Abstract
BackgroundIn adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role. MethodsSecondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13–23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect. ResultsThe three types of childhood abuse measured by the CTQ – emotional, physical and sexual – were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates. ConclusionsThese data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.
Highlights
Childhood abuse is typically associated with greater risk of alcohol and drug problems, in cross sectional and prospective designs, in adolescent and adults, not all studies replicate this finding (Brady and Back, 2012; Butt et al, 2011; Konkolÿ Thege et al, 2017; Simpson and Miller, 2002)
The exception was the relationship between sexual abuse and drug problems, which was not reliable
There were no differences between the genders in the strength of these associations, apart from emotional abuse which had a stronger relationship with drug problems in males (Figure 1D)
Summary
Childhood abuse is typically associated with greater risk of alcohol and drug problems, in cross sectional and prospective designs, in adolescent and adults, not all studies replicate this finding (Brady and Back, 2012; Butt et al, 2011; Konkolÿ Thege et al, 2017; Simpson and Miller, 2002). The relationship between adult psychiatric states (including depression, anxiety) and alcohol/drug problems is mediated by drug use coping motives (Dvorak et al, 2014; Gonzalez et al, 2011; Holahan et al, 2001; McDevitt-Murphy et al, 2015; Mooney et al, 2008; O'Hare and Sherrer, 2011; Peirce et al, 1994; Reardon et al, 2002; Schuckit et al, 2006; Simpson et al, 2014; Stewart et al, 2001; Yeater et al, 2010; Young-Wolff et al, 2009) These studies suggest drug use coping motives are a crucial psychological mechanism driving substance dependence in vulnerable groups.
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