Relations between adverse childhood experiences and comorbid psychopathology in youth with a substance use disorder

Both youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of comorbid disorders in SUD youth with ACE-history. Additionally, we aimed to examine relations between ACEs, overall household experience, and general distress. We used cross-sectional YIT-study data from interviews with Dutch youth (aged 16-22) upon SUD treatment entry for cannabis, alcohol, or stimulant use. We measured ACE-types experienced up until 15 years of age, past-year DSM-5 disorders, general distress (DASS-21), and overall household experience rating. Logistic regressions quantified relations between ACE sum score and anxiety, depressive, behavior, and any disorder. Higher ACE sum scores related to increased risks for a(n) anxiety (OR = 1.12, highest odds = 2.84; χ2(1) = 6.71, p < .010; Nagelkerke R2 = 0.2), depressive (OR = 1.21, highest odds = 5.43; χ2(1) = 18.11, p < .001;...Show moreBoth youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of comorbid disorders in SUD youth with ACE-history. Additionally, we aimed to examine relations between ACEs, overall household experience, and general distress. We used cross-sectional YIT-study data from interviews with Dutch youth (aged 16-22) upon SUD treatment entry for cannabis, alcohol, or stimulant use. We measured ACE-types experienced up until 15 years of age, past-year DSM-5 disorders, general distress (DASS-21), and overall household experience rating. Logistic regressions quantified relations between ACE sum score and anxiety, depressive, behavior, and any disorder. Higher ACE sum scores related to increased risks for a(n) anxiety (OR = 1.12, highest odds = 2.84; χ2(1) = 6.71, p < .010; Nagelkerke R2 = 0.2), depressive (OR = 1.21, highest odds = 5.43; χ2(1) = 18.11, p < .001; Nagelkerke R2 = 0.6), behavior (OR = 1.20, highest odds = 5.24; χ2(1) = 17.41, p < .001; Nagelkerke R2 = 0.6), and any (OR = 1.25, highest odds = 7.58; χ2(1) = 17.26, p < .001; Nagelkerke R2 = 0.7) disorder. Exploratory analyses revealed that frequency of parental fighting, being hit/abused, getting belittled, emotional neglect, physical neglect, insufficient household income, long parental sickness, and overall household experience positively related to DASS-21. In a hierarchical regression analysis with all ACEs and overall household experience, only emotional neglect related to DASS-21 (B = 3.68, t(373) = 2.41, p = .017). Overall household experience did not improve the model (F(12) = 3.51, p < .001; R2change < .001). In hierarchical regression analyses containing ACE sum score and overall household experience, overall household experience was not uniquely related to DASS-21 (t = -0.22, p = .824; R2change < .01). In conclusion, ACEs relate to comorbid disorders in SUD youth. Our exploratory research suggests that ACE frequency might influence this relation, while overall household experience does not further explain this relation. Further research should investigate which ACE measures (a.o., type, frequency) strongly relate to SUDs and psychopathology and examine improved treatment options.Show less

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Relations between adverse childhood experiences and comorbid psychopathology in youth with a substance use disorder