TY - JOUR
AU - A. Kassim
AU - A. Sabry
AU - C. Schweitzer
AU - R. Burynski
AU - A. DiGiovanni
AU - D. Bu
AU - M. Russell
AU - S. Sandelich
A1 - 
AB - Introduction Substance use is frequently encountered in emergency department (ED) visits and may reflect underlying emotional or developmental challenges. Adverse childhood experiences (ACEs) are linked to both emotional dysregulation and later substance use, but this relationship is rarely examined in acute care settings. We investigated whether recent substance use, as measured by the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) screening tool, is associated with ACEs, emotional dysregulation, and use of cognitive reappraisal (an adaptive emotion regulation strategy) among adult ED patients. Methodology In this cross-sectional study, 58 adult ED patients completed the ACE Inventory, the Difficulties in Emotion Regulation Scale (DERS), the Emotion Regulation Questionnaire (ERQ)-Cognitive reappraisal subscale, and the TAPS screening. Descriptive statistics characterized the sample. Pearson correlations and linear regression analyses (adjusting for age and gender) examined associations between TAPS scores and ACE, DERS, and ERQ scores. Results TAPS scores were positively correlated with ACEs (r = 0.23, P < 0.05) and DERS scores (r = 0.30, P < 0.01), and negatively correlated with ERQ-Cognitive reappraisal scores (r = -0.22, P < 0.05). In regression models, higher TAPS scores significantly predicted greater ACE burden, higher DERS scores, and lower ERQ-Cognitive reappraisal scores (all P < 0.05, with covariate adjustment). Participants reporting alcohol or marijuana use had significantly higher mean ACE scores than non-users. Conclusion Recent substance use identified during ED visits was associated with greater childhood trauma exposure and poorer emotion regulation. Substance use in the ED may serve as a marker of underlying emotional dysregulation and adversity. These findings support the incorporation of trauma-informed screening and referral practices into ED care as part of integrated care models to better address these underrecognized psychosocial factors.
AD - Urology, Penn State College of Medicine, Hershey, USA.; Internal Medicine, Penn State College of Medicine, Hershey, USA.; Anesthesiology, Penn State College of Medicine, Hershey, USA.; Neurosurgery, Penn State College of Medicine, Hershey, USA.; Pediatric Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
AN - 41664779
BT - Cureus
C5 - Opioids & Substance Use
CP - 1
DA - Jan
DO - 10.7759/cureus.101182
DP - NLM
ET - 20260109
IS - 1
JF - Cureus
LA - eng
N2 - Introduction Substance use is frequently encountered in emergency department (ED) visits and may reflect underlying emotional or developmental challenges. Adverse childhood experiences (ACEs) are linked to both emotional dysregulation and later substance use, but this relationship is rarely examined in acute care settings. We investigated whether recent substance use, as measured by the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) screening tool, is associated with ACEs, emotional dysregulation, and use of cognitive reappraisal (an adaptive emotion regulation strategy) among adult ED patients. Methodology In this cross-sectional study, 58 adult ED patients completed the ACE Inventory, the Difficulties in Emotion Regulation Scale (DERS), the Emotion Regulation Questionnaire (ERQ)-Cognitive reappraisal subscale, and the TAPS screening. Descriptive statistics characterized the sample. Pearson correlations and linear regression analyses (adjusting for age and gender) examined associations between TAPS scores and ACE, DERS, and ERQ scores. Results TAPS scores were positively correlated with ACEs (r = 0.23, P < 0.05) and DERS scores (r = 0.30, P < 0.01), and negatively correlated with ERQ-Cognitive reappraisal scores (r = -0.22, P < 0.05). In regression models, higher TAPS scores significantly predicted greater ACE burden, higher DERS scores, and lower ERQ-Cognitive reappraisal scores (all P < 0.05, with covariate adjustment). Participants reporting alcohol or marijuana use had significantly higher mean ACE scores than non-users. Conclusion Recent substance use identified during ED visits was associated with greater childhood trauma exposure and poorer emotion regulation. Substance use in the ED may serve as a marker of underlying emotional dysregulation and adversity. These findings support the incorporation of trauma-informed screening and referral practices into ED care as part of integrated care models to better address these underrecognized psychosocial factors.
PY - 2026
SN - 2168-8184 (Print); 2168-8184
SP - e101182
ST - Substance Use Behaviors as Markers of Emotional Dysregulation and Childhood Adversity Among Adult Emergency Department Patients
T1 - Substance Use Behaviors as Markers of Emotional Dysregulation and Childhood Adversity Among Adult Emergency Department Patients
T2 - Cureus
TI - Substance Use Behaviors as Markers of Emotional Dysregulation and Childhood Adversity Among Adult Emergency Department Patients
U1 - Opioids & Substance Use
U3 - 10.7759/cureus.101182
VL - 18
VO - 2168-8184 (Print); 2168-8184
Y1 - 2026
ER -