Despite extensive evidence linking childhood exposure to adverse parenting and subsequent substance use, the extant research literature is more limited regarding individual difference factors that may moderate this association. This study examines the moderating role of anxiety sensitivity (AS) in the association between childhood exposure to parental threatening behaviors and substance use in a sample of late adolescents with clinical anxiety. One hundred fifty-one late adolescents with clinical levels of anxiety (18.61 years old; SD = 0.91) completed measures assessing childhood exposure to parental threatening behaviors, AS, alcohol/tobacco and illicit substance use frequency, negative affect, and history of negative life events. A significant moderating effect of AS in the association between childhood exposure to parental threatening behaviors and both average and illicit drug use was found—even after controlling for participants' age and history of negative life events. Specifically, for individuals with high AS, as childhood exposure to parental threatening behaviors increased so too did average and illicit substance use frequency; however, for individuals with low AS, childhood exposure to parental threatening behaviors was not significantly associated with either substance use frequency. Findings underscore the profound impact that early negative experiences have on substance use outcomes, particularly for individuals with high AS who have difficulty coping with and regulating physiological arousal. Limitations and clinical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]