Scientific Meeting 2023 - Lightning Talks Day 2

Tuesday, March 14
11:40am to 12:45pm

Presenter: Tzung-Shiang Ou

Psychological Pathways from Childhood Stressful Life Events to Cigarette, Marijuana, and Excessive Alcohol Use in Early Middle Adulthood: A Longitudinal Examination

Ou, Tzung-Shiang; Huber, Lesa; Macy, Jonathan; Chow, Angela; Lin, Hsien-Chang

Purpose: Previous studies demonstrated a robust association between childhood stressful life events and substance use behaviors in later life. However, less is known about the pathways through which they are connected. This study investigated how childhood stressful life events and substance use behaviors in early middle adulthood are connected through a sequential psychological pathway from internalizing problems to externalizing problems.

Methods: This study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Waves I-V (1994-2018). Adolescents aged 18 or younger at Wave I were included (N=2,326). Substance use behaviors were captured by past 30-day cigarette use, marijuana use, cigarette and marijuana co-use, and past-year excessive alcohol use at Wave V. Generalized structural equation modeling (GSEM) was conducted to investigate the sequential mediation relationship between childhood stressful life events and substance use behaviors through internalizing problems and subsequent externalizing problems, controlling for baseline gender, age, and race/ethnicity.

Results: The structural models demonstrated that childhood stressful life events at Wave I was positively associated with cigarette use and marijuana use (ORs=1.77, 1.03, respectively; both ps < 0.001) and past 30-day cigarette and marijuana co-use at Wave V (OR=1.02, p < 0.001). Internalizing problems at Wave III and externalizing problems at Wave IV sequentially mediated the aforementioned associations (all ps < 0.01).

Conclusion: The results demonstrated that childhood stressful life events are associated with increased cigarette use, marijuana use, and cigarette and marijuana co-use in early middle age through internalizing problems in early adulthood and subsequent externalizing problems in later adulthood. Therefore, to prevent adults who experienced childhood stressful life events from using substances in their early middle adulthood, interventions that address mental health problems including internalizing problems and subsequent externalizing problems in adulthood are warranted.