Exploring the relationship between alcohol use, childhood maltreatment, and treatment needs among female prisoners

OBJECTIVE: This study examined the relationship between child maltreatment and adult alcohol dependency among a sample of newly incarcerated female prisoners. METHOD: This secondary data analysis utilized information gathered through face-to-face interviews with female inmates at intake (N = 1198) within the Texas prison system from 1998 to 1999. RESULTS: Using DSM-IV criteria we found that, among women who reported drinking at least 10 drinks in the last year, 40% scored as alcohol dependent. Bivariate findings revealed that women who were alcohol dependent were also more likely to have grown up in disorganized family situations, including parental drug and alcohol use-related problems, childhood neglect, and childhood physical and sexual abuse. As adults, these women were far more likely to have utilized mental health services and substance user treatment programs. Supportive of Widom and colleagues (1995), multivariate analyses revealed that childhood neglect (not physical or sexual abuse) was a significant predictor of alcohol dependency. Finally, among the alcohol dependent group, 62% indicated a willingness to participate in substance user treatment programs. CONCLUSIONS: These findings emphasize that childhood neglect is related to long-term negative consequences in the form of alcohol use related problems in adulthood. Our findings strongly point to the need for improved screening, assessment procedures, and programming for women prisoners.     

Exploring the Relationship Between Alcohol Use,Childhood Maltreatment,and Treatment Needs Among Female Prisoners

Objective.?This study examined the relationship between child maltreatment and adult alcohol dependency among a sample of newly incarcerated female prisoners. Method.?This secondary data analysis utilized information gathered through face-to-face interviews with female inmates at intake (N = 1198) within the Texas prison system from 1998 to 1999. Results.?Using DSM-IV criteria we found that, among women who reported drinking at least 10 drinks in the last year, 40% scored as alcohol dependent. Bivariate findings revealed that women who were alcohol dependent were also more likely to have grown up in disorganized family situations, including parental drug and alcohol use-related problems, childhood neglect, and childhood physical and sexual abuse. As adults, these women were far more likely to have utilized mental health services and substance user treatment programs. Supportive of Widom and colleagues (), multivariate analyses revealed that childhood neglect (not physical or sexual abuse) was a significant predictor of alcohol dependency. Finally, among the alcohol dependent group, 62% indicated a willingness to participate in substance user treatment programs. Conclusions.?These findings emphasize that childhood neglect is related to long-term negative consequences in the form of alcohol use related problems in adulthood. Our findings strongly point to the need for improved screening, assessment procedures, and programming for women prisoners.     

Youth Problem Drinking: The Role of Parental and Familial Relationships

Background: Alcohol use continues to be an important global public health problem and adolescence seems to be a decisive period of time in the development of drinking patterns into adulthood. While most studies concentrate on frequency and amount of alcohol, fewer studies address “problem drinking.” Gathering information on youth's alcohol-related behavioral consequences is especially important. Objectives: Current research focuses on gathering information on the background of problem drinking behavior with special attention to parental/familial relationships. Methods: The survey was conducted within the youth health behavior – Makó research project in 2012 (n = 1,981, aged 13–18 years, 50.9% males). Anonymous, self-administered questionnaires contained items on sociodemographics, substance use, and parental/familial relationships (such as parental control and awareness or variables of family environment). Results: Problem drinking (identified in 17.2% of the sample) was more common among males and high school students and those from lower socioeconomic status groups compared to their counterparts. Among the familial/parental variables, negative family interactions, discussion of problems with parents, physical and sexual abuse were positively related to adolescent problem drinking, whereas parental control and awareness, and the positive identification with parents proved to be protective factors. Conclusions/Importance: We conclude that parents and the family were important correlates of adolescents' problem drinking. Our findings suggest that on-going school interventions to prevent the development of problem drinking among youth should include parents and the family.     

Gender differences in the development of substance-related problems: the impact of family history of alcoholism, family history of violence and childhood conduct problems

OBJECTIVE: This study examined gender differences regarding the relative influence of family history of alcoholism (FHA) and family history of violence (FHV) on reported childhood conduct problems (CCP) and adult problems with alcohol, drugs and violence. METHOD: The participants were 110 men and 103 women with alcohol-related problems recruited within 30 days of enrolling in treatment for substance abuse or dependence. Participants completed self-report measures of pretreatment violence, FHV, CCP, substance use and consequences, and demographics; a semi-structured interview was used to assess FHA. RESULTS: Structural equation modeling (SEM) analyses revealed gender differences with regard to the influence of FHA and FHV as important factors in the development of childhood and adult behavioral problems. For women, the influence of FHA on subsequent childhood conduct problems and adult problems with alcohol was accounted for by FHV. For men, FHA was not directly associated with CCP or adult problems with alcohol and violence, but was associated with adult drug problems. For both men and women, FHV was associated with CCP, and CCP were associated with adult problems with drugs and violence. CONCLUSIONS: Overall, the analyses illustrate the relative importance of FHV as a risk factor in the developmental course leading to problems with drugs and violence among individuals with alcohol-related problems enrolled in treatment for substance abuse or dependence. Further, there was evidence that women may be impacted more than men by family background variables (both FHA and FHV) in terms of the development of adult problems with alcohol, drugs and violence.     

Adverse Childhood Experiences (ACEs) and Alcohol Abuse among South Carolina Adults

Background: Adverse childhood experiences (ACEs) have been associated with negative adult health outcomes, including alcohol misuse. The impact of ACEs on alcohol use may vary by gender, with ACEs impacting women more than men in coping with adulthood stressors. Objectives: The objective of this study is to examine the gender-specific relationships between ACEs and self-reported binge drinking and heavy drinking in adulthood among South Carolina residents. Methods: This study analyzed a sample of 8492 respondents who completed the 2014 or 2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. Logistic regression was used to examine the impact of types and the number of ACEs on binge drinking and heaving drinking in adulthood. Results: Thirty-seven percent of men and 22.8% of women survey respondents reported binge drinking and 12.2% of men and 4.1% of women reported heavy drinking. Almost all categories of ACE were associated with increased odds of reporting binge and heavy drinking; household mental illness had the greatest odds for men (aOR 1.31, 95% CI 1.30–1.33) and emotional abuse had the greatest odds for women (aOR 1.42, 95% CI 1.40–1.43). Men and women with four or more ACEs had greater odds of reporting binge and heavy drinking compared to their counterparts. Conclusions/Importance: Given the potential for negative outcomes associated with alcohol misuse and transmission of risky alcohol-related behaviors from parent to child, strategies that utilize a multigenerational approach could have a large impact on population health.     

Childhood and adolescent predictors of alcohol abuse and dependence in young adulthood

OBJECTIVE: To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. METHOD: Data were taken from an ethnically diverse urban sample of 808 students (51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. RESULTS: Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative consequences from antisocial behaviors and held more favorable views on alcohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. CONCLUSIONS: These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood.     

The MAO-A gene, platelet MAO-B activity and psychosocial environment in adolescent female alcohol-related problem behaviour

BACKGROUND: Antisocial behaviour has been associated with polymorphic variants in candidate genes and recently also gene-environmental interaction models have been presented. It has been suggested that antisocial behaviour, associated with alcohol consumption in males, is related to a variation in the monoamine oxidase A gene (MAO-A) promoter. Furthermore, platelet MAO-B activity has in several studies been reported to be low in male alcoholics, while this has not been the case with regard to female alcoholics. Aims of the present study were to: (1) investigate possible interactions between the MAO-A polymorphism, family relations and maltreatment/sexual abuse on adolescent alcohol-related problem behaviour among female adolescents; (2) to investigate if platelet MAO-B enzyme activity interacted with environment to predict female alcohol-related problems. METHODS: A random sample of 114 female individuals from a total population of 16- and 19-year adolescents from a Swedish county, who volunteered to participate in the study, were interviewed, filled in a questionnaire and a blood sample was drawn. RESULTS: In contrast to what has been reported in males, presence of the long (4-repeat) variant of the MAO-A gene in females interacted significantly with an unfavourable environment (poor family relations or maltreatment/abuse/sexual abuse) to increase the risk for high scores of alcohol-related problems. Furthermore, females with low platelet MAO-B activity showed an increased risk of alcohol-related problem behaviour in an unfavourable environment. CONCLUSIONS: Poor psychosocial environment interacts with the high activity MAO-A genotype and low platelet MAO-B enzyme activity to increase vulnerability for female adolescent alcohol-related problem behaviour.     

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

IntroductionChildhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.MethodYoung adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.ResultsWe found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.ConclusionThe results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.     

Exposure to childhood neglect and physical abuse and developmental trajectories of heavy episodic drinking from early adolescence into young adulthood

BackgroundAlthough the literature suggests that childhood maltreatment (CM) relates to adolescent heavy episodic drinking (HED), few studies have examined the long-term effects of CM on adolescent HED. This study is the first to examine associations between exposure to CM and trajectories of HED from adolescence to young adulthood for the US population.MethodsFour waves of data from the National Longitudinal Study of Adolescent Health were used. A total of 8503 adolescents followed from adolescence (7th–12th grades) into young adulthood (ages 24–32) were assessed on CM and past-year HED frequency. Using growth curve modeling, trajectories of adolescent HED were examined, with subtype, frequency, and severity of CM as the primary independent variables. All of our analyses controlled for common risk factors for adolescent HED, including demographics, parental and peer alcohol use, parental education and employment, family income, parent–child relationship, and adolescent depression.ResultsAfter controlling for potential risk factors, neglect and physical abuse, both individually and in conjunction, were associated with faster increases in HED during adolescence and persistently elevated HED over much of adolescence and young adulthood. The frequency of neglect and physical abuse, individually and in conjunction, was also associated with the trajectory of HED, such that additional instances of these types of maltreatment were associated with faster increases in HED during adolescence and higher rates of peak use during young adulthood.ConclusionChild neglect and physical abuse appear to have long-lasting adverse effects on HED beyond adolescence and throughout much of young adulthood.     

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings

Background : Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. Objective: To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Methods: Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Results: Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Conclusions: Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.     

Disentangling the complex association between childhood sexual abuse and alcohol-related problems: a review of methodological issues and approaches

This review describes and evaluates methodological approaches aimed at unraveling the association between childhood sexual abuse (CSA) and later misuse of alcohol, which is complicated by the significant overlap between factors that elevate risk for CSA exposure and those that increase risk for problem alcohol use. We critique methods used to distinguish direct effects of CSA events on alcohol-related outcomes from the effects of risk factors frequently present in families in which CSA exposure occurs (e.g., parental alcohol-related problems). These methods include measurement and adjustment for potentially confounding factors and the use of co-twin designs. The findings across methodological approaches provide support for a CSA-specific risk for alcohol misuse, despite the significant contribution of family background factors to overall risk, but much work remains to be done before a comprehensive model for this association can be proposed. Additional directions for research, including the incorporation of measured genes and the use of longitudinal designs, are proposed to further efforts to model the pathways from CSA to alcohol-related problems.     

The long-term effects of childhood maltreatment experiences on subsequent illicit drug use and drug-related problems in young adulthood

ObjectivesThe objective of this study was to examine the associations between (a) childhood maltreatment (i.e., physical abuse, sexual abuse, and neglect) and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood.MethodsWave 1 and Wave 3 public-use data from the National Longitudinal Study of Adolescent Health were used. Logistic regressions, controlling for adolescent drug use and other important family and peer contextual processes, were estimated to determine the associations between (a) childhood maltreatment experiences and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood.ResultsAmong the participants, 31.9% reported some form of childhood maltreatment. Childhood physical abuse was associated with a 37% (OR = 1.37; 95% CI = 1.04, 1.80) increase in illicit drug use during the 30 days prior to the Wave 3 survey, a 48% (OR = 1.48; 95% CI = 1.16, 1.89) increase in illicit drug use during the year prior to the Wave 3 survey, and a 96% (OR = 1.96; 95% CI = 1.40, 2.76) increase in drug-related problems in young adulthood. The latter two associations persisted even after controlling for illicit drug use in adolescence. Neglect among females was associated with a higher likelihood of past year illicit drug use in young adulthood (OR = 1.31; 95% CI = 1.002, 1.71). However, this association was not significant once the effect of illicit drug use in adolescence was statistically controlled for.ConclusionsThe present findings suggest that childhood maltreatment is related to subsequent illicit drug use and drug-related problems in young adulthood and that some of these associations differ by gender. Implications for preventive intervention are discussed.     

Relationships between adult women's alcohol problems and their childhood experiences of parental violence and psychological aggression

OBJECTIVE: The objective of this study is to examine the associations between mother physical abuse, mother psychological aggression, father physical abuse and father psychological aggression and women's alcohol dependence while controlling for several demographic variables, childhood sexual abuse and mother and father alcohol problems. METHOD: Samples of women in treatment for substance use disorders (n = 225) and receiving services for domestic violence (n = 222) volunteered to be in the study. We used the Parent-Child Conflict Tactics Scales to assess retrospectively experiences of parental aggression during childhood and the Composite International Diagnostic Interview for a diagnosis of alcohol dependence based on International Classification of Diseases (ICD-10) criteria. RESULTS: Logistic regression applied to the data showed that being in the substance use disorder treatment sample, being unemployed and not being black were significantly related to a higher likelihood of lifetime diagnosis of alcohol dependence. Mother psychological aggression was found to be significantly associated with alcohol dependence. Father psychological aggression was found to be significantly related to alcohol dependence for nonwhite women but not for white women. Mother and father physical abuse were both found to be significantly related to alcohol dependence, but only for women who did not report childhood sexual abuse. CONCLUSIONS: Associations between experiences of childhood abuse and development of alcohol problems for women are complex. Experiences of mother and father abuse need to be examined separately with samples of women who are of different ethnicities and samples of women who are receiving services for different problems.     

The relationship of childhood abuse history and substance use in an Alaska sample

This study confirms a strong link between childhood abuse history and substance misuse based upon data obtained from an ethnically diverse (largely Alaska Native) sample of 192 pregnant women in substance misuse treatment in the mid-1990s. Nearly three-quarters of the women reported childhood victimization. Compared to women with no abuse history, abused women were significantly younger at the age of onset of substance misuse, used substances more frequently, had experienced more blackouts, had more family members with substance-misuse concerns, were more likely to have been raped, revealed more psychological problems, and had less formal education. Risk patterns differed slightly for women with physical versus sexual abuse histories, with the experience of physical violence having a stronger relationship with adulthood problem behaviors than the experience of sexual molestation. Overall, findings suggest an interactive cycle of violence and substance misuse that begins very early in childhood, especially for women who were physically abused, and continues in adulthood, though no cause-end-effect conclusions can be drawn. Treatment and prevention implications of these findings are discussed.     

Childhood Maltreatment,Emotional Lability,and Alcohol Problems in Young Adults At-Risk for ADHD: Testing Moderation and Moderated Moderation

Childhood maltreatment and alcohol problems are common among young adults with attention-deficit hyperactivity disorder (ADHD). However, little is known about the degree to which maltreatment and alcohol problems are associated; potential pertinent mediating or moderating mechanisms, such as emotional lability; and whether this association varies by sex. We examined, in a sample of adults at risk for ADHD (N = 122, 37% male), the association between childhood maltreatment and alcohol problems, whether emotional lability mediated or moderated this association, and whether either role of emotional lability differed between men and women. Emotional lability moderated the association between emotional neglect and alcohol problems; maltreatment increased risk for alcohol problems for those scoring high tovery high on emotional lability, but not for those with very low-moderate levels. The association between emotional abuse and alcohol problems depended both on emotional lability and sex; emotional abuse decreased the risk for alcohol problems among men very low/low on emotional lability, but not for men who were moderate to very high on emotional lability, or for women. These findings have implications for the way in which targeting maltreatment and emotional lability may be incorporated into prevention and intervention programs to prevent alcohol problems among men and women at risk for ADHD.     

Adolescent alcohol use development and young adult outcomes

This study used latent growth modeling to examine the effects of level of alcohol use and development of alcohol use during adolescence, on young adult outcomes for males and females. Adolescents (N=480; mean=13.03 years, S.D.=1.44; 264 female) were assessed annually over a 4-year period and then 5–6 years later in young adulthood (mean=22.49 years, S.D.=1.50). Chronicity of alcohol use in adolescence was related to higher alcohol use, alcohol-related problems, aggressive behavior, theft, and suicide ideation in young adulthood among both males and females. Development of alcohol use during adolescence was related to alcohol-related problems in young adulthood for males and females, and to higher levels of alcohol use and aggressive behavior for males only. The results indicate that development of alcohol use as well as level of alcohol use in adolescence is important for future adjustment outcomes, and that these relationships vary as a function of gender.     

The developmental antecedents of illicit drug use: evidence from a 25-year longitudinal study

BACKGROUND: The present study examined the developmental antecedents of illicit drug use and abuse/dependence. METHODS: A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1265 New Zealand children. Measures included assessments of adolescent and young adult illicit drug use and abuse/dependence; cannabis use to age 25; measures of parental adjustment; measures of exposure to childhood sexual abuse, physical abuse, and interparental violence; novelty-seeking; childhood and early adolescent adjustment and substance use; and affiliation with substance-using peers. RESULTS: Illicit drug use and abuse/dependence from ages 16 to 25 were significantly associated (all p values<.05) with a range of parental adjustment measures; exposure to abuse in childhood; individual factors; and measures of childhood and early adolescent adjustment. Analyses using repeated measures logistic regression models suggested that parental illicit drug use, gender, novelty-seeking, and childhood conduct disorder predicted later illicit drug use and abuse/dependence. Further analyses revealed that these pathways to illicit drug use and abuse/dependence were mediated via cannabis use, affiliation with substance-using peers, and alcohol use during ages 16-25. CONCLUSIONS: The current study suggested that the illicit drug use and abuse/dependence were associated with a range of early life circumstances and processes that put individuals at greater risk of illicit drug use and abuse/dependence. However, the use of cannabis in late adolescence and early adulthood emerged as the strongest risk factor for later involvement in other illicit drugs.     

Childhood adversity in alcohol- and drug-dependent women presenting to out-patient treatment

Eighty alcohol- and/or drug-dependent women who were consecutive admissions to a representative out-patient alcohol and drug service in Christchurch were interviewed with the aim of establishing the extent of exposure to childhood adversity including childhood sexual, physical and emotional abuse and parental problems. The results show that a sizeable percentage of the women came from backgrounds characterized by parental conflict and alcohol and drug problems. Within their first 15 years 51% were subjected to sexual abuse involving attempted or completed oral, anal or vaginal intercourse and 39% were exposed regularly to physical abuse perpetrated by their parents or main parental figures. Over half reported experiencing emotional abuse rated as being 'very distressing' and two-thirds had been exposed to 'very distressing' parental problems. The main implication for clinical practice arising from the results of this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug services may need to routinely screen and plan treatment for childhood adversity and associated problems in all clients presenting for alcohol and drug treatment.     

Adolescent Repeated Alcohol Intoxication as a Predictor of Young Adulthood Alcohol Abuse: The Role of Socioeconomic Context

Aims. Trajectories of alcohol abuse from adolescence onwards are not well known. We examined the relationship between repeated alcohol intoxication in adolescence and later alcohol abuse, testing whether this association varies depending on individuals’ socioeconomic context. Methods. Study participants (n = 674, age 22–35 years in 2009) belong to the French TEMPO cohort study; their parents also participate in an epidemiological study—the GAZEL cohort. Repeated alcohol intoxication was assessed by questionnaire in adolescence (1999) (defined by ≥3 episodes of alcohol intoxication in the preceding 12 months). In young adulthood (2009), alcohol abuse was assessed by the WHO AUDIT questionnaire. Socioeconomic characteristic studied was childhood family income. Data were analyzed using logistic regression models controlling for age, sex, childhood temperament, parental history of alcohol use, and the quality of family relations. Results. Among adolescents who reported repeated alcohol intoxication, 30.8% reported alcohol abuse in young adulthood (adjusted OR=4.27, 95%CI 2.21–8.27). This association appeared stronger in participants who grew up in families with low income (adjusted OR=11.86, 95%CI 3.35–41.94 vs. 2.49, 95%CI 1.09–5.68 for youths from families with intermediate or high income). Conclusions. In most adolescents (69.2%), alcohol abuse is a time-limited behavior. Nonetheless, in participants from low income families, the likelihood of persistent alcohol abuse beyond adolescence may be increased. Although some limitations are noted, a preliminary conclusion is that alcohol abuse trajectories over time need to be monitored, particularly in certain subgroups.     

Childhood physical and sexual abuse and subsequent alcohol and drug use disorders in two American-Indian tribes

OBJECTIVE: The purpose of this study was to examine the relationship of childhood physical and sexual abuse to subsequent lifetime alcohol or drug use disorders among American Indians (AIs) by using cross-sectional and retrospective data collected from a structured epidemiological interview. METHOD: A sample of 3,084 AIs from two tribal populations-Southwest and Northern Plains--participated in a large-scale, community-based study. Participants were asked about traumatic events and family history and were administered standard diagnostic measures of substance use disorders. RESULTS: Prevalence of childhood physical abuse was approximately 7% for both tribes, and childhood sexual abuse was 4%-5%, much higher for females. The Northern Plains tribe had higher prevalences of substance use disorders. Childhood physical abuse had a significant main effect in bivariate models of substance dependence, but remained significant only in the multivariate models of substance dependence for the Northern Plains tribe. Correlates of disorder were psychiatric and medical comorbidity, parental alcohol problems and adult experience of physical attacks. CONCLUSIONS: Childhood physical abuse had a stronger effect than childhood sexual abuse on lifetime substance dependence. Childhood sexual abuse, on the other hand, was more associated with lifetime substance abuse. Females more commonly experienced childhood abuse but were less likely than males to develop substance use disorders. Although additional covariates reduced the main effect on disorder, results provide clinical guidance to constellations of risk factors and expand the population at risk to include males.