From childhood adversity to substance use: exploring predictors in Lithuanian young adults

Abstract

Introduction. Adverse childhood experiences (ACEs) are recognized risk factors for later substance use, yet data remain scarce – particularly regarding the differentiated effects of specific types of ACEs and their distinct associations with various psychoactive substances. Current study is one of the first in Lithuania to explore the associations between specific ACEs and substance use expression in young adulthood (ages 18–29), a developmental period defined by Arnett’s theory of emerging adulthood and full neurological maturation. Methods. This cross-sectional study included a total of 709 participants (26.5% male, 73.5% female) completed an online survey between September and November 2024. Substance use was assessed using validated instruments: AUDIT (alcohol), CUDIT-R (cannabis), ASSIST (other substances), and self-reported smoking behavior. ACEs were measured using a combination of adapted ACE questionnaire items) and the MACE scale, covering ten categories of childhood adversity. Structural Equation Modeling (SEM) was employed to examine predictive relationships. Results. Sexual abuse, physical neglect, emotional neglect, and physical abuse consistently predicted higher levels of alcohol, cannabis, and other substance use. Verbal abuse, conversely, showed significant negative associations across several substance categories. Smoking was positively associated with sexual abuse and negatively with witnessing interpersonal violence. Notably, a family history of addiction was not significantly related to substance use, suggesting that genetic predisposition may play a less central role than environmental or psychosocial factors. Conclusions. The findings underscore the differentiated impact of specific adverse childhood experiences on the use of various psychoactive substances. This highlights the necessity for further research that not only examines adverse experiences individually, but also explores the distinct associations between different types of psychoactive substances and these early life stressors. Such an approach is essential for uncovering substance-specific pathways and developing more targeted prevention and intervention strategies.