Cited by 134Child Abuse and TraumaSubstance Abuse Treatment and OutcomesChild Welfare and Adoption

The effect of adverse childhood experience on clinical diagnosis of a substance use disorder: results of a nationally representative study

Open access
LeTendre, McKenzie Lynn, Reed, Mark B.·2017·Substance Use & Misuse

Abstract

BACKGROUND: Substance abuse is one of the most common health outcomes associated with adverse childhood experience, and poses a significant public health threat. OBJECTIVES: The purpose of this study is to demonstrate a relationship between adverse childhood experience and a substance use disorder using nationally representative data as well as to test whether religion moderates this relationship. METHODS: We conducted a secondary analysis using data from the National Longitudinal Study of Adolescent to Adult Health (n = 11,279). Three types of adverse childhood experiences were considered; physical, emotional, and sexual abuse. Logistic regression was used to determine whether risk for developing an alcohol use, cannabis use, or other drug use disorder in adulthood increased as exposure to multiple types of adverse childhood experiences increased while controlling for prior substance use and other demographic variables that have shown associations with substance use. In addition, religiosity was investigated as a possible moderator of the relationship between adverse childhood experience and substance abuse. RESULTS: The likelihood of developing a substance use disorder later in life increased as the score on the adverse childhood experience index increased. While religiosity did significantly reduce the likelihood of developing a substance use disorder, no moderating effects were observed. Conclusions/importance: This study underscores the long-term consequences of exposure to childhood adversity.

Integrity signals

Registry

Crossref · 10.1080/10826084.2016.1253746

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 19 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The interaction between religiosity and adverse childhood experience was not significantly related to alcohol use disorder diagnosis.

    “The interaction between religiosity and adverse childhood experience was not significantly associated with having an AUD.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Religiosity lowered the probability of an alcohol use disorder diagnosis by 10%.

    “Furthermore, religiosity decreased the probability of having an AUD by 10%.”
    Quote in the paperNot a substantial claim
  • Findingown data

    With model covariates controlled, each one-point increase on the adverse childhood experience index was associated with 34% higher odds of an adult alcohol use disorder diagnosis.

    “Controlling for model covariates, each one-unit increase in the adverse childhood experience scale was associated with 34% higher odds of developing an AUD in adulthood.”
    Quote in the paperSubstantial claim
  • Findingown data

    Each one-point increase on the adverse childhood experience index was associated with 47% higher odds of an adult cannabis use disorder diagnosis.

    “A one-unit increase in the adverse childhood experience scale was associated with 47% higher odds of developing a CUD in adulthood.”
    Quote in the paperSubstantial claim
  • Findingown data

    The interaction between religiosity and cannabis use disorder was not significant.

    “The interaction between religiosity and CUD was not significant.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 14
  • May combine two claims. 13
  • The quote only partly states this claim. 1
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Importance of religion and frequency of prayer were not significantly related to lifetime diagnosis of any substance use disorder in bivariate or multivariate analysis, so they were excluded from the final models.

    “Neither of these items were significantly associated with lifetime diagnosis of any type of substance use disorder in bivariate or multivariate analysis, and thus were not included in the final models.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Diner and colleagues showed that religiosity supported adaptive coping by increasing self-efficacy in adults and by reassuring them that difficult life events can be overcome.

    “Diner and colleagues demonstrated religiosity aided in adaptive coping through improving self-efficacy in adults, and providing reassurance that problematic life-events can be overcome (Diner, Suh, Lucas, & Smith, 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Diner, Suh, Lucas, & Smith, 1999

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A substantial body of research has found an association between religiosity and lower substance use during adolescence.

    “Additionally, a great deal of research has shown an association between religiosity and reduced substance use in adolescence (Kendler, Liu, Gardner, McCullough, Larson, & Prescott, 2005; Piedmont, 2004; Robinson, Bolton, Rasic, & Sareen, 2012; Wallace, & Williams, 1997).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Kendler, Liu, Gardner, McCullough, Larson, & Prescott, 2005

      Not checked in the free run.

    • cites Piedmont, 2004

      Not checked in the free run.

    • cites Robinson, Bolton, Rasic, & Sareen, 2012

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In that meta-analysis, 79 of 100 studies reported a significant positive correlation between religion and positive emotions and general psychological well-being.

    “In this meta-analysis 79 out of 100 studies reported a significant positive correlation between religion and positive emotions as well as general psychological well-being.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Koenig (2001)

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Participants who left the study after Wave I were more likely than those who completed Waves I, III, and IV to report cannabis use and other drug use at Wave I, while alcohol use did not differ between the groups.

    “We found no differences in alcohol use between these groups; however, survey respondents who dropped out after Wave I were more likely to report both cannabis (p<0.05) and other drug use (p<0.05).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A meta-analysis by Koenig found that religiosity was positively associated with resilience traits including optimism, social support, and active coping.

    “In a meta-analysis of quantitative studies, Koenig (2001) found positive associations between religiosity and several resilience characteristics such as optimism, social support and an active coping style.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Koenig (2001)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Religiosity has been linked to positive outcomes among people exposed to chronic or traumatic stress.

    “Furthermore, religiosity has been associated with positive outcomes in populations exposed to chronic or traumatic stress (Williams, Larson, Buckler, Heckman, and Pyle, 1991).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams, Larson, Buckler, Heckman, and Pyle, 1991

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    National survey analyses such as Monitoring the Future have found that adolescents with higher religiosity have lower rates of alcohol abuse, cannabis use, and tobacco use.

    “Analyses of national samples such as the Monitoring the Future Study have also shown an association between higher levels of religiosity and lower rates of alcohol abuse, cannabis use, and tobacco use among adolescents (Wallace, Brown, Bachman, & LaVice, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wallace, Brown, Bachman, & LaVice, 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Adult health conditions such as substance abuse may be preventable by focusing efforts on primary prevention of childhood physical, emotional, and sexual abuse and other adverse childhood experiences.

    “This study draws attention to the idea that adult health conditions such as substance abuse may be prevented by focusing efforts towards primary prevention of childhood physical, emotional and sexual abuse, as well as other adverse childhood experiences (Alpert, 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Alpert, 2010

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The analyses were weighted and their parameter and variance estimates were adjusted for Add Health's complex sampling design.

    “We used the SPSS (ver. 22) Complex Samples procedure to conduct weighted analyses with parameter and variance estimates that have been adjusted for the complex sampling design of the Add Health survey.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Recall bias may be present because adverse childhood experience questions were asked at Wave IV.

    “First, because the questions related to adverse childhood experiences were asked in Wave IV, it is possible some recall bias may exist.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Research has shown that trauma-informed substance abuse treatment leads to better outcomes, including greater symptom reduction and higher treatment retention.

    “Research has shown substance abuse treatment using a trauma-informed approach has led to better treatment outcomes, such as greater symptom reduction and increased retention in treatment (Amaro, Chernoff, Brown, Arévalo, & Gatz, 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Amaro, Chernoff, Brown, Arévalo, & Gatz, 2007

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Evidence from several large nationally representative samples converges on an association between religiosity and lower substance use, which highlights religiosity as an important resilience factor.

    “The convergence of evidence from multiple large, nationally representative samples documenting an association between religiosity and reduced substance use highlights this construct as an important resilience factor.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Study design and conductreasoning

    Because Add Health is longitudinal, substance use was measured in early adolescence rather than retrospectively, which increased the accuracy of those measures.

    “Because of the longitudinal nature of the Add Health study, information regarding substance use was assessed during early adolescence, rather than retrospectively, increasing the accuracy of these substance use measures.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Study design and conductown data

    The data are not representative of the current US population and are weighted according to older data, which limits generalizability.

    “Second, the data used in this study are not representative of the current US population, but are weighted according to older data, limiting the generalizability of the findings.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationown data

    By establishing a strong positive relationship between early life adversity and substance abuse in a large population-based sample, this study emphasizes the importance of a trauma-informed approach to substance abuse treatment.

    “By establishing a strong positive relationship between early life adversity and substance abuse in a large, population based sample, this study emphasizes the importance of a trauma-informed approach to substance abuse treatment.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    Religiosity did not moderate the effect of adverse childhood experiences on the likelihood of a substance use disorder, so the second hypothesis was not supported.

    “Although religiosity was negatively associated with the probability of developing any type of substance use disorder, it did not moderate the effect of adverse childhood experiences on the likelihood of developing a substance use disorder; thus, the second hypothesis in this study was not supported.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The positive association between adverse childhood experience and substance abuse found in this study agrees with prior research on that relationship.

    “The positive relationship between adverse childhood experiences and substance abuse observed in this study is consistent with other research documenting this relationship (Felitti, et al., 1998; Dube, et al., 2003.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Felitti, et al., 1998

      Not checked in the free run.

    • cites Dube, et al., 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A prior Add Health study found religiosity was a protective factor that reduced binge drinking odds by 9%, cannabis use odds by 20%, and cigarette smoking odds by 13%, but only among heterosexual adults.

    “A previous study using the Add Health data showed that religiosity was a significant protective factor reducing the odds of binge drinking by 9%, cannabis use by 20%, and cigarette smoking by 13%, only in heterosexual adults (Rostosky, et al., 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rostosky, et al., 2007

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The questions used to build the religiosity scale may not accurately capture the multidimensional nature of religiosity.

    “It is possible the questions used to construct the religiosity scale in this study did not accurately capture the multidimensional nature of the construct.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Monitoring the Future data showed that higher religiosity reduced alcohol abuse, cigarette smoking, and cannabis use.

    “Data from the Monitoring the Future study also demonstrated higher levels of religiosity reduced alcohol abuse, cigarette smoking and cannabis use (Wallace, et al., 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wallace, et al., 2003

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Adverse childhood experience exposure has historically not been routinely assessed in treatment settings, leading to under-recognition and improper treatment.

    “Although exposure to adverse childhood events has significant implications for substance abuse treatment, it has historically not been routinely assessed in treatment settings leading to under-recognition and improper treatment (Davidson, 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Davidson, 2001

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The sample weights were designed to match US demographic trends at the time of the 1994 Wave I data collection.

    “Samples were weighted to match the demographic trends of the U.S. population when the first Wave of data was collected in 1994.”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim.

    Interpretationown data

    Across the outcomes, each one-point increase on the adverse childhood experience index was associated with at least a 34% increase in the odds of a clinically significant adult substance use disorder.

    “These results indicate a positive relationship between adverse childhood experiences and substance abuse where each one unit increase in the adverse childhood experience scale was associated with at least a 34% increase in the odds of developing a clinically significant substance use disorder in adulthood.”
    Quote in the paperSubstantial claim
24 of 24
  • The paper relies on this without support.

    There is little prior research on how religiosity influences the relationship between childhood trauma exposure and substance abuse.

    “There is little research investigating the influence of religiosity on the relationship between exposure to childhood trauma and substance abuse; thus, future research is needed to help further explain this important relationship.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • As the number of ACEs increases, the risk for SUD during life also increases.

    “Moreover, various studies have found that this risk has a cumulative effect; as the number of ACEs increases, the risk for SUD during life also increases (Dube et al., 2003;LeTendre & Reed, 2017).”
  • Four of the included studies evidenced the cumulative effect of ACEs on the diagnosis of SUD.

    “Four of the included studies have evidenced the cumulative effect of ACEs on the diagnosis of SUD (Gomez et al., 2018;LeTendre & Reed, 2017;Levenson, 2016;Shin et al., 2018), which was already demonstrated in previous research (Dube et al., 2003).”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Lifetime drug-use responses are labeled as past-year use

    Minor

    The Wave I other-drug variable is described as being built from questions about lifetime use, but a positive response is then defined as past-year use. A lifetime-use response does not establish when the use occurred.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 26

  1. Alpert E., 2010
  2. Amaro H., 2007, 35, 845
  3. Bennett E., 1994, 15, 426
  4. Davidson J., 2001, 286, 584
  5. Diner E., 1999, 125, 102
  6. Downs W., 1998, 6, 35
  7. Dube S., 2003, 111, 564
  8. Esser M., 2014, 11, 1403
  9. Felitti V., 1998, 14, 245
  10. Good M., 2006, 35, 41
  11. Green J., 2010, 67, 113
  12. Kendler A., 2005, 160, 496
  13. Koenig H., 2001, 3, 97
  14. National Drug Intelligence Center (NDIC), 2011
  15. Patrick M., 2011, 25, 330
  16. Piedmont R., 2004, 18, 213
  17. Pilowsky D. J., 2009, 99, 258
  18. Robinson J., 2012, 29, 983
  19. Rostosky S., 2007, 40, 440
  20. Rostosky S., 2003, 40, 358
  21. Schaefer F., 2008, 38, 507
  22. Stahre M., 2014, 11, 130
  23. Udry J., 1998, 241
  24. Wallace J., 2003, 64, 843
  25. Wallace J., 1997, 444
  26. Williams D., 1991, 32, 1257

Cited by

Sorted by citations

Authors
LeTendre, M. L., & Reed, M. B.
Affiliations
San Diego State University (US)
Corresponding author
Reed, Mark B.
Venue
Substance Use & Misuse
Published
2017-02-01
Volume
52
Issue
6
Pages
689-697
ISSN
  • 1082-6084 (ISSN-L)
  • 1532-2491
OpenAlex
W2584413012
Cited by
134
References
28
Citations by year
2026: 13 · 2025: 14 · 2024: 18 · 2023: 21 · 2022: 16 · 2021: 14 · 2020: 21 · 2019: 4 · 2018: 10 · 2017: 3
FWCI
12.86
Type
journal article
Language
en
Open access
Locations
  • Substance Use & Misuse (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01HD031921)
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 use disorders, alcoholism, cannabis use disorder, drug use disorders, physical abuse, emotional abuse, sexual abuse, religiosity, moderation, childhood adversity, Add Health
MeSH terms
Marijuana Use, Adolescent, Adult, Alcoholism, Child, Child Abuse, Child Abuse, Sexual, Female, Humans, Longitudinal Studies, Male, Religion, Risk Factors, United States, Logistic Models, Substance-Related Disorders, Young Adult

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