Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Can J Psychiatry. 2012 Nov;57(11):677-86. doi: 10.1177/070674371205701105.
To examine the association between a history of 5 types of childhood maltreatment (that is, physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) and several substance use disorders (SUDs), including alcohol, sedatives, tranquilizers, opioids, amphetamines, cannabis, cocaine, hallucinogens, heroin, and nicotine, in a nationally representative US adult sex-stratified sample.
Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative US sample of adults aged 20 years and older (n = 34 653). Logistic regression models were conducted to understand the relations between 5 types of childhood maltreatment and SUDs separately among men and women after adjusting for sociodemographic variables and Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and II mental disorders.
All 5 types of childhood maltreatment were associated with increased odds of all individual SUDs among men and women after adjusting for sociodemographic variables, with the exception of physical neglect and heroin abuse or dependence, emotional neglect, and amphetamines and cocaine abuse or dependence among men (adjusted odds ratio range 1.3 to 4.7). After further adjustment for other DSM Axis I and II mental disorders, the relations between childhood maltreatment and SUDs were attenuated, but many remained statistically significant. Differences in the patterns of findings were noted for men and women for sexual abuse and emotional neglect.
This research provides evidence of the robust nature of the relations between many types of childhood maltreatment and many individual SUDs. The prevention of childhood maltreatment may help to reduce SUDs in the general population.
在一个具有全国代表性的美国成年性别分层样本中，研究 5 种类型的儿童期虐待（即身体虐待、性虐待、情感虐待、身体忽视和情感忽视）与几种物质使用障碍（SUDs）之间的关联，包括酒精、镇静剂、安定剂、阿片类药物、安非他命、大麻、可卡因、迷幻剂、海洛因和尼古丁。
数据来自全国酒精相关状况调查（NESARC），这是一个具有全国代表性的成年美国人样本，年龄在 20 岁及以上（n=34653）。在调整了社会人口统计学变量和精神疾病诊断与统计手册（DSM）轴 I 和 II 精神障碍后，进行逻辑回归模型，以了解 5 种类型的儿童期虐待与 SUDs 之间的关系，分别在男性和女性中。
在调整了社会人口统计学变量后，所有 5 种类型的儿童期虐待都与男性和女性所有个体 SUDs 的发生几率增加有关，除了身体忽视与海洛因滥用或依赖、情感忽视与安非他命和可卡因滥用或依赖之间的关系，在男性中（调整后的比值比范围为 1.3 至 4.7）。在进一步调整其他 DSM 轴 I 和 II 精神障碍后，儿童期虐待与 SUDs 之间的关系减弱，但许多仍具有统计学意义。对于男性和女性，性虐待和情感忽视的发现模式存在差异。
这项研究提供了证据，证明许多类型的儿童期虐待与许多个体 SUDs 之间存在着牢固的关系。预防儿童期虐待可能有助于减少普通人群中的 SUDs。
