The ties between child maltreatment and substance abuse
Sunny Shin, Ph.D., an associate professor in Virginia Commonwealth University's School of Social Work, has led a number of studies exploring the relationship between child maltreatment and adolescent substance abuse.
Shin, who joined VCU's faculty in 2013, recently discussed his research and explained what types of prevention and intervention efforts might help.
What overarching conclusions have you drawn from your research into the ties between adverse childhood events and substance abuse?
First, we found that exposure to early severe stress including child maltreatment have long-lasting adverse effects on substance abuse. For example, our studies have found that compared to individuals who never experienced any maltreatment, people with a history of childhood maltreatment experienced a steeper increase in rates of binge drinking during adolescence and persistently higher binge drinking beyond adolescence and throughout much of young adulthood. Our research also indicated that victims of adverse childhood events may develop more problematic patterns of substance use than non-victims. Using a sample of adolescents who were selected from publicly funded service systems, we found that adolescent victims of childhood sexual abuse were about five times more likely to be heavy polysubstance users than were non-victims.
Could you tell me a bit about your research methodology? How did you arrive at your conclusions?
Our studies have employed a variety of study methods to answer our research questions including a community survey, online survey, and randomized clinical trials. Our group also enjoys using sophisticated data analysis techniques, such as structural equations modeling, latent class analysis and latent curve modeling, which allows us to rule out some competing explanations for associations and which are also necessary to the development of causal models of the etiology and outcomes of adverse childhood events and substance abuse problems.
Given what you've found on the relationship between adverse childhood events and substance abuse, what strategies would you suggest might help the problem?
Health professionals who interact with maltreated children must recognize that the presence of child maltreatment, even emotional abuse or neglect alone, may place a substantial number of young people at risk for later substance abuse. Simultaneously, from a clinical perspective, the most worrisome group is those children who have experienced multiple types of child maltreatment. Our study finding that adolescents who experience multiple types of maltreatment have a greater likelihood of substance abuse than those with single types of maltreatment suggests that there are cumulative effects of multicategory maltreatment on substance abuse. Due to the cumulative maltreatment they experienced in childhood, their health may be compromised in such a way that substance use has a more debilitating effect than might otherwise be expected.
Furthermore, given the long-term effects we found between adverse childhood events and substance abuse, we suggest the need for prevention and intervention efforts implemented throughout adolescence and young adulthood for those individuals who suffered childhood maltreatment including emotional, physical and sexual abuse, and neglect. Interventions with children who have been exposed to child maltreatment should focus on the developmental sequelae of maltreatment, including psychological distress, maladaptive coping styles, poor self-control and impulsivity.
What led you to study this topic?
My determination to study early severe stress such as child abuse and neglect has evolved out of both my social work practice and empirically-based research experience. Before entering a graduate program, I was a social work practitioner at hospital settings, conducting intake interviews and providing case management for maltreated children and their families. I worked extensively with maltreated children who had a variety of challenges, including alcohol and other drug abuse. This practice experience helped me become acutely aware of the variety of developmental problems encountered by maltreated children, their need for preventive and treatment intervention, and the frustration professionals experience in working with these children. The goal of my professional career is to generate empirical evidence that impacts policy, practice and service delivery for children and families at risk of both adverse childhood events and substance abuse.
You've said that you intend to shift gears in the coming years and explore the neurobiological side of this topic. Can you tell me more about that?
Recent studies found that exposure to early severe stress and maltreatment might negatively influence brain development and functioning. I intend to explore whether and how childhood maltreatment exerts enduring morphometric and functional effects on brain regions that are responsible for the enhanced vulnerability to substance use, dependence and relapse.