Identifying connections between adverse childhood events and substance use disorders

New research from Penn Medicine finds that people with anxiety and substance use disorders reported experiencing more adverse childhood experiences and lacking protective factors, such as close family connections, that can mitigate their harms.

Physical and sexual abuse, having parents who misuse substances, and witnessing violent crime are tragic events that don’t remain locked in a single point in time. Rather, they are termed adverse childhood experiences (ACEs) and 64% of American adults who participated in a recent survey reported experiencing at least one ACE prior to turning 18 years old. The wake of these events can extend into adulthood and include harmful behaviors such as self-medicating.

An open bottle of prescription pills spilling onto a table with a tumbler of whiskey.
Image: iStock/Feverpitched

This new research, published in Nature Human Behavior, shows that individuals exposed to ACEs are at increased risk of developing mood, anxiety, and substance use disorders. In part, the substance use disorder risk is related to the use of alcohol or drugs to self-medicate mood and anxiety disorders.

Henry Kranzler, a professor of psychiatry and the director of the Center for Studies of Addiction in the Perelman School of Medicine, co-authored the work. He and his colleagues found that people with these mental health conditions reported experiencing more ACEs and lacking protective factors, such as close family connections, that can mitigate their harms.

The group led by Kranzler examined associations among ACEs, mood or anxiety disorders, and substance dependence in 12,668 individuals (42.5% Black and 42.1% white) and compared two primary hypotheses: self-medication and substance-induced psychiatric disorders. Stronger support was found for the self-medication hypothesis, suggesting that interventions focusing on coping skills and emotional resilience may help reduce the risk of future mental health issues in children exposed to ACEs.

“Earlier intervention is key,” says Rachel Kember, an assistant professor of psychiatry and study co-author. “The findings provide a better understanding of how it may be best to intervene based on an individual’s specific needs.”

Genetic factors also play a role, with some individuals having a higher genetic predisposition for developing substance use, mood, or anxiety disorders. The interaction between genetic risk and childhood adversity influences the development of mental health disorders, highlighting the importance of understanding different pathways and designing early interventions to promote emotional regulation and coping skills.

Read more at Penn Medicine News.