Widom Cathy Spatz, White Helene Raskin, Czaja Sally J, Marmorstein Naomi R
Department of Psychiatry, New Jersey Medical School, Newark, NJ, USA.
J Stud Alcohol Drugs. 2007 May;68(3):317-26. doi: 10.15288/jsad.2007.68.317.
The purpose of this study was to determine the long-term effects of child abuse and neglect on alcohol use in middle adulthood.
Individuals with documented cases of childhood physical and sexual abuse and/or neglect (n = 500) and matched controls (n = 396) from a metropolitan county in the Midwest were followed and interviewed in middle adulthood. Outcomes were Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnoses of alcohol abuse or dependence in young adulthood (age 29) and excessive drinking in middle adulthood (age 40).
Women with documented histories of child abuse or neglect reported higher past-year typical quantity (p < .01) and past-month number of days drinking eight or more drinks (p < .05) than nonabused/nonneglected women. Controlling for parental alcohol/drug problems, the effect of child maltreatment on excessive drinking in middle adulthood was not significant for women. For women, the final structural equation model revealed an indirect path through alcohol diagnosis in young adulthood (p < .05) to excessive drinking in middle adulthood (p < .001) but no direct path from child abuse and neglect to excessive drinking in middle adulthood. For men, there were no significant paths from child abuse and neglect to alcohol diagnosis in young adulthood or excessive drinking in middle adulthood. For men and women, parental alcohol/drug problems had a significant indirect effect on the offspring's drinking in middle adulthood (p < .001) through young adult alcohol diagnosis (p < .001).
Consequences of abuse and neglect persist into middle adulthood for women, through continuation of earlier alcohol problems, suggesting the need for interventions throughout the life course. The influence of parental alcohol and drug problems warrants further attention.
本研究旨在确定儿童期受虐待和忽视对中年期饮酒的长期影响。
对来自美国中西部一个大都市县的有儿童期身体虐待、性虐待和/或忽视记录的个体（n = 500）以及匹配的对照组（n = 396）进行跟踪，并在中年期进行访谈。结果指标为《精神疾病诊断与统计手册》第三版修订本中关于青年期（29岁）酒精滥用或依赖的诊断以及中年期（40岁）过度饮酒的诊断。
有儿童期虐待或忽视记录的女性报告的过去一年典型饮酒量（p <.01）以及过去一个月中饮酒8杯及以上的天数（p <.05）高于未受虐待/未被忽视的女性。在控制了父母的酒精/药物问题后，儿童期虐待对中年期过度饮酒的影响对女性而言并不显著。对于女性，最终的结构方程模型显示出一条从青年期酒精诊断（p <.05）到中年期过度饮酒（p <.001）的间接路径，但没有从儿童期虐待和忽视到中年期过度饮酒的直接路径。对于男性，没有从儿童期虐待和忽视到青年期酒精诊断或中年期过度饮酒的显著路径。对于男性和女性，父母的酒精/药物问题通过青年期酒精诊断（p <.001）对后代中年期饮酒有显著的间接影响（p <.001）。
虐待和忽视的后果在女性中年期持续存在，通过早期酒精问题的延续，这表明需要在整个生命过程中进行干预。父母酒精和药物问题的影响值得进一步关注。
