Walsh Kate, Keyes Katherine M, Koenen Karestan C, Hasin Deborah
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA.
J Psychiatr Res. 2015 Mar;62:7-13. doi: 10.1016/j.jpsychires.2015.01.002. Epub 2015 Jan 14.
No population-representative US study has examined how lifetime exposure to gender-based violence (GBV) is related to a broad range of mood/anxiety and substance use disorders. The current study advances the literature by examining the relative contributions of developmental timing of earliest GBV exposure and amount of lifetime GBV exposure on risk for eight mood/anxiety and ten substance use disorders. Participants were 20,089 women from wave 2 (2004-2005) of the National Epidemiologic Survey of Alcohol and Related Conditions. Women reporting lifetime GBV (25%; n = 5284) had 3.6 and 2.5 times the odds of meeting lifetime mood/anxiety and substance use disorder criteria, respectively. Number of types and number of incidents of GBV were associated with risk for both types of disorders in a dose-response fashion; when examined simultaneously, number of types of GBV was the stronger predictor of mood/anxiety and substance use disorders. Relative to those who first experienced GBV during adulthood, first exposure during childhood and adolescence was associated with increased risk for mood/anxiety and substance use disorders. One in four women reported lifetime GBV, which had pernicious effects on mood/anxiety and substance use disorders, particularly for women who had experienced multiple types of GBV. The GBV effect varied by developmental period of exposure. Prevention of GBV is critical to reducing its burden. Among those exposed to GBV, clinicians should consider assessing a range of disorders and providing integrated treatment targeting multiple outcomes.
美国尚无具有人口代表性的研究探讨一生中遭受基于性别的暴力(GBV)与广泛的情绪/焦虑及物质使用障碍之间的关系。本研究通过考察最早遭受GBV的发育时间以及一生中遭受GBV的次数对8种情绪/焦虑障碍和10种物质使用障碍风险的相对影响,推动了该领域的文献发展。研究对象为来自全国酒精及相关疾病流行病学调查第二轮(2004 - 2005年)的20,089名女性。报告一生中遭受过GBV的女性(25%;n = 5284)符合一生中情绪/焦虑障碍和物质使用障碍标准的几率分别是其他人的3.6倍和2.5倍。GBV的类型数量和事件数量与这两类障碍的风险均呈剂量反应关系;同时考察时,GBV的类型数量是情绪/焦虑障碍和物质使用障碍更强的预测因素。与成年期首次经历GBV的女性相比,儿童期和青春期首次接触GBV会增加情绪/焦虑障碍和物质使用障碍的风险。四分之一的女性报告一生中遭受过GBV,这对情绪/焦虑障碍和物质使用障碍有不良影响,尤其是对经历过多种GBV的女性。GBV的影响因接触的发育时期而异。预防GBV对于减轻其负担至关重要。在遭受GBV的人群中,临床医生应考虑评估一系列障碍,并提供针对多种结果的综合治疗。