Child Maltreatment and Alcohol Use in Emerging Adulthood: The Potential Mediating Roles of Psychological Stress and Delinquent/Criminal Behavior

Background and Purpose: Maltreated children represent a subpopulation of U.S. children particularly vulnerable to problematic alcohol use in emerging adulthood (EA), a separate period of the life course covering approximately ages 18 to 25. Numerous studies have found that maltreated children are 2-6 times more likely to develop alcohol use in later life than are non-maltreated children. However, there is a paucity of empirically-based knowledge about the developmental processes linking child maltreatment and alcohol use in EA. Currently minimal understanding of such developmental mechanisms limits the success of prevention and intervention efforts for this highly vulnerable population. Recognizing that a variety of interrelated genetic and environmental factors are likely to link child maltreatment and alcohol use later in life, the present study examined the role of psychological stress and delinquent/criminal behavior that might lead from child maltreatment to alcohol use in EA. A substantial body of literature suggests that experience of childhood maltreatment predicts the development of both psychological distress and delinquent/criminal behavior, which are widely known risk factors for alcohol use and misuse.

Methods: Data for the present study were collected from 337 young people aged 18-25 in the community (mean age=21.9 years; SD=2.1 years). Slightly more than half were female (51.9%); 57.5% were enrolled in college; and the majority of participants were White (64.6%). Four types of child maltreatment (emotional, physical and sexual abuse, and neglect) were evaluated using a computer-assisted self-interviewing (CASI) method of the Childhood Trauma Questionnaire. We performed structural equation modeling to investigate whether child maltreatment influences alcohol use through psychological distress and delinquent/criminal behavior, and to determine pathways for these effects in a multivariate context. We also examined variations in these pathways by four different alcohol use outcomes including frequency of alcohol use, binge drinking, alcohol-related problems, and alcohol use disorders (AUD).

Results: We found that all four types of child maltreatment are associated with either psychological stress or delinquent/criminal behavior: standardized coefficients ranged from .12 to .51. For example, emotional abuse was related to psychological distress (β=.32), which in turn influenced AUD (β=.08). A test of indirect effects of emotional abuse on AUD found that these relationships were partially mediated by psychological distress (β=.16). In addition, physical abuse was associated with delinquent/criminal behavior (β=.39), which was positively related to alcohol-related problems (β=.59). We found, however, no indirect effect of physical abuse on alcohol-related problems through delinquent/criminal behavior. All of our analyses controlled for common risk factors for child maltreatment and alcohol use, including parental alcoholism, family income, and peer drinking.

Conclusion: Our study confirmed that child maltreatment is associated with problematic drinking behavior in EA. We also found that psychological distress may play a significant role in linking childhood emotional abuse to AUD in EA. The present study suggests that reducing psychological stress would be a potentially useful target to prevent problematic alcohol use among young people who have early exposure to child maltreatment.