Pathways from Childhood Abuse to Posttraumatic Stress and Substance Use Disorders: Differences between U.S.-Born and Foreign-Born Latino Americans

Background and Purpose:

Childhood abuse is a major social and health concern. Studies reported childhood abuse is associated with behavioral health issues, such as posttraumatic stress disorders and substance use disorders (Brewin et al., 2000).  Despite the significance of the association, little is known about the effects of childhood abuse on SUD among Latino Americans, the fastest growing ethnic minority population in the U.S.  Rooted in the Hispanic-paradox hypothesis (Vega et al., 1998), this study aimed to investigate the pathways of childhood abuse, past-year posttraumatic stress disorders (PY-PTSD) and past-year substance use disorders (PY-SUD) among Latino Americans.  

Methods:

We utilized data on Latino Americans (N=2,554) from the National Latino and Asian American Study (NLAAS), which is the first nationally-representative survey on the mental health of Latino Americans aged 18 years or older in the U.S.  The weighted sample included 48.5% females and 43% U.S.-born.  The average age of participants was 38.02 years (SD=15.03, range 18-97).  To test our hypotheses, childhood physical abuse (CPA) and childhood sexual abuse (CSA) as exogenous variables, PY-SUD as the endogenous variable, PY-PTSD as the mediator, and control variables were measured. Chi-square and t-test analyses were examined to compare the estimates of the variables between U.S.-born and foreign-born Latinos. Path analyses were also performed to investigate the direct and indirect effects of CA on PY-SUD through PTSD for the whole Latino group and the U.S.-born and foreign-born subgroups.

Results:

Findings indicated the prevalence of PY-SUD in U.S.-born Latinos (5.1%) was significantly higher than that of foreign-born Latinos (1.4%), indicating a large between-group difference (p<.001).  This pattern held true for both CPA and CSA (p<.001).  The rate of CPA in U.S.-born Latinos (36.2%) was nearly one-third higher than that of foreign-born Latinos (28.9%), and the rate of CSA in U.S.-born Latinos (17.4%) was nearly double that of foreign-born Latinos (9.1%). In Model-1 for all Latinos, CPA was positively associated with both PY-PTSD (p<.001) and PY- SUD (p<.01), while CSA was positively associated with PY-PTSD (p<.001), but not with PY-SA.  In turn, PY-PTSD mediated the association between both CPA and CSA and PY- SUD.  Model 2 for U.S.-born Latinos indicated an identical pattern to that of Model-1. Contrary to the similar patterns in Models-1 and-2, Model 3 for foreign-born Latinos revealed considerable differences. Specifically, only CPA was positively associated with PY-PTSD (p<.001), which, in turn, was positively associated with PY- SUD (p<.001). As such, PY-PTSD mediated only the link between CPA and PY- SUD in foreign-born Latinos.

Conclusions and Implications:

This study contributes to the useful information regarding the pathways from childhood abuse to PTSD and SUD for the U.S.-born and foreign-born Latinos and its application in social work research and practice.  It is important to investigate the influence of childhood abuse to decrease the likelihoods of PTSD and SUD for Latino Americans.  This knowledge can be used by social work practitioners in developing and implementing specific prevention and intervention programs for U.S.-born and foreign-born Latinos to reduce PTSD and SUD as well as to improve Latinos’ well-being.