《精神疾病诊断与统计手册》第四版中物质使用障碍在领养家庭和继亲家庭中的环境传播

Environmental transmission of DSM-IV substance use disdorders in adoptive and step families.

作者信息

Newlin D B, Miles D R, van den Bree M B, Gupman A E, Pickens R W

机构信息

Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland 21224, USA.

出版信息

Alcohol Clin Exp Res. 2000 Dec;24(12):1785-94.

PMID:11141037

Abstract

BACKGROUND

One factor contributing to the 3- to 5-fold increase in risk for substance use disorders (SUDs) among children of alcoholics may be the rearing environment. These influences may include availability of substances, modeling of SUDs, inadequate parenting, or other factors. The contribution of parental environmental influences on offspring with SUDs may be estimated independently of genetic influences through assessment of adoptees raised by nonbiological parents.

METHODS

Relative risk of SUDs was assessed in adult adoptees (N = 442) of alcoholic and nonalcoholic adoptive parents as well as in stepchildren (N = 1859) with alcoholic or nonalcoholic stepfathers who participated in the community-based National Longitudinal Alcohol Epidemiologic Survey (NLAES).

RESULTS

Rearing by an alcoholic adoptive mother was associated with increased DSM-IV alcohol abuse. Rearing by an alcoholic adoptive father was predictive of adoptees' illicit drug use, as well as DSM-IV drug dependence. Rearing by an alcoholic stepfather was predictive of stepchild DSM-IV alcohol abuse, illicit drug use, and drug dependence, whereas an alcoholic stepmother was associated with increased illicit drug use in the stepchild. Alcoholism in adoptive parents or step parents did not increase risk for offspring DSM-IV alcohol dependence. In both adoptive and biological families, there was a subadditive interaction of mother by father alcoholism such that the rate of substance abuse when both parents were alcoholic was less than that expected based on the additive effects of each alcoholic parent.

CONCLUSIONS

Rearing by an alcoholic parent had a greater influence on alcohol abuse by offspring than on alcohol dependence. The increased risk of proband illicit drug use and drug dependence associated with paternal alcoholism suggested nonspecificity of environmental transmission. Both maternal and paternal cultural transmission effects influenced offspring SUDs.

摘要

背景

酗酒者子女患物质使用障碍（SUDs）的风险增加3至5倍，其促成因素之一可能是养育环境。这些影响因素可能包括物质的可得性、物质使用障碍的行为示范、不当养育或其他因素。通过评估由非亲生父母抚养的养子女，可以独立于遗传影响来估计父母环境影响对患有物质使用障碍的后代的作用。

方法

在参与基于社区的全国酒精流行病学纵向调查（NLAES）的成年养子女（N = 442）中，评估了由酗酒和不酗酒养父母抚养的子女患物质使用障碍的相对风险，同时也评估了有酗酒或不酗酒继父的继子女（N = 1859）患物质使用障碍的相对风险。

结果

由酗酒的养母抚养与《精神疾病诊断与统计手册》第四版（DSM-IV）中酒精滥用的增加有关。由酗酒的养父抚养可预测养子女的非法药物使用以及DSM-IV中的药物依赖。由酗酒的继父抚养可预测继子女DSM-IV中的酒精滥用、非法药物使用和药物依赖，而酗酒的继母则与继子女非法药物使用的增加有关。养父母或继父母酗酒并不会增加后代患DSM-IV酒精依赖的风险。在收养家庭和亲生家庭中，父母酗酒存在亚相加相互作用，即父母双方均酗酒时物质滥用的发生率低于基于每位酗酒父母相加效应所预期的发生率。