Perception of Childhood Maltreatment: Implications for Early Adult Substance Abuse
Laura J. Elwyn, MSW, State University of New York at Albany, Carolyn A. Smith, PhD, State University of New York at Albany, and Timothy Ireland, PhD, Niagara University.
Purpose: Prior research indicates that persons undergoing treatment for substance abuse often report experiencing maltreatment in childhood with subsequent implications for intervention and treatment. Less is known, however, about the impact of actual versus perceived maltreatment in childhood on substance abuse. This paper examines whether the retrospective perception of childhood abuse plays a mediating role in the impact of maltreatment on young adult substance abuse. Methods: Data for this paper are from the Rochester Youth Development Study (RYDS), a longitudinal investigation of the development of antisocial behavior in a community sample of 1,000 urban youth followed from age 13 to adulthood. Measures come from a combination of interview data and official records collected through age 22. Substantiated maltreatment measures from CPS records include an ever-prevalence measure of substantiated maltreatment and subtypes. Self-reported maltreatment measures, obtained when respondents were age 22, involve recall of specific behaviors indicating physical abuse, sexual abuse, and neglect in childhood. In addition, respondents were asked after each set of behaviors whether they perceived themselves to have been maltreated in childhood. Substance abuse is measured by a self-reported cumulative index of use of 10 drugs. Analysis controls for gender, race/ethnicity, parent education, family stability, and poverty. Findings: Distribution of maltreatment experiences showed that of those who had substantiated maltreatment reports, only 35.6% had an adult perception of abuse as a child. Of those who perceived themselves to have been maltreated, 45.5% had official reports of maltreatment. Of those who self reported an event of maltreatment, only 30.9% perceived themselves as having been maltreated, although almost all of those who perceived themselves as having been abused reported some event of maltreatment. The central research question was the extent to which perception of childhood maltreatment predicted substance abuse. We compared three groups: those with no history of maltreatment, either official or self reported, and no perception of maltreatment; those with a history of maltreatment, but no perception of maltreatment; and those with both history and perception of maltreatment. Using logistic regression, we found that both the groups with a history of maltreatment had a significantly higher likelihood of engaging in drug use as young adults than the group with no history of maltreatment (OR for group with no perception =1.88, p < .01; OR for group with perception=5.27, p < .001). The group with both history and perception of maltreatment had a significantly higher likelihood of drug use than the group with a history of maltreatment but no perception of maltreatment (OR=2.81, p < .001). Implications: More objective measures of maltreatment, including a substantiated CPS finding, do not necessarily result in an adult perception of childhood abuse. Perception of childhood abuse may be an important mediator of the effect of early maltreatment on young adult drug use. In turn this indicates possible benefits of intervention strategies with maltreated adolescents and young adults that focus on emotional and cognitive processing of childhood experiences to prevent or reduce substance use.