Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jan;35(1):7-13.
doi: 10.1016/j.addbeh.2009.07.004. Epub 2009 Aug 8.

Adverse childhood events as risk factors for substance dependence: partial mediation by mood and anxiety disorders

Kara R Douglas  1 , Grace Chan, Joel Gelernter, Albert J Arias, Raymond F Anton, Roger D Weiss, Kathleen Brady, James Poling, Lindsay Farrer, Henry R Kranzler
Affiliations

Adverse childhood events as risk factors for substance dependence: partial mediation by mood and anxiety disorders

Kara R Douglas et al. Addict Behav. 2010 Jan.

Abstract

Aims: Adverse childhood events (ACEs) are associated with negative health outcomes. We examined ACEs as risk factors for substance dependence (SD) and the mediating effects of mood and anxiety disorders on the relations between ACEs and SD risk.

Design: We compared early life experiences in 2061 individuals with a lifetime diagnosis of alcohol, cocaine, or opioid dependence and 449 controls.

Measurements: Diagnostic and ACE data were obtained using the Semi-Structured Assessment for Drug Dependence and Alcoholism.

Findings: Childhood abuse or exposure to violent crime was positively related to the number of lifetime mood and anxiety disorders and to SD risk. Mood and anxiety disorders had their first onset a mean of nearly 3 years before the first SD diagnosis and partially mediated the effect of ACEs on SD risk.

Conclusion: ACEs appear to contribute additively to the risk of SD, with mood and anxiety disorders in the causal path for a portion of this risk. The identification and effective treatment of mood and anxiety disorders associated with ACEs could reduce the risk of developing SD.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cross-classification frequencies of three traumatic childhood experiences (TCEs): violent crime, sexual abuse, and physical abuse.
Figure 2
Figure 2
Cross-classification frequencies of lifetime alcohol, cocaine, and opioid dependence. Note that the number of subjects with each disorder or combination of disorders includes only those with complete data on all three dependence diagnoses, so that the total is less than the total subject sample included in the analyses.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. 4th Edition. American Psychiatric Press Inc: Washington, DC; 1994. Diagnostic and Statistical Manual of Mental Disorders.
    1. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience. 2006;256(3):174–186. - PMC - PubMed
    1. Anda RF, Whitfield CL, Felitti VJ, Chapman D, Edwards VJ, Dube SR, et al. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services. 2002;53(8):1001–1009. - PubMed
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology. 1986;51(6):1173–1182. - PubMed
    1. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry. 1994;151(8):1132–1136. - PubMed

Publication types