Department of Psychiatry,State University of New York,Brooklyn, NY,USA.
Department of Psychiatry,Yale School of Medicine,New Haven, CT,USA.
Psychol Med. 2018 Jul;48(9):1540-1550. doi: 10.1017/S0033291717003208. Epub 2018 Jan 9.
Exposure to child maltreatment has been shown to increase lifetime risk for substance use disorders (SUD). However, this has not been systematically examined among race/ethnic groups, for whom rates of exposure to assaultive violence and SUD differ. This study examined variation by race/ethnicity and gender in associations of alcohol (AUD), cannabis (CUD), and tobacco (TUD) use disorders with three types of childhood interpersonal violence (cIPV): physical abuse, sexual abuse, and witnessing parental violence.
Data from the National Epidemiologic Survey of Alcohol-Related Conditions-III (N: 36 309), a US nationally representative sample, was utilized to examine associations of DSM-5 AUD, CUD and TUD with cIPV among men and women of five racial/ethnic groups. Models were adjusted for additional risk factors (e.g. parental substance use problems, participant's co-occurring SUD).
Independent contributions of childhood physical and sexual abuse to AUD, CUD, and TUD, and of witnessing parental violence to AUD and TUD were observed. Associations of cIPV and SUD were relatively similar across race/ethnicity and gender [Odds Ratios (ORs) ranged from 1.1 to 1.9], although associations of physical abuse with AUD and TUD were greater among males, associations of parental violence and AUD were greater among females, and associations of parental violence with AUD were greater among Hispanic women and American Indian men.
Given the paucity of research in this area, and the potential identification of modifiable risk factors to reduce the impact of childhood interpersonal violence on SUDs, further research and consideration of tailoring prevention and intervention efforts to different populations are warranted.
已有研究表明，儿童期虐待经历会增加终生物质使用障碍（SUD）的风险。然而，这在不同种族/民族群体中尚未得到系统研究，因为这些群体遭受攻击暴力和 SUD 的比率不同。本研究检查了种族/民族和性别差异对三种儿童期人际暴力（cIPV）与酒精（AUD）、大麻（CUD）和烟草（TUD）使用障碍之间关联的影响：身体虐待、性虐待和目睹父母暴力。
本研究使用了来自美国全国代表性样本的国家酒精流行病学调查-III（N=36309）的数据，以检查 DSM-5 AUD、CUD 和 TUD 与五种种族/民族群体的男性和女性中的 cIPV 之间的关联。模型调整了其他风险因素（例如父母的物质使用问题、参与者同时存在的 SUD）。
观察到儿童期身体和性虐待对 AUD、CUD 和 TUD 的独立贡献，以及目睹父母暴力对 AUD 和 TUD 的独立贡献。cIPV 和 SUD 的关联在种族/民族和性别之间相对相似[比值比（ORs）范围为 1.1 至 1.9]，尽管身体虐待与 AUD 和 TUD 的关联在男性中更大，父母暴力与 AUD 的关联在女性中更大，而父母暴力与 AUD 的关联在西班牙裔女性和美国印第安男性中更大。
鉴于该领域研究的匮乏，以及确定可改变的风险因素以减少儿童期人际暴力对 SUD 的影响的潜力，有必要进一步研究并考虑针对不同人群定制预防和干预措施。
