Parental pattern, childhood trauma, and impulsivity contribute to the severity of crack cocaine addiction: a cluster analysis.

OBJECTIVE

To determine clusters (groups) of substance use in crack cocaine users through severity scores on the sixth version of the Addiction Severity Index (ASI-6) and compare the groups in relation to risk factors, such as parental style, childhood maltreatment, and impulsivity.

METHODS

This cross-sectional study included 531 men with substance use disorder who were admitted to an inpatient addiction treatment unit in southern Brazil. To detect more homogeneousgroups of individuals, the K-means clustering based on ASI-6 scores was used to create groups of individuals with similar severity scores in different areas. Parenting styles were assessed using the Measure of Parental Style, childhood trauma was assessed using the Childhood Trauma Questionnaire, and impulsivity was measured using the Barratt Impulsivity Scale 11. Poisson regression was used for association analysis.

RESULTS

Two distinct clusters were identified, which differed significantly across all composite scores (p < 0.001). These associations were further confirmed through Poisson regression analysis. The more severe cluster showed significantly higher scores for maternal abuse (p = 0.026), sexual abuse (p = 0.003), motor impulsivity (p = 0.014), and unplanned impulsivity above the 75th percentile (p =0.032) than the less severe group. Other parenting styles, trauma types, and impulsivity did not differsignificantly between the groups.

CONCLUSIONS

Dividing patients into severity clusters can contribute to more targeted treatments. Further research on outpatients would reinforce the importance of early life factors and impulsivity treatment.