Methods: Five databases were searched in November of 2020 to find studies published between 1980 and 2020 on the connection between CSA and subsequent substance use problems. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used to guide the review. Studies were included if they focused on pathways linking CSA and any type of substance use among males and were published in peer reviewed journals. Hand-searching or pearling was not performed.
Results: Initially, the search strategy identified 250 studies. The screening procedures, consisting of title-, abstract-, and full-text-review, led to eight articles, published between 2014 and 2020, that were included in the final analysis. The identified pathways linking CSA and SUD in male minors and adults included anger, trauma-related intrusions, negative post-traumatic cognitions, avoidance behaviors, tendency to dissociate, and general PTSD symptoms. The majority of the studies referred to self-medication as a possible explanation. The located studies revealed that CSA is common among men dealing with SUD.
Conclusion: The identified articles revealed that history of CSA among men struggling with SUDs is common and that CSA has adverse long-term effects on the afflicted individual. Consistent with Khantzian’s self-medication hypothesis, problematic substance use seems to be a way to cope with the psychological reactions that developed as a response to the trauma. While the pathways differ in their specific characteristics, male survivors of CSA appear to use drugs or alcohol to deal with anger, manage intrusive thoughts, or distance themselves from the trauma. The function of self-medication deserves more attention in the addiction treatment field, especially among men sexually abused as children. Future research could utilize these pathways to develop interventions to effectively treat substance use disorders.