Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA.
Subst Use Misuse. 2021;56(6):854-860. doi: 10.1080/10826084.2021.1899230. Epub 2021 Mar 16.
Adverse childhood experiences (ACEs) are associated with negative health outcomes, yet their associations with performance-enhancing substance (PES) use are unclear. This study aimed to determine whether ACEs predict greater use of legal and illegal PES in young adults.
We analyzed data from the National Longitudinal Study of Adolescent to Adult Health ( = 14,322), Waves I (1994-1995) and III (2001-2002). ACEs included childhood sexual abuse, physical abuse, two neglect indicators, and cumulative ACEs. Legal (e.g. creatine monohydrate) and illegal (e.g. non-prescription anabolic-androgenic steroids; AAS) PES use was assessed.
Sexual abuse had the greatest effect and predicted higher odds of legal PES use (men: adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.06-2.59; women: AOR 3.74, 95% CI 1.63-8.59) and AAS use (men: AOR 8.89, 95% CI 5.37-14.72; women: AOR 5.73, 95% CI 2.31-14.18). Among men, a history of physical abuse (AOR 3.04, 95% CI 2.05-4.52), being left alone by a parent/guardian (AOR 2.33, 95% CI 1.50-3.60), and basic needs not being met (AOR 3.47, 95% CI 2.30-5.23) predicted higher odds of AAS use. Among women, basic needs not being met (AOR 2.94, 95% CI 1.43-6.04) predicted higher odds of AAS use. Among both men and women, greater number of cumulative ACEs predicted higher odds of both legal and illegal PES use.
ACEs predict greater PES use among young adults. Clinicians should monitor for PES use among those who have experienced ACEs and provide psychoeducation on the adverse effects associated with PES use.
不良的童年经历（ACEs）与负面健康结果有关，但它们与使用增强性能的物质（PES）的关系尚不清楚。本研究旨在确定 ACEs 是否预测年轻人中更多地使用合法和非法 PES。
我们分析了来自全国青少年至成人健康纵向研究（N = 14322），第 I 波（1994-1995 年）和第 III 波（2001-2002 年）的数据。ACEs 包括儿童期性虐待、身体虐待、两个忽视指标和累积 ACEs。评估了合法（例如肌酸一水合物）和非法（例如非处方合成代谢雄激素类固醇；AAS）PES 的使用。
性虐待的影响最大，预测了更高的合法 PES 使用几率（男性：调整后的优势比 [AOR] 1.66，95%置信区间 [CI] 1.06-2.59；女性：AOR 3.74，95% CI 1.63-8.59）和 AAS 使用（男性：AOR 8.89，95% CI 5.37-14.72；女性：AOR 5.73，95% CI 2.31-14.18）。在男性中，有过身体虐待史（AOR 3.04，95% CI 2.05-4.52）、被父母/监护人单独留下（AOR 2.33，95% CI 1.50-3.60）和基本需求未得到满足（AOR 3.47，95% CI 2.30-5.23）预测 AAS 使用的几率更高。在女性中，基本需求未得到满足（AOR 2.94，95% CI 1.43-6.04）预测 AAS 使用的几率更高。对于男性和女性，累积 ACEs 的数量越多，预测合法和非法 PES 使用的几率就越高。
ACEs 预测年轻人中 PES 使用的几率更高。临床医生应监测那些经历过 ACEs 的人的 PES 使用情况，并提供有关 PES 使用相关不良影响的心理教育。
