The Moderation Effect of Disability Status on the Associations Among ACEs, Mental Health, and Binge Drinking

ABSTRACT

Purpose

Mental health and substance use social workers must be prepared to work with people with disabilities, as this population has higher rates of adverse childhood experiences (ACEs), and ACEs can lead to mental health and substance use problems. The study’s purpose is to assess the moderating effect of disability on the interrelationships among ACEs, mental health, and binge drinking.

Materials and Methods

Using data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) survey, we first used multigroup confirmatory factor analysis to establish the underlying factor structure of the ACEs questionnaire for respondents with and without disabilities. Next, we used multigroup structural equation modeling to assess the mediating effect of mental health difficulties on the association between ACEs and binge drinking for respondents with and without disabilities.

Results

A three-factor measurement model (emotional or physical abuse, sexual abuse, and household dysfunction) demonstrated excellent model fits. Mental health difficulties significantly mediated the association between ACEs and binge drinking for all respondents. Disability status was a statistically significant moderator of a few associations, with more mental health variance explained by ACEs for the disabled respondents. Direct paths showed household dysfunction and sexual abuse had greater impacts on mental health for disabled respondents, and indirect paths showed these factors also had greater impacts on binge drinking among disabled respondents.

Discussion and Conclusion

To prevent mental health and binge drinking problems among disabled individuals, we need evidence-based interventions to identify their ACEs and provide accessible, trauma-informed treatments to them.

KEYWORDS:

• Binge drinking
• substance misuse
• mental health
• adverse childhood experiences
• trauma
• disability

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The 2021 BRFSS may be accessed here: https://www.cdc.gov/brfss/annual_data/annual_2021.html

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.