Pathways from childhood maltreatment to emerging adulthood: investigating trauma-mediated substance use and dating violence outcomes among child protective services-involved youth

Intimate Partner Violence Perpetration Among Sexual Minority Young Adults: Associations With Alcohol Use, PTSD Symptoms, Internalized Homophobia, and Heterosexist Discrimination

Lesbian, gay, bisexual, queer, and other sexual minority (LGBQ+) young adults report similar or higher rates of intimate partner violence (IPV) perpetration than their heterosexual peers. Elevated IPV risk among LGBQ+ young adults may be attributable to experiencing heterosexist discrimination and internalized homophobia. In addition, LGBQ+ people report disproportionate posttraumatic stress disorder (PTSD) symptoms, alcohol use, and IPV perpetration in dating relationships. Thus, this study explored which combinations of IPV risk factors (i.e., experiencing heterosexist discrimination, internalized homophobia, PTSD symptoms, alcohol use) related to forms of IPV perpetration, inclusive of psychological, physical, and sexual forms, in a sample of 342 LGBQ+ young adults. Internalized homophobia was related to psychological IPV perpetration at high and medium levels of PTSD symptoms and only high levels of alcohol use. PTSD symptoms and alcohol use interacted to predict psychological IPV perpetration; and PTSD symptoms related to increased psychological IPV perpetration at high and medium, but not low, alcohol use levels. Alcohol use was positively related to physical IPV perpetration. No other risk factors or interactions were significantly related to physical or sexual IPV perpetration. Results were consistent with prior findings that linked internalized homophobia, alcohol use, and PTSD symptoms to IPV perpetration and highlight the interacting nature of these IPV perpetration risk factors. Comprehensive IPV interventions with LGBQ+ young adults should evaluate the impact of simultaneously targeting these multiple IPV risk factors considering their interacting contributions to IPV perpetration risk. More research is needed to examine the temporal relations between minority stress, PTSD symptoms, alcohol use, and IPV perpetration.

Mattering, substance use, and addictive behaviors: review, analysis, and implications for treatment and prevention

In the current article, we examine mattering to others as a relational resource and discuss how feelings of not mattering are uniquely implicated in addiction and substance use. We describe the mattering construct and how it is conceptualized, and we comprehensively review existing evidence based primarily on research with adolescents that links feelings of not mattering with addictive tendencies in general, and specific tendencies (e.g., excessive drinking and drug use and excessive social media use). A central premise of this article is the need to take race and ethnicity into account when considering the potential link between feelings of not mattering and substance use among young people with minority status and various ethnicities who may be especially prone to feeling marginalized and insignificant as a result of adverse experiences reflecting being ostracized and not socially accepted. Potential models of drinking and addictive tendencies that can easily incorporate the mattering construct are also outlined to underscore the conceptual relevance of feelings of not mattering to others. Mattering is also considered in terms of how internalization (i.e., not mattering to oneself) potentiates impulsive and risky behavior. Our article concludes with discussion of the implications for treatment and prevention in addiction and substance use and directions for future research that should further illuminate the role of feelings of not mattering to others and not mattering to oneself.

An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial–parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

A trauma model of substance use: Elaboration and preliminary validation

The current study expands on and integrates previous theoretical models concerning the pathways that link child maltreatment to substance use disorder. The proposed model, based on the self-medication hypothesis, suggests that experiences of neglect and abuse during childhood can lead to substance use and abuse both directly and indirectly, via dissociation resulting from failed attempts to integrate experiences of maltreatment in childhood. The model was tested on ten substances (painkillers, stimulants, sedatives, marijuana, cocaine, ecstasy, hallucinogens, heroin, inhalants, and methamphetamine) via structural equation modeling (SEM) in a sample comprising 1040 community-dwelling adults (67 % women) aged between 18 and 78 (M = 29.55, SD = 11.37). Fit indexes of the SEM were good, thus supporting the hypothesized model. Specific forms of child maltreatment were related to increased use of specific substances; however, experience of childhood neglect (both physical and emotional) was found to have a central role in predicting use of most substances. Although no single pathway can fully explain the origins of substance abuse, the current study provides evidence of a critical developmental pathway to it, with implications for theory and clinical practice.

Unpacking Violent Behavior in Young Adulthood: The Relative Importance of Hazardous Alcohol Use

Young adulthood is an important developmental period for investigating the nature of violent behavior. This study examines the unique contribution of alcohol use to violence perpetration among young adults in the Australian community, after accounting for the influence of sociodemographic, early life, trait, and well-being influences. Cross-sectional, self-report data was collected from 507 young adults aged 18-20 years in the Australian general community via an online survey. Sequential logistic regressions examined the relative and independent contribution of adverse childhood experiences (ACEs), impulsivity, psychological distress, and hazardous alcohol use to past-year violent behavior. Results show one in eight young adults aged 18-20 (13%) reported at least one act of violent behavior in the past year, primarily assault perpetrated against another person. Sequential logistic regression identified that after controlling for other risk factors, the number of ACEs reported and hazardous alcohol use were independently and positively associated with increased odds of reporting violent behavior in young adulthood. These findings demonstrate that ACEs and hazardous alcohol use are important, independent correlates of violent behavior in young adults. While preventing early adversity is key for reducing violence in the community, this evidence suggests that it is also important to target proximal causes such as hazardous alcohol use. Increasing early and widespread access to evidence-based, trauma-informed violence-prevention programs targeting risk factors across multiple settings is critical for reducing harm and supporting young people into healthy adulthood.

Childhood Maltreatment and Anhedonic Symptoms: Test of a Dual-risk Model in Emerging Adults

Anhedonia, defined as deficits in positive affect and approach related behaviors, remains an understudied trauma response. As anhedonic responses to interpersonal violence are associated with a more severe course of psychopathology that is more difficult to treat, an increased focus on risk factors for anhedonia is necessary. The present study sought to address this gap in the literature by testing a theoretical model that highlights two transdiagnostic pathways leading to anhedonic responses in emerging adults attending college. Specifically, our study examined how childhood maltreatment subtypes (a) uniquely associate with depressive and post-traumatic stress (PTS) manifestations of anhedonia and (b) how temperament (i.e., anticipatory positive affect) and distress (i.e., negative mood) explain these relations. At baseline, a racially diverse sample of 462 emerging adults (Age_Mean = 19.45; 75.5% female; 45.5% White) completed self-report forms on childhood abuse and neglect, anticipatory positive affect, negative mood, and anhedonia. Individuals completed measures of temperament and psychological distress again 6-weeks, and 12-weeks later. Latent growth curve models were utilized to test our model. Consistent with hypotheses, deficits in anticipatory positive affect uniquely explained the relation between neglect and depressive/PTS anhedonic symptoms. Meanwhile, negative mood mediated the relation between abuse and both forms of anhedonia. These findings support the theory that two separate risk pathways lead to anhedonia. Support for our model suggests that distinguishing between pathways for anhedonic responses may be the key to a more targeted, transdiagnostic, trauma-informed approach for treating and preventing these deleterious, treatment-resistant, internalizing symptoms.

The Link Between Adversity and Dating Violence Among Adolescents Hospitalized for Psychiatric Treatment: Parental Emotion Validation as a Candidate Protective Factor

Adolescents are at risk for becoming victims or perpetrators for a variety of forms of dating violence, including cyber violence, physical violence, psychological abuse, and sexual abuse. Interestingly, a robust predictor of dating violence is adverse experiences during childhood; however, factors that could mitigate the risk of dating violence for those exposed to adversity have seldom been examined. Using the cumulative stress hypothesis as a lens, the current study examined severity of adverse experiences as a predictor of dating violence within a sample at risk for both victimization and perpetration of dating violence: An adolescent (12-17 years old; N = 137) sample who were receiving inpatient psychiatric treatment. First, the current study aimed to replicate previous findings to determine whether adversity predicted dating violence and whether this varied by gender. Then, the current study examined one factor that could mitigate the relation between adversity and dating violence-parental emotion validation. High rates of maternal emotion validation resulted in no relation between adversity and dating violence perpetration and victimization; however, the relation was present at average and low levels of maternal emotion validation. Next, by adding gender as an additional moderator to the model, we found that high rates of paternal emotion validation extinguished the relation between adversity and dating violence perpetration, but only for adolescent boys. This pattern was not found for maternal emotion validation. Interestingly, the relation between adversity and dating violence victimization did not vary as a function of maternal or paternal validation of emotion for either child gender. These findings are discussed in terms of their meaning within this sample, possible future directions, and their implications for the prevention of dating violence.

Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning

The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.

Patterns of Child Maltreatment and the Development of Conflictual Emerging Adult Romantic Relationships: An Examination of Mechanisms and Gender Moderation

Individuals who experienced child maltreatment are at heightened risk for involvement in conflictual romantic relationships. The aim of this study was to examine the effect of patterns of child maltreatment on the development of maladaptive romantic relationships in emerging adulthood (EA), as well as to determine whether childhood physical aggression and disinhibition mediate this risk. Utilizing a longitudinal sample of emerging adult participants (N = 398 emerging adults; M_age = 19.67 years) who took part in a summer research camp as children (M_age = 11.27 years), we employed a combination of person-centered and variable-centered methods to test study aims. Significant differences in child behavior and developmental pathways emerged not only between those who experienced maltreatment and those who did not, but also among maltreated individuals with different constellations of maltreatment experiences. Specifically, childhood aggression was a robust mechanism underlying the risk associated with chronic/multi-subtype maltreatment, and the risk associated with neglect only, for involvement in dysfunctional EA romantic relationships. Together, these findings highlight the utility of person-centered methods for conceptualizing maltreatment, identify childhood aggression as a pathway of risk, and the underscore the criticality of prevention and early intervention to interrupt the intergenerational transmission of high conflict and aggression within families.

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

Background and aims

Childhood adversity is a strong, and concerningly prevalent, risk factor for the later development of substance misuse. Yet despite substantial accumulating evidence for causal mechanisms, there has been little attempt to synthesize the strength of the evidence. Importantly, these mechanisms may be amenable to intervention, providing targets for substance use prevention among those exposed to childhood adversity. The present review aimed to systematically identify mediating and moderating mechanisms operating between childhood adversity and substance use.

Methods

A systematic review was conducted. Electronic databases (PubMed, MEDLINE, PsycINFO, Web of Science and CINAHL) were searched from 1998 to 2020 for modifiable mediators and moderators of the relationship between childhood adversity and substance use in people aged 10–24. Data was qualitatively synthesised, using a socio-ecological perspective to group mediators/moderators into individual, interpersonal, community, and public policy/cultural levels of behaviour.

Results

After screening against eligibility criteria, 50 studies were included in the current review. The mediators at the individual level of behaviour showing the largest and most consistent effect sizes included externalising behaviour, anger, coping motives for substance use, and post-traumatic stress symptoms. Among individual-level moderators, religiosity, future orientation and depressive symptoms all attenuated the relationship between childhood adversity and substance use. At the interpersonal level, peer relationships and mother-child relationships mediated the effect of adversity on substance use. Moderators included family cohesion and relationship quality. Community factors were less commonly studied, though school mobility and educational achievement mediated 14% and 28% of the total effect of childhood adversity on substance use respectively. No mediators or moderators were identified for public policy/culture.

Conclusions

A substantial proportion of the relationship between childhood adversity and substance use in youth is mediated through individual, interpersonal and community factors. Coupled with the knowledge that existing, evidence-based programs effectively address many of the identified mediators and moderators, this review advances knowledge on optimal targets to prevent substance misuse among those exposed to childhood adversity.

Emancipated Foster Youth and Intimate Partner Violence: An Exploration of Risk and Protective Factors

Due to their high rates of parental maltreatment and violence exposure, youth in the foster care system are considered particularly vulnerable to experiencing intimate partner violence (IPV) in adolescence and young adulthood. Those who have emancipated from foster care may be at a heightened risk, as they are significantly more likely to struggle in a variety of critical domains (i.e., mental health, substance use, and delinquency). This longitudinal study is the first to explore the impact of demographic, individual, family, and foster care system factors on IPV involvement for foster care alumni at age 23/24. Analyses were conducted on three waves of quantitative data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (the Midwest Study). We find that approximately 21% of the young adults in our sample were involved in some type of IPV at age 23/24, with bidirectional violence the most commonly reported form. Males were more likely than females to report IPV victimization, whereas females were more likely than males to report IPV perpetration and bidirectional violence. Young adults who reported parental IPV prior to foster care entry were more likely to be involved in bidirectionally violent partnerships than nonviolent partnerships in young adulthood, as were young adults who reported neglect by a foster caregiver and those who reported greater placement instability while in the foster care system. Anxiety at baseline increased the odds of IPV perpetration at age 23/24, and posttraumatic stress disorder (PTSD) at baseline decreased the odds of IPV perpetration at age 23/24. Understanding the characteristics and experiences that place these young adults at risk for IPV will allow for more effective and targeted prevention efforts.

Association Between Dating Violence and Behavioral and Health Outcomes Among Early Adolescents From Denmark: The Role of Exposure to Childhood Maltreatment

AIM

To examine the unique contribution of child maltreatment victimization on the association between adolescent dating violence (ADV) and four negative behavioral and health-related factors.

METHOD

In total, 2,934 7th grade students (M = 13.5, SD = .5) filled out questionnaires at school. Binominal logistic regression was performed to assess the impact of child maltreatment on the relationship between ADV and behavioral and health-related factors.

RESULTS

After child maltreatment was taken into account, associations between ADV and the negative behavioral and health-related factors became weaker.

CONCLUSIONS

The findings from the present study suggest that focusing on one victimization type (such as ADV) when examining psychological outcomes, can be problematic as the causal relationship may be misrepresented when an adolescent's broader victimization profile and context is not considered.

Is All Dating Violence Equal? Gender and Severity Differences in Predictors of Perpetration

The present study assesses the extent of perpetration of physical violence in predominately Hispanic high school students in the Rio Grande Valley, Texas. The relationship between adverse childhood experiences, exposure to interparental violence, attachment, emotion regulation, and impulsivity on two distinct, mutually exclusive, categories of severity of physical teen dating violence (TDV) perpetration is further explored. Participants completed self-report measures as part of a larger, anonymous web-based questionnaire. Two categories (i.e., minor/moderate and severe) were created to discern the contextual variables associated with different levels of severity of physical violence perpetration by males and females. Eight-hundred and twenty-nine 14- to 18-year-old adolescents from four different high schools participated in the study, of whom 407 reported having been in a dating relationship in the last 12 months. The results demonstrate that when only the most severe item of TDV is taken into consideration, the rates of violence perpetration by males and females are almost equal and remarkably lower than those reported in the literature. However, when the assessment includes minor/moderate levels of violence, such as pushing, the rates of violence perpetration by females are twice those of males and are consistent with those reported in the literature. Furthermore, different variables are associated with different levels of severity of violence perpetration. The results support approaches that emphasize the need to take the context of the violence into consideration, since all levels are not equal. The need to take the severity of violence into account in studies assessing dating violence is highlighted.

Exposure to Violence and Posttreatment Substance Use Among Patients With Opioid Use Disorder

Exposure to violence can lead to a dramatic increase in the likelihood of the development of a substance use disorder (SUD). Given the overlap between the two, substance use for survivors of violence, then, can be a coping mechanism to manage the traumatic effects of abuse and persistent use can evolve into a diagnosable SUD. This study was designed to examine the posttreatment substance use among adults who have a history of exposure to violence and sought treatment for opioid use disorder. Data for this study were drawn from the Comprehensive Addiction Treatment Outcome Research system. Among the 13,105 patients included in the study, 444 (3.4%) received a formal diagnosis for opioid use disorder. Female victims of violence are at a greater risk of suffering injuries related to violence, resulting in increased levels of medical care utilization, which may prompt the initiation and prolonged use of prescription pain relief medication. Related to this important finding is another indicating that exposure to violence at multiple points in the past was associated with more severe indicators of substance use. These data show that there is a relationship between exposure to violence, SUDs, and relapse among patients seeking treatment. Not only must patients and treatment providers address these past violent experiences as important psychological factors in recovery, but in the context of opioid use disorder, physical injuries contributing to chronic pain may also trigger persistent substance use.

Comparison of the CADRI and CTS2 for Measuring Psychological and Physical Dating Violence Perpetration and Victimization

Advancing dating violence (DV) research requires consistent conceptualization and measurement. However, empirical sudies on the measurement of psychological and physical DV perpetration and victimization are uncommon. There were three aims of the current study: (a) to examine the construct validity of psychological and physical DV perpetration and victimization on the Conflict in Adolescent Dating Relationships Inventory (CADRI) and Revised Conflict Tactics Scales (CTS2) using factor analysis; (b) to compare empirically derived DV scales with ones using face valid definitions of psychological and physical DV within each measure; and (c) to compare results obtained from the CADRI with those obtained from the CTS2. A diverse sample of undergraduates (N = 512; 63.9% female, 50.0% White, 16.2% Black, and 22.9% Latino) completed an online survey. There were two-factor solutions for each survey and DV perpetration and victimization: moderate psychological DV and severe psychological/physical DV on the CADRI; and moderate psychological and physical DV and severe psychological and physical DV on the CTS2. Multiple regression analyses showed that results were similar for empirically and rationally derived scoring methods with one exception: On the CTS2, risk factors associated with moderate DV were not the same as those associated with psychological DV. Moreover, the unique contribution of risk factors to each form of DV depended on which survey was used. In multivariate studies of risk factors associated with psychological and physical DV, the CADRI and CTS2 do not appear to be interchangeable, and may lead to different conclusions about the relative importance of risk factors.

Childhood physical abuse and physical dating violence in young adulthood: The mediating role of adverse mental health

OBJECTIVE

The purpose of this study was to examine whether adverse mental health (i.e., symptoms of anxiety, posttraumatic stress disorder, and depression) mediated the relation between childhood physical abuse (CPA) and physical dating violence (DV) victimization/perpetration in young adulthood.

METHOD

We used four waves of data from an ongoing longitudinal study. The sample consisted of 864 adolescents including 282 Hispanic Americans, 248 European Americans, 240 African Americans, and 94 other, with a mean age of 17 years at Wave 3.

RESULTS

Structural equation modeling suggested that posttraumatic stress disorder symptoms mediated the link between CPA and both physical DV victimization (β = .06, 95% CI: 0.01, 0.11) and perpetration (β = .07, 95% CI: 0.02, 0.13). Anxiety and depressive symptoms, however, did not show significant indirect effects.

CONCLUSIONS

Findings highlight the importance of interventions targeting posttraumatic stress symptoms for adolescents who experienced CPA in preventing physical DV in young adulthood.

Gender-Moderated Pathways From Childhood Abuse and Neglect to Late-Adolescent Substance Use

Substantial research has linked childhood maltreatment to the development of substance use in adolescence. However, gender differences in the mechanisms that connect child abuse and neglect to substance use remain unclear. In this study, we applied multiple-group structural equation modeling in a sample of 1,161 youths (boys, n = 552; girls, n = 609) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine gender differences in the associations between childhood abuse and neglect exposure from ages 0-12 years and substance use severity at age 18 as mediated by early substance use at age 14 and psychological symptoms (anger, anxiety, and depression) at age 16. In both genders, neglect directly predicted substance use severity, β = .25, p < .001 for boys and β = .17, p = .007 for girls; and early substance use, β = .03, p = .002 for boys and β = .06, p = .005 for girls; and anger mediated this association, β = .10, p < .001 for boys and β = .06, p = .005 for girls. Anger mediated paths from abuse in boys, β = .06, p = .018. In girls, early substance use mediated the path from abuse to substance use severity, β = .06, p = .008, with the mediated effect and direct path from abuse to early substance use significantly moderated by gender. For substance use severity, R² = .26 for girls and R² = .27 for boys. These findings demonstrate the prominence of neglect in predicting substance use severity and gender differences in paths from abuse.

A Study Space Analysis and Narrative Review of Trauma-Informed Mediators of Dating Violence

Research linking child maltreatment and dating violence in adolescence and emerging adulthood has proliferated in the past two decades; however, the precise mechanisms by which these experiences are related remain elusive. A trauma-informed perspective suggests four particularly promising mediators: maladaptive attachment, emotion regulation difficulties, emotional distress, and hostility. The current article characterizes the status of the empirical literature examining these four mediators using a study space analysis and a narrative review of existing research. An extensive literature search identified 42 papers (44 studies) that met the following criteria: (1) at least one measure of child maltreatment (emotional, physical, sexual, neglect, or exposure to intimate partner violence); (2) a measure of one of the four mediator variables; (3) a measure of dating violence perpetration or victimization; and (4) a sample of adolescents or young adults. The study space analysis suggested several important observations about the research on this topic, including a dearth of studies examining hostility as a mediator and little research using prospective designs or clinical samples. There are also limitations with the conceptualization and measurement of dating violence, child maltreatment, and some of the mediator variables. In addition, few studies examined more than one mediator variable in the same study. The narrative review suggested that maladaptive attachment (specifically insecure attachment styles), emotion regulation difficulties (specifically regulation of the emotion of anger), and emotional distress construed broadly represent promising mediators of the association between child maltreatment and dating violence, but conclusions about mediation must remain tentative given the state of the literature. The discussion offers recommendations for improved theoretical and empirical rigor to advance future research on mechanisms linking child maltreatment and dating violence.

The Impact of Intimate Partner Violence Exposure in Adolescence and Emerging Adulthood: A Developmental Psychopathology Approach

Despite increased attention on parental intimate partner violence (IPV) exposure, a relative paucity of research has examined the developmental consequences of this traumatic experience within a life span approach. The aim of the present study was to examine how parental IPV exposure may relate to mental health during the transition from adolescence to emerging adulthood. Furthermore, we examined whether the impact of parental IPV exposure was unique from more commonly studied maltreatment experiences, specifically neglect and physical abuse. A large, racially and ethnically diverse sample (N_baseline = 1,042; 56% female; M_age = 15.1, SD = 0.79; 31.4% Hispanic, 29.4% White, 27.9% African American, 3.6% Asian, 7.7% biracial or other) of adolescents completed a baseline assessment for parental physical IPV exposure and maltreatment as well as measures for symptoms of depression, posttraumatic stress, and substance use, annually for 6 consecutive years. Mixed-level modeling was used to examine how parental IPV exposure was uniquely associated with different patterns of mental health across developmental epochs. Findings demonstrated a multifaceted relation with mental health. For internalizing symptoms, the effect was pronounced during adolescence, and neglect increased the risk for depression symptomatology. Meanwhile, parental-IPV-exposed adolescents were at increasing risk for substance use as they aged into adulthood. Symptom levels and trajectories were independent and distinct from maltreatment experiences. This study helps illuminate parental IPV exposure's unique influence on well-being during vulnerable developmental periods. It also calls attention to the importance of developing suitable intervention/prevention programs to target this vulnerable population.

The Influence of Childhood Adversity on Rural Black Men's Sexual Risk Behavior

BACKGROUND

Young Black men living in resource-poor rural environments are disproportionately affected by both adverse childhood experiences and HIV/STIs. The influence of childhood adversity on sexual risk behavior remains to be examined among this vulnerable population.

PURPOSE

In this study, we investigated the influence of overall adversity as well as three subcomponents, abusive parenting, parental neglect, and witnessing family violence, on men's engagement in sexual risk behavior. We hypothesized that adverse experiences would predict engagement in sexual risk behaviors including multiple sexual partnerships, inconsistent condom use, frequent sexual activity, and concurrent substance abuse and sexual activity. We tested formally the extent to which defensive relational schemas mediated these associations.

METHODS

Hypotheses were tested with data from 505 rural Black men (M age = 20.29, SD = 1.10) participating in the African American Men's Health Project. Participants were recruited using respondent-driven sampling. Self-report data were gathered from participants via audio computer-assisted self-interviews.

RESULTS

Bi-factor analyses revealed that, in addition to a common adversity factor, neglect independently predicted sexual risk behavior. Men's defensive relational schemas partially mediated the influence of the common adversity factor as well as the neglect subcomponent on sexual risk behavior.

CONCLUSIONS

The present research identified a potential risk factor for sexual risk behavior in an understudied and vulnerable population. Adverse childhood experiences in general, and neglect in particular, may place many young Black men at risk for engaging in sexual risk behavior due in part to the influence of these experiences on men's development of relational schemas characterized by defensiveness and mistrust.

Multiple Dimensions of Childhood Abuse and Neglect Prospectively Predict Poorer Adult Romantic Functioning

The present study used data from the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) to investigate how multiple dimensions of childhood abuse and neglect predict romantic relationship functioning in adulthood. Several dimensions of abuse and neglect (any experience, type, chronicity, co-occurrence, and perpetrator) were rated prospectively from birth through age 17.5 years. Multimethod assessments of relational competence and violence in romantic relationships were conducted repeatedly from ages 20 to 32 years. As expected, experiencing childhood abuse and neglect was associated with lower romantic competence and more relational violence in adulthood. Follow-up analyses indicated that lower romantic competence was specifically associated with physical abuse, maternal perpetration, chronicity, and co-occurrence, whereas more relational violence was uniquely associated with nonparental perpetration. We discuss these novel prospective findings in the context of theory and research on antecedents of romantic relationship functioning.

Developmental Pathways from Child Maltreatment to Adolescent Substance Use: The Roles of Posttraumatic Stress Symptoms and Mother-Child Relationships

While many studies have identified a significant relation between child maltreatment and adolescent substance use, the developmental pathways linking this relation remain sparsely explored. The current study examines posttraumatic stress (PTS) symptoms, mother-child relationships, and internalizing and externalizing problems as potential longitudinal pathways through which child maltreatment influences adolescent substance use. Structural equation modeling was conducted on 883 adolescents drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The pathways of PTS symptoms linked physical and sexual abuse to substance use, and the pathways of mother-child relationships linked emotional abuse and neglect to substance use. None of the four types of maltreatment affected substance use via internalizing or externalizing problems. The findings suggest that intervention efforts aimed at addressing posttraumatic stress symptoms and improving mother-child relationship quality may be beneficial in reducing substance use among adolescents with child maltreatment histories.

An Ecodevelopmental Exploration of Mediators Between Maltreatment in Childhood and Drug use During Pregnancy

Child maltreatment is associated with increased risk of substance abuse in adulthood. However, prior investigations have not examined substance use specifically in pregnancy, and have relied on self-report of substance use. The present study addresses these gaps via secondary analysis of 295 primarily low-income, Black postpartum women who agreed to complete a brief questionnaire and subsequently provided urine and hair samples. A clear relationship emerged between self-reported maltreatment and positive toxicology (with drug use present in 37.2% of maltreated participants and 17.1% of non-maltreated participants; p < .001). Depression and violence exposure were positively associated with maltreatment and with drug use. The combined effect of violence exposure and depression mediated the association between maltreatment and drug use during pregnancy (the bootstrapped 95% confidence interval of total indirect effect ranged from .17-.86). This investigation is the first to show an association between childhood maltreatment and toxicological evidence of drug use in pregnancy.

Substantiated Childhood Maltreatment and Intimate Partner Violence Victimization in Young Adulthood: A Birth Cohort Study

Little is known about the associations between various types of childhood maltreatment and multiple forms of intimate partner violence victimization in early adulthood. This study examines the extent to which childhood experiences of maltreatment increase the risk for intimate partner violence victimization in early adulthood. Data for the present study are from 3322 young adults (55 % female) of the Mater Hospital-University of Queensland Study of Pregnancy with the mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first antenatal clinic visit at Brisbane's Mater Hospital from 1981 through to 1983. Participants completed the Composite Abuse Scale at 21-year follow-up and linked this dataset to agency recorded substantiated cases of childhood maltreatment. In adjusted models, the odds of reporting emotional intimate partner violence victimization were 1.84, 2.64 and 3.19 times higher in physically abused, neglected and emotionally abused children, respectively. Similarly, the odds of physical intimate partner violence victimization were 1.76, 2.31, 2.74 and 2.76 times higher in those children who had experienced physical abuse, sexual abuse, neglect and emotional abuse, respectively. Harassment was 1.63 times higher in emotionally abused children. The odds of severe combined abuse were 3.97 and 4.62 times greater for emotionally abused and neglected children, respectively. The strongest associations involved reports of child emotional abuse and neglect and multiple forms of intimate partner violence victimization in young adulthood. Childhood maltreatment is a chronic adversity that is associated with specific and multiple forms of intimate partner violence victimization in adulthood.

Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect

Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

Negative urgency mediates the relationship between childhood maltreatment and problems with alcohol and cannabis in late adolescence

BACKGROUND

Childhood maltreatment is an important risk factor for problems with alcohol and other drugs such as cannabis. Although this link has been well established, the mechanisms in this association require further study. High levels of impulsivity and difficulties with emotion regulation are often associated with childhood maltreatment. Negative urgency--an emotion-based facet of impulsivity--is a strong predictor of substance use problems and may be a particularly relevant facet of impulsivity in the link between childhood maltreatment and alcohol and cannabis outcomes. However, few studies have examined the specific mediational pathway from childhood maltreatment to alcohol and cannabis problems through negative urgency.

OBJECTIVES

We tested the hypothesis that the associations between history of childhood maltreatment and current alcohol and cannabis problems would be mediated by negative urgency, but not other facets of impulsivity.

METHODS

Participants (N=232), who were in late adolescence (mean age=19.75), completed self-report measures of different facets of impulsivity, past childhood maltreatment, and current alcohol and cannabis use and problems.

RESULTS

In analyses including several facets of impulsivity as simultaneous mediators, negative urgency was the only facet to mediate the associations of childhood maltreatment severity with alcohol and cannabis problems.

CONCLUSIONS

These findings provide support for negative urgency as a unique mediator of the associations between childhood maltreatment and both alcohol and cannabis problems, suggesting that future work on mechanisms in these associations should focus on mood-based impulsivity.

From Violence in the Home to Physical Dating Violence Victimization: The Mediating Role of Psychological Distress in a Prospective Study of Female Adolescents

Symptoms of psychological distress may be one pathway through which child maltreatment and witnessing violence in the home relate to dating violence victimization. This study examined whether psychological distress in mid-adolescence mediated the link between child maltreatment and witnessing violence in early adolescence and dating violence victimization in young adulthood. The sample included female participants (N = 532) from the National Survey of Child and Adolescent Well Being who were 18 years or older in the fifth and final wave of data collection. At the time of entry into the study, participants were 12.81 (SD = 1.23) years old. Sixteen percent of participants identified as Hispanic; 53 % identified their race as White, 33 % as Black, and 11 % as American Indian. Results showed that psychological distress may play a causal role in the relationship of violence in the home to dating violence victimization. Interventions targeting psychological distress, particularly in samples at risk for child maltreatment, may reduce the risk of dating violence victimization.