Designed to establish a causal relationship between childhood victimization and young adults' substance abuse, this study also examined depression's role as mediator in that causal relationship. The study employs child-abuse measures that weigh both the type (sexual, physical) and the persistence of abuse. The study took as its substance-abuse measures the DSM-IV criteria for current alcohol abuse, current marijuana abuse, and current drug abuse. Data from the first 5 waves of the National Youth Survey (NYS) was employed, along with data from its 7th wave, to establish the temporal order needed to determine causal relationship. Childhood physical abuse proved a strong predictor of young adults' current substance abuse, although sexual abuse did not. Depression was shown to mediate the relationship of physical abuse to current alcohol abuse and current drug abuse, but not to current marijuana abuse.
A secondary dataset, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, was employed to examine racial/ethnic differences in access to specialty and non-specialty substance abuse treatment (compared with no access to treatment). The study found that non-Hispanic White Americans were (1) likelier than members of all racial/ethnic minority groups (other than Hispanics) to address substance abuse by accessing care through specialty addiction-treatment facilities, and were (2) also less likely to access substance abuse care through non-specialty facilities. Because non-specialty facilities may have staffs whose professional training does not target treating chronic, bio-psycho-social illness such as substance abuse, our results imply that treatment facilities deemed non-specialty may need to enhance staff training, in order to ensure individuals are properly screened for substance use conditions and are referred for or provided with effective counseling and medications as appropriate.
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