The impact of child maltreatment and adverse childhood experiences on problematic alcohol use in a nationally representative survey of youth

Child maltreatment and problematic alcohol use in adolescence represent significant public health concerns with interrelated risks. We examined relationships between maltreatment exposure, non-maltreatment adversities, and problematic alcohol use in a representative sample of Australian youth aged 16–24 (n = 3,500). Structural equation models revealed that youth experiencing multiple maltreatment types reported greater levels of problematic alcohol use, even after controlling for non-maltreatment adversities, mental health, and gender. When accounting for co-occurrence, only sexual abuse was independently associated with alcohol problems. Household substance use was most strongly associated with youth problematic alcohol use among non-maltreatment adversities, while self-perceived racial bias showed an inverse relationship. Duration of maltreatment was directly associated with alcohol outcomes, though neither age of onset nor duration moderated the relationship between maltreatment exposure and alcohol use. These findings highlight the need for comprehensive prevention and intervention strategies addressing both maltreatment and family-level risk factors for problematic alcohol use.