Long-term effects of child abuse and neglect on alcohol use and excessive drinking in middle adulthood.
OBJECTIVE
The purpose of this study was to determine the long-term effects of child abuse and neglect on alcohol use in middle adulthood.


METHODS
Individuals with documented cases of childhood physical and sexual abuse and/or neglect (n = 500) and matched controls (n = 396) from a metropolitan county in the Midwest were followed and interviewed in middle adulthood. Outcomes were Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnoses of alcohol abuse or dependence in young adulthood (age 29) and excessive drinking in middle adulthood (age 40).


RESULTS
Women with documented histories of child abuse or neglect reported higher past-year typical quantity (p < .01) and past-month number of days drinking eight or more drinks (p < .05) than nonabused/nonneglected women. Controlling for parental alcohol/drug problems, the effect of child maltreatment on excessive drinking in middle adulthood was not significant for women. For women, the final structural equation model revealed an indirect path through alcohol diagnosis in young adulthood (p < .05) to excessive drinking in middle adulthood (p < .001) but no direct path from child abuse and neglect to excessive drinking in middle adulthood. For men, there were no significant paths from child abuse and neglect to alcohol diagnosis in young adulthood or excessive drinking in middle adulthood. For men and women, parental alcohol/drug problems had a significant indirect effect on the offspring's drinking in middle adulthood (p < .001) through young adult alcohol diagnosis (p < .001).


CONCLUSIONS
Consequences of abuse and neglect persist into middle adulthood for women, through continuation of earlier alcohol problems, suggesting the need for interventions throughout the life course. The influence of parental alcohol and drug problems warrants further attention.
Widom
Cathy Spatz
CS
Department of Psychiatry, New Jersey Medical School, Newark, NJ, USA. cwidom@jjay.cuny.edu
White
Helene Raskin
HR
Czaja
Sally J
SJ
Marmorstein
Naomi R
NR
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology*; D015984:Causality; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015146:Midwestern United States; D012016:Reference Values; D012737:Sex Factors