Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring.

The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.

Regular Cannabis Use During the First Year of the Pandemic: Studying Trajectories Rather Than Prevalence.

INTRODUCTION: Cannabis use in the U.S. rose early in the COVID-19 pandemic, but it is unclear whether that rise was temporary or permanent. This study estimated the nature and sociodemographic correlates of U.S. adult subpopulations regularly using cannabis by examining weekly trajectories of use during the first year of the pandemic. METHODS: Data came from the Understanding America Study, a nationally representative panel of U.S. adults (N=8,397; March 10, 2020-March 29, 2021). A growth mixture model was deployed to identify subgroups with similar regular cannabis use. Sociodemographic correlates of subgroups were examined using multinomial logistic regression. RESULTS: Four cannabis-use groups were identified. Most participants did not regularly use cannabis (no regular use; 81.7%). The other groups increased regular use until April 2020 but then diverged. Some (7.1%) decreased thereafter, whereas others (3.4%) maintained their elevated use until October 26, 2020 before decreasing. The last group (7.7%) sustained their elevated use throughout. Individuals aged between 18 and 39 years, unmarried, living in poverty, without a college degree, and with longer unemployment or underemployment spells had higher odds of being in the other groups with more weekly use than in the no-regular-use group. CONCLUSIONS: The analyses revealed population subgroups with prolonged regular cannabis use and a disproportionate concentration of socioeconomically vulnerable members of society in these subgroups. These findings elucidate important heterogeneity in the subpopulations using cannabis, highlighting the urgent need to tailor public health programs for subgroups that may have unique service needs.

Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences.

Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.

Changes in sexual identity and substance use during young adulthood.

BACKGROUND: Sexual identity is dynamic, and changes in identity (e.g., from heterosexual to lesbian, gay, bisexual, or queer [LGBQ+]) are common during young adulthood. It is not well-understood how sexual identity changes may be associated with substance use risk. METHODS: Two waves of data (baseline: October, 2018-October, 2019; follow-up: May-October, 2020) were used from a prospective cohort of young adults (N = 1896; mean age=21.2). Frequency of past 30-day use and new initiation of five substance use outcomes (alcohol, any tobacco, e-cigarettes, cannabis, illicit drugs) were compared across four groups: consistently heterosexual (N = 1567), consistently LGBQ+ (N = 244), heterosexual to LGBQ+ (N = 65), and LGBQ+ to heterosexual (N = 20). RESULTS: Consistently LGBQ+ (vs. consistently heterosexual) participants reported greater frequency of past 30-day use of alcohol (aOR=1.34, 95% CI=1.04-1.72), any tobacco products (aOR=1.88, CI=1.34-2.63), e-cigarettes (aOR=1.49, CI=1.01-2.19), cannabis (aOR=1.36, CI=1.01-1.84), and illicit drugs (aOR=2.84, CI=1.77-4.56). Heterosexual to LGBQ+ (vs. consistently heterosexual) participants reported greater frequency of past 30-day use of any tobacco products (aOR=1.87, CI=1.06-3.33) and illicit drugs (aOR=2.48, CI=1.10-5.62), and had greater risk of initiating alcohol (aRR=1.82, CI=1.02-3.25) and cannabis use (aRR=2.90, CI=1.81-4.64). LGBQ+ to heterosexual (vs. consistently LGBQ+) participants reported lower frequency of past 30-day use of alcohol (aOR=0.35, CI=0.14-0.88) and any tobacco products (aOR=0.15, CI=0.03-0.80). CONCLUSIONS: Identifying as LGBQ+ was associated with increased risk for frequent substance use, and newly adopting an LGBQ+ identity was associated with increased risk for new substance use initiation. Prevention and treatment interventions may need to tailor messaging to young people who have newly adopted an LGBQ+ identity.

Associations of attention problems and family context in childhood and adolescence with young adult daily smoking: General and smoking-specific family contexts.

BACKGROUND: The potential heterogeneity in daily smoking across young adulthood has been relatively understudied. Relatedly, the unique and joint associations of earlier risk factors with young adults' daily smoking largely remain unknown. To address these gaps, this work identified subgroups of daily smoking trajectories during young adulthood and linked them to earlier attention problems and smoking-specific and general family context. METHODS: Data came from the Seattle Social Development Project, a longitudinal study following a community sample (N = 808). Participants' daily smoking was measured from ages 21-33. Earlier attention problems were assessed at ages 14-16 and 18. Earlier smoking-specific and general family factors were assessed at ages 10-16 and 18. RESULTS: Growth mixture models produced four profiles: chronic daily smokers, increasers, decreasers, and no-daily smokers. Results from multinomial logistic regressions revealed that earlier attention problems and smoking-specific family factors may contribute to daily smoking in the early 20 s, whereas earlier general family context provided protection for trajectories of daily smoking characterized by changes in the late 20 s and early 30 s DISCUSSION: Selective prevention strategies that expand people's repertoire of healthy options to address attention problems might be helpful, considering the possibility of using tobacco as means to mitigate attention problems. Our findings also highlight the importance of nurturing earlier general family context, a relatively overlooked dimension in smoking prevention efforts, to facilitate young adult smokers' desistence from daily smoking, particularly those who have attention problems in adolescence.

Drug use trajectories among U.S. adults during the first year of the COVID-19 pandemic.

This study characterized the prevalence, sociodemographic characteristics, and behavioral health of U.S. adult subpopulations with distinct drug use trajectories during the first year of the COVID-19 pandemic. Adult respondents (n = 8306) in a nationally-representative longitudinal study completed 13 monthly web surveys (March 2020-March 2021). Frequency of past-week drug use, cannabis use, and alcohol use (range:0-7), as well as anxiety and depressive symptoms, were assessed at each survey. Growth mixture models were used to parse out distinct subpopulations with homogenous drug use trajectories based on mean drug use days over time. Four drug use trajectories were identified: Stable Abstinence (85.7% [95%CI = 85.0-86.5] of the sample) with <1 mean past-week drug use days; Escalating Infrequent Use (7.1% [95%CI = 6.6-7.7]) with 0.2 March mean past-week drug use days and increases from April to October; Use Cessation (4.3% [95%CI = 3.8-4.7]) with 1.1 March mean past-week drug use days that initially increased, then sharply decreased to near zero; and Stable Frequent Use (2.9% [95%CI = 2.5-3.3]) with between 2.4 and 3.5 past-week drug use days across the study period. Compared to the stable abstinence group, the other subgroups were more likely to be Hispanic or Black, younger in age, unemployed, below the federal poverty line, and less likely to have a college degree or be married. They also reported higher levels of alcohol and cannabis use, as well as higher anxiety and depressive symptoms. These results provide opportunities to optimize the targeted delivery of preventive interventions for substance use during the COVID-19 pandemic and future public health emergencies.

Cumulative Neighborhood Risk and Subsequent Internalizing Behavior among Asian American Adolescents.

Neighborhood disadvantage is a developmental context that may contribute to Asian American adolescent internalizing problems, yet there is a dearth of longitudinal studies as well as examination of cultural protective factors. Co-ethnic density, or the proportion of individuals of the same racial/ethnic background in the neighborhood that is often cited as a protective factor for racial/ethnic minority groups, has not been adequately examined in Asian American youth. This study examined the longitudinal association between cumulative neighborhood risk and internalizing behavior, and the moderating role of sex and co-ethnic density using an Asian American subsample (N = 177; 45.2% female; ages 10-12, 14-15; Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Samoan, Vietnamese, and other ethnic backgrounds) of a longitudinal panel study over a span of 6 years. Cumulative neighborhood risk during early adolescence (ages 10-14) was significantly associated with internalizing behavior at mid-adolescence (age 15) controlling for prior levels of internalizing behavior. There was no evidence of moderation by co-ethnic density or sex, indicating that reducing neighborhood disadvantage may be a promising preventive measure to address mental health problems for both sexes of Asian American adolescents.

Alcohol use trajectories among U.S. adults during the first 42 weeks of the COVID-19 pandemic.

BACKGROUND: This study characterized the prevalence, drinking patterns, and sociodemographic characteristics of U.S. adult subpopulations with distinct drinking trajectories during the COVID-19 pandemic's first 42 weeks. METHODS: Adult respondents (n = 8130) in a nationally representative prospective longitudinal study completed 21 biweekly web surveys (March 2020 to January 2021). Past-week alcohol drinking frequency (drinking days [range: 0 to 7]) and intensity (binge drinking on usual past-week drinking day [yes/no]) were assessed at each timepoint. Growth mixture models identified multiple subpopulations with homogenous drinking trajectories based on mean drinking days or binge drinking proportional probabilities across time. RESULTS: Four drinking frequency trajectories were identified: Minimal/stable (72.8% [95% CI = 71.8 to 73.8]) with <1 mean past-week drinking days throughout; Moderate/late decreasing (6.7% [95% CI = 6.2 to 7.3) with 3.13 mean March drinking days and reductions during summer, reaching 2.12 days by January 2021; Moderate/early increasing (12.9% [95% CI = 12.2 to 13.6) with 2.13 mean March drinking days that increased in April and then plateaued, ending with 3.20 mean days in January 2021; and Near daily/early increasing (7.6% [95% CI = 7.0 to 8.2]) with 5.58 mean March drinking days that continued increasing without returning to baseline. Four drinking intensity trajectories were identified: Minimal/stable (85.8% [95% CI = 85.0% to 86.5%]) with <0.01 binge drinking probabilities throughout; Low-to-moderate/fluctuating (7.4% [95% CI = 6.8% to 8%]) with varying binge probabilities across timepoints (range:0.12 to 0.26); Moderate/mid increasing (4.2% [95% CI = 3.7% to 4.6%]) with 0.39 April binge drinking probability rising to 0.65 during August-September without returning to baseline; High/early increasing trajectory (2.7% [95% CI = 2.3% to 3%]) with 0.84 binge drinking probability rising to 0.96 by June without returning to baseline. Males, Whites, middle-aged/older adults, college degree recipients, those consistently working, and those above the poverty limit were overrepresented in various increasing (vs. minimal/stable) frequency trajectories. Males, Whites, nonmarried, those without college degree, 18 to 39-year-olds, and middle aged were overrepresented in increasing (vs. minimal/stable) intensity trajectories. CONCLUSIONS: Several distinct U.S. adult sociodemographic subpopulations appear to have acquired new drinking patterns during the pandemic's first 42 weeks. Frequent alcohol use assessment in the COVID-19 era could improve personalized medicine and population health efforts to reduce drinking.

Risk factors for intimate partner violence perpetration among college students: Impact of childhood adversities.

Objective Intimate partner violence (IPV) among college students is a significant problem that negatively affects their physical and emotional health. This study aimed at examining risk factors, especially childhood adversities at the individual, relationship, and community levels, of IPV perpetration among college students. Methods: The sample from seven universities in the U.S. and Canada (N = 3,725) completed an online survey. Major variables included IPV perpetration, five types of childhood adversities, alcohol and drug use, depression, and demographic information. Logistic regression was performed. Results: Peer violence victimization, witnessing parental IPV, experiencing child maltreatment, drug use, and depression were associated with a higher odd of perpetrating IPV. Conclusions: Research and practice must account for exposure to multiple risk factors when intervening with college students. An integrative approach that combines trauma-informed interventions with substance use and mental health treatment may be most successful at IPV perpetration prevention and intervention among college students.

AIM for Teen Moms: Social Support's Role in Contraception Use Among Young Mothers.

PURPOSE: Rapid repeat pregnancy is associated with negative outcomes for teen mothers and their offspring. Contraceptive use can reduce this risk. We explored the impact of AIM for Teen Moms, a future-oriented behavioral intervention, on emotional and tangible support and the influence of this support on the attitudes, intentions, and past 3-month contraceptive use behaviors. METHOD: Participants were 295 first-time moms (ages 15-19) in Los Angeles County who participated in a randomized control trial intervention to reduce rapid repeat pregnancies. Participants completed surveys at baseline and 36-months. Hypotheses were tested using multivariate and interaction analysis. RESULTS: Teen mothers in treatment group reported more emotional (ß =.13, p < .05) and tangible support (ß =.13, p < .05). Higher tangible support was positively associated with birth control attitudes (ß =.13, p < .05), which, in turn, predicted intention to use birth control (ß =.31, p < .001). Intention to use birth control also predicted higher past 3-month birth control use (ß =.18, p < .01); there was also a direct path from attitude to 3-month birth control use (ß =.35, p < .001). There was no association between emotional support and birth control attitudes, intentions, or behaviors. CONCLUSION: AIM for Teen Mom's effects on contraception use at 36 months was mediated by social support, specifically tangible support, which, in turn, affected birth control attitudes, intentions, and reported birth control use. Interventionists must consider how intervention content can specifically address the building of target support to meet the needs of teen mothers.

Cumulative Violence Exposure and Alcohol Use Among College Students: Adverse Childhood Experiences and Dating Violence.

Multiple types of childhood adversities are risk factors for dating violence among college-age youth and in turn, dating violence is associated with alcohol use. This work quantitatively examines associations of childhood adversity and dating violence with alcohol use among college students using a cumulative stress approach. Multi-campus surveys were collected from March to December 2016 in four universities across the United States and Canada (n = 3,710). Latent class analysis identified patterns of childhood adversity and dating violence. Regression analyses investigated the associations of latent class patterns with past year number of drinks, alcohol use frequency, and problematic drinking. Latent class analysis produced seven classes: "low violence exposure" (18.5%), "predominantly peer violence" (28.9%), "peer violence and psychological child abuse" (10.8%), "peer and parental domestic violence" (9.9%), "peer and psychological dating violence" (17%), "peer and dating violence" (6.6%), and "childhood adversity and psychological dating violence" (8.3%). Compared to the "low violence exposure" group, "peer and psychological dating violence" (B = .114, p < .05), "peer and dating violence" (B = .143, p < .05), and "childhood adversity and psychological dating violence" (B = .183, p < .001) groups were significantly associated with problematic drinking. Results highlight how childhood adversity and dating violence contribute to problematic alcohol use, suggesting interventions that address both childhood adversity and dating violence may be most effective at reducing alcohol misuse among college students.

Suicidal ideation among North Korean refugees in South Korea: Exploring the influence of social network characteristics by gender.

Rates of death by suicide among North Korean refugees are three times higher than those among their host-country counterparts in South Korea. However, social and cultural factors predicting suicidality among North Korean refugees are not well known. Thus, we explored how social networks affect suicidal ideation in a sample of 405 North Korean refugees in South Korea using egocentric network data. Network diversity (number of different types of ties) was a protective factor for suicidal ideation among women. Having a help-providing and trustworthy church-based tie was a protective factor for women, whereas it was a risk factor for men. It is likely that women connected to people in diverse social contexts received more support to effectively deal with adversities. Because South Korean churches provide tailored worship services and financial aid to North Korean refugees, women might receive emotional comfort from church-based ties whom they can trust and receive help from, whereas men might become distressed about being financially dependent on others, which contradicts cultural expectations of a man's traditional role. Our findings have implications for mental health practitioners serving vulnerable populations, and highlight the importance of understanding the cultural context of social networks and gender in suicide research.

Psychological Intimate Partner Violence, Insecure Attachment, and Parental Psychological Control from Adolescence to Emerging Adulthood.

We examine if psychological intimate partner violence (pIPV) is predicted by parental psychological control (PPC) via insecure attachment. Our results analyzing longitudinal data from the Child Development Project show that PPC perceived at age 16 predicts insecure attachment at age 18, which then predicts pIPV at age 24. Moreover, the paths with attachment anxiety are consistently significant while ones with attachment avoidance are not. Further, all the paths are significant regardless of the gender of the adolescents and parents, which indicates that PPC is detrimental regardless of the gender of the adolescents or parents. Lastly, PPC perceived at age 16 does not directly predict pIPV at age 24, which suggests that social learning theory of aggression (Bandura, 1978) may not explain the association from PPC to pIPV. Our results suggest that research and practice would benefit by considering PPC as an antecedent of pIPV via insecure attachment from adolescence to emerging adulthood.

Perceived Racial Discrimination and Mental Health in Diverse Groups of Asian Americans: The Differing Impacts by Age, Education, and Ethnicity.

The aim of this study was to examine how perceived racial discrimination is associated with mental distress among diverse Asian Americans and to explore the potential moderators in the relationship. Based on the 2015 Asian American Quality of Life (AAQoL) survey (n = 2609), direct influences were tested of the contextual (demographic, health-related, and immigration-related) variables and perceived racial discrimination on mental distress, as well as their interactions. About 30% of the sample reported perceived racial discrimination, and 44% fell into the category of having mental distress. Perceived racial discrimination was associated with 1.90 times higher odds of mental distress and had significant interactions with age, education, and ethnicity. The association of mental distress with perceived racial discrimination was higher among those who were 60 or older, less educated, and Vietnamese than among their respective counterparts. Findings can guide strategic and targeted interventions for high-risk groups.

Childhood Community Risk Factors on Intimate Partner Violence Perpetration and Victimization Among College Students.

The study examined the effect of community environments, such as community cohesion, community safety, and community poverty, in childhood on the likelihood of Intimate Partner Violence (IPV) perpetration and victimization in young adulthood. The study used the cross-sectional survey data of 2,082 college students collected in 2016-2017 from six universities in the U.S. and the data for the childhood community environment from the 2007-2011 American Community Survey. Hierarchical regressions were performed separately by gender to 1) assess the effects of community factors in addition to individual factors for IPV perpetration and victimization, and to 2) identify the interaction effect of community cohesion with community poverty on IPV perpetration and victimization. Community factors of community cohesion and community poverty were significantly correlated to different types of IPV. For IPV perpetration, only community cohesion was significant for, the interaction effect between community cohesion and poverty showed that higher community cohesion lowered the risk of community poverty on later IPV perpetration in both genders. For IPV victimization, only female students were affected by community poverty, whereas none of the community factors had an impact on male students. The findings imply the significance of early interventions and policies strengthening the community environment, especially community cohesion, for preventing IPV. The findings also suggest that assessing risk and protective factors on IPV in multiple contexts during childhood is important to develop effective programs preventing IPV.

Vaping and psychotic experiences among college students in the United States.

AIM: While cigarette and marijuana use has been linked to psychotic experiences, few empirical studies have examined the relation between vaping and psychotic experiences. METHODS: We analyzed data from the Healthy Minds Survey (September 2020 - December 2020; N = 29,232 students from 36 universities), and used multiple logistic regression models to examine the associations between vaping over the past 30 days and psychotic experiences over the past 12 months, adjusting for age, gender, and race/ethnicity. We then additionally adjusted for cigarette and marijuana use, as well as depression and anxiety. RESULTS: Roughly 14 % of students in the sample reported psychotic experiences over the past year, and around 14-15 % of students reported vaping over the past month. In multiple logistic regression models, vaping was significantly associated with psychotic experiences (aOR 1.88; 95 % CI: 1.63-2.18). This association attenuated but remained statistically significant even after adjusting for any cigarette use and marijuana use, and after adjusting for depression and anxiety. CONCLUSIONS: Among college students, vaping was significantly associated with psychotic experiences, even after accounting for simple measures of cigarette and marijuana use, and mental health problems, calling for more prospective studies to examine the association.

Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers.

BACKGROUND: Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS: Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS: Grandfather's cannabis use was significantly linked to mother's normative beliefs (ß = .22, p = .006), but not attitudes (ß = .12, p = .182). Teen mothers' attitude was associated with intention (ß = .79, p < .001); intention predicted cannabis behavior (ß = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (ß = .21, p = .002); attitude predicted intention (ß = .73, p < .001) and intention predicted behavior (ß = .60, p < .001). DISCUSSION: Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.

Adverse childhood experiences and the substance use behaviors of Latinx youth.

PURPOSE: Adverse childhood experiences (ACEs) are associated with substance use, how cultural factors influence this association for Latinx youth is unknown. This study uses longitudinal data to examine associations of cultural factors, ACEs and substance use among Latinx young adults. METHODS: Latinx youth (N = 1179) completed surveys from a longitudinal study at seven assessment points from 2005 to 2016; ACEs was assessed when participants were on average 21.6 and substance use 23.9 years. ACEs measured psychological, physical, and sexual abuse, parental violence, divorce, substance use, mental illness, and incarceration. A three-stage hierarchical ordinary least squares (alcohol use) and negative binomial regression models (problematic alcohol, marijuana and tobacco use) were estimated to evaluate the role of cultural factors (acculturation, enculturation and ethnic identity) and ACEs in shaping substance use behaviors. RESULTS: Controlling for cultural variables, ACEs sum (B = 0.03, p = .01), maltreatment (B = 0.16, p < .01), and household (B = 0.12, p = .03) subdomains predicted alcohol use. One additional increase in maltreatment (IRR=1.23, 95 % CI: 1.00, 1.53) predicted 23 % higher count of problematic alcohol use. Maltreatment (IRR=1.50, 95 % CI: 1.05, 2.13) and household (IRR=1.66, 95 % CI: 1.18, 2.32) subdomains predicted increased counts of marijuana use. Four or more ACEs predicted increased counts of tobacco use (IRR=1.49, 95 % CI: 1.08, 2.06) among Latinx young adults. CONCLUSIONS: Results suggest a predictive relationship between ACEs, and alcohol, marijuana and tobacco use, after accounting for cultural factors. Beyond acculturation, enculturation and ethnic identity, findings identify ACEs as a salient predictor of substance use among Latinx young adults.

Associations between prospective and retrospective measures of child abuse and self-reported adult health at midlife.

BACKGROUND: The long-term health effects of physical child abuse are well documented in self-report, retrospective studies. However, there have been few longitudinal, multimethod studies on physiological responses to stress and the onset of chronic disease, thereby slowing the advancement of prevention and intervention programs. OBJECTIVES: This study used survey data from an extended longitudinal study to examine prospective and retrospective associations between measures of physical child abuse and adult health in the 40s. PARTICIPANTS AND SETTING: Data are from an ongoing longitudinal study of the correlates and consequences of child maltreatment that began in the 1970s with a sample of 457 children. METHODS: Bivariate correlations and multiple regression models with covariates were used to assess associations between measures of physical child abuse and outcomes of self-reported health in adulthood. RESULTS: Physical child abuse, measured retrospectively, was moderately related to reports of overall health, as well as a number of adult health problems and conditions, such as back and chest pain, hypertension, and certain forms of cancer. Associations were also observed for lifetime alcohol problems and past-year doctor and emergency room visits. Fewer associations between prospective parent self-report measures of physical child abuse and adult health were identified, although child welfare (official record) reports performed similarly to retrospective measures. CONCLUSIONS: This study adds important information on the long-term health effects of child physical abuse, as well as measurement differences in the prediction of adult health outcomes. Conclusions drawn from prospective and retrospective studies of abuse are at best inconsistent, and possibly incompatible.

Violence, HIV Risks, and Polysubstance Use Among HIV-Positive People Who Inject Drugs in Ukraine.

Violence experience has been consistently associated with HIV risks and substance use behaviors. Although many studies have focused on intimate partner violence (IPV), the role of violence at a structural level (i.e., police abuse) remains relevant for people who inject drugs. This study evaluated the association of IPV and police-perpetrated violence experiences with HIV risk behaviors and substance use in a cohort of HIV-positive people who inject drugs in Ukraine. We also evaluated possible moderation effects of gender and socioeconomic status in the links between violence exposure and HIV risk and polysubstance use behaviors. Data came from the Providence/Boston-CFAR-Ukraine Study involving 191 HIV-positive people who inject drugs conducted at seven addiction treatment facilities in Ukraine. Results from logistic regressions suggest that people who inject drugs and experienced IPV had higher odds of polysubstance use than those who did not experience IPV. Verbal violence and sexual violence perpetrated by police were associated with increased odds of inconsistent condom use. The odds of engaging in polysubstance use were lower for women in relation to police physical abuse. We found no evidence supporting socioeconomic status moderations. Violence experiences were associated with substance use and sexual HIV risk behaviors in this cohort of HIV-positive people who inject drugs in Ukraine. Trauma-informed prevention approaches that consider both individual and structural violence could improve this population's HIV risks.

RESUMEN: La experiencia de violencia se ha asociado sistemáticamente con las conductas de riesgo para la adquisición o transmisión del VIH y con el uso de sustancias. Aunque muchos estudios se han centrado en la violencia infligida por la pareja íntima (VPI), el papel de la violencia estructural (es decir, el abuso policial) sigue siendo relevante para las personas que se inyectan drogas. Este estudio evaluó la asociación entre las experiencias de violencia perpetrada por la policía y la pareja íntima con los conductas de riesgo para la adquisición o transmisión del VIH y el uso de sustancias en una cohorte de personas VIH positivas que se inyectan drogas en Ucrania. También evaluamos los posibles efectos de moderación del género y el estatus socioeconómico entre la exposición a la violencia y los comportamientos de riesgo para la transmisión del VIH y uso de múltiples sustancias. Los datos provienen del estudio Providence / Boston-CFAR-Ucrania en el que participaron 191 personas infectadas por el VIH que se inyectan drogas, realizado en siete centros de tratamiento de adicciones en Ucrania. Los resultados de las regresiones logísticas sugieren que, en comparación con las personas que se inyectan drogas que no experimentaron IPV, las que experimentaron IPV tenían mayor probabilidad de uso de múltiples sustancias. La violencia sexual perpetrada por la policía se asoció con mayores probabilidades de un uso inconsistente del condón. No encontramos evidencia que apoye las moderaciones de género o estatus socioeconómico. Las experiencias de violencia se asociaron con el uso de sustancias y las conductas sexuales de riesgo para la transmisión del VIH en esta cohorte de personas VIH positivas que se inyectan drogas en Ucrania. Los enfoques de prevención basados en las experiencias traumáticas que tienen en cuenta tanto la violencia individual como la estructural podrían mejorar las conductas de riesgo para la transmission del VIH de esta población.