Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood

Judith A Stein,Michelle Burden Leslie,Adeline Nyamathi

doi:10.1016/s0145-2134(02)00382-4

Judith A Stein, Michelle Burden Leslie + Show 1 more

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https://doi.org/10.1016/s0145-2134(02)00382-4

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Abstract

Objective: This study, using latent variable methodology, explores simultaneously the relative effects of childhood abuse and early parental substance abuse on later chronic homelessness, depression, and substance abuse problems in a sample of homeless women. We also examine whether self-esteem and recent violence can serve as mediators between the childhood predictors and the dysfunctional outcomes. Method: The sample consists of 581 homeless women residing in shelters or sober living centers in Los Angeles (54% African-American, 23% Latina, 22% White, mean age=33.5 years). Multiple-indicator latent variables served as predictors and outcomes in structural models. Childhood abuse was indicated by sexual, physical, and verbal abuse. Results: Childhood abuse directly predicted later physical abuse, chronic homelessness, depression, and less self-esteem. Parent substance use directly predicted later substance use problems among the women. Recent physical abuse predicted chronic homelessness, depression, and substance use problems. Greater self-esteem predicted less depression and fewer substance use problems. Childhood abuse also had significant indirect effects on depression, chronic homelessness, and drug and alcohol problems mediated through later physical abuse and self-esteem. Conclusions: Although there was a strong relationship between childhood abuse and parent drug use, childhood abuse was the more pervasive and devastating predictor of dysfunctional outcomes. Childhood abuse predicted a wider range of problems including lower self-esteem, more victimization, more depression, and chronic homelessness, and indirectly predicted drug and alcohol problems. The mediating roles of recent physical abuse and self-esteem suggest salient leverage points for change through empowerment training and self-esteem enhancement in homeless women.

Highlights

Using a latent variable methodology, we test simultaneously the relative contributions of childhood abuse and parent substance abuse to later chronic homelessness, depression, and substance abuse problems in a sample of currently homeless women
This study explores whether early abuse, as manifested in sexual, physical, or verbal abuse, or parent substance abuse have the more pervasive effect on later adverse behavioral and psychological outcomes and whether recent physical abuse and lower self-esteem can mediate between childhood influences and current maladaptive outcomes
The present study contributes to studies among at-risk vulnerable women by relating malleable intervening variables to adverse outcomes that represent health risk behaviors and psychological distress

Summary

Introduction

Using a latent variable methodology, we test simultaneously the relative contributions of childhood abuse and parent substance abuse to later chronic homelessness, depression, and substance abuse problems in a sample of currently homeless women. This study explores whether early abuse, as manifested in sexual, physical, or verbal abuse, or parent substance abuse have the more pervasive effect on later adverse behavioral and psychological outcomes and whether recent physical abuse and lower self-esteem can mediate between childhood influences and current maladaptive outcomes. Research and interventions among homeless, impoverished women tend to concentrate on current lifestyle behaviors; less attention has been given to the role of their early childhood experiences. Exploring the contribution of early life experiences to a current lifestyle of maladaptive behaviors, chronic homelessness, and psychological distress would highlight the importance and value of early interventions among dysfunctional families. Homeless women report disproportionately high rates of childhood physical and sexual abuse histories (Browne, 1993; Browne & Bassuk, 1997; Goodman, 1991) along with childhood histories of economic and social disadvantage, and turmoil (Sullivan, Burnam, Koegel, & Hollenberg, 2000)

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