title: Longitudinal Effects of Early Childhood Maltreatment on Co-Occurring Substance Misuse and Mental Health Problems in Adulthood: The Role of Adolescent Alcohol Use and Depression.
abstract: This study tested a developmental model in which subtypes of childhood maltreatment were hypothesized to have direct and indirect effects on co-occurring depression, anxiety, and substance misuse in adulthood. Indirect effects involved adolescent alcohol use and depression, which were included as mediators in the tested models.
  
  
  
  This prospective longitudinal study (N = 332; 52.4% male) followed the participants from childhood (18 months to 6 years of age) to adulthood (31-41 years old, M = 36.21). Maltreatment subtypes included parent-reported physical and emotional abuse and child-reported sexual abuse. Adult outcomes included measures of substance misuse and mental health (i.e., depression and anxiety). Latent class analysis and structural equation models were used to identify classes of substance misuse and mental health co-occurrence and to test mediating effects of adolescent alcohol use and depression.
  
  
  
  Three classes were identified: (a) low risk of substance misuse and low mental health symptoms, (b) moderate substance misuse risk and mild depression and anxiety, and (c) moderate substance misuse risk and moderate to high depression and anxiety. Structural models showed that effects of childhood sexual abuse were fully mediated by adolescent alcohol use and depression. Physical abuse increased adolescent depression but did not have direct or indirect effects on adult outcome classes. Emotional abuse had a direct effect on the adult classes.
  
  
  
  Children exposed to severe emotional abuse are at higher risk for comorbid substance misuse, depression, and anxiety into their mid-30s, after taking into account evidence of alcohol use and depression during adolescence. Sexual and physical abuse have more proximal effects on adolescent alcohol use and depression, which then influence the risk of adult problems.
authors.affiliation: Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington.
authors.forename: Martie L
authors.initials: ML
authors.lastname: Skinner
authors.affiliation: Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, Hawaii.
authors.forename: Seunghye
authors.initials: S
authors.lastname: Hong
authors.affiliation: Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington.
authors.forename: Todd I
authors.initials: TI
authors.lastname: Herrenkohl
authors.affiliation: Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami, Miami, Florida.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Brown
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, California.
authors.forename: Jungeun Olivia
authors.initials: JO
authors.lastname: Lee
authors.affiliation: Social Development Research Group, School of Social Work, University of Washington, Seattle, Washington.
authors.forename: Hyunzee
authors.initials: H
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000523:psychology*; D000066608:Underage Drinking / Q000523:psychology*