The Link Between Child Maltreatment and Substance Abuse

Natalie Vilhena-Churchill, a psychology intern, presented her findings on the relationship between child maltreatment and substance abuse in adults at the Grand Rounds held on April 16 at Ontario Shores Centre for Mental Health Sciences (Ontario Shores). The study also credited Abby L. Goldstein, from the University of Toronto, as a contributor.

Vilhena-Churchill’s research study set out to determine the missing link between childhood maltreatment and substance use problems later in life. In this study, child maltreatment was defined to include multiple forms of maltreatment including emotional, physical and sexual abuse/neglect. Substance abuse later in life focused on two substances that are most commonly used in emerging adulthood: alcohol and marijuana. It is important to research the relationship between maltreatment and substance use in this age group (19 to 25) because young adulthood is a transitional period linked to the emergence of many mental health concerns.

The study looked at individuals who have endorsed alcohol or marijuana use by posting flyers, online and on campuses in Toronto. The survey was completed online using a trauma questionnaire addressing all types of childhood maltreatment. Participants in the study included 218 young adults who reported using alcohol in the past year and 125 who reported marijuana use in the past year. A high percentage of respondents were female – (71.9 per cent and 66.9 per cent of respondents, respectively.) The study concluded that experiencing multiple types of maltreatment results in higher rates of alcohol and other substance abuse among those with a history of maltreatment.

“As clinicians, this is a really important gap to assess,” noted Vilhena-Churchill.

The study painted a picture of the relationship between maltreatment and substance abuse by citing emotion dysregulation as a predecessor for substance abuse problems. The ability to regulate emotion develops early in life and can be disrupted by maltreatment as it impacts the biological systems responsible for regulation emotion. Many studies have identified mood regulating motives as significant reasons for substance abuse.

Several motives were presented as predictors of substance use, including internal factors such as enhancement/coping, and external factors including social/conformity. Coping motives emerged as a significant mediator in the relationship between maltreatment and substance use. Child maltreatment was related to greater problems resulting from substance use, not simply substance use itself. Coping motives are an important link here – these individuals are not necessarily using more, just in a way that creates problems for them. In regards to marijuana use, there was also a direct path linking child maltreatment to emotion dysregulation and substance abuse – sometimes skipping the coping motives mediator in between.

People who have experienced more than one type of maltreatment are more susceptible to difficulties with emotion regulation, which leads to greater use of alcohol/marijuana to cope with negative mood and increased substance abuse problems.

These findings are important for clinicians because they highlight emotion regulation and coping strategies as important intervention targets for individuals with a history of childhood maltreatment. They also shed light on the need for clinicians to consider using interventions that address the development of healthy emotion regulation, which would help reduce the need for substances to regulate mood.