Childhood exposure to adversity and risk of substance-use disorder in two American Indian populations: the meditational role of early substance-use initiation

Whitesell, Nancy Rumbaugh; Beals, Janette; Mitchell, Christina M.; Manson, Spero M.; Turner, R. Jay; AI-SUPERPFP Team

doi:10.15288/jsad.2009.70.971

Cited by 102Substance Abuse Treatment and OutcomesIndigenous Health, Education, and RightsChild Abuse and Trauma

Childhood exposure to adversity and risk of substance-use disorder in two American Indian populations: the meditational role of early substance-use initiation

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Whitesell, Nancy Rumbaugh, Beals, Janette, Mitchell, Christina M., Manson, Spero M., Turner, R. Jay, AI-SUPERPFP Team·2009·Journal of Studies on Alcohol and Drugs

DOI 10.15288/jsad.2009.70.971PMC PMC2776127

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Abstract

OBJECTIVE: We examined the relationship of childhood exposure to adversity and risk of substance-use disorder in two culturally distinct American Indian reservation communities, exploring both the role of early initiation of substance use in mediating this relationship and variation in risk across types of adversity exposure. METHOD: The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project provided data from 2,927 American Indians on the occurrence and age at onset of adversities, substance use, and substance-use-disorder symptoms. RESULTS: The risk of substance-use disorder associated with early adversity was explained partially by early initiation of substance use. Three types of adversity (major childhood events, traumas, and witnessed violence) were associated with early onset of substance use and increased risk of substance-use disorder. Gender and tribe were also related to variation in both early substance use and substance-use disorder. CONCLUSIONS: Early exposure to adverse events was associated with early substance use and the subsequent development of substance-use disorders among American Indians. public health initiatives targeting substance use and substance-use disorders in American Indian communities should include efforts to help children in these communities cope with adversities they encounter.

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Trauma and exposure to stress are highly prevalent in the American Indian community and are highly comorbid with substance use.
“Trauma and exposure to stress are also highly prevalent in the American Indian community and are highly comorbid with substance use (Ehlers et al., 2013; Whitesell et al., 2009).”
From Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data (2018) · cites this paper as Whitesell et al., 2009

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Retracted
Three studies examining the mechanisms linking stress exposure to delinquency and substance use among North American indigenous adolescents
Hautala, D. S. (2016) · Lincoln (University of Nebraska)
Understanding Mental and Behavioral Health of American Indian Youth: An Application of the Social Convoy Model
Ivanich, J. (2018) · Lincoln (University of Nebraska)
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Additional file 1 of Experiences of Alaska Native people living with burn injury and opportunities for health system strengthening
Smith, M. B., Brownson, E. G., Newman, A. K., Madison, C., Fuentes, M. M., Amtmann, D., Carrougher, G. J., Gibran, N. S., & Stewart, B. T. (2023) · Figshare · doi:10.6084/m9.figshare.24571728
Early stress, impulsivity and suicidal behavior in users of psychoactive substances
Júnior, E. B. C. (2020) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Understanding Substance Use in Alaska Native Youth- A Social Network Perspective
Mason, M., Schultz, K., Zhang, S., & Ivanich, J. (2026) · BMC Public Health · doi:10.1186/s12889-026-27557-0
An Investigation of Socially Relevant Moderators of Childhood Substance Familiarity
Moore, A., Lewis, B., Hinckley, J. D., Nixon, S. J., & Bhatia, D. (2026) · Journal of Child & Adolescent Substance Use · doi:10.1080/29973368.2026.2681627
Summary and Discussion
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0009
List of Figures
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.002.0006
Recommendations
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0010
Civil and Criminal Justice Responses to the Sexual Victimization of American Indian and Alaska Native Children
Steele, P. D. (2026) · doi:10.1093/9780190275662.001.0001
Legal Cases and Court Decisions Cited
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0011
Multivariate Analysis of Foster Care Placement
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.005.0003
Characteristics of Child Sexual Abuse Episodes
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0005
Dedication
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.002.0005
Multivariate Analysis of Child Sexual Abuse Disclosures During the Forensic Interview
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.005.0002
AIAN–Settler Colonist Relations in Historical and Legal Contexts
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0002
Justice System Actions in Response to Child Sexual Abuse Allegations and Cases
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0006
Investigating the Prevalence of Child Sexual Abuse and Associated Factors
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0003
Notes
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0012
Child Sexual Abuse Allegations and Cases in Tribal and Nontribal Justice Systems
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0008
List of Tables
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.002.0007
Introduction
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0001
Child Sexual Abuse Theories and Explanatory Models
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0004
Multivariate Analysis of Case Episode Characteristics
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.005.0001
Multivariate Analysis of Adoption Case Characteristics
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.005.0004
Child Sexual Abuse Allegations and Cases in Tribal and Nontribal Justice Systems
Steele, P. D. (2026) · Oxford University Press eBooks · doi:10.1093/9780190275662.003.0007

The relationship of cumulative and proximal adversity to onset of substance dependence symptoms in two American Indian communities
Whitesell, N. R., Beals, J., Mitchell, C. M., Keane, E., Spicer, P., & Turner, R. J. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.06.008 · Cited by 29 · see citing works
Is Childhood Adversity Before Age 5 Associated with Adolescent and Young Adult Substance Use? Findings from a U.S. Prospective Cohort Study
Mulia, N., Li, L., Williams, E., Guo, Z., Witbrodt, J., Tam, C. C., & Lui, C. K. (2024) · Figshare · doi:10.6084/m9.figshare.27186950
Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review
Grummitt, L., Kelly, E., Barrett, E., Keyes, K., & Newton, N. (2021) · PLOS ONE · doi:10.1371/journal.pone.0252815 · Cited by 51 · see citing works
Childhood characteristics associated with stage of substance use of American Indians: family background, traumatic experiences, and childhood behaviors
O'Connell, J. M., Novins, D. K., Beals, J., Whitesell, N., Libby, A. M., Orton, H. D., & Croy, C. D. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.07.012 · Cited by 34 · see citing works
Family-centered treatment for American Indian adolescent substance abuse: toward a culturally and historically informed strategy
Boyd‐Ball, A. J., & Dishion, T. J. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511543968.021 · Cited by 12 · see citing works

Authors: Whitesell, N. R., Beals, J., Mitchell, C. M., Manson, S. M., Turner, R. J., & AI-SUPERPFP Team
Affiliations: Colorado School of Public Health (US)
Florida State University (US)
ORCID: Whitesell, Nancy Rumbaugh
Manson, Spero M.
Turner, R. Jay
Venue: Journal of Studies on Alcohol and Drugs
Publisher: Alcohol Research Documentation, Inc.
Published: 2009-11
Volume: 70
Issue: 6
Pages: 971-981
ISSN: 1937-1888 (ISSN-L)
1938-4114
DOI: 10.15288/jsad.2009.70.971
PMC: PMC2776127
OpenAlex: W2037405610
Cited by: 102
References: 60
Citations by year: 2026: 26 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 7 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 4 · 2014: 1 · 2013: 4 · 2012: 4
FWCI: 1.78
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Studies on Alcohol and Drugs (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (P01MH042473, R01MH048174)
National Institute on Drug Abuse (R01DA014817, R01DA017803)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Health › Indigenous Health, Education, and Rights
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: childhood adversity, substance use disorders, Native Americans, reservation communities, childhood trauma, witnessing violence, mediation, gender differences, tribal differences, risk and protective factors
MeSH terms: Adolescent, Adult, Age Factors, Child, Cross-Cultural Comparison, Data Collection, Female, Humans, Indians, North American, Male, Middle Aged, Risk Factors, Sex Factors, United States, Age of Onset, Substance-Related Disorders, Young Adult

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Childhood exposure to adversity and risk of substance-use disorder in two American Indian populations: the meditational role of early substance-use initiation

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