Adverse Childhood Experiences and Substance Use: A Parallel Mediation Analysis of Depressive Symptoms and Low Self-Control

Adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction, are common among adolescents and have been linked to increased substance use. This study examined how depressive symptoms and low self-control mediate the relationship between ACEs and substance use in a statewide representative sample of over 23,000 Florida high school students. Using generalized structural equation modeling with bootstrapped indirect effects, analyses revealed that ACEs were significantly associated with greater substance use, and that both depressive symptoms and low self-control mediated this relationship. Although low self-control was the stronger mediator, these factors collectively accounted for more than one-third of the total association between ACEs and substance use. These findings highlight the need for prevention and intervention efforts that target both emotional and behavioral factors to reduce substance use risk among adolescents exposed to adversity. Further research is recommended to explore additional mediators and to confirm these pathways over time.