Zhu Jenney, Racine Nicole, Devereux Chloe, Hodgins David C, Madigan Sheri
Department of Psychology, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
School of Psychology, University of Ottawa, Ottawa, ON, Canada; Children's Hospital of Eastern Ontario Research Institute.
Child Abuse Negl. 2023 Sep 7:106431. doi: 10.1016/j.chiabu.2023.106431.
Adverse childhood experiences (ACEs) can be associated with negative health outcomes such as substance use. However, extant literature assessing this association is mixed.
The present meta-analysis was conducted to obtain a pooled effect size for the association between ACEs and substance use (i.e., smoking, problematic alcohol use, heavy alcohol use, illicit drug use, and cannabis use).
The present meta-analyses included 102 studies (N = 901,864), where 42.32 % of participants were male, and the mean age was 30.91 years.
Searches were conducted in MEDLINE, Embase, and PsycINFO in August 2021 and moderators were examined. Inclusion criteria included studies that measured ACEs prior to age 18 and substance use, and were published in English. All analyses were completed in Comprehensive Meta-Analysis Software, Version 3.0 (Borenstein et al., 2009).
Pooled effect sizes between ACEs and smoking [OR = 1.803 (95 % CI 1.588, 2.048)], problematic alcohol use [OR = 1.812 (95 % CI 1.606, 2.044)], heavy alcohol use [OR = 1.537 (95 % CI 1.344, 1.758)], cannabis use [OR = 1.453 (95 % CI 1.184, 1.786)] and illicit drug use [OR = 1.695 (95 % CI 1.530, 1.878)] were significant. Significant moderators contribute to the understanding of the association between ACEs and substance use, and are discussed extensively.
ACEs confer risk for substance use and trauma-informed approaches to substance use treatment should be considered. Study limitations and implications are discussed.
童年不良经历（ACEs）可能与诸如物质使用等负面健康结果相关。然而，评估这种关联的现有文献结果不一。
进行本次荟萃分析以获得ACEs与物质使用（即吸烟、有问题的酒精使用、大量饮酒、非法药物使用和大麻使用）之间关联的合并效应量。
本次荟萃分析纳入了102项研究（N = 901,864），其中42.32%的参与者为男性，平均年龄为30.91岁。
于2021年8月在MEDLINE、Embase和PsycINFO中进行检索，并对调节因素进行了考察。纳入标准包括在18岁之前测量ACEs和物质使用情况且以英文发表的研究。所有分析均在综合荟萃分析软件3.0版（Borenstein等人，2009年）中完成。
ACEs与吸烟[比值比（OR）= 1.803（95%置信区间1.588，2.048）]、有问题的酒精使用[OR = 1.812（95%置信区间1.606，2.044）]、大量饮酒[OR = 1.537（95%置信区间1.344，1.758）]、大麻使用[OR = 1.453（95%置信区间1.184，1.786）]以及非法药物使用[OR = 1.695（95%置信区间1.530，1.878）]之间的合并效应量均具有统计学意义。显著的调节因素有助于理解ACEs与物质使用之间的关联，并进行了广泛讨论。
ACEs会增加物质使用的风险，应考虑采用创伤知情的物质使用治疗方法。讨论了研究的局限性和意义。
