不良童年经历与酒精和大麻共病风险模式：波多黎各青年的纵向研究。
Adverse Childhood Experiences and Risk Patterns of Alcohol and Cannabis Co-Use: A Longitudinal Study of Puerto Rican Youth.
机构信息
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York.
Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; Center for Intergenerational Psychiatry, Division of Child Psychiatry, New York State Psychiatric Institute/Columbia University Irving Medical Center, New York, New York.
出版信息
J Adolesc Health. 2023 Sep;73(3):421-427. doi: 10.1016/j.jadohealth.2023.04.010. Epub 2023 Jun 7.
PURPOSE
Adverse childhood experiences (ACEs) are common in Puerto Rican youths. Few large longitudinal studies of Latine youth examined what predicts co-use of alcohol and cannabis in late adolescence and young adulthood. We investigated the prospective association between ACEs with alcohol/cannabis co-use in Puerto Rican youth.
METHODS
Participants from a longitudinal study of Puerto Rican youth (n = 2,004) were included. Using multinomial logistic regressions to test associations between prospectively reported ACEs (11 types, reported by parents and/or children, categorized as 0-1, 2-3, and 4+ ACEs) with young adult alcohol/cannabis use patterns in the past month (i.e., no lifetime use, low-risk [no binge drinking and cannabis use < 10], binge-drinking only, regular cannabis use only, and alcohol/cannabis co-use). Models were adjusted for sociodemographic variables.
RESULTS
In this sample, 27.8% reported 4+ ACEs, 28.6% endorsed binge drinking, 4.9% regular cannabis use, and 5.5% alcohol/cannabis co-use. Compared to individuals with no lifetime use, those reporting 4+ (vs. 0-1) ACEs had greater odds of low-risk use (adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI] = 1.04-2.45), regular cannabis use (aOR 3.13 95% CI = 1.44-6.77), and alcohol/cannabis co-use (aOR 3.57, 95% CI = 1.89-6.75). In relation to low-risk use, reporting 4+ ACEs (vs. 0-1) was associated with 1.96 odds (95% CI = 1.01-3.78) of regular cannabis use and 2.24 odds (95% CI = 1.29-3.89) of alcohol/cannabis co-use.
DISCUSSION
Exposure to 4+ ACEs was associated with the occurrence of adolescent/young adulthood regular cannabis use and alcohol/cannabis co-use. Importantly, ACEs exposure differentiated young adults who were co-using compared to those engaged in low-risk use. Preventing ACE or interventions for Puerto Rican youth experiencing 4+ ACEs may mitigate negative consequences associated with alcohol/cannabis co-use.
目的
在波多黎各青少年中，不良的童年经历（ACEs）很常见。很少有针对拉丁裔青年的大型纵向研究探讨了哪些因素预测了青少年晚期和成年早期同时使用酒精和大麻。我们调查了 ACEs 与波多黎各青少年同时使用酒精和大麻之间的前瞻性关联。
方法
参与者来自波多黎各青少年的一项纵向研究（n=2004）。使用多项逻辑回归检验前瞻性报告的 ACEs（11 种类型，由父母和/或孩子报告，分为 0-1、2-3 和 4+ ACEs）与年轻成年人过去一个月内的酒精/大麻使用模式之间的关联（即无终生使用、低风险[无狂欢性饮酒和大麻使用<10]、仅狂欢性饮酒、仅定期使用大麻和酒精/大麻同时使用）。模型调整了社会人口统计学变量。
结果
在该样本中，27.8%的人报告了 4+ ACEs，28.6%的人狂欢性饮酒，4.9%的人定期使用大麻，5.5%的人同时使用酒精和大麻。与终生未使用者相比，报告 4+ ACEs（而非 0-1 ACEs）的个体更有可能出现低风险使用（调整后的优势比[aOR]1.60，95%置信区间[CI]为 1.04-2.45）、定期使用大麻（aOR 3.13，95%CI 为 1.44-6.77）和同时使用酒精和大麻（aOR 3.57，95%CI 为 1.89-6.75）。就低风险使用而言，报告 4+ ACEs（而非 0-1 ACEs）与定期使用大麻的 1.96 倍（95%CI 为 1.01-3.78）和同时使用酒精和大麻的 2.24 倍（95%CI 为 1.29-3.89）相关。
讨论
暴露于 4+ ACEs 与青少年/成年早期定期使用大麻和同时使用酒精和大麻有关。重要的是，ACEs 暴露区分了同时使用酒精和大麻的年轻人与低风险使用者。预防 ACE 或为经历 4+ ACEs 的波多黎各青年提供干预措施可能会减轻与同时使用酒精和大麻相关的负面后果。
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