title: The role of substance use coping in the relation between childhood sexual abuse and depression among methamphetamine users in South Africa.
abstract: OBJECTIVE
  Childhood sexual abuse (CSA) is a critical global health issue associated with poor psychosocial outcomes. Individuals with CSA histories are at risk for drug use, which is a growing problem in the Western Cape of South Africa. The present study of methamphetamine users in this region examined whether substance use coping, a contextually relevant type of avoidance-based coping, mediates the relation between CSA and depressive symptoms.
  
  
  METHODS
  Participants included 161 men and 108 women seeking treatment for methamphetamine use. Participants completed a computer-assisted survey and a face-to-face interview with clinic staff to evaluate history of CSA, current substance use severity and coping, and current depressive symptoms.
  
  
  RESULTS
  Nearly a third of participants reported a history of CSA, and the average methamphetamine use severity score exceeded the threshold of high risk. A history of CSA was significantly associated with higher substance use coping and more depression symptoms. Substance use coping was a significant mediator of the association between CSA and depression symptoms.
  
  
  CONCLUSIONS
  In this study of high-risk methamphetamine users, substance use coping emerged as a common means of managing stress, especially for those with a history of CSA, which was further linked to depressive symptoms. These findings underscore the potential benefit of integrating coping interventions and mental health treatment into substance abuse treatment programs, particularly for those with a history of childhood abuse and violence. (PsycINFO Database Record
authors.affiliation: Duke Global Health Institute, Duke University.
authors.forename: Martha K
authors.initials: MK
authors.lastname: Berg
authors.affiliation: Duke Global Health Institute, Duke University.
authors.forename: Andréa L
authors.initials: AL
authors.lastname: Hobkirk
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town.
authors.forename: John A
authors.initials: JA
authors.lastname: Joska
authors.affiliation: Duke Global Health Institute, Duke University.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Meade
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013019:South Africa
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine