Pathways Linking Childhood Physical Abuse to Alcohol Misuse in Adolescent Boys and Girls: A Prospective Cohort Study From Rio de Janeiro, Brazil

Abstract

The purpose of this study was to identify if childhood physical abuse is a risk factor for adolescent alcohol misuse and the specific pathways linking childhood physical abuse and alcohol misuse in boys and girls. The study enrolled 785 students from the baseline and first wave of a prospective cohort study developed at six high schools in Rio de Janeiro, Brazil. The Childhood Trauma Questionnaire (CTQ), Conflict Tactics Scale-Form R (CTS-1), and Alcohol Use Disorders Identification Test (AUDIT) were used to identify childhood and adolescence physical abuse and alcohol misuse, respectively. Multigroup path analysis was performed to explore the postulated pathways between the exposures and outcomes. Childhood physical abuse was a significant risk factor for alcohol misuse in adolescence for both sexes. Among girls, childhood physical abuse increased the risk of adolescent revictimization and school delay, which were mediators between childhood physical abuse and alcohol misuse. Among boys, childhood physical abuse has a direct effect on increasing the risk of alcohol misuse. School delay was also a mediator from more social determinants to alcohol misuse in both sexes, whereas not living with the mother in adolescence mediated such effects only among boys. Childhood physical abuse increases the risk of alcohol misuse in adolescence through different pathways in boys and girls. Strategies aimed at reducing alcohol misuse and other mental health problems in adolescence should incorporate such specificities.