•Childhood maltreatment (CM) is common experience for people with opioid use disorder (OUD).•Women with OUD experience childhood sexual abuse (41%) more often than men (16%).•People with OUD often ...report childhood physical abuse (43%) and neglect (40%).•Most studies evaluate childhood sexual or physical abuse among OUD treatment samples.•“Gold standard” definitions of CM produce the highest prevalence rates of CM.
Experience of childhood maltreatment (CM) is a risk factor for opioid use disorder (OUD). CM is also associated with comorbid mental disorders and poor treatment outcomes among people with OUD. To our knowledge, this is the first systematic review and meta-analysis to estimate the prevalence of CM among people with OUD.
We searched MEDLINE, EMBASE, and PsycINFO to identify observational studies that evaluated CM among people with OUD from January 1990 to June 2020. Prevalence of each CM type, sample characteristics, and methodological factors were extracted from each eligible study. Random-effects meta-analyses were used to pool prevalence estimates. Stratified meta-analyses were used to assess heterogeneity.
Of the 6,438 publications identified, 113 studies reported quantitative CM data among people with OUD and 62 studies (k = 62; N = 21,871) were included in primary analyses. Among people with OUD, the estimated prevalence of sexual abuse was 41% (95% CI 36–47%; k = 38) among women and 16% (95% CI 12–20%; k = 25) among men. Among all people with OUD, prevalence estimates were 38% (95% CI 33–44%; k = 48) for physical abuse, 43% (95% CI 38–49%; k = 31) for emotional abuse, 38% (95% CI 30–46%; k = 17) for physical neglect, and 42% (95% CI 32–51%; k = 17) for emotional neglect. Sex, history of injecting drug use, recruitment methods, and method of assessing CM were associated with substantial heterogeneity.
People with OUD frequently report the experience of CM, supporting the need for trauma-informed interventions among this population. Future research should consider the impact of CM on OUD presentations and when assessment is appropriate, use of validated instruments.
In this Third Edition of Counseling Survivors of Childhood Sexual Abuse, Claire Burke Draucker and Donna S. Martsolf identify the significant healing processes which are essential to achieve ...recovery. These include disclosing the abuse; reinterpreting it from an adult perspective; addressing issues related to the context of the abuse; and making desired life changes. Each of these processes is discussed in conjunction with the most effective counseling interventions to facilitate resolution. Carefully chosen case examples demonstrate the appropriate use interventions in practice. The Third Edition includes a wealth of new material covering memory retrieval, outcome research, multicultural counseling, emerging therapeutic approaches, and neuroscience and counseling. Dynamics and difficulties in the therapeutic relationship are also discussed in great depth.
Child maltreatment has emerged as an important risk factor for substance use. However, despite evidence consistently demonstrating that substance use peaks during emerging adulthood, less is known ...about the specificity of maltreatment effects on substance use during this critical developmental period. Further, the factors that might play a role in these associations are not well understood.
The current study examined the associations between child maltreatment types (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) and past month marijuana, alcohol, and tobacco use among emerging adults, and tested whether impulsivity accounted for these associations.
Participants were 500 emerging adults ranging in age between 18 and 25 years old (M = 18.96, SD = 1.22, 49.6% male) recruited from a large, public university in the Midwest United States.
Tests of indirect effects suggested that impulsivity accounted for associations between emotional abuse and past month marijuana, alcohol, and tobacco use.
Current findings provide support for impulsivity as a mechanism linking childhood emotional abuse to substance use among emerging adults, highlighting the need for targeted screening and intervention.
Abstract Objectives Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the ...linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. Methods Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. Results After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of ( B , SE , p ): major depression (0.426, 0.094, <.001); anxiety disorder (0.364, 0.089, <.001); suicidal ideation (0.395, 0.089, <.001); suicide attempt (1.863, 0.403, <.001); alcohol dependence (0.374, 0.118, <.002); and illicit drug dependence (0.425, 0.113, <.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, .017); decreased self-esteem (−0.371, 0.181, .041); and decreased life satisfaction (−0.510, 0.189, .007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (−0.381, 0.091, <.001), increased number of sexual partners (0.175, 0.035, <.001); increased medical contacts for physical health problems (0.105, 0.023, <.001); and welfare dependence (0.310, 0.099, .002). Effect sizes (Cohen's d ) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. Conclusions CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial.
This study investigated (a) whether childhood sexual abuse (CSA) was uniquely associated with adult sexual risk behavior, after controlling for other types of childhood maltreatment and (b) whether ...there were additive or interactive effects of different types of maltreatment on adult sexual risk behavior. Participants were 414 women (M age = 28 years) attending a publicly funded STD clinic. All women completed a computerized survey assessing childhood maltreatment (sexual, physical, psychological abuse, and neglect) and sexual risk behavior. Analyses showed that sexual abuse, physical abuse, psychological abuse, and neglect were associated with adult sexual risk behavior. Multivariate analyses that controlled for all other forms of child maltreatment showed that only CSA was uniquely associated with adult sexual risk behavior (i.e., percentage of episodes of unprotected sex in the past 3 months and number of lifetime partners). The authors found little support for an additive or an interactive model of the effects of different types of childhood maltreatment on adult sexual risk behavior; CSA alone was the best predictor of adult sexual risk behavior. Sexual risk reduction interventions are needed for women who were sexually abused as children. Continued research on the effects of multitype maltreatment on adult sexual risk behavior is needed.
While awareness of institutional child sexual abuse has grown in recent years, there remains limited understanding of its occurrence and outcomes as a distinct form of abuse. Drawing on research ...commissioned by the Australian Royal Commission into Institutional Responses to Child Sexual Abuse, this article presents a rapid review of available evidence on the impacts of institutional abuse on victim/survivors. Literature searches identified 75 sources spanning international peer reviewed work and reports to Government that document or quantify the impacts of mostly historical child sexual abuse occurring in religious, educational, sporting and residential or out-of-home care settings. Consistent with child sexual abuse in other contexts, institutional child sexual abuse is found to be associated with numerous, pervasive and connected impacts upon the psychological, physical, social, educative and economic wellbeing of victims/survivors. Further, institutional child sexual abuse is associated with vicarious trauma at the individual, family and community level, and with impacts to the spiritual wellbeing of victims/survivors of abuse that occurs in religious settings. The identified literature suggests the trauma of institutional child sexual abuse may be exacerbated by the interplay of abuse dynamics in institutional settings, which may reduce or impede circumstances supporting disclosure, belief, support and protection from future harm. Acknowledging the limitations of the present study and the available evidence, this narrative synthesis provides insights into the complex impacts of institutional child sexual abuse.
To summarize the relationship between abuse during childhood and physical health outcomes in adulthood and to examine the role of potential moderators, such as the type of health outcome assessed, ...gender, age, and the type of abuse. Studies using self-report assessment methods were compared with studies using objective or independently verifiable methods.
The current study is a quantitative meta-analysis comparing results from 78 effect sizes across 24 studies including 48,801 individuals.
Experiencing child abuse was associated with an increased risk of negative physical health outcomes in adulthood (effect size d = 0.42, 95% Confidence Interval = 0.39-0.45). Neurological and musculoskeletal problems yielded the largest effect sizes, followed by respiratory problems, cardiovascular disease, gastrointestinal and metabolic disorders. Effect sizes were larger when the sample was exclusively female and when the abuse was assessed via self-report rather than objective, independently verifiable methods.
Child abuse is associated with an increased risk of poor physical health in adulthood. The magnitude of the risk is comparable to the association between child abuse and poor psychological outcomes. However, studies often fail to include a diverse group of participants, resulting in a limited ability to draw conclusions about the population of child abuse survivors as a whole. Important methodological improvements are also needed to better understand potential moderators.
Child abuse is a major public health problem. In order to establish the prevalence of abuse exposure among children, measures need to be age-appropriate, sensitive, reliable and valid. This study ...aimed to investigate the psychometric properties of the Adverse Childhood Experiences Questionnaire Abuse Short Form (ACE-ASF). The ACE-ASF is an 8-item, retrospective self-report questionnaire measuring lifetime physical, emotional and sexual abuse. Data from a nationally representative sample of 15-year-old, school-going adolescents (n=1733, 55.5% female) from the Romanian Health Behavior in School-Based Children Study 2014 (HBSC) were analyzed. The factorial structure of the ACE-ASF was tested with Exploratory Factor Analysis (EFA) and confirmed using Confirmatory Factor Analysis (CFA). Measurement invariance was examined across sex, and internal reliability and concurrent criterion validity were established. Violence exposure was high: 39.7% physical, 32.2% emotional and 13.1% sexual abuse. EFA established a two-factor structure: physical/emotional abuse and sexual abuse. CFA confirmed this model fitted the data well χ2(df)=60.526(19); RMSEA=0.036; CFI/TLI=0.990/0.986. Metric invariance was supported across sexes. Internal consistency was good (0.83) for the sexual abuse scale and poor (0.57) for the physical/emotional abuse scale. Concurrent criterion validity confirmed hypothesized relationships between childhood abuse and health-related quality of life, life satisfaction, self-perceived health, bullying victimization and perpetration, externalizing and internalizing behaviors, and multiple health complaints. Results support the ACE-ASF as a valid measure of physical, emotional and sexual abuse in school-aged adolescents. However, the ACE-ASF combines spanking with other types of physical abuse when this should be assessed separately instead. Future research is needed to replicate findings in different youth populations and across age groups.
Background and aims
Most studies of the association between child maltreatment and subsequent problem alcohol use are retrospective. We studied the association of prospectively substantiated child ...maltreatment with problem alcohol use in adulthood.
Design
We used a prospective cohort record linkage correlational design using data from a statutory child protection agency of prospectively substantiated child maltreatment linked to a birth cohort from a major metropolitan maternity hospital.
Setting
The Mater‐University of Queensland Study of Pregnancy in Brisbane, Australia.
Participants
Of the 3762 young people at the 21‐year follow‐up, 169 (4.5%) had a history of substantiated maltreatment by 16 years. This was most commonly emotional abuse (n = 90).
Measurements
The main outcome was heavy alcohol use at the 21‐year follow‐up, defined as four or more standard drinks per day. Secondary outcomes were life‐time and 12‐month diagnoses of alcohol use disorders in 2531 participants who completed the Composite International Diagnostic Interview‐auto (CIDI‐auto) version. Predictor variables were physical, sexual and emotional abuse, as well as neglect.
Findings
At follow‐up, 407 of the 3762 participants reported heavy alcohol use (10.8%). On adjusted analyses, participants who had experienced emotional abuse were significantly more likely to report heavy alcohol use at the time of interview (adjusted odds ratio = 1.856; 95% confidence interval = 1.038–3.319; P = 0.037). Neglect was associated with a life‐time CIDI diagnosis of an alcohol use disorder. Other types of child maltreatment were not significantly associated with any of the outcomes.
Conclusions
Prospectively identified experience of childhood emotional abuse and neglect appears to be positively associated with problem alcohol use at age 21.
Background: Substance abuse is one of the most common health outcomes associated with adverse childhood experience, and poses a significant public health threat. Objectives: The purpose of this study ...is to demonstrate a relationship between adverse childhood experience and a substance use disorder using nationally representative data as well as to test whether religion moderates this relationship. Methods: We conducted a secondary analysis using data from the National Longitudinal Study of Adolescent to Adult Health (n = 11,279). Three types of adverse childhood experiences were considered; physical, emotional, and sexual abuse. Logistic regression was used to determine whether risk for developing an alcohol use, cannabis use, or other drug use disorder in adulthood increased as exposure to multiple types of adverse childhood experiences increased while controlling for prior substance use and other demographic variables that have shown associations with substance use. In addition, religiosity was investigated as a possible moderator of the relationship between adverse childhood experience and substance abuse. Results: The likelihood of developing a substance use disorder later in life increased as the score on the adverse childhood experience index increased. While religiosity did significantly reduce the likelihood of developing a substance use disorder, no moderating effects were observed. Conclusions/importance: This study underscores the long-term consequences of exposure to childhood adversity.
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