不良儿童经历与自杀意念和行为对青少年饮酒和吸食大麻频率的交互影响。
Interactive effect of adverse child experiences and suicidal thoughts and behaviors on adolescent alcohol and cannabis use frequency.
机构信息
Division of Behavioral Health, Calhoun Cardiology Center, School of Medicine, University of Connecticut.
Coordinated Care Services Inc.
出版信息
Psychol Addict Behav. 2023 Dec;37(8):1019-1029. doi: 10.1037/adb0000947. Epub 2023 Jul 13.
OBJECTIVE
Adolescents with adverse childhood experiences (ACEs) and suicidality may engage in high levels of substance use to alleviate distress. Most studies of associations among ACEs, suicidality, and substance use rely on retrospective reports by adults. Comparatively less is known about concurrent relationships between ACEs, suicide risk, and substance use in adolescents, which is important for prevention. This study tested if the associations between ACEs and drinking and between ACEs and cannabis use would be even stronger among youth with suicidal ideation or attempt, relative to youth without suicidal ideation or attempt.
METHOD
High schoolers ( = 1,625; 50.8% male; 47.1% female; 2% nonbinary) from western New York completed the Youth Risk Behavior Survey. Ordinal regressions tested main effects and interactions of the number of ACEs and suicidal ideation/behavior (i.e., none, ideation/plan, attempt) on categories of past-month drinking and cannabis days of use, controlling for age, gender, and race/ethnicity.
RESULTS
Significant ACEs by suicide interactions on adolescent drinking indicate that the association between ACEs and drinking was stronger for adolescents with suicide attempt adjusted odds ratio (AOR = 2.63) compared to youth with no ideation or attempt (AOR = 1.56) and suicidal ideation/planning only (AOR = 1.58). Main effects of ACEs (AORs = 1.95-2.08) and suicide attempt (vs. no suicidal ideation/attempt [AOR = 2.11] and suicidal ideation/plan [AOR = 2.11]) were associated with greater cannabis use; interactions were not significant.
CONCLUSIONS
Associations between ACEs and drinking were particularly strong for adolescents with suicide attempt. Conversely, ACEs and suicide attempt were independently associated with cannabis use. Mitigating against ACEs may reduce both adolescent alcohol and cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
目的
有不良童年经历（ACEs）和自杀意念的青少年可能会大量使用物质来缓解痛苦。大多数关于 ACEs、自杀意念和物质使用之间关联的研究都依赖于成年人的回顾性报告。相比之下，青少年时期 ACEs、自杀风险和物质使用之间的并发关系知之甚少，这对于预防很重要。本研究检验了 ACEs 与饮酒之间的关联，以及 ACEs 与大麻使用之间的关联，在有自杀意念或尝试的青少年中，相对于没有自杀意念或尝试的青少年，这些关联是否更强。
方法
来自纽约西部的高中生（n=1625；50.8%为男性；47.1%为女性；2%为非二元性别）完成了《青少年风险行为调查》。有序回归检验了 ACEs 数量和自杀意念/行为（即无、意念/计划、尝试）与过去一个月饮酒和大麻使用天数的主要效应和交互作用，控制了年龄、性别和种族/民族。
结果
自杀意念/行为与 ACEs 的交互作用对青少年饮酒有显著影响，表明 ACEs 与饮酒的关联在有自杀尝试的青少年中更强（调整后的优势比[AOR]=2.63），而在没有自杀意念或尝试的青少年中较弱（AOR=1.56），在只有自杀意念/计划的青少年中也较弱（AOR=1.58）。ACEs 的主要效应（AORs=1.95-2.08）和自杀尝试（与无自杀意念/尝试相比[AOR=2.11]，与自杀意念/计划相比[AOR=2.11]）与大麻使用量增加有关；交互作用不显著。
结论
自杀尝试与 ACEs 之间的关联在有自杀尝试的青少年中尤其强烈。相反，ACEs 和自杀尝试与大麻使用独立相关。减轻 ACEs 可能会减少青少年的酒精和大麻使用。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
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