Latent Typologies of Psychiatric Symptom Comorbidity With Substance Use: Associations With Adverse Childhood Experiences

Abstract

Adverse childhood experiences (ACEs) and lifetime traumatic events are closely linked to development of comorbid psychiatric symptoms and substance use. Although research shows the risk for psychiatric and substance use comorbidity conferred by early adversity, most studies have not modeled multivariate symptom patterns that include posttraumatic stress disorder (PTSD) symptom criteria (i.e., re-experiencing, effortful avoidance, numbing, and hyperarousal). The aim of the present study was to model multivariate patterns of substance use and psychiatric symptoms, including PTSD criteria, and examine associations between these patterns and early adversity. Latent profile analysis (LPA) was used in a large, nonclinical sample of community adults (N = 1,431). Relations between profile membership, cumulative ACEs, and demographic covariates were then evaluated. Results indicated four distinct profiles of psychiatric symptom comorbidity (PSC): (a) PTSD dominant with elevated illicit drug and cannabis use; (b) anxiety and depression dominant with elevated use across substances; (c) avoidance dominant with low severity of all other psychiatric symptoms and substance use; and (d) psychiatrically healthy. Analyses identified significant associations between profile membership and cumulative ACEs and other traumatic events. Cumulative ACEs and traumatic events were highest among the PTSD dominant profile. A greater understanding of heterogeneous patterns of PSC may allow for future development of treatment care paths that correspond to standard criteria of symptom presentation and severity.