Striking differences emerged in the childhood and adult histories of females and males. Although overall levels of childhood trauma were high, females were more likely than males to experience a range of problems in childhood. These difficulties for women were more likely to continue after the age of 18 in the form of unwanted sexual activity and violence as adults, frequently from a partner or boyfriend. Their introduction to heroin use was also more likely to be through a partner or boyfriend. In addition, women had a higher prevalence of most adult psychiatric disorders, suicidal thoughts, persistent suicidal thoughts, and suicide attempts (Chatham, et al., 1999; Chiang, et al., 2007). Evidence of a more dysfunctional family background for female participants confirms earlier studies identifying these family background factors as strongly associated with the development of both substance use disorders and mental illness in females (Graeven & Schaef, 1978; Hyman, Garcia, & Sinha, 2006). Women were likely to have sought treatment at a younger age and to remain in treatment for longer (Chatham, et al., 1999). Whether earlier treatment seeking is due to the higher rates of psychiatric problems, dysfunctional family background and adult violence experienced by women is unclear.
