Latent Classes of Substance Use in Young Adult Survivors of Child Maltreatment and Adversity: A 20-Year Prospective Investigation

Persistent substance use during the transition into adulthood increases risk for long-term mental and physical health problems. Participants ( N = 483) and their caregivers were recruited at age 4 years due to exposure to (or high risk for) child abuse and/or neglect. Data on adverse childhood experiences (ACEs) were collected prospectively during participant ages 0–18 years between the 1990s and early 2000s. In 2012, participants reported past 12-month substance use at a follow-up online survey in young adulthood (M age = 23.8). A latent class analysis using nine dichotomous substance use indicators was fit to the data. Comparative fit indices favored a 4-class solution characterized by (1) high rates of tobacco and cannabis use ( n = 66), (2) high rates of heroin/non-prescription opioid and non-prescription tranquilizer/sedative use ( n = 21), (3) high rates of poly-substance use ( n = 21), and (4) low rates of substance use ( n = 375). Abstainers generally experienced fewer childhood adversities and adult IPV exposure relative to other classes and tended to report less substance use as adolescents. This work reinforces the prospective association between childhood adversity and problematic patterns of substance use observed in young adulthood, and offers key implications for providers, researchers, and policymakers.