Hughes Tonda, McCabe Sean Esteban, Wilsnack Sharon C, West Brady T, Boyd Carol J
College of Nursing (MC 802), University of Illinois at Chicago, Chicago, IL 60612-7350, USA.
Addiction. 2010 Dec;105(12):2130-40. doi: 10.1111/j.1360-0443.2010.03088.x. Epub 2010 Sep 15.
There is consensus in the research literature that substance use disparities exist among sexual minority women and men; however, few studies have examined risk factors that may contribute to these disparities.
To compare reports of life-time victimization experiences in a US national sample of adult heterosexual and sexual minority women and men and to examine the relationships between victimization experiences and past-year substance use disorders.
DESIGN, PARTICIPANTS, MEASUREMENTS: The secondary data analyses used 2004-05 (wave 2) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data collected in structured diagnostic face-to-face interviews in the United States. Substance use disorders (SUDs) were defined according to DSM-IV criteria and included past-year alcohol abuse, alcohol dependence, drug abuse and drug dependence. The sample consisted of 34 653 adults aged 20 years and older; approximately 2% of the respondents self-identified as sexual minority (lesbian, gay or bisexual).
Results showed strong associations between victimization and any past-year SUDs and confirmed findings from several previous studies indicating that, compared with heterosexuals, sexual minority women and men are at heightened risk for life-time victimization. However, prevalence of the seven victimization experiences and the degree of association between individual victimization experiences and SUDs varied substantially across sexual minority subgroups. The childhood victimization variables-especially childhood neglect-showed the strongest and most consistent associations with SUDs. Odds of SUDs were generally higher among both female and male respondents, regardless of sexual identity, who reported multiple (two or more) victimization experiences than among those who reported no life-time victimization, suggesting a possible cumulative effect of multiple victimization experiences.
Higher rates of life-time victimization, particularly victimization experienced in childhood, may help to explain higher rates of substance use disorders among sexual minorities. However, more research is needed to understand better the complex relationships among sexual orientation, victimization and substance use.
研究文献中存在共识，即性少数群体中的女性和男性在物质使用方面存在差异；然而，很少有研究探讨可能导致这些差异的风险因素。
比较美国全国成年异性恋和性少数群体中的女性和男性一生受侵害经历的报告，并研究受侵害经历与过去一年物质使用障碍之间的关系。
设计、参与者、测量方法：二次数据分析使用了2004 - 2005年（第2波）美国国家酒精及相关疾病流行病学调查（NESARC）的数据，这些数据是在美国通过结构化诊断面对面访谈收集的。物质使用障碍（SUDs）根据《精神疾病诊断与统计手册》第四版（DSM - IV）标准定义，包括过去一年的酒精滥用、酒精依赖、药物滥用和药物依赖。样本包括34653名20岁及以上的成年人；约2%的受访者自我认同为性少数群体（女同性恋、男同性恋或双性恋）。
结果显示，受侵害与过去一年的任何物质使用障碍之间存在强烈关联，并证实了先前几项研究的结果，表明与异性恋者相比，性少数群体中的女性和男性一生受侵害的风险更高。然而，七种受侵害经历的患病率以及个体受侵害经历与物质使用障碍之间的关联程度在性少数群体亚组中差异很大。童年受侵害变量——尤其是童年期忽视——与物质使用障碍的关联最为强烈且一致。无论性取向如何，报告有多次（两次或更多次）受侵害经历的女性和男性受访者患物质使用障碍的几率通常高于报告无一生受侵害经历的受访者，这表明多次受侵害经历可能存在累积效应。
一生受侵害率较高，尤其是童年期经历的受侵害，可能有助于解释性少数群体中物质使用障碍率较高的现象。然而，需要更多研究来更好地理解性取向、受侵害和物质使用之间的复杂关系。
