Childhood maltreatment and alcohol problems in young adulthood: coping style as a mediator and potential intervention target.

Children exposed to maltreatment (abuse, neglect) are twice as likely to develop a substance use disorder (SUD) compared to those not exposed. Effective prevention of SUD is lacking in this population, due to gaps in understanding how maltreatment leads to SUD. One proposed mechanism is how maltreated children cope with subsequent stressors throughout life. They appear more likely to use avoidant coping styles, such as denial, distraction, or using substances to cope, which have been linked to poorer psychological functioning. The current study aimed to investigate whether avoidant coping mediated the relationship between childhood maltreatment and young adult alcohol use, using longitudinal data.

Young Australians were recruited through social media, provided informed consent, and completed three surveys online approximately one year apart. At baseline, participants reported on experiences of maltreatment before age 18: emotional, physical, and sexual abuse, and emotional and physical neglect. At Wave 2, participants reported their use of avoidant coping strategies. At Wave 3, alcohol use problems were assessed with the Alcohol Use Disorders Identification Test (AUDIT). Multiple imputation was used to handle missing data. Mediation analyses were run using the PROCESS macro for SPSS, controlling for socio-demographics and other adverse childhood experiences.

The sample comprised 568 participants, mean age 21.39, 70% female. Maltreatment predicted greater avoidant coping (b=0.091, 95%CI 0.063-0.118) and greater alcohol problems (b=0.057, 95%CI 0.008-0.107). Avoidant coping predicted greater alcohol problems (b=0.447, 95%CI 0.265-0.629). Avoidant coping significantly mediated the relationship between childhood maltreatment and alcohol problems (b=0.040, 95%CI 0.020-0.061), accounting for 70% of this relationship.

Results suggest that young adults exposed to childhood maltreatment use more avoidant coping strategies to deal with stressors, and these strategies may fuel greater alcohol use problems. Interventions to reduce avoidant coping may help to prevent alcohol use problems among young adults exposed to childhood maltreatment.