Risk and Protective Factors for Early Substance Use Initiation: A Longitudinal Study of Mexican‐Origin Youth

Substance use initiation in adolescence is a critical issue, given its association with substance dependency and associated problems in adulthood. However, due to the dearth of fine‐grained longitudinal studies, the factors associated with early initiation are poorly understood, especially in minority youth. The present study examined substance use initiation in a sample of Mexican‐origin youth (n = 674) assessed annually from age 10 to 16. Using discrete‐time survival analyses, we found that initiation escalated rapidly from late childhood to adolescence, and we identified a wide range of factors, from the individual to the cultural level of analysis, that significantly increased or decreased risk for early initiation. These findings have important implications for programs aimed at preventing early substance use by Mexican‐origin youth.     

Substance Abusing Mothers with a History of Childhood Abuse and Their Children's Depressive Symptoms: The Efficacy of Family Therapy

This study examined the associations among maternal history of childhood abuse, substance use, and depressive symptoms and the change in children's depressive symptoms in therapy. Mothers (N = 183) were randomly assigned into either a family or an individual treatment condition. Mothers were assessed for their childhood abuse retrospectively, baseline depressive symptoms, and substance use, whereas their children's depressive symptoms were measured five times during 1.5 years. Maternal childhood abuse was associated with a slower decline in child depressive symptoms through elevated maternal depressive symptoms, only in individual treatment. Maternal substance use further moderated this mediation pathway. This study supports the efficacy of family therapy in protecting children of mothers with a substance use disorder and a history of childhood abuse.     

A fractured journey of growth: making meaning of a ‘Broken’ childhood and parental mental ill-health

The psychopathological impact of parental mental ill-health on children is well known. However, little research explores positive and negative interpretations of such exposure in childhood, from the adult child's perspective. Using interpretative phenomenological Analysis this study sought subjective interpretations of the ‘lived’ experiences of growing up in a family with parental mental ill-health. A purposive sample of seven adult children provided data for analysis through semi-structured interviews. One superordinate theme: A fractured journey of growth to adulthood, overarched six subordinate themes. Four themes captured stigma, shame, social isolation and betrayal. Juxtaposed with this, two themes captured purposeful redefinition of self and psychological growth. This study captures the chronicity of traumatic distress and sense of betrayal experienced by these participants in childhood through unrelenting exposure to parental mental ill-health. However, despite unpredictability, fear, and neglect in childhood, they identified the emergence of inner strengths in adult life: unexpected growth in empathy and compassion, high resourcefulness, and personal authenticity through higher education. Findings highlight that positively redefining ‘self’ in adult life is possible in the aftermath of childhood trauma associated with parental mental ill-health. Implications for therapy include: (a) moving forward from childhood trauma and (b) managing ongoing family dynamics in adult-life.     

Depressive Symptoms and Their Association With Adverse Environmental Factors and Substance Use in Runaway and Homeless Youths

We used diathesis‐stress and stress‐sensitization models to determine whether family maltreatment, street‐related traumatic events, stressful life events, and substance use were associated with depressive symptoms in runaway and homeless youths (RHY) in Los Angeles. Greater severity of depressive symptoms was significantly related to family maltreatment, being exposed to more traumatic stressors during homelessness, and current substance use compared to no substance use. Family maltreatment was also found to moderate the relationship between traumatic stressors and depressive symptoms. Importantly, cumulative exposure to the investigated risk factors at varying levels was associated with more severe depressive symptoms. Using a trauma‐informed approach to screen for RHY at risk of depression may pave the way for secondary prevention of major depression in RHY.     

Childhood trauma and risk for suicidal distress in justice-involved children

Justice-involved children (JIC) have higher rates of trauma exposure and suicidality than the general population. The Childhood Trauma Model predicts that children can accumulate multiple traumatic experiences that can be more harmful than a single traumatic event. The purpose of this study is to investigate the individual and cumulative effects of childhood trauma on suicidal distress among JIC. The study employs logistic regression to analyze panel data on 2367 12–16 year-olds from the Florida Department of Juvenile Justice (FLDJJ). The study shows that 9 types of individual traumatic experiences increased risk for suicidal ideation from 22 to 180%. For one unit increase in the trauma score, the risk for suicidal distress increased 25%, so that JIC who experienced 5 types of traumas were 2.4 times more likely to experience suicidal distress as JIC who experienced a single trauma. These findings illustrate the need to invest mental health services and suicide prevention resources in populations in the juvenile justice system. Intervention must be tailored to serve children who suffered specific traumatic events, as well as those who experience multiple types of trauma. Further, policies that manage JIC as kid criminals rather than as traumatized children may exacerbate their suicidality and problematic behavior.     

Adolescents in residential treatment: The prevalence of ACEs,substance use and justice involvement

Abstract

Although associations between developmental trauma, juvenile justice involvement and youth substance use have been previously reported in the published literature, the interconnection among these three factors has not been adequately studied. This article describes the interconnection among these three factors and calls for greater attention to the role of adverse childhood experiences (ACEs) in the diagnosis and treatment of youth who present with histories of substance use and/or offending behavior. Pilot data are presented that show high rates of self-reported trauma exposure, substance use history, justice involvement, and mental health problems in a sample of adolescents in residential treatment. The data point to the need for residential treatment centers to consider trauma histories in developing treatment plans for youth with current and prior substance use and offending behavior.     

Adolescent Psychological Functioning and Membership in Latent Adolescent–Parent Communication Dual Trajectory Classes

The primary goal of this study was to examine the relationship between adolescents’ psychological functioning (as indicated by depressive symptoms) and substance use (alcohol and drug use) and membership in adolescent–parent communication trajectory subgroups in a large, diverse community sample of adolescents from the United States (n = 1,057; 53% female; 51% Caucasian; Age: M = 16.15, SD = .75). Adolescents completed questionnaires at three annual assessments. Fit indices from parallel process growth mixture models suggested three dual trajectory classes: (1) Average communication with both parents (Average‐Both); (2) Good adolescent–mother and poor adolescent–father communication (Good‐Mom/Poor‐Dad); and (3) Poor adolescent–mother and good adolescent–father communication (Poor‐Mom/Good‐Dad). The trajectory classes differed by gender. In addition, psychological functioning and substance use were differentially related to the trajectory classes.     

Maternal Lifetime Trauma Exposure,Prenatal Cortisol,and Infant Negative Affectivity

Little research has examined the impact of maternal lifetime trauma exposure on infant temperament. We examined associations between maternal trauma history and infant negative affectivity and modification by prenatal cortisol exposure in a sociodemographically diverse sample of mother–infant dyads. During pregnancy, mothers completed measures of lifetime trauma exposure and current stressors. Third‐trimester cortisol output was assessed from maternal hair. When infants were 6 months old, mothers completed the Infant Behavior Questionnaire‐Revised. In analyses that controlled for infant sex and maternal age, education, race/ethnicity, and stress during pregnancy, greater maternal trauma exposure was associated with increased infant distress to limitations and sadness. Higher and lower prenatal cortisol exposure modified the magnitude and direction of association between maternal trauma history and infant rate of recovery from arousal. The association between maternal trauma history and infant distress to limitations was somewhat stronger among infants exposed to higher levels of prenatal cortisol. The analyses suggested that maternal lifetime trauma exposure is associated with several domains of infant negative affectivity independently of maternal stress exposures during pregnancy and that some of these associations may be modified by prenatal cortisol exposure. The findings have implications for understanding the intergenerational impact of trauma exposure on child developmental outcomes.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

Do Secondary Trauma Symptoms in Spouses of Combat-Exposed National Guard Soldiers Mediate Impacts of Soldiers’ Trauma Exposure on Their Children?

This exploratory study examines the associated effects of combat exposure on Soldiers assigned to a Midwestern Army National Guard unit. It also explores the secondary and mediating effects of combat exposure on Soldier’s spouses and children. The correlations of combat exposure with trauma symptoms, substance abuse, domestic violence and secondary trauma symptoms among family members are identified. Survey results suggest that immediate family members of combat-exposed Soldiers with high levels of post traumatic stress disorder (PTSD) are at risk for developing secondary traumatic stress. Secondary trauma symptoms in these spouses are a risk-increasing mediating variable between trauma symptoms in combat-exposed Soldiers and secondary trauma symptoms in their children. Results from this investigation emphasize the need for further inquiry into this topic. They further highlight the need for preventive and treatment efforts targeted toward all family members and relationships in order to lessen the effects of combat exposure.     

Substance use in youth adopted from foster care: Developmental mechanisms of risk

Children who enter foster care are at unique risk for developing substance abuse due to experiencing early life stressors. A large body of research has revealed robust effects of various stressors on later substance use, implicating the role of early neurobiological changes that create chronic internalizing problems. However, less literature has investigated externalizing behavior as a mechanism underlying this relationship. Moreover, few studies have examined these mechanisms through a model of cumulative risk. The present study examined whether the prospective association between cumulative pre-adoptive risk (e.g., maltreatment, age at placement, foster placement instability, ever having lived with birth parent) and adolescent/young-adult substance use was mediated by childhood internalizing and externalizing problems in youth adopted from foster care. Participants included 82 adoptees, most with histories of prenatal substance exposure (72%). We tested parent-rated internalizing and externalizing problems across 5 years in childhood as simultaneous mediators of cumulative risk and level of substance use 11–15 years later. Bootstrapping mediation procedures, controlling for age, prenatal substance exposure, adolescent/young adult mental health symptomatology, and youth participation in follow-up, revealed a significant indirect effect of cumulative risk on substance use through childhood internalizing problems, but not externalizing problems. These results underline the importance of mitigating early risk for children in the child welfare system and call for targeting childhood emotion dysregulation to reduce likelihood of substance abuse among previously high-risk adoptees. Nevertheless, low rates of substance use overall in the present sample underscore the positive impact of adoptive placement on mitigating risk for substance abuse among foster youth.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

New Directions for Research Examining Sexual Trauma Histories of Gay Men

Summary

Research efforts have been unable to accurately examine the effect of childhood sexual trauma in the adult lives of gay men. Complications stemming from precise definitions of abuse, as well as the subjectivity inherent in the terms, make comprehensive research difficult. As abuse and traumatic events may sometimes be subtle and not involve overt violence, these more delicate events are often overlooked or unaccounted for. Further, because it is a complex endeavor to obtain accurate reporting from children, research efforts rely on the self-reports of adults remembering traumatic events. The symptomatology that results from trauma, including amnesia and dissociation, also affects the reliability of self-report. Additionally, gay men have been notably absent from sexual trauma research efforts for a variety of reasons. A research study which investigates childhood sexual trauma in the histories of adult gay men is discussed. Directions for future research efforts are suggested.     

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma

The potential effects of maternal trauma on mother–infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother–infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4–6 months. Split‐screen videotaped interaction was coded on a one‐second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self‐contingency and interactive contingency of behavior by time‐series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper‐contingent, high‐arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.     

Problem Behavior and Heart Rate Reactivity in Adopted Adolescents: Longitudinal and Concurrent Relations

The present longitudinal study examined resting heart rate and heart rate variability and reactivity to a stressful gambling task in adopted adolescents with aggressive, delinquent, or internalizing behavior problems and adopted adolescents without behavior problems (total N=151). Early‐onset delinquent adolescents showed heart rate hyporeactivity to the stress‐eliciting gambling task compared to late‐onset delinquent adolescents and adolescents without behavior problems. Heart rate, heart rate variability, and reactivity to stress were not related to environmental factors such as early‐childhood parental sensitivity, parental socioeconomic status, or adoptee's health status at arrival. We conclude that the distinction between delinquency and aggression and between childhood‐onset and adolescence‐onset delinquency is important for the study of stress reactivity in adolescents.     

Adolescent Pathways to Co‐Occurring Problem Behavior: The Effects of Peer Delinquency and Peer Substance Use

Delinquency and substance use are more likely to co‐occur in adolescence compared to earlier and later developmental periods. The present study examined developmental pathways to co‐occurring problem behavior from 6th to 10th grade (N = 2,002), testing how peer delinquency and substance use were linked to transitioning between abstaining, delinquency, substance use, and co‐occurring problem behavior. Developmentally, most youth transition from abstinence to delinquent behavior and then escalate to co‐occurring problem behavior. Once co‐occurring problem behavior onsets, remitting to single‐problem behavior or abstinence is unlikely. The impact of peers on problem behavior is domain‐specific when individuals transition from abstaining to a single‐problem behavior, but is more general with respect to escalation of and desistance from problem behavior.     

A Randomized Controlled Trial Assessing the Efficacy of Cognitive Behavioral Therapy for Substance‐Dependent Domestic Violence Offenders: An Integrated Substance Abuse‐Domestic Violence Treatment Approach (SADV)

The current study evaluates a therapy for substance‐dependent perpetrators of partner violence. Sixty‐three males arrested for partner violence within the past year were randomized to a cognitive behavioral substance abuse‐domestic violence (SADV; n = 29) or a drug counseling (DC; n = 34) condition. Seventy percent of offenders completed eight core sessions with no differences between SADV and DC conditions in the amount of substance or aggression at pretreatment. SADV participants had fewer cocaine‐positive toxicology screens and breathalyzer results during treatment, were less likely to engage in aggressive behavior proximal to a drinking episode, and reported fewer episodes of violence than DC participants at posttreatment follow‐up. SADV shows promise in decreasing addiction and partner violence among substance‐dependent male offenders.     

Examining the Psychosocial Functioning and Characteristics of Incarcerated Girls with a Substance Use Disorder

The purpose of this study was to identify the psychosocial characteristics of incarcerated girls with a substance use disorder. Profile analysis, the repeated measures extension of multivariate analysis of variance, was conducted to compare a state-based sample of incarcerated girls with (n = 140) and without (n = 63) a substance use disorder across multiple subscales of the Multidimensional Adolescent Assessment Scale. Girls with a substance use disorder had higher levels of problem severity. They were more likely to have problems related to alcohol use, drug use, aggression, and cognition. Incarcerated girls with a substance use disorder may benefit from intense interventions that focus on cognitive restructuring or cognitive recovery, and interventions that promote coping and stress management skills.     

Adult Attachment Stability–Instability Before and After Marriage Between Intimate Partner Violence (IPV) and Non‐IPV Women Separated from Partners During Military Duty in Indonesia

The quality of attachment between intimate partners is important for women to maintain healthy relationships. Yet, the quality of attachment style and relationship can be marred and disrupted in women exposed to trauma due to intimate partner violence (IPV). Research suggests that the impact of trauma on women can be transmitted over generations due to the inability to regulate emotions, specifically in dealing with their children. The aim of this study was to explore the disruption of adult attachment patterns by comparing a group of women in Indonesia who have been affected by IPV, and a group of women who have not been affected by IPV but who have been separated from their partner during military duty. A cross‐sectional study comparing two groups: women exposed to IPV (n = 35) and women not exposed to IPV (n = 35) was carried out. The adult attachment scale before and after marriage was obtained using Experiences in Close Relationships‐Revised scales. The results revealed a significant shift of attachment style on the Avoidant dimension of the non‐IPV group separated by partner military duty and a slight change on the overall attachment of the IPV group, but relative stability on the Anxiety dimensions. The study interpreted the findings as being more supportive of the prototype perspective rather than the revisionist perspective. Family therapists may reduce the attachment Avoidant dimension as a therapeutic goal of intervention to change the insecure to a more secure working model.     

Intergenerational Trauma Among Substance-Using Native American,Latina, and White Mothers Living in the Southwestern United States

The high rates of traumatic experiences reported by women who use alcohol and drugs have been documented in the literature. This study builds on the existing literature by examining the experiences of intergenerational family loss trauma among 226 mothering female substance users from 3 racial and ethnic groups: Native American (26.5%), Latina (24.8%), and White (48.7%). Demographic information, substance use, intergenerational exposure to mothering, and other family traumatic losses were compared across racial and ethnic groups. Data indicate both similarities and significant differences in demographic characteristics, type of drug use, and traumatic family loss experiences—with a higher percentage of Native American women reporting instances of intergenerational family loss. The extent of intergenerational family traumatic loss among women who use substances is discussed, along with social policies that perpetuate such loss. Recommendations for effectively intervening at the individual, family, and policy levels are presented.