Childhood Maltreatment, Self-Control, and Alcohol Drinking Patterns during the Transition to Adulthood

Background and Purpose: Exposure to childhood maltreatment has been linked to adult alcohol use and dependence. Specifically, numerous studies have found that maltreated children are 2-6 times more likely to develop alcohol use and dependence in later life than are non-maltreated children. However, few studies have examined the pathways linking childhood maltreatment to alcohol use during the transition to adulthood (ages 18-25). Currently minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in behavioral self-control (e.g., impulsivity) and emotional self-control (e.g., anger control) are a critical factor that mediates the association between exposure to childhood maltreatment and risk for alcohol use and dependence. A substantial body of research substantiates that experience of childhood maltreatment predicts the development of poor self-control, which is widely known risk factors for alcohol use and dependence.

Methods: Young adults (N=339; mean age= 21.7) were recruited from the community, and participated in an hour-long structured interview: slightly more than half were female (51.9%) and 64.6% were White. Four types of childhood maltreatment (i.e., emotional abuse, physical abuse, sexual abuse, and neglect) were carefully evaluated using a computer-assisted self-interviewing (CASI) method of the Childhood Trauma Questionnaire. A battery of key assessments completed by the respondents included the Wills Self-Control Scale, Brief Symptom Inventory, Rutgers Alcohol Problem Index, and Structured Clinical Interview for DSM-IV.

We performed two separate analyses of structural equation modeling (SEM) to specify the roles of two related, but different self-control processes (i.e., behavioral self-control and emotional self-control) in linking childhood maltreatment to four different patterns of drinking behaviors during the transition to adulthood. They included drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. We also examined the effects of childhood maltreatment subtypes (e.g., physical abuse, neglect) on different drinking patterns. All of our analyses controlled for common risk factors for alcohol use, including psychological distress, parental alcoholism, and peer alcohol use.

Results: The final models fit the data well (CFI > .95; RMSEA ≤ .04). Mutual adjustment for different maltreatment subtypes suggested that emotional abuse might be the major driver of drinking behaviors among the victims of child maltreatment. Structural modeling analyses also indicated that childhood maltreatment is associated with alcohol use and dependence, primarily through both poor behavioral self-control and poor emotional self-control. In a SEM analysis for emotional self-control, the paths from childhood maltreatment to drinking behavior via poor emotional self-control were greater for pathological drinking patterns such as binge drinking and alcohol-related problems than simple counts of drinking frequency.

Conclusions and Implications: We found that both behavioral and emotional self-control play a significant role in linking childhood maltreatment to problematic alcohol use during the transition to adulthood. The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have exposure to childhood maltreatment.