Banducci Anne N, Hoffman Elana, Lejuez C W, Koenen Karestan C
Center for Addictions, Personality, and Emotion Research, University of Maryland College Park, Department of Psychology, 1147 Biology Psychology Building, College Park, MD 20742, United States.
Center for Addictions, Personality, and Emotion Research, University of Maryland College Park, Department of Psychology, 1147 Biology Psychology Building, College Park, MD 20742, United States.
Addict Behav. 2014 Oct;39(10):1522-7. doi: 10.1016/j.addbeh.2014.05.023. Epub 2014 Jun 2.
Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests that this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized that among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed.
We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse.
Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed.
Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings.
患有物质使用障碍（SUDs）的成年人报告的虐待儿童发生率高于未患SUDs的成年人。先前的研究表明，这种虐待行为与物质使用者中较高的精神病、创伤后应激障碍、身体健康问题、酒精依赖和大麻依赖发生率相关。对于物质使用者经历的与虐待儿童相关的其他问题知之甚少。我们假设，在患有SUDs的成年人中，虐待儿童与所有《精神疾病诊断与统计手册》（DSM-IV-TR）精神障碍、物质依赖及所评估的共病发生率升高有关。
我们使用DSM-IV-TR结构化临床访谈、人格障碍诊断工具和儿童创伤问卷（CTQ）对280名接受物质使用治疗的住院患者进行了评估。我们使用卡方检验和回归分析来确定精神障碍、物质依赖和共病发生率是否因虐待儿童而有所不同。
与我们的假设一致，CTQ得分较高与精神障碍（情绪障碍、焦虑障碍、精神病症状和人格障碍）和物质依赖（酒精依赖和可卡因依赖）发生率升高相关。此外，在报告有过虐待儿童经历的个体中，所有共病模式（如酒精依赖和焦虑共病）的发生率更高。在所有检查的物质依赖类型中，曾遭受虐待的个体所评估的所有精神障碍发生率均显著更高。
有过虐待经历的物质使用障碍个体，因其虐待经历，精神和物质使用障碍发生率尤其升高。这些发现对住院物质使用治疗环境中的个体具有重要的治疗意义。
