Schuck A M, Widom C S
The University at Albany, School of Criminal Justice, NY, USA.
Child Abuse Negl. 2001 Aug;25(8):1069-92. doi: 10.1016/s0145-2134(01)00257-5.
Previous research has reported a relationship between childhood victimization experiences and alcohol problems in females. This paper has two distinct goals: (1) to determine whether it is appropriate to make a causal inference regarding the association between early child abuse and neglect and alcohol symptoms in females; and (2) to examine five potential mechanisms (depression, worthlessness, social isolation/loneliness, low self esteem, and using alcohol and/or drugs to cope) that may mediate the relationship between child abuse and neglect and alcohol symptomatology.
Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on sex, age, race, and approximate social class with nonabused and non-neglected children and followed prospectively into young adulthood. Subjects were administered a 2-h in-person interview, including the NIMH Diagnostic Interview Schedule (DIS-III-R) to assess alcohol use and abuse. Analyses are restricted to females in the sample (N = 582).
Structural equation modeling provides support for the inference that childhood victimization plays a causal role in the development of alcohol symptoms in women. There also is support for the hypothesized mediating role of two mechanisms (depression and using alcohol/drugs to cope), but not for the other mediators.
Evidence from this prospective study suggests that childhood victimization may be one of the causal factors in the development of alcohol problems in females. Interventions should bedirected at abused and neglected females of all ages to help them to deal with depression and to develop coping strategies to prevent the development of serious alcohol problems.
先前的研究报告了童年受侵害经历与女性酒精问题之间的关系。本文有两个不同的目标：（1）确定就早期儿童虐待和忽视与女性酒精症状之间的关联做出因果推断是否合适；（2）检验五种可能介导儿童虐待和忽视与酒精症状学之间关系的潜在机制（抑郁、无价值感、社会隔离/孤独、低自尊以及使用酒精和/或药物来应对）。
1967年至1971年经证实的儿童虐待和忽视案例，在性别、年龄、种族和大致社会阶层方面与未受虐待和未被忽视的儿童进行匹配，并对其进行前瞻性追踪直至成年早期。对受试者进行了一次长达2小时的面对面访谈，包括使用美国国立精神卫生研究所诊断访谈表（DIS-III-R）来评估酒精使用和滥用情况。分析仅限于样本中的女性（N = 582）。
结构方程模型为童年受侵害在女性酒精症状发展中起因果作用这一推断提供了支持。对于两种机制（抑郁和使用酒精/药物来应对）的假设中介作用也有支持，但对其他中介因素则没有。
这项前瞻性研究的证据表明，童年受侵害可能是女性酒精问题发展的因果因素之一。干预措施应针对所有年龄段受虐待和被忽视的女性，帮助她们应对抑郁，并制定应对策略以防止严重酒精问题的发展。
