Objectives: This article investigates distinct patterns of adverse childhood experiences (ACEs) in a representative sample of US older adults, and how the ACEs patterns relate to major depression and substance use disorder (SUD). Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions III. The study sample consisted of older adults aged 55 or older (N = 11,386). The dependent variable was past-year SUD measuring any DSM-5 diagnosis for alcohol, tobacco, cannabis, and other illicit drugs. The independent variables were the classes of ACEs identified using 11 types of early adversities. The mediating variable was past-year major depressive disorder. We conducted a latent class analysis (LCA) to identify latent classes of ACEs, estimated the relationships between the ACEs classes, major depressive disorder, and SUD, and tested mediation by major depression. Results: Results of the LCA identified four classes of ACEs: High Adversity (6%), Low Adversity (69%), Child Abuse (16%), and Parental Substance Use (8%). The three classes of High Adversity, Child Abuse, and Parental Substance Use showed significantly higher rates of SUD than the Low Adversity class. The High Adversity and Child Abuse classes were more likely to have major depression compared to the Low Adversity class. In addition, major depression mediated the association between ACEs and SUD for those two classes. Conclusion: The findings provide evidence for a long-term impact of ACEs on mental health and SUD later in life and emphasize trauma-informed care principles in interventions for older adults with SUD.

The purpose of this study was to prospectively examine the relationships between socioeconomic status (SES), demographic variables and mental health and to determine whether number of life stressors mediated these relationships. Wave 1 (2001-02) and 2 (2004-05) data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 34,459) were used in the current study. Controlling for wave 1 mental health, a mediation model was tested to determine the relative impact of socioeconomic and demographic variables (all measured at wave 1) on mental health 3 years later (wave 2). The number of life stressors experienced in the 12 months prior to wave 1, assessed at wave 1, was evaluated as the mediator. Findings indicated that SES, age, race/ethnicity, gender and marital status independently predicted changes in mental health ratings at wave 2. In addition, the number of life stressors mediated the relation between socioeconomic and demographic variables and mental health. Exposure to life stressors helps to explain commonly reported socioeconomic and demographic disparities in mental health. Findings may suggest that reducing exposure to stressors and/or improving coping with life stressors may both improve mental health and reduce health disparities.

This article provides an overview of the characteristics of adolescent alcohol use, normative and subgroup variations in drinking behavior, and the important factors associated with an increased risk for developing alcohol problems in later adolescence and young adulthood. Parental or family histories of alcoholism, temperament traits, conduct problems, cognitive functioning, alcohol expectancies, and peer and other social relations are identified as factors influencing an adolescent's susceptibility for initiating a variety of alcohol use behaviors. The deviance prone model, proposed by Sher in 1991, is presented as an important tool for testing possible relationships among the various risk factors and their sequencing that leads to early adolescent alcohol use and drug initiation. It is also possible to extend the model to allow for an examination of the complex interplay of risk factors that lead to the development of alcohol use problems in late adolescence and young adults.

Objective: The aim of this study was to characterize aggression and its relationship to psychiatric co-morbidity, attention-deficit/hyperactivity disorder (ADHD) subtype, and ADHD symptom severity in clinically referred ADHD youngsters. We also wanted to ascertain whether reactive and impulsive aggression is more prevalent than proactive aggression in an ADHD sample. Method: Consecutively referred ADHD children and adolescents ( n = 268) and community controls ( n = 100) were assessed systematically regarding demographics, psychiatric diagnosis, overt aggression severity, proactive and reactive aggression severity, and ADHD symptom severity using correlational analysis and analysis of covariance (ANCOVA). Results: Across all aggression measures, ADHD children were more aggressive than community controls. ADHD children with nonanxiety co-morbid disorders were more aggressive than ADHD children without such co-morbidity. The number of co-morbid psychiatric diagnoses and ADHD symptom severity were significantly associated with aggression. ADHD youngsters demonstrated significantly more reactive than proactive forms of aggression across all co-morbid diagnoses. Conclusions: Aggression is common in clinically referred ADHD youngsters and should be identified as a legitimate target for psychopharmacological treatment in children and adolescents with moderate to severe ADHD and nonanxiety co-morbid diagnostic disorders.

The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants (N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health–related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed.