife injury was associated with poor socioeconomic status in multiple domains. Focussed efforts to address socioeconomic disparities should be a priority as a public health measure for vulnerable children.
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Affiliation(s)
- John-Joe Reilly
- Department of Major Trauma, East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham, UK
| | - David N Naumann
- Department of Major Trauma, East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham, UK.
- University of Birmingham, Birmingham, UK.
| | - Louise Morris
- Department of Major Trauma, East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham, UK
| | - Lauren Blackburn
- Department of Major Trauma, East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham, UK
| | - Adam Brooks
- Department of Major Trauma, East Midlands Major Trauma Centre, Queens Medical Centre, Nottingham, UK
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23
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Jebraeili H, Davudizadeh S, Rezaee R. The relationship between adverse childhood experiences and impulsive and risky behaviors: the mediating role of positive and negative emotional motivations. J Inj Violence Res 2022; 15:1748. [PMID: 36335464 PMCID: PMC10369327 DOI: 10.5249/jivr.v15i1.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/27/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Although the impact of adverse childhood experiences (ACEs) on healthy behaviors of adulthood is largely investigated, the role of these adversities in a wide variety of impulsive and risky behaviors (RBs) as well as the role of mediating variables has been rarely studied. Therefore, the present study aimed to investigate the mediating role of positive-negative emotional motivations in the relationship between ACEs and RBs. METHODS In a cross-sectional study, 401 adults of the general population of Kermanshah (201 individuals) and Kurdistan (200 individuals) were selected and they were assessed using the Risky, Impulsive, & Self-destructive behavior Questionnaire (RISQ) and the Childhood Trauma questionnaire (CTQ). Data were analyzed using latent profile analysis (LPA), the correlation tests and structural equation modeling. RESULTS The prevalence of ACEs using LPA was estimated 37.7%. There was a significant correlation between all types of child abuse (not child neglect) and RBs. Emotional motivations played a mediating role in the relationship between ACEs and RBs (RMSEA=0.07, SRMR=0.05, CFI=0.92, TFI=0.90). The proposed model could explain about 11% of the variance of emotional motivations and around 70% of the variance of RBs. CONCLUSIONS Considering the impact of ACEs on emotional motivations and the impact of emotional motivations on RBs, intervention on emotional motivations may help to reduce RBs in people who suffer from ACEs.
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Affiliation(s)
- Hashem Jebraeili
- Health Psychology, Department of Psychology, School of Social and Educational Sciences, Razi University, Kermanshah, Iran.
| | | | - Roya Rezaee
- School of Social Sciences and Education, Razi University, Kermanshah, Iran
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24
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The Martinsburg Initiative: A Collaboration Between Public Safety, Public Health, and Schools to Address Trauma and Substance Use. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:S355-S358. [PMID: 36194806 PMCID: PMC9531965 DOI: 10.1097/phh.0000000000001591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Martinsburg Initiative (TMI) is a community-based model developed in Martinsburg, West Virginia, that implements a comprehensive approach to adverse childhood experiences and substance use prevention and mitigation by leveraging partnerships in public health and health care, public safety, and education. TMI receives coordinated federal funding and technical assistance from the Centers for Disease Control and Prevention, the Washington-Baltimore High Intensity Drug Trafficking Agency, and the National Association of County and City Health Officials to integrate evidence-based and promising strategies. It advances such strategies by translating them for implementation within the community, evaluating the reach and potential impact of the model, and by engaging key stakeholders. Preliminary results describing program reach and short-term outcomes collected for a subset of the interventions during implementation are presented. The model uses touchpoints across multiple community sectors in the city of Martinsburg to break the cycle of trauma and substance use across the life span.
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25
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Valério ID, Soares ALG, Menezes AMB, Wehrmeister FC, Gonçalves H. Child maltreatment and substances use throughout adolescence and adulthood: Data from a Brazilian Birth Cohort. CHILD ABUSE & NEGLECT 2022; 131:105766. [PMID: 35763956 DOI: 10.1016/j.chiabu.2022.105766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment has been associated with substance use later in life, but few studies have used repeated measures. OBJECTIVE To assess the association between child maltreatment and use of psychoactive substances from adolescence to early adulthood, and whether this differs by sex. PARTICIPANTS AND SETTING 3641 participants from the 1993 Pelotas Birth Cohort, Brazil. METHODS Child maltreatment (psychological, physical and sexual abuse, and physical neglect) was assessed up to age 15 and use of psychoactive substances (smoking, harmful use of alcohol and use of illicit drugs) was assessed at ages 15, 18, and 22 years. Associations between child maltreatment and use of substances at each time point were analyzed using logistic regression, adjusted for confounders. RESULTS Overall, child maltreatment was associated with substance use, and the strength of the associations decreased over time. E.g., the association between psychological abuse and harmful use of alcohol was OR 2.17 (95%CI 1.80, 2.62; p-value < 0.001) at 15 years, OR 1.61 (95%CI 1.31, 1.97; p-value < 0.001) at 18 years, and OR1.55 (95%CI 1.22, 1.96; p-value < 0.001) at 22 years. When sex differences were evident, stronger associations were observed among females. E.g., the association between physical abuse and smoking at 15 years was OR 3.49 (95%CI 2.17, 5.62) in females and OR 0.87 (95%CI 0.30, 2.52) in males (p-value for sex interaction = 0.041). CONCLUSIONS Child maltreatment was associated with psychoactive substance in adolescence and early adulthood. Strategies to prevent use of substances could benefit those who suffered maltreatment in childhood.
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Affiliation(s)
- Inaê Dutra Valério
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil.
| | - Ana Luiza G Soares
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Ana Maria Baptista Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
| | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro Street, 1160-3rd floor, Pelotas, RS 96020-220, Brazil
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26
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Clements-Nolle KD, Lensch T, Drake CS, Pearson JL. Adverse childhood experiences and past 30-day cannabis use among middle and high school students: The protective influence of families and schools. Addict Behav 2022; 130:107280. [PMID: 35279622 DOI: 10.1016/j.addbeh.2022.107280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/01/2022]
Abstract
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.
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27
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Wisdom AC, Govindu M, Liu SJ, Meyers CM, Mellerson JL, Gervin DW, DePadilla L, Holland KM. Adverse Childhood Experiences and Overdose: Lessons From Overdose Data to Action. Am J Prev Med 2022; 62:S40-S46. [PMID: 35597582 PMCID: PMC9761611 DOI: 10.1016/j.amepre.2021.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Adverse childhood experiences and overdose are linked in a cycle that affects individuals and communities across generations. The Centers for Disease Control and Prevention's Overdose Data to Action cooperative agreement supports a comprehensive public health approach to overdose prevention and response activities across the U.S. Exposure to traumatic events during childhood can increase the risk for myriad health outcomes, including overdose; therefore, many Overdose Data to Action recipients leveraged funds to address adverse childhood experiences. METHODS In 2021, an inventory of Overdose Data to Action‒funded activities implemented in 2019 and 2020 showed that 34 of the 66 recipients proposed overdose prevention activities that support people who have experienced adverse childhood experiences or that focus on preventing the intergenerational transmission of adverse childhood experiences. Activities were coded by adverse childhood experience prevention strategy, level of the social ecology, and whether they focused on neonatal abstinence syndrome. RESULTS Most activities among Overdose Data to Action recipients occurred at the community level of the social‒ecologic model and under the intervene to lessen harms adverse childhood experience prevention strategy. Of the 84 adverse childhood experience‒related activities taking place across 34 jurisdictions, 44 are focused on neonatal abstinence syndrome. CONCLUSIONS Study results highlight the opportunities to expand the breadth of adverse childhood experience prevention strategies across the social ecology. Implementing cross-cutting overdose and adverse childhood experience‒related activities that span the social‒ecologic model are critical for population-level change and have the potential for the broadest impact. Focusing on neonatal abstinence syndrome also offers a unique intervention opportunity for both adverse childhood experience and overdose prevention.
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Affiliation(s)
- April C Wisdom
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Madhumita Govindu
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen J Liu
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina M Meyers
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jenelle L Mellerson
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Derrick W Gervin
- Extramural Research Operations, National Center for Injury Prevention and Control, National Center for Environmental Health, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lara DePadilla
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristin M Holland
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Scheidell JD, Dyer TV, Knittel AK, Caniglia EC, Thorpe LE, Troxel AB, Lejuez CW, Khan MR. Incarceration and Subsequent Pregnancy Loss: Exploration of Sexually Transmitted Infections as Mediating Pathways. J Womens Health (Larchmt) 2022; 31:242-251. [PMID: 34061656 PMCID: PMC8864438 DOI: 10.1089/jwh.2020.8980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Incarceration is linked to risk of sexually transmitted infection (STI) postrelease among women. There has been little examination of incarceration's association with related sexual and reproductive outcomes such as pelvic inflammatory disease (PID) and pregnancy loss, or the role of STI in this relationship and whether these relationships differ between Black and White women. Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined cross-sectional associations between incarceration (Wave IV; 2007-2008; ages 24-34) and history of STI and PID (n = 5,968), and longitudinal associations between incarceration and later pregnancy loss in mid-adulthood (Wave V; 2016-2018; ages 34-43) among women who had ever been pregnant (n = 2,353); we estimated racial differences. Using causal mediation, we explored whether STI mediated associations with pregnancy loss. Results: Incarceration was associated with a history of STI (White adjusted prevalence ratio [APR]: 1.54, 95% confidence interval [CI] 1.14-2.06; Black APR: 1.26, 95% CI 1.02-1.56); the association between incarceration and PID was null among White women (APR: 0.99, 95% CI 0.47-2.09) and elevated among Black women (APR: 2.82, 95% CI 1.36-5.83). Prior incarceration did not appear associated with pregnancy loss among White women (APR: 1.01, 95% CI 0.70-1.45), but was associated among Black women (APR: 1.38, 95% CI: 0.97-1.97), with STI appearing to partially mediate. Conclusions: Pregnancy loss may be elevated among Black women who have been incarcerated, and incarceration-related increases in STI may account for some of this association.
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Affiliation(s)
- Joy D. Scheidell
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Address correspondence to: Joy D. Scheidell, PhD, MPH, Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, 227 East 30th Street, Office 624, New York, NY 6402, USA
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Andrea K. Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ellen C. Caniglia
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lorna E. Thorpe
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Andrea B. Troxel
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Carl W. Lejuez
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Maria R. Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.,Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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Trauma and Emotion Regulation: Associations with Depressive Symptoms and Cocaine Use among Treatment-seeking Adults. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00713-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Berg CJ, Windle M, Dodge T, Cavazos-Rehg P, Yang YT, Ma Y, Haardörfer R. Marijuana Use and Increases in Use over Time among Young Adult College Students in the State of Georgia: Analyses of Sociocontexual Predictors. Subst Use Misuse 2022; 57:350-359. [PMID: 34913832 DOI: 10.1080/10826084.2021.2012691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND While research has assessed correlates of marijuana use, there has been less focus on predictors of differing levels of changes in use during young adulthood, a critical period for use/escalation. OBJECTIVES We examined changes in marijuana use and related sociocontextual predictors (e.g., earlier-onset substance use, parental use, college type). METHODS Using data from Georgia college students (ages 18-25 years) in a 2-year, 6-wave longitudinal study (64.6% female, 63.4% White), 2-part random-effects modeling examined use at any assessment and number of days used. RESULTS Predictors of use status at any assessment included being male (OR = 1.87, 95%CI = [1.28-2.73]), Black (OR = 1.91, 95%CI = [1.15-3.19]), earlier-onset marijuana (OR = 2.63, 95%CI = [1.70-4.06]), cigarette (OR = 2.04, 95%CI = [1.19-3.48]), and alcohol users (OR = 1.49, 95%CI = 1.00-2.22]), parental tobacco (OR = 2.14, 95%CI = [1.18-3.86]) and/or alcohol use (OR = 1.55, 95%CI = [1.09-2.20]), and attending private (vs. public) institutions (OR = 1.68, 95%CI = [1.10-2.59]). Predictors of lower likelihood of use over time included being male (OR = 0.87, 95%CI = [0.77-0.98]), earlier-onset cigarette use (OR = 0.82, 95%CI = [0.68-0.98]), parental alcohol use (OR = 0.86, 95%CI = [0.77-0.97]), and private institution students (OR = 1.17, 95%CI = [1.02-1.34]). Predictors of more days used at baseline included being male (OR = 1.77, 95%CI = [1.40-2.23]), Black (OR = 1.42, 95%CI = [1.04-1.93]), earlier-onset marijuana (OR = 2.32, 95%CI = [1.78-3.01]) and alcohol users (OR = 1.29, 95%CI = [1.01-1.66]), and parental tobacco use (OR = 1.90, 95%CI = [1.32-2.73]). Predictors of fewer days used over time included being older (OR = 0.98, 95%CI = [0.97-1.00]), parental tobacco use (OR = 0.86, 95%CI = [0.78-0.95]), and attending private institutions (OR = 0.89, 95%CI = [0.83-0.93]). CONCLUSIONS Intervention efforts can be informed by current findings that correlates of baseline use (e.g., being male, attending private institutions) also predicted less use over time, and one's earlier use and parents' use of various substances impacted young adult use.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Michael Windle
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Y Tony Yang
- Center for Health Policy and Media Engagement, School of Nursing, George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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NLRP3 Inflammasome Is Involved in Cocaine-Mediated Potentiation on Behavioral Changes in CX3CR1-Deficient Mice. J Pers Med 2021; 11:jpm11100963. [PMID: 34683104 PMCID: PMC8540128 DOI: 10.3390/jpm11100963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022] Open
Abstract
Microglia, the primary immunocompetent cells of the brain, are suggested to play a role in the development of drug addiction. Previous studies have identified the microglia-derived pro-inflammatory factor IL1β can promote the progression of cocaine addiction. Additionally, the activation status of microglia and “two-hit hypothesis” have been proposed in the field of drug addiction to explain how early life stress (ELS) could significantly increase the incidence of drug addiction in later life. However, the mechanisms underlying microglia prime and full activation and their roles in drug addiction remain greatly unexplored. Here, we employed CX3CR1-GFP mice (CX3CR1 functional deficiency, CX3CR1−/−) to explore whether primed microglia could potentiate cocaine-mediated behavioral changes and the possible underlying mechanisms. CX3CR1−/− mice revealed higher hyperlocomotion activity and conditional place preference than wild-type (WT) mice did under cocaine administration. In parallel, CX3CR1−/− mice showed higher activity of NLR family pyrin domain-containing 3 (NLRP3) inflammasome than WT mice. Interestingly, CX3CR1 deficiency itself could prime NLRP3 signaling by increasing the expression of NLPR3 and affect lysosome biogenesis under basal conditions. Taken together, our findings demonstrated that the functional status of microglia could have an impact on cocaine-mediated reward effects, and NLRP3 inflammasome activity was associated with this phenomenon. This study was consistent with the two-hit hypothesis and provided solid evidence to support the involvement of microglia in drug addiction. Targeting the NLRP3 inflammasome may represent a novel therapeutic approach for ameliorating or blocking the development of drug addiction.
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Hjorthøj C, Posselt CM, Nordentoft M. Development Over Time of the Population-Attributable Risk Fraction for Cannabis Use Disorder in Schizophrenia in Denmark. JAMA Psychiatry 2021; 78:1013-1019. [PMID: 34287621 PMCID: PMC8295899 DOI: 10.1001/jamapsychiatry.2021.1471] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Cannabis use and potency of cannabis have increased during the past 2 decades. If the association between cannabis use and schizophrenia is causal, this should be reflected in an increase in the proportion of cases of schizophrenia being attributable to cannabis, the population-attributable risk fraction (PARF). OBJECTIVE To determine whether the PARF for cannabis use disorder in schizophrenia has increased over time. DESIGN, SETTING, AND PARTICIPANTS This nationwide, register-based historical prospective cohort study included all people in Denmark born before December 31, 2000, who were alive and 16 years or older at some point from January 1, 1972, to December 31, 2016. Data analysis was performed from August 2020 to April 2021. EXPOSURE Diagnosis of cannabis use disorder. MAIN OUTCOMES AND MEASURES Diagnosis of schizophrenia, with estimated PARF of cannabis use disorder in schizophrenia from 1972 to 2016. RESULTS A total of 7 186 834 individuals were included in the analysis, including 3 595 910 women (50.0%) and 3 590 924 men (50.0%). The adjusted hazard ratio for schizophrenia fluctuated at approximately 4 (with 95% CIs ranging from approximately 3 to 6) throughout most of the study period when people diagnosed with cannabis use disorder were compared with those without cannabis use disorder. The PARF of cannabis use disorder in schizophrenia also fluctuated, but with clear evidence of an increase from 1995 (when the PARF was relatively stable around 2.0%, with a 95% CI of approximately 0.3% to either side) until reaching some stability around 6.0% to 8.0% (with a 95% CI of approximately 0.5% to either side) since 2010. CONCLUSIONS AND RELEVANCE The results from these longitudinal analyses show the proportion of cases of schizophrenia associated with cannabis use disorder has increased 3- to 4-fold during the past 2 decades, which is expected given previously described increases in the use and potency of cannabis. This finding has important ramifications regarding legalization and control of use of cannabis.
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Affiliation(s)
- Carsten Hjorthøj
- Copenhagen Research Center for Mental Health–CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark,Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Copenhagen and Aarhus, Denmark
| | - Christine Merrild Posselt
- Copenhagen Research Center for Mental Health–CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health–CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Copenhagen and Aarhus, Denmark
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Folk JB, Ramos LM, Bath EP, Rosen B, Marshall BD, Kemp K, Brown L, Conrad S, Tolou-Shams M. The prospective impact of adverse childhood experiences on justice-involved youth's psychiatric symptoms and substance use. J Consult Clin Psychol 2021; 89:483-498. [PMID: 34264697 PMCID: PMC8754104 DOI: 10.1037/ccp0000655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Justice-involved youth report high rates of adverse childhood experiences (ACEs; abuse, neglect, household dysfunction) and are at high risk for elevated behavioral health needs (i.e., substance use, psychiatric symptoms). Research with broad samples of adolescents shows ACEs predict behavioral health outcomes, yet most research on the impact of ACEs among justice-involved youth focuses on recidivism. The present study addresses this gap by examining the prospective association between ACEs and psychiatric symptoms, substance use, and substance-related problems (i.e., consequences of use) among first-time justice-involved youth. METHOD First-time justice-involved youth (n = 271; 54.3% male; M age = 14.5 years; 43.5% Latinx; non-Latinx: 34.2% White, 8.6% Black, 7.1% Other, 6.7% Multiracial) and their caregivers were assessed at youth's first court contact and 4- and 12-month follow-ups. Youth and caregivers reported youth's exposure to ACEs through a series of instruments at baseline and 4-months (e.g., Childhood Trauma Questionnaire Short-Form; Traumatic Life Events Inventory). Primary outcomes included youth alcohol and cannabis use (Adolescent Risk Behavior Assessment), consequences of use (Brief Young Adult Alcohol Consequences Questionnaire; Brief Marijuana Consequences Scale), and psychiatric symptoms (Behavior Assessment System for Children; National Stressful Events Survey PTSD Short Scale). RESULTS Youth were exposed to three ACEs, on average, prior to first justice contact (M = 3). Exposure to more ACEs, particularly abuse, predicted substance use and psychiatric outcomes. Gender differences emerged for cannabis use and internalizing symptoms. CONCLUSIONS Implications for trauma-responsive juvenile justice reform are discussed, including screening for ACEs and their sequelae at first court contact and considering the role of masculine norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Johanna B. Folk
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Lili M.C. Ramos
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Eraka P. Bath
- University of California, Los Angeles, Department of Psychiatry, 150 UCLA, Medical Plaza Driveway, Los Angeles, CA 90095
| | - Brooke Rosen
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
| | - Brandon D.L. Marshall
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Kathleen Kemp
- The Warren Alpert Medical School of Brown University, School of Public Health, 222 Richmond St, Providence, RI 02903
| | - Larry Brown
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Selby Conrad
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St, Providence, RI 02903
| | - Marina Tolou-Shams
- University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, 1001 Potrero Ave, San Francisco, CA 94110
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How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood. J Youth Adolesc 2021; 50:1234-1253. [PMID: 33948830 DOI: 10.1007/s10964-021-01440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.
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Tang S, Jones CM, Wisdom A, Lin HC, Bacon S, Houry D. Adverse childhood experiences and stimulant use disorders among adults in the United States. Psychiatry Res 2021; 299:113870. [PMID: 33780857 PMCID: PMC8211100 DOI: 10.1016/j.psychres.2021.113870] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/11/2021] [Indexed: 11/18/2022]
Abstract
Recent data indicate a resurgence of stimulant use and harms in the United States; thus, there is a need to identify risk factors to inform development of effective prevention strategies. Prior research suggests adverse childhood experiences (ACEs) are common among individuals using stimulants and may be an important target for prevention. National Epidemiological Survey on Alcohol and Related Conditions was used to estimate prevalence of ACEs among U.S. adults using amphetamine-type stimulants (ATS), cocaine, or both. Multivariable logistic regression examined associations between ACEs and stimulant use and use disorders. Among adults reporting lifetime ATS use, 22.1% had ≥4 ACEs, 24.9% had 2-3 ACEs, 22.4% had 1 ACE, 30.6% reported no ACEs. Among adults with lifetime ATS use disorder, 29.3% reported ≥4 ACEs, 28.7% reported 2-3 ACEs, 21.6% reported 1 ACE, and 20.4% reported no ACEs. Multivariable logistic regression found a significant relationship between number of ACEs and stimulant use and use disorders. In conclusion, we found a strong relationship between increasing ACE exposures and stimulant use and use disorders. Advancing comprehensive strategies to prevent ACEs and treating underlying trauma among those using stimulants holds great promise to reduce stimulant use and its health and social consequences in the United States.
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Affiliation(s)
- Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA.
| | - Christopher M Jones
- Office of the Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - April Wisdom
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - Hsien-Chang Lin
- School of Public Health, Indiana University, Bloomington, USA
| | - Sarah Bacon
- Office of Strategy and Innovation, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
| | - Debra Houry
- Office of the Director, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, USA
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Amaro H, Sanchez M, Bautista T, Cox R. Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism. Neuropharmacology 2021; 188:108518. [PMID: 33716076 PMCID: PMC8126433 DOI: 10.1016/j.neuropharm.2021.108518] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
Applying a social determinants of health framework, this review brings attention to evidence from social sciences and neuroscience on the role of selected social factors in individual and population-level vulnerability to substance use and substance use disorders (SUDs). The understanding that social vulnerability to substance use and SUDs is multifaceted and occurs across different levels of influence (individual, interpersonal, community, and societal) is underscored. We propose that socially based stressors play a critical role in creating vulnerability to substance use and SUDs, and as such, deserve greater empirical attention to further understand how they "get under the skin." Current knowledge from social sciences and neuroscience on the relationships among vulnerability to substance use resulting from stressors, exposure to socially toxic childhood environments, and racism and discrimination are summarized and discussed, as are implications for future research, practice, and policy. Specifically, we propose using a top-down approach to the examination of known, yet often unexplored, relationships between vulnerability to substance use and SUDs, related inequities, and potential differential effects across demographic groups. Finally, research gaps and promising areas of research, practice, and policy focused on ameliorating social vulnerabilities associated with substance use and SUDs across the lifespan are presented. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.
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Affiliation(s)
- Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, United States.
| | - Tara Bautista
- Yale Stress Center, School of Medicine, Yale University, United States.
| | - Robynn Cox
- Suzanne Dworak-Peck School of Social Work, Schaeffer Center for Health Policy and Economics, And Edward R. Roybal Institute on Aging, University of Southern California, United States.
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Opara I, Weissinger GM, Lardier DT, Lanier Y, Carter S, Brawner BM. Mental Health Burden among Black Adolescents: The Need for Better Assessment, Diagnosis and Treatment Engagement. SOCIAL WORK IN MENTAL HEALTH 2021; 19:88-104. [PMID: 34248423 PMCID: PMC8262091 DOI: 10.1080/15332985.2021.1879345] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N=154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups experienced high amounts of trauma exposure history, recent suicidality, substance use, and depressive symptoms. Nearly one in four adolescents in the out of treatment group met diagnostic criteria for anxiety disorders. Implications include better screening for mental health symptoms to ensure Black adolescent have access to mental health treatment.
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38
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De la Peña-Arteaga V, Nogueira SO, Lynskey M, Hines LA. The Relationship Between Childhood Physical and Sexual Abuse and Adolescent Cannabis Use: A Systematic Review. Front Psychiatry 2021; 12:631245. [PMID: 34122168 PMCID: PMC8187570 DOI: 10.3389/fpsyt.2021.631245] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/28/2021] [Indexed: 01/21/2023] Open
Abstract
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.
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Affiliation(s)
- Víctor De la Peña-Arteaga
- Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sarah O Nogueira
- Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Michael Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Lindsey A Hines
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Ararso Y, Beharie NN, Scheidell JD, Schatz D, Quinn K, Doran KM, Khan MR. The Joint Effect of Childhood Abuse and Homelessness on Substance Use in Adulthood. Subst Use Misuse 2021; 56:660-667. [PMID: 33678119 DOI: 10.1080/10826084.2021.1887249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Childhood abuse and homelessness are independently associated with substance use. Though childhood abuse and homelessness are strongly correlated, research on the joint effect of exposure to both traumatic life events on substance use is limited. Objective: To estimate independent and joint effects of childhood abuse and homelessness on substance use risk during emerging adulthood and adulthood. Methods: Using the National Longitudinal Study of Adolescent to Adult Health (N = 12,288), we measured associations between exposure to physical or sexual abuse in childhood, homelessness in childhood or emerging adulthood, or exposure to both traumas and outcomes of binge drinking, marijuana use, cocaine use, methamphetamine use, and prescription opioid misuse during emerging adulthood (Wave III, ages 18-26 years) and adulthood (Wave IV, ages 24-32 years). Results: In adjusted analyses, exposure to childhood abuse alone, homelessness alone, and both childhood abuse and homelessness were significant correlates of most substance use indicators in emerging adulthood. Those jointly exposed to childhood abuse and homelessness had disproportionate risk of substance use, particularly use of cocaine (adjusted odds ratio (AOR)=4.25, 95% confidence interval (CI): 2.70, 6.71) and methamphetamine (AOR = 6.59, 95% CI: 3.87, 11.21). The independent and combined effects of abuse and homelessness generally persisted into adulthood though associations tended to weaken. Conclusions/Importance: Those with exposure to abuse, homelessness, and both adverse outcomes constitute a high-risk population for substance use. Addressing abuse and homelessness should be a component of preventing drug risk for screening, treatment, and prevention efforts.
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Affiliation(s)
- Yonathan Ararso
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | | | - Joy D Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Daniel Schatz
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Kelly Quinn
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Kelly M Doran
- Ronald O. Perelman Department of Emergency Medicine, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Maria R Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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Zhornitsky S, Le TM, Dhingra I, Adkinson BD, Potvin S, Li CR. Interpersonal Risk Factors for Suicide in Cocaine Dependence: Association with Self-Esteem, Personality Traits, and Childhood Abuse. Suicide Life Threat Behav 2020; 50:867-883. [PMID: 32030810 PMCID: PMC7518050 DOI: 10.1111/sltb.12621] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/10/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Studies have linked cocaine dependence to suicidality. According to the Interpersonal Theory of Suicide, suicidal behavior becomes likely with the simultaneous presence of perceived burdensomeness (PB), lack of (or thwarted) belongingness (TB), and acquired fearlessness about death (FAD). Here, we examined personality and other variables, including depression, self-esteem, childhood abuse, and substance use, as predictors of these risk factors in cocaine-dependent individuals (CDs). METHODS Seventy CDs and 70 healthy controls (HCs) participated. We examined group differences in a group-by-sex analysis of variance and identified predictors of PB, TB, and FAD in stepwise regressions. RESULTS CDs exhibited elevated PB and TB but not FAD, compared to HCs. CDs also exhibited elevated harm avoidance, novelty seeking, depression, and lower self-esteem and reward dependence. Females reported elevated sexual abuse, harm avoidance, reward dependence, depression, but lower FAD, relative to males, among CDs and HCs. Among CDs, PB was predicted by lower self-esteem and greater emotional abuse; TB was predicted by lower self-esteem and reward dependence, as well as greater emotional and sexual abuse; and FAD was predicted by lower harm avoidance and greater physical abuse. CONCLUSIONS Interventions targeting suicidality in cocaine dependence should take into consideration self-esteem, personality traits, and childhood abuse.
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Affiliation(s)
- Simon Zhornitsky
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Thang M. Le
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Isha Dhingra
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
| | - Brendan D. Adkinson
- Interdepartmental Neuroscience Program Yale University School of Medicine New Haven Connecticut
| | - Stephane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal Montreal QC Canada
- Department of Psychiatry Faculty of Medicine Université de Montréal Montréal QC Canada
| | - Chiang‐shan R. Li
- Department of Psychiatry Yale University School of Medicine New Haven Connecticut
- Interdepartmental Neuroscience Program Yale University School of Medicine New Haven Connecticut
- Department of Neuroscience Yale University School of Medicine New Haven Connecticut
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Feingold D, Livne O, Rehm J, Lev-Ran S. Probability and correlates of transition from cannabis use to DSM-5 cannabis use disorder: Results from a large-scale nationally representative study. Drug Alcohol Rev 2020; 39:142-151. [PMID: 31916333 DOI: 10.1111/dar.13031] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/11/2019] [Accepted: 12/12/2019] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
| | - Ofir Livne
- Lev Hasharon Medical Center, Netanya, Israel
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany
| | - Shaul Lev-Ran
- Lev Hasharon Medical Center, Netanya, Israel.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lotzin A, Buth S, Sehner S, Hiller P, Martens MS, Read J, Härter M, Cowlishaw S, Schäfer I. Learning How to Ask - Does a one-day training increase trauma inquiry in routine substance use disorder practice? Results of a cluster-randomized controlled trial. J Subst Abuse Treat 2019; 107:8-16. [PMID: 31757266 DOI: 10.1016/j.jsat.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 11/30/2022]
Abstract
AIMS To examine the effectiveness of a one-day skills training program for increasing trauma inquiry in routine substance use disorder treatment. DESIGN Cluster-randomized two-armed controlled trial, with 12 substance use disorder (SUD) organizations operating 25 counseling centers, randomly assigned to training in trauma inquiry (13 counseling centers of 8 SUD organizations) or no training (12 counseling centers of 4 SUD organizations). SETTING SUD counseling centers in Northern Germany. CASES N = 5204 SUD counseling services. INTERVENTION The professionals assigned to the intervention group received a one-day training in trauma inquiry plus a 1.5-hour refresher session 3 months later. Professionals in the control group received no training. MEASURES Over a 12-month period, professionals documented for each counseling service whether they asked the client about four traumatic events: physical abuse, emotional abuse, sexual abuse and neglect. ANALYSIS Primary outcomes were rates of asking about physical abuse, sexual abuse, emotional abuse and neglect in the 6 months after training. These were compared across conditions, while adjusting for baseline probabilities in the 6 months before training, using mixed-effects logistic regression. FINDINGS In the 6 months after training, the rate of asking about physical abuse was 18% higher in the SUD counseling services of trained professionals, relative to services of untrained professionals (OR = 1.18, 95% CI = [1.01-1.37, p = .035]). No effect was found for asking about sexual abuse, emotional abuse and neglect. CONCLUSION A one-day training program in trauma inquiry, combined with a brief refresher session, was effective in increasing inquiries about physical abuse in routine counseling practice. The training was ineffective in increasing inquiries about sexual abuse, emotional abuse and neglect. The effectiveness of a one-day training of trauma inquiry might be increased by a longer training, or by combining it with additional elements, such as ongoing supervision.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
| | - Sven Buth
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Philipp Hiller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Marcus-Sebastian Martens
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - John Read
- School of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Sean Cowlishaw
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia; Population Health Sciences, University of Bristol, Beacon House, Queens Road, Bristol BS8 1QU, UK
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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Thal SB, Daniels JK, Jungaberle H. The link between childhood trauma and dissociation in frequent users of classic psychedelics and dissociatives. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1614234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sascha B. Thal
- Department of Clinical Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Judith K. Daniels
- Department of Clinical Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
- Psychological University Berlin, Berlin, Germany
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Cole J, Sprang G, Silman M. Interpersonal Trauma Exposure, Trauma Symptoms, and Severity of Substance Use Disorder among Youth Entering Outpatient Substance Abuse Treatment. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:341-349. [PMID: 32318204 PMCID: PMC7163824 DOI: 10.1007/s40653-018-0239-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A substantial body of literature has found associations between interpersonal victimization, trauma symptoms, and substance use disorders (SUD) among adolescents. Secondary data analysis was conducted on structured interview data collected by treatment providers as 172 adolescents (ages 12-19) entered outpatient substance abuse treatment. Results indicate high prevalence rates of interpersonal trauma exposure: 71.5% self-reported trauma exposure, specifically direct physical abuse or assault, sexual abuse or assault, and/or witnessing intimate partner violence of a parent. Severity of SUD, as measured by number of DSM-5 criteria endorsed, was not only associated with the number of types of criterion A events for Posttraumatic Stress Disorder but also more self-reported internalizing problems. There was no significant relationship between the severity of SUD and the severity of trauma symptoms at treatment intake, gender, or attention problems. Ongoing assessment of possible trauma symptoms is recommended throughout substance abuse treatment with youth who have reported trauma exposure, as well as continued screening of trauma exposure.
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Affiliation(s)
- Jennifer Cole
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky, 333 Waller Avenue, Suite 480, Lexington, KY 40504 USA
| | - Ginny Sprang
- Department of Psychiatry, Center on Trauma and Children, University of Kentucky, Lexington, KY USA
| | - Miriam Silman
- Center on Trauma and Children, University of Kentucky, Lexington, KY USA
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Sanvicente-Vieira B, Rovaris DL, Ornell F, Sordi A, Rothmann LM, Niederauer JPO, Schuch JB, von Diemen L, Kessler FHP, Grassi-Oliveira R. Sex-based differences in multidimensional clinical assessments of early-abstinence crack cocaine users. PLoS One 2019; 14:e0218334. [PMID: 31226126 PMCID: PMC6588218 DOI: 10.1371/journal.pone.0218334] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022] Open
Abstract
Crack cocaine use disorder (CUD) has been related to sex differences. This work aimed to compare the severity of drug use and the severity of other negative related outcomes in males and females with CUD. A total of 1344 inpatients (798 males and 546 females) with crack cocaine use disorder (CUD) were evaluated by a detailed multidimensional clinical assessment, including addiction severity and trauma exposure. Linear regression predicted higher drug use severity (β = 0.273, p < 0.001) and more problems in domains related to childcare issues (β = 0.321), criminal involvement (β = 0.108), work-related problems (β = 0.281) and social support impairments (β = 0.142) for females, all with p < 0.001. Alcohol problems were predicted to be higher in males (β = -0.206, P < 0.001). Females had higher rates of other mental disorders, particularly trauma and stress-related disorders (OR: 3.206, CI: 2.22, 4.61). Important sex differences also emerged in trauma history and HIV infection prevalence. CUD has a more severe clinical presentation among females facing early abstinence. Sex differences in the CUD course indicate the need for consideration of sex-specific interventions and research.
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Affiliation(s)
- Breno Sanvicente-Vieira
- Developmental Cognitive Neuroscience Lab, School of Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Brain Institute of Rio Grande do Sul, Porto Alegre, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Diego Luiz Rovaris
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil
- Attention Deficit Disorder Outpatient Program, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Anne Sordi
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Melo Rothmann
- Developmental Cognitive Neuroscience Lab, School of Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Brain Institute of Rio Grande do Sul, Porto Alegre, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - João Paulo Ottolia Niederauer
- Developmental Cognitive Neuroscience Lab, School of Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Brain Institute of Rio Grande do Sul, Porto Alegre, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Jaqueline Bohrer Schuch
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratory of Immunosenescence, Graduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab, School of Health Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Brain Institute of Rio Grande do Sul, Porto Alegre, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul, Brazil
- * E-mail:
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Hoffman EA, Clark DB, Orendain N, Hudziak J, Squeglia LM, Dowling GJ. Stress exposures, neurodevelopment and health measures in the ABCD study. Neurobiol Stress 2019; 10:100157. [PMID: 30949565 PMCID: PMC6430638 DOI: 10.1016/j.ynstr.2019.100157] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/06/2019] [Accepted: 03/08/2019] [Indexed: 01/07/2023] Open
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study, a large, longitudinal study of brain development and child health, is uniquely positioned to explore relationships among stress, neurodevelopment, and psychiatric symptomatology, including substance use and addiction. There is much we do not know about how adverse experiences affect the developing brain and cognitive, social, emotional, and academic outcomes. The data collected by the ABCD Study will allow the examination of the relationships among these variables in adolescence, including the effects of stressors (e.g., abuse, neglect, household challenges, parental substance use) on psychological adjustment and other stress responses. A comprehensive protocol that includes physical and mental health, substance use, culture and environment, neurocognitive assessments, biospecimen analyses, and structural and functional neuroimaging will provide opportunities for learning about the impacts of stressors on health and other outcomes in the context of adolescent development. This knowledge could lead to the development of interventions that reduce or even reverse the impacts of stressors.
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Affiliation(s)
- Elizabeth A. Hoffman
- National Institute on Drug Abuse (NIDA), National Institutes of Health, Bethesda, MD, USA
- Corresponding author. 6001 Executive Blvd, Room 5103, MSC 9581, Bethesda, MD, 20892-9591, USA.
| | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Natalia Orendain
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - James Hudziak
- College of Medicine/Fletcher Allen Health Care, University of Vermont, Burlington, VT, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
| | - Gayathri J. Dowling
- National Institute on Drug Abuse (NIDA), National Institutes of Health, Bethesda, MD, USA
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Thompson MP, Kingree JB, Lamis D. Associations of adverse childhood experiences and suicidal behaviors in adulthood in a U.S. nationally representative sample. Child Care Health Dev 2019; 45:121-128. [PMID: 30175459 DOI: 10.1111/cch.12617] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/27/2018] [Accepted: 08/12/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents and young adults. The current study extends the research linking adverse childhood experiences (ACEs) to suicidal behaviors by testing these associations using a nationally representative sample, assessing for suicide ideation and attempts in adulthood, controlling for established risk factors for suicidality, and measuring a broad array of ACEs. METHODS The sample included 9,421 participants from the National Longitudinal Study of Adolescent Health who participated in four waves of assessments spanning 13 years. We examined longitudinal associations between eight different ACEs (physical, sexual, and emotional abuse, neglect, parental death, incarceration, alcoholism, and family suicidality) with suicidal ideation and suicide attempts in adulthood, while controlling for depression, problem alcohol use, drug use, delinquency, impulsivity, gender, race, age, and urbanicity. We also tested for cumulative associations of ACEs with suicide ideation and attempts. RESULTS Logistic regression analyses indicated that physical, sexual, and emotional abuse, parental incarceration, and family history of suicidality each increased the risk by 1.4 to 2.7 times for suicidal ideation and suicide attempts in adulthood. The accumulation of ACEs increased the odds of suicide ideation and attempts. Compared with those with no ACEs, the odds of seriously considering suicide or attempting suicide in adulthood increased more than threefold among those with three or more ACEs. CONCLUSIONS Intervention strategies need to prevent ACEs from occurring and, if they do occur, should take into account the impact of cumulative ACEs on suicide risk. Future research should focus on identifying mediating mechanisms for the ACEs-suicidality association using longitudinal research designs and determine which ACEs are most important to include in a cumulative ACE measure.
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Affiliation(s)
- Martie P Thompson
- Department of Youth, Family, and Community Studies, Clemson University, Clemson, South Carolina
| | - J B Kingree
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina
| | - Dorian Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine/Grady Health System, Atlanta, Georgia
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Beharie N, Scheidell JD, Quinn K, McGorray S, Vaddiparti K, Kumar PC, Frueh BC, Boone L, Khan MR. Associations of Adolescent Exposure to Severe Violence with Substance Use From Adolescence into Adulthood: Direct Versus Indirect Exposures. Subst Use Misuse 2019; 54:191-202. [PMID: 30541369 PMCID: PMC6482818 DOI: 10.1080/10826084.2018.1495737] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND While previous research has documented the impact of violence on substance use, none has looked longitudinally across the lifespan to measure independent effects of direct and indirect violence exposure. OBJECTIVE To examine independent associations between adolescent experiences of violence and subsequent substance use in adolescence and adulthood in the United States. METHOD Using the National Longitudinal Study of Adolescent to Adult Health (N = 12,288), we examined being shot or stabbed ("experienced"), being threatened with a knife or gun ("threatened"), and seeing someone either shot or stabbed ("witnessed") during adolescence (Wave I) as correlates of substance use in adolescence and adulthood (Wave IV) via logistic regression. RESULTS Violence exposure was a significant correlate of drug use in adolescence and several associations remained significant in adulthood. Witnessing violence had the highest point estimates in the adjusted models in adolescence for each substance use outcome (e.g., Cocaine-Adjusted Odds Ratios [AOR] = 2.59, 95% confidence interval [CI] = 1.21, 5.54). However, the point estimates for threatened with violence or experienced violence were highest in three out of the four drug outcomes in adulthood (e.g., Threatened with violence: Binge drinking-AOR = 1.41, 95% CI = 1.08, 1.83). Conclusion/Importance: Adolescent exposure to witnessing violence had stronger effects on substance use in adolescence, while experiencing and being threatened with violence in adolescence had stronger effects on substance use in adulthood. Violence prevention efforts targeted toward adolescents may lead to a reduction in substance use throughout the life-course, and clinicians and policy makers should be aware of the downstream effects of violence experienced in adolescence.
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Affiliation(s)
- Nisha Beharie
- a Behavioral Science Training Program, NYU Rory Meyers College of Nursing , New York, New York , USA
| | - Joy D Scheidell
- b Department of Population Health, NYU School of Medicine , New York , New York , USA
| | - Kelly Quinn
- b Department of Population Health, NYU School of Medicine , New York , New York , USA
| | - Susan McGorray
- c College of Public Health & Health Professions College of Medicine , University of Florida , Gainesville , Florida , USA
| | - Krishna Vaddiparti
- c College of Public Health & Health Professions College of Medicine , University of Florida , Gainesville , Florida , USA
| | - Pritika C Kumar
- b Department of Population Health, NYU School of Medicine , New York , New York , USA
| | - B Christopher Frueh
- d Department of Psychology , University of Hawaii, Hilo , Hilo, Hawaii , USA
| | - Lauren Boone
- e Health Behavior Health Education, University of Michigan School of Public Health , Brooklyn , New York , USA
| | - Maria R Khan
- b Department of Population Health, NYU School of Medicine , New York , New York , USA
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Early socioeconomic adversity and cardiometabolic risk in young adults: mediating roles of risky health lifestyle and depressive symptoms. J Behav Med 2018; 42:150-161. [PMID: 30039261 DOI: 10.1007/s10865-018-9952-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 07/14/2018] [Indexed: 02/08/2023]
Abstract
The study examined the mediating roles of risky health lifestyle and depressive symptoms in relation to childhood/adolescence adversity and young adult cardiometabolic risk with data from the National Longitudinal Study of Adolescent to Adult Health (n = 9421). Four classes of youth emerged from a latent class analysis with varying early adversity patterns: (a) both low disadvantaged SES and stressful experience (54.8%), (b) high disadvantaged SES and low stressful experience (31.0%), (c) low disadvantaged SES and high stressful experience (10.9%), and (d) both high disadvantaged SES and stressful experience (3.3%). Early adversity had multiple direct and indirect effects on CM risk for those experiencing SES-related adversities. Instead, early adversity generated mediational processes between adversity and CM risks through risky health lifestyle and depressive symptoms for those experiencing stressful experience. Implications for intervention when dealing with youths who have experienced multiple forms of early adversity are discussed.
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50
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Schauer M, Robjant K. Commentary on Scheidell et al. (2018): En-counting adversities; the 'building blocks' of psychopathology. Addiction 2018; 113:57-58. [PMID: 29226536 DOI: 10.1111/add.14067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Maggie Schauer
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany.,vivo international e.V., Konstanz, Germany
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