Donatella Marazziti, Manuel Glauco Carbone, Alessandro Arone, Riccardo Gurrieri, Liliana Dell’Osso, Lara Foresi Crowther

Key words: substance use disorder, executive functions, emotional dysregulation, adhd, attachment, incarcerated youth

Objective: Youth violence, often linked to drug offenses, is a major concern in socially and politically unstable regions worldwide. Early attachment and stressors influence behavioral development, highlighting the importance of addressing underlying psychopathology. This study examined clinical, psychopathological, and cognitive profiles in incarcerated young adults with substance use issues, considering social, familial, and environmental factors.
Method: This cross-sectional study enrolled 40 male young adults (mean age 21.05 ± 1.15 years) with SUD, participating in a resocialization program in Medellin. Participants completed questionnaires assessing affective lability (ALS-SF), emotion dysregulation (DERS), executive functions (BRIEF-A), ADHD symptoms (ASRS), attachment styles (CA-MI-R), and stressful life events (SRRS). Data were analyzed using non-parametric tests, Spearman's rank correlations, and multiple linear regressions.
Results: Multiple linear regression analyses revealed significant predictive relationships. The number of substances used was predicted by poorer emotional control (β = -0.440, p = .007), greater executive dysfunction (β = 0.060, p = .015), higher childhood trauma (β = -0.360, p = .006), and a higher CA-MI-R score (β = 2.316, p = .017). Childhood trauma reported was predicted by greater executive dysfunction (β = 0.536, p = .013), lower socioeconomic status (β = -0.119, p = .035), a greater number of substances used (β = -0.256, p = .006), benzodiazepine use (β = -0.299, p = .014), and poorer emotional control (β = -0.331, p = .016). Affective lability, emotion dysregulation, and executive dysfunction were significantly intertwined with ADHD traits.
Conclusions: This study provides evidence for the complex interplay of attachment, executive function, emotion regulation, and ADHD symptoms in incarcerated young adults with SUD. Executive dysfunction, impulsivity, emotional dysregulation, and attachment insecurity significantly contribute to substance use and childhood trauma, fueling a vicious cycle. Interventions addressing relational trauma, deficits, and broader factors are needed to disrupt this cycle, promote rehabilitation, and reduce recidivism.