Associations of severe violence exposure with substance use, internet addiction, and telomere length among Taiwanese children

Few studies have examined the longitudinal association between severe childhood violence exposure, substance use, Internet addiction, and telomere length. This study sought to investigate this under-researched association, utilizing a sample of Taiwanese children. The sample included a control group of 126 children (girls: 48.4%) not exposed to violence and a high risk group of 119 children (girls: 29.4%) exposed to severe violence (polyvictimization, severe parental physical abuse, or repeated sexual victimization). Buccal cell telomere length (TL) was measured at 10-years old (2014). Substance use and Internet addiction were measured at 10-years old (2014), 12-years old (2016), 14-years old (2018), and 17-years old (2021). Multivariate regression analysis revealed that those in the high-risk group had significantly higher rates of alcohol use experience (ORs: 4.622-18.140, ps < .05) and higher levels of Internet addiction (β: 0.343-0.494, ps < .05) across time than did those in the control group. Short TL was associated with severe violence exposure (p = .043) and psychological disorders or symptoms (p = .048) in 2014. Those in the high-risk group with shorter TLs exhibited elevated rates of substance use (ps < 0.0167 with Bonferroni correction), from 10-years old (2014) to 17-years old (2021). Our findings, representing the first longitudinal study with an Asian population, highlight the long-lasting effects of severe child maltreatment on substance use. Timely preventive interventions should be implemented for children exposed to severe violence, especially those with telomere erosion.