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A Sequential Mixed-Methods Study Examining Moderators and Mediators of Adverse Childhood Experiences on Alcohol Use among Latinx Young Adults


Background: The Adverse Childhood Experience (ACE) Questionnaire has been used to establish the relationship between ACEs and alcohol use among Latinx populations. This scale was developed using predominantly non-Latinx White samples; applying this scale to Latinx groups is problematic as diverse adversities have not been considered. Furthermore, scant research explores variables that moderate or mediate the relationship between ACEs and risky drinking among second-generation Latinx young adults. Guided by the Stress-Buffering Hypothesis and Stress and Negative Affect Model, this project aimed to elucidate these gaps.

Methods: A exploratory sequential mixed methods study was developed to examine these gaps. Participants were recruited between August 2021-August 2022. AIM 1 (Chapter 2) used a qualitative methodological approach to explore childhood adversities experienced by Latinx young adults, and social support needs wanted during the adversity (n=20). AIM 2 (Chapter 3) tested moderating effects of social support types on the relationship between ACEs and risky drinking in a sample of second-generation Latinx young adults (n=143). AIM 3 (Chapter 4) tested whether depression and anxiety mediated this relationship.

Results: Aim 1: Themes that surfaced include enduring financial insecurity, taking on adult-like responsibilities, witnessing community violence, food insecurity, deportation-related adversity, racism-related adversity, housing instability, and being bullied. Participants reported wanting emotional, instrumental, informational support in addition to individual therapy during the adversity. Aim 2: Multiple hierarchical linear regression analyses showed a positive association between ACEs and risky drinking (AUDIT total score, AUDIT-C, Heavy Episodic Drinking). Only emotional/information support significantly moderated the relationship between ACEs and risky drinking (AUDIT total); this effect was opposite of what was predicted. Specifically, emotional/information support strengthened the relationship between ACEs and risky drinking Aim 3: Mediation analyses showed positive associations between ACEs, depression, and risky drinking as measured by the AUDIT. Depression partially mediated the relationship between ACEs and risky drinking (AUDIT total score). Significant effects were not observed for other measures of risky drinking or other models investigated.

Conclusions: The findings support the need to enhance the ACE scale and develop interventions focused on mental health to reduce risky drinking behaviors among this group of individuals.

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