Concomitance between childhood sexual and physical abuse and substance use problems. A review.

This review focuses on the apparent connection between childhood sexual or physical abuse (CSA, CPA) and later substance use problems (SUPs) among adolescents and adults. The rates of CSA among females with SUPs were found to be, on average, nearly two times higher than those found in the general population, and the rates of SUPs among women with CSA histories were found to be similarly elevated. The rates of CSA were not found to be elevated among males with SUPs, but men with histories of CSA were found to be at greater risk for SUPs than men in the general population. Women, girls, and boys with SUPs were found to have elevated rates of CPA relative to the general population, while adult males with SUPs were not found to have elevated rates of CPA. Concomitance rates were not found to vary systematically with regard to either the methodological quality of the studies included nor the year of study publication. Additional descriptive examination of selected studies indicates that among women, childhood abuse is likely to be a factor in the development of SUPs, but that the relationship is mediated by other psychiatric conditions, such as anxiety and depressive disorders.