Links between alcohol and other drug problems and maltreatment among adolescent girls: Perceived discrimination, ethnic identity, and ethnic orientation as moderators

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Abstract

Objectives

This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls.

Methods

These relations were examined using archived data from a community sample of 168 Black and Hispanic adolescent girls who participated in a school-based substance use intervention.

Results

The results revealed that maltreatment was linked to AOD problems, but only through its relation with posttraumatic stress symptoms; maltreatment was positively related to posttraumatic stress symptoms, which were positively related to AOD problems. Both perceived discrimination and ethnic orientation were significant moderators. Specifically, greater perceived discrimination was associated with an increased effect of maltreatment on posttraumatic stress symptoms. Ethnic orientation demonstrated protective properties in the relation between maltreatment and AOD problem severity, such that the effect of maltreatment on AOD problem severity was less for girls with average to high ethnic orientation compared to girls with low ethnic orientation.

Conclusions

The findings of this study underscore the importance of developing interventions for Black and Hispanic girls that target maltreatment and AOD use concurrently and address ethnicity-specific factors.

Introduction

Any form of neglect, physical abuse, emotional abuse, sexual abuse, or any combination of these that occurs constitutes maltreatment (Shin, Edwards, & Heeren, 2009). It is widely accepted that maltreatment experiences and alcohol and other drug (AOD) use often co-occur in adolescence (Bensley et al., 1999, Kilpatrick et al., 2000). Studies have found that adolescent girls report more experiences of maltreatment than adolescent boys (e.g., Tubman, Montgomery, Gil, & Wagner, 2004), and some reports indicate that as many as 60% of adolescent girls in AOD use treatment have experienced maltreatment (Simpson & Miller, 2002).

In studies with samples comprising adolescent girls who experienced maltreatment, one well-documented psychological correlate is posttraumatic stress symptoms. Findings from both longitudinal and cross-sectional research with adolescents have demonstrated that maltreatment and posttraumatic stress symptoms are linked (Kilpatrick et al., 2000, Lansford et al., 2002). Further, posttraumatic stress symptoms are thought to be the key link in understanding the relationship between maltreatment experiences and problematic AOD use among adolescents (Kilpatrick et al., 2003).

Adolescent research has also shown significant relations between AOD use and some ethnicity-specific factors, including perceived discrimination (Flores, Tschann, Dimas, Pasch, & de Groat, 2010), ethnic identity (James, Kim, & Armijo, 2000), and ethnic orientation (Gil, Wagner, & Tubman, 2004). Additionally, significant associations among adolescent AOD use, posttraumatic stress symptoms, and ethnicity specific factors have been found (e.g., Flores et al., 2010). However, we could find no studies that examined the relations among maltreatment, posttraumatic symptoms, AOD problems, and ethnicity-specific factors in a single explanatory model. Illuminating these associations would inform clinical interventions targeting problems associated with maltreatment experiences and AOD use in adolescent girls, in particular. Thus, this study examined the relations among maltreatment, posttraumatic symptoms, AOD problems, and ethnicity-specific factors in a cross-sectional sample of Black and Hispanic adolescent girls.

Section snippets

Maltreatment, posttraumatic stress and AOD use among adolescent girls

Among adolescents, research has shown that maltreatment is a strong risk factor for binge drinking even when controlling for parents’ problem drinking (Shin et al., 2009), and that younger adolescents (i.e., eighth graders) with maltreatment histories have an eight times greater risk for heavy alcohol use than their non-maltreated counterparts (Bensley et al., 1999). Research has also shown that when the girls are maltreated, they exhibit AOD abuse at younger ages than non-maltreated girls (

Participants

This study used archival data from Black and Hispanic adolescent girls (n = 168) who participated in a larger study (R21AA014914, PI: Montgomery; N = 185) designed to investigate the efficacy of a Guided Intervention for Real Life Skills (GIRLS), a brief motivational school-based intervention for reducing girls’ AOD use. Because the current study sought to investigate the hypothesized relations among Black and Hispanic adolescent girls, exclusively, data collected from girls of other ethnicities

Results

This study tested a relational model examining the links between maltreatment experiences among girls and their AOD problems using structural equation modeling (SEM) techniques in Mplus 4.1 (Muthén & Muthén, 2006). SEM analysis was used to estimate the direct and indirect effects of independent and mediating factors with a single indicator path analytic approach and a robust weighted least squares solution.

To reduce clutter in the figure (see Fig. 2), not all details of the analyses are

Discussion

This study examined the relation between maltreatment experiences and AOD problems in a sample of Black and Hispanic adolescent girls who were participants in a school-based AOD use intervention. Two primary hypotheses were delineated and tested with this sample. First, it was hypothesized that maltreatment would predict AOD problems with these girls, but that posttraumatic stress symptoms would mediate the relation between maltreatment and AOD problems. Second, it was hypothesized that

References (51)

  • J.N. Briere et al.

    Immediate and long-term impacts of child sexual abuse

    The Future of Children

    (1994)
  • B.S. Brodsky et al.

    The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression

    American Journal of Psychiatry

    (2001)
  • G.H. Brody et al.

    Perceived discrimination and the adjustment of Black youth: A five-year longitudinal analysis with contextual moderation effects

    Child Development

    (2006)
  • I. Cuellar et al.

    An acculturation scale for Mexican American normal and clinical populations

    Hispanic Journal of Behavioral Science

    (1980)
  • E. Flores et al.

    Perceived racial/ethnic discrimination, posttraumatic stress symptoms, and health risk behaviors among Mexican American adolescents

    Journal of Counseling Psychology

    (2010)
  • G. Gamst et al.

    Effects of Latino acculturation and ethnic identity on mental health outcomes

    Hispanic Journal of Behavioral Sciences

    (2002)
  • E.T. Gershoff

    Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review

    Psychological Bulletin

    (2002)
  • F.X. Gibbons et al.

    Perceived discrimination and substance use in Black parents and their children: A panel study

    Journal of Personality and Social Psychology

    (2004)
  • A.G. Gil et al.

    Culturally sensitive substance abuse intervention for Hispanic and Black adolescents: Empirical examples from the alcohol treatment targeting adolescents in need (ATTAIN) project

    Addiction

    (2004)
  • D.D. Hallfours et al.

    Which comes first in adolescence—Sex and drugs or depression?

    American Journal of Preventive Medicine

    (2005)
  • J.M. Haro et al.

    Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys

    International Journal of Methods in Psychiatric Research

    (2006)
  • S. Holm

    A simple sequentially rejective multiple test procedure

    Scandinavian Journal of Statistics

    (1979)
  • W.H. James et al.

    The influence of ethnic identity on drug use among ethnic minority adolescents

    Journal of Drug Education

    (2000)
  • R.C. Kessler et al.

    Lifetime and 12-month prevalence of DSM-III-R psychiatric disorder in the United States: Results from the National Comorbidity Survey

    Archives of General Psychiatry

    (1994)
  • R.C. Kessler et al.

    The prevalence, distribution, and mental health correlates of perceived discrimination in the United States

    Journal of Health and Social Behavior

    (1999)
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    Research supported by funding from the National Institute on Alcohol Abuse and Alcoholism (grant #R21AA014914) and the Florida Education Fund.

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