Harford Thomas C, Yi Hsiao-ye, Grant Bridget F
CSR, Incorporated, 2107 Wilson Boulevard, Suite 1000, Arlington, VA 22201, USA.
National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Bethesda, MD 20892, USA.
Child Abuse Negl. 2014 Aug;38(8):1389-98. doi: 10.1016/j.chiabu.2014.02.011. Epub 2014 Mar 21.
The aim of this study is to examine associations among childhood physical, emotional, or sexual abuse and violence toward self (suicide attempts [SA]) and others (interpersonal aggression [IA]). Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2 (n=34,653). Multinomial logistic regression examined associations between type of childhood abuse and violence categories, adjusting for demographic variables, other childhood adversity, and DSM-IV psychiatric disorders. The prevalence of reported childhood abuse was 4.60% for physical abuse, 7.83% for emotional abuse, and 10.20% for sexual abuse. Approximately 18% of adults reported some form of violent behavior, distributed as follows: IA, 13.37%; SA, 2.64%; and SA with IA, 1.85%. After adjusting for demographic variables, other childhood adversity, and psychiatric disorders, each type of childhood abuse was significantly related to increased risk for each violence category as compared with the no violence category. Furthermore, the odds ratio of childhood physical abuse was significantly higher for SA with IA when compared with IA, and the odds ratio of childhood sexual abuse was significantly higher for SA and SA with IA when compared with IA. Childhood physical, emotional, and sexual abuse is directly related to the risk for violent behaviors to self and others. Both internalizing and externalizing psychiatric disorders impact the association between childhood abuse and violence. The inclusion of suicidal behaviors and interpersonal aggression and internalizing/externalizing psychiatric disorders within an integrated conceptual framework will facilitate more effective interventions for long-lasting effects of child abuse.
本研究旨在探讨童年期身体虐待、情感虐待或性虐待与针对自身的暴力行为(自杀未遂[SA])以及针对他人的暴力行为(人际攻击[IA])之间的关联。数据来自全国酒精及相关状况流行病学调查第1波和第2波(n = 34,653)。多项逻辑回归分析了童年虐待类型与暴力行为类别之间的关联,并对人口统计学变量、其他童年逆境和《精神疾病诊断与统计手册》第四版(DSM-IV)中的精神障碍进行了调整。报告的童年身体虐待患病率为4.60%,情感虐待患病率为7.83%,性虐待患病率为10.20%。约18%的成年人报告有某种形式的暴力行为,分布如下:人际攻击,13.37%;自杀未遂,2.64%;自杀未遂伴人际攻击,1.85%。在对人口统计学变量、其他童年逆境和精神障碍进行调整后,与无暴力行为类别相比,每种童年虐待类型均与各暴力行为类别的风险增加显著相关。此外,与人际攻击相比,童年身体虐待与自杀未遂伴人际攻击的比值比显著更高;与人际攻击相比,童年性虐待与自杀未遂以及自杀未遂伴人际攻击的比值比显著更高。童年期身体、情感和性虐待与针对自身和他人的暴力行为风险直接相关。内化性和外化性精神障碍均影响童年虐待与暴力行为之间的关联。将自杀行为、人际攻击以及内化性/外化性精神障碍纳入一个综合概念框架内,将有助于制定更有效的干预措施,以应对儿童虐待的长期影响。