Linking Childhood Maltreatment to Patterns of Adolescent Substance Use

Introduction:

Childhood maltreatment is an understudied, but important, risk factor for adolescent substance use (SU) and disorders. Understanding the link between maltreatment and SU is critical for the development of effective interventions among the maltreated population. Prior research has been limited by overly focusing on physical and sexual abuse, and a small number of studies have considered the risk maltreatment poses for unique SU typologies, despite evidence that adolescents who use tend to report concurrent use of a variety of substances. Thus, it is unclear whether maltreatment increases the risk for specific SU patterns. The current study demonstrates the utility of latent class analysis (LCA) for understanding the links between childhood maltreatment and adolescent SU.

Method:

Data were drawn from the Longitudinal Studies of Child Abuse and Neglect; participants included 904 individuals (44% male; mean age = 18.50 years, SD = .60). First, LCA was used to identify and describe SU patterns using 6 binary indicators based on self-reports at age 18: alcohol use, binge drinking, problematic drinking, marijuana use, tobacco use, and other illicit drug use. Second, SU pattern membership was predicted by maltreatment using 5 binary indicators based on allegations filed with local Child Protective Services agencies prior to age 18: physical abuse, sexual abuse, emotional abuse, neglect, and witnessing domestic violence. Third, gender was explored as a moderator of these links between maltreatment and SU patterns. 

Results:

A 3-class model was selected as optimal for describing SU patterns: Low Risk Users (66% prevalence), Tobacco/Marijuana Users (11%), and Heavy Users (23%). Physical abuse was the only significant predictor of SU pattern membership. Those who experienced physical abuse had increased odds of membership in the Tobacco/Marijuana Users (OR=2.52, 95% CI=1.55-4.09) and Heavy Users classes (OR=1.73, 95% CI=1.17-2.58) compared to the Low Risk Users class. However, gender moderated the effects of maltreatment on SU. Physical and emotional abuse and neglect were related to higher-risk of SU for females whereas neglect was related to higher-risk of SU for males.

Conclusions:

These findings underscore the importance of particular types of maltreatment as risk factors for substance use and gender-based health disparities in these risks. Importantly, they point toward a possible need for targeted interventions for this population.