A Hospital-Based Infant Safe Sleep Intervention and Safe Sleep Practices Among Young Women: A Prospective Longitudinal Study.

INTRODUCTION: The rates of sudden unexpected infant death (SUID) are still high in the U.S. The longitudinal effects of SUID preventive education on infant safe sleep practices are less known. The current study evaluated the effects of a comprehensive hospital-based, SUID preventive intervention on safe infant sleep practices in the first six months of life and to identify factors associated with infant sleep practices. METHODS: Using a one-group pretest and multiple posttest design, the current quantitative study examined the impacts of the infant safe sleep intervention among 411 women recruited at a large, urban, university medical center. Participants were prospectively followed and completed four surveys from childbirth. Linear mixed models were used to evaluate the effects of the SUID prevention program on four sleep practice outcomes, including removing unsafe items from the sleeping environment, bed sharing, room sharing without bed sharing, and placing the infant in a supine sleep position. RESULTS: Compared to the baseline, participants were less likely to use unsafe items (e.g., soft bedding) in infants' sleeping areas over time. However, we found that participants reported more frequent bed sharing at 3-month and 6-month follow-ups, compared to the baseline. CONCLUSIONS: Overall, maternal education and family income were positively related to healthy infant safe sleep practices. A hospital-based preventive intervention pairing an educational initiative with home-visiting services might improve safe sleep practices to remove accidental suffocation risks from the infant sleep environment.

Improving Birth Outcomes Among Low-Income Families: The Effect of a Home Visiting Intervention.

The American Academy of Pediatrics (AAP) recognizes the benefit of home visiting programs in promoting positive birth outcomes. Despite this recommendation, previous studies have found mixed results with respect to the impact of home visits on birth outcomes. We evaluated the impact of the Comprehensive Health Investment Project (CHIP) home visiting services on improving birth outcomes among low-income families. The present study used a sample of 1,110 children and families to examine how a team-based home visiting program influenced 2 significant birth outcomes, namely, birth weight and preterm birth. Using propensity score matching, the current study found that the home visited group had significantly lower rates of low birth weight compared with a propensity-matched comparison group (P < .01). Home visiting programs may play an important role in promoting positive birth outcomes, particularly when they are provided during pregnancy.

Understanding the Intergenerational Cycle of Trauma and Violence: Maternal Adverse Childhood Experiences and Parent-to-Child Aggression Risk.

Adverse childhood experiences (ACEs), such as exposure to maltreatment and household dysfunction, are major risk factors for physical and mental health problems across the lifespan. While the relationship between ACEs and health outcomes is well established, what effects ACEs might have on parent-to-child aggression are less known. The negative consequences of ACEs on parental aggression can be even more pronounced with multiple exposures to different patterns of ACEs. This study examined the association between patterns of maternal ACEs and subsequent parent-child aggression risk. A diverse sample of young women (N = 329; mean age = 26.3 years) was recruited at a large, urban university medical center. Participants completed self-report measures of the ACEs Questionnaire and the Adult-Adolescent Parenting Inventory-2. Latent class analysis was used to identify classes of women with similar patterns of exposure to ACEs and to examine the associations between ACEs classes and parent-to-child aggression risk. Three latent classes, characterized by distinct patterns of maternal ACEs, were identified: Low ACEs (63% of the sample), High Parental Separation/Divorce (20%), and High/Multiple ACEs classes (17%). Women in the High/Multiple ACEs class were more likely to report higher levels of parent-to-child aggression risk (i.e., inappropriate expectations, belief in corporal punishment, lack of empathy) than those in the other classes (Wald(2) = 8.63, p = .013). Preventive interventions targeting parental attitudes and behaviors among young women exposed to ACEs may decrease the risk for further perpetuation of aggression in the next generations.

The Effects of Father-Perpetration of Maltreatment on Adolescent Health Risk.

Maltreatment perpetrated by fathers may entail distinct characteristics and threats, and therefore differing effects from maltreatment perpetrated by mothers alone. This study examines the extent to which father perpetration of maltreatment is associated with variability in subsequent adolescent health outcomes relative to mother-alone maltreatment. A sample of youth (N = 377) with recently completed Child Protective Services investigations concerning reports of maltreatment attributed to fathers and/or mothers was drawn from the second National Survey of Child and Adolescent Well-being. Youth were 11-17 years old (M = 13.8, SD = 2) at 18-month follow-up. Predictor variables (baseline) included caseworker-reported perpetrator (father vs mother alone), maltreatment type and severity, and co-occurring risk factors (prior reports of maltreatment, caregiver substance use, serious mental health problems, and recent arrest or detention, and intimate partner violence). Outcome measures were youth-reported sexual risk behavior (the number of past-year sexual partners), substance use severity (use of illicit drugs other than marijuana, number of substances used, and CRAFFT raw scores), and parent-to-adolescent physical aggression (minor, moderate, and severe) at 18-month follow-up. Structural equation modeling assessed the effects of father perpetration on outcomes. Father perpetration was prospectively associated with more parent-to-adolescent aggression (ß = 0.16, p = .034) and less sexual risk behavior (ß = -0.17, p = .017) than mother-alone perpetration. Findings suggest protective effects of father perpetration relative to mother-alone perpetration on sexual risk taking but greater risk on further victimization by parents. Future research is needed to replicate findings and examine potential youth gender differences.

An Exploration of Practitioners' Perceptions and Beliefs About Trauma-Informed Youth Drug Prevention Programs: a Qualitative Study.

Adverse childhood experiences (ACEs), such as childhood maltreatment and household dysfunction, have been linked to adolescent substance use. As a result, there exists a pressing need for trauma-informed, substance use preventive intervention for adolescents with a history of ACEs. The primary aim of this qualitative study is to increase our understanding of practitioners' perceptions of substance use among ACE-exposed youth and their views on trauma-informed adolescent substance use prevention programs. The present study conducted six focus groups (N = 32) among current child and adolescent health and human service providers in a mid-Atlantic urban area. The focus groups explored the practitioners' views on the main reasons that youth with a history of ACEs use illicit substances and suggestions on components, constructs, or techniques of trauma-informed substance use prevention programs and perceived barriers in implementing such programs. Transcripts of the focus groups were analyzed using open coding and subsequent axial coding, which was followed by thematic analysis. Thematic analysis identified ten themes within three categories, including the etiology of substance use among ACE-exposed youth, barriers to preventing substance use among ACEs-exposed youth, and suggested program components for trauma-informed prevention programs. These findings provide support for developing a preventive intervention that addresses trauma symptoms and overall skill buildings to prevent substance use among ACE-exposed youth. Teaching skills to cope with trauma symptoms, enhancing knowledge about the signs and symptoms of trauma, and improving key social and emotional learning competencies might be important and effective strategies to curb substance use among ACE-exposed youth.

The roles of child maltreatment and fathers in the development of substance use in an at-risk sample of youth: A longitudinal study.

BACKGROUND: Despite ample cross-sectional evidence linking child maltreatment and father involvement to adolescent substance use, little is known about the longitudinal impact of child maltreatment and father involvement in the developmental course of substance use from early adolescence to late adolescence. OBJECTIVE: The primary aim of the study was to examine the long-term effects of childhood maltreatment (i.e., maltreatment type, perpetrator identity) and the quality and quantity of father involvement on developmental trajectories of substance use among high-risk youth. PARTICIPANTS AND SETTING: Data were drawn from the Longitudinal Studies of Child Abuse and Neglect. Study participants included 681 U.S. adolescents who had experienced or were at risk for child maltreatment. METHODS: Latent Growth Poisson Modeling was conducted to examine developmental trajectories of substance use at ages 12, 14, 16, and 18. RESULTS: Child emotional abuse and greater quantity of father involvement were associated with a higher initial number of substances used, while higher quality of father-child relationships was associated with a lower initial number of substances used. Emotional abuse and greater quantity of father involvement were associated with slower increases in the number of substances used over time. CONCLUSIONS: The findings suggest that engaging fathers and promoting nurturing parenting and positive parent-adolescent interactions may be important for programs and policies aimed to prevent early adolescent substance use initiation. Furthermore, early identification of emotional abuse among adolescents could help to prevent initial polysubstance use onset.

Preventing E-cigarette use among high-risk adolescents: A trauma-informed prevention approach.

Exposure to childhood trauma increases the risk of tobacco use during adolescence. Recent studies have also reported potentially increased vulnerabilities to electronic cigarette (e-cigarette) use among youth with a history of childhood trauma. While empirical evidence supporting the relationship between childhood trauma and adolescent e-cigarette use is emerging, few effective preventive interventions are available to curb e-cigarette use among adolescent victims of childhood trauma. This article reviews current evidence with respect to how childhood trauma could increase risk for nicotine dependence and e-cigarette use in adolescent populations. Furthermore, this paper describes the development, design, and implementation of Rise Above (RA), a randomized, controlled trial of a trauma-informed, e-cigarette preventive intervention. Lessons learned are also discussed, including the challenges of implementing evidence-informed prevention work within communities vulnerable to traumatic events.

Maternal adverse childhood experiences and postpartum depressive symptoms in young, low-income women.

OBJECTIVES: Exposure to adverse childhood experiences (ACEs), such as child maltreatment and family dysfunction, is highly prevalent. Previous research has shown an association between ACEs and adult depression. The aim of the current study was to expand the existing literature by testing the association between ACEs and postpartum depression (PPD) symptoms in an urban, ethnically diverse sample of women. METHODS: Participants (N = 746; ages 18-47; mean age = 27.3) were recruited at a large, urban university medical center as part of the Longitudinal Infant and Family Environment (LIFE) study. The association between ACEs and PPD symptoms were tested via hierarchical linear regression models. RESULTS: The majority of the participants (61%) reported experiencing at least one type of ACEs prior to age 18. ACEs were positively associated with PPD symptoms (ß = .29, p < .001), controlling for maternal race/ethnicity, age, educational attainment, marital status, household income, and infant gender and birth order. CONCLUSIONS: The results showed that exposure to ACEs was related to PPD symptoms among low-income women. Screenings for ACEs during prenatal checkups may help identify women at risk of depression and facilitate timely prevention and treatment efforts.

Childhood maltreatment, motives to drink and alcohol-related problems in young adulthood.

BACKGROUND: Young adults with a history of child maltreatment (CM) are often vulnerable to alcohol-related problems. Drinking motives have been widely studied to explain alcohol-related problems in young adulthood. OBJECTIVES: The aims of the current study were to examine the link between CM and alcohol-related problems and to test whether CM is indirectly related to alcohol-related problems via different types of drinking motives. PARTICIPANTS AND SETTING: Two hundred eight participants were recruited in a mid-Atlantic urban area (M age = 19.7, 78.4 % female) via advertisements placed throughout the community. METHODS: Participants completed self-report measures of CM (Childhood Trauma Questionnaire), types of drinking motives (the Drinking Motives Questionnaire Revised Short Form), and alcohol-related problems (Rutgers Alcohol Problem Index). Structural equation modeling (SEM) was used to test whether CM was associated with alcohol use, both directly and indirectly, through drinking motives. RESULTS: We found that both coping (ß = 0.53,p < 0.001) and enhancement drinking motives (ß = 0.15, p = 0.031) were associated with alcohol-related problems. Additionally, CM was related to alcohol-related problems indirectly via coping motive (ß = 0.11, p = 0.028). CONCLUSION: Young adults with a history of CM may use alcohol to cope with trauma-related negative emotionality. Targeting emotional distress in CM-exposed individuals may be helpful in preventing and treating alcohol-related problems in this vulnerable population.

Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms.

BACKGROUND: Childhood maltreatment (CM) has been repeatedly linked to future problem drinking. Depression has been identified as a potential factor contributing to problematic alcohol use in maltreated individuals. However, depression has been operationalized as the presence or number of depression symptoms in the majority of previous studies. The role of other relevant measures of depression, such as depressive implicit associations, is not well understood. OBJECTIVES: The present study addresses this gap in the literature by examining the mediating role of both depression symptoms and depressive implicit associations. METHODS: A community sample of young adults (N = 208, mean age = 19.7, 78.4% females) completed self-report measures of CM, depression symptoms, and problem drinking. Depressive implicit associations were assessed by a computer-based implicit association test (IAT). Structural equation modeling (SEM) was used to examine the direct link between CM and problem drinking as well as indirect links through depression symptoms and depressive implicit associations. RESULTS: CM was significantly associated with both depression symptoms (ß = 0.35, p < .001) and depressive implicit associations (ß = 0.36, p < .001). Additionally, CM was associated with problem drinking indirectly via depression symptoms during young adulthood (ß = .06, p = .019). CONCLUSION: Our study provides evidence for the role of depression symptoms, but not for depressive implicit associations, in linking CM and problem drinking. Treating depression in individuals with a history of CM may help to prevent problem drinking in this vulnerable population.

Childhood maltreatment and alcohol-related problems in young adulthood: The protective role of parental warmth.

BACKGROUND: Alcohol use among young adults is highly prevalent. Individuals exposed to childhood maltreatment are particularly vulnerable to alcohol use and alcohol-related problems. Few studies have examined family protective factors, such as parental warmth, that may mitigate the effects of childhood maltreatment on alcohol-related problems. OBJECTIVE: The current study seeks to examine the extent to which parental warmth reduces the effect of childhood exposure to maltreatment on alcohol-related problems in young adulthood. PARTICIPANTS AND SETTING: Participants were young adults (N = 337; mean age = 21.7), who were recruited from an urban community and completed in-person interviews assessing childhood maltreatment, parental warmth, and alcohol-related problems. METHODS: Multiple hierarchical linear regression models were used to examine whether maternal and paternal warmth reduced the impact of childhood exposure to maltreatment on alcohol-related problems in young adulthood. Common risk factors for alcohol-related problems, including psychological symptoms and peer and parental alcohol use, were also entered into the models. RESULTS: We found a significant moderating effect of paternal warmth on the associations between childhood emotional abuse and alcohol-related problems (ß= -0.29, p < .05). Specifically, the association between emotional abuse and alcohol-related problems was weaker among individuals with higher levels of paternal warmth. Moderating effects of maternal warmth on the maltreatment-problematic alcohol use relation were not supported. CONCLUSION: The results of this research suggest that parental warmth may not only relate to fewer alcohol-related problems among offspring, but may also modify the associations between childhood emotional abuse and alcohol-related problems during young adulthood.

Adverse Childhood Experiences and E-Cigarette Use During Young Adulthood.

BACKGROUND AND OBJECTIVES: E-cigarette use among young people is highly prevalent. Individuals exposed to adverse childhood experiences such as childhood maltreatment (CM) may be at particular risk, as CM has been linked to nicotine dependence. Studies testing the association between CM and e-cigarette use are lacking, including research that examines pathways linking CM to e-cigarette use. METHODS: Using a community sample of young adults (N = 208; ages 18-21), we examined the relationship between CM and e-cigarette use and explored the potential role of impulsivity in linking CM to e-cigarette use via a series of structural equation models controlling for demographic characteristics. RESULTS: CM was significantly associated with lifetime e-cigarette use. Furthermore, CM was associated with negative urgency (NU), whereas NU and sensation seeking were significantly related to lifetime e-cigarette use. NU fully mediated the relationship between CM and lifetime e-cigarette use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Our results suggest that young adults with a history of CM might be vulnerable to e-cigarette use and that NU played a significant role in linking CM to lifetime e-cigarette use. Addressing NU in young adults with a history of CM might be a useful avenue for preventing e-cigarette use in this population. (Am J Addict 2019;28:303-310).

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes.

INTRODUCTION: Childhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use. METHOD: Young adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models. RESULTS: We found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood. CONCLUSION: The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.

Profiles of adverse childhood experiences and impulsivity.

The influence of adverse childhood experiences (ACEs), which often include childhood exposure to maltreatment and household dysfunction, on health risk behaviors during young adulthood has been widely documented. A vulnerability marker for the increased risky behaviors among young ACEs victims such as impulsivity remains to be explored. The present study investigated how different profiles of ACEs influence impulsivity in young adulthood. Respondents were young people (N = 336; ages 18-25) who were recruited from the community. Latent class analysis (LCA) was used to identify subpopulations of individuals based on varying exposure to 13 types of ACEs, including childhood maltreatment, household dysfunction, and community violence. Four distinct classes emerged: Low ACEs (56%), Household Dysfunction/Community Violence (14%), Emotional ACEs (14%), and High/Multiple ACEs (16%). Multiple regression analyses found that compared to those in the Low ACEs class, young adults in the Emotional ACEs and High/Multiple ACEs respectively, reported increased levels of negative urgency, controlling for sociodemographic characteristics and other impulsivity traits. This result suggests that childhood exposure to multiple ACEs at high levels is particularly related to impulsive self-control in the context of intense negative emotionality.

Patterns of adverse childhood experiences and substance use among young adults: A latent class analysis.

INTRODUCTION: Adverse childhood experiences (ACEs) have been strongly linked with subsequent substance use. The aim of this study was to investigate how different patterns of ACEs influence substance use in young adulthood. METHODS: Using a community sample of young individuals (N=336; ages 18-25), we performed latent class analyses (LCA) to identify homogenous groups of young people with similar patterns of ACEs. Exposure to ACEs incorporates 13 childhood adversities including childhood maltreatment, household dysfunction, and community violence. Multiple linear and logistic regression models were used in an effort to examine the associations between ACEs classes and four young adult outcomes such as alcohol-related problems, current tobacco use, drug dependence symptoms, and psychological distress. RESULTS: LCA identified four heterogeneous classes of young people distinguished by different patterns of ACEs exposure: Low ACEs (56%), Household Dysfunction/Community Violence (14%), Emotional ACEs (14%), and High/Multiple ACEs (16%). Multiple regression analyses found that compared to those in the Low ACEs class, young adults in the High/Multiple ACEs class reported more alcohol-related problems, current tobacco use, and psychological symptoms, controlling for sociodemographic characteristics and common risk factors for substance use such as peer substance use. CONCLUSIONS: Our findings confirm that for many young people, ACEs occur as multiple rather than single experiences. The results of this research suggest that exposure to poly-victimization during childhood is particularly related to substance use during young adulthood.

Evaluation of Yoga for Preventing Adolescent Substance Use Risk Factors in a Middle School Setting: A Preliminary Group-Randomized Controlled Trial.

Adolescence is a key developmental period for preventing substance use initiation, however prevention programs solely providing educational information about the dangers of substance use rarely change adolescent substance use behaviors. Recent research suggests that mind-body practices such as yoga may have beneficial effects on several substance use risk factors, and that these practices may serve as promising interventions for preventing adolescent substance use. The primary aim of the present study was to test the efficacy of yoga for reducing substance use risk factors during early adolescence. Seventh-grade students in a public school were randomly assigned by classroom to receive either a 32-session yoga intervention (n = 117) in place of their regular physical education classes or to continue with physical-education-as-usual (n = 94). Participants (63.2 % female; 53.6 % White) completed pre- and post-intervention questionnaires assessing emotional self-regulation, perceived stress, mood impairment, impulsivity, substance use willingness, and actual substance use. Participants also completed questionnaires at 6-months and 1-year post-intervention. Results revealed that participants in the control condition were significantly more willing to try smoking cigarettes immediately post-intervention than participants in the yoga condition. Immediate pre- to post-intervention differences did not emerge for the remaining outcomes. However, long-term follow-up analyses revealed a pattern of delayed effects in which females in the yoga condition, and males in the control condition, demonstrated improvements in emotional self-control. The findings suggest that school-based yoga may have beneficial effects with regard to preventing males' and females' willingness to smoke cigarettes, as well as improving emotional self-control in females. However additional research is required, particularly with regard to the potential long-term effects of mind-body interventions in school settings. The present study contributes to the literature on adolescence by examining school-based yoga as a novel prevention program for substance use risk factors.

Identifying Sensitive Periods for Alcohol Use: The Roles of Timing and Chronicity of Child Physical Abuse.

BACKGROUND: Childhood maltreatment, particularly physical abuse (PA), increases the risk of alcohol use during young adulthood. Although prior research underscores the importance of examining the roles of PA-event characteristics such as timing of and chronicity of PA in initiating and maintaining alcohol use, few studies have explored the risk of developing alcohol use based on the timing and chronicity of PA. METHODS: Using a community sample of 300 young adults (ages 18 to 25), this study examined how variations in timing and chronicity of PA relate to 4 distinct drinking behaviors including drinking frequency, binge drinking, alcohol-related problems, and alcohol use disorder (AUD) in the past 12 months. We controlled for sociodemographic information, other types of maltreatment, and common risk factors for alcohol use, such as psychological distress, parental alcoholism, and peer alcohol use in all analyses. This study used person-centered and developmental-stage-based characterizations of PA timing and chronicity to explore the relationship between timing and chronicity of PA and later drinking behaviors. RESULTS: Overall, individuals who were physically abused, particularly during adolescence, and who chronically experienced PA, reported higher levels of monthly drinking frequency and more pathological drinking behaviors such as binge drinking, alcohol-related problems, and AUD. CONCLUSIONS: This study describes the specific roles of timing and chronicity of PA in understanding the increased vulnerability to alcohol use among victims of PA. Our findings suggest that PA during adolescence and chronic PA are related to problematic drinking behaviors in young adulthood.

The different faces of impulsivity as links between childhood maltreatment and young adult crime.

Crime is a major public health and safety threat. Many studies have suggested that early exposure to child maltreatment increases an individual's risk for persistent serious crime in adulthood. Despite these findings about the connection between child maltreatment and criminal behavior, there is a paucity of empirically-based knowledge about the processes or pathways that link child maltreatment to later involvement in crime. Using a community sample of 337 young adults (ages 18-25) in a U.S. metropolitan area, the present study examined the role of various facets of impulsivity in linking child maltreatment to crime. A series of factor analyses identified three types of crime including property crime, violent crime, and fraud. Structural equation modelings were conducted to examine the associations among childhood maltreatment, four facets of impulsivity, and criminal behavior, controlling for sociodemographic information, family income and psychological symptoms. The present study found that child emotional abuse was indirectly related to property crime and fraud through urgency while a lack of premeditation mediates the relationship between child neglect and property crime. Child physical abuse was directly related to all three types of crime. Personality traits of urgency and lack of premeditation may play a significant role in the maltreatment-crime link. Preventive interventions targeting impulsivity traits such as urgency and a lack of premeditation might have promising impacts in curbing criminal behavior among maltreatment victims.

Examining the role of psychological distress in linking childhood maltreatment and alcohol use in young adulthood.

BACKGROUND AND OBJECTIVES: Childhood maltreatment is related to alcohol use as well as psychological distress in young adulthood. Few studies have examined whether psychological distress mediates the relationship between child maltreatment and alcohol use. We examined the role of psychological distress in linking child maltreatment subtypes (ie, emotional abuse, physical abuse, sexual abuse, neglect) to four patterns of alcohol use, including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol dependence. METHODS: We used a community sample of young adults (N = 337), who completed an interview assessing exposure to childhood maltreatment, current psychological distress, and drinking behaviors. RESULTS: Emotional abuse was associated with psychological distress, whereas psychological distress was related to more pathological drinking behaviors such as alcohol-related problems and alcohol dependence. Subsequent analyses indicated significant mediated effects between emotional abuse and alcohol-related problems and alcohol dependence via psychological distress, even after controlling for demographic factors, other maltreatment subtypes, parental alcoholism, and peer alcohol use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Findings suggest that among four types of childhood maltreatment, emotional abuse might be the major driver of pathological drinking among child maltreatment victims. Interventions aimed at negative emotionality may be useful in preventing and treating problematic drinking among the victims of childhood emotional abuse.