Exposure to Childhood Abuse and Later Substance Use: Indirect Effects of Emotion Dysregulation and Exposure to Trauma.

"There were a number of limitations of the study. One was the use of retrospective self‐report measures. Given the cross‐sectional nature of this study, we were unable to make assertions about causality, time of onset for ED, trauma exposure, or substance use. Prospective, longitudinal studies are required to examine the temporal course of trauma exposure and psychiatric symptoms to determine if the proposed relationships between ED, later trauma, childhood abuse, and future substance use will be supported by the evidence from such studies. The indirect model presented was also vulnerable to the problem of omitted variables because the mediators were not randomly assigned. In addition, the study utilized screening measures that assessed risky behaviors and symptoms that may be associated with SUDs, but could not provide diagnoses, thus limiting the clinical implications of our results. This work was primarily supported by the National Institute of Mental Health (MH071537; MH100122) and the National Institute of Child Health and Human Development (HD071982). Support also included Emory and Grady Memorial Hospital General Clinical Research Center, NIH National Centers for Research Resources (M01 RR00039). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additionally, the contents of this report do not represent the views of the Department of Veterans Affairs or the United States Government. Amar Mandavia and Gabriella G. N. Robinson contributed equally to the work and are co‐first authors."