One well-established outcome of child maltreatment is an increased likelihood of substance use in emerging adulthood. However, research identifying the indirect pathways that explain this relation is lacking, thereby limiting substance use prevention efforts for the child maltreatment population. The present study helped address this gap by accessing data from The Longitudinal Studies on Child Abuse and Neglect (LONGSCAN; n = 1,136), a prospective cohort study of child maltreatment from birth through age eighteen. Internalizing and externalizing problems at age twelve were examined as indirect effects of the relation between child maltreatment prior to age four and substance use at age eighteen. A multiple mediator model tested the total and specific indirect effects of internalizing and externalizing concerns while controlling for demographic risk factors. Results demonstrated that the total indirect effect for internalizing and externalizing behaviors was statistically significant, Standardized Point Estimate = 0.01, 95% CI: 0.00-0.02. Examination of the specific indirect effects revealed that only externalizing behaviors constituted an indirect pathway, Standardized Point Estimate = 0.01, 95% CI: 0.00-0.03. These results suggest that externalizing behaviors at the transition to adolescence are important intervention targets for reducing the risk for substance use in emerging adulthood in the child maltreatment population.

虐待儿童的一个公认结果是在成年后使用药物的可能性增加。然而，缺乏确定解释这种关系的间接途径的研究，从而限制了对虐待儿童人群的物质使用预防工作。本研究通过访问关于虐待和忽视儿童的纵向研究 (LONGSCAN; n= 1,136)，一项关于从出生到 18 岁儿童虐待的前瞻性队列研究。将 12 岁时的内化和外化问题作为 4 岁前虐待儿童与 18 岁物质使用之间关系的间接影响进行了检查。一个多中介模型测试了在控制人口风险因素的同时内化和外化关注点的总体和特定间接影响。结果表明，内化和外化行为的总间接影响具有统计学意义，标准化点估计= 0.01，95% CI：0.00-0.02。对特定间接影响的检查表明，只有外化行为构成了间接途径，标准化点估计= 0.01，95% CI：0.00-0.03。这些结果表明，向青春期过渡的外化行为是降低虐待儿童人群中成年后药物使用风险的重要干预目标。