Considering the Mediating Effects of Drug and Alcohol Use, Mental Health, and Their Co-Occurrence on the Adverse Childhood Experiences–Recidivism Relationship

Date01 July 2019
Published date01 July 2019
Subject MatterArticles
Considering the Mediating
Effects of Drug and Alcohol
Use, Mental Health, and
Their Co-Occurrence
on the Adverse Childhood
Jessica M. Craig
, Haley R. Zettler
, Kevin T. Wolff
and Michael T. Baglivio
Prior research has demonstrated a relationship between adverse childhood experiences (ACEs) and
recidivism among justice-involved youth. It has also been found that drug and alcohol use, mental
health, and their co-occurrence increase recidivism. As there is evidence that ACEs increase the
likelihood of both drug and alcohol use and mental health problems, it is surprising that prior
research has yet to examine whether these factors mediate the ACE-recidivism relationship. Using
data from a large sample of adjudicated juveniles in Florida, the current study examines the mediating
effects of drug and alcohol use, mental health problems, and their co-occurrence on the ACEs-
recidivism relationship. For the entire sample, the results found that current drug use, current
mental health problems, and their co-occurrence served as partial mediators of the ACEs-recidivism
relationship. Further, important gender and racial differences in these mediating effects were
revealed. Implications for these findings within justice-involved youth are discussed.
recidivism, child maltreatment, comorbidity, substance use, mental health
Department of Criminal Justice, University of North Texas, Denton, TX, USA
University of Memphis, Memphis, TN, USA
John Jay College of Criminal Justice, New York, NY, USA
Truecore Behavioral Solutions, Tampa, FL, USA
Corresponding Author:
Jessica M. Craig, Department of Criminal Justice, University of North Texas, 410 S. Avenue C, Chilton Hall, 273 L, Denton,
TX 5017, USA.
Youth Violence and JuvenileJustice
2019, Vol. 17(3) 219-240
ªThe Author(s) 2018
Article reuse guidelines:
DOI: 10.1177/1541204018796910
Since the 1990s, the examination and identi fication of criminogenic risk factors ha s become a
common focus in the study of crime (Farrington, 2000). One recent addition to this literature is the
impact of adverse childhood experiences (ACEs). Initially identified in the public health literature,
ACEs refer to a set of negative events that when experienced during an individual’s childhood or
adolescence have been linked to a wide variety of negative life outcomes ranging from chronic
diseases to offending (Bellis, Lowey, Leckenby, Hughes, & Harrison, 2014; Felitti et al., 1998; Fox,
Perez, Cass, Baglivio, & Epps, 2015; Hillis et al., 2004; Hillis, Anda, Felitti, & Marchbanks, 2001).
More recently, scholars have sought to identify potential factors that may moderate the relationship
between ACEs and offending. Evidence from a variety of samples has indicated several factors such
as low substance use, low daring, and low hyperactivity which serve to buffer the harmful effect of
ACEs on later offending (Craig, Baglivio, Wolff, Piquero, & Epps, 2017; Craig, Intravia, Wolff, &
Baglivio, 2017; Craig, Piquero, Farrington, & Ttofi, 2017; Wolff & Baglivio, 2017).
Along with examining these moderating effects, others have considered potential mediators in the
effects of ACEs on later life outcomes. Recent research by Walters and Espelage (2018) found
support for a mediating relationship between victimization and substance use through its impact on
cognitive impulsivity. Douglas and colleagues (2010) examined the potential mediating effects of
mood and anxiety disorders on the relationship between ACEs and substance use and found that
mental health disorders partially mediated the effect of ACEs on substance use risk. These findings
are particularly salient as comorbidity of substance use and mental health issues is known to be
higher among justice-involved youth (Abrantes, Hoffman, & Ant on, 2005; Shufelt & Cocozza,
2006; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002). The current research aims to extend
this area of inquiry, by assessing whether the co-occurrence of mental health problems, drug use, and
alcohol use mediate the effects of ACEs on recidivism. Prior to presenting the central analyses of the
current study, we first offer a discussion of the known effects of both poor mental health and drug/
alcohol use on crime, first individually and then when these two issues are co-occurring. Next, we
turn to the impact of ACEs on crime, mental health, and drug and alcohol use. Finally, we close the
review of the literature with a discussion of the motivation for the current study.
Impact of Mental Health on Crime
Much empirical attention has been devoted to the relationship between mental health and offending
(Silver, Felson, & Vaneseltine, 2008; Silver, Piquero, Jennings, Piquero, & Leiber, 2011; Teplin
et al., 2006). Abram and his colleagues (2004) reported that justice-involved youth had a higher
prevalence of mental health issues than their counterparts outside of the justice system. Among
juvenile offenders, those with a mental illness were also more likely to recidivate than those without
such issues (Prins & Draper, 2009; Skeem, Winter, Kennealy, Louden, & Tatar, 2013). While most
people with mental health issues do not engage in violent behavior and only a small percentage of
violence has been attributed to mental illness (Reuve & Welton, 2008), those with mental illnesses
often exhibit impaired judgment (Silver et al., 2008). This impacts their decision-making, conse-
quently increasing their like lihood of engaging in risky behav ior. It has also been argued that
violence is more likely to occur when the mental disorder involves substance abuse or paranoia
(Elbogin & Johnston, 2009; Link & Stueve, 1995; Steadman et al., 1998).
As Silver, Felson, and Vaneseltine (2008) pointed out, studying the relationship between mental
health and violent criminal behavior is challenging as both issues evidence several of the same risk
factors such as stressful life events, socioeconomic status, gender, and age. In order to control for
many of these risk factors, Silver et al. analyzed a nationally representative sample of inmates to
determine whether those who had been formerly treated for mental health issues had been convicted
of violent offenses, namely, assault and homicide, more than nonviolent offenses. The results
indicated that those who had received mental health-related treatment were more likely to have a
220 Youth Violence and Juvenile Justice 17(3)

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