Adverse Childhood Experiences, Executive Functions, and Substance Use in an Indigenous Residential Treatment Program - Jessie Lund (2021)

Intergenerational trauma among Indigenous peoples in Canada is identified as an ongoing detrimental outcome of Canadian colonialism. Both adverse childhood experiences (ACEs) and substance use problems appear to be difficulties perpetuating intergenerational trauma among this population. While it is known that ACEs increase risk for a multitude of poor mental and physical health outcomes, the underlying mechanisms are less clear. Executive functions (EFs) may be one plausible mechanism linking ACEs to substance use difficulties, as EFs are both affected by chronic stress during childhood and are associated with poor outcomes later in life. This community-based research project was driven by Indigenous partnership who wanted to better understand how ACEs are implicated in the substance use difficulties their clients are facing. With this in mind, the goal of this study was to examine the interrelationships between ACEs, EF, and substance use outcomes among clients at an Indigenous substance use treatment program in Northwestern Ontario. To do this, 80 participants completed self-report questionnaires at two time points while in treatment. Ultimately, the number of ACEs experienced did not predict EF difficulties. However, family substance use predicted difficulties across all EFs and severity of neglect predicted difficulties in working memory specifically. ACEs did not predict age of first alcohol or cannabis use, though this relationship approached statistical significance. More than half of the sample demonstrated clinically significant post-traumatic stress disorder symptoms, which were both associated with number of past ACEs and predicted EF difficulties seen within the sample. Ultimately, this study serves as a preliminary step toward better understanding the link between ACEs and EFs among Indigenous adults with substance use difficulties, providing a knowledge base for future prevention, intervention, and research pursuits.