Predictors of drug-use patterns in maltreated children and matched controls followed up into middle adulthood.
OBJECTIVE
This study examines whether child abuse; child neglect; demographic, family and social, behavioral, economic, and neighborhood risk; and protective factors predict different drug-use patterns into middle adulthood.


METHODS
Using a prospective cohort design, individuals with documented cases of childhood physical and sexual abuse and neglect (processed during 1967-1971) and a matched control group were followed into middle adulthood. Participants completed in-person interviews in 1989-1995 (average age 29), 2000-2002 (average age 39.5), and 2003-2004 (average age 41). The sample for this study included 374 women and 332 men.


RESULTS
Four patterns of drug use were revealed: (a) abstinence and low use (34%), (b) adolescent and young adult limited use (31%), (c) chronic-persistent use (29%), and (d) late use (7%). The chronic-persistent pattern was associated with being male, parental substance-use problems, involvement in crime, and neighborhood problems. The late-use pattern was significantly associated with childhood neglect and being Black, when other risk factors were controlled; bivariate analyses also indicated associations with female gender, lower income, and greater neighborhood disadvantage.


CONCLUSIONS
This study revealed two patterns of drug use involving substance use and substance-related problems in middle adulthood that are associated with different sets of risk factors. Further research is needed to understand the late-drug-use pattern, which appears to disproportionately involve low-income Black women with histories of childhood neglect. These individuals may be missed in efforts to prevent or reduce drug use among youths.
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA. helen.wilson@rosalindfranklin.edu
Helen W
HW
Wilson
Cathy Spatz
CS
Widom
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult