Gender Differences in Emotion-Mediated Pathways from Childhood Sexual Abuse to Problem Drinking in Adolescents in the Child Welfare System

Abstract

It is well-established that childhood sexual abuse (CSA) increases risk for later substance abuse. However, less is known about the mechanisms by which CSA increases risk of substance abuse, including problem drinking. Research points to negative emotions as potential explanatory links between CSA and problem drinking, and suggests that pathways may differ for men and women. In the current study, we examined three potential mechanisms (anger, anxiety, and depression symptoms) by which CSA increases vulnerability for alcohol problems in a sample of youth receiving child welfare services (N = 301). Path analyses revealed that relations between CSA and problem drinking were partially mediated by anger symptoms in male adolescents. In female adolescents, links between CSA and problem drinking were fully mediated by anxiety and anger symptoms. These findings highlight similarities and differences in how CSA increases vulnerability for alcohol problems in male and female adolescents. Clinical and research implications are discussed.

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Acknowledgements

We thank the Child Welfare adolescents who participated in the Maltreatment Adolescent Pathways (MAP) study, and who remained involved over the 2 to 3 years of follow-up. We also thank our partners in the Child Welfare agencies and Associations who supported the study, as well as the MAP Advisory Board. We thank the many funding agencies who supported the MAP study: The Canadian Institutes of Health Research; Ontario Mental Health Foundation; Health Canada; Public Health Agency of Canada; Ontario Ministry of Children & Youth Services, and the Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario. Secondary analyses for this report were supported by a CIHR Team grant in boys’ and men’s health (TE3 138302). Finally, we thank all of the MAP study investigators: Christine Wekerle, Harriet MacMillan, Michael Boyle, Nico Trocmé, Eman Leung, Randall Waechter, Deb Goodman, Brenda Moody, and Bruce Leslie.

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Correspondence to Amanda Hudson.

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All participants provided informed consent. Participants over 16 years of age provided consent to participate themselves, and those less than 16 years of age provided verbal assent to participate and had their parents or guardians provide written consent.

Research was conducted in accordance with institutional ethical guidelines and APA ethical standards, and was approved by the institutional research ethics board, as well as participating CAS agencies.

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The authors declare that they have no conflict of interest.

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The research was supported by funding from: The Canadian Institutes of Health Research; Ontario Mental Health Foundation; Health Canada; Public Health Agency of Canada; Ontario Ministry of Children & Youth Services, and the Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario. Secondary analyses for this report were supported by a CIHR Team grant in boys’ and men’s health (TE3 138302) awarded to Chris Wekerle.

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Hudson, A., Wekerle, C., Goldstein, A.L. et al. Gender Differences in Emotion-Mediated Pathways from Childhood Sexual Abuse to Problem Drinking in Adolescents in the Child Welfare System. Journ Child Adol Trauma 10, 19–28 (2017). https://doi.org/10.1007/s40653-016-0125-9

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Keywords

  • Sexual abuse
  • Problem drinking
  • Anger
  • Anxiety
  • Depression