Heterogeneity in childhood trauma and impulsivity among adolescents with new psychoactive substance use disorders: a latent profile analysis

Abstract

Background Adolescent patients with new psychoactive substance use disorders represent a growing public health concern worldwide. Childhood trauma and impulsivity are clinically relevant characteristics among adolescents with new psychoactive substance use disorders, but heterogeneity in their co-occurring patterns remains underexplored. Methods A cross-sectional study enrolled 1,026 adolescent patients with new psychoactive substance use disorders from 10 primary community healthcare centers in Tianjin, China. Childhood trauma, impulsivity, and perceived parenting styles were assessed using the CTQ-SF, BIS-11, and s-EMBU-C, respectively. Latent profile analysis was conducted using the item-mean scores of five CTQ-SF and three BIS-11 subscales as eight continuous indicators. Univariable and multivariable R3STEP analyses in Mplus examined factors associated with profile membership while accounting for classification uncertainty. Results Three distinct profiles were identified: (1) Low Childhood Trauma–Low Impulsivity (n = 645, 62.9%); (2) High Emotional Neglect–High Impulsivity (n = 263, 25.6%); and (3) High Childhood Trauma–High Impulsivity (n = 118, 11.5%). In the primary multivariable R3STEP model, perceived parenting dimensions showed profile-specific conditional associations with latent profile membership. Associations involving the 12-month clinically documented relapse count were examined in an expanded sensitivity model and treated as exploratory. Conclusion This study reveals substantial heterogeneity in childhood trauma and impulsivity among adolescents with new psychoactive substance use disorders. The identification of three distinct profiles provides a preliminary descriptive framework for stratified assessment and hypothesis generation regarding profile-informed interventions. Longitudinal studies are needed to evaluate the stability, clinical utility, and prognostic relevance of these profiles.