Sleep debt-induced anxiety and addiction to substances of abuse: A narrative review.

Substance Use Disorder (SUD) has been conceptualized as an outcome of a dysregulated reward system. However, individuals with SUD suffer from anxiety with an intensity depending on the abstinence period length. This review discusses the role of anxiety as a major contributor to the initiation and perpetuation of SUD, and its dependence on an up-regulated defense-antireward system. In addition, it is discussed that sleep debt, and its psychosocial consequences, promote anxiety, contributing to SUD generation and maintenance. Healthy sleep patterns can be disrupted by diverse medical conditions and negative psychosocial interactions, resulting in accumulated sleep debt and anxiety. Within this narrative review, we discuss the interplay between the motivation-reward and defense-antireward systems, framing the progression from recreational drug use to addiction. This interplay is nuanced by sleep debt-induced anxiety and its psychosocial consequences as contributory vulnerability factors in the genesis of addiction.

Mental health predictors of Internet Gaming Disorder: a longitudinal study.

OBJECTIVE: We aim to evaluate whether a wide range of baseline mental disorders predict Internet Gaming Disorder (IGD) one to three years later, among university students. METHODS: Prospective cohort study with a follow-up period of one to three years (September 2018-June 2022) in 6 Mexican universities. Participants were first-year university students (N=2,144) free of symptoms indicative of IGD at entry (baseline). Ten mental disorders (bipolar, major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder, binging and/or purging, intermittent explosive disorder, psychotic experiences, attention deficit hyperactivity disorder) at baseline were the main risk factors for IGD at the end of the follow-up. We used Cox regression to model the IGD incidence rate. RESULTS: Any mental disorder at baseline was associated with an increase in 2.33 times (1.26-4.31) the rate of IGD 1 to 3 years later. Several individual disorders were associated with rates of IGD in multiple models, with comorbid conditions diminishing most of these associations. CONCLUSIONS: Only major depressive disorder and bipolar disorder remained associated with a new case of IGD. Discrepant results from available longitudinal studies on the role of specific mental disorders in the development of IGD needs to be further investigated.

Substance Use and Its Relationship With Attachment and Early Maladaptive Schemes in Adolescents in Ecuador.

Given the scarcity of studies addressing substance consumption and its relationship with attachment styles and early maladaptive schemas in adolescents, the present study is proposed. Aims of this study are to analyze the relationship among attachment styles, early maladaptive schemas, and substance use; test the predictive role of attachment styles on substance use; and observe the mediating role of early maladaptive schemas in the relationship between attachment and substance use. The sample consisted of 1533 adolescents from Ecuador (53.9% males) aged between 14 and 18 years (M = 15.76; SD = 1.25). The attachment styles of security, value to parental authority, parental permissiveness, parental interference, self-sufficiency and resentment against parents, childhood trauma, and family concern predict substance use (tobacco, alcohol, tranquilizers/sedatives or sleeping pills, hashish or marijuana, cocaine, GHB or liquid ecstasy, ecstasy, amphetamines/speed, hallucinogens, heroin, inhalants/volatiles), and the mediating role of early maladaptive schemas is confirmed (explained variance up to 33.33%). Identifying risk or vulnerability factors, such as attachment and early maladaptive schemas related to substance consumption, is especially relevant for designing and implementing preventive interventions in the adolescent population.

Could school programs based on social-emotional learning prevent substance abuse among adolescents?

In this editorial, we comment on the article Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs by Liu et al. While the article focused on the issue of suicide and social-emotional learning programs as a possible intervention, we here discuss evidence of other reported outcomes and if it could be an effective way to prevent substance abuse among adolescents.

How Dangerous? Substance Use Risk Perceptions in Chilean Preadolescents.

Early substance use initiation among children represents a significant risk to public health. Research suggests that early positive perceptions and cognitions of elementary students toward substance use may predict later use during adolescence. Studies among adolescent populations have shown an inverse relationship between substance use and risk perceptions. To gain insight into alcohol, tobacco, and marijuana risk perceptions prior to adolescence, we analyzed data from the Chilean Early Childhood Longitudinal Survey (ELPI). In a sample of 5,278 families (mean age of preadolescents 10.63 years, SD = .64; 50.5% males), our findings showed that an important proportion of Chilean 10 years old did not perceive occasional tobacco, alcohol, or marijuana use to be high-risk activities. However, the majority of respondents did consider daily substance use to be a high-risk activity, with some variation across substances. Overall, older preadolescents were more likely to consider substance use to be less risky compared to their slightly younger counterparts. Our analysis also demonstrated that past month substances use by caregivers were all found to be predictive of low-medium risk perceptions among preadolescents surveyed, while conversely, caregivers' negative reactions to finding out their child had used a substance decreased the likelihood of holding low-medium risk perceptions. Individuals from single-parent households were less likely to consider substance use as being high-risk compared to their peers. Preadolescents with caregivers reporting higher average incomes were also more likely to hold lower risk perceptions of occasional substance use. Implications for public policies to prevent substance use in the pre-adolescent population are discussed.

Risk and protective factors associated with substance use among Puerto Rican youths after Hurricane María: a cross-sectional study.

BACKGROUND: Identifying factors associated with post-disaster youth substance use is a crucial element of developing evidence-based prevention and intervention efforts. Hurricane María struck Puerto Rico in September of 2017 and the wide-spread impact from this disaster, including exposure to trauma, displacement, and disrupted social supports had the potential to negatively impact levels of substance use among youth across the archipelago. However, post-disaster substance use remains under-investigated in this context. The current study sought to identify risk and protective factors associated with substance use among Puerto Rican youth in the aftermath of Hurricane Maria. METHODS: Cross-sectional, secondary data analyses were conducted using school-based survey data collected at all schools in Puerto Rico between February 1 and June 29, 2018 (5-9 months after Hurricane María). Social supports, substance use, and trauma symptoms were assessed. An ordinal regression analysis was conducted to identify student factors associated with greater likelihood of post-disaster substance use. RESULTS: A total of 36,485 participants (50.7% female, grades 7-12), were included in an ordinal regression analysis that compared the likelihood of respondents endorsing high, low, or no substance use after Hurricane María based on reported adult social support, counselor/teacher social support, peer social support, ptsd symptomatology, and gender. Findings showed that, when compared to students that endorsed low or no substance use, those who reported having adult social support demonstrated a 58% reduction in odds (OR = 0.42, 95% CI: 0.34-0.53) of reporting high substance use after Hurricane María, while students who reported having teacher/counselor social support demonstrated a 21% reduction in odds (OR = 0.79, 95% CI: 0.69-0.89) of reporting high substance use. Additionally, those that reported having peer social support demonstrated a 31% increase in odds (OR = 1.31, 95% CI: 1.10 to 1.58) of reporting higher substance use, compared to those that reported low or no substance use. CONCLUSIONS: While social support was generally protective, prevention efforts to build positive family and community connections may be indicated. Evidence-based school screenings of substance use and trauma may help direct intervention to those most at risk for co-occurring issues.

Substance use and adolescent mental health during the COVID-19 pandemic in Brazil: a longitudinal approach

Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.

Illicit Fentanyl Use and Hepatitis C Virus Seroconversion Among People Who Inject Drugs in Tijuana and San Diego: Results From a Binational Cohort Study.

BACKGROUND: Illicitly manufactured fentanyl (IMF) increases overdose mortality, but its role in infectious disease transmission is unknown. We examined whether IMF use predicts hepatitis C virus (HCV) and human immunodeficiency virus (HIV) incidence among a cohort of people who inject drugs (PWID) in San Diego, California and Tijuana, Mexico. METHODS: PWID were recruited during 2020-2022, undergoing semi-annual interviewer-administered surveys and HIV and HCV serological rapid tests through 2024. Cox regression was conducted to examine predictors of seroconversion considering self-reported IMF use as a 6-month lagged, time-dependent covariate. RESULTS: Of 398 PWID at baseline, 67% resided in San Diego, 70% were male, median age was 43 years, 42% reported receptive needle sharing, and 25% reported using IMF. HCV incidence was 14.26 per 100 person-years (95% confidence interval [CI]: 11.49-17.02), and HIV incidence was 1.29 (95% CI: .49-2.10). IMF was associated with HCV seroconversion, with a univariable hazard ratio (HR) of 1.64 (95% CI: 1.09-2.40), and multivariable HR of 1.57 (95% CI: 1.03-2.40). The direction of the relationship with HIV was similar, albeit not significant (HR 2.39; 95% CI: .66-8.64). CONCLUSIONS: We document a novel association between IMF and HCV seroconversion among PWID in Tijuana-San Diego. Few HIV seroconversions (n = 10) precluded our ability to assess if a similar relationship held for HIV. IMF's short half-life may destabilize PWID-increasing the need for repeat dosing and sharing smoking materials and syringes. New preventive care approaches may reduce HCV transmission in the fentanyl era.

Cannabidiol and addiction.

Cannabidiol (CBD) has been investigated for several therapeutic applications, having reached the clinics for the treatment of certain types of epilepsies. This chapter reviews the potential of CBD for the treatment of substance use disorders (SUD). We will present a brief introduction on SUD and current treatments. In the second part, preclinical and clinical studies with CBD are discussed, focusing on its potential therapeutic application for SUD. Next, we will consider the potential molecular mechanism of action of CBD in SUD. Finally, we will summarize the main findings and perspectives in this field. There is a lack of studies on CBD and SUD in comparison to the extensive literature investigating the use of this phytocannabinoid for other neurological and psychiatric disorders, such as epilepsy. However, the few studies available do suggest a promising role of CBD in the pharmacotherapy of SUD, particularly related to cocaine and other psychostimulant drugs.

Binational study on partner aggression in university students / Estudio binacional sobre las agresiones de pareja en estudiantes universitarios.

This research assesses violence in university students couples from Argentina and Ecuador. It focuses on its association with jealousy and other variables. Seven hundred and fourteen students (528 from the National University of La Plata, Argentina, and 186 students from the University of Cuenca, Ecuador) were surveyed using a cross cutting design. The measures used were Conflict in Adolescents Dating Relationships Inventory, Multidimensional Jealousy Scale, and other ad hoc methods related to faithfulness, substance use, and stress during dating relationship. A predominance of verbal/emotional violence was found, and 3.8% of the participants had high values in total abuse and more than half reported having committed at least one physical act against his/her partner. In a logistic regression model, it was also verified that belonging to the group of high violence was positive and significantly associated with factors behavioral jealousy, cognitive jealousy, stress and substance use and negative and significantly associated with the age at the beginning of the relationship.

En esta investigación se dimensiona comparativamente la violencia en parejas de estudiantes de nivel universitario de la Argentina y de Ecuador y se explora la asociación con los celos y otras covariables teóricamente relevantes mediante análisis multivariado. Con un diseño de corte transversal se encuestaron 714 estudiantes (528 de la Universidad Nacional de La Plata, Argentina, y 186 de Universidad de Cuenca, Ecuador). Los instrumentos utilizados fueron el Conflict in Adolescents Dating Relationships Inventory, la Multidimensional Jealousy Scale e items ad hoc sobre fidelidad, consumo de sustancias y estrés durante la relación de pareja. Si bien se halló un predominio de la violencia verbal/emocional, el 3,8 % de los participantes alcanzó alto valor en la medida de abuso total cometido y más de la mitad informó haber cometido, por lo menos, un acto violento físico durante la relación índice. En modelo de regresión logística se verificó que la condición de pertenecer al grupo de alta violencia se asoció positiva y significativamente con los factores celos comportamentales, celos cognitivos,estrés y consumo de sustancias, y negativa y significativamente con la edad al comienzo de la relación.

Adolescent health-risk behaviours in Uruguay: Patterns from national cross-sectional school surveys conducted in 2006, 2012 and 2019.

BACKGROUND: There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. METHODS: Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. RESULTS: We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. CONCLUSION: Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Explaining Substance Use among Puerto Rican Older Adults: Impact of Perceived Discrimination, Perceived Stress, and Social Activities.

Background: Despite Puerto Ricans having one of the highest rates of substance use among Hispanic groups in the United States, limited research has focused on the impact of perceived discrimination and stress on substance use among older adults. Individuals who experience stressful events are inclined to engage in harmful behaviors as a coping mechanism. Objectives: Based on the propositions of the General Strain Theory, the current study explores the relationship between perceived discrimination, perceived stress, social activities, and the use of alcohol and cigarettes. Methods: Baseline data from the Boston Puerto Rican Health Study collected in 2014 was used to conduct a logistic regression analysis. Results: The findings reveal that while perceived discrimination is significantly linked to both types of substance use, social activities may serve as a protective factor for cigarette use. Conclusion/Importance: Our study findings emphasize the need to examine perceived discrimination as a stressor impacting the health and well-being of Puerto Ricans in later adulthood. Policy implications for reducing substance use and directions for future research are discussed.

Implications of Impulsivity on Criminal Behavior in Individuals With Substance Use Disorder.

OBJECTIVE: Our aim was to analyze the association between criminal behavior and impulsivity in individuals with drug addiction and investigate whether impulsiveness mediates the relationship between drug use severity and legal problems. METHODS: This cross-sectional study included 773 men diagnosed with addiction (295 alcohol users and 478 users of crack/polysubstance) while undergoing addiction treatment. The BIS-11 and ASI-6 were applied to assess impulsivity, criminal behavior, and drug use. RESULTS: The prevalence of criminal behavior was 41.7% (n = 123) in alcohol users and 64.9% (n = 310) in users of crack/polysubstance. Earlier use of different substances and higher impulsivity scores were observed in individuals with criminal history. Mediation analyses revealed that impulsiveness acts as a mediator factor between substance use and criminal behavior, enhancing the severity of legal problems. CONCLUSION: Our findings can help in deciding on tailored treatment strategies, focusing not only on substance use, but also on the prevention of social problems, criminality, and impulsivity.

Voices of the unhoused from Santa Fe, New Mexico: A mixed methods study of health status, substance use, and community harm reduction program perspectives.

No published studies have examined the community service priorities and harm reduction perspectives of unhoused people in Santa Fe, New Mexico. We conducted a mixed methods pilot study of 56 unhoused people at community locations in Santa Fe to: (1) assess the current prevalence of chronic medical conditions and substance use; (2) highlight community service priorities; and (3) explore views of innovative community harm reduction programs. Our first hypothesis was there would be high prevalence of chronic medical conditions, for which we found high prevalence of post-traumatic stress disorder, major depression, substance use disorders, chronic pain, and hypertension. Our second hypothesis was that we would find top community service priorities of housing, food, and health care. We found long- and short-term housing and food, but not healthcare, top priorities. Our third hypothesis was that we would find mixed support for community harm reduction initiatives like managed alcohol programs and overdose prevention centers. We found positive, not mixed, support for these community harm reduction programs among Santa Fe's unhoused. Unhoused study participants ranged in age 27-77 years, with lifetime years unhoused from less than one year to 63 years. Study limitations included small sample size, convenience sampling, and descriptive results. Policies and program initiatives supporting additional Housing First options, managed alcohol programs, and overdose prevention centers in the Santa Fe community are clearly indicated to increase engagement with this vulnerable population. Future research should focus on inclusion of the perspectives of the unhoused in the design, conduct, evaluation, and dissemination of community programs to meet the needs of the unhoused, with re-defined outcomes to include changes in quality of life, program engagement, demarginalization, and future goals and plans, beyond currently utilized health and social service program outcome measures.

Examining the effects of parental migration on youth mental health and substance use: a qualitative study in rural Yucatán, México.

Background: Parental migration is common in Mexico and Latin America, where individuals pursue work to improve their family's economic opportunities and children remain home in their community under the care of the remaining parent or extended family. A research gap remains about the impact of parental migration on mental health and substance use in children who remain at home. The current study explored risk and resilience factors relating to mental health and substance use among Mexican youth remaining at home when one or more parents migrate. Methods: This qualitative study applied attachment theory and thematic analysis to analyze 26 in-depth interviews with youth (17-21 years old), parents, and a focus group with high-school teachers in a town with history of migration both domestically and internationally (Yucatan, México). Results: Respondents across groups perceived that parental migration was related to 1) less parental/caregiver oversight and support due to family demands on the remaining parent and 2) the deterioration of youth mental health. Lack of youth oversight and the poor mental health of youth were perceived as drivers of youth seeking out and consuming alcohol and substances. In terms of parental remittances, youth reported observing among their peers increased access to material goods such as clothing and technology (e.g., smartphones) and increased access to alcohol. Resilience factors included parental awareness of the role of good communication with youth and teachers and youth access to and utilization of self-care resources such as mutual aid meetings for substance use recovery. Conclusion: Poor mental health and substance use among youth and parents were perceived to be related to parental absence, stressors on the remaining parent or family, and undermined healthy parent-child attachment. Youth themselves are a source of insight for recommendations on interventions to reduce youth isolation and substance use risk. We recommend the intentional engagement of youth in developing intervention research and tailoring evidence-based interventions to mitigate parental absence's impact and promote parent-child attachment for youth and families remaining at home.

How policymakers innovate around behavioral health: adoption of the New Mexico "No Behavioral Health Cost-Sharing" law.

State policymakers have long sought to improve access to mental health and substance use disorder (MH/SUD) treatment through insurance market reforms. Examining decisions made by innovative policymakers ("policy entrepreneurs") can inform the potential scope and limits of legislative reform. Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation. Based on key informant interviews (n = 30), this study recounts the law's passage and intended impact. Key facilitators to the law's passage included receptive leadership, legislative champions with medical and insurance backgrounds, the use of local research evidence, advocate testimony, support from health industry figures, the severity of MH/SUD, and increased attention to MH/SUD during the COVID-19 pandemic. Findings have important implications for states considering similar laws to improve access to MH/SUD treatment.

Intervention diversity predicts social rehabilitation indicators at discharge in Therapeutic Communities.

INTRODUCTION: The Therapeutic Community Model narrows the gap in substance use disorder's network of assistance in Brazil by offering residential treatment to socially vulnerable populations. Due to a historical lack of evidence-based approaches, the government has established treatment guidelines and has been trying to implement training and monitoring methods. METHOD: This study analysed real-world data from the monitoring system implemented in the largest network of institutions receiving public funds in the State of Sao Paulo. Data came from 8109 records of individuals admitted between 2014 and 2016 in 48 institutions. RESULTS: Results showed that less than half of the sample was exposed to at least one therapeutic activity from each of the recreational, spiritual, educational and selfcare intervention domains, as proposed by the national guidelines. Social rehabilitation outcome (SRO) defined by housing and self-support at discharge was reported by 21 % of the sample, who stayed in residential treatment for 82.6 days in average. More than half completed the therapeutic programme while 27.3 % dropout. Treatment duration and the diversity of the interventions offered were significantly associated with SRO when mutually adjusted. Chances of SRO increased nearly 5 times when residents were offered the full range of intervention domains, even when controlling for treatment duration. Treatment duration increased chances of SRO in a dose-response manner with a threefold increase for stays up to 90 days and over 9 times for stays longer than 90 days. CONCLUSION: Our findings offer evidence to promote treatment guidelines compliance and to pave the way for the implementation of monitoring systems for this modality of treatment in Brazil and abroad.

Substance use and adolescent mental health during the COVID-19 pandemic in Brazil: a longitudinal approach.

OBJECTIVE: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. METHODS: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conducted in 73 public middle schools in three Brazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). RESULTS: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. CONCLUSIONS: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.

Quasi-randomized trial of solution-focused brief therapy intervention for readiness to change and alcohol and other drug use in a Brazilian community-based treatment center.

OBJECTIVE: Strategies to increase readiness to change may enhance community-based substance use treatment outcomes. This study evaluated the effect of solution-focused brief therapy (SFBT) on readiness to change and substance use compared to treatment as usual (TAU) in a Brazilian community-based substance use treatment center. METHODS: One hundred two adults (M = 36.79, SD = 10.29) were quasi-randomized into SFBT or TAU groups. Assessments were completed at baseline, post-test, and 1-month follow-up. The primary outcome was the changes in readiness to change at post-test and 1-month follow-up. The secondary outcome was the change in substance use at 1-month follow-up. RESULTS: Through Quade non-parametric analysis of covariance (ANCOVA), both groups decreased tobacco, alcohol, and cocaine/crack use at 1-month follow-up, but SFBT had greater reductions in alcohol use (p = .05). ANCOVA analysis demonstrated no differences between groups on readiness to change at any time point. However, among participants who used multiple substances (n = 59), SFBT showed higher readiness to change at post-test (p = .05). CONCLUSIONS: These findings strengthen the evidence that SFBT holds promise for positive community-based substance use treatment outcomes.

A network analysis of early trauma and impulsive behavior in individuals with mono- and poly-dependence of alcohol and crack cocaine.

OBJECTIVE: To investigate the relationship between impulsivity and early trauma through a network analysis in individuals diagnosed with different substance use disorders (SUD). METHODS: This cross-sectional study includes a sample of 556 men with SUD (195 with alcohol use, 157 with crack cocaine use and 214 with multiple substance use). The Childhood Trauma Questionnaire was applied to investigate early trauma and the Barratt Impulsiveness Scale to assess impulsive behavior. The connection between trauma and impulsivity was assessed using network analysis through Fused Graphical Lasso algorithm. RESULTS: No connection was observed between impulsivity and trauma networks in individuals with alcohol use. In cocaine users, networks were linked through the motor domain and sexual abuse nodes. Inversely connections were observed between emotional neglect node and perseverance and not planning nodes. In poly-use, the connection between impulsivity and trauma networks was weak, with cognitive complexity being the node that connects to the trauma network through physical abuse. There were inversely proportional connections between motor domain and emotional neglect nodes, and cognitive instability and physical neglect. CONCLUSIONS: Our results suggest that the relationship between the type of early (childhood) trauma and the expression of impulsivity could lead to a different substance use profile.