A growing body of research is demonstrating that exposure to early childhood physical and sexual abuse is associated with adult outcomes including revictimization, substance use disorders, and numerous mental and physical health problems. A recent study examined the impact of early childhood abuse, including effects on 12-month treatment outcomes, in a population of 146 homeless women with children undergoing residential substance abuse treatment.

The study was a secondary analysis of data from the SAMHSA Homelessness Prevention Project and used the statistical technique of propensity scores to control for differences between women who had experienced early abuse and those who had not. Results of the study were as follows:

• 69% reported some form of childhood abuse, and most reported exposure to multiple forms of abuse (physical, sexual, emotional);
• 89% reported being abused at some point in their lives;
• women with early childhood abuse reported greater severity of dysfunctional psychological symptoms and functioning as well as poorer treatment outcomes in the areas of substance use, mental health, and recent trauma;
• no differences were found in either time (number of days) in treatment or treatment completion between abused and nonabused women. The differential response to treatment appeared due instead to a history of early childhood trauma.

Comments by Norma Finkelstein, PhD, LICSW:
The study findings reinforce the importance of improving both the identification and assessment of childhood abuse and trauma as well as developing treatment interventions for women that address trauma and co-occurring disorders. Counselors would benefit from increased training in the provision of trauma-informed, integrated treatment models of care.