Targets for Intervention to Prevent Substance Use in Young People Exposed to Childhood Adversity: A Systematic Review

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Jun 7

PMID 34097711

Citations 12

Authors

Lucinda Grummitt

Erin Kelly

Emma Barrett

Katherine Keyes

Nicola Newton

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Childhood adversity is a strong, and concerningly prevalent, risk factor for the later development of substance misuse. Yet despite substantial accumulating evidence for causal mechanisms, there has been little attempt to synthesize the strength of the evidence. Importantly, these mechanisms may be amenable to intervention, providing targets for substance use prevention among those exposed to childhood adversity. The present review aimed to systematically identify mediating and moderating mechanisms operating between childhood adversity and substance use.

Methods: A systematic review was conducted. Electronic databases (PubMed, MEDLINE, PsycINFO, Web of Science and CINAHL) were searched from 1998 to 2020 for modifiable mediators and moderators of the relationship between childhood adversity and substance use in people aged 10-24. Data was qualitatively synthesised, using a socio-ecological perspective to group mediators/moderators into individual, interpersonal, community, and public policy/cultural levels of behaviour.

Results: After screening against eligibility criteria, 50 studies were included in the current review. The mediators at the individual level of behaviour showing the largest and most consistent effect sizes included externalising behaviour, anger, coping motives for substance use, and post-traumatic stress symptoms. Among individual-level moderators, religiosity, future orientation and depressive symptoms all attenuated the relationship between childhood adversity and substance use. At the interpersonal level, peer relationships and mother-child relationships mediated the effect of adversity on substance use. Moderators included family cohesion and relationship quality. Community factors were less commonly studied, though school mobility and educational achievement mediated 14% and 28% of the total effect of childhood adversity on substance use respectively. No mediators or moderators were identified for public policy/culture.

Conclusions: A substantial proportion of the relationship between childhood adversity and substance use in youth is mediated through individual, interpersonal and community factors. Coupled with the knowledge that existing, evidence-based programs effectively address many of the identified mediators and moderators, this review advances knowledge on optimal targets to prevent substance misuse among those exposed to childhood adversity.

Citing Articles

Longitudinal Pathways From Maltreatment to Substance Use Through Delay Discounting During Adolescence and Into Young Adulthood.

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PMID: 39697391 PMC: 11650661. DOI: 10.1016/j.jaacop.2024.02.003.

Is Childhood Adversity Before Age 5 Associated with Adolescent and Young Adult Substance Use? Findings from a U.S. Prospective Cohort Study.

Mulia N, Li L, Williams E, Guo Z, Witbrodt J, Tam C Subst Use Misuse. 2024; 60(1):64-73.

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Refining the Universal, School-Based OurFutures Mental Health Program to Be Trauma Informed, Gender and Sexuality Diversity Affirmative, and Adherent to Proportionate Universalism: Mixed Methods Participatory Design Process.

Grummitt L, Bailey S, Kelly E, Birrell L, Gardner L, Halladay J JMIR Pediatr Parent. 2024; 7:e54637.

PMID: 39167794 PMC: 11375394. DOI: 10.2196/54637.

Sex Differences in the Relationship Between Nucleus Accumbens Volume and Youth Tobacco or Marijuana Use Following Stressful Life Events.

Assari S, Sheikhattari P J Ment Health Clin Psychol. 2024; 8(2):1-13.

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Prevalence and Correlates of Substance Use Among Youth Living with HIV in Fishing Communities in Uganda.

Brathwaite R, Mutumba M, Nannono S, Ssewamala F, Filiatreau L, Namatovu P AIDS Behav. 2024; 28(7):2414-2426.

PMID: 38605252 DOI: 10.1007/s10461-024-04339-6.

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