Three potential mediators of the effects of child abuse and neglect on adulthood substance use among women

Objective: This study examined mechanisms that might account for the association between early childhood abuse and neglect, and substance use and related problems in adulthood for women. Method: Women with documented cases of early childhood abuse and/or neglect and matched controls were interviewed in young adulthood (mean age = 29 years) and again in middle adulthood (mean age = 40) (n=582). We examined the mediating effects of posttraumatic stress disorder (PTSD) symptoms, stressful life events, and delinquent and criminal behavior measured in young adulthood on substance use-related problems and illicit drug use measured in middle adulthood. Results: We found that all three potential mediators mediated the effects of abuse and neglect on substance-use problems and illicit drug use. When all three mediators were considered simultaneously, only stressful life events mediated the effects of child abuse and neglect for substance use-related problems and PTSD mediated for illicit drug use. These relationships were not moderated by race/ethnicity, although the effects of abuse and neglect on the mediators differed for white and non-white women. Conclusions: These findings suggest that interventions are needed with maltreated girls to recognize and attend to their PTSD symptoms and to assist them in developing coping strategies to deal with stressful life events in an attempt to reduce risk of subsequent substance use and related problems.