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伴侣的酒精问题对女性身心健康的影响。

The impact of partner alcohol problems on women's physical and mental health.

作者信息

Dawson Deborah A, Grant Bridget F, Chou S Patricia, Stinson Frederick S

机构信息

Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, NIAAA/LEB Room 3071, 5635 Fishers Lane, MSC 9304, Bethesda, Maryland 20892-9304, USA.

出版信息

J Stud Alcohol Drugs. 2007 Jan;68(1):66-75. doi: 10.15288/jsad.2007.68.66.

Abstract

OBJECTIVE

The purpose of this study was to examine the association between partner alcohol problems and selected physical and mental health outcomes among married or cohabiting women, before and after adjusting for potential confounders, and to compare these associations with those reflecting the impact of the women's own alcohol-use disorders (AUDs).

METHOD

This analysis is based on data from the Wave 1 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a cross-sectional, retrospective survey of a nationally representative sample of U.S. adults 18 years of age and older. The analytic sample consisted of 11,683 married or cohabiting women. Classification of their own AUDs was based on self-report of symptoms operationalizing the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for alcohol abuse or dependence. Current partner alcohol problems were identified by the women after an explanation that recapitulated the essence of these criteria. Physical health measures included criminal victimization of any type, injury, emergency-department and hospital visits, self-reported fair or poor health, and Short Form-12 Health Survey Questionnaire, Version 2 (SF-12v2), -based physical quality of life. Mental health measures included DSM-IV mood and anxiety disorders, number of past-year stressors, and SF-12v2-based mental/psychological quality of life. All measures refer to the 12 months immediately preceding the interview. Associations were tested using bivariate and multivariate logistic and linear regression models.

RESULTS

At the bivariate level, women whose partners had alcohol problems were more likely to experience victimization, injury, mood disorders, anxiety disorders, and being in fair or poor health than women whose partners did not have alcohol problems (odds ratio [OR]: 1.7-4.5). They also experienced more life stressors and had lower mental/psychological quality-of-life scores. All but one of these differences remained significant after adjusting for potential confounders, which included the significantly greater rates of substance use and AUDs among women whose partners had alcohol problems. Although the magnitudes of the ORs decreased after adjustment (adjusted OR [AOR]: 2.1-3.4), they generally exceeded the AORs associated with the women's own AUDs.

CONCLUSIONS

Partner alcohol problems pose diverse health threats for women that go beyond their well-documented association with domestic violence. Mood, anxiety, stress, general health, and quality-of-life problems should be addressed by groups that provide couples' treatment or counseling to female partners of alcoholics.

摘要

目的

本研究旨在探讨已婚或同居女性伴侣的酒精问题与特定身心健康结局之间的关联,在调整潜在混杂因素前后进行比较,并将这些关联与反映女性自身酒精使用障碍(AUDs)影响的关联进行对比。

方法

本分析基于2001 - 2002年全国酒精及相关状况流行病学调查(NESARC)第一波的数据,这是一项对18岁及以上美国成年人具有全国代表性样本的横断面回顾性调查。分析样本包括11,683名已婚或同居女性。她们自身AUDs的分类基于依据《精神疾病诊断与统计手册》第四版(DSM - IV)中酒精滥用或依赖标准对症状的自我报告。在向女性解释这些标准的本质后,由她们确定当前伴侣的酒精问题。身体健康指标包括任何类型的刑事受害、受伤、急诊和住院就诊、自我报告的健康状况一般或较差,以及基于简短健康调查问卷第2版(SF - 12v2)的身体生活质量。心理健康指标包括DSM - IV中的情绪和焦虑障碍、过去一年的应激源数量,以及基于SF - 12v2的心理/精神生活质量。所有指标均指访谈前紧接的12个月。使用双变量和多变量逻辑回归及线性回归模型检验关联。

结果

在双变量水平上,伴侣有酒精问题的女性比伴侣没有酒精问题的女性更有可能经历受害、受伤、情绪障碍、焦虑障碍以及健康状况一般或较差(优势比[OR]:1.7 - 4.5)。她们也经历更多生活应激源,且心理/精神生活质量得分更低。在调整潜在混杂因素后,除一项差异外,所有这些差异仍具有统计学意义,潜在混杂因素包括伴侣有酒精问题的女性中物质使用和AUDs发生率显著更高。尽管调整后OR值有所下降(调整后OR[AOR]:2.1 - 3.4),但它们总体上超过了与女性自身AUDs相关的AOR值。

结论

伴侣的酒精问题对女性构成了多种健康威胁,这超出了其与家庭暴力之间已充分记录的关联。为酗酒者的女性伴侣提供夫妻治疗或咨询的团体应关注情绪、焦虑、压力、总体健康和生活质量问题。

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