Child Neglect, Depressive Symptoms, and Substance Use Among Children and Adolescents Reported to Child Protective Services

Introduction: Child neglect is the most common type of child maltreatment, making up 73.8% of government reports of child abuse (US DHHS, 2012). Children who have experienced neglect are at a significant risk for the development of internalizing psychopathology as well as associated substance use behaviors (Oshri et al., 2012/2013). The association between child abuse and adolescent substance use has been shown to vary across gender (Burnette et al., 2012; Gilbert et al., 2009). However, still missing is longitudinal research, nested by gender, that can inform preventative intervention programs on the underlying mechanisms between child neglect and subsequent health risk behaviors such as substance use (Boyce & Maholmes, 2013). The purpose of the current study is to elucidate gender differences in the pathways from emotional versus supervision neglect experiences in childhood to substance use problems in adolescence.

Methods: Using data from the National Survey of Child and Adolescent Well-Being (NSCAW), a sample of 796 children was examined at three time points (aged 11-13 at wave 1, 12-15 at wave 2, and 14-16 at wave 3). The NSCAW is a nationally representative, longitudinal survey of children and families who have been the subjects of investigation by Child Protective Services (CPS). Emotional and supervision neglect were indicated by CPS reports at wave 1. Depressive symptoms were assessed at wave 2 using the Children’s Depression Inventory (Kovacs, 1992) and substance use was assessed using an ordinal scale of lifetime use at wave 3.

Results: Structural equation modeling was used to test the impact of child neglect on adolescent substance use through depressive symptoms in early adolescence.  Model fit was good (χ² (20) = 75.55, p = .01 CFI =.91; RMSEA = .03; SRMR = .05).  Multiple group analyses revealed significant moderation by gender and, among males, supervision neglect at time 1 significantly predicted depressive symptoms at time 2 (β = .22; p < .05) and depressive symptoms at time 2 significantly predicted cannabis use at time 3 (β = .26; p < .05).  Mediation analyses confirmed an indirect effect from supervision neglect to increased substance use via depressive symptoms among males (β = .08; p< .01). 

Conclusion: Children who are neglected are at significant risk for the development of psychopathology and other substance use behaviors compared to children exposed to other maltreatment types. Results suggest the need for development of indicated preventive intervention tailored to neglected children, as well as the need to address depressive symptomatology during early adolescence in order to modify risk for subsequent involvement in substance use behaviors during adolescence.