Experiences of Maltreatment and Adolescent Substance Use

Despite contributing to our understanding of substance use among maltreated adolescents, research on this link has been limited by reductionist thinking and methods that do not accurately address the heterogeneity within these two complex multidimensional constructs. This study addresses this issue through the use of a person-centered approach. Specifically, this study draws data from the Longitudinal Studies of Child Abuse and Neglect to explore the utility of three latent class models in extracting meaningful information on the relationship between experiences of maltreatment and adolescent substance use (N = 902). Model 1 examined the associations between latent classes of maltreatment and substance use, and whether sex differences exist across these associations. Three classes of maltreatment were identified, labeled “No/low neglect”, “Severe emotional/physical/neglect”, and “Severe sexual/physical/neglect”. Adolescents comprising the “Severe emotional/physical/ neglect” class were found to have the highest mean count of substances used over the last year, even after considering participants’ sex. Model 2 examined the associations between latent classes of adolescent substance use and observed indicators of maltreatment, and whether sex differences exist across these associations. Five classes emerged from this latent class model, labeled “Low risk users”, “Heavy users”, “Tobacco users”, “Heavy alcohol users”, and “Tobacco/Cannabis users”. Almost all indicators of maltreatment increased the risk of being classified into the “Heavy users” and “Tobacco users” classes, which was consistent across male and female adolescents. Lastly, Model 3 examined whether associations exist between the previously identified classes of maltreatment and classes of substance use. Findings indicated that males comprising the “Severe emotional/physical/ neglect” class were more likely than those in the “No/low neglect” class to be classified in the “Heavy users” class compared to the “Low risk users” class. Among female adolescents, those in the “Severe emotional/physical/ neglect” class were more likely than those in the “No/low neglect” class to be classified in the “Tobacco users” and “Tobacco/cannabis” classes, relative to the “Low risk users” class. Taken together, findings demonstrate how a person-centered approach can assist with developing a more nuanced understanding of the complex relationship between maltreatment and adolescent substance use. This study provides some explanation for the differences of substance use that exist within the general population of maltreated adolescents and draws attention to the need for selective prevention programming for this at-risk population.