Childhood victimization and alcohol symptoms in females: causal inferencesand hypothesized mediators

Objective: Previous research has reported a relationship between childhood victimization experiences and alcohol problems in females. This paper has t wo distinct goals: (1) to determine whether it is appropriate to make a cau sal inference regarding the association between early child abuse and negle ct and alcohol symptoms in females; and (2) to examine five potential mecha nisms (depression, worthlessness, social isolation/loneliness, low self est eem, and using alcohol and/or drugs to cope) that may mediate the relations hip between child abuse and neglect and alcohol symptomatology. Method: Substantiated cases of child abuse and neglect from 1967 to 1971 we re matched on sex, age, race, and approximate social class with nonabused a nd non-neglected children and followed prospectively into young adulthood. Subjects were administered a 2-h in-person interview, including the NIMH Di agnostic Interview Schedule (DIS-III-R) to assess alcohol use and abuse. An alyses are restricted to females in the sample (N = 582). Results: Structural equation modeling provides support for the inference th at childhood victimization plays a causal role in the development of alcoho l symptoms in women. There also is support for the hypothesized mediating r ole of two mechanisms (depression and using alcohol/drugs to cope), but not for the other mediators. Conclusions: Evidence from this prospective study suggests that childhood v ictimization may be one of the causal factors in the development of alcohol problems in females. Interventions should be directed at abused and neglec ted females of all ages to help them to deal with depression and to develop coping strategies to prevent the development of serious alcohol problems. (C) 2001 Elsevier Science Ltd. All rights reserved.