Shultz Samuel K, Shaw Martha, McCormick Brett, Allen Jeff, Black Donald W
Department of Psychiatry, 2-126B MEB/Psychiatry Research, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242, USA.
J Gambl Stud. 2016 Sep;32(3):877-87. doi: 10.1007/s10899-015-9588-0.
This study investigates the characteristics of individuals with DSM-IV pathological gambling (PG) who experienced childhood maltreatment and rates of maltreatment occurring in their first-degree relatives (FDRs). 94 subjects with DSM-IV PG, 91 controls, and 312 FDRs were assessed for childhood maltreatment as part of a family study of PG. Maltreatment was evaluated using the Revised Childhood Experiences Questionnaire. The Family Assessment Device was used to evaluate the functionality of the PG subject's (or control's) family of origin. Data were analyzed using logistic regression by the method of generalized estimating equations. Rates of maltreatment were significantly higher in subjects with PG than controls (61 vs. 25 %, P < 0.001). Subjects with PG who experienced maltreatment were more likely to be female, had more severe PG symptoms, had co-occurring mood and anxiety disorders, and reported greater early family life dysfunction than those with PG who did not experience maltreatment. Rates of maltreatment were higher in FDRs of PG subjects than controls (41 vs. 24 %, P = .002). Rates in FDRs of individuals with PG who experienced maltreatment themselves were still higher that in FDRs of those with PG who did not experience maltreatment (50 vs. 28 %, P = .009). The former were also more likely to have anxiety disorders, substance use disorders, and suicide attempts. The results suggest that childhood maltreatment in persons with PG is common and intergenerational. Rates of maltreatment in FDRs of PG subjects are high, particularly among those who experienced abuse. The implications of the findings are discussed.
本研究调查了患有《精神疾病诊断与统计手册》第四版（DSM-IV）病理性赌博（PG）且童年期受过虐待的个体特征，以及其一级亲属（FDRs）中发生虐待的比率。作为PG家庭研究的一部分，对94名患有DSM-IV PG的受试者、91名对照者和312名FDRs进行了童年期虐待评估。使用修订版童年经历问卷评估虐待情况。家庭评估工具用于评估PG受试者（或对照者）原生家庭的功能。采用广义估计方程法通过逻辑回归分析数据。PG受试者中虐待发生率显著高于对照组（61%对25%，P<0.001）。与未经历虐待的PG受试者相比，经历过虐待的PG受试者更可能为女性，PG症状更严重，同时患有情绪和焦虑障碍，且报告的早期家庭生活功能障碍更严重。PG受试者的FDRs中虐待发生率高于对照组（41%对24%，P = 0.002）。自身经历过虐待的PG个体的FDRs中的发生率仍高于未经历虐待的PG个体的FDRs（50%对28%，P = 0.009）。前者也更可能患有焦虑障碍、物质使用障碍和有自杀企图。结果表明，PG患者童年期虐待很常见且具有代际性。PG受试者的FDRs中虐待发生率很高，尤其是在那些经历过虐待的人当中。讨论了研究结果的意义。
