Carliner Hannah, Keyes Katherine M, McLaughlin Katie A, Meyers Jacquelyn L, Dunn Erin C, Martins Silvia S
Columbia University, New York.
Columbia University, New York.
J Am Acad Child Adolesc Psychiatry. 2016 Aug;55(8):701-8. doi: 10.1016/j.jaac.2016.05.010. Epub 2016 May 27.
Although potentially traumatic events (PTEs) are established risk factors for substance use disorders among adults, little is known about associations with drug use during adolescence, an important developmental stage for drug use prevention. We examined whether childhood PTEs were associated with illicit drug use among a representative sample of US adolescents.
Data were drawn from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A), which included adolescents aged 13 to 18 years (N = 9,956). Weighted logistic regression models estimated risk ratios for lifetime use of marijuana, cocaine, nonmedical prescription drugs, other drugs, and multiple drugs.
Exposure to any PTE before age 11 years was reported by 36% of the sample and was associated with higher risk for use of marijuana (risk ratio [RR] = 1.50), cocaine (RR = 2.78), prescription drugs (RR = 1.80), other drugs (RR = 1.90), and multiple drugs (RR = 1.74). A positive monotonic relationship was observed between number of PTEs and marijuana, other drug, and multiple drug use. Interpersonal violence was associated with all drug use outcomes. Accidents and unspecified events were associated with higher risk for marijuana, cocaine, and prescription drug use.
Potentially traumatic events in childhood are associated with risk for illicit drug use among US adolescents. These findings add to the literature by illustrating a potentially modifiable health behavior that may be a target for intervention. The results also highlight that adolescents with a trauma history are a high-risk group for illicit drug use and may benefit from trauma-focused prevention efforts that specifically address traumatic memories and coping strategies for dealing with stressful life events.
尽管潜在创伤性事件(PTEs)是成年人物质使用障碍的既定风险因素,但对于其与青少年药物使用之间的关联却知之甚少,而青少年时期是药物使用预防的重要发育阶段。我们研究了童年期PTEs是否与美国青少年代表性样本中的非法药物使用有关。
数据取自全国共病调查复制版青少年补充调查(NCS-A),其中包括13至18岁的青少年(N = 9956)。加权逻辑回归模型估计了终生使用大麻、可卡因、非医疗处方药物、其他药物和多种药物的风险比。
样本中有36%的人报告在11岁之前经历过任何PTEs,这与使用大麻(风险比[RR]=1.50)、可卡因(RR = 2.78)、处方药(RR = 1.80)、其他药物(RR = 1.90)和多种药物(RR = 1.74)的较高风险相关。观察到PTEs的数量与大麻、其他药物和多种药物使用之间呈正单调关系。人际暴力与所有药物使用结果相关。事故和未明确事件与使用大麻、可卡因和处方药的较高风险相关。
童年期潜在创伤性事件与美国青少年非法药物使用风险相关。这些发现通过阐明一种可能可改变的健康行为(可能成为干预目标),为文献增添了内容。结果还突出表明,有创伤史的青少年是非法药物使用的高危群体,可能会从专门针对创伤记忆和应对压力性生活事件的应对策略的以创伤为重点的预防措施中受益。