Assessment of Adverse Childhood Experiences & Resilience in Adults With Substance Use Disorders & Healthy Controls: A Case-Control Study
S. L. Langstieh, S. Singh, M. S. SenIntroduction
Substance use disorders (SUDs) remain a major public health challenge globally and in India, with relapse rates remaining high despite available treatments. Adverse Childhood Experiences (ACEs) are widely recognized as risk factors for SUDs, impacting neurobiological and psychosocial development. Resilience, the capacity to adapt and recover from adversity, may buffer this risk but is underexplored in Indian clinical populations.
Objectives
To compare the prevalence and severity of ACEs and levels of resilience in adults with substance use disorders and healthy controls within an Indian clinical setting.
Methods
A nine-month case-control study was conducted at the Institute of Human Behaviour & Allied Sciences, Delhi. Thirty-five adults diagnosed with SUD per DSM-5 criteria and 35 matched healthy controls were recruited. Participants were assessed using the WHO ACE-International Questionnaire (ACE-IQ) for childhood adversity and Connor-Davidson Resilience Scale (CD-RISC) for resilience. Additional clinical and demographic data were collected via semi-structured interviews and validated scales including ASSIST, GHQ-12, SDS, and RCQ.
Results
The SUD group reported significantly higher frequency and severity of ACEs than controls (p = 0.001), especially emotional abuse and exposure to community violence. Resilience scores did not differ significantly overall, but lower resilience correlated with greater ACE severity among SUD patients. Higher ACE exposure was associated with socio-educational deprivation and clinical risk factors, including perpetuating influences on substance use. The readiness to change was reflected in higher contemplation and action scores in the SUD group.
ACE Binary, ACE Frequency & Resilience (CD-RISC) scores amongst the participants Table 1. Long description.