ArticlePreventive medicine2020
Adverse childhood experiences, internalizing/externalizing symptoms, and associated prescription opioid misuse: A mediation analysis.
Article in Preventive medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Impact of adverse childhood experiences on analgesia-related outcomes: a systematic review.British journal of anaesthesia · 2025Pooled it
- Dopamine system as a mediator between psychological symptoms and relapse tendency: a cross-sectional study in women undergoing compulsory rehabilitation in Zhengzhou, China.Frontiers in public health · 2026Article
- The Role of Child Maltreatment and Revictimization on Substance Use Trajectories Among Women Involved in the Criminal Justice System.Women & criminal justice · 2025Article
- Associations of childhood adversity and substance use disorder polygenic scores with disorder severity and diagnostic criteria.Psychological medicine · 2025Article
- Adolescents' Adverse Childhood Experiences, Poor Mental Health, and Substance Use During the COVID-19 Pandemic.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Article
- Relationships Between Recent Adverse Childhood Experiences (ACEs) and Somatic Symptoms in Adolescence.Journal of child and family studies · 2024Article
- Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019-2020.BMC pregnancy and childbirth · 2023Article
- The mediating role of internalizing and externalizing symptoms in the association between child neglect and suicide attempt in adulthood.International journal of injury control and safety promotion · 2022Article
- The mediating role of anxiety/depression symptoms between adverse childhood experiences (ACEs) and somatic symptoms in adolescents.Journal of adolescence · 2022Article
- Early Life Stress and Risks for Opioid Misuse: Review of Data Supporting Neurobiological Underpinnings.Journal of personalized medicine · 2021Review
- Sources of prescription opioids and tranquilizers for misuse among U.S. young adults: differences between high school dropouts and graduates and associations with adverse outcomes.Journal of addictive diseasesArticle
- Opioid use disorder in pediatric populations: considerations for perioperative pain management and precision opioid analgesia.Expert review of clinical pharmacologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
Adverse childhood experiences (ACEs) are associated with mental health and substance use problems, but lesser known is how they interconnect. The objective of this study was to examine how internalizing and externalizing symptoms mediate the association of ACEs with prescription opioid misuse in order to understand how ACEs interconnect with mental health and substance use problems. Adults aged 18 or older from the National Epidemiological Survey on Alcohol and Related Conditions Wave 3 (NESARC-III) conducted in 2012-2013 were included (N = 36,309). The prescription opioid misuse outcomes examined include prescription opioid misuse status, early-onset status of prescription opioid misuse, frequency of past-year prescription opioid misuse, and opioid use disorder. A natural effect model and regression analyses were used to conduct the mediation analyses. We found that respondents with higher ACE scores had greater odds of reporting past-year and lifetime prescription opioid misuse and DSM-V-diagnosed opioid use disorder as well as early onset of prescription opioid misuse (AORs range from 1.06 to 1.12). These associations are partially mediated by internalizing and externalizing symptoms. The findings suggest that internalizing and externalizing symptoms may be potential pathways through which ACEs are associated with prescription opioid misuse. Our results underscore the importance of preventing ACEs and reducing risk for internalizing and externalizing symptoms after exposure, which may reduce later prescription opioid misuse.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.