Adverse Childhood Experiences Predict Early Initiation of Opioid Use Behaviors.

Introduction: Although a substantial body of research documents a relationship between traumatic stress in childhood and the initiation of substance use later in the life course, only limited research has examined potential linkages between adverse childhood experiences (ACEs) and the initiation of non-medical prescription opioid use and other opioid use behaviors. The present study contributes to this growing body of work by investigating the association of childhood trauma with early initiation of a series of opioid use behaviors. Methods: New York City young adults (n = 539) ages 18-29 who reported non-medical use of prescription opioids or heroin use in the past 30 days were recruited using Respondent-Driven Sampling in 2014-16. Ten ACEs were assessed via self-report with the ACE Questionnaire. Associations between number of ACEs and self-reported ages of initiating seven opioid use behaviors (e.g., non-medical prescription opioid use, heroin use, heroin injection) were estimated with multivariable logistic regression. Results: Eighty nine percent of participants reported at least one ACE, and 46% reported four or more ACEs, a well-supported threshold indicating elevated risk for negative health consequences. Every increase of one trauma was associated with a 12-23% increase in odds of early initiation across the seven opioid use behaviors. Findings also document that the mean age at initiation increased with increasing risk severity across the behaviors, contributing to evidence of a trajectory from opioid pill misuse to opioid injection. Discussion: Increasing number of childhood traumas was associated with increased odds of earlier initiation of multiple opioid misuse behaviors. In light of prior research linking earlier initiation of substance use with increased substance use severity, present findings suggest the importance of ACEs as individual-level determinants of increased opioid use severity. Efforts to prevent onset and escalation of opioid use among at-risk youth may benefit from trauma prevention programs and trauma-focused screening and treatment, as well as increased attention to ameliorating upstream socio-structural drivers of childhood trauma.

Parental Attachment, Adult-Child Romantic Attachment, and Marital Satisfaction: An Examination of Cultural Context in Taiwanese and Thai Heterosexual Couples.

Relationship dynamics between married couples can differ considerably, with varying impacts on relationship satisfaction. However, very limited research attention has been paid to how intergenerational attachment, relating to an individual's perception of his/her own and that of his/her parents' attachment, can affect marital dynamics within different cultural contexts. The current study examined associations between married heterosexual couples' romantic attachment, perception of parental attachment, and marital satisfaction in 100 Thai couples (M age = 45.59 years, SD = 10.86) and 73 Taiwanese couples (M age = 39.55 years, SD = 9.13). Results revealed that romantic attachment anxiety was negatively associated with marital satisfaction in the Taiwanese couples; in the Thai couples, neither romantic attachment anxiety nor avoidance was associated with marital satisfaction. Husbands reported higher romantic attachment anxiety than their wives in Taiwan, but this was not observed in the Thai couples. Taiwanese wives reported higher scores on their perceived parental attachment avoidance than did their husbands; whereas the reverse trend was observed in the Thai couples. These findings highlight the need to consider intergenerational aspects of attachment in cultural contexts, and they have important implications for practitioners working with couples from Asian cultural backgrounds.

Resilience among IDUs: planning strategies to help injection drug users to protect themselves and others from HIV/HCV infections.

Many long-term injection drug users (IDUs) engage in planning strategies. In this pilot study, we examine the relation of one planning strategy to IDUs' engaging in safer injection practices. Sixty-eight IDUs were recruited in 2010 from a New York City (NYC) needle exchange program and referrals to participate in an innovative Staying Safe Intervention that teaches strategies to stay HIV/HCV uninfected. Responses to a baseline 185-item survey were analyzed using correlations and odds ratios. Planning ahead to have steady access to clean equipment was correlated with both individually based and networks-based safety behaviors including storing clean needles; avoiding sharing needles, cookers, and filters with other injectors; and providing clean needles to sex partners. Implications related to resilience in IDUs are discussed and the study's limitations have been noted.