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Effects of Maltreatment on Physical Health in Female Adolescents and Young Women with a Substance Use Disorder

Stacy, Valerie A. (2012) Effects of Maltreatment on Physical Health in Female Adolescents and Young Women with a Substance Use Disorder. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Child abuse is a ubiquitous phenomenon with deleterious effects on physical health including poor general health, physical disability, medical diagnoses, and surgical procedures. Associated disruption to neurobiological systems may underlie additional health risk behaviors. Individuals abused as children are more likely to engage in antisocial behavior (ASB) and to carry a diagnosis of substance use disorder (SUD). Both ASB and SUD are associated with physical health problems. Although the prevalence of SUD and conduct disorder (CD) is higher in males, females with these diagnoses are among the most impaired. Consequences for females include affiliation with deviant males, intimate partner violence (IPV), risky sexual behavior, pregnancy, prostitution, and sexually transmitted diseases including HIV/AIDS.
This secondary analysis uses data collected from 1990 to 2000 as part of a longitudinal study exploring biobehavioral development in drug-abusing female adolescents. Participants are 189 females with SUD, 14 to 18 years of age at baseline and 19 to 23 at follow-up. Two cross-sectional and one longitudinal hypothesis were tested: 1) At ages 14-18 child abuse--physical (CPA), sexual (CSA), and emotional (CEA)--is associated with physical health problems, mediated by ASB and number of SUDs; 2) at ages 19-23 adult violence--physical (including but not limited to IPV and reflecting victimization, perpetration, and mutual violence), sexual, and emotional abuse--is associated with physical health problems, mediated by ASB2 and number of SUDs2; and 3) all predictors and mediators from visits 1 and 2--CPA, CSA, CEA, adult physical, sexual, and emotional abuse; ASB1,2, number of SUDs1,2--and physical health problems1 are associated with physical health problems2.
Contrary to expectations, at ages 14-18 only CSA was associated with physical health problems, mediated by ASB1. At ages 19-23 adult violence was not significantly associated with physical health problems2. ASB2 evidenced a direct relationship with physical health problems2, mediated by number of SUDs2. In the longitudinal analysis predictors significantly associated with physical health problems2 were physical health problems1 and number of SUDs2. These findings are discussed in light of current literature along with implications for treatment and intervention.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Stacy, Valerie
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee CoChairMezzich, Ada
Committee ChairKlein, Roger D.rklein@pitt.eduRKLEIN
Committee MemberGallagher, Jere
Committee MemberHirsch, Amanda J.hirscham@pitt.eduHIRSCHAM
Committee MemberFertman, Carl I.carl@pitt.eduCARL
Committee MemberKirisci, Leventlevent@pitt.eduLEVENT
Date: 30 August 2012
Date Type: Publication
Defense Date: 15 May 2012
Approval Date: 30 August 2012
Submission Date: 29 August 2012
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 128
Institution: University of Pittsburgh
Schools and Programs: School of Education > Psychology in Education
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: substance use disorder antisocial behavior child abuse child maltreatment physical health female
Date Deposited: 30 Aug 2012 12:31
Last Modified: 15 Nov 2016 14:02


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