Alexithymia mediates the association between childhood trauma and adolescent E-cigarette use

• Published in: Drug and alcohol dependence 2022-07, Vol.236, p.109500-109500, Article 109500
• Main Authors: Sutherland, Benjelene D., Fallah-Sohy, Nilofar, Kopera, Maciej, Jakubczyk, Andrzej, Sutherland, Matthew T., Trucco, Elisa M.
• Format: Article
• Language: English
• Subjects: Adolescence; Adolescent; Adolescents; Adverse Childhood Experiences; Affective Symptoms - psychology; Alexithymia; Child; Child abuse & neglect; Childhood; Childhood trauma; Children; Cigarettes; Clinical assessment; Coping; Coping strategies; Dopamine; E-cigarette use; Electronic cigarettes; Electronic Nicotine Delivery Systems; Emotional abuse; Emotional neglect; Emotions; Humans; Nicotine; Noradrenaline; Norepinephrine; Personality; Psychological distress; Public health; Reliability; Reproducibility of Results; Risk analysis; Risk factors; Smoking; Social environment; Teenagers; Trauma; Vaping; Verbalization
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109500

Adolescent electronic cigarette use (e-cigarette) is a public health concern and factors associated with vaping remain to be understood. Childhood emotional abuse/neglect is a risk factor for e-cigarettes. Yet, pathways by which trauma impacts use remain unclear. Alexithymia (i.e., difficulties identifying and describing feelings) is one possible link. Indeed, emotional abuse/neglect leads to difficulties identifying and verbalizing emotions. This impairment may lead to distress and promote e-cigarette use as a coping strategy. Using parallel mediation, this study examined the degree to which alexithymia, assessed using the Toronto Alexithymia Scale, mediates the link between emotional abuse/neglect, assessed using the Child and Adolescent Trauma Screen, and e-cigarette use. The sample (n = 166) consisted of adolescents from a larger multi-wave study. Emotional abuse/neglect predicted difficulty describing feelings (effect = 0.23, p = 0.001), which in turn predicted e-cigarette use (effect = 0.30, p = 0.004). Moreover, difficulty describing feelings mediated the link between emotional abuse/neglect and e-cigarette use (sum of indirect 95% CI [1.68, 16.48]). Difficulty identifying feelings was not a significant mediator and the externally-oriented thinking subscale was excluded due to low reliability. As e-cigarettes are often used in social contexts, teens who experience difficulty describing feelings may vape as a means of connecting emotionally with others. Moreover, nicotine, found in most e-cigarettes, releases dopamine and noradrenaline in the brain modulating action, learning, and memory processes; plausibly, improving verbalization of emotions. Programming which identifies nuances in alexithymia among adolescents with emotional abuse/neglect could mitigate e-cigarette use or delay initiation. •The link between childhood trauma and e-cigarette use via alexithymia was tested.•Emotional abuse/neglect predicted alexithymia among adolescents.•Difficulty describing (not identifying) feelings predicted e-cigarette use.•Emotional abuse/neglect was not directly associated with e-cigarette use.•Treatment linked with emotion verbalization could mitigate e-cigarette use onset.