{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:13:52Z","timestamp":1787019232291,"version":"build-2736575974"},"reference-count":37,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trauma, Violence, &amp; Abuse"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>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 I\u00b2 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.<\/jats:p>","DOI":"10.1177\/15248380251325193","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T06:21:04Z","timestamp":1742278864000},"page":"731-740","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Childhood Emotional Maltreatment and Substance Use in Adolescents: A Mini Multilevel Meta-Analytical Review"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2403-2368","authenticated-orcid":false,"given":"Mohammad","family":"Hashim","sequence":"first","affiliation":[{"name":"Jamia Millia Islamia, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hina","family":"Sheel","sequence":"additional","affiliation":[{"name":"De Montfort University, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-5434","authenticated-orcid":false,"given":"Usama","family":"Rehman","sequence":"additional","affiliation":[{"name":"De Montfort University, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Baiden P. Stewart S. L. Dunnen W. D. (2014). Childhood abuse and cannabis use among adolescents with mental health needs in Ontario Canada. Journal of Substance Use 19(1\u20132) 18\u201324. https:\/\/doi.org\/10.3109\/14659891.2012.727522","DOI":"10.3109\/14659891.2012.727522"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Barahmand U. Khazaee A. Hashjin G. S. (2016). Emotion dysregulation mediates between childhood emotional abuse and motives for substance use. Archives of Psychiatric Nursing 30(6) 653\u2013659. https:\/\/doi.org\/10.1016\/j.apnu.2016.02.007","DOI":"10.1016\/j.apnu.2016.02.007"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Belfrage A. Mj\u00f8lhus Nj\u00e5 A. L. Lunde S. \u00c5rstad J. Fodstad E. C. Lid T. G. Erga A. H. (2023). Traumatic experiences and PTSD symptoms in substance use disorder: A comparison of recovered versus current users. Nordisk Alkohol- & Narkotikatidskrift: NAT 40(1) 61\u201375. https:\/\/doi.org\/10.1177\/14550725221122222","DOI":"10.1177\/14550725221122222"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Buckle S. K. Lancaster S. Powell M. B. Higgins D. J. (2005). The relationship between child sexual abuse and academic achievement in a sample of adolescent psychiatric inpatients. Child Abuse & Neglect 29(9) 1031\u20131047. https:\/\/doi.org\/10.1016\/j.chiabu.2004.12.013","DOI":"10.1016\/j.chiabu.2004.12.013"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Campbell A. T. (2010). Therapeutic jurisprudence: A framework for evidence-informed health care policymaking. International Journal of Law and Psychiatry 33(5\u20136) 281\u2013292. https:\/\/doi.org\/10.1016\/j.ijlp.2010.09.001","DOI":"10.1016\/j.ijlp.2010.09.001"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Casey B. Jones R. M. (2010). Neurobiology of the adolescent brain and behavior. Journal of the American Academy of Child and Adolescent Psychiatry 49(12) 1189\u20131285. https:\/\/doi.org\/10.1016\/j.jaac.2010.08.017","DOI":"10.1016\/j.jaac.2010.08.017"},{"key":"e_1_3_3_8_1","doi-asserted-by":"crossref","unstructured":"Cecil C. A. M. Viding E. Fearon P. Glaser D. McCrory E. J. (2017). Disentangling the mental health impact of childhood abuse and neglect. Child Abuse & Neglect 63 106\u2013119. https:\/\/doi.org\/10.1016\/j.chiabu.2016.11.024","DOI":"10.1016\/j.chiabu.2016.11.024"},{"key":"e_1_3_3_9_1","doi-asserted-by":"crossref","unstructured":"Cheung M. W.-L. (2014). Modeling dependent effect sizes with three-level meta-analyses: A structural equation modeling approach. Psychological Methods 19(2) 211\u2013229. https:\/\/doi.org\/10.1037\/a0032968","DOI":"10.1037\/a0032968"},{"key":"e_1_3_3_10_1","doi-asserted-by":"crossref","unstructured":"Clarke P. B. Lewis T. F. Myers J. E. Henson R. A. Hill B. (2020). Wellness emotion regulation and relapse during substance use disorder treatment. Journal of Counseling & Development 98(1) 17\u201328. https:\/\/doi.org\/10.1002\/jcad.12296","DOI":"10.1002\/jcad.12296"},{"key":"e_1_3_3_11_1","doi-asserted-by":"crossref","unstructured":"De Oliveira I. R. Matos-Ragazzo A. C. Zhang Y. Vasconcelos N. M. Velasquez M. L. Reis D. Ribeiro M. G. Da Rocha M. M. Rosario M. C. Stallard P. Cecil C. A. M. (2018). Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth. Child Abuse & Neglect 80 312\u2013323. https:\/\/doi.org\/10.1016\/j.chiabu.2018.03.021","DOI":"10.1016\/j.chiabu.2018.03.021"},{"key":"e_1_3_3_12_1","doi-asserted-by":"crossref","unstructured":"Dir A. L. Hulvershorn L. A. (2019). Sex differences in adolescent neurobiological risk for substance use and substance use disorders. Current Addiction Reports 6(4) 514\u2013521. https:\/\/doi.org\/10.1007\/s40429-019-00276-w","DOI":"10.1007\/s40429-019-00276-w"},{"key":"e_1_3_3_13_1","doi-asserted-by":"crossref","unstructured":"Doyle C. (1997). Emotional abuse of children: Issues for intervention. Child Abuse Review 6(5) 330\u2013342. https:\/\/doi.org\/10.1002\/(SICI)1099-0852(199712)6:5<330::AID-CAR355>3.0.CO;2-C","DOI":"10.1002\/(SICI)1099-0852(199712)6:5<330::AID-CAR355>3.3.CO;2-3"},{"key":"e_1_3_3_14_1","doi-asserted-by":"crossref","unstructured":"Fallon I. P. Tanner M. K. Greenwood B. N. Baratta M. V. (2020). Sex differences in resilience: Experiential factors and their mechanisms. European Journal of Neuroscience 52(1) 2530\u20132547. https:\/\/doi.org\/10.1111\/ejn.14639","DOI":"10.1111\/ejn.14639"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.02.033"},{"key":"e_1_3_3_16_1","doi-asserted-by":"crossref","unstructured":"Harrer M. Cuijpers P. Furukawa T. A. Ebert D. D. (2021). Doing Meta-Analysis with R: A Hands-On Guide (1st ed.). Chapman and Hall\/CRC. https:\/\/doi.org\/10.1201\/9781003107347","DOI":"10.1201\/9781003107347"},{"key":"e_1_3_3_17_1","doi-asserted-by":"crossref","unstructured":"Hashim M. Alimoradi Z. Pakpour A. Pfaltz M. Ansari S. Asif R. Iqbal N. (2024). Association of childhood emotional maltreatment with adolescents\u2019 psychopathology: A systematic review and meta-analysis. Trauma Violence and Abuse 25(4) 2986\u20133004. https:\/\/doi.org\/10.1177\/15248380241233538","DOI":"10.1177\/15248380241233538"},{"key":"e_1_3_3_18_1","doi-asserted-by":"crossref","unstructured":"Hashim M. Iqbal N. Halligan S. Alimoradi Z. Pfaltz M. Farooqi S. R. Khan I. Gal\u00e1n C. A. Vostanis P. (2024). Association of childhood sexual abuse with adolescent\u2019s psychopathology: A systematic review and meta-analysis. Trauma Violence & Abuse 26(3) 483\u2013496. https:\/\/doi.org\/10.1177\/15248380241281365","DOI":"10.1177\/15248380241281365"},{"key":"e_1_3_3_19_1","doi-asserted-by":"crossref","unstructured":"Hashim M. Osmany M. Alimoradi Z. Dar K. A. Iqbal N. (2024). Prevalence of social anxiety during COVID-19 pandemic: A systematic review and meta-analysis. Current Psychology 43(46) 35604\u201335615. https:\/\/doi.org\/10.1007\/s12144-024-06617-x","DOI":"10.1007\/s12144-024-06617-x"},{"key":"e_1_3_3_20_1","doi-asserted-by":"crossref","unstructured":"Hawkins J. D. Catalano R. F. Miller J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin 112(1) 64. https:\/\/doi.org\/10.1037\/0033-2909.112.1.64","DOI":"10.1037\/0033-2909.112.1.64"},{"key":"e_1_3_3_21_1","doi-asserted-by":"crossref","unstructured":"Herzog R. \u00c1lvarez-Pasquin M. J. D\u00edaz C. Del Barrio J. L. Estrada J. M. Gil \u00c1. (2013). Are healthcare workers\u2019 intentions to vaccinate related to their knowledge beliefs and attitudes? A systematic review. BMC Public Health 13(1) 154. https:\/\/doi.org\/10.1186\/1471-2458-13-154","DOI":"10.1186\/1471-2458-13-154"},{"key":"e_1_3_3_22_1","doi-asserted-by":"crossref","unstructured":"Hoeve M. Colins O. F. Mulder E. A. Loeber R. Stams G. J. J. M. Vermeiren R. R. J. M. (2015). The association between childhood maltreatment mental health problems and aggression in justice-involved boys. Aggressive Behavior 41(5) 488\u2013501. https:\/\/doi.org\/10.1002\/ab.21586","DOI":"10.1002\/ab.21586"},{"key":"e_1_3_3_23_1","doi-asserted-by":"crossref","unstructured":"Kim J. Williams S. (2009). Linking childhood maltreatment to substance use in college students: The mediating role of self-worth contingencies. Journal of Aggression Maltreatment & Trauma 18(1) 88\u2013105. https:\/\/doi.org\/10.1080\/10926770802616399","DOI":"10.1080\/10926770802616399"},{"key":"e_1_3_3_24_1","doi-asserted-by":"crossref","unstructured":"Lansford J. E. Deater-Deckard K. Dodge K. A. Bates J. E. Pettit G. S. (2004). Ethnic differences in the link between physical discipline and later adolescent externalizing behaviors. Journal of Child Psychology and Psychiatry and Allied Disciplines 45(4) 801\u2013812. https:\/\/doi.org\/10.1111\/j.1469-7610.2004.00273.x","DOI":"10.1111\/j.1469-7610.2004.00273.x"},{"key":"e_1_3_3_25_1","doi-asserted-by":"crossref","unstructured":"Liberati A. Altman D. G. Tetzlaff J. Mulrow C. Gotzsche P. C. Ioannidis J. P. A. Clarke M. Devereaux P. J. Kleijnen J. Moher D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ 339(jul21 1) b2700\u2013b2700. https:\/\/doi.org\/10.1136\/bmj.b2700","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_3_3_26_1","doi-asserted-by":"crossref","unstructured":"Liu X.-Q. Guo Y.-X. Wang X. (2023). Delivering substance use prevention interventions for adolescents in educational settings: A scoping review. World Journal of Pschiatry 13(7) 409. https:\/\/doi.org\/10.5498\/wjp.v13.i7.409","DOI":"10.5498\/wjp.v13.i7.409"},{"key":"e_1_3_3_27_1","doi-asserted-by":"crossref","unstructured":"Luthar S. S. Mendes S. H. (2020). Trauma-informed schools: Supporting educators as they support the children. International Journal of School & Educational Psychology 8(2) 147\u2013157. https:\/\/doi.org\/10.1080\/21683603.2020.1721385","DOI":"10.1080\/21683603.2020.1721385"},{"key":"e_1_3_3_28_1","doi-asserted-by":"crossref","unstructured":"Molnar B. E. Beatriz E. D. Beardslee W. R. (2016). Community-level approaches to child maltreatment prevention. Trauma Violence & Abuse 17(4) 387\u2013397. https:\/\/doi.org\/10.1177\/1524838016658879","DOI":"10.1177\/1524838016658879"},{"key":"e_1_3_3_29_1","doi-asserted-by":"crossref","unstructured":"Moran P. B. Vuchinich S. Hall N. K. (2004). Associations between types of maltreatment and substance use during adolescence. Child Abuse & Neglect 28(5) 565\u2013574. https:\/\/doi.org\/10.1016\/j.chiabu.2003.12.002","DOI":"10.1016\/j.chiabu.2003.12.002"},{"key":"e_1_3_3_30_1","doi-asserted-by":"crossref","unstructured":"Morelen D. Shaffer A. (2012). Understanding clinical legal and ethical issues in child emotional maltreatment. Journal of Aggression Maltreatment & Trauma 21(2) 188\u2013201. https:\/\/doi.org\/10.1080\/10926771.2012.639054","DOI":"10.1080\/10926771.2012.639054"},{"key":"e_1_3_3_31_1","doi-asserted-by":"crossref","unstructured":"Morgan R. L. Whaley P. Thayer K. A. Sch\u00fcnemann H. J. (2018). Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environment International 121(Pt 1) 1027\u20131031. https:\/\/doi.org\/10.1016\/j.envint.2018.07.015","DOI":"10.1016\/j.envint.2018.07.015"},{"key":"e_1_3_3_32_1","doi-asserted-by":"crossref","unstructured":"Reading R. Bissell S. Goldhagen J. Harwin J. Masson J. Moynihan S. Parton N. Pais M. S. Thoburn J. Webb E. (2009). Promotion of children\u2019s rights and prevention of child maltreatment. The Lancet 373(9660) 332\u2013343. https:\/\/doi.org\/10.1016\/S0140-6736(08)61709-2","DOI":"10.1016\/S0140-6736(08)61709-2"},{"key":"e_1_3_3_33_1","doi-asserted-by":"crossref","unstructured":"Schlensog-Schuster F. Keil J. Von Klitzing K. Gniewosz G. Schulz C. C. Schlesier-Michel A. Mayer S. Stadelmann S. D\u00f6hnert M. Klein A. M. Sierau S. Manly J. T. Sheridan M. A. White L. O. (2024). From Maltreatment to psychiatric disorders in childhood and adolescence: The relevance of emotional maltreatment. Child Maltreatment 29(1) 142\u2013154. https:\/\/doi.org\/10.1177\/10775595221134248","DOI":"10.1177\/10775595221134248"},{"key":"e_1_3_3_34_1","doi-asserted-by":"crossref","unstructured":"Schober P. Boer C. Schwarte L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia 126(5) 1763\u20131768. https:\/\/doi.org\/10.1213\/ANE.0000000000002864","DOI":"10.1213\/ANE.0000000000002864"},{"key":"e_1_3_3_35_1","doi-asserted-by":"crossref","unstructured":"Tanaka M. Wekerle C. Schmuck M. L. Paglia-Boak A. (2011). The linkages among childhood maltreatment adolescent mental health and self-compassion in child welfare adolescents. Child Abuse & Neglect 35(10) 887\u2013898. https:\/\/doi.org\/10.1016\/j.chiabu.2011.07.003","DOI":"10.1016\/j.chiabu.2011.07.003"},{"key":"e_1_3_3_36_1","doi-asserted-by":"crossref","unstructured":"Vannini P. Gagliardi G. P. Kuppe M. Dossett M. L. Donovan N. J. Gatchel J. R. Quiroz Y. T. Premnath P. Y. Amariglio R. Sperling R. A. (2021). Stress resilience and coping strategies in a sample of community-dwelling older adults during COVID-19. Journal of Psychiatric Research 138 176\u2013185. https:\/\/doi.org\/10.1016\/j.jpsychires.2021.03.050","DOI":"10.1016\/j.jpsychires.2021.03.050"},{"key":"e_1_3_3_37_1","doi-asserted-by":"crossref","unstructured":"Villalta L. Smith P. Hickin N. Stringaris A. (2018). Emotion regulation difficulties in traumatized youth: A meta-analysis and conceptual review. European Child & Adolescent Psychiatry 27(4) 527\u2013544. https:\/\/doi.org\/10.1007\/s00787-018-1105-4","DOI":"10.1007\/s00787-018-1105-4"},{"key":"e_1_3_3_38_1","doi-asserted-by":"crossref","unstructured":"Xiao Z. Murat Baldwin M. Wong S. C. Obsuth I. Meinck F. Murray A. L. (2023). The impact of childhood psychological maltreatment on mental health outcomes in adulthood: A systematic review and meta-analysis. Trauma Violence & Abuse 24(5) 3049\u20133064. https:\/\/doi.org\/10.1177\/15248380221122816","DOI":"10.1177\/15248380221122816"}],"container-title":["Trauma, Violence, &amp; Abuse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248380251325193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15248380251325193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248380251325193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:16:27Z","timestamp":1782346587000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15248380251325193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/15248380251325193"],"URL":"https:\/\/doi.org\/10.1177\/15248380251325193","relation":{},"ISSN":["1524-8380","1552-8324"],"issn-type":[{"value":"1524-8380","type":"print"},{"value":"1552-8324","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]}}}