What could be a potential long-term impact on children who have been abused?

The choice highlighting the increased risk of substance abuse and relational issues accurately reflects the potential long-term impacts on children who have experienced abuse. Research consistently shows that children with a history of abuse are at a higher risk for developing various psychological and behavioral problems, including substance use disorders. This link often stems from the trauma they have experienced, leading to unhealthy coping mechanisms, such as turning to drugs or alcohol.

Additionally, relational issues are common among survivors of abuse. Children can struggle with trust, intimacy, and communication in their relationships, both with peers and in future romantic partnerships. The trauma may shape their ability to form healthy connections, resulting in patterns of conflict, isolation, or difficulty in maintaining friendships and other social relationships.

The other options do not accurately capture the realities faced by abused children. Stronger academic performance and career aspirations, increased happiness and social engagement, and enhanced decision-making skills are generally seen as outcomes associated with positive environments, support systems, and resilience, which may not be present for children who have endured abuse. Thus, the answer emphasizing substance abuse and relational issues illustrates the unfortunate reality many survivors must confront as they navigate their lives.