{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:56:30Z","timestamp":1790736990076,"version":"4.1.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-37883-3","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T18:45:16Z","timestamp":1769971516000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The unique contributions of adverse childhood experiences to increases in post-traumatic stress symptoms and problematic substance use after trauma exposure"],"prefix":"10.1038","volume":"16","author":[{"given":"Maor Daniel","family":"Levitin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dvora","family":"Shmulewitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einav","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Skvirsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaul","family":"Lev-Ran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Kor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mikulincer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"37883_CR1","doi-asserted-by":"publisher","first-page":"e356","DOI":"10.1016\/S2468-2667(17)30118-4","volume":"2","author":"K Hughes","year":"2017","unstructured":"Hughes, K. et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public. Health. 2, e356\u2013e366 (2017).","journal-title":"Lancet Public. Health"},{"key":"37883_CR2","doi-asserted-by":"publisher","first-page":"1581447","DOI":"10.1080\/2331205X.2019.1581447","volume":"6","author":"EM Zarse","year":"2019","unstructured":"Zarse, E. M. et al. The adverse childhood experiences questionnaire: two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Med. 6, 1581447 (2019).","journal-title":"Cogent Med."},{"key":"37883_CR3","doi-asserted-by":"publisher","unstructured":"Sahle, B. W. et al. The association between adverse childhood experiences and common mental disorders and suicidality: an umbrella review of systematic reviews and meta-analyses. European Child and Adolescent Psychiatry vol. 31 1489\u20131499 Preprint at (2022). https:\/\/doi.org\/10.1007\/s00787-021-01745-2","DOI":"10.1007\/s00787-021-01745-2"},{"key":"37883_CR4","doi-asserted-by":"publisher","unstructured":"Kalmakis, K. A. & Chandler, G. E. Health consequences of adverse childhood experiences: A systematic review. Journal of the American Association of Nurse Practitioners vol. 27 457\u2013465 Preprint at (2015). https:\/\/doi.org\/10.1002\/2327-6924.12215","DOI":"10.1002\/2327-6924.12215"},{"key":"37883_CR5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.chiabu.2017.03.016","volume":"69","author":"MT Merrick","year":"2017","unstructured":"Merrick, M. T. et al. Unpacking the impact of adverse childhood experiences on adult mental health. Child. Abuse Negl. 69, 10\u201319 (2017).","journal-title":"Child. Abuse Negl."},{"key":"37883_CR6","doi-asserted-by":"crossref","unstructured":"Frewen, P., Zhu, J. & Lanius, R. Lifetime traumatic stressors and adverse childhood experiences uniquely predict concurrent PTSD, complex PTSD, and dissociative subtype of PTSD symptoms whereas recent adult non-traumatic stressors do not: results from an online survey study. Eur J. Psychotraumatol 10, 1606625 (2019).","DOI":"10.1080\/20008198.2019.1606625"},{"key":"37883_CR7","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1080\/07448481.2019.1577860","volume":"68","author":"KA Kalmakis","year":"2020","unstructured":"Kalmakis, K. A., Chiodo, L. M., Kent, N. & Meyer, J. S. Adverse childhood experiences, post-traumatic stress disorder symptoms, and self-reported stress among traditional and nontraditional college students. J. Am. Coll. Health. 68, 411\u2013418 (2020).","journal-title":"J. Am. Coll. Health"},{"key":"37883_CR8","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1007\/s10608-022-10328-7","volume":"46","author":"S Haim-Nachum","year":"2022","unstructured":"Haim-Nachum, S., Sopp, M. R., Bonanno, G. A. & Levy-Gigi, E. The lasting effects of early adversity and updating ability on the tendency to develop PTSD symptoms following exposure to trauma in adulthood. Cognit Ther. Res. 46, 1101\u20131112 (2022).","journal-title":"Cognit Ther. Res."},{"key":"37883_CR9","unstructured":"Mikulincer, M. & Shaver, P. R. Attachment in Adulthood: Structure, Dynamics, and Change (Guilford, 2010)."},{"key":"37883_CR10","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1037\/tra0000374","volume":"11","author":"M Cloitre","year":"2019","unstructured":"Cloitre, M. et al. Emotion regulation mediates the relationship between aces and physical and mental health. Psychol. Trauma. 11, 82\u201389 (2019).","journal-title":"Psychol. Trauma."},{"key":"37883_CR11","unstructured":"Mahanta, D., Deb Barman, J. A. & Review Paper on Adverse Childhood Experiences and Its Relation with Coping Strategies A. 12."},{"key":"37883_CR12","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1037\/0022-006X.68.5.782","volume":"68","author":"C Hammen","year":"2000","unstructured":"Hammen, C., Henry, R. & Daley, S. E. Depression and sensitization to stressors among young women as a function of childhood adversity. J. Consult Clin. Psychol. 68, 782\u2013787 (2000).","journal-title":"J. Consult Clin. Psychol."},{"key":"37883_CR13","doi-asserted-by":"publisher","unstructured":"McLaughlin, K. A. et al. Childhood adversities and post-traumatic stress disorder: Evidence for stress sensitisation in the World Mental Health Surveys. British Journal of Psychiatry vol. 211 280\u2013288 Preprint at (2017). https:\/\/doi.org\/10.1192\/bjp.bp.116.197640","DOI":"10.1192\/bjp.bp.116.197640"},{"key":"37883_CR14","doi-asserted-by":"publisher","unstructured":"Khantzian, E. J. The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry vol. 4 231\u2013244 Preprint at (1997). https:\/\/doi.org\/10.3109\/10673229709030550","DOI":"10.3109\/10673229709030550"},{"key":"37883_CR15","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000764.supp","author":"M Luciano","year":"2022","unstructured":"Luciano, M. et al. Supplemental material for posttraumatic stress Disorder, drinking to Cope, and harmful alcohol use: A multivariate Meta-Analysis of the Self-Medication hypothesis. J. Psychopathol. Clin. Sci. https:\/\/doi.org\/10.1037\/abn0000764.supp (2022).","journal-title":"J. Psychopathol. Clin. Sci."},{"key":"37883_CR16","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1080\/07347324.2020.1816518","volume":"38","author":"TF McGovern","year":"2020","unstructured":"McGovern, T. F. & Addiction Attachment, Trauma, and recovery: the power of connection. Alcohol Treat. Q. 38, 537\u2013539 (2020).","journal-title":"Alcohol Treat. Q."},{"key":"37883_CR17","doi-asserted-by":"crossref","unstructured":"Bryant, D. J., Coman, E. N. & Damian, A. J. Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting. Addictive Behav. Reports 12, 100293 (2020).","DOI":"10.1016\/j.abrep.2020.100293"},{"key":"37883_CR18","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3109\/00952990.2013.848876","volume":"40","author":"ZW Zhai","year":"2014","unstructured":"Zhai, Z. W., Kirisci, L., Tarter, R. E. & Ridenour, T. A. Psychological dysregulation during adolescence mediates the association of parent-child attachment in childhood and substance use disorder in adulthood. Am. J. Drug Alcohol Abuse. 40, 67\u201374 (2014).","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"37883_CR19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jsat.2018.07.010","volume":"93","author":"M Mergler","year":"2018","unstructured":"Mergler, M. et al. Differential relationships of PTSD and childhood trauma with the course of substance use disorders. J. Subst. Abuse Treat. 93, 57\u201363 (2018).","journal-title":"J. Subst. Abuse Treat."},{"key":"37883_CR20","doi-asserted-by":"publisher","unstructured":"Hicks, T. A., Zaur, A. J., Keeley, J. W. & Amstadter, A. B. The association between recreational cannabis use and posttraumatic stress disorder: A systematic review and methodological critique of the literature. Drug and Alcohol Dependence vol. 240 Preprint at (2022). https:\/\/doi.org\/10.1016\/j.drugalcdep.2022.109623","DOI":"10.1016\/j.drugalcdep.2022.109623"},{"key":"37883_CR21","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.jpsychires.2024.01.041","volume":"171","author":"TC Saraiya","year":"2024","unstructured":"Saraiya, T. C. et al. Trauma-related shame predicts daily non-medical prescription opioid use among individuals with PTSD symptoms. J. Psychiatr Res. 171, 171\u2013176 (2024).","journal-title":"J. Psychiatr Res."},{"key":"37883_CR22","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.3109\/10826084.2016.1168445","volume":"51","author":"MT Tull","year":"2016","unstructured":"Tull, M. T. et al. The role of emotion regulation difficulties in the relation between PTSD symptoms and the learned association between Trauma-Related and cocaine cues. Subst. Use Misuse. 51, 1318\u20131329 (2016).","journal-title":"Subst. Use Misuse"},{"key":"37883_CR23","doi-asserted-by":"crossref","unstructured":"Chilcoat, H. D. & Breslau, N. Investigations of causal pathways between PTSD and drug use disorders. in Addictive Behaviors vol. 23 827\u2013840 (1998).","DOI":"10.1016\/S0306-4603(98)00069-0"},{"key":"37883_CR24","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1093\/alcalc\/agz098","volume":"55","author":"J Jung","year":"2021","unstructured":"Jung, J. et al. Adverse childhood experiences are associated with High-Intensity binge drinking behavior in adulthood and mediated by psychiatric disorders. Alcohol Alcohol. 55, 204\u2013214 (2021).","journal-title":"Alcohol Alcohol."},{"key":"37883_CR25","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.drugalcdep.2013.10.014","volume":"134","author":"KM Keyes","year":"2014","unstructured":"Keyes, K. M. et al. Exposure to the Lebanon war of 2006 and effects on alcohol use disorders: the moderating role of childhood maltreatment. Drug Alcohol Depend. 134, 296\u2013303 (2014).","journal-title":"Drug Alcohol Depend."},{"key":"37883_CR26","doi-asserted-by":"crossref","unstructured":"Guillaume, S. et al. Associations between adverse childhood experiences and clinical characteristics of eating disorders. Sci Rep 6, 35761 (2016).","DOI":"10.1038\/srep35761"},{"key":"37883_CR27","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1016\/j.addbeh.2013.01.027","volume":"38","author":"SE Ullman","year":"2013","unstructured":"Ullman, S. E., Relyea, M., Peter-Hagene, L. & Vasquez, A. L. Trauma histories, substance use coping, PTSD, and problem substance use among sexual assault victims. Addict. Behav. 38, 2219\u20132223 (2013).","journal-title":"Addict. Behav."},{"key":"37883_CR28","doi-asserted-by":"crossref","unstructured":"Shmulewitz, D., Eliashar, R., Levitin, M. D. & Lev-Ran, S. Test characteristics of shorter versions of the Alcohol, smoking and substance involvement screening test (ASSIST) for brief screening for problematic substance use in a population sample from Israel. Subst Abuse Treat. Prev. Policy 18, 58 (2023).","DOI":"10.1186\/s13011-023-00566-7"},{"key":"37883_CR29","doi-asserted-by":"publisher","first-page":"4635","DOI":"10.1017\/S0033291724002794","volume":"54","author":"D Shmulewitz","year":"2024","unstructured":"Shmulewitz, D. et al. Comorbidity of problematic substance use and other addictive behaviors and anxiety, depression, and post-Traumatic stress disorder: A network analysis. Psychol. Med. 54, 4635\u20134645 (2024).","journal-title":"Psychol. Med."},{"key":"37883_CR30","unstructured":"iPanel."},{"key":"37883_CR31","doi-asserted-by":"crossref","unstructured":"Shmulewitz, D. et al. Exposure to online hate speech is positively associated with post-traumatic stress disorder symptom severity. Sci Rep 15, 29869 (2025).","DOI":"10.1038\/s41598-025-16168-1"},{"key":"37883_CR32","doi-asserted-by":"crossref","unstructured":"Shmulewitz, D. et al. Prevalence of Substance and Behavioral Addictions and Common Mental Health Disorders in Israel, 2022\u20132025. (2025).","DOI":"10.64898\/2026.02.16.26346376"},{"key":"37883_CR33","doi-asserted-by":"crossref","unstructured":"Harrison, E., Drake, T., Pius, R. & Finalfit Quickly Create Elegant Regression Results Tables and Plots When Modelling. (2018). https:\/\/finalfit.org\/","DOI":"10.32614\/CRAN.package.finalfit"},{"key":"37883_CR34","doi-asserted-by":"crossref","unstructured":"Jamshidian, M., Jalal, S. & Jansen, C. MissMech: An R Package for Testing Homoscedasticity, Multivariate Normality, and Missing Completely at Random (MCAR). JSS Journal of Statistical Software vol. 56 (2014). http:\/\/www.jstatsoft.org\/","DOI":"10.18637\/jss.v056.i06"},{"key":"37883_CR35","doi-asserted-by":"publisher","unstructured":"Woods, A. D. et al. Missing data and multiple imputation decision tree. Preprint at https:\/\/doi.org\/10.31234\/osf.io\/mdw5r\u00a0(2021).","DOI":"10.31234\/osf.io\/mdw5r\u00a0(2021)."},{"key":"37883_CR36","unstructured":"Qualtrics, X. M."},{"key":"37883_CR37","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1111\/j.1360-0443.2007.02114.x","volume":"103","author":"R Humeniuk","year":"2008","unstructured":"Humeniuk, R. et al. Validation of the alcohol, smoking and substance involvement screening test (ASSIST). Addiction 103, 1039\u20131047 (2008).","journal-title":"Addiction"},{"key":"37883_CR38","unstructured":"Humeniuk, R. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for Use in Primary Care (World Health Organization, 2010)."},{"key":"37883_CR39","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/jts.22059","volume":"28","author":"CA Blevins","year":"2015","unstructured":"Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K. & Domino, J. L. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J. Trauma. Stress. 28, 489\u2013498 (2015).","journal-title":"J. Trauma. Stress"},{"key":"37883_CR40","unstructured":"Weathers, F. et al. The PTSD Checklist for DSM-5 (PCL-5). (2013)."},{"key":"37883_CR41","unstructured":"World Health Organization. Adverse Childhood Experiences International Questionnaire. (2018)."},{"key":"37883_CR42","unstructured":"R Core Team. R: A Language and environment for statistical computing. R Foundation Stat. Computing. https:\/\/www.R-project.org\/\u00a0(2024)."},{"key":"37883_CR43","doi-asserted-by":"crossref","unstructured":"Rosseel, Y. Lavaan: an R package for structural equation modeling. J Stat. Softw 48, 1-36 (2012).","DOI":"10.18637\/jss.v048.i02"},{"key":"37883_CR44","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1038\/s41562-020-0912-z","volume":"4","author":"U Simonsohn","year":"2020","unstructured":"Simonsohn, U., Simmons, J. P. & Nelson, L. D. Specification curve analysis. Nat. Hum. Behav. 4, 1208\u20131214 (2020).","journal-title":"Nat. Hum. Behav."},{"key":"37883_CR45","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1037\/a0035878","volume":"28","author":"M Haller","year":"2014","unstructured":"Haller, M. & Chassin, L. Risk pathways among traumatic stress, posttraumatic stress disorder symptoms, and alcohol and drug problems: A test of four hypotheses. Psychol. Addict. Behav. 28, 841\u2013851 (2014).","journal-title":"Psychol. Addict. Behav."},{"key":"37883_CR46","doi-asserted-by":"crossref","unstructured":"Kaufman-Parks, A. M., Longmore, M. A., Manning, W. D. & Giordano, P. C. A prospective study of adverse childhood experiences and illicit drug use in adulthood. Journal Hum. Services 43, 71-96 (2024).","DOI":"10.52678\/001c.117729"},{"key":"37883_CR47","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/ajad.13673","volume":"34","author":"JE Chambers","year":"2025","unstructured":"Chambers, J. E. et al. Adverse childhood experiences, insecure attachment, and appointment compliance in an outpatient addiction psychiatry treatment population. Am. J. Addictions. 34, 334\u2013341 (2025).","journal-title":"Am. J. Addictions"},{"key":"37883_CR48","doi-asserted-by":"publisher","unstructured":"Strathearn, L. et al. Pathways Relating the Neurobiology of Attachment to Drug Addiction. Frontiers in Psychiatry vol. 10 Preprint at (2019). https:\/\/doi.org\/10.3389\/fpsyt.2019.00737","DOI":"10.3389\/fpsyt.2019.00737"},{"key":"37883_CR49","unstructured":"Selected Data from the 2021 Social Survey on Languages. Israel Central Bureau of Statistics (2022). www.cbs.gov.il\/he\/mediarelease\/DOcLib\/2022\/19_22_244b"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37883-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37883-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37883-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T11:33:14Z","timestamp":1771414394000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37883-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["37883"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-37883-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]},"assertion":[{"value":"7 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6870"}}