Associations between types of maltreatment and substance use during adolescence

Objective: The aim of this study was to investigate associations between four categories of maltreatment and substance use among adolescents. Method: All 10th through 12th graders (n = 2,187) at six public high schools in a rural Oregon county filled out an anonymous survey that included questions about their experience of emotional, sexual, and physical abuse and their use of a variety of substances. Substance use was subsequently categorized as: (1) tobacco use, (2) alcohol use, and (3) illicit drug use. Experience of maltreatment was subsequently categorized as: (1) no type of maltreatment, (2) emotional abuse, (3) physical abuse, (4) sexual abuse, and (5) sexual and physical abuse. Results: Results showed that all four categories of maltreatment were associated with increased levels of all three categories of substance use. Statistical comparisons of the magnitude effects of different types of maltreatment on substance use indicated a linear trend with the effects of emotional abuse being significantly lower than those of physical or sexual abuse, and the effects of the combination of physical and sexual abuse being significantly higher than the other types. Conclusion: Results suggested that all types of maltreatment, including emotional abuse, are related to significantly higher levels of substance use and should be considered serious risk factors for substance use during adolescence. Results also indicated that the strength of association between maltreatment and substance use varies by type of maltreatment. Youth who have experienced both physical and sexual abuse are at especially high risk of substance use. (C) 2004 Elsevier Ltd. All rights reserved.