Academic journal article Advances in Mental Health

Coping Motives as Moderators of the Relationship between Emotional Distress and Alcohol Problems in a Sample of Adolescents Involved with Child Welfare

Academic journal article Advances in Mental Health

Coping Motives as Moderators of the Relationship between Emotional Distress and Alcohol Problems in a Sample of Adolescents Involved with Child Welfare

Article excerpt

Childhood maltreatment (CM) is a significant public health concern with adverse effects seen throughout the lifespan, including increased rates of alcohol abuse and dependence among those with a history of CM (Gilbert, Widom, Browne, Fergusson, Webb, & Janson, 2009; Simpson & Miller, 2002; Tonmyr, Thornton, Draca, & Wekerle, 2010). In addition, CM has been identified as a significant risk factor for the development of alcohol problems and alcohol use disorders in adolescents. In a recent review, Tonmyr et al. (2010) identified 30 studies that examined the relationship between CM and adolescent alcohol use. These studies utilised various measures of alcohol use, including age at first use, alcohol use in the past 30 days, binge drinking (i.e., consuming 5+ drinks on a single occasion) in the past 30 days, and alcohol problems (i.e., negative consequences of alcohol use). The majority of studies found significant associations between childhood maltreatment and various measures of adolescent alcohol use and problems, and these findings were consistent across types of CM (i.e., sexual, physical, and emotional abuse and neglect).

In addition to the association between CM and alcohol problems among adolescents in general, there is some evidence that adolescents who receive child welfare services are at particular risk of substance use problems (Aarons et al., 2008; Pilowsky & Wu, 2006; Traube, James, Zhang, & Landsverk, 2012). Aarons et al. (2008) examined child welfare-related risk factors as predictors of substance involvement (i.e., degree of alcohol and other drug involvement, ranging from less than six lifetime occasions of substance use to substance dependence) and found that child welfarerelated risk factors, including age of entry into child welfare and number of out-of-home placements by age at entry, were associated with substance involvement over and above CM variables (i.e., childhood abuse and neglect). There are, however, some conflicting findings regarding the link between CM and alcohol problems among adolescents involved with child welfare. For example, in an earlier study using data from the 1-year assessment of youth in the Maltreatment and Adolescents Pathways (MAP) Longitudinal Study, we compared rates of substance use among adolescents involved with child welfare and adolescents from a school-based sample (Wekerle, Leung, Goldstein, Thornton, & Tonmyr, 2009). We found that the prevalence of alcohol use and problems was lower for the child welfare sample, although rates of illicit drug use and drug-related problems was higher. Although these findings regarding alcohol use are inconsistent with much of the research on CM and alcohol use and problems, they may reflect a failure to identify adolescents involved with child welfarewho are most at risk of alcohol problems. The purpose of the present study was to develop a framework for identifying child welfare adolescents who may be at greatest risk of alcohol problems and may, therefore, benefit most from preventive interventions.

In general, little is known about the psychological mechanisms that influence the relationship between CM and alcohol problems and about factors that might assist with identifying adolescents most in need of interventions. Identifying variables that underlie (i.e., mediators) or accentuate/attenuate (i.e., moderators) the relationship between CM and alcohol problems is particularly important for the development of targeted interventions, where these additional factors may serve as either the primary intervention focus (for mediators) or may serve as markers for determining who might benefit most from treatment (for moderators). Because we are unable to erase adverse experiences of childhood, we must instead focus on developing interventions that target the malleable variables that influence the relationship between CM and alcohol use.

To date, much of the research has focused on mediating variables. …

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