Life stress exposures, substance use, and justice system involvement from adolescence to adulthood: Identifying protective factors in a US national cohort study - Differences in incarceration rates across US demographic groups are greatest among young adults (ages 18-25), and life stress exposure is nearly universal in justice-involved populations. Given elevated rates of criminal justice involvement for substance-related offenses among some demographic groups, and the prevalence of cannabis and other illicit drug use among incarcerated populations, research is needed to further understand the relationship between life stress exposures and the course of cannabis and other drug use across the lifespan and to highlight critical intervention opportunities. We recognize that certain population groups experience high prevalence of adverse childhood experiences (ACEs) and negative health outcomes, yet few studies have considered sociodemographic differences in associations between ACEs and substance use. Furthermore, virtually no research has examined variations in adult stress exposures and substance use, and their relevance to incarceration. Addressing the aforementioned gaps, this study investigates population group differences in stress exposures during an understudied developmental period, emerging adulthood, and how these exposures may influence risk for incarceration through substance use. This secondary analysis study leverages general population data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) and integrates a developmental perspective into a socioecological framework to examine life stress exposures found prevalent in population subgroups that have had limited access to resources. Our first aim is to examine longitudinal associations between young adult stress exposures and later cannabis and other drug use and incarceration, accounting for ACEs. The second aim is to investigate sub-population developmental pathways from stress exposures to incarceration. We innovate by employing propensity scoring methods and marginal structural modeling to determine causal and cumulative effects of stress exposures on incarceration risk from adolescence (ages 12-17) to early mid-adulthood (ages 33-43), setting us apart from extant life stress research that concentrates primarily on childhood exposures. Our third aim will use moderated causal mediation to identify salient population-specific protective social supports (such as adult mentorship, faith-based engagement, and mental health service use) within the neighborhood environment that most strongly attenuate effects of young adult stress exposures on cannabis and other drug use and, ultimately, incarceration risk. Findings from this epidemiologic study will have great potential to inform meaningful development of community-tailored and developmentally appropriate multilevel interventions in US subpopulations at increased risk for incarceration. Doing so can help prevent young people’s further entrenchment in the criminal justice system and alleviate the harmful consequences of incarceration on families and in their communities.
