Victims of childhood maltreatment often experience revictimization later in life. However, there is scant knowledge of the explanatory mechanisms that generate this phenomenon. Problematic substance use is a maladaptive coping strategy that may increase the risk of revictimization after maltreatment. We used linear regressions and mediation analyses to investigate the explanatory role of problematic substance use in the association between childhood maltreatment and violent revictimization in young adulthood. We analyzed linked survey-register data on a sample of senior high school graduates in Norway ( n = 3,156) who were followed longitudinally until ages 32 to 33 (2021). Ordinary least squares regression analyses showed that childhood maltreatment was associated with both problematic substance use and violent revictimization, adjusted for a wide range of covariates. Moreover, problematic substance use was associated with an increased risk of violent revictimization in young adulthood. Mediation analyses showed that about one eighth (12.0%) of the association between childhood maltreatment and violent revictimization was mediated by problematic substance use. Sensitivity tests indicated that the mediation may be susceptible to unmeasured confounding. Thus, it is unclear whether the mediating role of problematic substance use can be interpreted causally within a counterfactual framework. In conclusion, reducing problematic substance use among victims of childhood maltreatment may mitigate the risk of violent revictimization later in life. Early detection and tailored treatment of problematic substance use could be one way to prevent violent revictimization following childhood maltreatment. Therefore, equitable access to primary and specialized healthcare services is essential, both for victims of maltreatment and individuals with habits of (borderline) problematic substance use. However, the majority of the maltreatment-revictimization pathway (88.0%) is not statistically explained by substance use, which implies that other mechanisms are also at play.

中文翻译：

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童年早期的虐待和再受害：有问题的物质使用是中介吗？关联调查 - 注册数据研究


童年虐待的受害者通常在以后的生活中再次受害。然而，对于产生这种现象的解释机制知之甚少。有问题的物质使用是一种适应不良的应对策略，可能会增加虐待后再次受害的风险。我们使用线性回归和中介分析来研究有问题的物质使用在儿童期虐待与成年早期暴力再受害之间关联的解释作用。我们分析了挪威高中毕业生样本 （n = 3,156） 的关联调查登记数据，这些毕业生被纵向跟踪至 32 至 33 岁 （2021）。普通最小二乘回归分析显示，儿童期虐待与有问题的物质使用和暴力再受害有关，并针对广泛的协变量进行了调整。此外，有问题的物质使用与年轻年暴力再受害的风险增加有关。调解分析显示，儿童期虐待与暴力再受害之间的关联中约有八分之一 （12.0%） 是由有问题的物质使用介导的。敏感性测试表明，中介可能容易受到未测量的混杂的影响。因此，目前尚不清楚是否可以在反事实框架内对有问题物质使用的中介作用进行因果解释。总之，减少儿童虐待受害者的问题物质使用可能会降低以后生活中暴力再受害的风险。对有问题的物质使用进行早期发现和量身定制的治疗可能是防止儿童期虐待后暴力再受害的一种方法。 因此，公平获得初级和专业医疗保健服务至关重要，无论是对于虐待受害者还是有（边缘）有问题物质使用习惯的个人。然而，大多数虐待-再受害途径 （88.0%） 在统计学上不能用物质使用来解释，这意味着其他机制也在起作用。