Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
Department of Psychology, Oklahoma State University, Stillwater, Oklahoma.
J Adolesc Health. 2024 Dec;75(6):890-903. doi: 10.1016/j.jadohealth.2024.07.014. Epub 2024 Sep 27.
Experiencing multiple adverse childhood experiences (ACEs) is associated with alcohol use in female adolescents and emerging adults. Protective and compensatory experiences (PACEs) have been theorized to off-set the health and behavioral consequences from the accumulation of ACEs throughout childhood. This study examines the association between protective experiences and subsequent alcohol and binge alcohol use frequency over one month among female adolescent and emerging adults reporting high and low levels of two ACE dimensions (household dysfunction and emotional abuse/neglect).
One hundred 43 females between the ages of 15-24 who indicated at least one binge episode in the past two weeks completed the six-item ACEs scale, the PACEs scale, and demographics at baseline. Alcohol consumption was measured prospectively over the next month during weekly appointments using the timeline follow back approach.
Two PACEs factors had significant direct associations, a source of unconditional love was associated with less frequent alcohol use (β = -0.437, 95% confidence interval [CI] -0.744, -0.131, exp(β) = 0.65, p = .005) in the context of high household dysfunction; and having a trusted adult to count on for help and advice (β = -1.373, 95% CI -2.283, -0.464, exp(β) = 0.25, p = .003) predicted fewer binge occasions in the context of high emotional abuse/neglect. Regardless of ACE dimension exposure, nonsport social group membership was associated more frequent alcohol use over the month across all ACE dimensions (β = 0.11-0.74, 95% CI -0.11, 0.74, exp(β) = 1.37 - 1.62, p ≤ .002); and having a trusted adult to count on for help and advice was associated with a 5.7 times more frequent of alcohol use among those with low household dysfunction (β = 1.74, 95% CI 0.83, 2.65, exp(β) = 5.70, p < .001).
Few PACE items are associated with direct reductions in alcohol outcomes. Indeed, there is consistently heightened risk associated with nonsport group membership for alcohol use frequency, regardless of experiences of childhood adversity. Future research should identify which protective factors have the most potential to off-set alcohol use by ACE dimension.
经历多种不良的童年经历（ACEs）与女性青少年和成年早期的饮酒行为有关。保护和补偿经历（PACEs）被认为可以减轻整个童年时期 ACEs 积累所带来的健康和行为后果。本研究考察了在报告两种 ACE 维度（家庭功能障碍和情感虐待/忽视）高水平和低水平的女性青少年和成年早期中，保护经历与随后一个月内的酒精和 binge 饮酒频率之间的关联。
100 名年龄在 15-24 岁之间的女性，在过去两周内至少有一次 binge 发作，她们在基线时完成了六项 ACEs 量表、PACEs 量表和人口统计学调查。在接下来的一个月内，通过每周预约使用时间线回溯法前瞻性地测量酒精消费。
两个 PACEs 因素有显著的直接关联，一个无条件的爱的来源与较高家庭功能障碍背景下较少的饮酒频率有关（β=-0.437，95%置信区间[-0.744，-0.131]，exp(β)=0.65，p=0.005）；而有一个可信赖的成年人可以帮助和提供建议（β=-1.373，95%置信区间[-2.283，-0.464]，exp(β)=0.25，p=0.003）则与较高情感虐待/忽视背景下较少的 binge 发作有关。无论 ACE 维度的暴露情况如何，非体育社交群体成员身份与整个 ACE 维度中一个月内更频繁的饮酒有关（β=0.11-0.74，95%置信区间-0.11，0.74，exp(β)=1.37-1.62，p≤0.002）；而有一个可信赖的成年人可以帮助和提供建议，则与家庭功能障碍较低的人更频繁的饮酒有关（β=1.74，95%置信区间 0.83，2.65，exp(β)=5.70，p<0.001）。
很少有 PACE 项目与直接减少酒精相关结果有关。事实上，无论童年逆境经历如何，非体育群体成员身份与酒精使用频率始终存在着更高的风险。未来的研究应该确定哪些保护因素最有可能通过 ACE 维度来减轻酒精使用。
