Department of Health Sciences, California State University, Northridge, 18111 Nordhoff, St. Northridge, CA 91330, United States.
Department of Kinesiology, Health, & Nutrition, University of Texas, San Antonio, 1 UTSA Cir., San Antonio, TX 78249, United States.
Addict Behav. 2018 Jan;76:298-304. doi: 10.1016/j.addbeh.2017.08.037. Epub 2017 Sep 1.
Research suggests that college students are an especially vulnerable subset of the population for substance use and misuse. However, despite evidence of the high prevalence of adverse childhood experiences (ACE) among students and the link between family-based ACE and substance use among older adults, this relationship remains understudied in college populations. Moreover, whether ACE represents a shared risk across substance use behaviors and ethnic groups is unknown.
Data are student responses (n=2953) on the 2015 American College Health Association's National College Health Assessment II (ACHA-NCHA II) administered at one of the largest, most diverse public universities in California. Multivariable logistic and negative binomial regression models tested the association between individual and accumulated ACE and past 30-day alcohol, tobacco, marijuana, and illicit drug use, past 12-month prescription medication misuse and polysubstance use.
Between 50% and 75% of students involved in substance use were ACE exposed. There was a significant dose-response relationship between ACE and substance use and polysubstance use. Although accumulated ACE increased risk for substance use, there was considerable ethnic variability in these associations.
The graded effects of ACE for substance use underscore the link between family-based stressors and these behaviors in emergent adult college students. Our findings make a compelling case for investing in health initiatives that prioritize ACE screening and access to trauma-informed care in campus communities. Continued research with college populations is needed to replicate findings and clarify the role of ethnicity and culture in trauma response and help seeking behaviors.
研究表明，大学生是滥用和误用药物的高危人群。然而，尽管有证据表明学生群体中普遍存在不良的童年经历（ACE），且家庭 ACE 与成年人的药物使用之间存在关联，但在大学生群体中，这一关系仍未得到充分研究。此外，ACE 是否代表了跨物质使用行为和族裔群体的共同风险尚不清楚。
数据来自于加利福尼亚州最大、最多样化的公立大学之一的 2015 年美国大学生健康协会全国大学生健康评估 II（ACHA-NCHA II）的学生调查结果（n=2953）。多变量逻辑和负二项回归模型检验了个体 ACE 和累积 ACE 与过去 30 天酒精、烟草、大麻和非法药物使用、过去 12 个月处方药物滥用和多药物使用之间的关联。
50%至 75%的参与物质使用的学生存在 ACE 暴露。ACE 与物质使用和多药物使用之间存在显著的剂量反应关系。尽管累积 ACE 增加了物质使用的风险，但这些关联在族裔方面存在相当大的差异。
ACE 对物质使用的分级影响突显了家庭压力源与大学生这一新兴成年人群体中这些行为之间的联系。我们的研究结果有力地证明了在校园社区中，有必要投资于健康计划，优先考虑 ACE 筛查和获得创伤知情护理。需要进一步研究大学生群体，以复制这些发现，并阐明种族和文化在创伤反应和寻求帮助行为中的作用。
