Adverse childhood experiences, posttraumatic stress disorder symptoms, and compulsive behaviors among adults in substance use treatment: A latent class analysis.

Adverse childhood experiences (ACEs) are prevalent and associated with common problems among adults with substance use disorders (SUDs), including posttraumatic stress disorder (PTSD) symptoms and compulsive behaviors. Most studies consider cumulative ACEs when examining their associations with health and behavioral outcomes. We tested whether patterns of ACEs related to SUD symptoms, PTSD symptoms, and compulsive behaviors among adults receiving treatment for substance use. We identified latent classes of ACEs using medical record data from 721 patients in residential SUD treatment and conducted Wald chi-square tests to assess whether these latent classes differed in alcohol and drug use disorder symptoms, PTSD symptoms, compulsive sexual behavior, and compulsive gambling. We identified four latent classes: high ACEs (15.1%), maltreatment (12.4%), household problems (22.3%), and low ACEs (49.1%). There were significant differences across latent classes in drug use disorder symptoms, PTSD symptoms, and compulsive sexual behavior, χ2(1, N = 721) = 37.42-107.07, ps < .001. Participants in the high ACEs and household problems classes had more drug use disorder symptoms than those in the low ACEs class. Relative to all other classes, individuals in the low ACEs class had the lowest PTSD symptoms and those in the high ACEs class had the highest PTSD symptoms. Findings indicate that adults with SUDs who have more ACEs have the highest risk for PTSD symptoms and compulsive sexual behavior. Screening for ACEs while considering ACE patterns and frequency may benefit treatment planning for SUD patients with comorbid concerns such as PTSD symptoms and compulsive sexual behavior.

Examining trauma, anxiety, and depression as predictors of dropout from residential treatment for substance use disorders.

Substance use disorders (SUDs) are highly prevalent and have deleterious effects on one's health and well-being. Inpatient treatment for SUDs reduces patient relapse, which subsequently ameliorates these negative effects on the individual and society. Additionally, those who complete treatment are less likely to relapse compared to those who do not complete treatment. Thus, maintaining patient engagement in treatment and reducing the rates of those leaving against medical advice (AMA) is particularly important. Examining the factors and comorbidities that may contribute to treatment dropout has the potential to identify at-risk patients in need of additional individualized intervention. The current study aimed to examine comorbid anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms as predictors of dropout AMA in a residential substance use treatment population. Results showed that patients with social anxiety were more likely to leave treatment AMA, while those with PTSD were more likely to complete treatment. Findings suggest that PTSD-specific treatment, as offered in this facility, may help with patient retention, while group focused therapy may be distressing to those with social anxiety. Clinical implications of this research may include incorporating evidence-based practice for social anxiety early during inpatient treatment to reduce anxiety such that patients may better engage with SUDs treatment.

Sexual Narcissism and Hypersexuality Relate to Sexual Coercion in Hookups among U.S. University Students.

Sexual violence remains a prevalent issue on college campuses. Sexual coercion, a form of sexual violence, is frequently employed within casual sexual encounters (i.e., hookups). The present study investigated hypersexuality and sexual narcissism as unique predictors of sexual coercion and examined whether there were gender differences in these associations. Participants (N = 793, ages 18-25) were undergraduate students at a large southeastern university who have: (1) engaged in sexual activity within the past six months and (2) had at least one prior hookup experience. Respondents completed surveys online assessing levels of sexual narcissism, hypersexuality, and sexual coercion perpetration in hookups. Participants primarily identified as female (71.7%), White (84.2%), and heterosexual (86.6%), with an average of 9.77 sexual engagements per month. Bivariate correlations and independent samples t-tests were conducted to examine associations between and gender differences across study variables, respectively. We assessed the factor structure of study variables using confirmatory factor analysis and tested hypotheses using structural equation modeling. Compared to women, men scored higher on sexual exploitation and all hypersexuality subscales. After establishing good-fitting measurement models, we found that both sexual narcissism and hypersexuality predicted increased sexual coercion perpetration and that gender did not moderate these associations. Study findings demonstrated that sexual narcissism and hypersexuality are risk factors for sexual coercion perpetration in hookups across gender. Although associations were consistent across gender, men may report higher levels of sexual coercion perpetration risk factors. Future researchers could focus on gender differences in the etiology of sexual coercion risk factors.

Effects of Alcohol Use and Minority Stress on Intimate Partner Violence Perpetration among Transgender and Gender Diverse People.

OBJECTIVE: Intimate partner violence (IPV) is highly prevalent among transgender and gender diverse (TGD) adults. Integrated theories of minority stress and alcohol-related IPV suggest minority stress risk and protective factors should interact with alcohol use to predict IPV, although this has never been examined in TGD adults. Thus, we examined the synergistic influence of alcohol use, minority stress, and TGD community connectedness on IPV perpetration among TGD adults. METHOD: A sample of 137 TGD adults completed a cross-sectional survey assessing minority stressors (i.e., internalized transnegativity, identity outness), TGD community connectedness, alcohol use/problems, and IPV perpetration (i.e., psychological, physical, and gender minority identity-specific abuse). We regressed each form of IPV perpetration on alcohol use/problems and tested the moderating effect of internalized transnegativity, identity outness, and community connectedness on the association between alcohol use/problems and IPV perpetration. RESULTS: The association between alcohol use/problems and all forms of IPV perpetration were moderated by internalized transnegativity and identity outness, but not TGD community connectedness. Alcohol use/problems related to each form of IPV perpetration at low and medium, but not high levels, of identity outness and internalized transnegativity. CONCLUSIONS: Alcohol use/problems is an important risk factor for IPV perpetration among TGD adults and this association may be exacerbated by less identity outness. Further, internalized transnegativity might not influence IPV risk at high levels of alcohol use. TGD-affirming IPV prevention programs might focus on reducing alcohol use and related problems while providing a safe and accessible space for TGD individuals at various levels of identity outness.

Impulsivity Dimensions Predict Treatment Dropout Among Women in Residential Treatment for Substance Use Disorders.

Residential treatment for substance use disorders (SUDs) is effective at reducing substance use, dependence, and other related problems. However, dropout from treatment against medical advice (AMA) is common in residential treatment settings. Studies have shown that impulsivity is associated with substance misuse and treatment dropout in predominately male samples, but less is known regarding whether impulsivity dimensions predict treatment dropout among women. This study examined impulsivity dimensions (ie, negative urgency, positive urgency, lack of perseverance, lack of premeditation, and sensation seeking) as predictors of dropout AMA among women in a residential substance use treatment facility (N = 229). Logistic regression results demonstrated that elevations in lack of perseverance and sensation seeking were associated with an increased odds of treatment dropout AMA and that lack of premeditation was associated with a decreased odds of treatment dropout AMA. Study findings suggest that early evidence-based interventions for sensation seeking and lack of perseverance may improve retention of women in residential treatment.

Intimate Partner Violence Perpetration Among Sexual Minority Young Adults: Associations With Alcohol Use, PTSD Symptoms, Internalized Homophobia, and Heterosexist Discrimination.

Lesbian, gay, bisexual, queer, and other sexual minority (LGBQ+) young adults report similar or higher rates of intimate partner violence (IPV) perpetration than their heterosexual peers. Elevated IPV risk among LGBQ+ young adults may be attributable to experiencing heterosexist discrimination and internalized homophobia. In addition, LGBQ+ people report disproportionate posttraumatic stress disorder (PTSD) symptoms, alcohol use, and IPV perpetration in dating relationships. Thus, this study explored which combinations of IPV risk factors (i.e., experiencing heterosexist discrimination, internalized homophobia, PTSD symptoms, alcohol use) related to forms of IPV perpetration, inclusive of psychological, physical, and sexual forms, in a sample of 342 LGBQ+ young adults. Internalized homophobia was related to psychological IPV perpetration at high and medium levels of PTSD symptoms and only high levels of alcohol use. PTSD symptoms and alcohol use interacted to predict psychological IPV perpetration; and PTSD symptoms related to increased psychological IPV perpetration at high and medium, but not low, alcohol use levels. Alcohol use was positively related to physical IPV perpetration. No other risk factors or interactions were significantly related to physical or sexual IPV perpetration. Results were consistent with prior findings that linked internalized homophobia, alcohol use, and PTSD symptoms to IPV perpetration and highlight the interacting nature of these IPV perpetration risk factors. Comprehensive IPV interventions with LGBQ+ young adults should evaluate the impact of simultaneously targeting these multiple IPV risk factors considering their interacting contributions to IPV perpetration risk. More research is needed to examine the temporal relations between minority stress, PTSD symptoms, alcohol use, and IPV perpetration.

Alcohol Use and Compulsive Sexual Behaviors in College Students: The Moderating Effect of Alcohol-Related Sexual Expectancies.

Compulsive sexual behaviors (CSB) and alcohol use are prevalent among college students. Alcohol use frequently co-occurs with CSB; however, further examination of risk factors of co-occurring alcohol use and CSB is needed. We examined the moderating effect of alcohol-related sexual expectancies, specifically sexual drive and affect expectancies, on the association between alcohol use/problems and CSB among 308 college students from a large university in the southeastern United States. Alcohol use/problems and CSB had a positive significant relationship among college students high in sexual drive expectancies and high and average in sexual affect expectancies. These findings suggest that alcohol-related sexual expectancies may be a risk factor for alcohol-related CSB.

A Meta-Analysis Linking Parent-to-Child Aggression and Dating Abuse During Adolescence and Young Adulthood.

Relationship continuity and social learning theories provide support for parent-to-child aggression as one potential explanatory factor for dating abuse (DA); however, empirical results are mixed across studies as to the strength of this association. This meta-analysis sought to estimate the overall size of this effect among adolescent and young adult samples and investigate potential moderating factors including sample and measurement variables. Records were identified using a computerized search of databases with several keywords. Peer-reviewed journal articles and dissertations were included if they measured both parent-to-child aggression and DA perpetration and/or victimization among adolescents (aged 12-18) or young adults (aged 18-29). Sixty-six records met inclusion criteria, yielding 370 unique effect sizes for the relation between parent-to-child aggression and DA across 94 unique samples. As hypothesized, there was a small-to-medium effect size between parent-to-child aggression and subsequent DA during both adolescence and young adulthood. The strength of these findings was consistent across DA outcome (perpetration and victimization) and both physical and psychological forms, youth and parent gender, and youth age. Stronger associations were found when the gender of the parental aggressor was undefined compared to either a defined paternal or maternal aggressor. Records using the Conflict Tactics Scale to measure both parent-to-child aggression and DA yielded stronger associations compared to sources that used different measures, but single informant versus multiple informants did not yield any differences.