Childhood maltreatment and the risk of substance problems in later life.

This paper examines the risk of developing problems in adolescence and adulthood, particularly those associated with substance use, as a consequence of experiencing physical or sexual abuse during childhood. We review both retrospective and prospective research, conducted with both adolescent and adult respondents. Although there are some marked discrepancies in the findings from retrospective and prospective studies, these are probably due to differences in methodology, particularly between using official records and self-report to identify cases of abuse. Despite the wide range of methodologies and samples used in these studies, most indicate that the experience of childhood abuse is a risk factor for a number of common mental disorders in adolescence and adulthood, including alcohol and drug-related problems. In many cases, the experience of abuse appears to lead in later life to increased feelings of depression and anxiety which, while not sufficient to result in the diagnosis of a mental health disorder, place the victims at greater risk of developing substance problems. Multivariate studies indicate that this positive association remains even when controlling for important variables such as the presence of parental alcohol problems. The paper concludes with a number of recommendations for future research, so that it can be established whether the risk arises specifically from child abuse or neglect, or from the more general impact on child development of adverse family relationships.