The Impact of Child Maltreatment on the Development of Alcohol and Substance Use: Comparing Trajectories of Alcohol and Substance Use in Adolescence and Young Adulthood Between Victims and Non-Victims of Maltreatment

The purpose of this dissertation is to examine the impact of self-reported child maltreatment and involvement of child welfare services (CWS) on alcohol, marijuana, and other substance use in adolescence and young adulthood. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative dataset, and hierarchical linear and generalized linear modeling, we first investigated the long-term impact of child maltreatment and involvement of CWS on alcohol, marijuana and other substance use in young adulthood. We found that experiencing poly-victimization impacted average monthly alcohol consumption when compared to non-victims of maltreatment. After conditioning on identified covariates and modification by biological sex, all measures of maltreatment except sexual abuse are associated with an increased odds of more frequent marijuana use, and poly-victimization is associated with an increased odds of more frequent use of other substances in adulthood. Next we examined the effect of self-reported childhood maltreatment victimization and involvement of child welfare on trajectories of alcohol, marijuana, and other substance use from adolescence into young adulthood. Results from these analyses show that, overall, maltreatment is associated with higher amounts of alcohol consumed and higher odds of using marijuana and other substances at higher levels. Through stratified analyses for males and females, we were able to identify separate associations by specific measures of maltreatment and CWS involvement. Developmental trajectories for all participants revealed patterns of increasing use of alcohol, marijuana, and other substances into late adolescence and emerging adulthood, followed by gradual decreases in use as participants aged into young adulthood; however, some differences by maltreatment or CWS status in the use of alcohol, marijuana, and other substances persisted into adulthood. Substance use prevention and intervention efforts should consider the role of maltreatment and related trauma on substance use for both males and females in the general population.Doctor of Philosoph