Substance problems in women with histories of child abuse, partner violence, and racism

This exploratory study examined associations of childhood abuse, male partner abuse, and distress from racism experiences with severity of substance use problems in a sample of 125 primarily low income, minority women seen in a large urban substance problem treatment program. It also examined relationships between these variables and the women's sense of perceived vulnerability, self-silencing beliefs and behaviors, and subjective distress.;Substance problem severity data were taken from the Addiction Severity Index used by the setting at intake. Additional data were collected through self-administered instruments: the Childhood Trauma Questionnaire, the revised Conflict Tactics Scale, the Index of Race Related Stress, the Women's Experience with Battering Scale, the Silencing the Self Scale, and the Trauma Symptom Checklist. The women's experiences were also explored through a number of researcher-developed questions.;High rates of childhood abuse, past male partner abuse, and current year male partner abuse were found in the study sample. For African American women racism experiences were frequent and distressful. Twenty-two percent of the women reported that they were at least partially influenced at some time to seek treatment for a substance use problem because of abuse by a male partner.;Based on bivariate correlations, severity of current year male partner psychological abuse, physical abuse, sexual abuse and injury were all positively associated with alcohol problem severity. Severity of past male partner psychological abuse was associated with alcohol problem severity while severity of past male partner sexual abuse was associated with drug problem severity. In African American women, distress from institutional racism was associated with drug problem severity. Severity of childhood abuse, past male partner abuse, current year male partner abuse, and drug problem were associated with self-silencing beliefs and behaviors. Severity of childhood abuse, racism distress, and drug problem were associated with subjective distress. Many women who answered open-ended questions described that they used substances to cope with histories of abuse.;The researcher proposes a model explaining the relationship of the other study variables to substance problem severity.