Primary Submission Category: Life-course/developmental
Adult psychological distress and cannabis use: The role of childhood adversity
Authors: Celina Morales, Annie Ro,
Presenting Author: Celina Morales*
Background: Adult mental stress has been associated with cannabis use. However, the confounding impact of adverse childhood experiences (ACEs) on this relationship still needs to be comprehensively assessed by different adult age groups. Childhood adversity can have a long-lasting impact on mental health and substance use behaviors, including cannabis use. This study investigates whether ACEs attenuate the association between past 30-day psychological distress and cannabis use frequency in different adult age groups.
Methods: Data from the 2021, 2022, and 2023 Adult California Health Interview Survey (N=67,548) were used. The Kessler Psychological Distress Scale was used to measure past 30-day distress. Past 30-day cannabis use was measured as 0 days, 1-2 days, 3-5 days, 6-9 days, 10-19 days, 20-29 days, 30 days or more. Adverse childhood experiences counts were 0, 1, 2, 3, and 4+. Age was grouped as 18-29, 30-39, 40-59, and 60+. Stepwise ordinal logistic regression models tested the hypothesized relationships. All analyses were survey-weighted.
Results: In our analytic sample, 15% had used cannabis in the past 30 days, 8% reported past 30-day psychological distress, 33% had 0 ACEs, 21% had 1 ACE, 15% had 2 ACEs, 12% had 3 ACEs, and 20% had 4+ ACEs. Among adults aged 18-29 (AOR=1.61; 95% CI: 1.16, 2.23, p<0.01) and 30-39 (AOR=1.83; 95% CI: 1.30, 2.57; p<0.01), ACEs the distress-cannabis relationship was positive and significant but was partially attenuated after accounting for ACEs. ACEs completely attenuated the relationship among adults aged 40 and older. After adding ACEs to the model, psychological distress was no longer positively associated with cannabis use among adults 40-59 (p=0.08) and 60+ (p=0.09)
Conclusion: This study found that ACEs attenuate associations between psychological distress and cannabis use, but the extent varies by age group. Among younger adults, adult distress plays a critical role in cannabis use, over and above ACEs. However, among older adults, child adversity has a greater impact on cannabis use than past month distress.