Vulnerability to alcohol use disorders following early sexual abuse: The role of effortful control

The experience of child/adolescent sexual abuse (CASA) has been clearly linked to regulatory deficits, alcohol consumption, and an increased risk for alcohol abuse/dependence. However, it has been emphasized that not all CASA-exposed individuals share such experiences; rather, alternative factors may increase one's vulnerability to alcohol-related outcomes. This article aims to theoretically examine the potential influence of effortful control (EC), a key construct in the development of self-regulation, as a vulnerability factor to alcohol use disorders following CASA. Within the diathesis-stress model, research is reviewed which supports the relations among lower EC abilities, the experience of CASA exposure(s), and the enhanced likelihood of alcohol use disorder development. It is posited that as EC is lower, less severe CASA is needed to facilitate risk for alcohol-related psychopathology via impairment in neuroendocrine and behavioral regulation. In turn, CASA exposure may negatively impact developing EC and also increasing likelihood of alcohol use disorder development. To this end, a thorough description of EC is provided, shared pathways between EC and CASA are reviewed, and finally, these pathways are linked to alcohol use.