Exogenous Predictors of Substance Use in a Sample of Maltreated Youth with Child Welfare Involvement

Background and Purpose: Adolescents with child welfare involvement are among the most vulnerable youth populations. Research has shown that youth involved with the child welfare system experience physical, developmental, social, and educational problems more frequently than youth in the general population. These inequities are often associated with substance use in general adolescent samples. Studies of maltreatment and substance use tend to focus on intrapersonal predictors such as trauma history, behavioral dysregulation, mental health diagnoses, and cognitive functioning. However, few studies have focused on the exogenous predictors of substance use in this population. The current cross sectional study sought to examine the relationship between exogenous predictors and current substance use. 

Methods: Self-reported data were collected from 249 youth who had experienced maltreatment and had an open child welfare case. Youth were between the ages of 12 and 15 with a majority identifying as female (61.2%) and a person of color (77.6%). Past-year substance use was assessed by asking youth to report whether they had used one of thirteen types of substances. Because the frequencies were low for each type of substance, the youth’s responses were combined into a dichotomous variable for any past-year substance use. Exogenous (predictor) variables included widely-used measures of exposure to community violence, parental supervision, associations with deviant and prosocial peers, and school connectedness. All measures demonstrated strong internal consistency (alphas ranging from .76 to .90).

Bivariate (chi-square tests and correlations) and multivariate (logistic regression) analyses were used to examine the association of past-year substance use with demographic and exogenous predictors. The logistic regression model included each exogenous factor and 3 control variables (age, gender, and race). Exploratory analyses examined the multivariate predictors of past-year substance use separately for females and males.

Results: Thirty percent of the sample reported using any substances in the past year. Bivariate analyses indicated statistically significant correlations (p<.01) between past-year substance use and community violence, peer deviance, and prosocial peers. The logistic regression model found two significant predictors of substance use: community violence and peer deviance. Youth who had exposure to more community violence and those with more deviant peers were more likely to report past-year substance use. There was also a trend (p=.06) for prosocial peers to have a buffering effect. For females, the logistic regression had three significant predictors: community violence, deviant peers and prosocial peers, whereas for males the only significant predictor was community violence.

Conclusions and Implications: The results suggest that while intrapersonal factors are often examined as predictors of substance use for youth involved with child welfare, there are also important exogenous predictors that need to be considered. This study illustrates that for youth with child welfare involvement who have experienced forms of maltreatment, exposure to community violence and peer relationships are influential factors in their substance use. Additionally, the findings highlight the need to examine gender differences when developing prevention methods for this population. Largely, the study’s findings suggest a need for tailored interventions that provide a holistic approach to preventing substance use in this vulnerable population.