Adverse Childhood Experiences and Mental Health in an Adolescent Partial Hospital Program.

Childhood adversity has been associated with myriad physical, emotional, and mental health symptoms across the lifespan, including higher risk for substance abuse, depression, suicidal ideation, and premature mortality. The current study evaluates the association between cumulative adverse childhood experiences and mental health distress at admission and discharge in an adolescent partial hospital program. Data were collected from 157 adolescents through clinical assessments administered during admission and discharge procedures (Youth Outcomes Questionnaire Self-Report (YOQ-SR), Treatment Support Measure (TSM), and Center for Youth Wellness Adverse Childhood Experiences Questionnaire Teen (CYW ACE-Q Teen)). Regression analyses were conducted to assess how cumulative ACEs predict admission mental health distress (Intrapersonal Distress, Critical Items, and Total Score) as well as mental health distress at discharge, above and beyond other clinically relevant factors. While ACEs significantly predicted overall distress at admission (p = .026), there were no other significant associations between ACEs and outcomes at admission, nor ACEs and any outcomes at discharge. This suggests experiences of adversity may not hinder or influence outcomes over the course of treatment in this setting. Experiences of adversity were highly endorsed in this sample; thus, further understanding of experiences of trauma and resilience in acute treatment settings is a critical area for future research to improve interventions for adolescents.

Emotion differentiation in early recovery from alcohol use disorder: Associations with in-the-moment affect and 3-month drinking outcomes.

BACKGROUND: Early recovery from alcohol use disorder (AUD) is commonly associated with high levels of negative affect, stress, and emotional vulnerability, which confer significant relapse risk. Emotion differentiation-the ability to distinguish between discrete emotions-has been shown to predict relapse after treatment for a drug use disorder, but this relationship has not been explored in individuals recovering from AUD. METHODS: The current study used thrice daily random and up to thrice daily self-initiated ecological momentary assessment surveys (N = 42, observations = 915) to examine whether 1) moments of high affective arousal are characterized by momentary differences in emotion differentiation among individuals in the first year of a current AUD recovery attempt, and 2) individuals' average emotion differentiation would predict subsequent alcohol use measured by the timeline follow-back over a 3-month follow-up period. RESULTS: Multilevel models showed that moments (Level 1) of higher-than-average negative affect (p < 0.001) and/or stress (p = 0.033) were characterized by less negative emotion differentiation, while moments of higher-than-average positive affect were characterized by greater positive emotion differentiation (p < 0.001). At the between-person level (Level 2), participants with higher stress overall had lower negative emotion differentiation (p = 0.009). Linear regression showed that average negative, but not positive, emotion differentiation was inversely associated with percent drinking days over the subsequent 3-month follow-up period (p = 0.042). Neither form of average emotion differentiation was associated with drinking quantity. CONCLUSIONS: We found that for individuals in early AUD recovery, affective states are associated with acute shifts in the capacity for emotion differentiation. Further, we found that average negative emotion differentiation prospectively predicts subsequent alcohol use.