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Risk factors for problematic youth alcohol use – study

Young people who experience multiple types of maltreatment in childhood have a 55 per cent higher rate of problematic alcohol use compared with those who do not experience abuse, new Australian Catholic University research shows.

Those with a history of childhood sexual abuse also have a 46 per cent higher rate of alcohol misuse as teenagers and young adults compared with those who have not experienced this type of maltreatment.

Youth who were raised in a household with substance abuse issues or mental illness also had a higher proportion of problematic alcohol use – 56 and 51 per cent respectively – compared with those who did not. Young people who witnessed or were a victim of neighbourhood violence had a 44 per cent higher rate of problematic alcohol use compared with those without such an experience.

The research, based on a nationally representative sample of 3500 participants aged 16 to 24 from the landmark Australian Child Maltreatment Study (ACMS), examined the link between problematic drinking in young adulthood and their earlier experiences of abuse or neglect, or non-maltreatment adversities in childhood.

Problem drinking was defined as six or more drinks for males or five or more drinks for females in a single session at least once a week in the past year or being diagnosed with an alcohol use disorder.

Research lead and Institute of Child Protection Studies (ICPS) PhD candidate Dhatsayini Rattambige said the study was the first of its kind to determine whether individual types of adversity uniquely contributed to the risk of problem drinking in youth or whether their effects overlapped.

“We aimed to understand which specific adversities independently contribute to alcohol risk when they naturally co-occur because these experiences rarely happen in isolation,” she said.

The research, published in the international journal Child Maltreatment, found an experience of multiple maltreatment types including exposure to domestic violence, emotional abuse, physical abuse, sexual abuse, and neglect was significantly associated with higher levels of problematic alcohol use. The ACMS study showed 40 per cent of Australians aged 16 to 24 experienced multi-type maltreatment in childhood.

“This isn't a small problem affecting a minority; it's affecting a substantial proportion of young Australians,” Ms Rattambige said. “The accumulation of multiple maltreatment types may create neurological and psychological adaptations that heighten vulnerability to using alcohol to manage stress and emotional distress.”

All types of maltreatment were associated with problematic alcohol use, but when accounting for the fact that more than one type of child maltreatment is often experienced, sexual abuse was still independently associated.

“Sexual abuse may create distinctive psychological consequences. Survivors believe that alcohol will help them manage their trauma symptoms and use it to help them cope,” Ms Rattambige said. “The impacts of other types of child maltreatment appeared to overlap rather that constitute a unique risk in the way sexual abuse does.”

Ms Rattambige said the specific associations identified by the research required evidence-based interventions.

“Young adults who experienced sexual abuse, multi-type maltreatment or lived with someone who had substance use or mental health issues have higher rates of problematic alcohol abuse. This new insight helps us focus our interventions, rather than just knowing there’s a general link between adversity and alcohol problems,” she said.

“We need integrated approaches that address both maltreatment and other adverse childhood experiences.”

ICPS Director and one of the ACMS chief-investigators Professor Daryl Higgins, who co-authored the new research along with Professor Michael Cole, of ACU, Professor Ben Matthews, of QUT, Professor Sarah Whittle, of The University of Melbourne, and others from the ACMS team, said problematic alcohol use was a major public health concern, but it was preventable.

“Focusing on maltreatment prevention will deliver important health outcomes across the population,” he said.