Childhood sexual abuse and adolescent substance use: a latent class analysis.

Children who have exposure to child sexual abuse (CSA) are at particular risk for developing substance abuse in adolescence, but the extent to which CSA may shape patterns of adolescent substance use remains uncertain. The aim of this paper is to characterize the variations in patterns of adolescent substance use and to examine the association between CSA and qualitatively distinct patterns of adolescent substance use. Latent class analyses identified homogenous groups of adolescents with similar patterns of substance use using a sample of 1019 adolescents (mean age: 15.9 years; range: 13-18) who were selected from five publicly funded service systems. Different patterns of latent class structures were identified in boys and girls (a 4-class solution for girls and a 3-class solution for boys). CSA was associated with an increased risk of being a heavy polysubstance user in girls, even after adjustment of age, race/ethnicity, parental substance use, sibling use, peer use, psychopathology and other forms of childhood maltreatment including physical abuse and neglect. Findings indicate that female victims of CSA who are involved with public service systems are at high risk for developing multiple-substance use in adolescence.