Dark tetrad may mediate the link between adverse childhood experiences and tramadol abuse among youths.

Adverse childhood experiences (ACEs), encompassing various forms of childhood abuse, neglect, and household dysfunctions, have been documented as a risk factor in tramadol abuse among young people. However, studies exploring the mechanism through which this association occurs remain sparse. We investigated whether dark tetrad traits would mediate the relationship between ACEs and tramadol abuse among youths in Nigeria. Through a cross-sectional design and convenience sampling technique, 250 youths aged 15-35 years (males: n = 163, 65.2%; females: n = 87, 34.8%; mean age = 23.16 years, SD = 4.65 years) were sampled. These participants completed relevant measures of ACEs, dark tetrad, and tramadol abuse. Results showed that higher scores on ACEs were associated with dark tetrad traits, except on the Machiavellianism domain. ACEs also positively predicted tramadol abuse. Although all domains of the dark tetrad traits predicted tramadol abuse, only the narcissism, psychopathy, and sadism domains mediated the ACEs-tramadol abuse link, whereas Machiavellianism did not mediate this relationship. Interventions may do well to incorporate personality-targeted approaches in addressing narcissism, psychopathy, and sadism while also integrating trauma-informed care to reduce tramadol abuse among youths.