Childhood Mistreatment, PTSD, and Substance Use in Latinx: The Role of Discrimination in an Omitted-Variable Bias.
Childhood mistreatment
Nativity differences
Omitted variable bias
Perceived discrimination
Posttraumatic stress disorder
Substance use disorders
Journal
International journal of behavioral medicine
ISSN: 1532-7558
Titre abrégé: Int J Behav Med
Pays: England
ID NLM: 9421097
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
accepted:
03
01
2021
pubmed:
25
3
2021
medline:
25
3
2021
entrez:
24
3
2021
Statut:
ppublish
Résumé
Childhood mistreatment (CM) has been associated with adult posttraumatic disorder (PTSD) and substance use disorders (SUDs) in the general population. Few studies have examined the role of PTSD in the CM-SUD association among Latinx. This cross-sectional study evaluated a theory-driven conceptual model with a specific focus on the impact of perceived discrimination, which may interfere with these associations. Using a nationally representative sample and structural equation modeling (SEM), the study evaluated the mediation of PTSD in the CM-SUD link, adjusting for or omitting discrimination and other sociodemographic variables that are known predictors of Latinx behavioral health. Multi-subsample analyses were then conducted to review nativity differences (US-born = 924.43% and immigrant = 1630.57%). The fully specified final model (model 1, covariates adjusted) failed to show a significant mediation of PTSD in the tested link, but a direct detrimental effect group of discrimination, for all Latinx. The mediation was only supported, when treating discrimination and other covariates as omitted variables (model 5), which also showed additional direct and indirect effect of CM on SUD. In subsample analyses, models of US-born and immigrant-Latinx subpopulations were identical but showed nativity differences when omitting covariates. When discrimination and other covariates were fully adjusted, Latinx exposed to trauma were more likely to develop SUD in adulthood, regardless of when traumatic exposure occurred. This unexpected finding challenges theories explaining the CM-SUD connection, suggesting possible model misspecifications of parametric SES; namely, omitting the unique impact of perceived discrimination in Latinx can lead to biased results. From a clinical standpoint, both trauma and discrimination must be addressed when assessing Latinx behavioral health.
Sections du résumé
BACKGROUND
BACKGROUND
Childhood mistreatment (CM) has been associated with adult posttraumatic disorder (PTSD) and substance use disorders (SUDs) in the general population. Few studies have examined the role of PTSD in the CM-SUD association among Latinx. This cross-sectional study evaluated a theory-driven conceptual model with a specific focus on the impact of perceived discrimination, which may interfere with these associations.
METHOD
METHODS
Using a nationally representative sample and structural equation modeling (SEM), the study evaluated the mediation of PTSD in the CM-SUD link, adjusting for or omitting discrimination and other sociodemographic variables that are known predictors of Latinx behavioral health. Multi-subsample analyses were then conducted to review nativity differences (US-born = 924.43% and immigrant = 1630.57%).
RESULTS
RESULTS
The fully specified final model (model 1, covariates adjusted) failed to show a significant mediation of PTSD in the tested link, but a direct detrimental effect group of discrimination, for all Latinx. The mediation was only supported, when treating discrimination and other covariates as omitted variables (model 5), which also showed additional direct and indirect effect of CM on SUD. In subsample analyses, models of US-born and immigrant-Latinx subpopulations were identical but showed nativity differences when omitting covariates.
CONCLUSION
CONCLUSIONS
When discrimination and other covariates were fully adjusted, Latinx exposed to trauma were more likely to develop SUD in adulthood, regardless of when traumatic exposure occurred. This unexpected finding challenges theories explaining the CM-SUD connection, suggesting possible model misspecifications of parametric SES; namely, omitting the unique impact of perceived discrimination in Latinx can lead to biased results. From a clinical standpoint, both trauma and discrimination must be addressed when assessing Latinx behavioral health.
Identifiants
pubmed: 33761115
doi: 10.1007/s12529-021-09954-4
pii: 10.1007/s12529-021-09954-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
602-615Informations de copyright
© 2021. International Society of Behavioral Medicine.
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