ARCHIVED: Executive Summary: Coping with Becoming a Teen: When You Have Been Maltreated as a Child

Introduction

It is well established that many adolescents use alcohol and drugs. The likelihood of substance use problems in adolescence and adulthood increases with several risk factors, including childhood maltreatment, indicated by physical, sexual, and emotional abuse and/or neglect. With 15% of reported child welfare cases having confirmed caregiver alcohol and/or other drug abuse, youth involved with the child welfare system are an at-risk group for substance abuse and substance use-related problems, such as academic problems, unsafe sex practices, driving under the influence of alcohol or other drugs, getting into fights, and dating violence. Despite research confirming increased risk of substance abuse among youth involved in child welfare and those with histories of childhood maltreatment, to date, the impact of child welfare involvement and maltreatment on substance use among Ontario youth is not well documented.

Purpose

The purpose of this study was to examine:

• differences in substance use among youth involved with the child welfare system compared with youth who are not;
• the specific relationship between childhood maltreatment experiences and substance use;
• gender differences in substance use between youth involved with the child welfare system and youth who are not; and
• the impact of post-traumatic stress disorder (PTSD) symptoms on the relationship between childhood maltreatment and substance use.

Method

Comparisons between youth involved with child welfare and youth who are not were based on two separate samples: youth participants in the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study, and student participants in the Ontario Student Drug Use and Health Survey (OSDUHS), formerly the Ontario Student Drug Use Survey (OSDUS). The use of identical substance use items in both studies made direct comparisons between the samples possible.

Results

Youth involved with child welfare reported higher use of cannabis and other drugs. Females in this category were especially at risk, reporting greater cannabis and other drug use in their lifetime, as well as frequent other drug use, compared with females in Ontario who were not involved in the child welfare system. All types of maltreatment, except sexual abuse, were linked with substance use patterns, although these relationships varied depending on who provided the information regarding maltreatment history (the child welfare caseworker or the youth).

MAP females emerged as at greater risk across a range of substance use variables, compared with MAP males, suggesting that females are a particular high-risk group for a range of substance problems.

Results also indicated that for females, clinical levels of problems were associated with alcohol and drug use. PTSD symptoms were found to be a significant mediator of the childhood maltreatment-adolescent substance use relationship. This mediation, however, was moderated by gender. Specifically, for females involved with child welfare, PTSD symptomatology explained the relationship between a history of childhood maltreatment and drug use.

Discussion and Implications

While adolescence is a time of risk taking and experimental substance use, the findings indicate that child welfare teens are an at-risk group for substance use, especially drug use. Child welfare females are a high-risk group, reporting functional impairments with

drinking and drug use. For females, affective disturbance may be a key component, as PTSD symptomatology significantly mediated the relationship between a history of maltreatment and substance use.

A wide range of strategies are indicated: targeted prevention and drug education activities and multifaceted treatment programs that address both trauma backgrounds and substance abuse issues.

Training for child welfare caseworkers should include screening for substance use and substance-related problems, strategies for managing PTSD symptoms and for developing healthy coping methods. Female youth involved with child welfare, as a higher risk group, may need special attention and gender-specific approaches to interventions should be a consideration.