When considering transition from first use to first CUD symptom, survival analysis revealed significant predictors in EA women only. Physical abuse predicted transition across the risk period [HR = 1.34, 95%CI: (1.02–1.78)] and MDD increased the hazard of transition to first CUD symptom prior to age 19 [HR = 1.86, 95%CI: (1.24–2.79)] (Table 4). No trauma exposure, psychiatric disorder, or substance use conferred risk for transition to first CUD symptom in AA women, although, PTSD diagnosis did reach trend level for transition to first CUD symptom in both EA and AA women.