This study examined whether it is appropriate to make a causal inference regarding the association between early child abuse and neglect and alcohol symptoms in females, and it also analyzed whether five potential mechanisms may mediate the relationship between child abuse and neglect and alcohol symptomatology.
The data used in these analyses are part of a research project based on a cohort design study in which abused and neglected children were matched with nonabused and non-neglected children and followed prospectively into young adulthood. In the first phase of the research, a large group of adults abused and/or neglected as children approximately 20 years ago were followed up through an examination of official juvenile and criminal records and compared with a matched control group of children. Only cases that were serious enough to come to the attention of the authorities were included in this study. Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on sex, age, race, and approximate social class with nonabused and non-neglected children and followed prospectively into young adulthood. Subjects were administered a 2-hour in-person interview, including the National Institute of Mental Health Diagnostic Interview Schedule, to assess alcohol use and abuse. The analyses were restricted to females in the sample (n=582). The dependent variable was the number of alcohol symptoms, determined by the person's response to the Alcohol Abuse or Dependence component of the DIS-III-R. The five potential mechanisms for mediating the relationship between child abuse and neglect and alcohol symptomatology were depression, worthlessness, social isolation/loneliness, low self-esteem, and using alcohol and/or drugs to cope. For the women studied, being abused and neglected in their childhoods increased the number of alcohol symptoms manifested later in their lives. This relationship remained significant even after controlling for other potentially confounding factors, including race, IQ, family poverty, and parents' alcohol or drug history. The findings provide preliminary support for two potential mechanisms or mediating variables in the relationship between childhood abuse and/or neglect and alcohol abuse. These are depression symptoms and using alcohol/drugs to cope. This report recommends that interventions be directed at abused and neglected females of all ages to help them deal with depression and develop coping strategies that will prevent the development of serious alcohol abuse problems. 7 figures, 3 tables, and 72 references