Childhood Emotional Maltreatment and Substance Use in Adolescents: A Mini Multilevel Meta-Analytical Review

Abstract

This meta-analysis examines the association between childhood emotional maltreatment (CEM) and substance use, utilizing a multilevel meta-analytic approach to address the complexity of multiple effect sizes across studies. CEM, often perpetrated by family members or caregivers, is a significant predictor of various negative outcomes, including substance use, yet the variability in study designs, participant characteristics, and outcome measures has made it challenging to establish a clear relationship. By employing a multilevel model, this analysis captured variances both between and within studies, accounting for sampling differences and enhancing the precision of effect size estimates. Data from 6 studies, involving 7,624 participants (41.07% female, mean age 15.88), were analyzed. The studies, which used cross-sectional designs and assessed CEM using the Childhood Trauma Questionnaire, highlighted substance use issues, such as alcohol and cannabis consumption, among CEM-affected populations. Random-effects models were used throughout, and moderators, including participant demographics, type of CEM, and substance use, were explored to explain variability in findings. Results revealed significant heterogeneity, which was quantified using the I² statistic, and sensitivity analyses confirmed the robustness of the findings. This multilevel approach provided a more comprehensive understanding of the relationship between CEM and substance use, emphasizing the need for targeted interventions that address the specific role of childhood emotional abuse in adolescent substance use vulnerability.