Adult memory and appraisal of maltreatment in childhood: Implications for problem substance use.

摘要

Objective. Alcohol and drug abuse are major public health concerns. Child maltreatment has been identified as a risk factor that increases the likelihood of substance use problems in adulthood. However, most studies have used retrospective reports of maltreatment and the few studies that have used prospective measures of maltreatment have found a weaker association with adult substance use problems. This study examines whether adult memory and appraisal of maltreatment is the primary pathway through which substantiated child maltreatment effects adult substance use problems.;Methods. Data are from the Rochester Youth Development Study (RYDS), a longitudinal study of youth and young adult development spanning almost 20 years. RYDS provides multiple interviews with the sample of 1,000 participants and their caregivers as well as information from official sources including Child Protective Services (CPS). Substantiated CPS reports of child maltreatment and adult retrospective recall of childhood maltreatment were used to predict illegal drug use, alcohol related problems, and driving under the influence of drugs or alcohol at two adult developmental stages. The effect of early adolescent attachment to parent was also examined, and analyses controlled for adolescent substance use problems, family poverty, parental substance use, and family instability. Multivariate path analyses were conducted using Mplus.;Results. Memory of maltreatment was positively associated with all three substance use problems. Memory of maltreatment completely mediated any association between substantiated CPS reports and substance use problems in both early adulthood and adulthood. There was no direct association or other indirect association between prospectively measured CPS reports and adult substance use problems.;Conclusion. These findings indicate that memory of maltreatment is the primary mediator between child and adolescent maltreatment and adult substance use problems. Thus, prospectively measured substantiated reports of maltreatment do not increase the likelihood of substance use problems in adulthood for the sizable proportion of persons who do not report memories of maltreatment. These results can inform our understanding of why abuse or neglect in childhood leads to substance use problems in adulthood for some people but not for others. This in turn has implications for prevention and treatment of substance use problems.