The associations of adverse childhood experiences and resilience with psychopathology and addictive behaviour in Chinese patients with substance use disorder.

Abstract

Adverse-childhood-experiences (ACEs) are prevalent in substance-use-disorder (SUD) but show complex interplay with resilience, psychopathology and addictive-behaviour. The stress-diathesis model predicts that ACEs can induce psychopathologies and undermine resilience, leading to addictive-behaviour. However, previous research seldom investigated these variables using network analysis, and evidence remains limited to the Western population. We aimed to study the symptom-behaviour network for ACEs and resilience in the Chinese setting. This cross-sectional study recruited 400 Chinese SUD patients, with 67% having comorbid psychiatric disorders, 61.5% having polysubstance use, and 63.3% having actively used substance within 30 days. We administered self-report scales to measure ACEs, resilience and psychological dependence. Clinician-rated scales measured substance-use-severity and psychopathologies. The regularized-partial-correlation-network with centrality indices examined the interplay of ACEs and resilience with psychopathologies and addictive-behaviour. The shortest-path-analysis outlined the graph-theoretic paths within the network, which linked ACEs (the independent variable) to substance-use-severity (the outcome variable) through intermediate variables. In the network, ACEs and resilience showed weak connections with psychopathology, psychological dependence and substance-use-severity. Moreover, anxiety and depressive symptoms, emotional and physical abuse showed high centrality. The graph-theoretic paths linking childhood abuse and substance-use-severity did not include psychopathological nodes but psychological dependence; whereas the paths linking childhood neglect and substance-use-severity included resilience and psychological dependence. ACEs, in particular physical and emotional abuse, may be intervention targets for bringing changes to the symptom-behaviour network. Trauma-informed assessments and interventions should be considered. Longitudinal research is needed to verify causal mechanisms for the associations of ACEs with addictive-behaviour.