Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Psychopharmacology (Berl). 2011 Nov;218(1):1-17. doi: 10.1007/s00213-011-2236-1. Epub 2011 Mar 5.
Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of chronicity and severity.
We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders.
Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities.
Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.
暴露于压力可能是导致饮酒和酒精使用障碍的重要因素。压力源在整个生命过程中出现在多个时间点，具有不同程度的持续性和严重性。
我们回顾了流行病学研究中关于四种不同压力源（灾难性事件、儿童虐待、常见的成人生活压力源在人际关系、职业、财务和法律领域，以及少数族裔压力）与饮酒和酒精使用障碍之间关系的证据。
研究普遍表明，暴露于恐怖主义或其他灾难后，饮酒量会增加。研究表明，酒精使用障碍的发生率几乎没有增加，但有酒精使用障碍病史的人更有可能报告饮酒以应对创伤事件。儿童虐待是青少年期饮酒和成年酒精使用障碍早期发病的一致风险因素，越来越多的证据表明，特定的多态性可能与儿童虐待相互作用，增加饮酒和障碍的风险。离婚和失业等生活压力事件会增加酒精障碍的风险，但在性别特异性方面，流行病学对这些关联的共识尚未达成。最后，歧视的感知和歧视的客观指标都与种族/民族和性少数群体的饮酒和酒精使用障碍有关。
综上所述，这些文献表明，暴露于压力是个体饮酒和酒精使用障碍风险差异的重要组成部分。然而，该研究的许多领域仍有待研究，包括更多关注各种压力源在酒精使用障碍过程中的作用，以及当个体暴露于压力源时潜在的风险调节因素。
