An examination of pathways from childhood maltreatment to adolescent binge drinking

The roles of child maltreatment and fathers in the development of substance use in an at-risk sample of youth: A longitudinal study

BACKGROUND

Despite ample cross-sectional evidence linking child maltreatment and father involvement to adolescent substance use, little is known about the longitudinal impact of child maltreatment and father involvement in the developmental course of substance use from early adolescence to late adolescence.

OBJECTIVE

The primary aim of the study was to examine the long-term effects of childhood maltreatment (i.e., maltreatment type, perpetrator identity) and the quality and quantity of father involvement on developmental trajectories of substance use among high-risk youth.

PARTICIPANTS AND SETTING

Data were drawn from the Longitudinal Studies of Child Abuse and Neglect. Study participants included 681 U.S. adolescents who had experienced or were at risk for child maltreatment.

METHODS

Latent Growth Poisson Modeling was conducted to examine developmental trajectories of substance use at ages 12, 14, 16, and 18.

RESULTS

Child emotional abuse and greater quantity of father involvement were associated with a higher initial number of substances used, while higher quality of father-child relationships was associated with a lower initial number of substances used. Emotional abuse and greater quantity of father involvement were associated with slower increases in the number of substances used over time.

CONCLUSIONS

The findings suggest that engaging fathers and promoting nurturing parenting and positive parent-adolescent interactions may be important for programs and policies aimed to prevent early adolescent substance use initiation. Furthermore, early identification of emotional abuse among adolescents could help to prevent initial polysubstance use onset.

Preventing E-cigarette use among high-risk adolescents: A trauma-informed prevention approach

Exposure to childhood trauma increases the risk of tobacco use during adolescence. Recent studies have also reported potentially increased vulnerabilities to electronic cigarette (e-cigarette) use among youth with a history of childhood trauma. While empirical evidence supporting the relationship between childhood trauma and adolescent e-cigarette use is emerging, few effective preventive interventions are available to curb e-cigarette use among adolescent victims of childhood trauma. This article reviews current evidence with respect to how childhood trauma could increase risk for nicotine dependence and e-cigarette use in adolescent populations. Furthermore, this paper describes the development, design, and implementation of Rise Above (RA), a randomized, controlled trial of a trauma-informed, e-cigarette preventive intervention. Lessons learned are also discussed, including the challenges of implementing evidence-informed prevention work within communities vulnerable to traumatic events.

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

INTRODUCTION

Childhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.

METHOD

Young adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.

RESULTS

We found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.

CONCLUSION

The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.

Adverse Environmental Exposures During Gestation and Childhood: Predictors of Adolescent Drinking

Adverse conditions, including exposures to drugs and other environmental influences during early development, may affect behaviors later in life. This study examined the role of environmental influences from the gestation and childhood on adolescent drinking behavior. 917 mother/offspring dyads were followed prospectively from pregnancy to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14 years. Prenatal exposures to alcohol, tobacco, and marijuana were measured during gestation. Data were collected at each phase on childhood environment, including parenting practices, quality of the home environment, maternal depression and hostility, and lifetime exposure to child maltreatment and community violence. Alcohol outcomes were offspring age of drinking initiation and level of drinking at age 16 years. Cox Proportional Hazards ratios were used to model offspring age of drinking initiation. Logistic regression analyses were used to evaluate significant predictors of drinking level. Childhood environment, including less parental strictness, greater exposure to violence and childhood maltreatment, significantly predicted earlier age of alcohol initiation. Level of drinking among the adolescent offspring was significantly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to initiate alcohol use early and drink at higher levels. Early and heavier alcohol use was associated with early exposures to adversity such as prenatal alcohol exposure, and child exposures to maltreatment and violence. These results highlight the importance of environmental adversity and less effective parenting practices on the development of adolescent drinking behavior.

Prenatal alcohol and other early childhood adverse exposures: Direct and indirect pathways to adolescent drinking

We examined direct and indirect pathways between adverse environmental exposures during gestation and childhood and drinking in mid-adolescence. Mothers and their offspring (n=917 mother/child dyads) were followed prospectively from second trimester to a 16-year follow-up assessment. Interim assessments occurred at delivery, 6, 10, and 14years. Adverse environmental factors included gestational exposures to alcohol, tobacco, and marijuana, exposures to childhood maltreatment and violence, maternal psychological symptoms, parenting practices, economic and home environments, and demographic characteristics of the mother and child. Indirect effects of early child behavioral characteristics including externalizing, internalizing activity, attention, and impulsivity were also examined. Polytomous logistic regression analyses were used to evaluate direct effects of adverse environmental exposures with level of adolescent drinking. Structural equation modeling (SEM) was applied to simultaneously estimate the relation between early adversity variables, childhood characteristics, and drinking level at age 16 while controlling for significant covariates. Level of drinking among the adolescent offspring was directly predicted by prenatal exposure to alcohol, less parental strictness, and exposures to maltreatment and violence during childhood. Whites and offspring with older mothers were more likely to drink at higher levels. There was a significant indirect effect between childhood exposure to violence and adolescent drinking via childhood externalizing behavior problems. All other hypothesized indirect pathways were not significant. Thus most of the early adversity measures directly predicted adolescent drinking and did not operate via childhood behavioral dysregulation characteristics. These results highlight the importance of adverse environmental exposures on pathways to adolescent drinking.

Association between maltreatment and polydrug use among adolescents

Different studies have related sexual and physical abuse during childhood and adolescence to the development of substance abuse disorders. Nevertheless, we are not aware of the role that other more common maltreatment types, such as neglect, will play among the most risky pattern of consumption: the polydrug use. A clinical sample of 655 adolescents, divided into two groups: polydrug users and non-polydrug users, were assessed on their pattern of drug consumption, history of childhood maltreatment, current psychopathology and their family history of alcoholism. Polydrug users had a greater prevalence of all types of maltreatment, although the most associated to this group were sexual abuse and emotional neglect. Other relevant variables to adolescent consumption were: the diagnosis of depressive disorder, the presence of anxiety traits and the family history of alcohol dependence. Polydrug users have higher risks of having had problems during infancy and adolescence, such as maltreatment and other psychopathological conditions, with the addition of family history of alcoholism. Accordingly, practitioners should take into account that those variables may influence polydrug abuse because it is the most risky pattern for subsequent dependence of substances, and they should always be considered during treatment.

Child maltreatment and risk behaviors: The roles of callous/unemotional traits and conscientiousness

Child maltreatment poses significant risk to the development of callous/unemotional traits as well as risk behaviors such as engaging in violence, having sex with strangers, and binge drinking. In the current study, the indirect pathway from child maltreatment to risk behaviors was examined via callous/unemotional traits; whereas the conscientious personality trait was tested as a moderator of this indirect pathway. Young adults and parents (N=361; Mage=19.14, SD=1.44) completed questionnaires on child maltreatment histories, callousness/unemotional traits, personality characteristics, and risk behaviors. Structural equation modeling was used to examine the hypothesized direct, indirect and conditional indirect effects. Findings showed indirect links between the child maltreatment latent factor and physical fighting, having sex with strangers, and binge drinking via callous/unemotional traits. Furthermore, the conscientiousness personality type significantly buffered the connection between callous/unemotional traits and physical fighting, supporting a conditional indirect effects. Callous/unemotional traits are important factors in the underlying mechanism between child maltreatment and risk behaviors among young adults, and conscientiousness serves as a protective factor against violence. Preventive intervention programs and clinicians may benefit from focusing in addressing callous/unemotional traits among youth who report childhood maltreatment experiences as well as targeting conscientiousness as a protective factor.

Interactive Effect of Child Maltreatment and Substance Use on Depressed Mood Among Adolescents Presenting to Community-Based Substance Use Treatment

Adolescents referred to community behavioral health centers (CBHC) for substance use (SU) problems report high rates of child maltreatment. Although SU and maltreatment are independent risk factors for adolescent depression, few studies have examined their interactive effects. This study examined the interactive effects of SU (alcohol and marijuana) and exposure to different types of trauma on depressed mood among 74 adolescents referred to a CBHC for SU. Hierarchical regressions controlling for sex and common adolescent comorbidities showed that sexual abuse had a stronger relationship with depressed mood than other types of maltreatment. Although SU was not independently related to depressed mood, consistent with the self-medication hypothesis, increased SU was associated with lower levels of depressed mood among adolescents with greater exposure to sexual abuse. Results suggest that teens presenting to CBHCs for SU should be assessed for multiple forms of maltreatment and for depressed mood.

The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents

Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment.

A longitudinal examination of different etiological pathways to alcohol use and misuse

BACKGROUND

Sher, Grekin, and Williams (2005) pointed out the existence of 4 main etiological, but not mutually exclusive, models that might explain the development of alcohol use and misuse. The aim of the present study was to explore 3 of these 4 pathways in which psychological (personality and drinking motives) and environmental (child maltreatment) variables may play a relevant role: positive affect regulation, negative affect regulation, and deviance proneness.

METHODS

Three hundred and fourteen young adults in the 18 to 29 year age range completed different personality, alcohol use, and child maltreatment questionnaires at Time 1. Five years later, they responded to drinking motives, antisocial behavior, alcohol use, and alcohol-related problems questionnaires.

RESULTS

The path analyses showed that emotional abuse predicted negative emotionality, which, in turn, prospectively predicted alcohol-related problems through coping-with-depression drinking motives (negative affect regulation). Emotional neglect predicted lesser positive emotionality, and physical abuse predicted unconscientious disinhibition personality characteristics. In turn, these 2 broad personality domains predicted drinking at weekends at Time 2 through enhancement drinking motives (positive affect regulation). Finally, physical neglect predicted disagreeable disinhibition, and both disinhibition domains directly predicted antisocial behavior 5 years later which, in turn, predicted drinking at weekends, drinking on weekdays, and alcohol-related problems (deviance proneness).

CONCLUSIONS

The findings describe the specific role of distal (maltreatment and personality) and more proximal (antisocial behavior and drinking motives) variables in the different pathways involved in the development of alcohol use and misuse.

Alcohol and tobacco use among maltreated and non-maltreated adolescents in a birth cohort

AIMS

This study examines whether child maltreatment experience predicts adolescent tobacco and alcohol use.

METHODS

The subjects were participants in the Mater-University Study of Pregnancy (MUSP), a birth cohort of 7223, of whom 5158 (71.4%) were available for analysis at the 14-year follow-up. Child protection history was obtained from the state's child protection agency and confidentially linked. Exposure to reported child maltreatment was the primary predictor variable. The outcome variables were self-reported smoking and alcohol use. Associations were adjusted for potential confounders.

RESULTS

Reported child maltreatment was associated with early adolescent smoking [odds ratio (OR) 1.76, 95% confidence interval (CI) = 1.32-2.34] after adjustment for socio-demographic variables and coexisting alcohol use. Both neglect/emotional abuse (OR 2.03, 95% CI = 1.20-3.42) and neglect/emotional abuse that included physical abuse (OR 1.85, 95% CI = 1.19-2.88) were associated with smoking after full adjustment, including for coexisting alcohol use. After full adjustment, including coexisting smoking, only child neglect/emotional abuse predicted early adolescent alcohol use (OR 1.78, 95% CI = 1.06-2.97), but not the other types of maltreatment.

CONCLUSIONS

Reported child maltreatment predicts early adolescent smoking after adjusting for alcohol use, but does not predict alcohol use after adjustment for smoking. Both smoking and alcohol use are predicted by reported child neglect. Early adolescent smoking is also predicted by multi-type maltreatment that includes physical abuse.