Child maltreatment severity, chronic substance abuse, and disability status

Purpose: Biological theories explain how exposure to child maltreatment and chronic substance abuse result in significant health reductions, often years or decades after the maltreatment and substance abuse end. Relationships among these variables are known to exist; however, the relative impact of each risk factor on disability status is not clear. Method: Adults receiving inpatient treatment for a substance use disorder (SUD) were assessed for chronic illness and disability (CID), years abusing substances, and child maltreatment severity using the Child Trauma Questionnaire (n = 112). A logistic regression model classified participants by CID status based on criterion variables; using transformed data and model parameters, the odds and probabilities were calculated for each criterion variable to determine the clinical impact of each risk factor on CID. Results: The majority (52.7%) of participants reported CID; the majority screened positively for child maltreatment (87.4%). Our model was significant and demonstrates that the odds for CID increase as a function of maltreatment severity; years abusing substances did not significantly increase the odds. For those reporting the most severe levels of maltreatment, the odds of experiencing CID translates to odds ratio (OR) = 1.92, with an associated probability of 66%. Implications: Child maltreatment severity is an important predictor of CID status, and was more likely to explain CID than years abusing drugs and alcohol in our clinical sample. Trauma-informed concurrent treatment for 3 clinical conditions of CID, childhood maltreatment, and SUD is needed for the majority of individuals seeking treatment for SUD.