Adverse childhood events as risk factors for substance dependence: partial mediation by mood and anxiety disorders
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Aims Adverse childhood events (ACEs) are associated with negative health outcomes. We examined ACEs as risk factors for substance dependence (SD) and the mediating effects of mood and anxiety disorders on the relations between ACEs and SD risk.Design We compared early life experiences in 2061 individuals with a lifetime diagnosis of alcohol, cocaine, or opioid dependence and 449 controls.Measurements Diagnostic and ACE data were obtained using the Semi-Structured Assessment for Drug Dependence and Alcoholism.Findings Childhood abuse or exposure to violent crime was positively related to the number of lifetime mood and anxiety disorders and to SD risk. Mood and anxiety disorders had their first onset a mean of nearly 3 years before the first SD diagnosis and partially mediated the effect of ACEs on SD risk.Conclusion ACEs appear to contribute additively to the risk of SD, with mood and anxiety disorders in the causal path for a portion of this risk. The identification and effective treatment of mood and anxiety disorders associated with ACEs could reduce the risk of developing SD.
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Despite variations in measures, age ranges, and sample sizes, the collective findings drawn from more than 40,000 participants converged that abuse and lower perceived quality of relationships with primary caregivers, disrupted family processes, maltreatment including witnessing family violence, negative family interactions, parental discord or divorce, substantiated maltreatment including subst
“Despite the variations in measures, the range in age of the participants, and the sample size of each of the studies, the collective findings drawn from more than 40,000 participants converged: abuse and lower perceived quality of relationships with their primary caregivers (Douglas et al., 2010), disrupted family processes (Gavazzi et al., 2008), maltreatment, including witnessing family violence”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Douglas et al., 2010
Cumulative effect of childhood trauma on substance dependence risk: each additional type of violent crime/abuse experience nearly doubles odds of dependence on alcohol, cocaine, and/or opioids.
“For example, there is a cumulative effect of childhood trauma on the risk of substance dependence, in which for every unit increase in the number of types of violent crime/abuse experiences, the odds of a person developing dependence on alcohol, cocaine, and/or opioids almost doubled (Douglas et al., 2010; Fig. 6).”
From Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development (2021) · cites this paper as Douglas et al., 2010
These results replicate findings from several previous studies.
“These results replicate findings from several previous studies (48–52).”
From Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic (2020) · cites this paper as [51]
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- Authors
- Douglas, K. R., Chan, G., Gelernter, J., Arias, A. J., Anton, R. F., Weiss, R. D., Brady, K., Poling, J., Farrer, L., & Kranzler, H. R.
- Affiliations
- University of Connecticut (US)
- Yale University (US)
- Medical University of South Carolina (US)
- Harvard University (US)
- Boston University (US)
- Corresponding author
- Kranzler, Henry R.
- ORCID
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 35
- Issue
- 1
- Pages
- 7-13
- ISSN
- 0306-4603 (ISSN-L)
- PMC
- PMC2763992
- OpenAlex
- W1986896992
- Cited by
- 269
- References
- 41
- Citations by year
- 2026: 14 · 2025: 10 · 2024: 18 · 2023: 19 · 2022: 25 · 2021: 16 · 2020: 35 · 2019: 15 · 2018: 17 · 2017: 18 · 2016: 14 · 2015: 16 · 2014: 12 · 2013: 7 · 2012: 15
- FWCI
- 11.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (AA11330, R01AA011330, AA 13736, K05AA017435, AA-03510, AA17435, K24AA013736)
- National Institute on Drug Abuse (DA-12849, DA 12690, DA022288, K24DA022288, R01DA012690, R01DA018432, K24DA015105, R01DA012849, DA15105)
- National Institute of General Medical Sciences (T32GM008607)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- adverse childhood experiences, substance dependence, mood disorders, anxiety disorders, mediation, childhood abuse, alcoholism, cocaine dependence, opioid use disorder, childhood adversity
- MeSH terms
- Adult, Anxiety Disorders, Child, Child Abuse, Family Relations, Female, Humans, Life Change Events, Male, Middle Aged, Risk Factors, Domestic Violence, Mood Disorders, Substance-Related Disorders
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