Study helps untangle the link between childhood maltreatment and adolescent substance use in South Africa

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When adolescents who have experienced maltreatment use alcohol and drugs to cope with their negative feelings, their risk of developing problematic substance use is greatly increased, a new study has found.

The study was led by the University of Cape Town in collaboration with researchers at the Universities of Exeter and Stellenbosch. Titled “Coping Motives as a Mediator of the Relationship between Child Maltreatment and Substance use Problems in South African Adolescents” and published in Child Abuse and Neglect, the study was conducted in several Cape Town schools by Psychology Masters student Ayesha Assim and Associate Professor Debbie Kaminer.

“Understanding how and why experiences of child abuse result in a higher likelihood of misusing substances is critical for developing early, targeted interventions to improve long-term outcomes for maltreated youth”, said Associate Professor Lee Hogarth of the University of Exeter.

Past studies have found that young adults who endured childhood maltreatment are more prone to abusing substances when their use of alcohol or drugs is driven by coping motives – the belief that substances will help them to cope with feelings of anxiety, depression, or distress. By contrast, those who use substances for socialising, pleasure, or conforming to peer pressure face lower risks of developing problematic patterns of use. Until now, it has been unclear just how early this risk pathway begins, as the dangers posed by coping motives compared with other substance use motives have seldom been investigated in adolescents. This is a critical gap in our understanding, as the earlier that interventions to address substance abuse can be put in place, the better the long-term outcomes will be.

The study involved 688 high school learners, aged 13 to 18 years. The researchers gathered information on experiences of childhood maltreatment, alcohol and marijuana use, motives for this use, and problematic behaviours arising from this use. Among the 26 percent of participants who reported using alcohol and the 20 percent who reported using marijuana, a history of childhood maltreatment significantly predicted the severity of substance-related problems. Moreover, the use of coping motives explained a significant portion of this relationship.

“Adolescents who have suffered abuse are more likely to struggle with feelings of anxiety, depression and distress than other teens, but at the same time they are less likely to have developed effective coping strategies for dealing with these emotions, due to poor role modelling and lack of emotional responsiveness from parents,” explains Associate Professor Hogarth. “As a result, they are more likely than non-abused adolescents to turn to substances to manage their negative feelings. Unfortunately, using substances to cope is likely to increase problems in living, thereby exacerbating feelings of distress and creating a vicious cycle.”

The study found that using alcohol or marijuana to conform with peers also plays some role in increasing risk for problematic alcohol use, although less so than coping motives.

“These findings highlight the critical importance of understanding the underlying motives behind substance use among adolescents who have experienced childhood maltreatment,” said Associate Professor Debbie Kaminer. “By identifying coping motives and, to a lesser extent, conformity motives as key mediators, we can better target interventions that address these underlying psychological drivers.”

The implications of this study extend beyond academic research, suggesting practical applications for public health and psychoeducational initiatives aimed at preventing substance misuse among vulnerable youth populations. “The study findings clearly demonstrate that equipping maltreated adolescents with more effective coping skills for managing their difficult feelings could be vital for reducing problematic substance use,” says Associate Professor Kaminer. “Investing in such early intervention programs could bring long-term health and mental health benefits for the well-being of youth who have suffered maltreatment.”