Associations between Adverse Childhood Experiences and Performance-Enhancing Substance Use among Young Adults


Ganson, Kyle T.; Murray, Stuart B.; Mitchison, Deborah; Hawkins, Misty A. W.; Layman, Harley; Tabler, Jennifer; & Nagata, Jason M. (2021). Associations between Adverse Childhood Experiences and Performance-Enhancing Substance Use among Young Adults. Substance Use & Misuse. vol. 56 (6) pp. 854-860


Background and Objective Adverse childhood experiences (ACEs) are associated with negative health outcomes, yet their associations with performance-enhancing substance (PES) use are unclear. This study aimed to determine whether ACEs predict greater use of legal and illegal PES in young adults.Methods We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (n=14,322), Waves I (1994-1995) and III (2001-2002). ACEs included childhood sexual abuse, physical abuse, two neglect indicators, and cumulative ACEs. Legal (e.g. creatine monohydrate) and illegal (e.g. non-prescription anabolic-androgenic steroids; AAS) PES use was assessed.Results Sexual abuse had the greatest effect and predicted higher odds of legal PES use (men: adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.06-2.59; women: AOR 3.74, 95% CI 1.63-8.59) and AAS use (men: AOR 8.89, 95% CI 5.37-14.72; women: AOR 5.73, 95% CI 2.31-14.18). Among men, a history of physical abuse (AOR 3.04, 95% CI 2.05-4.52), being left alone by a parent/guardian (AOR 2.33, 95% CI 1.50-3.60), and basic needs not being met (AOR 3.47, 95% CI 2.30-5.23) predicted higher odds of AAS use. Among women, basic needs not being met (AOR 2.94, 95% CI 1.43-6.04) predicted higher odds of AAS use. Among both men and women, greater number of cumulative ACEs predicted higher odds of both legal and illegal PES use.Conclusions ACEs predict greater PES use among young adults. Clinicians should monitor for PES use among those who have experienced ACEs and provide psychoeducation on the adverse effects associated with PES use.



Adverse childhood experiences

Reference Type

Journal Article

Journal Title

Substance Use & Misuse


Ganson, Kyle T.
Murray, Stuart B.
Mitchison, Deborah
Hawkins, Misty A. W.
Layman, Harley
Tabler, Jennifer
Nagata, Jason M.

Year Published


Volume Number


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May 12, 2021





Reference ID