The relationship between child abuse and negative outcomes among substance users: psychopathology, health, and comorbidities

Addict Behav. 2014 Oct;39(10):1522-7. doi: 10.1016/j.addbeh.2014.05.023. Epub 2014 Jun 2.

Abstract

Background: Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests that this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized that among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed.

Method: We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse.

Results: Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed.

Conclusions: Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings.

Keywords: Child abuse; Comorbidities; Psychopathology; Substance use.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Adult Survivors of Child Abuse / statistics & numerical data
  • Alcoholism / epidemiology
  • Alcoholism / psychology
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Cocaine-Related Disorders / epidemiology
  • Cocaine-Related Disorders / psychology
  • Comorbidity
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Personality Disorders / epidemiology
  • Personality Disorders / psychology
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology
  • Substance Abuse Treatment Centers
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*
  • Surveys and Questionnaires