JOURNALOFADOLESCENT HEALTH1992;13:6Sf3-662
Substance Abuse Among Sexually Abused Adolescents and Their Families JEANNE
T, HGRNANDBZ,
Ph.D.,
M.S.P.H.
The concurrenceof substance abuse and history of sexual abuse amon adolescents has prompted this study of sub-
stance abuse patterns among families of adolescents who report incest or extrafamilial sexual abuse. A total of 3,179 ninth-grade students in a rural midwestem state completed a survey that included questions about individual and family substance abuse. Adolescents who had been sexually abused were more likely to report substance abuse for themselves as well as for member, of their immediate families. They were also more likely to report that they used substances because of family problems, school problems, and because they were sad, lonely, or angry. Adolescents reporting a parent with an alcohol or a drug problem wehe more likely to use cigarettes, marijuana, aicohol, w “speed.” Adolescents experiencing extrafamilial abuse reported more alcohol abuse and more alcohol-related problems than those who experienced incest. There were similar *ports of parental and familial alcohol and dxug problems among those experiencing incest and those experiencing extrafamilial abuse. Those with drug-abusing parents, however, were most likely to report some kind of sexual abuse history. RRY WORDS:
Sexual abuse Child abuse Substance abuse Alcoholism
The relationship between sexual abuse and adolescent substance use is a timely and important re-
FNWI theDeprtment of Psychiatry, University of North CarolinaChapi Uirr, Chatxl Hill. North Carolina. -... _._ . .. . ;9ddms rep&nt re&ests to: jennne T. Hernandez, Ph.D M.S.PJ-L Department of Psychinty, CB 7160, Uniwrsity of Nod carolina--ckapc~ Hill, Ckapet Hill, NC 27599-7160. MiInusnipt accepted ]uly 4. 1992.
search question, although direct causal links are difficult to ascertain (l-3). Sexual abuse and substance use have been described as having common etiologies (1). Both occur more often among children whose parents themselves have histories of child abuse or substance abuse (2-8). In many cases, parents’ substance use precedes abuse of their children (9-13). Numerous studies report adolescent substance abuse to correlate with early childhood abuse and neglect (14-18). Rates of previous sexual abuse are high among chemicalJy dependent adolescents in clinical populations (8,19-22), with rates of incest at 7-9% and rates of extrafamilial sex abuse at 13% (23,24). Among incarcerated substance abusers, the rate of sexual abuse has been estimated to be 20%; in many cases, their substance use began during adolescence (25). In one study of sexually abused adolescent girls, for example, 59% used drugs (21). Substance use during adolescence can lead to school failure, depression, unintended injury, suicide, juvenile delinquency (26), and sexual risk taking (27-31). Most studies examining the link between substance use and sexual abuse are clinically based. Further, they do not differentiate specific forms of substance use and sexual abuse (i.e., incest and extrafamilial abuse). As both sexual abuse and substance abuse can have devastating effects on adolescents’ behavior, it is important to better understand their prevalence in the general population and their family correlates. Therefore, this study examines histories of incest, extrafamilial sexual abuse, and substance use among a large sample of high school adolescents and their families, in order to address three issues: 1) how sexual abuse relates to substance use among adolescents; 2) whether his-
0 Society for Adolescent Medicine, 1992 published by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, NY 10010
December 1992
SUBSTANCE ABUSE AMONG SEXUALLY ABUSED TEENS
tories of incest and extrafamilial sexual abuse correlate differently with adolescent substance use; and 3) how parental substance abuse correlates with adolescent substance use and sexual abuse.
Methods Procedure In 1989, a survey instrument was administered to all 6th, 9th, and 12th graders in 94% of the school districts in the Minnesota public school system by the State Department of Education. The survey was part of the Minnesota State Drug-Free Schools and Communities Act of 1986. The Department of Education contracted the coding and verification of the data on the (approximately) 90,000 students’ questionnaires. The anonymous, self-administered, paper-and-pencil questionnaire was completed in less than 1 hr in classrooms with school personnel present. Owing to the cost of managing an.d analyzing such a large data set, a computer-generated random sample of those adolescents completing the survey was used. The sample was examined to ensure its similarity to the total sample. Fewer behavioral data were available for sixth graders who were, therefore, deleted from the analysis. Only the responses of ninth graders (n = 3,178) were analyzed, as they are farther away from the legal drinking age than 12th graders, and school is still compulsory for most ninth graders because of their age. The survey instrument included questions on risk-taking behaviors, family history of substance use, and history of sexual abuse. The question on incest asked, “Has any older or stronger member of your family ever touched you sexually or had you touch them sexually ?” The question on extrafamilial sexual abuse asked, “Has any adult or older person outside the family ever touched you sexually against your wishes or forced you to touch them sexually?” Sexual abuse was defined as incest or extrafamilial abuse. Students were asked to report whether drug use or alcohol use by any family member repeatedly caused family, health, job, or legal problems. They were asked the frequency of their use of a variety of drugs, the amount of alcohol they drank on usual drinking occasions, and how often they became intoxicated when they drank. They were also asked to report how often, if ever, they experienced symptoms of heavy alcohol use or other substance use, such as tolerance, blacking out, passing out, or inflicting injury to self or others. In this study, a drinking problem was defined as drinking more than once
659
a month in addition to having three or more of the symptoms noted above. Statistical Analysis TO address
the first issue, differences between abused and nonabused adolescents on substanceuse items were analyzed using Student’s t-tests; the items were rated on a continuous scale from o (never) to 6 (daily). Differences in answers to categorical questions were analyzed using x2 analyses. To address the second issue, Student’s f-test and x2 analyses compared family and personal substanceuse behaviors among adolescents experiencing incest as opposed to extrafamilial sexual abuse. As incest and extrafamilial abuse appear to be additive in their effect on adolescent risk-taking behavior, students experiencing both types of abuse were excluded from the latter analyses (32). To address the third issue, Student’s f-tests were performed to examine the relationships between having a parent with an alcohol problem or a parent with a drug problem, and having a history of extrafamilial sex abuse, incest, or substance abuse. Adolescents with alcohol-abusing parents or drug-using parents were then compared to their counterparts without substance-abusing parents; a second analysis compared those with alcohol-abusing parents to those with drug-using parents. In the analyses addressing the third issue, adolescents were excluded who had both a parent with an alcohol problem nnd a parent with a drug problem, and who had experienced both incest and extrafamilial sexual abuse.
Results Of the 3,179 students in the sample (1643 males and 1535 females), 311 (10%) reported having experienced some form of sexual abuse; 75 students (3%) reported having been sexually abused in anA out of the family; 58 (2%) had experienced incest alone; and 178 (6%) experienced extrafamilial sex abuse alone. There was significantly more substance use among adolescents who were sexually abused than among those who were not sexually abused. This was found for cigarettes, alcohol, marijuana, inhalants and “speed”, and for cocaine and “crack”. The number of drinking-related problems was also greater in those who were sexually abused (see Tables 1 and 2). Sexually abused adolescents were also more likely to report drinking and drug problems with relatives and with nonfamily members who were living in the home (see Tables 2 and 3).
HERNANDEZ
660
JOURNAL OF ADOLESCENT HEALTH Vol. 13, No. 8
Table 1. Substance Use in Adolescents Experiencing Incest and Extrafamilial Sex Abuse (EFA) No Any Incest EFA abuse abuse (n = 311) (n = 2867) (n = 58) (n = 178) Cigarettes Marijuana Inhalents Speed Amount of alcohol Frequency of Cocaine Crack
Tz SD X SD R SD X SD R SD z SD X SD ‘j? SD
2.89 2.03 1.89 1.42 1.33 0.94 1.60 1.23 3.72 2.32 2.22 1.19 1.23 0.80 1.19 0.78
2.04b 1.70 l.36b 1.00 1.12b 0.52 1.P 0.66 2.86b 2.20 1.7oh 1.01 1.05b 0.37 1.03b 0.29
2.53 1.91 1.79 1.44 1.19 0.76 1.46 1.09 3.04 2.24 1.89 0.98 1.12 0.59 1.06 0.53
2.83 2.01 1.77 1.28 1.29 0.84 1.50 1.11 3.87” 2.33 2.28b 1.23 1.16 .67 1.19 0.83
“Significant at p < 0.05. hSignificant at p < 0.01.
Substance-use patterns of adolescents with incest versus extrafamilial abuse histories differed only in their alcohol consumption (see Table 1). Those with histories of extrafamilial abuse reported more alcohol consumption and a greater frequency of drinking. They also reported more incidents of intoxication, more drinking before school, and more problems with blacking out during consumption (see Table 2). Those with extrafamilial abuse histories more often said they drank because they were sad, lonely, or angry. Student’s t-test analyses showed that adolescents reporting a parent with an alcohol problem also reported more alcohol use, more alcohol intoxication, and more cigarette, marijuana, and hard drug use. Adolescents having a parent with a drug problem also reported more use of cigarrettes, “speed,” and alcohol, and more alcohol intoxication (see Table 4). Tables 2 and 3 showed that sexually abused adolescents were more likely to have a parent with a drug or an alcohol problem, in or out of the home. The analysis comparing the 221 adolescents with alcohol-abusing parents to the 32 adolescents with drug-using parents showed that those with drug-using parents were more likely to report extrafamilial abuse (X2 (1, 249) = 8.27, p < 0.01) and more likely to report incest (X2 (1, 249) = 5.53, p < 0.01); no differences were noted in their substance use.
Discussion The results substantiated a relationship between use of a variety of illegal substances and history of sexual abuse among adolescents in a high school population. Among the sexually abused there were also indications of school-related problems because of substance use, such as missing school, using substances because of school problems, and using before or during school. The results probably underestimate the link, as the rates of substance and sexual abuse are reported to be even greater among adolescents who are not enrolled in school, that is, who have dropped out and/or run away (33). In a cross-sectional study such as this one, it is difficult to assign causality to the variables. Nevertheless, the connection between parental alcohol problems and adolescent use of alcohol and ciga-
Table 2. Alcohoi Use of Abused and Nonabused Adolescents and of Those Experiencing Incest and ExtrafamilialSexual Abuse (EFA) No Any abuse abuse Incest EFA (n = 311) (n = 2867) (n = 58) (n = 178) % % % %
Has drinking problem Tolerance Blackouts Commits violence Can’t stop drinking Misses school Drinks Before school During school After school Why drink To get high Because parents do Family problems School problems Sad, lonely, angry
8 30 46 20
2b 2oh 22b 7h
5 23 30 7
7 28 49” 18
12 16
5b 4b
9
4
12 14
16 11 27
sb 3b 14”
5 10 19
18” 8 26
28
15b
26
30
5 21 14
2h 1 4”
3 14 7
4 20 15
10
24”
sb
12
15
sb sb
17 14
11 13
lb
2
3
21
Family alcohol problems Parent in household 16 Parent not in household 14 Another relative 19 Nonfamily but in home 4 “Significant at p < 0.05. ‘Significant at p < 0.01.
December1992
SUBSTANCEABUSE AMONG SEXUALLYABUSED TEENS
Table 3. Drug Patterns of SexuallyAbused and Nonabused Adolescents and of Those Experiencing
Table 4. Substance Use and History of Sexual Abuse for Adolescents With and Without a Parent With a Lkug or Alcohol Problem
Incest and ExtrafamilialAbuse (EFA) Any
No
abuse
abuse
Parent5
EFA (1 ;0311) (n =v;867) (n = 58) (n = 178) Incest % Uses intravenous drugs 6 Previously treated 6
Uses drugs Beforeschool During school After school Parents aware of use Uses drugs To get high Because parents do Family problems School problems Sad, lonely, anary Drug problems Parent at home Parent not at home Another relative Nonfamily in the home
66x
Alcohol No Problem Problem
1
2
4
3”
5
4
13 10 19 10
4” 3” 7” 3”
12 7 21 13
10 8 16 7
19
8”
17
19
2 II 8
0” 1” 1”
5 7 7
0 9 6
11
2”
3
11
9
2”
12
6
6 13
2” 4”
3 9
3 9
4
1
0
3
“Significant at p < 0.01.
rettes may suggest modeling and/or genetic links. A similar relationship between parental drug problems and adolescent “gateway” drug use was shown. The
relationship between use of hard drugs among adolescents and drug use by their parents was not significant, possibly because there were so few of the former sample. There were higher percentages of drinking and drug problems in the families of sexually abused adolescents. Alcohol problems were more common than drug problems among the parents of sexually abused adolescents, perhaps because there is more alcohol abuse than drug abuse among adults in general, however, that adolescents with drug using parents are most likely to report either type of sexual abuse, may indicate more overall pathologic behavior among drug-abusing parents, or may indicate a social class difference. That adolescents experiencing extrafamilial sexual abuse reported heavier drinking than adolescents reporting incest, suggests that extrafamilial abuse can be concurrent with and possibly a consequence of adolescents’ substance use. Also, the extrafami-
Drug
No
Problem Problem (n = 221) (n = 2901) (n = 32) (n = 3090)
% Cigarette5
R SD Marijuana j? SD Amount of Tz Alcohd SD Frequency of x Intoxication SD Inhalants Sz SD Speed x SD Cocaine K SD Crack x SD
2.77 2.02 1.73 1.31 3.78 2.28 2.10 1.09 1.19 1.01 1.39 1.01 1.10 0.51 1.04 0.36
2.04” 1.69 1.36b 99 2.85b 2.19 1.71b 1.02 1.13 0.68 1.18b 0.68 1.05 0.39 1.04 0.35
2.97 2.16 1.90 1.51 3.87 2.46 2.25 1.21 1.28 0.81 1.78 1.52 1.15 0.88 1.28 1.11
2.08’ 1.73 1.38 1.02 2.W 2.46 1.73b 1.02 1.04 0.55 1.19” ,.L’?J 1.06 0.39 1.04 0.34
“Signit~cantat p
Substance Abuse Among Sexually Abused Adolescents and Their Families JEANNE
T, HGRNANDBZ,
Ph.D.,
M.S.P.H.
The concurrenceof substance abuse and history of sexual abuse amon adolescents has prompted this study of sub-
stance abuse patterns among families of adolescents who report incest or extrafamilial sexual abuse. A total of 3,179 ninth-grade students in a rural midwestem state completed a survey that included questions about individual and family substance abuse. Adolescents who had been sexually abused were more likely to report substance abuse for themselves as well as for member, of their immediate families. They were also more likely to report that they used substances because of family problems, school problems, and because they were sad, lonely, or angry. Adolescents reporting a parent with an alcohol or a drug problem wehe more likely to use cigarettes, marijuana, aicohol, w “speed.” Adolescents experiencing extrafamilial abuse reported more alcohol abuse and more alcohol-related problems than those who experienced incest. There were similar *ports of parental and familial alcohol and dxug problems among those experiencing incest and those experiencing extrafamilial abuse. Those with drug-abusing parents, however, were most likely to report some kind of sexual abuse history. RRY WORDS:
Sexual abuse Child abuse Substance abuse Alcoholism
The relationship between sexual abuse and adolescent substance use is a timely and important re-
FNWI theDeprtment of Psychiatry, University of North CarolinaChapi Uirr, Chatxl Hill. North Carolina. -... _._ . .. . ;9ddms rep&nt re&ests to: jennne T. Hernandez, Ph.D M.S.PJ-L Department of Psychinty, CB 7160, Uniwrsity of Nod carolina--ckapc~ Hill, Ckapet Hill, NC 27599-7160. MiInusnipt accepted ]uly 4. 1992.
search question, although direct causal links are difficult to ascertain (l-3). Sexual abuse and substance use have been described as having common etiologies (1). Both occur more often among children whose parents themselves have histories of child abuse or substance abuse (2-8). In many cases, parents’ substance use precedes abuse of their children (9-13). Numerous studies report adolescent substance abuse to correlate with early childhood abuse and neglect (14-18). Rates of previous sexual abuse are high among chemicalJy dependent adolescents in clinical populations (8,19-22), with rates of incest at 7-9% and rates of extrafamilial sex abuse at 13% (23,24). Among incarcerated substance abusers, the rate of sexual abuse has been estimated to be 20%; in many cases, their substance use began during adolescence (25). In one study of sexually abused adolescent girls, for example, 59% used drugs (21). Substance use during adolescence can lead to school failure, depression, unintended injury, suicide, juvenile delinquency (26), and sexual risk taking (27-31). Most studies examining the link between substance use and sexual abuse are clinically based. Further, they do not differentiate specific forms of substance use and sexual abuse (i.e., incest and extrafamilial abuse). As both sexual abuse and substance abuse can have devastating effects on adolescents’ behavior, it is important to better understand their prevalence in the general population and their family correlates. Therefore, this study examines histories of incest, extrafamilial sexual abuse, and substance use among a large sample of high school adolescents and their families, in order to address three issues: 1) how sexual abuse relates to substance use among adolescents; 2) whether his-
0 Society for Adolescent Medicine, 1992 published by Elsevier Science Publishing Co., Inc., 655 Avenue of the Americas, New York, NY 10010
December 1992
SUBSTANCE ABUSE AMONG SEXUALLY ABUSED TEENS
tories of incest and extrafamilial sexual abuse correlate differently with adolescent substance use; and 3) how parental substance abuse correlates with adolescent substance use and sexual abuse.
Methods Procedure In 1989, a survey instrument was administered to all 6th, 9th, and 12th graders in 94% of the school districts in the Minnesota public school system by the State Department of Education. The survey was part of the Minnesota State Drug-Free Schools and Communities Act of 1986. The Department of Education contracted the coding and verification of the data on the (approximately) 90,000 students’ questionnaires. The anonymous, self-administered, paper-and-pencil questionnaire was completed in less than 1 hr in classrooms with school personnel present. Owing to the cost of managing an.d analyzing such a large data set, a computer-generated random sample of those adolescents completing the survey was used. The sample was examined to ensure its similarity to the total sample. Fewer behavioral data were available for sixth graders who were, therefore, deleted from the analysis. Only the responses of ninth graders (n = 3,178) were analyzed, as they are farther away from the legal drinking age than 12th graders, and school is still compulsory for most ninth graders because of their age. The survey instrument included questions on risk-taking behaviors, family history of substance use, and history of sexual abuse. The question on incest asked, “Has any older or stronger member of your family ever touched you sexually or had you touch them sexually ?” The question on extrafamilial sexual abuse asked, “Has any adult or older person outside the family ever touched you sexually against your wishes or forced you to touch them sexually?” Sexual abuse was defined as incest or extrafamilial abuse. Students were asked to report whether drug use or alcohol use by any family member repeatedly caused family, health, job, or legal problems. They were asked the frequency of their use of a variety of drugs, the amount of alcohol they drank on usual drinking occasions, and how often they became intoxicated when they drank. They were also asked to report how often, if ever, they experienced symptoms of heavy alcohol use or other substance use, such as tolerance, blacking out, passing out, or inflicting injury to self or others. In this study, a drinking problem was defined as drinking more than once
659
a month in addition to having three or more of the symptoms noted above. Statistical Analysis TO address
the first issue, differences between abused and nonabused adolescents on substanceuse items were analyzed using Student’s t-tests; the items were rated on a continuous scale from o (never) to 6 (daily). Differences in answers to categorical questions were analyzed using x2 analyses. To address the second issue, Student’s f-test and x2 analyses compared family and personal substanceuse behaviors among adolescents experiencing incest as opposed to extrafamilial sexual abuse. As incest and extrafamilial abuse appear to be additive in their effect on adolescent risk-taking behavior, students experiencing both types of abuse were excluded from the latter analyses (32). To address the third issue, Student’s f-tests were performed to examine the relationships between having a parent with an alcohol problem or a parent with a drug problem, and having a history of extrafamilial sex abuse, incest, or substance abuse. Adolescents with alcohol-abusing parents or drug-using parents were then compared to their counterparts without substance-abusing parents; a second analysis compared those with alcohol-abusing parents to those with drug-using parents. In the analyses addressing the third issue, adolescents were excluded who had both a parent with an alcohol problem nnd a parent with a drug problem, and who had experienced both incest and extrafamilial sexual abuse.
Results Of the 3,179 students in the sample (1643 males and 1535 females), 311 (10%) reported having experienced some form of sexual abuse; 75 students (3%) reported having been sexually abused in anA out of the family; 58 (2%) had experienced incest alone; and 178 (6%) experienced extrafamilial sex abuse alone. There was significantly more substance use among adolescents who were sexually abused than among those who were not sexually abused. This was found for cigarettes, alcohol, marijuana, inhalants and “speed”, and for cocaine and “crack”. The number of drinking-related problems was also greater in those who were sexually abused (see Tables 1 and 2). Sexually abused adolescents were also more likely to report drinking and drug problems with relatives and with nonfamily members who were living in the home (see Tables 2 and 3).
HERNANDEZ
660
JOURNAL OF ADOLESCENT HEALTH Vol. 13, No. 8
Table 1. Substance Use in Adolescents Experiencing Incest and Extrafamilial Sex Abuse (EFA) No Any Incest EFA abuse abuse (n = 311) (n = 2867) (n = 58) (n = 178) Cigarettes Marijuana Inhalents Speed Amount of alcohol Frequency of Cocaine Crack
Tz SD X SD R SD X SD R SD z SD X SD ‘j? SD
2.89 2.03 1.89 1.42 1.33 0.94 1.60 1.23 3.72 2.32 2.22 1.19 1.23 0.80 1.19 0.78
2.04b 1.70 l.36b 1.00 1.12b 0.52 1.P 0.66 2.86b 2.20 1.7oh 1.01 1.05b 0.37 1.03b 0.29
2.53 1.91 1.79 1.44 1.19 0.76 1.46 1.09 3.04 2.24 1.89 0.98 1.12 0.59 1.06 0.53
2.83 2.01 1.77 1.28 1.29 0.84 1.50 1.11 3.87” 2.33 2.28b 1.23 1.16 .67 1.19 0.83
“Significant at p < 0.05. hSignificant at p < 0.01.
Substance-use patterns of adolescents with incest versus extrafamilial abuse histories differed only in their alcohol consumption (see Table 1). Those with histories of extrafamilial abuse reported more alcohol consumption and a greater frequency of drinking. They also reported more incidents of intoxication, more drinking before school, and more problems with blacking out during consumption (see Table 2). Those with extrafamilial abuse histories more often said they drank because they were sad, lonely, or angry. Student’s t-test analyses showed that adolescents reporting a parent with an alcohol problem also reported more alcohol use, more alcohol intoxication, and more cigarette, marijuana, and hard drug use. Adolescents having a parent with a drug problem also reported more use of cigarrettes, “speed,” and alcohol, and more alcohol intoxication (see Table 4). Tables 2 and 3 showed that sexually abused adolescents were more likely to have a parent with a drug or an alcohol problem, in or out of the home. The analysis comparing the 221 adolescents with alcohol-abusing parents to the 32 adolescents with drug-using parents showed that those with drug-using parents were more likely to report extrafamilial abuse (X2 (1, 249) = 8.27, p < 0.01) and more likely to report incest (X2 (1, 249) = 5.53, p < 0.01); no differences were noted in their substance use.
Discussion The results substantiated a relationship between use of a variety of illegal substances and history of sexual abuse among adolescents in a high school population. Among the sexually abused there were also indications of school-related problems because of substance use, such as missing school, using substances because of school problems, and using before or during school. The results probably underestimate the link, as the rates of substance and sexual abuse are reported to be even greater among adolescents who are not enrolled in school, that is, who have dropped out and/or run away (33). In a cross-sectional study such as this one, it is difficult to assign causality to the variables. Nevertheless, the connection between parental alcohol problems and adolescent use of alcohol and ciga-
Table 2. Alcohoi Use of Abused and Nonabused Adolescents and of Those Experiencing Incest and ExtrafamilialSexual Abuse (EFA) No Any abuse abuse Incest EFA (n = 311) (n = 2867) (n = 58) (n = 178) % % % %
Has drinking problem Tolerance Blackouts Commits violence Can’t stop drinking Misses school Drinks Before school During school After school Why drink To get high Because parents do Family problems School problems Sad, lonely, angry
8 30 46 20
2b 2oh 22b 7h
5 23 30 7
7 28 49” 18
12 16
5b 4b
9
4
12 14
16 11 27
sb 3b 14”
5 10 19
18” 8 26
28
15b
26
30
5 21 14
2h 1 4”
3 14 7
4 20 15
10
24”
sb
12
15
sb sb
17 14
11 13
lb
2
3
21
Family alcohol problems Parent in household 16 Parent not in household 14 Another relative 19 Nonfamily but in home 4 “Significant at p < 0.05. ‘Significant at p < 0.01.
December1992
SUBSTANCEABUSE AMONG SEXUALLYABUSED TEENS
Table 3. Drug Patterns of SexuallyAbused and Nonabused Adolescents and of Those Experiencing
Table 4. Substance Use and History of Sexual Abuse for Adolescents With and Without a Parent With a Lkug or Alcohol Problem
Incest and ExtrafamilialAbuse (EFA) Any
No
abuse
abuse
Parent5
EFA (1 ;0311) (n =v;867) (n = 58) (n = 178) Incest % Uses intravenous drugs 6 Previously treated 6
Uses drugs Beforeschool During school After school Parents aware of use Uses drugs To get high Because parents do Family problems School problems Sad, lonely, anary Drug problems Parent at home Parent not at home Another relative Nonfamily in the home
66x
Alcohol No Problem Problem
1
2
4
3”
5
4
13 10 19 10
4” 3” 7” 3”
12 7 21 13
10 8 16 7
19
8”
17
19
2 II 8
0” 1” 1”
5 7 7
0 9 6
11
2”
3
11
9
2”
12
6
6 13
2” 4”
3 9
3 9
4
1
0
3
“Significant at p < 0.01.
rettes may suggest modeling and/or genetic links. A similar relationship between parental drug problems and adolescent “gateway” drug use was shown. The
relationship between use of hard drugs among adolescents and drug use by their parents was not significant, possibly because there were so few of the former sample. There were higher percentages of drinking and drug problems in the families of sexually abused adolescents. Alcohol problems were more common than drug problems among the parents of sexually abused adolescents, perhaps because there is more alcohol abuse than drug abuse among adults in general, however, that adolescents with drug using parents are most likely to report either type of sexual abuse, may indicate more overall pathologic behavior among drug-abusing parents, or may indicate a social class difference. That adolescents experiencing extrafamilial sexual abuse reported heavier drinking than adolescents reporting incest, suggests that extrafamilial abuse can be concurrent with and possibly a consequence of adolescents’ substance use. Also, the extrafami-
Drug
No
Problem Problem (n = 221) (n = 2901) (n = 32) (n = 3090)
% Cigarette5
R SD Marijuana j? SD Amount of Tz Alcohd SD Frequency of x Intoxication SD Inhalants Sz SD Speed x SD Cocaine K SD Crack x SD
2.77 2.02 1.73 1.31 3.78 2.28 2.10 1.09 1.19 1.01 1.39 1.01 1.10 0.51 1.04 0.36
2.04” 1.69 1.36b 99 2.85b 2.19 1.71b 1.02 1.13 0.68 1.18b 0.68 1.05 0.39 1.04 0.35
2.97 2.16 1.90 1.51 3.87 2.46 2.25 1.21 1.28 0.81 1.78 1.52 1.15 0.88 1.28 1.11
2.08’ 1.73 1.38 1.02 2.W 2.46 1.73b 1.02 1.04 0.55 1.19” ,.L’?J 1.06 0.39 1.04 0.34
“Signit~cantat p
