Drug Use Trajectories and the Transition to Adulthood Among Maltreated Youth

University Of Maryland Baltimore, Baltimore MD

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Abstract

DESCRIPTION (provided by applicant): The goal of this project is to contribute to the prevention of three interrelated, harmful and costly behaviors that peak in early adulthood: drug abuse, HIV/AIDS-related sexual risk behaviors and intimate partner violence (IPV). The project builds on the 20-year multisite prospective Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). LONGSCAN includes structured interviews with high-risk youth and their primary caregivers every two years from age 4 through 18 and regular review of Child Protective Services records with detailed coding of child and adolescent maltreatment (CM). The proposed study aims to add a wave of data collection when participants are between 22 and 25 years old. The specific aims are to: 1) examine the impact of CM and related risk factors on age of drug use onset, trajectories of use, and Substance Use Disorders (SUD); 2) test the independent and combined effects of CM, related risk factors, and drug use on HIV/AIDS-related sexual risk behavior and IPV; 3) test the independent and combined effects of CM, drug use, related risk factors, and mutable protective factors on early adult resilience across multiple domains; and 4) test innovative models of the long-term patterns of neglectful parenting and their impact on drug outcomes, sexual risk behavior and IPV. Neglect is by far the most prevalent form of CM and the most strongly associated with parental drug abuse of any CM type, yet also the most understudied regarding its long-term course and effects on drug use. Predictive models will include tests of potential moderation by three risk factors (violence exposure, maternal depression, and parental, family, and peer drug use) and three protective factors (maternal emotional support, positive father involvement, and caregiver stability). Hypotheses for each aim will be tested using general growth mixture models, structural equation models, latent class models, and tests of model invariance. By analyzing rich multi-informant data across 14 years of childhood and adolescence to predict the development of early adult SUD, sexual risk behavior, IPV, and resilience in a high-risk sample, the proposed project will substantially enhance the empirical foundation for the development of prevention, services, and policies targeting drug abuse and related health risk behaviors. This project will increase our knowledge of the development of three major public health problems following CM: drug abuse, sexual risk behavior, and IPV. By assessing maltreated and high-risk youth who have been followed since age four as they transition to adulthood, this study will identify key risk and protective factors, and the ages at which they are most influential. Results will inform prevention, treatment and policy.