How Multiple Childhood Maltreatments Lead To Greater Adolescent Binge Drinking

The research, which appears in the current issue of Addictive Behaviors, explored how binge drinking – consuming five or more alcoholic drinks on a single occasion at least once every two weeks – occurs more frequently when there are multiple categories of maltreatments. Researchers examined the relationship of binge drinking with the co-occurrence of specific maltreatments. These included neglect, physical abuse only, sexual abuse, neglect and physical abuse and the combination of neglect, physical and sexual abuse.

Adolescents, those between the ages of 12 and 21, with a sexual abuse history had more than two-fold greater odds of reporting binge drinking than those with no maltreatment. Teenagers who had experienced both neglect and physical abuse had 1.3 times higher odds of reporting binge drinking than those with no maltreatment while adolescents that experienced all three types of maltreatment were about 1.8 times more likely to report binge drinking. The study accounted for age, gender, race/ethnicity and parental alcoholism – which were strongly associated with adolescent binge drinking.

The authors noted that while other studies have reported that child maltreatment increases an individual's risk for alcohol abuse, only a few studies have examined the effect of childhood maltreatment on adolescent binge drinking. This association is important for understanding the common pattern of alcohol consumption among adolescents with child abuse and neglect.

"Research examining the effect of childhood maltreatment on later alcohol abuse needs to recognize the clustering effects of multiple types of childhood maltreatment on alcohol problems," the study noted.

The findings were based on the National Longitudinal Study of Adolescent Health which included a nationally representative sample of 12,748 adolescents who underwent a series of three interviews about their social environment between 1995 and 2002. The maltreatment questions were asked in the third interview using a computer-assisted self-interviewing method. Parental alcoholism, education and income were based on parental respondents, not adolescent participants.

"We now have strong evidence indicating that adverse childhood experiences such as child maltreatment increases an individual's risk for alcohol problems in adolescence," said Sunny Hyucksun Shin, Assistant Professor of Human Behavior in the Social Environment at Boston University's School of Social Work. "The new challenges we face in substance use research is to identify developmental mechanisms that link childhood maltreatment to heavy episodic drinking in adolescence that can be targeted in the future development of prevention intervention."

Adolescent binge drinking, the authors note, is a major public health problem, accounting for nearly one-fifth (18.8%) of the 10.8 million underage drinkers aged 12 to 20, according to 2005 data in the National Survey on Drug Abuse Health. The problems are greater in males (21.3%) than females (16.1%).

The prevalence of underage drinking has been linked to a host of immediate and long-term adverse outcomes, most notably obesity and high blood pressure, headaches, and concentration difficulties that leads to trouble learning and remembering. In addition to poor academic achievement, binge drinking has led to unprotected sexual activity, unsafe driving practices and motor vehicle accidents.

"Researchers examining the relationship between childhood maltreatments and risky alcohol use in adolescence should simultaneously consider all types of childhood maltreatment to address the totality of the child's experience," the authors concluded.

In addition to Sunny Hyucksun Shin, the other authors are Erika M. Edwards, project manager at Boston University Data Coordinating Center and Timothy Heeren, Professor of Biostatistics at Boston University's School of Public Health (BUSPH).

Funding for this study was provided by National Institute of Alcohol Abuse and Alcoholism through the BUSPH Youth Alcohol Prevention Center. The research and data from the Add Health program was funded by a grant from the National Institute of Child Health and Human Development.