Research Article - (2018) Volume 2, Issue 2
Clairmont Griffith1, Bernice La France1*, Clayton Bacchus2 and Gezzer Ortega3
1Department of Anesthesiology, Howard University Hospital and Howard University College of Medicine, US
2Inner City Family Services in Affiliation with Howard University Hospital, US
3Department of Surgery, Howard University Hospital and Howard University College of Medicine, US
Received date: June 23, 2018; Accepted date: July 18, 2018; Published date: July 23, 2018
Citation: Griffith C, France BL, Bacchus C, Ortega G (2018) A Study of Childhood Sexual Abuse as a Predictor of Adolescent Substance Abuse. J Addict Behav Ther Vol 2 No 2:8.
Copyright: © 2018 Griffith C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Past research indicates that childhood sexual abuse (CSA) is associated with various negative outcomes in adolescence and adulthood. Adolescents who have experienced CSA are at a higher risk of suffering from internalizing and externalizing problem behaviors such as anxiety, depression, aggression, delinquency and substance abuse as compared to their counterparts who have not faced maltreatment. While a lot of the research points to the fact that CSA is associated with a range of adverse outcomes during development, evidence linking childhood sexual abuse and substance abuse in adolescence shows conflicting results. Also, potentially traumatic events (PTEs) among children result in the development of trauma cases which set an individual to distress as they seek for measures that will help them deal with their past life events. Although previous research does not show a clear relationship between CSA and substance abuse during adolescence, various moderating factors such as the gender of the victim, age of the victim, the magnitude of the abuse and the relationship of the perpetrator to the victim determine the severity of the effects of CSA. These factors will be evaluated in this review as the main mediating elements that relate childhood sexual abuse with substance abuse during adolescence.
Childhood sexual abuse; Illicit drug use; Molestation; Marijuana-dependance
The problem of sexual abuse in children is often associated with a vast number of challenges that have an impact on the life of an individual as they grow up. Childhood sexual abuse could result in the associations of drug abuse mostly in the adolescent stages of an individual which is an important developmental stage in the prevention of drug use. There has been some research on the issue of childhood sexual abuse and its impact on substance abuse among adolescents. One of the research article attributing to explain the problem of child abuse and its impact on substance abuse among adolescents is “Childhood trauma and illicit drug use in adolescence.” Carliner et al. present the case of potentially traumatic events in childhood that contribute to the possibility of illicit drug use among the adolescents of the US [1]. Also, another article, “The impact of childhood abuse on inpatient substance users” by presents a study on the prevalence of child abuse in inflicting substance use disorders as one grows up [2]. The above articles and others reviewed in this paper present an argument on the problem of childhood sexual abuse which inflicts traumatic experiences in children as they grow up and eventually compel a majority of them into opting for substance abuse. Children are often delicate to maltreatment as such could exert specific effects on their mental health as they grow up. This paper, therefore, seeks to present an article review study on several articles about the problem of childhood sexual abuse in predicting substance abuse by adolescents.
The problem of sexual abuse in children sinister a type of trauma in children since it instills shame in the victim. An adult is often actively involved in child sexual abuse thus leading to a causal relationship between the two. In most cases, childhood sexual abuse (CSA) takes place when the victims are too young to ask for help or even help themselves. CSA could be in the form of rape, groping or molestation which often has a lasting impact on the survivors.
Carliner et al. argue that CSA leads to the exposure to potentially traumatic events (PTEs) on children which are risk factors that are established for the abuse of substances among adolescents [1]. Of great concern, CSA affects a significant number of children, and only a few of the cases undergo disclosure and investigation. The exposure to any form of PTE on children below the age of 11 years was reported as 36% of the sampled data presented in the study which was then associated with higher risks of the intake of prescription drugs, cocaine and marijuana on the risk ratio of 1.80, 2.78 and 1.50 respectively [1]. As such, the challenges in CSA result in potentially harmful behaviors resulting in traumatic memories. In return, as a result of the traumatic memories developed by an individual as they grow up from childhood into the adolescent stage, one could opt for coping strategies in helping them to deal with the stressful life events which in most cases ends in substance abuse as showed in Table 1.
| The impact of childhood abuse on inpatient substance users [2] | CSA is the major contributor to substance use among adolescents. |
| Traumatic disorders inflict adolescents to sink into drug use. | |
| Childhood trauma and illicit drug use in adolescence [1] | Incidents of rape and groping affected the mental health of a child. |
| A child victim of sexual abuse develops into a shameful adolescent. | |
| Disentangling the mental health impact of childhood abuse and neglect [5] | Rape and groping instances result to shameful experiences among growing adolescents. |
| Psychological health of an individual is often greatly affected by CSA. | |
| Trauma changes everything [3] | Incidences of trauma change the behavior and social interaction abilities of an individual. |
| The economic participation of a CSA victim is often disturbed. | |
| Neighborhood disadvantage and adolescent substance use disorder [6] | CSA affects the level of socialization of an individual with the people around them. |
| It is unlikely for CSA victims to take part in economic activities as most of them are substance abusers. | |
| An epidemiologic study of childhood sexual abuse and adult sleep disturbances [4] | CSA disturbs the mental health of an individual. |
| CSA victims often, owing to lack of sleep, opt for drug use to gain peace of mind. | |
| Anxious attachment, social isolation, and indicators of sex drive and compulsivity [7] | Victims of CSA often isolate themselves from others out of shameful experiences. |
| Most individuals tend to be anxious about the future and activities they get involved in thus end up abusing drugs. | |
| Childhood Sexual Abuse and Substance Abuse [9] | CSA could be as a result of parental neglation and maltreatment. |
| Most CSA victims opt for substance abuse as it is the cheapest way an individual can ease themselves of stress despite the drugs being harmful. | |
| Childhood trauma predicts antidepressant response in adults with major depression [8] | Trauma associated with CSA predicts incidences of depression on victims. |
| The use of antidepressants is effective during stages of depression among adolescents. |
Table 1: Main findings from the literature.
Juvenile individuals who engage in substance abuse instances often present a case of childhood disturbances that need to be realized and understood. Fox et al. in their article present a study based on a childhood-trauma screening tool development in the medical field which aims at identifying children at the risks of substance abuse disorders as they grow up [3]. From the study, the article argues that an additional adverse experience a child has to go through regarding sexual abuse increases the risk of engaging in illegal activities such as the abuse of substances by 35% [3]. From the review of the article, it is clear that the possibility of experiencing a high level of drug and substance abuse is high among children who experienced sexual abuse. However, the victims of CSA are at a higher risk of using drugs and other substances during adolescence thereby portraying a causal relationship with high levels of substance abuse to continued childhood molestation.
On the other hand, the third article presents a study on the impact of childhood sexual abuse on substance users. From the analysis of the article, adolescents who face substance abuse disorders (SUDs) report a high prevalence in their childhood experiences of molestation [1]. Banducci et al. argue that specific types of child sexual abuse result in some negative outcomes in particular regardless of the pattern of CSA in adolescents with SUDs [1]. Childhood sexual abuse is often related to risky sexual behaviors accompanied by emotional dysregulation. Among the users of substances, a significant number of substance abuse types is largely related to specific negative effects. From the article, one can draw out the arguments of the authors based on their point of view that CSA causes dysregulation of emotions among the children. Consequently, as the children grow up, they end up seeking measures to help them counter their emotions such as emotions of aggression or despise on themselves.
Consequently, childhood sexual abuse could result in negative consequences which could include insomnia. In such a case, adolescents who have experienced CSA could end up using substances to attract sleep. Lind et al. argue on the clinical implications brought about by poor mental health which is majorly attributed to CSA [4]. Lind et al. argue that the habitual use of drugs and substances is related to chronicity, addiction, and frequency, which negatively affects prosocial behaviour [4]. Substance use disorders pose major public health problems owing to their frequency and negative social, health and economic effects that it associates. As such, CSA is usually a traumatic experience among children, which causes adverse effects on a child in adolescence stages and later in life.
It is not clear whether maltreatment and CSA exert specific harmful effects of the mental health of an adolescent. However, Cecil et al. in their study analyzed potential confounding variables on the levels of exposure of adolescents to substance abuse [5]. CSA cases were associated with mental health outcomes thereby featuring unique effects on the use of drugs. While a carefree attitude and exploration mark childhood, some children suffer trauma through physical, emotional and sexual abuse, which are the major forms of maltreatment behavior.
In the article, “Neighborhood disadvantage and adolescent substance use disorder” Handley et al. present a case on the ecological-transactional model concerning development [6]. However, this development is limited to the use of substances among individuals, especially at the adolescent stage. It is the young adults who are looked up upon to contribute to contextual levels positively. As such, the issue of substance use among adolescents is looked upon considering child maltreatment as one of its major causes. From the review of the article, the authors argue that a vulnerable group of children who suffered from CSA conferred to the risk of substance abuse. The neighborhood disadvantage on economic development was as a result of marijuana-dependance symptoms among altered adolescents [6]. It is thus important to consider the risks of child maltreatment which are associated with multiple influence levels about the behavior of an individual.
Poor attachment to parents could be associated with CSA concerning the inability to form parent-child intimate relationships. The insecure attachment to parents social involvement and isolation measures accounted for sexual offenses and social involvement. As such, decreased levels of sexual preoccupation among children victims had a direct effect on the use of drugs in adolescents. Substance use disorders pose major public health problems owing to their frequency and negative social and health effects associated [7]. Generally, the study of the association between CSA in adolescence is marred with controversy mostly owing to the various moderating factors such as gender, age, the magnitude of the abuse and the relationship of the perpetrator to the victim.
Also, females who have suffered from CSA experience more psychological and behavioral problems as compared to males. Over the years, the number of strangers committing childhood sexual abuse has reduced considerably while the cases of victimization by people who are known to the victim has increased. Williams et al. noted that children also suffer abuse from their peers at school and social gatherings [8]. As girls and boys move from childhood to adolescence, they start intimate relations with their peers, which can be a source of sexual trauma. Female adolescents between the age of 12 and 17 years report the highest rates of rape and sexual assault from their intimate partners. Substance abuse among adolescents who have suffered from CSA is believed to be a maladaptive coping mechanism focused on coping with the negative feelings of trauma.
Just like the above-discussed articles, Tommyr and Margot, in their article present the issues of childhood sexual abuse and the correspondent abuse of substances [9]. Mental health indicators determine the influence of gender on the problem of substance abuse as fostered by CSA. However, there was a negligible association with the influence of gender between substance abuse and CSA. Tommyr and Margot, maintained that as such, substance abuse acts as the only means that can help in blocking away psychological pain thus enable the victim to dissociate him/herself from the traumatic memories and manage the traumatic emotions related to trauma [9]. People who experience severe forms of CSA have a higher chance of suffering from substance use problems and depression during adolescence and adult life [9]. Childhood maltreatment is also related to the earlier initiation of adolescents to alcohol and drug abuse. Besides, childhood exposure to adverse experiences such as physical and sexual abuse has a relation to increased risk of substance abuse during adulthood.
Concerning the reviewed articles above, it is evident that childhood sexual abuse contributes greatly to substance abuse among the adolescents. The potentially traumatic events are often associated with the risks of illicit use of drugs among the adolescents. As such, it is important that further research in the field of CSA and substance abuse be carried out to determine the effects that childhood sexual abuse results in. For example, in most cases, childhood maltreatment in the aspect of rape, molestation or groping could result in severe damage to a victim which could lead to depression, trauma and stress. Moreover, the number of suicides as a result of cases of depression or distress amidst the young generation has greatly increased [2]. It is therefore important that adequate research on the issue be carried out to determine the impact of CSA on suicidal events amidst the young generation in events where substance abuse gets out of hand for the victims.
Also, with regard to the further research on the issue of CSA, it is important that adequate courses of action be put in place concerning substance abuse. Since the effects of childhood maltreatment cases result to low self-esteem and inflict an individual to find other measures such as the use of drugs to feel a sense of fulfillment in having the shame inflicted upon them covered, it is necessary to fight CSA. As such, coming up with trauma-focused efforts in addressing and preventing traumatic issues and memories will be effective in helping the victims and additionally aid in impacting the victims with coping strategies that will enable them to deal with their distressed life events in a much positive way. Also, another measure that could be taken concerning the problem is the assessment of specific abuse types amidst users of substances and drugs to create an informative procedure in relapse prevention and treatment planning of traumatic events. It is, therefore important to access for childhood trauma in the management of depression and distress and consequently to consider supplemental or alternative treatments for child victims with a trauma history concerning an outpatient scenario. There is a need for the advocation of the prevention of child sexual abuse since its prevention may lead to a significant reduction in substance abuse by the adolescents and also aid in the prevention of other adverse effects such as suicide attempts.
From the above discussion on the review of different articles about the problem of childhood sexual abuse and substance abuse in adolescents, it is evident that childhood sexual abuse predicts substance in the adolescence stage of a victim's life. Childhood sexual abuse is associated with various negative outcomes in adolescence such as social withdrawal, depression and substance use disorders. Childhood maltreatment also leads to instances of anger, aggression and antisocial behavior. Substance abuse, therefore, acts as a way of easing the pain and suffering caused by the traumatic sexual abuse event thus reducing the negative effects associated. Concisely, childhood sexual abuse facilitates the development of re-victimization and vulnerability in later life, which amplifies the victim's risk of adolescent drug use. When treating substance abuse disorders during adolescence, it is essential to include CSA history. It remains the sure way that can help in managing and treating substance use problems resulting from childhood sexual abuse. Also, it is important that adequate measures be put in place concerning carrying out further research on this issue to determine the adverse effects, such as suicides that could be realized. Aiding the prevention of childhood sexual abuse through treatment measure of distress and trauma is important in contributing to the reduction of substance abuse cases among adolescents.
