Prospective Examination of the Path From Child Abuse and Neglect to Illicit Drug Use in Middle Adulthood: The Potential Mediating Role of Four Risk Factors

In the four-factor model for both men and women, CAN was significantly related to each of the mediators; however, no paths from the mediators to drug use were significant. For women, the second-order risk factors mediated the relationship between CAN and illicit drug use in middle adulthood. For men, on the other hand, neither child abuse and neglect nor the second-order risk factor predicted drug use in middle adulthood. These results suggest that for women, the path from CAN to drug use in middle adulthood is part of a general “problem behavior syndrome” evident earlier in life. This study matched children with documented cases of physical and sexual abuse and neglect (ages 0-11) during 1967-71 with nonmaltreated children and monitored them into middle adulthood (approximate age 39). Mediators (prostitution, homelessness, delinquency/crime, and poor school performance) were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995. Official arrest records where obtained through 1994 (n=1,196). Drug use was assessed with self-reports of past-year use of marijuana, psychedelics, cocaine, and/or heroin during 2000-2002 (n=896). Latent variable structural equation modeling was used to test a four-factor model with separate pathways from CAN to illicit drug use through each of the mediating risk factors, as well as a second-order model with a single mediating risk factor composed of prostitution, homelessness, delinquency/crime, and poor school performance. Analyses were performed separately for women and men, controlling for race/ethnicity and early drug use. 3 figures, 3 tables, and 50 references