Childhood Sexual Victimization and Substance Abuse
In studies that do not distinguish between alcohol and drug use, substance abuse has been associated with childhood sexual abuse victimization in many samples. Bailey and McCloskey (2005) found an association between childhood sexual abuse and later substance use, controlling for other forms of child abuse, and maternal substance use, among other things. In their sample of 112 substance-abusing women, Simons et al. (2003) report that 67.9% had experienced sexual abuse. Bergen et al. reported an enormous increase in risk of “extreme substance abuse” among sexually abused girls and boys in their Australian sample (Bergen, Martin, Richardson, Allison, & Roeger, 2004).
In studies that look at illicit drug use, the findings have been quite consistent; sexual abuse victimization and later illicit drug use are correlated (e.g., Dembo et al., 1988; Kim & Williams, 2009; Salomon et al., 2002; Sartor et al., 2013). Robertson et al. (2008) found that sexual maltreatment was associated with both common drug use and hard drug use. There are two notable exceptions. Among male college students, Kim and Williams (2009) found that sexual abuse was not associated with drug use. Fondacaro, Holt, and Powell (1999) found that drug dependence was approximately equal in male inmates who had been sexually abused and those who had not. The sample of 303 inmates was drawn randomly from a jail and prison population. These findings suggest that the association may depend on several factors such as severity or persistence of abuse and the level of substance problems.
In studies that have focused on alcohol use, the findings have been less consistent. In one set of studies, sexually abused individuals have been shown to exhibit more alcohol dependence (e.g., Silverman et al., 1996), more alcohol abuse symptoms (Epstein, Saunders, Kilpatrick, & Resnick, 1998), and a greater likelihood of early onset alcohol use than nonabused (individuals Sartor et al., 2013). Kim and Williams (2009) found that sexual abuse was significantly associated with alcohol use but not drug use among their sample of male college students.
In another set of studies, however, we find contradictions. Dembo et al. (1988) report that sexual abuse was not associated with an index of alcohol use (while it was associated with drug use), and authors of an Australian study found no significant association between childhood sexual abuse and later frequency or quantity of alcohol consumption (Fleming, Mullen, Sibthorpe, & Bammer, 1999). In a study reported by Fondacaro et al. (1999), alcohol use was lower among male inmates who reported a history of sexual abuse victimization compared to those who did not.