Domestic violence and risk of internalizing and externalizing problems in adolescents living with relatives displaying substance use disorders

Objective To investigate the association between exposure to domestic violence and increased risk of internalizing and externalizing problems and substance use among adolescents living with relatives with substance use disorder (SUD) at a low-income community of São Paulo, Brazil. Methods A cross-sectional study was conducted with 102 adolescents aged 12-17 years (M = 14.2, SD = 1.7) who were living with relatives suffering from SUD. Outcomes were measured using the Youth Self-Report (YSR), psychosocial stress factors questionnaire, Drug Use Screening Inventory (DUSI) and Phrase Inventory of Intrafamily Child Abuse (PIICA). Results The sample presented high prevalence of emotional/behavioral problems with YSR’s scores in the clinical range for Internalizing Problems (24.5%), Externalizing Problems (21.6%), and Total Problems (26.5%). The presence of mental health problems predicted substance use (PR = 2.22; 95% CI = 1.2-4.13), and substance use predicted increased risk of mental health problems. Alcohol use predicted more than double the risk of emotional/behavioral problems (PR = 2.01; 95% CI = 1.08-3.76), while illicit drug use was associated with an almost threefold increase in the prevalence of Internalizing (PR = 2.87; 95% CI = 1.19-6.89) and Externalizing Problems (PR = 3.3; 95% CI = 1.35-8.04). Conclusion Adolescents of relatives with SUD are at risk of developing emotional and behavioral problems. These findings reinforce the need to develop public mental health policies, which include protective interventions to adolescents living in families affected by substance use disorders.