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.
Wilson
Helen W
HW
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA. helen.wilson@rosalindfranklin.edu
Widom
Cathy Spatz
CS
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