Child maltreatment and the development of substance use and disorder

Dante Cicchetti, Elizabeth D. Handley

Research output: Contribution to journalReview articlepeer-review

93 Scopus citations


Children who experience maltreatment are at well-documented risk for the development of problematic substance use and disorder in adolescence and beyond. This review applies a developmental psychopathology framework to discuss the complex multilevel probabilistic pathways from child maltreatment to substance use and substance use disorder (SUD). We begin with an overview of the myriad vulnerabilities associated with child maltreatment, including the development of substance use and SUD. Prominent pathways that may potentiate liability for SUD are discussed. Specifically, we highlight the robust empirical support for the prominent externalizing pathway of risk, and also discuss the state of the research regarding the internalizing pathway. Consistent with the developmental psychopathology perspective, we then review biological processes such as neuroendrocrine mechanisms, allostatic load, and neurobiological pathways that may underlie child maltreatment risk, as well as discuss broader contextual issues. Elucidating the processes underlying the development of substance use and disorder among children exposed to this form of early adversity is paramount for not only informing developmental theories, but also designing effective prevention and intervention programs. Thus, implications for preventive interventions are provided. Finally, critical next steps for research within the area of child maltreatment and the developmental psychopathology of substance use and SUD are proffered.

Original languageEnglish (US)
Article number100144
JournalNeurobiology of Stress
StatePublished - Feb 2019

Bibliographical note

Funding Information:
We thank the National Institute on Drug Abuse for their support of this work (R01-DA017741; R01-DA12903).

Publisher Copyright:
© 2019 The Authors


  • Child maltreatment
  • Developmental cascades
  • Multiple levels of analysis
  • Prevention and intervention
  • Substance use
  • Substance use disorder


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