The Intervening Role of Urgency on the Association Between Childhood Maltreatment, PTSD, and Substance-Related Problems

A range of risk factors lead to opioid use and substance related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity—particularly urgency—and PTSD are related. Prior work has examined the association between these constructs and SRP largely independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment types, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP among those with significant maltreatment histories and negative urgency

The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems

A range of risk factors lead to opioid use and substance-related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity-particularly urgency-and PTSD are related. Prior work has examined the association between these constructs and substance-related problems independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP

Ecological systems contributors to internalizing symptoms in a national sample of adolescents during the COVID-19 pandemic

Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Leveraging data from a U.S. nationally diverse sample of 2,954 adolescents (ages 13-16), we examined the associations between factors at multiple levels of youths’ ecologies – spanning indicators of threat and deprivation – and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, we examined how these associations differed by adolescents’ racial/ethnic groups. Consistent with socio-ecological models, we found that indicators of threat and deprivation at the adolescents’ immediate home, and more distal neighborhood environments were associated with their depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socio-ecological predictors significantly differed across racial/ethnic groups. These findings have important implications for understanding multi-level contributors to mental health among adolescents which may inform research, practice, and policy