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Neighborhood Disadvantage and Adolescent Substance Use Disorder: The Moderating Role of Maltreatment.

ABSTRACT: The ecological-transactional model proposes that nested contexts interact to influence development. From this perspective, child maltreatment represents an individual-level risk factor posited to interact with numerous other nested contextual levels, such as the neighborhood environment, to affect development. The aim of this study was to investigate whether adolescents with maltreatment histories represent a vulnerable group for whom disadvantaged neighborhoods confer risk for substance use disorders. Participants were 411 adolescents (age 15-18; mean age = 16.24) from an investigation of the developmental sequelae of childhood maltreatment. Multiple-group structural equation models, controlling for family-level socioeconomic status, indicated that neighborhood disadvantage was associated with more marijuana-dependence symptoms among maltreated but not among non-maltreated adolescents. Moreover, among maltreated adolescents, those who experienced multiple subtypes of maltreatment were at greatest risk for problematic marijuana use in the context of neighborhood disadvantage. Interestingly, the direct effect of neighborhood disadvantage, but not the interaction with maltreatment, was related to adolescent alcohol-dependence symptoms. Results highlight the importance of considering multiple levels of influence when examining risk associated with child maltreatment.

SUBMITTER: Handley ED

PROVIDER: S-EPMC4515954 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Neighborhood Disadvantage and Adolescent Substance Use Disorder: The Moderating Role of Maltreatment.

Handley Elizabeth D ED Rogosch Fred A FA Guild Danielle J DJ Cicchetti Dante D

Child maltreatment 20150505 3

The ecological-transactional model proposes that nested contexts interact to influence development. From this perspective, child maltreatment represents an individual-level risk factor posited to interact with numerous other nested contextual levels, such as the neighborhood environment, to affect development. The aim of this study was to investigate whether adolescents with maltreatment histories represent a vulnerable group for whom disadvantaged neighborhoods confer risk for substance use dis ...[more]

PMID: 25947011

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Project description:BackgroundEvidence suggests that aspects of the neighborhood environment may influence risk of problematic drug use among adolescents. Our objective was to examine mediating roles of aspects of the school and peer environments on the effect of receiving a Section 8 housing voucher and using it to move out of public housing on adolescent substance use outcomes.MethodsWe used data from the Moving to Opportunity (MTO) experiment that randomized receipt of a Section 8 housing voucher. Hypothesized mediators included school climate, safety, peer drug use, and participation in an after-school sport or club. We applied a doubly robust, semiparametric estimator to longitudinal MTO data to estimate stochastic direct and indirect effects of randomization on cigarette use, marijuana use, and problematic drug use. Stochastic direct and indirect effects differ from natural direct and indirect effects in that they do not require assuming no posttreatment confounder of the mediator-outcome relationship. Such an assumption would be at odds with any causal model that reflects an intervention affecting a mediator and outcome through adherence to treatment assignment.ResultsHaving friends who use drugs and involvement in after-school sports or clubs partially mediated the effect of housing voucher receipt on adolescent substance use (e.g., stochastic indirect effect 0.45% [95% confidence interval: 0.12%, 0.79%] for having friends who use drugs and 0.04% [95% confidence interval: -0.02%, 0.10%] for involvement in after-school sports or clubs mediating the relationship between housing voucher receipt and marijuana use among boys). However, these mediating effects were small, contributing only fractions of a percent to the effect of voucher receipt on probability of substance use. No school environment variables were mediators.ConclusionsMeasured school- and peer-environment variables played little role in mediating the effect of housing voucher receipt on subsequent adolescent substance use.

Dataset Information

Neighborhood Disadvantage and Adolescent Substance Use Disorder: The Moderating Role of Maltreatment.

Publications

Neighborhood Disadvantage and Adolescent Substance Use Disorder: The Moderating Role of Maltreatment.

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